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
1. The pulse was moderately _tense_ in most cases. It intermitted in one
case, and in several others the tension was of a transient nature.
Hæmorrhages occurred in many cases. They were chiefly from the nose, but
in some instances they occurred from the stomach, bowels, and
hæmorrhoidal vessels.
2. Great flatulency attended in the stomach, but sickness and vomiting
were much less frequent than in former years. I saw but one case in which
diarrh[oe]a attended this fever.
3. I did not meet with a single instance of a glandular swelling in any
part of the body.
4. There was a general disposition to sweat in this fever from its
beginning. Two of my patients died, in whom no moisture could be excited
on the skin. But I recovered one with a dry skin, by means of a purge,
two bleedings, and blisters.
An efflorescence on the skin occurred in several instances. I saw black
matter discharged from a blister in one case, and blood in another.
5. The stools were green and black. Bile was generally discharged in
puking.
6. The blood exhibited the following appearances: siziness, lotura
carnium, sunken crassamentum, red sediment, and what is called dense or
unseparated blood. I saw no instance of its being dissolved.
7. The tongue was whitish and dark-coloured. This diseased appearance
continued, in some instances, several days after a recovery took place. I
saw no smooth, red, nor black tongue, and but one dry and one _natural_
tongue. The latter was followed by death.
I did not see a single case in which the disease came on without an
exciting cause; such as light clothing and bed-clothes, sitting at doors
after night, a long walk, gunning, and violent and unusual exercises of
any kind. It was excited in a number of people by their exertions to
extinguish a fire which took place in Water-street, between Market and
Chesnut-streets, on the morning of the 25th of August. I saw a fatal
instance of it succeed a severe tooth-ach. Whether this pain was the
exciting cause, or the first morbid symptom of the fever, I know not; but
I was led by it to bleed a young lady twice who complained of that pain,
and who had at the same time a tense pulse. Her blood had the usual
appearances which occur in the yellow fever.
The disease had different appearances in different parts of the city. It
was most malignant in Water-street; but in many instances it became less
so, as it travelled westward, so that about Ninth-street it appeared in
the form of a common intermittent.
In every part of the city it often came on, as in the year 1802, in all
the milder forms of autumnal fever formerly enumerated, and went off with
the usual symptoms of yellow fever. Again, it came on with all the force
and malignity of a yellow fever, and terminated, in a day or two, in a
common remittent or intermittent. These modes of attack were so common,
that it was impossible to tell what the character, or probable issue of a
fever would be, for two or three days.
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