North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826Various
History
North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826
Various
Medicine -- Periodicals
It would seem that the bad effects of emetics, and more particularly of
tartarized antimony, resulted, not only from their irritating qualities,
but also from the efforts of vomiting, during which the stomach is
compressed by the abdominal muscles, and made to contract very forcibly.
To this opinion I am naturally led from the circumstance, that
purgatives, whose action is certainly primarily irritating, are very
advantageously employed in yellow fever. It is not my intention to
attempt here an explanation of this seeming contradiction. Leaving to
others the accomplishment of this difficult task, I shall content myself
with stating, that during the whole course of my long practice, I have
seldom seen a patient die of this disease, whose bowels had been well
evacuated, and in whom perspiration had been excited within the first
twenty-four hours after the attack. I exhibited purgatives in almost
every instance _every day_, until copious evacuations had been procured,
and I generally found, that the mild purges were of greater service than
those of a severe and irritating nature. Senna, acidulated with lemon
juice or tamarinds, answered sometimes remarkably well, when the stomach
could retain it. Castor oil, manna, salts, magnesia, were frequently
employed by me with advantage; and although I did not make an extensive
use of calomel in this disease, yet I prescribed it to children, and to
adults, who, owing to great irritability of the stomach, could not
retain other purgative medicines. When I resorted to it, I generally did
so in doses sufficient to ensure a purgative effect, and never with a
view of exciting ptyalism. In doing this, I was not guided, however, by
any fear of the effects of a salivation, since I was well aware that a
ptyalism occurring in malignant diseases is often a favourable crisis;
but by a knowledge of the great difficulty experienced in producing it,
and from the observation, that in cases in which it was obtained, much
valuable time had been lost, and the patient might have recovered
without.
To promote the operation of the above remedies, purgative enemata were
resorted to, in the early stage of the fever; and were followed by the
frequent use of injections, composed of emollient decoctions, from which
the patient derived considerable relief and comfort.
As counter-irritants, blisters and sinapisms were used, and often with
great advantage. They were found of much value when applied to the
epigastric region, for the purpose of arresting the vomiting. Sinapisms
were in general preferred to blisters, as being more prompt in their
effects and more easily renewed. Blisters were sometimes applied to the
extremities in the different stages of the disease; but so far as I can
judge, from my experience, not with much real benefit.
Public-domain text, read in full here on John Shaqi.
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