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diff --git a/58861-8.txt b/58861-0.txt index f7a428f..707185d 100644 --- a/58861-8.txt +++ b/58861-0.txt @@ -1,39 +1,4 @@ -The Project Gutenberg eBook, Medical Inquiries and Observations, Vol. III -(of 4), by Benjamin Rush - - -This eBook is for the use of anyone anywhere in the United States and most -other parts of the world at no cost and with almost no restrictions -whatsoever. You may copy it, give it away or re-use it under the terms of -the Project Gutenberg License included with this eBook or online at -www.gutenberg.org. If you are not located in the United States, you'll have -to check the laws of the country where you are located before using this ebook. - - - - -Title: Medical Inquiries and Observations, Vol. III (of 4) - The Second Edition, Revised and Enlarged by the Author - - -Author: Benjamin Rush - - - -Release Date: February 27, 2019 [eBook #58861] - -Language: English - -Character set encoding: ISO-8859-1 - - -***START OF THE PROJECT GUTENBERG EBOOK MEDICAL INQUIRIES AND -OBSERVATIONS, VOL. III (OF 4)*** - - -E-text prepared by MWS, Jens Nordmann, Bryan Ness, and the Online -Distributed Proofreading Team (http://www.pgdp.net) from page images -generously made available by Internet Archive (https://archive.org) +*** START OF THE PROJECT GUTENBERG EBOOK 58861 *** @@ -264,7 +229,7 @@ internal, remote and exciting causes of fever, and are first roused into resistance by them. Let it not be thought, from these allusions, that I admit Dr. Cullen's -supposed vires naturæ medicatrices to have the least agency in this +supposed vires naturæ medicatrices to have the least agency in this re-action of the blood-vessels. I believe it to be altogether the effect of their elastic and muscular texture, and that it is as simply mechanical as motion from impressions upon other kinds of matter. @@ -539,7 +504,7 @@ blood-vessels in certain states of fever. 18. Do convulsions go off _suddenly_ in any cases from the nervous system? The convulsion in the blood-vessels goes off in the same manner -by a sweat, or by a hæmorrhage, frequently in the course of a night, and +by a sweat, or by a hæmorrhage, frequently in the course of a night, and sometimes in a single hour. 19. Does palsy in some instances succeed to convulsions in the nervous @@ -889,9 +854,9 @@ the blood. 6. Gangrene from the death of the blood-vessels. -7. Rupture of blood-vessels, producing hæmorrhage. +7. Rupture of blood-vessels, producing hæmorrhage. -8. Redness, phlegmon, pustules, and petechiæ on the skin, and tubercles +8. Redness, phlegmon, pustules, and petechiæ on the skin, and tubercles in the lungs, and on the liver and bowels. 9. Schirrus. @@ -915,7 +880,7 @@ the blood-vessels. All these effects of fever are different according to its grade. Dr. Blane says fevers are rarely inflammatory in the West-Indies; that is, they pass rapidly from simple morbid excitement to congestion, -hæmorrhage, gangrene, and death. This remark is confirmed by Dr. +hæmorrhage, gangrene, and death. This remark is confirmed by Dr. Dalzelle, who says the pneumony in the negroes, in the French West-India islands, rarely appears in any other form than that of the notha, from the arteries in the lungs being too much stimulated to produce common @@ -967,7 +932,7 @@ fevers perhaps depends upon a tendency to palsy in the arteries, independently of an affection of the heart or brain. This _prostrate_ state of fever more frequently when left to itself -terminates in petechiæ, buboes, carbuncles, abscesses, and +terminates in petechiæ, buboes, carbuncles, abscesses, and mortifications, according as serum, lymph, or red blood is effused in the viscera or external parts of the body. These morbid appearances have been ascribed to putrefaction, and the fever has received, from its supposed @@ -976,7 +941,7 @@ in a fever is rendered improbable, 1. By Dr. Seybert's experiments[5], which prove that it does not take place in the blood in a living state. It occurs in the excretions of -bile, fæces, and urine, but in this case it does not act as a ferment, +bile, fæces, and urine, but in this case it does not act as a ferment, but a stimulus only upon the living body. [5] Inaugural dissertation, entitled, "An Attempt to disprove the @@ -1292,14 +1257,14 @@ the obvious marks of inflammation. [10] On Dropsies, vol. II. -25. The _hæmorrhagic_ state of fever, in which are included discharges of +25. The _hæmorrhagic_ state of fever, in which are included discharges of blood from the nose, lungs, stomach, liver, bowels, kidneys and bladder, -hæmorrhoidal vessels, uterus, and skin. Hæmorrhages have been divided +hæmorrhoidal vessels, uterus, and skin. Hæmorrhages have been divided into active and passive. It would be more proper to divide them, like -other states of general fever, into hæmorrhages of strong and feeble +other states of general fever, into hæmorrhages of strong and feeble morbid action. There is seldom an issue of blood from a vessel in which there does not exist preternatural or accumulated excitement. We observe -this hæmorrhagic state of fever most frequently in malignant fevers, in +this hæmorrhagic state of fever most frequently in malignant fevers, in pulmonary consumption, in pregnancy, and in that period of life in which the menses cease to be regular. @@ -1314,7 +1279,7 @@ I have designedly omitted to take notice of other states of general fever accompanied with local disease, because they are most frequently combined with some one or more of those which have been mentioned. They may all be seen in Dr. Cullen's Synopsis, with their supposed respective -generic characters, under the class of pyrexiæ, and the order of fevers. +generic characters, under the class of pyrexiæ, and the order of fevers. We come now in the III. And last place, to mention the _misplaced_ states of fever. The term @@ -1351,9 +1316,9 @@ Gall stones and contusions now and then produce a hepatitis, but under no other circumstances do I believe it ever exists, but as a symptom of general or latent fever. -28. The hæmorrhoids are frequently a local disease, but they are +28. The hæmorrhoids are frequently a local disease, but they are sometimes accompanied with pain, giddiness, chills, and an active pulse. -When these symptoms occur, it should be considered as a _hæmorrhoidal_ +When these symptoms occur, it should be considered as a _hæmorrhoidal_ state of fever. 29. The opthalmia, when it occurs, as it frequently does in sickly @@ -1366,7 +1331,7 @@ head, may properly be called an _opthalmic_ state of fever. heat, a quick and tense pulse, and pains in the head, are _odontalgic_ and _otalgic_ states of fever. -32. The apthæ, from the pain and fever which attend them, are justly +32. The apthæ, from the pain and fever which attend them, are justly entitled to the name of the _apthous_ state of fever. 33. The symptoms of scrophula, as described by Dr. Hardy, in his treatise @@ -1424,15 +1389,15 @@ described by Dr. Hillary, in his account of the diseases of Barbadoes, is evidently a translation of an intermittent to one of the limbs. It is remarkable, that the leprosy and malignant fevers of all kinds have appeared and declined together in the same ages and countries. But -further, petechiæ sometimes appear on the skin without fever. Cases of -this kind, with and without hæmorrhages, are taken notice of by +further, petechiæ sometimes appear on the skin without fever. Cases of +this kind, with and without hæmorrhages, are taken notice of by Riverius[13], Dr. Duncan, and many other practical writers. They are cotemporary or subsequent to fevers of a malignant complexion. They occur likewise in the scurvy. From some of the predisposing, remote, and exciting causes of this disease, and from its symptoms and remedies, I -have suspected it, like the petechiæ mentioned by Riverius, to be +have suspected it, like the petechiæ mentioned by Riverius, to be originally a fever generated by human miasmata, in a misplaced state. The -hæmorrhages which sometimes accompany the scurvy, certainly arise from a +hæmorrhages which sometimes accompany the scurvy, certainly arise from a morbid state of the blood-vessels. The heat and quick pulse of fever are probably absent, only because the preternatural excitement of the whole sanguiferous system is confined to those extreme or cutaneous vessels @@ -1482,7 +1447,7 @@ The _mumps_, which made their appearance in December, 1792, continued to prevail during the month of January, 1793. Besides this disease there were many cases of catarrh in the city, brought on chiefly by the inhabitants exposing themselves for several hours on the damp ground, in -viewing the aërial voyage of Mr. Blanchard, on the 9th day of the month. +viewing the aërial voyage of Mr. Blanchard, on the 9th day of the month. The weather, which had been moderate in December and January, became cold in February. The mumps continued to prevail during this month with @@ -1546,7 +1511,7 @@ afterwards. There was something in the heat and drought of the summer months which was uncommon, in their influence upon the human body. Labourers every where gave out (to use the country phrase) in harvest, and frequently too -when the mercury in Fahrenheit's thermometer was under 84°. It was +when the mercury in Fahrenheit's thermometer was under 84°. It was ascribed by the country people to the calmness of the weather, which left the sweat produced by heat and labour to dry slowly upon the body. @@ -1574,7 +1539,7 @@ On the same day, I was called to the son of Mrs. M'Nair, who had been seized violently with all the usual symptoms of a bilious fever. I purged him plentifully with salts and cremor tartar, and took ten or twelve ounces of blood from his arm. His symptoms appeared to yield to these -remedies; but on the 10th of the month a hæmorrhage from the nose came +remedies; but on the 10th of the month a hæmorrhage from the nose came on, and on the morning of the 12th he died. On the 7th of this month I was called to visit Richard Palmer, a son of @@ -1939,13 +1904,13 @@ to it. It was excited in one case by a person's only wetting his feet, in the month of October, and neglecting afterwards to change his shoes and stockings. Every change in the weather, that was short of producing frost, evidently increased the number of sick people. This was obvious -after the 18th and 19th of September, when the mercury fell to 44° and -45°. The hopes of the city received a severe disappointment upon this +after the 18th and 19th of September, when the mercury fell to 44° and +45°. The hopes of the city received a severe disappointment upon this occasion, for I well recollect there was a general expectation that this change in the weather would have checked the disease. The same increase of the number of sick was observed to follow the cool weather which succeeded the 6th and 7th of October, on which days the mercury fell to -43° and 46°. +43° and 46°. It was observed that those persons who were _habitually_ exposed to the cool air, were less liable to the disease than others. I ascribe it to @@ -2127,7 +2092,7 @@ city last year. A gentleman of the medical profession, middle aged, of a delicate habit of body, and who had formerly suffered phthisical attacks, was attacked with the acute rheumatism. Some days after he was taken ill, he complained of uncommon fulness, and a very peculiar kind of sensation -about the præcordia, which it was judged proper to relieve by copious +about the præcordia, which it was judged proper to relieve by copious blood-letting. This being done, the uneasiness went off. It returned, however, three or four times, and was as often relieved by bleeding. During each of his fits (if I may call them so), the patient experienced @@ -2142,7 +2107,7 @@ rheumatism, and alternated with the limbs." [16] Outlines of a Theory of Fever. - [17] Vergasca, Sorbait, and Boate in Haller's Bibliotheca Medicinæ, + [17] Vergasca, Sorbait, and Boate in Haller's Bibliotheca Medicinæ, vol. iii. also by Dr. Stubbs in the Philosophical Transactions, and Riverius in his treatise de febre pestilenti. @@ -2184,14 +2149,14 @@ weak, frequent, and imperceptible before death, but I met with several cases in which it was full, active, and even tense in the last hours of life. -_Hæmorrhages_ belong to the symptoms of this fever as they appeared in +_Hæmorrhages_ belong to the symptoms of this fever as they appeared in the sanguiferous system. They occurred in the beginning of the disease, chiefly from the nose and uterus. Sometimes but a few drops of blood distilled from the nose. The menses were unusual in their quantity when they appeared at their stated periods, but they often came on a week or two before the usual time of their appearance. I saw one case of a -hæmorrhage from the lungs on the first day of the fever, which was -supposed to be a common hæmoptysis. As the disease advanced the +hæmorrhage from the lungs on the first day of the fever, which was +supposed to be a common hæmoptysis. As the disease advanced the discharges of blood became more universal. They occurred from the gums, ears, stomach, bowels, and urinary passages. Drops of blood issued from the inner canthus of the left eye of Mr. Josiah Coates. Dr. Woodhouse @@ -2199,7 +2164,7 @@ attended a lady who bled from the holes in her ears which had been made by ear-rings. Many bled from the orifices which had been made by bleeding, several days after they appeared to have been healed, and some from wounds which had been made in veins in unsuccessful attempts to draw -blood. These last hæmorrhages were very troublesome, and in some cases +blood. These last hæmorrhages were very troublesome, and in some cases precipitated death. II. I come now to mention the symptoms of this fever as they appeared in @@ -2223,13 +2188,13 @@ of a copious expectoration of yellow phlegm and mucus. But the _brain_ was principally affected with morbid congestion in this disease. It was indicated by the suffusion of blood in the face, by the redness of the eyes, by a dilatation of the pupils, by the pain in the head, by the -hæmorrhages from the nose and ears, by the sickness or vomiting, and by +hæmorrhages from the nose and ears, by the sickness or vomiting, and by an almost universal costive state of the bowels. I wish to impress the reader with these facts, for they formed one of the strongest indications for the use of the remedies which I adopted for the cure of this disease. It is difficult to determine the exact state of these viscera in every case of bilious and yellow fever. Inflammation certainly takes place in -some cases, and internal hæmorrhages in others; but I believe the most +some cases, and internal hæmorrhages in others; but I believe the most frequent affection of these viscera consists in a certain morbid accumulation of blood in them, which has been happily called, by Dr. Clark, an _engorgement_ or choaking of the blood-vessels. I believe @@ -2371,7 +2336,7 @@ Along with all the discharges from the stomach which have been described, there was occasionally a large worm, and frequently large quantities of mucus and tough phlegm. -The colour, quality, and quantity of the _fæces_ depended very much upon +The colour, quality, and quantity of the _fæces_ depended very much upon the treatment of the disease. Where active purges had been given, the stools were copious, f[oe]tid, and of a black or dark colour. Where they were spontaneous, or excited by weak purges, they had a more natural @@ -2380,8 +2345,8 @@ of an olive colour. Their smell was more or less f[oe]tid, according to the time in which they had been detained in the bowels. I visited a lady who had passed several days without a stool, and who had been treated with tonic remedies. I gave her a purge, which in a few hours procured a -discharge of fæces so extremely f[oe]tid, that they produced fainting in -an old woman who attended her. The acrimony of the fæces was such as to +discharge of fæces so extremely f[oe]tid, that they produced fainting in +an old woman who attended her. The acrimony of the fæces was such as to excoriate the rectum, and sometimes to produce an extensive inflammation all around its external termination. The quantity of the stools produced by a single purge was in many cases very great. They could be accounted @@ -2391,7 +2356,7 @@ preternatural effusions of bile into the bowels. I attended one person, and heard of two others, in whom the stools were as white as in the jaundice. I suspected, in these cases, the liver to be so constipated or paralyzed by the disease, as to be unable to secrete or -excrete bile to colour the fæces. Large round worms were frequently +excrete bile to colour the fæces. Large round worms were frequently discharged with the stools. The _urine_ was in some cases plentiful, and of a high colour. It was at @@ -2672,14 +2637,14 @@ sometimes extended to the breast. Like the yellow colour of the skin, they appeared and disappeared two or three times in the course of the disease. -5. Petechiæ were common in the latter stage of the fever. They sometimes +5. Petechiæ were common in the latter stage of the fever. They sometimes came on in large, and at other times in small red blotches; but they soon acquired a dark colour. In most cases they were the harbingers of death. 6. Several cases of carbuncles, such as occur in the plague, came under my notice. They were large and hard swellings on the limbs, with a black apex, which, upon being opened, discharged a thin, dark-coloured, bloody -matter. From one of these malignant sores a hæmorrhage took place, which +matter. From one of these malignant sores a hæmorrhage took place, which precipitated the death of the amiable widow of Dr. John Morris. 7. A large and painful anthrax on the back succeeded a favourable issue @@ -2697,14 +2662,14 @@ impression upon it. IX. The _blood_ in this fever has been supposed to undergo a change from a healthy to a putrid state, and many of its symptoms which have been -described, particularly the hæmorrhages and eruptions on the skin, have +described, particularly the hæmorrhages and eruptions on the skin, have been ascribed to this supposed putrefaction of the blood. It would be easy to multiply arguments, in addition to those mentioned in another place[27], to prove that no such thing as putrefaction can take place in the blood, and that the symptoms which have been supposed to prove its existence are all effects of a sudden, violent, and rapid inflammatory action or pressure upon the blood-vessels, and hence the external and -internal hæmorrhages. The petechiæ on the surface of the skin depend upon +internal hæmorrhages. The petechiæ on the surface of the skin depend upon the same cause. They are nothing but effusions of serum or red blood, from a rupture or preternatural dilatation of the capillary vessels[28]. The smell emitted from persons affected by this disease was far from @@ -3176,7 +3141,7 @@ been mistaken. They took the disease in common with the white people, and many of them died with it. I think I observed the greatest number of them to sicken after the mornings and evenings became cool. A large number of them were my patients. The disease was lighter in them than in white -people. I met with no case of hæmorrhage in a black patient. +people. I met with no case of hæmorrhage in a black patient. The tobacconists and persons who used tobacco did not escape the disease. I observed snuff-takers to be more devoted to their boxes than usual, @@ -3577,7 +3542,7 @@ The brain was not opened in this body, but it was not affected in three others whose brains were examined. Dr. Mackittrick, in his inaugural dissertation, published at Edinburgh in -the year 1766, "De Febre Indiæ Occidentalis, Maligna Flava," or upon the +the year 1766, "De Febre Indiæ Occidentalis, Maligna Flava," or upon the yellow fever of the West-Indies, says, that in some of the patients who died of it, he found the liver sphacelated, the gall bladder full of black bile, and the veins turgid with black fluid blood. In others he @@ -4265,7 +4230,7 @@ of New-York. "DEAR SIR, "Since the middle of last July we have had a bilious colic epidemic in -this neighbourhood, which exhibits phænomena very singular in this +this neighbourhood, which exhibits phænomena very singular in this climate; and, so far as I am informed, unprecedented in the medical records, or popular traditions of this country. To avoid unnecessary details it will suffice at present to observe, that the disease, on this @@ -4277,13 +4242,13 @@ usually meet in the histories of tropical writers. In the course of the disease, not only extreme constipation, frequent vomiting, and the most excruciating pains of the bowels and limbs, harass the unhappy patient; but to these succeed paralysis, convulsions, &c. and almost always -uncommon muscular debility, oppression of the præcordia, &c. are the +uncommon muscular debility, oppression of the præcordia, &c. are the consequence of a severe attack. Bile discharged in enormous quantities constantly assumes the most corrupted and acrimonious appearances, -commonly æruginous in a very high degree, and sometimes quite +commonly æruginous in a very high degree, and sometimes quite atrabilious. -"The inference I mean to draw from the phænomena of this disease, as it +"The inference I mean to draw from the phænomena of this disease, as it appears in this neighbourhood, and which I presume will also apply to your epidemic, is _this_, that from the uncommon protraction and intenseness of our summer and autumnal heats, but principally from the @@ -4906,7 +4871,7 @@ the disease, proceeding from the putrid miasmata fermenting with the salivary, bilious, and other inquiline humours of the body, is sometimes eradicated by timely emptying the abdominal viscera, on which it first fixes, after which a gentle sweat does as it were nip it in its bud. -Where the primæ viæ, but especially the stomach, is loaded with an +Where the primæ viæ, but especially the stomach, is loaded with an offensive matter, or contracted and convulsed with the irritation of its stimulus, there is no procuring a laudable sweat till that is removed; after which a necessary quantity of sweat breaks _out of its own accord_, @@ -5149,7 +5114,7 @@ artificial weak part in the bowels, I diverted the force of the fever to them, and thereby saved the liver and brain from fatal or dangerous congestions. The practice was further justified by the beneficial effects of a plentiful spontaneous diarrh[oe]a in the beginning of the -disease[66]; by hæmorrhages from the bowels, when they occurred from no +disease[66]; by hæmorrhages from the bowels, when they occurred from no other parts of the body, and by the difficulty or impracticability of reducing the system by means of plentiful sweats. The purges seldom answered the intentions for which they were given, unless they produced @@ -5433,7 +5398,7 @@ weather became cool. 2. The appearance of a moist and _white_ tongue, on the first day of the disease, a certain sign of an inflammatory fever. -3. The frequency of hæmorrhages from every part of the body, and the +3. The frequency of hæmorrhages from every part of the body, and the perfect relief given in some cases by them. 4. The symptoms of congestion in the brain, resembling those which occur @@ -5518,7 +5483,7 @@ purge. Dr. Woodhouse informed me that he had several times seen patients call for the close-stool while the blood was flowing from the vein. 5. It removed delirium, coma, and obstinate wakefulness. It also -prevented or checked hæmorrhages; hence perhaps another reason why not a +prevented or checked hæmorrhages; hence perhaps another reason why not a single instance of abortion occurred in such of my female patients as were pregnant. @@ -5667,10 +5632,10 @@ it. It occurs in fevers which depend upon the sensible qualities of the air, and in which no putrid or foreign matter has been introduced into the system. -8. The presence of petechiæ did not deter me from repeating +8. The presence of petechiæ did not deter me from repeating blood-letting, where the pulse retained its fulness or tension. I prescribed it with success in the cases of Dr. Mease, and of Mrs. Gebler, -in Dock-street, in each of whom petechiæ had appeared. Bleeding was +in Dock-street, in each of whom petechiæ had appeared. Bleeding was equally effectual in the case of the Rev. Mr. Keating, at a time when his arms were spotted with that species of eruptions which I have compared to moscheto-bites. I had precedents in Dr. De Haen[77] and Dr. @@ -5736,7 +5701,7 @@ upon a ship at sea; its destructive force was only to be opposed by handing every sail, and leaving the system to float, as it were, under bare poles. Such was the fragility (if I may be allowed the expression) of the blood-vessels, that it was necessary to unload them of their -contents, in order to prevent the system sinking from hæmorrhages, or +contents, in order to prevent the system sinking from hæmorrhages, or from effusions in the viscera, particularly the brain. 9. Such was the indomitable nature of the pulse, in some patients, that @@ -5757,15 +5722,15 @@ It was said that the bleeding was unnecessarily copious; and that many had been destroyed by it. To this I answer, that I did not lose a single patient whom I bled seven times or more in this fever. As a further proof that I did not draw an ounce of blood too much it will only be necessary -to add, that hæmorrhages frequently occurred after a third, a fourth, and +to add, that hæmorrhages frequently occurred after a third, a fourth, and in one instance (in the only son of Mr. William Hall) after a sixth bleeding had been used; and further, that not a single death occurred -from natural hæmorrhages in the first stage of the disease. A woman, who +from natural hæmorrhages in the first stage of the disease. A woman, who had been bled by my advice, awoke the night following in a bath of her blood, which had flowed from the orifice in her arm. The next day she was free from pain and fever. There were many recoveries in the city from similar accidents. There were likewise some recoveries from copious -natural hæmorrhages in the more advanced stages of the disease, +natural hæmorrhages in the more advanced stages of the disease, particularly when they occurred from the stomach and bowels. I left a servant maid of Mrs. Morris's, in Walnut-street, who had discharged at least four pounds of blood from her stomach, without a pulse, and with @@ -5842,7 +5807,7 @@ inconvenience[79]." [79] Page 114. 2. Pareus, after condemning bleeding in the plague, immediately adds an -account of a patient, who was saved by a hæmorrhage from the nose, which +account of a patient, who was saved by a hæmorrhage from the nose, which continued _two_ days[80]. [80] Skenkius, lib. vi. p. 881. @@ -5851,13 +5816,13 @@ continued _two_ days[80]. the yellow fever, in the month of August; but at that time I saw one, and heard of another case, in which death seemed to have been prevented by a bleeding at the nose. Perhaps the uniform good effects which were -observed to follow a spontaneous hæmorrhage from an orifice in the arm, +observed to follow a spontaneous hæmorrhage from an orifice in the arm, arose wholly from the _gradual_ manner in which the stimulus of the blood was in this way abstracted from the body. Dr. Williams relates a case of the recovery of a gentleman from the yellow fever, by means of small -hæmorrhages, which continued three days, from wounds in his shoulders +hæmorrhages, which continued three days, from wounds in his shoulders made by being cupped. He likewise mentions several other recoveries by -hæmorrhages from the nose, after "a vomiting of black humours and a +hæmorrhages from the nose, after "a vomiting of black humours and a hiccup had taken place[81]." [81] Essay on the Bilious or Yellow Fever of Jamaica, p. 40. @@ -6014,7 +5979,7 @@ from exercise in the cold and open air. I was first led to the practice of the partial application of cold water to the body, in fevers of too much force in the arterial system, by -observing its good effects in active hæmorrhages, and by recollecting the +observing its good effects in active hæmorrhages, and by recollecting the effects of a partial application of warm water to the feet, in fevers of an opposite character. Cold water when applied to the feet as certainly reduces the pulse in force and frequency, as warm water, applied in the @@ -6076,7 +6041,7 @@ the mercury introduced into the system in the form of an ointment, where it did _not_ produce a salivation. Among these, were the Rev. Dr. Blackwell, and Mr. John Davis. - [86] Bibliotheca Medicinæ Practicæ, vol. iii. p. 491. + [86] Bibliotheca Medicinæ Practicæ, vol. iii. p. 491. [87] Diseases of Long Voyages to Hot Climates, vol. ii. p. 334. @@ -6207,7 +6172,7 @@ cautioned many persons, whom I saw walking or riding in an unsafe manner, of the danger to which they exposed themselves; and thereby, I hope, prevented an attack of the disease in many people. - [89] Bibliotheca Medicinæ Practicæ, vol. ii. p. 93. and 387. + [89] Bibliotheca Medicinæ Practicæ, vol. ii. p. 93. and 387. It was from a conviction of the utility of low diet, gentle evacuations, and of carefully shunning all the exciting causes which I have mentioned, @@ -7539,7 +7504,7 @@ of bark. During the remaining part of the month, I was called to several cases of fever, which had symptoms of malignity of an alarming nature. The son of -Mr. Andrew Brown had a hæmorrhage from his nose in a fever, and a case of +Mr. Andrew Brown had a hæmorrhage from his nose in a fever, and a case of menorrhagia occurred in a woman, who was affected with but a slight degree of fever. @@ -7557,7 +7522,7 @@ their skin. I likewise attended three women, in whom I discovered the disease under forms in which I had often seen it in the year 1793. In two of them it appeared with symptoms of a violent colic, which yielded only to frequent bleedings. In the third, it appeared with symptoms of -pleurisy, which was attended with a constant hæmorrhage from the uterus, +pleurisy, which was attended with a constant hæmorrhage from the uterus, although blood was drawn almost daily from her arm, for six or seven days. About the middle of this month many people complained of nausea, which in some cases produced a puking, without any symptoms of fever. @@ -7728,18 +7693,18 @@ pupils, Mr. Alexander, called it more properly a _locked_ pulse. I think I observed this state of the pulse to occur chiefly in persons in whom the fever came on without a chilly fit. -Hæmorrhages occurred in all the grades of this fever, but less frequently +Hæmorrhages occurred in all the grades of this fever, but less frequently in my practice this year than in the year before. It occurred, after a ninth bleeding, in Miss Sally Eyre, from the nose and bowels. It occurred from the nose, after a sixth bleeding, in Mrs. Gardiner, who was at that time in the sixth month of her pregnancy. This symptom, which was accompanied by a tense and quick pulse, induced me to repeat the bleeding a seventh time. The blood was very sizy. I mention this fact to establish -the opinion that hæmorrhages depend upon too much action in the +the opinion that hæmorrhages depend upon too much action in the blood-vessels, and that they are not occasioned by a dissolved state of the blood. -There was a disposition at this time to hæmorrhage in persons who were in +There was a disposition at this time to hæmorrhage in persons who were in apparent good health. A private, in a company of volunteers commanded by Major M'Pherson, informed me that three of his messmates were affected by a bleeding at the nose, for several days after they left the city, on @@ -7835,11 +7800,11 @@ of my patients discharged black bile within an hour after they were affected by the fever, and many discharged that kind of matter which has been compared to coffee grounds, towards the close of the disease. -The fæces were black in most cases where the symptoms of the highest +The fæces were black in most cases where the symptoms of the highest grade of the fever attended. In one very malignant case the most drastic purges brought away, by fifty evacuations, nothing but natural stools. -The purges were continued, and finally black fæces were discharged, which -produced immediate relief[107]. In one person the fæces were of a light +The purges were continued, and finally black fæces were discharged, which +produced immediate relief[107]. In one person the fæces were of a light colour. In this patient the yellowness in the face was of an orange colour, and continued so for several weeks after his recovery. @@ -7966,7 +7931,7 @@ dangerous than when they were confined to the temples or forehead[111]. [110] Epidemics, book ii. sect. 2. - [111] Historia Febris Anomalæ Batavæ Annorum 1746, 1747, 1748, cap. i. + [111] Historia Febris Anomalæ Batavæ Annorum 1746, 1747, 1748, cap. i. I saw two cases in which a locked jaw attended. In one of them it occurred only during one paroxysm of the fever. In both it yielded in @@ -8060,7 +8025,7 @@ That species of eruption, which I have elsewhere compared to moscheto bites, appeared in Mrs. Sellers. John Ray, a day labourer, to whom I was called in the last stage of the -fever, had petechiæ on his breast the day before he died. +fever, had petechiæ on his breast the day before he died. That burning heat on the skin, called by the ancients "calor mordens," and from which this fever, in some countries, has derived the name of @@ -8119,7 +8084,7 @@ exacerbations of the fever. It assumed, in several instances, the symptoms of a colic and cholera morbus. In one case the fever, after the colic was cured, ended in a regular intermittent. In another, the colic was accompanied by a -hæmorrhage from the nose. I distinguished this bilious colic from that +hæmorrhage from the nose. I distinguished this bilious colic from that which is excited by lighter causes, by its always coming on with more or less of a chilliness[115]. The symptoms of colic and cholera morbus occurred most frequently in June and July. @@ -8141,7 +8106,7 @@ nosologists call the "pleuritis biliosa." 8. The puerperile fever was accompanied, during the summer and autumn, with more violent symptoms than usual. Dr. Physick informed me, that two women, to whom he was called soon after their delivery, died of uterine -hæmorrhages; and that he had with difficulty recovered two other lying-in +hæmorrhages; and that he had with difficulty recovered two other lying-in women, who were afflicted with that symptom of a malignant diathesis in the blood-vessels. @@ -8998,7 +8963,7 @@ than four or five paroxysms, it is probable the loss of blood would have been not only safe, but generally beneficial. I have, in the same history, given my reasons why _moderate_ bleeding in this, as well as many other diseases, does harm. In those cases where it has occurred in -large quantities from natural hæmorrhages, it has always done service in +large quantities from natural hæmorrhages, it has always done service in the West-Indies. The inefficacy, and, in some cases, the evils, of _moderate_ blood-letting are not confined to the yellow fever. It is equally ineffectual, and, in some instances, equally hurtful, in @@ -9119,7 +9084,7 @@ care this month, and one of rheumatism, which were attended with intermissions and exacerbations every other day. The weather on the 19th, 20th, 21st, and 22d days of July was very warm, -the mercury being at 90° in Fahrenheit's thermometer. The fevers of this +the mercury being at 90° in Fahrenheit's thermometer. The fevers of this month were all accompanied with black discharges from the bowels. Mr. Kittera, one of the representatives of Pennsylvania in the congress of the United States, in consequence of great fatigue on a warm day, was @@ -9216,7 +9181,7 @@ and bowels. So little rain fell during the autumnal months, that the wheat perished in many places. The weather in December was extremely cold. The lamps of the city were, in several instances, extinguished by it, on the night of the 23d of the month, at which time the mercury stood -at 2° below 0 in the thermometer. +at 2° below 0 in the thermometer. The yellow fever prevailed this year in Charleston, in South-Carolina, where it was produced by putrid exhalations from the cellars of houses @@ -9248,366 +9213,4 @@ Partly repeated chapter headings have been deleted. -***END OF THE PROJECT GUTENBERG EBOOK MEDICAL INQUIRIES AND OBSERVATIONS, -VOL. 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You may copy it, give it away or re-use it -under the terms of the Project Gutenberg License included with this -eBook or online at <a -href="http://www.gutenberg.org">www.gutenberg.org</a>. If you are not -located in the United States, you'll have to check the laws of the -country where you are located before using this ebook.</p> -<p>Title: Medical Inquiries and Observations, Vol. III (of 4)</p> -<p> The Second Edition, Revised and Enlarged by the Author</p> -<p>Author: Benjamin Rush</p> -<p>Release Date: February 27, 2019 [eBook #58861]</p> -<p>Language: English</p> -<p>Character set encoding: ISO-8859-1</p> -<p>***START OF THE PROJECT GUTENBERG EBOOK MEDICAL INQUIRIES AND OBSERVATIONS, VOL. III (OF 4)***</p> <p> </p> -<h4>E-text prepared by MWS, Jens Nordmann, Bryan Ness,<br /> - and the Online Distributed Proofreading Team<br /> - (<a href="http://www.pgdp.net">http://www.pgdp.net</a>)<br /> - from page images generously made available by<br /> - Internet Archive<br /> - (<a href="https://archive.org">https://archive.org</a>)</h4> <p> </p> <table border="0" style="background-color: #ccccff;margin: 0 auto;" cellpadding="10"> <tr> @@ -16055,368 +16035,9 @@ at various times.</p></div> <p> </p> <hr class="pg" /> -<p>***END OF THE PROJECT GUTENBERG EBOOK MEDICAL INQUIRIES AND OBSERVATIONS, VOL. 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