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.

    74/468 (page 66)
    the case is favorable, it will go on until the sweating and heat suljside together at the end of three days. The patient must be kept perfectly quiet; and if he is then nourished, he will have no return of the suffpring. He must not even be allowed to raise his head. If lie gets up, a laintness comes over hiiu, and the whole process is often renewed, with the addition of nausea and h)athing of food. In this case he almost certainly dies. This is the history of favorable cases. Purgiitives are not essential, and many do much harm. A mild dose of oil may be given if there is any thing in the stomach likely to ferment and prove irritating. A simple injection may prove useful. If patients were seen in the beginning, I gave them, as soon as persi:)iration began, a full dose of quinine. There is no doubt of its good effect in quieting pains and promoting perspiration. Sometimes a second dose would be advisable the following morn- ing. This was all that could be done, beyond regulating the drink and nourish-, ment. There was nothing more to do. There was no organic disease. Nothing was revealed by dissection. The poison caused a peculiar condition of the blood, which afterwards showed itself in the skin. .There were many little points in the treatment which, in the aggregate, were of vast importance. In regard to the application of ice to relieve the pains in the head, it was common, but not advisable, and afforded only temporary relief. The reaction from it vyas dangerous. Cups to the head, stomach, and back were much used at one time; but only in cases of plethora were they of service. Simple applications of mustard were generally sufficient to relieve tlie pain in the back. Absolute rest and. nourishment were of the highest possible importance. Any form of. stimulant may be given that the patient prefers; but malt liquors are the best. Brandy may often be given, even with the fever. Beef-tea is necessary, and if the stomach can not retain it, it must be given by injection. Where there is . acidity of the stomach, small doses of bicarbonate of soda, combined with the one-thirty-second part of a grain of morphia, had often an excellent effect. Sponging the patient is grateful and appropriate, but on no occasion must he be disturbed by the treatment. There is much in anticipating certain symp- toms. If there is a disposition to delirium and wandering, it may be guarded against by mild anodynes and stimulants. If this delirium is allowed to con-: tinue, the patient becomes comatose, and dies. It must be remembered that yellow fever patients are wholly irresponsible, and though they may talk rea- sonably, they do not appreciate their own condition. It was exceedingly difficult to keep patients quiet in bed; yet it was the most essential part of the treatment. I once saved an intelligent sea captain, during one of the epi- demics, by threatening to cut his throat if he dared to stir from a given posi- tion in the intervals of my visits. The treatment of yellow fever is simple. In old times, people thought because it was a mighty disease it needed mighty remedies; and, when I first went to New Orleans, it Avas customary to give sixty-grain doses of calomel, and even more than that; and yet some patients even then got well. With rational treatment, a large proportion will recover. The chief difficulty lies in preventing the patient from committing fatal acts of indiscretion in the absence of his physician. It should be remembered that every thing depends on rest and nutrition, and that nothing can be gained by;