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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    allowed to leave his bed. The reaetiimary fever, whieh ii; man}' cases follows the stage of calm, is usnally very moderate, and ix-quires no treatment but sponging. In very many cases malarial fever appeal's about the fourtli or fifth day of convalescence: it comes in the eveiu'ng, very insidiously, and the ])aticnt complains of liaving had a i-eslless night. Tins is repeated for two or three davs, and the patient dies. I saw many sucli cases during tlie past summer, and also observed that these attacks yielded to quinine if given promj)tly. Late in the season, I found it an advantage, in cases in which there seemed to be a malarial element, to commence the treatment of the disease by the administration of one or two ten-grain doses of quinine. Some patients seem stricken Avith death at tlie vei-y outset of their attack, and for these no treat- ment is of any avail. In a large majority of the cases recovery ensues if the plan of treatment here described be scrupulously followed. Dr. G. B. Thornton, who, like Dr. Mitchell, had the fullest public experi- ence during the yellow lever epidemics which scourged Memphis in 1867 and 1873, was, as in the latter year, in charge of the City Hospital in 1878. A victim of tlie fever twice, he writes as one should who adds to knowledge acquired by an extended practice, that of a personal nature. He gives the following, by request, as his metliod of treatment: Believing that yellow fever is a specific disease, a blood poisoiung caused by a peculiar miasm against which medical proi)hylaxis has proven inefficient, and that active heroic medication to arrest it, when once established, is not only useless but positively injurious, the successful treatment has to be by such medication and management as will alleviate suffering and assist natui-e to throw ofi' or eliminate this poison from the system. Tliere is a fixed course the disease must run, or, in other words, an evolution which must follow as a consequence of this blood toxemia. Tlierefore, assuming that the treatment must be essen- tially of this auxiliary character, it becomes an important question to do nothing that will interfere with the efl^orts of nature to eliminate this puison. While the disease can not be cut short or aborted, as an ordinary malarial fever, it can be modified and rendered more tolerant to the patient by judicious medication and nursing. Ordinarily I commence my treatment l)y a mercurial cathartic, followed, if necessary, in six or eigiit hours, Ijy castor-i)il. After the bowels are once thorougidy moved cathartics are no longer indicated during the course of the disease. Quinine, if admissible at all, should be administered early in the attack, in the cold stage whicli precedes the fever. In anticipation of the fever it is tliought, and I will not assert to the contrary, that given at this time in a positive dose, say ten grains, the fever is modified, and the temperature kept down. After the febrile stage is once established, my experience and observation is, quinine is positively injurious-. It does no good towards eliminating this poison, and only complicates the case by aggra- vating the gastric and cephalic disturbance. After a warm foot-bath, the patient should be placed between blankets, and blankets enough useil as cover, as not to oppress but keep the skin gently acting without exhausting perspira- tion. Woolen blankets are the best covers for yellow fever patients; they ab- sorb perspiration without causing the inconvenience that these fluids would on