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
9. There were cases of this fever so light, that patients were said to be
neither _sick_ nor _well_; or, in other words, they were sick and well
half a dozen times in a day. Such persons walked about, and transacted
their ordinary business, but complained of dulness, and, occasionally, of
shooting pains in their heads. Sometimes the stomach was affected with
sickness, and the bowels with diarrh[oe]a or costiveness. All of them
complained of night sweats. The pulse was quicker than natural, but
seldom had that convulsive action which constitutes fever. Purges always
brought away black stools from such patients, and this circumstance
served to establish its relationship to the prevailing epidemic. Now and
then, by neglect or improper treatment, it assumed a higher and more
dangerous grade of the fever, and became fatal, but it more commonly
yielded to nature, or to a single dose of purging physic.
10. There were a few cases in which the skin was affected with universal
yellowness, but without more pain or indisposition than usually occurs in
the jaundice. They were very frequent in the year 1793, and generally
prevail in the autumn, in all places subject to bilious fever.
11. There were _chronic_ cases of this fever. It is from the want of
observation that physicians limit the duration of the yellow fever to
certain days. I have seen many instances in which it has been protracted
into what is called by authors a slow nervous fever. The wife of captain
Peter Bell died with a black vomiting after an illness of nearly one
month. Dr. Pinckard, formerly one of the physicians of the British army
in the West-Indies, in a late visit to this city informed me, that he had
often seen the yellow fever put on a chronic form in the West-India
islands.
In delivering this detail of the various forms of the yellow fever, I am
aware that I oppose the opinions of many of my medical brethren, who
ascribe to it a certain uniform character, which is removed beyond the
influence of climate, habit, predisposition, and the different strength
and combinations of remote and exciting causes. This uniformity in the
symptoms of this fever is said to exist in the West-Indies, and every
deviation from it in the United States is called by another name. The
following communication, which I received from Dr. Pinckard, will show
that this disease is as different in its forms in the West-Indies as it
is in this country.
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