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MEDICAL INQUIRIES AND OBSERVATIONS.
MEDICAL INQUIRIES AND OBSERVATIONS.
BY BENJAMIN RUSH, M. D. PROFESSOR OF THE INSTITUTES AND PRACTICE OF MEDICINE, AND OF CLINICAL PRACTICE, IN THE UNIVERSITY OF PENNSYLVANIA. IN FOUR VOLUMES. VOL. I. THE SECOND EDITION, REVISED AND ENLARGED BY THE AUTHOR. PHILADELPHIA, PUBLISHED BY J. CONRAD & CO. CHESNUT-STREET, PHILADELPHIA; M. & J. CONRAD & CO. MARKET-STREET, BALTIMORE; RAPIN, CONRAD, & CO. WASHINGTON; SOMERVELL & CONRAD, PETERSBURG; AND BONSAL, CONRAD, & CO. NORFOLK. PRINTED BY T
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PREFACE.
PREFACE.
In this second edition of the following Medical Inquiries and Observations, the reader will perceive many additions, some omissions, and a few alterations. A number of facts have been added to the Inquiry into the Effects of Ardent Spirits upon the Body and Mind, and to the Observations upon the Tetanus, Cynanche Trachealis, and Old Age, in the first volume; also to the Observations upon Dropsies, Pulmonary Consumption, and Hydrophobia, contained in the second volume. The Lectures upon Animal Li
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AN INQUIRY INTO THE NATURAL HISTORY OF MEDICINE AMONG THE INDIANS OF NORTH-AMERICA; AND A COMPARATIVE VIEW OF THEIR DISEASES AND REMEDIES WITH THOSE OF CIVILIZED NATIONS. Read before the American Philosophical Society, held at Philadelphia, on the 4th of February, 1774.
AN INQUIRY INTO THE NATURAL HISTORY OF MEDICINE AMONG THE INDIANS OF NORTH-AMERICA; AND A COMPARATIVE VIEW OF THEIR DISEASES AND REMEDIES WITH THOSE OF CIVILIZED NATIONS. Read before the American Philosophical Society, held at Philadelphia, on the 4th of February, 1774.
Gentlemen [1] , I rise with peculiar diffidence to address you upon this occasion, when I reflect upon the entertainment you proposed to yourselves from the eloquence of that learned member, Mr. Charles Thompson , whom your suffrages appointed to this honour after the delivery of the last anniversary oration. Unhappily for the interests of science, his want of health has not permitted him to comply with your appointment. I beg, therefore, that you would forget, for a while, the abilities necessa
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AN ACCOUNT OF THE CLIMATE OF PENNSYLVANIA, AND ITS INFLUENCE UPON THE HUMAN BODY.
AN ACCOUNT OF THE CLIMATE OF PENNSYLVANIA, AND ITS INFLUENCE UPON THE HUMAN BODY.
In order to render the observations upon the epidemic diseases which compose the following volumes more useful, it will be necessary to prefix to them a short account of the climate of Pennsylvania, and of its influence upon the human body. This account may perhaps serve further, to lead to future discoveries, and more extensive observations, upon this subject. The state of Pennsylvania lies between 39° 43′ 25″, and 42° north latitude, including, of course, 2° 16′ 35″, equal to 157 miles from it
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AN ACCOUNT OF THE BILIOUS REMITTING FEVER, AS IT APPEARED IN PHILADELPHIA, IN THE SUMMER AND AUTUMN OF THE YEAR 1780.
AN ACCOUNT OF THE BILIOUS REMITTING FEVER, AS IT APPEARED IN PHILADELPHIA, IN THE SUMMER AND AUTUMN OF THE YEAR 1780.
Before I proceed to describe this fever, it will be necessary to give a short account of the weather, and of the diseases which preceded its appearance. The spring of 1780 was dry and cool. A catarrh appeared among children between one year, and seven years of age. It was accompanied by a defluxion from the eyes and nose, and by a cough and dyspnœa, resembling, in some instances, the cynanche trachealis, and in others a peripneumony. In some cases it was complicated with the symptoms of a biliou
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ADDITIONAL OBSERVATIONS UPON THE Scarlatina Anginosa.
ADDITIONAL OBSERVATIONS UPON THE Scarlatina Anginosa.
This disease has prevailed in Philadelphia, at different seasons, ever since the year 1783. It has blended itself occasionally with all our epidemics. Many cases have come under my notice since its first appearance, in which dropsical swellings have succeeded the fever. In some instances there appeared to be effusions of water not only in the limbs and abdomen, but in the thorax. They yielded, in every case that I attended, to purges of calomel and jalap. Where these swellings were neglected, th
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AN ACCOUNT INTO THE CAUSE AND CURE OF THE CHOLERA INFANTUM.
AN ACCOUNT INTO THE CAUSE AND CURE OF THE CHOLERA INFANTUM.
By this name I mean to designate a disease, called, in Philadelphia, the “vomiting and purging of children.” From the regularity of its appearance in the summer months, it is likewise known by the name of “the disease of the season.” It prevails in most of the large towns of the United States. It is distinguished in Charleston, in South Carolina, by the name of “the April and May disease,” from making its first appearance in those two months. It seldom appears in Philadelphia till the middle of
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OBSERVATIONS ON THE CYNANCHE TRACHEALIS.
OBSERVATIONS ON THE CYNANCHE TRACHEALIS.
The vulgar name of this disease in Pennsylvania is HIVES . It is a corruption of the word heaves , which took its rise from the manner in which the lungs heave in breathing. The worst degree of the disease is called the BOWEL HIVES , from the great motion of the abdominal muscles in respiration. It has been called suffocatio stridula by Dr. Home, and cynanche trachealis by Dr. Cullen. Professor Frank calls it trachitis, and Dr. Darwin considers it as a pleurisy of the windpipe. By the two latter
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AN ACCOUNT OF THE EFFICACY OF BLISTERS AND BLEEDING, IN THE CURE OF OBSTINATE Intermitting Fevers.
AN ACCOUNT OF THE EFFICACY OF BLISTERS AND BLEEDING, IN THE CURE OF OBSTINATE Intermitting Fevers.
The efficacy of these remedies will probably be disputed by every regular-bred physician, who has not been a witness of their utility in the above disease; but it becomes such physicians, before they decide upon this subject, to remember, that many things are true in medicine, as well as in other branches of philosophy, which are very improbable. In all those cases of autumnal intermittents, whether quotidian, tertian, or quartan, in which the bark did not succeed after three or four days trial,
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AN ACCOUNT OF THE DISEASE OCCASIONED BY DRINKING COLD WATER IN WARM WEATHER, AND THE METHOD OF CURING IT.
AN ACCOUNT OF THE DISEASE OCCASIONED BY DRINKING COLD WATER IN WARM WEATHER, AND THE METHOD OF CURING IT.
Few summers elapse in Philadelphia, in which there are not instances of many persons being diseased by drinking cold water. In some seasons, four or five persons have died suddenly from this cause, in one day. This mortality falls chiefly upon the labouring part of the community, who seek to allay their thirst by drinking the water from the pumps in the streets, and who are too impatient, or too ignorant, to use the necessary precautions for preventing its morbid or deadly effects upon them. The
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AN ACCOUNT OF THE EFFICACY OF COMMON SALT, IN THE CURE OF HÆMOPTYSIS.
AN ACCOUNT OF THE EFFICACY OF COMMON SALT, IN THE CURE OF HÆMOPTYSIS.
From the present established opinions and practice respecting the cause and cure of hæmoptysis, the last medicine that would occur to a regular-bred physician for the cure of it, is COMMON SALT ; and yet I have seen and heard of a great number of cases, in which it has been administered with success. The mode of giving it is to pour down from a tea to a table-spoonful of clean fine salt, as soon as possible after the hæmorrhage begins from the lungs. This quantity generally stops it; but the dos
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THOUGHTS UPON THE CAUSE AND CURE OF THE PULMONARY CONSUMPTION.
THOUGHTS UPON THE CAUSE AND CURE OF THE PULMONARY CONSUMPTION.
The ancient Jews used to say, that a man does not fulfil his duties in life, who passes through it, without building a house, planting a tree, and leaving a child behind him. A physician, in like manner, should consider his obligations to his profession and society as undischarged, who has not attempted to lessen the number of incurable diseases. This is my apology for presuming to make the consumption the object of a medical inquiry. Perhaps I may suggest an idea, or fact, that may awaken the i
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OBSERVATIONS UPON WORMS IN THE ALIMENTARY CANAL, AND UPON ANTHELMINTIC MEDICINES.
OBSERVATIONS UPON WORMS IN THE ALIMENTARY CANAL, AND UPON ANTHELMINTIC MEDICINES.
With great diffidence I venture to lay before the public my opinions upon worms: nor should I have presumed to do it, had I not entertained a hope of thereby exciting further inquiries upon this subject. When we consider how universally worms are found in all young animals, and how frequently they exist in the human body, without producing disease of any kind, it is natural to conclude, that they serve some useful and necessary purposes in the animal economy. Do they consume the superfluous alim
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AN ACCOUNT OF THE EXTERNAL USE OF ARSENIC, IN THE CURE OF CANCERS.
AN ACCOUNT OF THE EXTERNAL USE OF ARSENIC, IN THE CURE OF CANCERS.
A few years ago, a certain Doctor Hugh Martin, a surgeon of one of the Pennsylvania regiments stationed at Pittsburg, during the latter part of the late war, came to this city, and advertised to cure cancers with a medicine which he said he had discovered in the woods, in the neighbourhood of the garrison. As Dr. Martin had once been my pupil, I took the liberty of waiting upon him, and asked him some questions respecting his discovery. His answers were calculated to make me believe, that his me
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OBSERVATIONS UPON THE TETANUS.
OBSERVATIONS UPON THE TETANUS.
For a history of the different names and symptoms of this disease, I beg leave to refer the reader to practical books, particularly to Doctor Cullen's First Lines. My only design in this inquiry, is to deliver such a theory of the disease, as may lead to a new and successful use of old and common remedies for it. All the remote and predisposing causes of the tetanus act by inducing preternatural debility, and irritability in the muscular parts of the body. In many cases, the remote causes act al
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THE RESULT OF OBSERVATIONS MADE UPON THE DISEASES WHICH OCCURRED IN THE MILITARY HOSPITALS OF THE UNITED STATES, DURING THE REVOLUTIONARY WAR BETWEEN GREAT BRITAIN AND THE UNITED STATES.
THE RESULT OF OBSERVATIONS MADE UPON THE DISEASES WHICH OCCURRED IN THE MILITARY HOSPITALS OF THE UNITED STATES, DURING THE REVOLUTIONARY WAR BETWEEN GREAT BRITAIN AND THE UNITED STATES.
1. The army when in tents, was always more sickly, than in the open air. It was likewise more healthy when it was kept in motion, than when it lay in an encampment. 2. Young men under twenty years of age, were subject to the greatest number of camp diseases. 3. The southern troops were more sickly than the northern or eastern troops. 4. The native Americans were more sickly than the natives of Europe who served in the American army. 5. Men above thirty, and five and thirty years of age, were the
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AN ACCOUNT OF THE INFLUENCE OF THE MILITARY AND POLITICAL EVENTS OF THE AMERICAN REVOLUTION UPON THE HUMAN BODY.
AN ACCOUNT OF THE INFLUENCE OF THE MILITARY AND POLITICAL EVENTS OF THE AMERICAN REVOLUTION UPON THE HUMAN BODY.
There were several circumstances peculiar to the American revolution, which should be mentioned previously to an account of the influence of the events which accompanied it, upon the human body. 1. The revolution interested every inhabitant of the country of both sexes, and of every rank and age that was capable of reflection. An indifferent, or neutral spectator of the controversy, was scarcely to be found in any of the states. 2. The scenes of war and government which it introduced, were new t
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AN INQUIRY INTO THE RELATION OF TASTES AND ALIMENTS TO EACH OTHER, AND INTO THE INFLUENCE OF THIS RELATION UPON HEALTH AND PLEASURE.
AN INQUIRY INTO THE RELATION OF TASTES AND ALIMENTS TO EACH OTHER, AND INTO THE INFLUENCE OF THIS RELATION UPON HEALTH AND PLEASURE.
In entering upon this subject, I feel like the clown, who, after several unsuccessful attempts to play upon a violin, threw it hastily from him, exclaiming at the same time, that “there was music in it,” but that he could not bring it out. I shall endeavour, by a few brief remarks, to lay a foundation for more successful inquiries upon this difficult subject. Attraction and repulsion seem to be the active principles of the universe. They pervade not only the greatest, but the minutest works of n
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THE NEW METHOD OF INOCULATING FOR THE SMALL-POX. DELIVERED IN A LECTURE IN THE UNIVERSITY OF PENNSYLVANIA, ON THE 20TH OF FEBRUARY, 1781.
THE NEW METHOD OF INOCULATING FOR THE SMALL-POX. DELIVERED IN A LECTURE IN THE UNIVERSITY OF PENNSYLVANIA, ON THE 20TH OF FEBRUARY, 1781.
GENTLEMEN, It must afford no small pleasure to a benevolent mind, in the midst of a war which daily makes so much havoc with the human species, to reflect that the small-pox, which once proved equally fatal to thousands, has been checked in its career, and in a great degree subdued, by the practice of INOCULATION . It is foreign to my purpose to deliver to you the history of this art, and to mark the various steps that have attended its progress to its present state of improvement. We have yet t
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PART I.
PART I.
By ardent spirits, I mean those liquors only which are obtained by distillation from fermented substances of any kind. To their effects upon the bodies and minds of men, the following inquiry shall be exclusively confined. Fermented liquors contain so little spirit, and that so intimately combined with other matters, that they can seldom be drunken in sufficient quantities to produce intoxication, and its subsequent effects, without exciting a disrelish to their taste, or pain, from their disten
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PART II.
PART II.
But it may be said, if we reject spirits from being a part of our drinks, what liquors shall we substitute in their room? I answer, in the first place, 1. Simple Water. I have known many instances of persons who have followed the most laborious employments for many years in the open air, and in warm and cold weather, who never drank any thing but water, and enjoyed uninterrupted good health. Dr. Moseley, who resided many years in the West-Indies, confirms this remark. “I aver (says the doctor),
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PART III.
PART III.
We come now to the third part of this inquiry, that is, to mention the remedies for the evils which are brought on by the excessive use of distilled spirits. These remedies divide themselves into two kinds. I. Such as are proper to cure a fit of drunkenness, and II. Such as are proper to prevent its recurrence, and to destroy a desire for ardent spirits. I. I am aware that the efforts of science and humanity, in applying their resources to the cure of a disease, induced by an act of vice, will m
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OBSERVATIONS OF THE DUTIES OF A PHYSICIAN, AND THE METHODS OF IMPROVING MEDICINE. ACCOMMODATED TO THE PRESENT STATE OF SOCIETY AND MANNERS IN THE UNITED STATES. Delivered in the University of Pennsylvania, February 7, 1789, at the conclusion of a course of lectures upon chemistry and the practice of physic. PUBLISHED AT THE REQUEST OF THE CLASS.
OBSERVATIONS OF THE DUTIES OF A PHYSICIAN, AND THE METHODS OF IMPROVING MEDICINE. ACCOMMODATED TO THE PRESENT STATE OF SOCIETY AND MANNERS IN THE UNITED STATES. Delivered in the University of Pennsylvania, February 7, 1789, at the conclusion of a course of lectures upon chemistry and the practice of physic. PUBLISHED AT THE REQUEST OF THE CLASS.
GENTLEMEN, I Shall conclude our course of lectures, by delivering to you a few directions for the regulation of your future conduct and studies, in the line of your profession. I shall, first , suggest the most probable means of establishing yourselves in business, and of becoming acceptable to your patients, and respectable in life. Secondly , I shall mention a few thoughts which have occurred to me on the mode to be pursued, in the further prosecution of your studies, and for the improvement o
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AN INQUIRY INTO THE CAUSE AND CURE OF SORE LEGS.
AN INQUIRY INTO THE CAUSE AND CURE OF SORE LEGS.
However trifling these complaints may appear, they compose a large class of the diseases of a numerous body of people. Hitherto, the persons afflicted by them have been too generally abandoned to the care of empirics, either because the disease was considered as beneath the notice of physicians, or because they were unable to cure it. I would rather ascribe it to the latter, than to the former cause, for pride has no natural fellowship with the profession of medicine. The difficulty of curing so
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AN ACCOUNT OF THE STATE OF THE BODY AND MIND IN OLD AGE; WITH OBSERVATIONS ON ITS DISEASES, AND THEIR REMEDIES.
AN ACCOUNT OF THE STATE OF THE BODY AND MIND IN OLD AGE; WITH OBSERVATIONS ON ITS DISEASES, AND THEIR REMEDIES.
Most of the facts which I shall deliver upon this subject, are the result of observations made during the term of five years, upon persons of both sexes, who had passed the 80th year of their lives. I intended to have given a detail of the names, manner of life, occupations, and other circumstances of each of them; but, upon a review of my notes, I found so great a sameness in the history of most of them, that I despaired, by detailing them, of answering the intention which I have purposed in th
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MEDICAL INQUIRIES AND OBSERVATIONS.
MEDICAL INQUIRIES AND OBSERVATIONS.
BY BENJAMIN RUSH, M. D. PROFESSOR OF THE INSTITUTES AND PRACTICE OF MEDICINE, AND OF CLINICAL PRACTICE, IN THE UNIVERSITY OF PENNSYLVANIA. IN FOUR VOLUMES. VOL. II. THE SECOND EDITION, REVISED AND ENLARGED BY THE AUTHOR. PHILADELPHIA, PUBLISHED BY J. CONRAD & CO. CHESNUT-STREET, PHILADELPHIA; M. & J. CONRAD & CO. MARKET-STREET, BALTIMORE; RAPIN, CONRAD, & CO. WASHINGTON; SOMERVELL & CONRAD, PETERSBURG; AND BONSAL, CONRAD, & CO. NORFOLK. PRINTED BY
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AN INQUIRY INTO THE INFLUENCE OF PHYSICAL CAUSES UPON THE MORAL FACULTY. DELIVERED BEFORE THE AMERICAN PHILOSOPHICAL SOCIETY, HELD AT PHILADELPHIA, ON THE 27TH OF FEBRUARY, 1786.
AN INQUIRY INTO THE INFLUENCE OF PHYSICAL CAUSES UPON THE MORAL FACULTY. DELIVERED BEFORE THE AMERICAN PHILOSOPHICAL SOCIETY, HELD AT PHILADELPHIA, ON THE 27TH OF FEBRUARY, 1786.
GENTLEMEN, It was for the laudable purpose of exciting a spirit of emulation and inquiry, among the members of our body, that the founders of our society instituted an annual oration. The task of preparing, and delivering this exercise, hath devolved, once more, upon me. I have submitted to it, not because I thought myself capable of fulfilling your intentions, but because I wished, by a testimony of my obedience to your requests, to atone for my long absence from the temple of science. The subj
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AN INQUIRY INTO THE CAUSES AND CURE OF THE PULMONARY CONSUMPTION.
AN INQUIRY INTO THE CAUSES AND CURE OF THE PULMONARY CONSUMPTION.
In an essay, entitled “Thoughts on the Pulmonary Consumption [17] ,” I attempted to show that this disease was the effect of causes which induced general debility, and that the only hope of discovering a cure for it should be directed to such remedies as act upon the whole system. In the following inquiry, I shall endeavour to establish the truth of each of those opinions, by a detail of facts and reasonings, at which I only hinted in my former essay. The method I have chosen for this purpose, i
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OBSERVATIONS ON THE SYMPTOMS AND CURE OF DROPSIES.
OBSERVATIONS ON THE SYMPTOMS AND CURE OF DROPSIES.
Whether we admit the exhaling and absorbing vessels to be affected in general dropsies by preternatural debility, palsy, or rupture, or by a retrograde motion of their fluids, it is certain that their exhaling and absorbing power is materially affected by too much, or too little action in the arterial system. That too little action in the arteries should favour dropsical effusions, has been long observed; but it has been less obvious, that the same effusions are sometimes promoted, and their abs
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CASE I.
CASE I.
On the 15th of November, 1790, I was called to visit the daughter of William Webb, aged four years, who was indisposed with a cough, a pain in her bowels, a coma, great sensibility of her eyes to light, costiveness, and a suppression of urine, a slow and irregular, but tense pulse, dilated pupils, but no head-ach. I found, upon inquiry, that she had received a hurt on her head by a fall, about seven weeks before I saw her. From this information, as well as from her symptoms, I had no doubt of th
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CASE II.
CASE II.
On the 24th of the same month, I was called to visit the son of John Cypher, in South-street, aged four years, who had been hurt about a month before, by a wound on his forehead with a brick-bat, the mark of which still appeared. He had been ill for near two weeks with coma, head-ach, colic, vomiting, and frequent startings in his sleep. His evacuations by stool and urine were suppressed; he had discharged three worms, and had had two convulsion fits just before I saw him. The pupil of the right
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CASES III. AND IV.
CASES III. AND IV.
In the month of March, 1792, I attended two children of three years of age, the one the daughter of William King, the other the daughter of William Blake: each of whom had most of the symptoms of the inflammatory stage of the internal dropsy of the brain. I prescribed the loss of four ounces of blood, and a smart purge in both cases, and in the course of a few days had the pleasure of observing all the symptoms of the disease perfectly subdued in each of them....
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CASE V.
CASE V.
In the months of July and August, 1792, I attended a female slave of Mrs. Oneal, of St. Croix, who had an obstinate head-ach, coma, vomiting, and a tense, full, and slow pulse. I believed it to be the phrenicula, or internal dropsy of the brain, in its inflammatory stage. I bled her five times in the course of two months, and each time with obvious relief of all the symptoms of the disease. Finding that her head-ach, and a disposition to vomit, continued after the tension of her pulse was nearly
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CASE VI.
CASE VI.
The daughter of Robert Moffat, aged eight years, in consequence of the suppression of a habitual discharge from sores on her head, in the month of April, 1793, was affected by violent head-ach, puking, great pains and weakness in her limbs, and a full, tense, and slow pulse. I believed these symptoms to be produced by an inflammation of the brain. I ordered her to lose six or seven ounces of blood, and gave her two purges of jalap and calomel, which operated very plentifully. I afterwards applie
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CASE VII.
CASE VII.
A young woman of eighteen years of age, a hired servant in the family of Mrs. Elizabeth Smith, had been subject to a head-ach every spring for several years. The unusually warm days which occurred in the beginning of April, 1793, produced a return of this periodical pain. On the eighth of the month, it was so severe as to confine her to her bed. I was called to visit her on the ninth. I found her comatose, and, when awake, delirious. Her pupils were unusually dilated, and insensible to the light
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OBSERVATIONS UPON THE NATURE AND CURE OF THE GOUT.
OBSERVATIONS UPON THE NATURE AND CURE OF THE GOUT.
In treating upon the gout, I shall deliver a few preliminary propositions. 1. The gout is a disease of the whole system. It affects the ligaments, blood-vessels, stomach, bowels, brain, liver, lymphatics, nerves, muscles, cartilages, bones, and skin. 2. The gout is a primary disease, only of the solids. Chalk-stones, abscesses, dropsical effusions into cavities, and cellular membrane, and eruptions on the skin, are all the effects of a morbid action in the blood-vessels. The truth of this propos
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OBSERVATIONS UPON THE NATURE AND CURE OF THE HYDROPHOBIA.
OBSERVATIONS UPON THE NATURE AND CURE OF THE HYDROPHOBIA.
In entering upon the consideration of this formidable disease, I feel myself under an involuntary impression, somewhat like that which was produced by the order the king of Syria gave to his captains when he was conducting them to battle: “Fight not with small or great, save only with the king of Israel [74] .” In whatever light we contemplate the hydrophobia, it may be considered as pre-eminent in power and mortality, over all other diseases. It is now many years since the distress and horror e
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AN ACCOUNT OF THE MEASLES, AS THEY APPEARED IN PHILADELPHIA, IN THE SPRING OF 1789.
AN ACCOUNT OF THE MEASLES, AS THEY APPEARED IN PHILADELPHIA, IN THE SPRING OF 1789.
The weather in December, 1788, and in January, 1789, was variable, but seldom very cold. On the first of February, 1789, at six o'clock in the morning, the mercury in Fahrenheit's thermometer fell 5° below 0, in the city of Philadelphia. At twenty miles from the city, on the Schuylkill, it fell 12° below 0, at the same hour. On the 19th and 20th of this month, there fell a quantity of snow, the depth of which, upon an average, was supposed to be about eight or ten inches. On the 23d, 24th, 25th,
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AN ACCOUNT OF THE INFLUENZA, AS IT APPEARED IN PHILADELPHIA, IN THE AUTUMN OF 1789, IN THE SPRING OF 1790, AND IN THE WINTER OF 1791.
AN ACCOUNT OF THE INFLUENZA, AS IT APPEARED IN PHILADELPHIA, IN THE AUTUMN OF 1789, IN THE SPRING OF 1790, AND IN THE WINTER OF 1791.
The latter end of the month of August, in the summer of 1789, was so very cool that fires became agreeable. The month of September was cool, dry, and pleasant. During the whole of this month, and for some days before it began, and after it ended, there had been no rain. In the beginning of October, a number of the members of the first congress, that had assembled in New-York, under the present national government, arrived in Philadelphia, much indisposed with colds. They ascribed them to the fat
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LECTURE I.
LECTURE I.
Gentlemen , My business in this chair is to teach the institutes of medicine. They have been divided into physiology, pathology, and therapeutics. The objects of the first are, the laws of the human body in its healthy state. The second includes the history of the causes and seats of diseases. The subjects of the third are the remedies for those diseases. In entering upon the first part of our course, I am met by a remark delivered by Dr. Hunter in his introductory lectures to his course of anat
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LECTURE II.
LECTURE II.
Gentlemen , The stimuli which have been enumerated, when they act collectively, and within certain bounds, produce a healthy waking state. But they do not always act collectively, nor in the determined and regular manner that has been described. There is, in many states of the system, a deficiency of some stimuli, and, in some of its states, an apparent absence of them all. To account for the continuance of animal life under such circumstances, two things must be premised, before we proceed to t
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LECTURE III.
LECTURE III.
Gentlemen , Let us next take a view of the state of animal life in the different inhabitants of our globe, as varied by the circumstances of civilization, diet, situation, and climate. I. In the Indians of the northern latitudes of America there is often a defect of the stimulus of aliment, and of the understanding and passions. Their vacant countenances, and their long and disgusting taciturnity, are the effects of the want of action in their brains from a deficiency of ideas; and their tranqui
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MEDICAL INQUIRIES AND OBSERVATIONS.
MEDICAL INQUIRIES AND OBSERVATIONS.
BY BENJAMIN RUSH, M. D. PROFESSOR OF THE INSTITUTES AND PRACTICE OF MEDICINE, AND OF CLINICAL PRACTICE, IN THE UNIVERSITY OF PENNSYLVANIA. IN FOUR VOLUMES. VOL. III. THE SECOND EDITION, REVISED AND ENLARGED BY THE AUTHOR. PHILADELPHIA, PUBLISHED BY J. CONRAD & CO. CHESNUT-STREET, PHILADELPHIA; M. & J. CONRAD & CO. MARKET-STREET, BALTIMORE; RAPIN, CONRAD, & CO. WASHINGTON; SOMERVELL & CONRAD, PETERSBURG; AND BONSAL, CONRAD, & CO. NORFOLK. PRINTED BY
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OUTLINES OF A THEORY OF FEVER.
OUTLINES OF A THEORY OF FEVER.
As many of the diseases which are the subjects of these volumes belong to the class of fevers, the following remarks upon their theory are intended to render the principles and language I have adopted, in the history of their causes, symptoms, and cure, intelligible to the reader. I am aware that this theory will suffer by being published in a detached state from the general view of the proximate cause of disease which I have taught in my lectures upon pathology, as well as from its being depriv
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OF THE METHOD OF CURE.
OF THE METHOD OF CURE.
In the introduction to the history of the fever, I mentioned the remedies which I used with success, in several cases which occurred in the beginning of August. I had seen, and recorded in my note book, the efficacy of gentle purges in the yellow fever of 1762; but finding them unsuccessful after the 20th of August, and observing the disease to assume uncommon symptoms of great prostration of strength, I laid them aside, and had recourse to a gentle vomit of ipecacuanha, on the first day of the
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OF PURGING.
OF PURGING.
I have already mentioned my reasons for promoting this evacuation, and the medicine I preferred for that purpose. It had many advantages over any other purge. It was detergent to the bile and mucus which lined the bowels. It probably acted in a peculiar manner upon the biliary ducts, and it was rapid in its operation. One dose was sometimes sufficient to open the bowels; but from two to six doses were often necessary for that purpose; more especially as part of them was frequently rejected by th
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OF BLOOD-LETTING.
OF BLOOD-LETTING.
The theory of this fever which led me to administer purges, determined me to use blood-letting, as soon as it should be indicated. I am disposed to believe that I was tardy in the use of this remedy, and I shall long regret the loss of three patients, who might probably have been saved by it. I cannot blame myself for not having used it earlier, for the immense number of patients which poured in upon me, in the first week of September, prevented my attending so much to each of them, as was neces
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A NARRATIVE OF THE STATE OF THE BODY AND MIND OF THE AUTHOR, DURING THE PREVALENCE OF THE FEVER.
A NARRATIVE OF THE STATE OF THE BODY AND MIND OF THE AUTHOR, DURING THE PREVALENCE OF THE FEVER.
Narratives of escapes from great dangers of shipwreck, war, captivity, and famine have always formed an interesting part of the history of the body and mind of man. But there are deliverances from equal dangers which have hitherto passed unnoticed; I mean from pestilential fevers. I shall briefly describe the state of my body and mind during my intercourse with the sick in the epidemic of 1793. The account will throw additional light upon the disease, and probably illustrate some of the laws of
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OF THE METHOD OF CURE.
OF THE METHOD OF CURE.
The remedies employed for the cure of this fever were the same that I employed the year before. I shall only relate such effects of them as tend more fully to establish the practice adopted in the year 1793, and such as escaped my notice in my former remarks upon those remedies. My method of cure consisted, I. In the abstraction of the stimulus of blood and heat from the whole body, and of bile and other acrid humours from the bowels, by means of the following remedies: 1. Bleeding. 2. Purging.
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AN AN ACCOUNT OF SPORADIC CASES OF BILIOUS YELLOW FEVER, IN PHILADELPHIA, IN THE YEARS 1795 AND 1796.
AN AN ACCOUNT OF SPORADIC CASES OF BILIOUS YELLOW FEVER, IN PHILADELPHIA, IN THE YEARS 1795 AND 1796.
In my account of the yellow fever, as it appeared in Philadelphia in the year 1794, I took notice of several cases of it which occurred in the spring of the year 1795. Before I proceed to deliver the history of this disease as it appeared in 1797, I shall mention the diseases and state of the weather which occurred during the remaining part of the year 1795, and the whole of the year 1796. This detail of facts, apparently uninteresting to the reader in the present state of our knowledge of epide
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MEDICAL INQUIRIES AND OBSERVATIONS.
MEDICAL INQUIRIES AND OBSERVATIONS.
BY BENJAMIN RUSH, M. D. PROFESSOR OF THE INSTITUTES AND PRACTICE OF MEDICINE, AND OF CLINICAL PRACTICE, IN THE UNIVERSITY OF PENNSYLVANIA. IN FOUR VOLUMES. VOL. IV. THE SECOND EDITION, REVISED AND ENLARGED BY THE AUTHOR. PHILADELPHIA, PUBLISHED BY J. CONRAD & CO. CHESNUT-STREET, PHILADELPHIA; M. & J. CONRAD & CO. MARKET-STREET, BALTIMORE; RAPIN, CONRAD, & CO. WASHINGTON; SOMERVELL & CONRAD, PETERSBURG; AND BONSAL, CONRAD, & CO. NORFOLK. PRINTED BY
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OF PURGING.
OF PURGING.
From the great difficulty that was found in discharging bile from the bowels, by the common modes of administering purges, Dr. Griffitts suggested to me the propriety of giving large doses of calomel, without jalap or any other purging medicine, in order to loosen the bile from its close connection with the gall-bladder and duodenum, during the first day of the disease. This method of discharging acrid bile was found useful. I observed the same relief from large evacuations of fœtid
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OF EMETICS.
OF EMETICS.
It was said a practitioner, who was opposed to bleeding and mercury, cured this fever by means of strong emetics. I gave one to a man who refused to be bled. It operated freely, and brought on a plentiful sweat. The next day he arose from his bed, and went to his work. On the fourth day he sent for me again. My son visited him, and found him without a pulse. He died the next day. I heard of two other persons who took emetics in the beginning of the fever, without the advice of a physician, both
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OF DIET AND DRINKS.
OF DIET AND DRINKS.
The advantages of a weak vegetable diet were very great in this fever. I found but little difficulty, in most cases, in having my prohibition of animal food complied with before the crisis of the fever, but there was often such a sudden excitement of the appetite for it, immediately afterwards, that it was difficult to restrain it. I have mentioned the case of a young man, who was upon the recovery, who died in consequence of supping upon beef-stakes. Many other instances of the mortality of thi
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OF TONIC REMEDIES.
OF TONIC REMEDIES.
There were now and then remissions and intermissions of the fever, accompanied with such signs of danger from debility, as to render the exhibition of a few drops of laudanum, a little wine-whey, a glass of brandy and water, and, in some instances, a cup of weak chicken-broth, highly necessary and useful. In addition to these cordial drinks, I directed the feet to be placed in a tub of warm water, which was introduced under the bed-clothes, so that the patient was not weakened by being raised fr
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AN ACCOUNT OF THE BILIOUS YELLOW FEVER. AS IT APPEARED IN PHILADELPHIA, IN 1798.
AN ACCOUNT OF THE BILIOUS YELLOW FEVER. AS IT APPEARED IN PHILADELPHIA, IN 1798.
The yellow fever of the year 1797 was succeeded by scarlatina, catarrhs, and bilious pleurisies, in the months of November and December of the same year. The weather favoured the generation of the latter diseases. It became suddenly cold about the middle of November. On the 5th of December, the navigation of the Delaware was obstructed. There was a thaw on the 13th and 14th of this month, but not sufficient to open the river. In the month of January, 1798, the fevers discovered an uncommon deter
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AN ACCOUNT OF THE BILIOUS YELLOW FEVER. AS IT APPEARED IN PHILADELPHIA, IN 1799.
AN ACCOUNT OF THE BILIOUS YELLOW FEVER. AS IT APPEARED IN PHILADELPHIA, IN 1799.
The diseases which succeeded the fever of 1798, in November and December, were highly inflammatory. A catarrh was nearly universal. Several cases of sore throat, and one of erysipelas, came under my care in the month of November. The weather in December was extremely cold. It was equally so in the beginning of January, 1799, accompanied with several falls of snow. About the middle of the month, the weather moderated so much, so as to open the navigation of the Delaware. I met with two cases of m
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AN ACCOUNT OF SPORADIC CASES OF YELLOW FEVER. AS THEY APPEARED IN PHILADELPHIA, IN 1800.
AN ACCOUNT OF SPORADIC CASES OF YELLOW FEVER. AS THEY APPEARED IN PHILADELPHIA, IN 1800.
The weather in the month of January was less cold than is common in that month. Catarrhs, the cynanche trachealis, and bilious pleurisies were prevalent in every part of it. A few cases of yellow fever occurred likewise during this month. Several cases of erysipelas appeared in February. The month of March was unusually healthy. The weather was warm in April, and the city as healthy as in March. It was equally so in May and June. The spring fruits appeared early in the latter month, in large qua
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AN ACCOUNT OF SPORADIC CASES OF YELLOW FEVER. AS THEY APPEARED IN PHILADELPHIA, IN 1801.
AN ACCOUNT OF SPORADIC CASES OF YELLOW FEVER. AS THEY APPEARED IN PHILADELPHIA, IN 1801.
The month of January was intensely cold. In February it became more moderate. The diseases, during these two months, were catarrhs and a few pleurisies. In March and April there fell an unusual quantity of rain. The hay harvest began in the neighbourhood of Philadelphia on the 28th of May. A few mild cases of scarlatina anginosa occurred during these months. In June the weather was dry and healthy. On the 8th of July, a case of yellow fever occurred in the practice of Dr. Stewart. About the 15th
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AN ACCOUNT OF THE MEASLES, AS THEY APPEARED IN PHILADELPHIA, IN THE YEAR 1801.
AN ACCOUNT OF THE MEASLES, AS THEY APPEARED IN PHILADELPHIA, IN THE YEAR 1801.
I. The disease wore the livery of the autumnal fever in the following particulars. It was strongly marked by remissions and intermissions. The exacerbations came on chiefly at night. There were in many cases a constant nausea, and discharge of bile by puking. I saw one case in which the disease appeared with a violent cholera morbus, and several in which it was accompanied with diarrhœa and dysentery. II. Many severe cases of phrenzy, and two of cynanche trachealis appeared with the
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AN ACCOUNT OF THE BILIOUS YELLOW FEVER, AS IT APPEARED IN PHILADELPHIA, IN THE YEAR 1802.
AN ACCOUNT OF THE BILIOUS YELLOW FEVER, AS IT APPEARED IN PHILADELPHIA, IN THE YEAR 1802.
The weather during the month of January was unusually moderate and pleasant. In the latter end of it, many shrubs put forth leaves and blossomed. I saw a leaf of the honeysuckle, which was more than an inch in length, and above half an inch in breadth. There was but one fall of snow, and that a light one, during the whole month. The winds blew chiefly from the south-west in February. There was a light fall of snow on the 6th. A shad was caught in the Delaware, near the city, on the 17th. On the
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AN ACCOUNT OF THE BILIOUS YELLOW FEVER, AS IT APPEARED IN PHILADELPHIA, IN 1803.
AN ACCOUNT OF THE BILIOUS YELLOW FEVER, AS IT APPEARED IN PHILADELPHIA, IN 1803.
The weather in January was uniformly cold. On the 21st of the month, the Delaware was completely frozen. On the 4th of February there was a general thaw, attended with a storm of hail, thunder, and lightning, which lasted about three quarters of an hour. The diseases of both these winter months were catarrhs and bilious pleurisies. The latter appeared in a tertian type. The pain in the side was most sensible every other day. The weather was cold and dry in March, in consequence of which, vegetat
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AN ACCOUNT OF SPORADIC CASES OF YELLOW FEVER, AS THEY APPEARED IN PHILADELPHIA, IN THE YEAR 1804.
AN ACCOUNT OF SPORADIC CASES OF YELLOW FEVER, AS THEY APPEARED IN PHILADELPHIA, IN THE YEAR 1804.
The month of January was marked by deep snows, rain, clear and cold weather, and by the general healthiness of the city. In February there fell a deep snow, which was followed by several very cold days. There was likewise a fall of snow in March, which was succeeded by an uncommon degree of cold. Catarrhs and bilious pleurisies were very common during both these months. In the beginning of April, the weather was cold and rainy. There were but few signs of vegetation before the 15th of the month.
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AN ACCOUNT OF THE BILIOUS YELLOW FEVER, AS IT APPEARED IN PHILADELPHIA, IN THE YEAR 1805.
AN ACCOUNT OF THE BILIOUS YELLOW FEVER, AS IT APPEARED IN PHILADELPHIA, IN THE YEAR 1805.
For a history of the uncommonly cold and tempestuous winter of 1804 and 1805, the reader is referred to the Account of the Climate of Pennsylvania, in the first volume of these Inquiries and Observations. During the months of January, February, and March, there were a number of bilious catarrhs and pleurisies. On the 7th of April, I visited a patient in the yellow fever with Dr. Stewart. He was cured, chiefly by copious bleeding. The weather was rainy in May. After the middle of June, and during
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AN INQUIRY INTO THE VARIOUS SOURCES OF THE USUAL FORMS OF SUMMER & AUTUMNAL DISEASE IN THE UNITED STATES, AND THE MEANS OF PREVENTING THEM.
AN INQUIRY INTO THE VARIOUS SOURCES OF THE USUAL FORMS OF SUMMER & AUTUMNAL DISEASE IN THE UNITED STATES, AND THE MEANS OF PREVENTING THEM.
The business of the following inquiry is, I. To enumerate the various sources of the usual forms of the summer and autumnal disease in the United States. And, II. To mention the means of preventing them. To render the application of those means as extensive as possible, it will be proper to mention, under the first head, all those sources of summer and autumnal disease, which have been known to produce it in other countries, as well as in the United States. They are, 1. Exhalations from marshes.
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FACTS, INTENDED TO PROVE THE YELLOW FEVER NOT TO BE CONTAGIOUS.
FACTS, INTENDED TO PROVE THE YELLOW FEVER NOT TO BE CONTAGIOUS.
When fevers are communicated from one person to another, it is always in one of the following ways. 1. By secreted matters. 2. By excreted matters. The small-pox and measles are communicated in the former way; the jail, or, as it is sometimes called, the ship, or camp, and hospital fever, is communicated only by means of the excretions of the body. The perspiration, by acquiring a morbid and irritating quality more readily than any other excretion, in consequence of its stagnation and confinemen
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A DEFENCE OF BLOOD-LETTING AS A REMEDY FOR CERTAIN DISEASES.
A DEFENCE OF BLOOD-LETTING AS A REMEDY FOR CERTAIN DISEASES.
Blood-letting, as a remedy for fevers, and certain other diseases, having lately been the subject of much discussion, and many objections having been made to it, which appear to be founded in error and fear, I have considered that a defence of it, by removing those objections, might render it more generally useful, in every part of the United States. I shall begin this subject by remarking, that blood-letting is indicated, in fevers of great morbid excitement, 1. By the sudden suppression or dim
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AN INQUIRY INTO THE Comparative State of Medicine IN PHILADELPHIA, BETWEEN THE YEARS 1760 AND 1766, AND THE YEAR 1805.
AN INQUIRY INTO THE Comparative State of Medicine IN PHILADELPHIA, BETWEEN THE YEARS 1760 AND 1766, AND THE YEAR 1805.
In estimating the progress and utility of medicine, important advantages may be derived from taking a view of its ancient, and comparing it with its present state. To do this upon an extensive scale, would be difficult, and foreign to the design of this inquiry. I shall therefore limit it, to the history of the diseases and medical opinions which prevailed, and of the remedies which were in use, in the city of Philadelphia, between the years 1760 and 1766, and of the diseases, medical opinions,
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