The yellow fever epidemic of 1878, in Memphis, Tenn. : Embracing a complete list of the dead, the names of the doctors and nurses employed, names of all who contributed money or means, and the names and history of the Howards, together with other data, and lists of the dead elsewhere / By J.M. Keating.

  • Keating, John McLeod, 1830-1906
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: The yellow fever epidemic of 1878, in Memphis, Tenn. : Embracing a complete list of the dead, the names of the doctors and nurses employed, names of all who contributed money or means, and the names and history of the Howards, together with other data, and lists of the dead elsewhere / By J.M. Keating. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    Avlth some; neither can I attach inucli importance to the internal adminis- tration of diuretics or diaphoretics, wliich have l)ecn thought eliiiiiaative, in consequence of tlieir nauseating effects on the stomach. If we can not re- move the cause of diseased action, we should attempt to annul it or coun- teract its cfi'ects. The cause cf yellow fever, now ix'cognized to Ije a ]>eculiar zymotic poison, acting as a destructive ferment, de})resses and perverts tlic vital and functional f »rces, gives rise to great excitement of the circulation and torpor of the glandular and secretf>ry organs. The intense ereniacau.-is of the tissues, and high comhustion acting through the blood, may produce, in a short time, destructive changes in the most important organs of the body. The indications for treatment are ()l)vious, and are to remove all offending matter {rum the -prinuv via' and rouse the emunctories to acti(.in, and are best fulfilled by the administration of mercui'ials and salines, and promoting their action by wai-m diluents; at the same time that we attempt to reduce the temjicrature l)y sponging the uj)per extremities with ice-cold Avater, and assist in equalizing the circulation hy revulsives to the surface of the abdomen, and hot stimulating pediluvia. These are, I believe, the best means of disgorging the glandular apparatus and equalizing the circu- lation preparatory to the use of agents -which tend directly to counteract the destructive fermentation which is going on in the blood. All spoliative and depressing medication should now cease, though the action of the skin and kidneys should be promoted witliout disturl)ing the stomach ; for upon the proper perfornaance of their functions will depend the progress of the case and the impending lesion of the heart. Here judgment comes into play; and upon a recognition of the true pathological conditions of each individual case, and a knowledge of the therapeutical properties of the remedial agents adapted for its relief, will dejiend the result; always pi-ovided that the patient can be placed in a position suitable to his condition, and have all the agree- able surroundings which are required. Bland and nutritious liquid food shduld be regularly given to sheatlie the lining of the stomach, and neu- tralize or dilute the gastric juice; but warm drinks for other pur])oscs are to be discontinued. Crushed ice, or ice-water, may be used for their refrig- erant efiect only; but the urgent thirst, which necessarily ensues from the elimination of the watery elements of the blood by the induced catharsis, must be allayed by cool, pure water, or refrigerant, agreeable bevci-ages, mixed with good wine; otherwise, inspissated blood engorge the kidneys, and the case vill be materially injured. The ju-aclilioner will always liave to regard the idiosyncrasy of his jjJitient, and be governed by the peculiari- ties of each case. After sufficient catharsis has been induced, Avinc, and even the stronger alcoholic stimulants, are more efficient than any other class of medicines. They will be found, ia manageable cases of yellow fever, almost a sine qua non, preventing, cden iKtrihus, the supervention of the de- structive changes Avhich might otherwise occur, thus making a simple, mild case, which, if allowed to run its course expectantly, or attempted to be jugulated h.eroically, would become a full-fledged one, either to drag its slow course along, or terminate fatally. After congestions or other compli-