Medical Inquiries and Observations, Vol. 4: The Second Edition, Revised and Enlarged by the AuthorRush, Benjamin
History
Medical Inquiries and Observations, Vol. 4: The Second Edition, Revised and Enlarged by the Author
Rush, Benjamin
Medicine; Yellow fever -- Pennsylvania -- Philadelphia
3. There were _depressed_ or _locked_ cases, in which there were a sense
of great debility, but little or no pain, a depressed and slow pulse, a
cool skin, cold hands and feet, and obstructed excretions.
4. There were _divided_ or _mixed_ cases, in which the pulse was active
until the 4th day, after which it became depressed. All the other
symptoms of the locked state of the fever accompanied this depressed
state of the pulse.
5. There were cases in which the pulse imparted a perception like that of
a soft and _shattered_ quill. I have before mentioned that this state of
the pulse occurred in Dr. Jones and Dr. Dobell. I felt it but once, and
on the day of his attack, in the latter gentleman, and expressed my
opinion of his extreme danger to one of my pupils upon my return from
visiting him. I did not meet with a case which terminated favourably,
where I perceived this _shattered_ pulse. A disposition to sweat occurred
in this state of the fever.
6. There were what Dr. Caldwell happily called _walking_ cases. The
patients here were flushed or pale, had a full or tense pulse, but
complained of no pain, had a good appetite, and walked about their rooms
or houses, as if they were but little indisposed, until a day or two,
and, in some instances, until a few hours before they died. We speak of
a _dumb_ gout and _dumb_ rheumatism; with equal propriety, the epithet
might be applied to this form of yellow fever in its early stage. The
impression of the remote cause of the fever, in these cases, was beyond
sensation, for, upon removing a part of it by bleeding or purging, the
patients complained of pain, and the excitement of the muscles passed so
completely into the blood-vessels and alimentary canal, as to convert the
fever into a common and more natural form. These cases were always
dangerous, and, when neglected, generally terminated in death. Mr.
Brown's fever came on in this insidious shape. It was cured by the loss
of upwards of 100 ounces of blood, and a plentiful salivation.
7. There was the _intermitting_ form in this fever. This, like the last,
often deceived the patient, by leading him to suppose his disease was of
a common or trifling nature. It prevented Mr. Richard Smith from applying
for medical aid in an attack of the fever for several days, by which
means it made such an impression upon his viscera, that depleting
remedies were in vain used to cure him. He died in the prime of life,
beloved and lamented by a numerous circle of relations and friends.
8. There was a form of this fever in which it resembled the mild
remittent of common seasons. It was distinguished from it chiefly by the
black colour of the intestinal evacuations.
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