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
In the exhibition of this remedy, I was regulated by the pulse. If I
found it languid on the first day of the fever, I gave it before any
other medicine. When it was full and tense, I deferred it until I had
reduced the pulse to the emetic point by bleeding and purges. I observed,
with great pleasure, that mercury affected the mouth more speedily and
certainly where an emetic had been administered, than in other cases,
probably from awakening, by its stimulus, the sensibility of the stomach;
for such was its torpor, that in one case ten grains of tartar emetic,
and in another thirty grains, did not operate upon it, so as to excite
even the slightest degree of nausea.
In many cases, an emetic, given in the forming state of the disease,
seemed to effect an immediate cure.
Purges produced the same salutary effects that they did in former years.
I always combined calomel with them in the first stage of the disease.
A salivation was found to be the most certain remedy of any that was used
in this fever. I did not lose a single patient, in whom the mercury acted
upon the salivary glands. It was difficult to excite it in many cases,
from the mercury being rejected by the stomach, from its passing off by
the bowels, or from its stimulus being exceeded by the morbid action in
the blood-vessels.
Bleeding rendered the action of the mercury upon the mouth more speedy
and more certain, but I saw several cases in which a salivation was
excited in the most malignant forms of the fever, where no blood had been
drawn. It will not be difficult to explain the reason of this fact if we
recur to what was said formerly of the prostration of the system in this
fever. In its worst forms, there is often a total absence, or a feeble
degree of action in the blood-vessels, from an excess of the stimulus of
the remote cause of the fever. Here the mercury meets with no resistance
in its tendency to the mouth. Bleeding in this case would probably do
harm, by taking off a part of the pressure upon the system, and thereby
produce a re-action in the vessels, that might predominate over the
action of the mercury. The disease here does that for us by its force,
which, in other cases, we effect by depleting remedies.
Where the mercury showed a disposition to pass too rapidly through the
bowels, I observed no inconvenience from combining it with opium, in my
attempts to excite a salivation. The calomel was constantly aided by
mercurial ointment, applied by friction to different parts of the body.
Now and then a salivation continued for weeks and months after the crisis
of this fever, to the great distress of the patient, and injury of the
credit of mercury as a remedy in this disease. Dr. Physick has
discovered, that in these cases the salivation is kept up by carious
teeth or bone, and that it is to be cured only by removing them.
Public-domain text, read in full here on John Shaqi.
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