Medical Sketches of the Expedition to Egypt, from India

by Sir James McGrigor

The prognosis likewise depended much on the degree of the affection of the sensorium; when the patient was from the beginning comatose, the case terminated fatally. Several of the cases in the beginning of the season, particularly the natives of India, could never be roused. The typhomania was a more fatal delirium than the inflammatory species.

In the treatment of this disease, a variety of modes were put in practice; but so little success attended them, that some were inclined to despair of success from any. Though, with it, even many were lost, yet oxygenation and particularly the use of mercury had the most success.

Though every thing was done by General Baird that the situation and circumstances allowed, yet the gentlemen in the pest-houses laboured under so many disadvantages, that, for the most part, there was but little to be expected from any mode of treatment. In particular, not a little difficulty, as well as danger, was met with in affecting the gums. Safety required that the pest-houses should be at some distance; perhaps, in general, the distance at which they were placed was too great. The patient suffered much by the conveyance, and frequently the treatment of the disease was entered on at too late a period to promise success. In December, January, February, and March, patients suffered so much from the extreme severity of the weather, that in some instances it was not easy to determine whether a patient died from cold or from the plague.

So much dejection prevailed among the natives of India, that, from the moment of the attack, they gave themselves up, and said they were sent to the pest-house to die. They never could be prevailed upon to swallow a morsel of food nor any medicine, and some actually starved themselves.

With establishments of a proper structure, and under proper regulations, we may safely venture to affirm, that our loss from the plague in Egypt would not have been half of what it was.

In the treatment of this disease, the first indication was, to clear the primæ viæ. Some gentlemen exhibited emetics; but in general there was no time for this. The general practice at last was, to begin by giving a purge of calomel, and the general remark was, that, if it operated briskly, the head was relieved and the skin became soft.

The second indication most generally agreed upon, was the inducing ptyalism and perspiration. As offering the fairest prospect of effecting both at once, Mr Price proposed using the warm nitric-acid bath, but unfortunately our stock of nitric-acid was insufficient to do this, otherwise than on a small scale. Mr Price got a little of the acid at El Hammed; but, from circumstances there, he could not always have the warm bath; however, he writes, “On three of my patients, whose gums I could not readily affect with mercury, I determined to try the nitric-acid bath: it has shewn wonderful effects, ptyalism has been produced in all the three; but the cold has regularly induced rigors and severe attacks of fever, and I shall loose my patients.”

Nitric acid was given internally; and, where the patients would drink it, it shewed good effects. Mr O’Farrel, at Aboukir, succeeded in making three dragoons take it much diluted as their common drink; and they did well all of them.

Mr Price thought well of citric acid. In some of the Arabs he effected cures by this, and by a bath of strong vinegar.