Category Archives: Medicine

Item of the Day: Rush on Bloodletting (1789)

Full Title:

Medical Inquiries and Observations.  To which is added an Appendix, containing Observations on the Duties of a Physician, and the Methods of improving Medicine.  By Benjamin Ruch, M. D. Professor of Chemistry in the University of Pennsylvania.  The Second Edition.  Philadelphia, printed.  London, reprinted for C. Dilly, in the Poultry, MDCCLXXXIX.

An Account of the Effects 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 been a witness of their utility in the above disorder; but it becomes such physicians, before they decide upon this subject, to remember, that many things are true in medicine, as well as 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, I have seldom found it fail after the application of blisters to the wrists.

But in those cases where blisters had been neglected, or applied without effect, and where the disease had been protracted into the wintermonths, I have generally cured it by means of one or two moderate bleedings. 

The pulse in those cases is generally full, and sometimes a little hard, and the blood when drawn for the most part appears sizy. 

The bark is seldom necessary to prevent the return of the disorder.  It is always ineffectual, where bloodletting is indicated.  I have known several instances where pounds of this medicine have been taken without effect, in which the loss of ten or twelve ounces of blood has immediately cured the disorder.

How shall we reconcile the practice of bleeding in intermittents, with our modern theories of fever?

May not the long continuance of an intermittent, by debilitating the system, produce such an irritability in the arteries, as to dispose them to the species of inflammatory diathesis which is founded on indirect debility?  Or,

May not such congestions be formed in the viscera, as to produce the same species of inflammatory diathesis which occurs in several other inflammatory diseases?

Doctor Cullen has taught us, in his account of chronic hepatitis, that there may be topical affection and inflammatory diathesis, without much pain or fever; and had I not witnessed several cases of this kind, I should have been forced to have believed it possible, not only in this disorder, but in many others, from the facts which were communicated to me by Doctor Michaelis in his visit to Philadelphia in the year 1783.

I once intended to have added to this account of the efficacy of blisters and bleeding in curing obstinate intermittents, testimonies from a number of medical gentlemen, of the success with which they have used them; but these vouchers have become so numerous, that they would swell this essay far beyond the limits I wish to prescribe to it.   

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Filed under 1780's, Medicine, Posted by Matthew Williams, United States

Item of the Day: Parkinson’s Medical Admonitions (1803)

Full Title:

Medical Admonitions to Families, Respecting the Preservation of Health, and the Treatment of the Sick.  Also, a Table of Symptoms, Serving to Point out the Degree of Danger, and, to Distinguish one Disease from Another.  With Observations on the Improper Indulgence of Children, &c.  By James Parkinson, M.D.  Hoxton.  First American, from the Fourth English Edition.  Portsmouth, New-Hampshire: Printed for Charles Peirce, by N. S. & W. Peirce.  1803.

Gout.

The paroxysms of this tormenting disease are most commonly preceded, by a general uneasiness; the feet and legs are afflicted with numbness and coldness, and frequently also with the sense of prickling; the veins on the surface are also said to become unusually turgid, and the muscles of the leg to be affected with the cramp.  But the circumstances which have been observed, most particularly to precede the attacks of this disease, are the changes which, for some little time before, take place in the stomach; this organ generally suffers a considerable derangement of its functions; the appetite being much impaired, and the stomach and bowels distended with wind, the consequence of digestion not being properly carried on; the appetite becoming, however more eager before the attack. 

According to the observations of the attentive Sydenham, the paroxysm generally begins about two o’clock in the morning.  The patient, having gone to bed free from pain, is waked about the time with pain possessing commonly some part of the foot.  Soon after this, comes on a coldness and shivering, which terminates in fever.  The pain increasing, sometimes resembles that which might by expected to be produced by the stretching and tearing of the ligaments, or the gnawing of a dog; at others, the parts seem to suffer the effects of a tight stricture, or considerable pressure, being so feelingly alive, as not only, not to bear the weight of bed-clothes, but not even the heavy tread of any one across the room.  In this miserable state the patient continues, tossing about the bed, in vain trying the effect of variety of posture to lessen his sufferings.  At about the same hour of the following morning, the patient, in general, experiences a sudden mitigation of the pain, which he commonly attributes to the last position in which the limb was placed.  Soon after this, a moderate sweat coming on, he falls asleep, and, upon waking, finds that the pain is considerably diminished; but that the part which suffers is affected with a red shining swelling.  The pain sometimes continues two or three days, increasing at night, and becoming more mild towards morning. 

If, after the disease has thus completed its course in one foot, it disappears entirely, the patient regains use of the foot, and experiences a most grateful change–strength and alacrity having taken the places of debility and languor.  But it often happens, that after the violence of the first attack has subsided, a second will be experienced in the other foot.  In more inveterate cases, both feet, sometimes, are affected at the same time; an repeated paroxysms sometimes extend the sufferings of the patient for six weeks or two months, or even longer.     

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Filed under 1800's, Health, Medicine, Posted by Matthew Williams

Item of the Day: Observations on the Construction of Hospitals (1793)

Full Title: Observations on the construction of Hospitals, by Mr. Le Roy, Member of the Royal Academy of Sciences — (Extracted from an Essay on the Subject, which, with several elegant plans, was transmitted by the author to the Society, but could not be inserted entire, as it contained many remarks of a local nature, respecting Paris —only.

 Found In: Transactions of the American Philosophical Society, held at Philadelphia, for promoting Useful Knowledge. Vol. III> Philadelphia: Printed and sold by Robert Aitken & Son, No. 22, Market Street, M.DCC.XCIII. [1793]

 [pp. 348-350]

THE construction of Hospitals is in general objectionable, either because many of the wards do not admit of perfect ventilation, or because the air passes from one patient over another, by which means contagious diseases are often spread.

To avoid these inconveniences, a large Hospital should consist of distinct and separate buildings, each forming one ward, erected upon arches or columns, at a considerable height from the ground, and ranged at a distance from each other, like the tents of an encampment.

The cieling [sic] or roof of each ward should be formed into a number of spherical arches according to  its size, the crown of each arch being in the middle of the breadth of the ward, and opening into a funnel like a common chimney, which should be supplied with a vane, (resembling that we call a cow) so that it may always open to leeward.

In each floor, midway as to breadth, should be a row of holes at suitable distances from each other, to admit air from below, so constructed that the quantitiy of it may be regulated at pleasure.

In consequence of this structure there must be a constant change of air, for that which is in the lower part of the ward, being warmed by the patients and nurses, and the necessary fires, will ascend, and in consequence of the spherical construction of the roof, will be directed to the openings in it, and flow through them, while the holes in the floor will afford a constant supply of fresh air, which will move rapidly as it enters the from so low.

A number of arches with openings is preferable to a single arch in the center, because the air is passing from the extremeities of the room to the center flows, from one patient over another–and a plan or flat cieling [sic], even with apertures, is improper, because the upper air at a distance from the apertures cannot move to them.

The rooms may be warmed by placing grates or stoves over these holes in the floor, and no bad effect can be produced by t he fire as the air and vapours will ascend from it and go off by the holes in the cieling — If it be necessary to quicken the circulation of air, either on account of the sluggishness of the atmosphere, or of the contagious nature of any diseases in the ward, small fires may be fixed ingrates or stoves near the openings in the cieling, to increase the motion of the air.

To prevent the spreading of contagion, as well as to keep the sick from beholding the sufferings of each other, a screenof suitable height should be placed between each bed.

For contagious disorders and surgical cases, there should be a number of wards, at a distance from the Hospital, and to leeward of it with respect to prevailing winds. . . .

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Filed under 1790's, Culture, Early Republic, Health, Medicine, Posted by Caroline Fuchs

Item of the Day: General Observations on the Philosophy of Medicine (1809)

Full Title: General Observations on the Philosophy of Medicine; with some Anticipations of its Future State, Arising Out of a Comparison of its Progress with that of the Sciences in General. By Joseph William Gullifer, Esq. Edinburgh: Printed by James Ballantyne and Co. for the Author, 1809.

SECTION FIRST.

WHEN the Statesman sits down to study the profound views of the science of legislation, and the Physician to investigate the various results arising from the complicated structure of the human body, the object which both propose to themselves, at the commencement of their labours, bears a manifest relation to the same end. viz. the bettering the condition of the human species. The errors for the practical Statesman, however, and the policy by which he is governed, are soon discovered, and soon pointed out, by the discerning eye of an enlightened public; but the Physician is able to veil his errors, and conceal the imperfections of his art, under the specious appearance of knowledge. This concealment of ignorance, on the part of the Physician, could not long pass unregarded, if there were any convincing test whereby to judge either of the depth or of the soundness of those principles whereupon he proceeds.

 

SECTION SECOND.

That we are very far from the knowledge of first principles in medicine, has been often allowed; and that no department of science can be expected to go on in any state of progressive improvement, until some data, some elements, are furnished to conduct the inquirer, is likewise a fact that cannot be denied. It is from the want of some materials of this kind, that the medical student finds himself so much at a loss; –he studies, and he may still continue to do so; collecting ideas ad infinitum, without reaping any real or solid advantage; –he cannot even indulge the fond hope, or the alluring prospect, of benefiting posterity by his labours; –he discovers, amdist the immense mass of materials presented to his view, such a multiplicity of heterogeneous opinions, as bewilder the attention, and distract the memory, and which he can refer to no general head whatever; –he finds himself entangled in the mazes of an unintellibible phraseology, that claims no title to use, much less to distinction, but that which the venerable sanction of time always secures to monuments of antiquity.

SECTION THREE.

Various as the divisions of mental inquiry are found to be, and difficult as it is to pursue them with precision, from the vagueness of language itself, yet in no circle of knowledge is this inconvenience more sensibly felt than in medicine. How various are the terms which Physicians daily employ, without annexing any correct or distinct idea to them? I feel persuaded, from the prodigious improvement that chemistry has lately undergone, partly owing to the philosophical nomenclature introduced by the French, and partly to the scientific arrangement observed in classing the differnt parts of its’ system, that, if a path somewhat similar to this, that is, a plan conducted upon principles nearly allied to it, were once opened, and steadily pursued, we should then gain a very important desideratum to guide the studes of medical men. When speaking upon the soruces of minunderstanding and fallacy arising from the abmiguity of language, it ought not to be forgotten, as the Abbe de Condillac has well remarked, that we think only through the medium of words; and that the first step towards the attainment of a philosophical system, is the acquirement of an accurate language for the ideas we express. It is not, however, the language of medicine itself that is so exceptionalbe–the doctrinal parts of it are no less so. Whilst the doctrines of Sympathy, of Spasm, of Irritability, follow each other with such a rapid succession at one time, and are found to approach and to receed from each other like the oscillations of a pendulum at another, what prospective advantages can the science of medicine be expected to hold out? That which is so fluctuating, so eccentric in its orbit, so totally void of any solid foundation for its support, which is made to appear as the standard of perfection to-day, and becomes obsolete on the morrow, may please for a while the speculative theoretician, but can never prove useful to the patient inquirer after the sublime operations of nature.

 

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Filed under 1800's, Culture, Medicine, Natural Science, Philosophy, Posted by Caroline Fuchs

Item of the Day: Chesterfield to his Son (1774)

Full title: Letters Written by the Late Right Honourable Philip Dormer Stanhope, Earl of Chesterfield, to His Son, Philip Stanhope, Esq; Late Envoy Extraordinary at the Court of Dresden. Together with Several Other Pieces on Various subjects. Published by Mrs. Eugenia Stanhope, From the Originals Now in Her Possession. In Two Volumes. Vol. II. Dublin: Printed by G. Faulkner, in Parliament-street, M.DCC.LXXIV.

TO HIS SON.

LETTER LI.

London, February the 14th, O.S. 1752

My Dear Friend,

In a month’s time, I believe, I shall have the pleasure of sending you, and you will have the pleasure of reading, a work of Lord Bolingbroke, in two volumes octavo, upon the use of History; in several letters to Lord Hyde, then Lord Cornbury. It is now put into the press. It is hard to determine, whether this work will instruct or please most: the most material historical facts, from the great aera of the treaty of Munster, are touched upon, accompanied by the most solid reflections, and adorned by all that elegancy of style, which was peculiar to himself, and in which, if Cicero equals, he certainly does not exceed him; but every other writer falls short of him. I would advise you almost to get this book by heart. I think you have a turn to history; you love it, and have a memory to retain it; this book will teach you the proper use of it. Some people load their memories, indiscriminately, with historical facts, as others do their stomachs with food; and bring out the one, and bring up the other, entirely crude and undigested. You will find, in Lord Bolingbroke’s book, an infallible specific against that epidemical complaint*.

I remember a gentleman, who had read history in this thoughtless and undistinguishing manner, and who, having travelled, had gone through the Valteline. He told me that it was a miserable poor country, and therefore it was, surely, a great error in Cardinal Richelieu, to make such a rout, and put France to so much expence about it. Had my friend read history as he ought to have done, he would have known, that the great object of that Minister was to reduce the power of the house of Austria; and, in order to do that, to cut off, as much as he could, the communication between several parts of their then extensive dominions; which reflections would have justified the Cardinal to him, in the affairs of the Valteline. But it was easier to him to remember the facts, than to combine and reflect.

On observation, I hope, you will make in reading history; for it is an obvious and a true one. It is, that more people have made great fortunes in courts, by their exterior accomplishments, than by their interior qualifications. Their engaging address, the politeness of their manners, their air, their turn, hath almost always paved the way for their superior abilities, if they have such, to exert themselves. They have been Favourites, before they have been Ministers. In courts, an universal gentleness and douceur dans les maniéres is most absolutely necessary: an offended fool, or slighted valet de chambre, may, very possibly, do you more hurt at court, then ten men of merit can do you good. Fools, and low people, are always jealous of their dignity; and never forget nor forgive when they reckon a slight. On the other hand, they take civility, and a little attention, as a favor; remember, and acknowledge it: this, in my mind, is buying them cheap; and therefore they are worth buying. The Prince himself, who is rarely the shining genius of his court, esteems you only by hearsay, but likes you by his senses; that is from your air, your politeness, and your manner of addressing him; of which alone he is a judge. There is a court garment, as well as a wedding garment, without which you will not be received. That garment is the volto sciolto; an imposing air, an elegant politeness, easy and engaging manners, universal attention, an insinuating gentleness, and all those je ne sçais quoi that compose the Graces.

I am this moment disagreeably interrupted by a letter; not from you, as I expected, but from a friend of yours at Paris, who informs me, that you have a fever, which confines you at home. Since you have a fever, I am glad you have prudence enough, with it, to stay at home, and take care of yourself; a little more prudence might probably have prevented it. Your blood is young, and consequently hot; and you naturally make a great deal, by your good stomach, and good digestion; you should therefore, necessarily, attenuate and cool it, from time to time, by gentle purges, or by a very low diet, for two or three days together, if you would avoid fevers. Lord Bacon, who was a very great physician, in both senses of the word, hath this aphorism in his Essay upon Health, Nihil magis as sanitatem tribuit quam crebrae et domesticae purgationes. By domesticae, he means those simple uncompounding purgatives, which everybody can administer to themselves; such as senna-tea, stewed prunes and senna, chewing a little rhubarb, or dissolving an ounce and a half of manna in fair water, with the juice of half a lemon to make it palatable. Such gentle and unconfining evacuations would certainly prevent those feverish attacks, to which every body at your age is subject.

By the way, I do desire, and insist, that whenever, from any indisposition, you are not able to write to me upon the fixed days, that Christian shall; and give me a true account how you are. I do not expect from him the Ciceronian epistolary style; but I will content myself with the Swiss simplicity and truth.

I hope you extend your acquaintance at Paris, and frequent variety of companies; the only way of knowing the world: every set of company differs in some particulars from another, and a man of business must, in the course of his life, have to do with all sorts. It is a very great advantage to know the languages of the several countries one travels in; and different companies may, in some degree, be considered as different countries: each hath its distinctive language, customs, and manners: know them all, and you will wonder at none. Adieu, child. Take care of your health; there are no pleasures without it.

*We cannot but observe with pleasure, that at this time Lord Bolingbroke’s Philosophical works had not appeared; which accounts for Lord Chesterfield’s recommending to his son, in this as well as in some foregoing passages, the study of Lord Bolingbroke’s writings.

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Filed under 1770's, Family, History, Letters, Manners, Medicine, Posted by Matthew Williams

Item of the Day: The Works of John Fothergill (1784)

Full Title: The Works of John Fothergill, M.D.  . . . with some Account of his Life by John Coakley Lettsom. London: Printed for Charles Dilly, in the Puultry, M.DCC.LXXXIV. [1784] 

 

OF THE MANAGEMENT PROPER

AT THE

CESSATION OF THE MENSES

 

To the Medical Society in London.

Gentlemen,

THERE is a period in the life of Females to which, for the most part, they are taught to look with some degree of anxiety; as a period on which depends their enjoying a good or bad state of health during the residue of their lives.

The various and absurd opinions relative to the ceasing of the mentrual discharge, and its consequences, propagated through successive ages, have tended to embitter the hours of many a sensible women. Nor have these mistaken notions been confined to them only; they have occupied the minds of such who ought to have been better informed: some practitioners, in other respects able and judicious, if they have not favoured these erroneous and terrifying notions, seem not to have endeavoured to correct them, with the diligence and humanity which an object like this requires.

The design of this essay is to contribute my mite towards so necessary a purpose; to assist in removing these groundless apprehensions, and to substitute a reasonable confidence, that, with very little aid, Nature is sufficient to provide for her own security on this occasion.

You must forget for a moment that I am submitting these remarks to the judgment of a Society, every member of which, perhaps, is as capable of this work, and some much better than myself. I am writing to many sensible young men in the profession of physic, who, though they may have applied themselves to the general study and practice of our profession with diligence and success, may not yet, perhaps, know where to look for such information on this subject as may be sufficient to satisfy themselves and their patients, what managment is proper when the Menses are about to cease.

To propose a regimen that shall suit all the different cases that may occur, would require a volume. To give some general direction is all I intend, without entering into a minute description of the commencement, progress, and termination of the Menses. I must suppose every thing of this kind is already known, and that the single question is, What conduct, what management is necessary to be observed, when the Menses are about to cease, by the patient who consults her physician on the occasion? We are now sensible that the menstrual discharge is not, what it was too long and too generally believed be by many of the sex, an evacuation of peccant matter and morbid humour, sometimes acrimonious and malignant, whose retention, from its noxious qualities, never fails to be extremely injurious to the constitution. What opinion the ancients entertained concerning it, I need not repeat to you: that its malignancy was such as to affect even inanimate bodies. But these fables are wholly disbelieved, except by some of those who ought to be undeceived in a matter that so much concerns them.

It is now well known, and the sex cannot be too generally apprized of it, that the menstrual discharge possesses no such injurious or malignant properties; that it is solely a redundancy of that pure vital blood, which animates the whole frame of a healthy person; and that its retention is by no means attended, in general, with effects that are not as easily removed as any disorder to which they are subject.

That some acrimonious morbid humours may be discharged together with the Menses, when any such exist, is not improbable. So it happens likewise to men subject to piles, or other preternatural excretions.

Women who have unhappily imbibed that prejedice, are naturally alarmed at the consequences they apprehend must ensue from such a change in their constitution; and the more strongly they are preposessed with a belief, that by this channel has been regularly discharged whatever had a tendency to produce diseases, the more they are terrified with apprehensions of some of the worst complaints: and, indeed, it is not seldom that, by such anxiety, they bring on disorders that are not easily removed, attributing them to the cause we are speaking of, whilst they principally originate from anxiety.

 For the most part, the menstrual discharge, as has been mentioned, proceeds from a redundancy of good and healthy blood; this redundancy is formed for the most necessary purposes; continues whilst this necessity subsists; and ceases when, according to the constitution of the female frame, it is no longer required.

The powers communicated to the human system, generally expressed by the term Nature, are such as spontaneously bring about this cessation. The provision for the Mesnes ceases, and extra quantity of blood is not generated, and the vessels provided for its regular discharge by degrees collapse; and in general all this proceeds without any the least interruption to the health of the subject in which this alteration happens. Here it might not be improper to mention at what time this alteration first begins, and the general period of its cessation. These circumstances, however, may be found elsewhere so amply treated of, as to render it as unnecessary as it is foreign to my present design.

There are great numbers of women in whom the menstrual discharge ceases, without their perceiving any alteration in their usual health. There are some who, from being invalids during a part of the season which is appropriated to menstruation, find themselves by degrees recovering health and vigour, to which they have been strangers during that period, when this discharge leaves them entirely. Very tender, delicate, relaxed habits, subject to copious discharges, are often much benefited by the cessation. All, however, are not so fortunate. Some alterations frequently supervene, that render assistance necessary. . . .

 

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Filed under 1780's, Health, Medicine, Posted by Caroline Fuchs, Women

Item of the Day: Hutchin’s Almanack (1773)

Full Title: Hutchin’s Improved Almanack and Ephemeris of the Motions of the Sun and Moon; the Ture Places and Aspects of the Planets; The Rising and Setting of the Sun; and the Rising, Setting, and Southing of the Moon, for the Year of our Lord, 1773: Being the first after Bissextile or Leap Year. Containing also, The Lunations, Conjuctions, Eclipses, Judgment of the Weather, Rising and Setting of the Planets, Length of Days and Nights, Courts, Roads, &c. Together with Useful Tables, chronological Observations, and entertaining Remarks. By John Nathan Hutchins. New-York: Printed and sold by Hugh Gaine, at the Bible and Crown, in Havover-Square, where may be had the New-York Pocket Almanack.

Precaution to preserve SIGHT; and a Remedy for Weakness in the Sight. By Dr. Hill.

FIRST, never sit in absolute Gloom, or in a Blaze of Light, much less go suddenly from one into the other: A House situated North and South, is therfore wrong for any who are tender in Sight. Secondly, To avoid small Print in Reading, and all Attention to minute Objects. It is in vain to think of assisting the sight by Glasses; they represent Objects plainer, but commit a Kind of Violence upon the Eye, and always hurt weak ones. Thirdly, Never read in the Dusk: and when the Eyes are at all disordered, not by Candle Light. Fourthly, Never look into a bright Fire. Fifthly, Avoid all glaring Objects, especially in the Morning at first waking; therfore a Bed-chamber should never be so situated, as for the Sun to shine into it at that Time; and there should be no Red, nor too much White in it; and the Degree of Light should be moderate. Those who have weak Eyes, will find great Advantage in green Furniture in their Rooms, and in admitting the Light gradually to their Eyes at the Time of waking: And it is thus Nature provides for all her Creatures; the Day Light comes by very slow Degrees, and the first Object is univeral Green.

For a Weakness in the Sight, take two Ounces of Leaves of Rosemary, and put them into a Pint of Brandy; let it stand three Days, then strain and filter it through Paper; mix a Tea Spooful with Four of Plantain Water; make it warm, and wash the Inside of the Eye every Night going to Bed, moving your Eye till some get between the Eye and the Lid. By Degrees put less and less Water, till at length a Tea Spoonful of each is mixed.

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Filed under 1770's, Almanac, Medicine, Posted by Caroline Fuchs