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
I shall now deliver a short account of the remedies employed in the cure
of this disease.
I have said that the pulse was less active in this fever than in the
fevers of former years. It was seldom, however, so feeble as to forbid
bleeding. In Dr. Mease it called for the loss of 162 ounces of blood, and
in Mr. J. C. Warren for the loss of 200, by successive bleedings, before
it was subdued. But such cases were not common. In most of them, the
pulse flagged after two or three bleedings. But there were cases in which
the lancet was forbidden altogether. In these, the system appeared to be
prostrated, by the force of the miasmata, below the point of re-action.
This state of the disease manifested itself in a weak, quick, and
frequent pulse, languid eye, sighing, great inquietude, or great
insensibility. However unsafe bleeding was on the first day of this
fever, when it appeared with those symptoms, nature often performed that
operation upon herself from the gums, on the fourth or fifth day. I saw
several pounds of blood discharged on those days, and in that way, with
the happiest effects. It appeared to take place after the revival of the
blood-vessels from their prostrated state.
From a conviction that the system was depressed only in these cases, and
finding that it did not rise upon blood-letting, I resolved to try the
effects of emetics, in exciting and equalizing the action of the
blood-vessels. The experience I had had of the inefficacy of this remedy
in 1793, and of its ill effects in one instance in 1797, led me to
exhibit it with a trembling hand. I gave it for the first time to a son
of Richard Renshaw. I had bled him but once, and had in vain tried to
bring on a salivation. On the fifth day of his disease, his pulse became
languid and slow, his skin cool, a hæmorrhage had taken place from his
gums, and he discovered a restlessness and anxiety which I had often seen
a few hours before death. He took four grains of tartar emetic, with
twenty grains of calomel, at two doses. They operated powerfully, upwards
and downwards, and brought away a large quantity of bile. The effects of
this medicine were such as I wished. The next day he was out of danger. I
prescribed the same medicine in many other cases with the same success.
To several of my patients I gave two emetics in the course of the
disease. Some of them discharged bile resembling in viscidity the white
of an egg. But I saw one case in which great relief was obtained from the
operation of an emetic, where no bile was discharged.
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