Finding a disagreeable smell to arise from vinegar sprinkled upon the floor, after it had emitted all its acid vapour, I directed the floors of sick rooms to be sprinkled only with water. I found the vapour which arose from it to be grateful to my patients. A citizen of Philadelphia, whose whole family recovered from the fever, thought he perceived evident advantages from tubs of fresh water being kept constantly in the sick rooms.
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 from a horizontal posture. All these remedies were laid aside upon the return of a paroxysm of fever.
I did not prescribe bark in a single case of this disease. An infusion of the quassia root was substituted in its room, in several instances, with advantage.
Blisters were applied as usual, but, from the insensibility of the skin, they were less effectual than applications of mustard to the arms and legs. It is a circumstance worthy of notice, that while the stomach, bowels, and even the large blood-vessels are sometimes in a highly excited state, and overcharged, as it were, with life, the whole surface of the body is in a state of the greatest torpor. To attempt to excite it by internal remedies is like adding fuel to a chimney already on fire. The excitement of the blood-vessels, and the circulation of the blood, can only be equalized by the application of stimulants to the skin. These, to be effectual, should be of the most powerful kind. Caustics might probably be used in such cases with advantage. I am led to this opinion by a fact communicated to me by Dr. Stewart. A lighted candle, which had been left on the bed of a woman whom he was attending in the apparent last stage of the yellow fever, fell upon her breast. She was too insensible to feel, or too weak to remove it. Before her nurse came into her room, it had made a deep and extensive impression upon her flesh. From that time she revived, and in the course of a few days recovered. As a tonic remedy in this fever, Dr. Jackson has spoken to me in high terms of the good effects of riding in a carriage. Patients, he informed me, who were moved with difficulty, after riding a few miles were able to sit up, and, when they returned from their excursions, were frequently able to walk to their beds.
Much has been said, of late years, in favour of the application of warm olive oil to the body in the plague, and a wish has been expressed, by some people, that its efficacy might be tried in the yellow fever. Upon examining the account of this remedy, as published by Mr. Baldwin, three things suggest themselves to our notice. 1. That the oil is effectual only in the forming state of the disease; 2. That the friction which is used with it contributes to excite the torpid vessels of the skin; and 3. That it acts chiefly by depleting from the pores of the body. From the unity of the remedy of depletion, it is probable purging or bleeding might be substituted to the expensive parade of the sweat induced by the warm oil, and the smoke of odoriferous vegetables. But I must not conceal here, that there are facts which favour an idea, that oil produces a sedative action upon the blood-vessels, through the medium of the skin. Bontius says it is used in this manner in the East-Indies, for the cure of malignant fevers, after the previous use of bleeding and purging. It seems to have been a remedy well known among the Jews; hence we find the apostle James advises its being applied to the body, in addition to the prayers of the elders of the church[5]. It is thus in other cases, the blessings of Heaven are conveyed to men through the use of natural means.
During the existence of the premonitory symptoms, and before patients were confined to their rooms, a gentle purge, or the loss of a few ounces of blood, in many hundred instances, prevented the formation of the fever. I did not meet with a single exception to this remark.
Fevers are the affliction chiefly of poor people. To prevent or to cure them, remedies must be cheap, and capable of being applied with but little attendance. From the affinity established by the Creator between evil and its antidotes, in other parts of his works, I am disposed to believe no remedy will ever be effectual in any general disease, that is not cheap, and that cannot easily be made universal.