Medical Inquiries and Observations, Vol. 3: The Second Edition, Revised and Enlarged by the AuthorRush, Benjamin
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Medical Inquiries and Observations, Vol. 3: The Second Edition, Revised and Enlarged by the Author
Rush, Benjamin
Medicine; Yellow fever -- Pennsylvania -- Philadelphia
I shall now proceed to describe the symptoms which this fever assumed
during the periods which have been mentioned. This detail will be
interesting to physicians who wish to see how little nature regards the
nosological arrangement of authors, in the formation of the symptoms of
diseases, and how much the seasons influence epidemics. A physician, who
had practised medicine near sixty years in the city of Philadelphia,
declared that he had never seen the dysentery assume the same symptoms in
any two _successive_ years. The same may be said probably of nearly all
epidemic diseases.
In the arrangement of the symptoms of this fever, I shall follow the
order I adopted in my Account of the Yellow Fever of 1793, and describe
them as they appeared in the sanguiferous system, the liver, lungs, and
brain, the alimentary canal, the secretions and excretions, the nervous
system, the senses and appetites, upon the skin, and in the blood.
Two premonitory symptoms struck me this year, which I did not observe in
1793. One of them was a frequent discharge of pale urine for a day or two
before the commencement of the fever; the other was sleep unusually
sound, the night before the attack of the fever. The former symptom was a
precursor of the plague of Bassora, in the year 1773.
I. I observed but few symptoms in the sanguiferous system different from
what I have mentioned in the fever of the preceding year. The slow and
intermitting pulse occurred in many, and a pulse nearly imperceptible, in
three instances. It was seldom very frequent. In John Madge, an English
farmer, who had just arrived in our city, it beat only 64 strokes in a
minute, for several days, while he was so ill as to require three
bleedings a day, and at no time of his fever did his pulse exceed 96
strokes in a minute. In Miss Sally Eyre, the pulse at one time was at
176, and at another time it was at 140; but this frequency of pulse was
very rare. In a majority of the cases which came under my notice, where
the danger was great, it seldom exceeded 80 strokes in a minute. I have
been thus particular in describing the frequency of the pulse, because
custom has created an expectation of that part of the history of fevers;
but my attention was directed chiefly to the different degrees of _force_
in the pulse, as manifested by its tension, fulness, intermissions, and
inequality of action. The _hobbling_ pulse was common. In John Geraud, I
perceived a quick stroke to succeed every two strokes of an ordinary
healthy pulse. The intermitting, chorded, and depressed pulse occurred in
many cases. I called it the year before a _sulky_ pulse. One of my
pupils, Mr. Alexander, called it more properly a _locked_ pulse. I think
I observed this state of the pulse to occur chiefly in persons in whom
the fever came on without a chilly fit.
Public-domain text, read in full here on John Shaqi.
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