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
cured nineteen out of twenty of all the soldiers whom he attended, by
copious bleeding, provided it was performed within six hours after the
attack of the fever. Beyond that period, it mitigated its force, but
seldom cured. The quantity of blood drawn by the doctor, in this early
stage of the disease, was always from twenty to thirty ounces. I have
said the yellow fever of 1797 was more malignant than the fevers of 1793
and 1794. Its resemblance to the yellow fever in the West-Indies, in not
yielding to bleeding after the first day, is a proof of this assertion.
I was struck, during my attendance upon this fever, in observing the
analogy between its _mixed_ form and the malignant state of the
small-pox. The fever, in both, continues for three or four days without
any remission. They both have a second stage, in which death usually
takes place, if the diseases be left to themselves. By means of copious
bleeding in their first, they are generally deprived of their malignity
and mortality in their second stage. This remark, so trite in the
small-pox, has been less attended to in the yellow fever. The bleeding in
the first stage of this disease does not, it is true, destroy it
altogether, any more than it destroys an eruption in the second stage of
the small-pox, but it weakens it in such a manner that the patient passes
through its second stage without pain or danger, and with no other aid
from medicine than what is commonly derived from good nursing, proper
aliment, and a little gently opening physic.
It is common with those practitioners who object to bleeding in the
yellow fever, to admit it occasionally in _robust_ habits. This rule
leads to great error in practice. From the weak action of predisposing,
or exciting causes, the disease often exists in a feeble state in such
habits, while from the protracted or violent operation of the same
causes, it appears in great force in persons of delicate constitutions. A
physician, therefore, in prescribing for a patient in this fever, should
forget the natural strength of his muscles, and accommodate the loss of
blood wholly to the morbid strength of his disease.
The quantity of blood drawn in this fever was always proportioned to its
violence. I cured many by a single bleeding. A few required the loss of
upwards of a hundred ounces of blood to cure them. The persons from whom
that large quantity of blood was taken, were, Messieurs Andrew Brown,
Horace Hall, George Cummins, J. Ramsay, and George Eyre. But I was not
singular in the liberal and frequent use of the lancet. The following
physicians drew the quantities of blood annexed to their respective names
from the following persons, viz.
Dr. Dewees 176 ounces from Dr. Physick,
Dr. Griffitts 110 Mr. S. Thomson,
Dr. Stewart 106 Mrs. M'Phail,
Dr. Cooper 150 Mr. David Evans,
Dr. Gillespie 103 himself.
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