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
All the above named persons had a rapid and easy recovery, and now enjoy
good health. I lost but one patient who had been the subject of early and
copious bleeding. His death was evidently induced by a supper of
beef-stakes and porter, after he had exhibited the most promising signs
of convalescence.
OF PURGING.
From the great difficulty that was found in discharging bile from the
bowels, by the common modes of administering purges, Dr. Griffitts
suggested to me the propriety of giving large doses of calomel, without
jalap or any other purging medicine, in order to loosen the bile from its
close connection with the gall-bladder and duodenum, during the first day
of the disease. This method of discharging acrid bile was found useful.
I observed the same relief from large evacuations of f[oe]tid bile, in
the epidemic of 1797, that I have remarked in the fever of 1793. Mr.
Bryce has taken notice of the same salutary effects from similar
evacuations, in the yellow fever on board the Busbridge Indiaman, in the
year 1792. His words are: "It was observable, that the more dark-coloured
and f[oe]tid such discharges were, the more early and certainly did the
symptoms disappear. Their good effects were so instantaneous, that I have
often seen a man carried up on deck, perfectly delirious with subsultus
tendinum, and in a state of the greatest apparent debility, who, after
one or two copious evacuations of this kind, has returned of himself, and
astonished at his newly acquired strength[2]." Very different are the
effects of tonic remedies, when given to remove this apparent debility.
The clown who supposes the crooked appearance of a stick, when thrust
into a pail of water, to be real, does not err more against the laws of
light, than that physician errs against a law of the animal economy, who
mistakes the debility which arises from oppression for an exhausted state
of the system, and attempts to remove it by stimulating medicines.
[2] Annals of Medicine, p. 123.
After unlocking the bowels, by means of calomel and jalap, in the
beginning of the fever, I found no difficulty afterwards in keeping them
gently open by more lenient purges. In addition to those which I have
mentioned in the account of the fever of 1793, I yielded to the advice of
Dr. Griffitts, by adopting the soluble tartar, and gave small doses of it
daily in many cases. It seldom offended the stomach, and generally
operated, without griping, in the most plentiful manner.
However powerful bleeding and purging were in the cure of this fever,
they often required the aid of a _salivation_ to assist them in subduing
it.
Besides the usual methods of introducing mercury into the system, Dr.
Stewart accelerated its action, by obliging his patients to wear socks
filled with mercurial ointment; and Dr. Gillespie aimed at the same
thing, by injecting the ointment, in a suitable vehicle, into the bowels,
in the form of glysters.
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