Medical Sketches of the Expedition to Egypt, from India

by Sir James McGrigor

Our knowledge of this fact enables us to reconcile the different or opposite accounts given of the disease, and of its treatment by different writers.

In the Indian army, when the disease first broke out, the cases sent from the crowded hospitals of the 61st and 88th regiments, were from the commencement attended with the typhoid or low symptoms.

The cases sent from the Bengal volunteer battalion, and from the other corps, when the army was encamped near the marshy ground at El Hammed, were all of the intermittent or remittent type.

The cases which occurred, in the cold rainy months of December and January, had much of the inflammatory diathesis. Mr A. Whyte remarked, that every case admitted into the hospital, at Rahamania, had the symptoms of pneumonia.

In the end of the season, at Cairo, Ghiza, Boulac, and on crossing the isthmus of Suez, the disease wore the form of a mild continued fever.

The resemblance which some cases shewn and of others described to me bore to the West-Indian fever struck me very forcibly.

I know not that I can better describe the disease, than by a short statement of the cases of some of the medical gentlemen who had the disease; most of whom wrote me accurately every thing that they felt. Dr Whyte entered the pest-house at El Hammed on the evening of the 2d of January, 1802. In a letter of that date he writes to me, “I just now inoculated myself, by friction, with bubonic matter on the left thigh;” on the 3d, he says, “I have this morning inoculated myself by incision on the right fore-arm.” Mr Rice, then doing duty in the pest-house at El Hammed, gives the whole of the case. In a letter on the 3d of January, he writes to me, “Dr Whyte came here last night; soon after he came in, he rubbed some matter from the bubo of a woman on the inside of his thighs. The next morning, he inoculated himself in the wrist with a lancet, with matter taken from the running bubo of a Sepoy; he appears now very well.”

In subsequent letters, Mr Rice says, “that Dr Whyte continued in good health on the 5th, and all day on the 6th, till the evening, when he was attacked with rigors and other febrile symptoms. He said himself that it was the attack of an intermittent; and it bore a great resemblance to it. After sweating profusely, he was better in the morning of the 7th, but in the afternoon the shivering returned; and, after it had continued 30 minutes, a severe hot stage came on, then a profuse sweating followed, but with it much affection of the head, tremor of the limbs, particularly of the upper extremities, tongue black and dry, skin hot, pulse full, hard, and irregular, thirst great, prostration of strength, and anxiety. The head was the only place that he complained of, and it seemed to be the principal seat of his disease; he still persisted that the disease was not the plague; he would not allow his groin or arm-pits to be examined, and he refused all medical assistance.” He asked for a purgative, which Mr Rice gave him, and he requested to be bled, this Mr Rice thought the state of the symptoms would not justify him in doing. On the 8th, these symptoms continued, and there was some delirium; he begged to be removed from the pest-house at El Hammed, to the old pest-house at Rosetta, under the charge of Arabs. He was removed on the morning of the 9th, and died in the afternoon of that day very delirious.

2d, Mr Price did duty in the pest-house at Rosetta and at El Hammed from the beginning of November, 1801, and had a tertian which he never could completely remove. In the pest-house at El Hammed, he was in the evening of the 1st of January attacked with rigors and slight febrile symptoms; but he himself thought this was only an attack of his intermittent, he soon however felt an affection of his head, and tremor of his limbs, and knew his disease. On the morning of the 2d, three buboes appeared, two femoral and one axillary; he then became delirious, and had no recollection of any thing for several days. On the 5th, there was a remission of the fever. He was able, on the 7th, to write me, “that he had no fever, that one bubo was coming on, and that he was extremely debilitated.” On the 13th Mr Rice opened his bubo; but it was two months after this before he recovered.

I am sorry I cannot find a letter where the treatment of Mr Price is detailed; but I am pretty clear that it was by mercury, as this was his own practice at the time.