Some account of the last yellow fever epidemic of British Guiana / by Daniel Blair ; edited by John Davy.

Date:
1850
Catalogue details

Licence: Public Domain Mark

Credit: Some account of the last yellow fever epidemic of British Guiana / by Daniel Blair ; edited by John Davy. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    Among the medicines which were attended with danger in our yellow fever the salts of opium may be mentioned. In some cases when the irritability of stomach was accompanied by general restlessness and uneasiness, a ten or fifteen drop dose of the acetate of morphia has been followed by tranquillity, with- out any unpleasant symptom being induced; but, on the other hand, I have seen stupor, prostration, and complete narcotism follow the use of three drops of the solution of the acetate (one-tenth of a grain of the salt). This was in case 4099 of the Seaman's Hospital Eegister. It was in that case administered on the seventh day of illness. When this drug is used it should be administered early in the disease; but, considering the tact and discrimination necessary to obtain beneficial results, it would perhaps be more judicious to place it in the index expurgatorius of yellow fever materia medica. * Of the plans of treatment not adequately tried I would par- ticularise the transfusion of the nonpurgative salines. In four cases only was transfusion tried. They all died; but they were moribund when operated on. In the last stages of the disease, when in most cases the stomach rejects almost every thing, and the pulse is scarcely felt at the wrist, and the skin is livid and damp, transfusion of blood or of saline solutions into the veins seems the obvious mode of restoring the lost power of the heart. In any future epidemic it is worthy of an extended trial in the third stage of the disease. The imminence of the symptoms need not discourage the practitioner. Black vomit is no in- dication of gangrene or sphacelus; it is a curable symptom even now. Its first effects seem critical and salutary. It seems the last effort of nature to relieve the system of the disease. There may be but one element of success wanting in the struggle, and could we but manage this nisus, an epidemic would lose its terrors. The only practical point which need be adverted to, from the slight experience I have had of transfusion in yellow * [Opium or morphia, in doses similar to those mentioned in the text, and in a like condition,—viz. irritability of stomach, general restlessness, inability to sleep,—was used in Barbados, in the late endemic in many instances with advantage and with comparatively little risk of the bad effects referred to by the Author. In other epidemics, however, such bad effects may be pro- duced by it: too much caution, therefore, cannot be observed in making trial of it.] — Ed.
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