Chapter 3

could do any good for diseases, and went to the village-store to buy some patent medicine, which he took. The remedy producing no good effect, he bought some other medicine--purgative pills, as I understood--and took it. Some friends of the village, which, like other villages, especially in America, was full of doctors--brought him nostrums and popular remedies, which he took for some days, till he could not leave the bed any more, delirium set in, and I was at last applied for. I found him with all the symptoms of typhus, and scarcely any of scarlatina, except the tongue, which seemed to struggle between a typhoid and scarlatinous appearance, but soon took all the form and color of the former. There was no rash, not much of a sore-throat, but constant delirium and rapid sinking of the strength of the patient.

Under these circumstances, I believed I must treat him more for typhus than for scarlatina, and used cold baths; in which course I was encouraged by the fine reaction ensuing after every bath, and the slight clearing off of his mind for a few minutes. Internally, I used the muriatic-acid in the forms mentioned above (39), and the solution of chloride of lime, which was also used for a wash and sprinkled about the room. In order to draw the eruption towards the skin--provided there be any of the scarlatinous poison in his system,--I tried a few packs, but without avail. He grew weaker and weaker, though his skin continued to become red after every bath, and on the sixth day early in the morning, when we were about changing his linen, and I was holding him sitting up in bed, he expired in my arms. This is the only case of scarlet-fever, I lost under hydriatic treatment; and it is yet doubtful whether it can be considered as belonging to that disease. I have always considered it, and continue to do so now, a case of typhus, partly communicated by the typhoid exhalations of the other servant, and partly created in his own body, as he complained for more than a fortnight before, of nervous and feverish symptoms, which indicated a serious disease threatening him. The contagion of scarlatina may have made the case more dangerous by complicating it; but, be this as it may, it is certain that the symptoms were such from the beginning that a cure must have appeared most improbable at first sight to any physician of any school; and if there was a possibility of saving his life, it could only be done by the course I took; a course which had proved successful in several cases of typhus I had treated before, and which looked about as bad, and even worse than that of poor William McNought.

112. The young woman, who apparently communicated the typhoid contagion to William, was in quite as critical a condition as her fellow-servant; and for a while I doubted of her recovery. She continued delirious for more than a fortnight, and there were distinct putrid symptoms, her throat and glands ulcerating, and breaking in two places outside. For longer than a week she had not a lucid moment, became extenuated and powerless. We had to lift her into the baths and out; involuntary discharges from the bowels and the bladder took place; petechiae appeared, and every thing indicated a steady decay. Neither acids nor chloride of lime seemed to have any effect; the only thing, which revived her, was the tepid half-bath, of 70 deg., which she took twice a day for about twenty minutes. She was usually carried into the bath-room near by, and was commonly able to walk back assisted by the nurses. She took a pack occasionally for an hour or an hour and a half, as long as a few spots of the rash made their appearance. Her skin peeled off but imperfectly (there was not an appearance of desquamation on the driver's person, although he died about the tenth day after the disease had manifested itself). The patient not producing much heat, I used a poultice of hemlock-leaves and bran on her glands, the gargle of muriatic-acid, and ablutions of water and vinegar externally, when the skin was not prepared for a bath. Although of a weak, scrofulous habit, and having always been sickly, not only her life was saved, but her health became afterwards stronger, and her looks much better than they ever were before. The gland kept discharging for three or four months longer, and I have no doubt, to her great benefit.

With this patient, I never found the heat to exceed 100 deg. Fahr. and the delirium never had a very active character. For the greater part of the time, her skin was more cool than warm, and sometimes even clammy.

FOOTNOTES:

[7] Elements of Medicine, Vol. I. London, 1836.

[8] J. Armstrong, Practical Illustrations of the scarlet-fever, measles, &c. London, 1818.

[9] W. Withering. An account of the scarlet-fever, &c. London, 1779.

[10] Hamilton, in Edinburgh Journal.

[11] F. Jahn, in Hufeland's Journal, 1829.

[12] J. Wendt, das Wesen, die Bedeutung und aerztl. Behandl. des Scharlachs. Breslau, 1819.

[13] F. A. G. Berndt, D. Scharlachepidemie im Kuestriner Kreise, 1817-19, &c. Berlin, 1820.--The same, Bemerk. ueber das Scharlachfieber, &c. Greifswalde, 1827.

[14] Peart, Practical informations on malignant scarlet-fever and sore-throat, in which a new mode of treatment is freely communicated. London, 1802.

[15] J. B. Brown, On scarlatina, and its successful treatment by the Acidum-aceticum-dilutum of the Pharmacopaeia. London, 1846.

[16] The forms in which I have given this acid are the following:

Take three ounces of raspberry syrup and fifteen drops of muriatic acid. Rub the whole of the acid with two or three spoonfuls of syrup in a porcelain mortar (or, if there is none, in a soup-plate with the foot of a wine-glass, or a tumbler) for a minute or two; then add some more of the syrup and rub again, and thus continue till the acid is well divided and mixed up with the syrup. Of this mixture give the patient a teaspoonful every hour or two, or oftener, according to the symptoms.

An other form for a gargle is this:

Take a cup of coarse pearl-barley (or of rice), roast it till yellow; then boil it with one quart of water for ten minutes; add one teaspoonful of muriatic-acid, and four or six tablespoonfuls of honey; mix it well and use it for a gargle, tepid. The decoction should be passed through some linen, or a sieve, before the acid and honey are added, to keep back the barley or rice-grains.

The syrup should be used for inflammation of the tonsils; the gargle for inflammation of the fauces or pharynx.

[17] Schnitzlein, das Scharlachfieber, seine Geschichte, Erkenntniss und Heilung: Muenchen, 1851.

[18] Schneemann, die sichere Heilung der Scharlachkrankheit durch eine neue, voellig gefahrlose Heilmethode. Hannover, 1848.

[19] Lindsley, Boston Med. and Surg. Journal, May, 1850.

[20] C. A. W. Richter, das Wasserbuch. Berlin, 1856.

[21] Berend, Oppenheimer Zeitschrift. April, 1848.

[22] Hauner, Deutsche Klinik, 1850, No. 41.

[23] Hufeland, Hedenus, Burdach, Berndt, Cramer, Maclure, Feron, &c.

[24] Lehmann, Harnier, Wagner, Vogel, Steimmig, Schwartze, Cock, Pfaff, Baumgaertner, Belitz, &c.

[25] Currie, on the effects of cold and tepid water. London.

[26] Kolbany, Beobacht. ueber den Nutzen des lauen und kalten Wassers im Scharlachf. Pressburg, 1808.

[27] Reuss, d. Wesen der Exantheme. Nuernberg, 1818. Vol. III.

[28] A. Edler von Froehlichsthal, Abhandl. ueber d. kraeftige, sichere und schnelle Wirkung der Uebergiessungen &c. im Faul-, Nerven-, Gallen-, Brenn- und Scharlachfieber. Wien, 1842.

[29] L. Hesse, in Rust's Magaz. Vol. XXVII. 1.

[30] R. Steimmig, Erfahr. und Betracht. ueber d. Scharlachfieber und seine Behandl. Karler., 1828.

[31] P. ex. Reich, who kept the sick-room quite cold, and made his scarlet-patients walk out in any weather; he assures us that he cured his patients in five days, an interesting fact, for the correctness of which, however, the Doctor alone is responsible.

[32] A visit at my establishment of a gentleman, a short time ago, whom I treated for scarlatina anginosa in the city of New-York in February, 1851, reminds me of the sensation caused among his friends by our walking out together on the tenth day in a snow-storm, to take dinner at a restaurant's, where we consumed a partridge and sundry other articles, after which we took a further walk of half an hour. Some physicians of my acquaintance told me "I was killing the man," to which I replied, I would let them know, when he was dead. However, he never experienced the slightest inconvenience from his early exposure; on the contrary, he felt bright and strong on coming home, and has been in pretty good health ever since. He saved, last year, the life of a nephew, who had been given up, by packing him, in scarlet-fever, whilst two of the patient's sisters were allowed to die soon after--unpacked!--Their uncle had been compelled to leave the place of their residence, and the parents had neither courage nor confidence in the water-cure to repeat the process, though their son--whom I saw a few weeks afterwards in vigorous health,--had been saved by it. They had more confidence in drugs which had done nothing for him.

[33] Mr. Rossteuscher, who became afterwards proprietor of a water-cure-establishment near Cassel.

[34] "And something may be done by way of gargles, to correct the state of the throat, and to prevent the distressing and perilous consequences, which would otherwise be likely to flow from it. A weak solution of the chloride of soda may be employed for this purpose; and if the disease occur in a child that is not able to gargle, this solution may be injected into the nostrils and against the fauces, by means of a syringe or elastic bottle. The effect of this application is sometimes most encouraging. A quantity of offensive sloughy matter is brought away; the acid discharge is rendered harmless; the running from the nose and diarrhoea cease, &c."

"From several distinct and highly respectable sources, _chlorine_ itself has been strongly pressed upon my notice, as a most valuable remedy in the severest forms of scarlet-fever." Watson, Principles and Practice of Physic.

Dr. Watson also recommends a _drink_, prepared of a drachm of _chlorate of potass_ to a pint of water, and has found great improvement from the use of a pint to a pint and a half of this solution daily.

Brown gives his scarlet-patients the pure _liquor calcii chloridi_, or the _aqua oxymuriatica_ in quantities of one teaspoonful every two or three hours and considers this remedy as almost a specific. A solution of the same remedy may be used as a gargle, and also as a wash; and if used internally, I would rather recommend it in preference to the pure liquor, in the hands of persons not used to medical practice. In putrid cases, also the packing sheet may be dipped in a thin solution of chloride.--From an aversion to drugs--very natural in a hydriatic physician--I have never tried medicated sheets, getting along very nicely without them, but I think they must have sufficient virtue to recommend themselves to physicians and parents, who would like to try them.

[35] Captain Claridge, who communicated the above case to the English, and by reprint also to the American public, erroneously reported it a case of _measles_. How he could have made the mistake, I do not know, as the word "Scharlachfieber" in German does not resemble "measles" at all, the latter being called "Masern" in my mother-tongue; but the thought that many a case, which had a bad issue, might have been treated, these twenty-one years, after my method, and many a life might have been saved, but for the mistake of C. C., has often distressed me.

[36] Nothing is more dangerous to the interest of an establishment, where many people are promiscuously collected, than a case of contagious disease, such as small-pox, scarlatina, measles, typhus, &c. I remember a hydriatic establishment in Pennsylvania being broken up entirely, and the physician deprived for a time of the means of subsistence, by his honest and well-founded confidence in the hydriatic treatment of small-pox, and by the generous steps he took in taking a friendless patient, afflicted with that dreaded disease, to his own house, to cure him. He anticipated the pleasure it would procure him to show how quickly and how safely he would dispose of the case, and exulted in being able to communicate the fact to his patients. Alas, he little knew, how feeble their confidence in the water-cure was as yet, and how much more they thought of their own safety, than of the water-cure, their physician and the life and health of a poor destitute fellow-creature. They all left him--part of them came to Florence--and long before he had cured his small-pox patient, he had not one of his old patients left to witness the cure! However impolitic it may appear, I cannot but express my admiration of Dr. S.'s noble conduct on the occasion, who proved himself not only an honest adherer to our excellent mode of treatment, but also a kind and generous man, worthy of more encouragement than he received at the time.

With that event before me and with a number of some thirty-five or forty patients in the house, I, of course, tried to make them as easy as I could, and confiding in the power of my treatment, sent my own two children, _Paul_, about eight and a half, and _Eliza_, about four years old, to play with the little scarlet-patient, to show how little I was afraid of the disease. In doing so, I, at the same time, satisfied my own heart, by insuring the possibility of treating my darlings myself for scarlatina, which I might not be able to do, were I to let the opportunity escape. Both were taken by the disease, and finding their reaction rather torpid, and the whole process of the disease not without danger, I was glad--when all was over--that I had been able to treat them myself.

I am happy to declare, that none of _my_ patients were frightened away, and that all those who were attacked by the contagion, came off in a very short time and without the least bad consequences. The only exception, in the case of a person who was not a patient, and who came under my hands, after other remedies had been tried on him, I shall communicate hereafter.