North Carolina Newspapers

VOLUME IV. NEWBERN, N. C. SATURDAY, SEPTEMBER 22, 1821. NUMBER 183. -i ryTD AND PUBLISHED WEEKLY, BY PASTEUR $ WATSON, J 3 per annum half in advance. FROM THE RICH3IOND ENQUIRER TYPHUS FEVER. ' 7b M? Efror of the Enquirer. , Gentlemen Through the medium of your paper I will offer some remarks on the nature and character of a fever n lt . ol.l.r fPQtcn is iiu" r . . . i . , . - i - rvrpvai iiiv rAciui'-M r II f in thf? . Uenbur, Nottaway and Brunswick in Va and Warren, North-Carolina. This fever appears to be travelling from west to east, and some few years .back scour- counties oi J .I.r. nortn OTPSl OI IUC rtiniu,V trJ i i and KiJto 1813 it occasionally maae us in tin counties of Mecklen- ar and Brunswick, in the form of Ty prwii Pneumonia. oor. nrdin 1814. it will be for re- q:uc ,tc- f - n 'JVZra i - . w .n.A 1 nJre man uu -v - - .mmffs more than usually cold a change has perceptibly taken ! plice in both these respects, our summers i,,rnmP warmer and our diseases more violent and more malignant, and yellow fever Ins shown itself in various parts of t'ie United States. In the month of Jan i:irv 1818, a disease made its appearance ia "the county of uMecklenburg on the borders of lloanoke in the first instance, & from thence extended over that countyand the neighbouring ones. Its attack was usheredin by a chill, a severe fever en sued, attendended with a peculiar pun cent, rather than intense'heat of the skin, pain of the head and side frequently in tensely severe, difficulty in Dreaming, 1 .AM.!mrta Vi -rl f r-rn nonf I full soft and eaiily yielding to pressure: occasionally a sick stomach, bowels slow, I urine high colored, most commonly an expectoration of a bilious blood gela tinous matter; as the season advanced snd the weather became warmer, the pins of the head and side were less fre quently present, the general symptons of inflammation were less apparent, the fever wa less intense, and about midsummer many attacked complained only of a chill, slight fever, pains of the head and occa sionally sick stomach with bilious vomi tings and diarrhoeas. After a few par oxysms the fever would entirely subside a coldness of the hands and feet would come on with cold clammy sweats, and the pulse would scarcely be felt; at oth i times the patient feeling perfectly well would be suddenly attacked, sometimes in the field at labour and sometimes in the house, and fill as if shot, arid lie in a stupid state with cold feet and hands and profuse cold sweat and weak thread-like pulse, but perfectly clear and open in its beats. At other times again a decree of 1 liquor and lassitude would precede the attack for a few days, a dull heavy feel ing of the head would be present, the blood vessels of the , eyes would appear red and inflamed and' the eye would be dull and heavy, frequently watery, and a general yellow tinge observable about the fire, neck and whites of the" eyes, with occasional sense ot fulness of the stom ach, flatulence, disturbed sleep, slight ten sion of the pulse, but often full, soft and yielding the tongue mostly covered with a thick yellow mucus and fur, urine about natural in appearance, the trunk of the bouy warm the extremities cold. These symptoms after continuing a few davs uould often in a few hours successively grow worse, the coldness of the general surface would rapidly increase with very profuse cold perspiration, and entire pros tration of strength and a carelessness as to events follow; subsultus, stupor and profound coma would come on and the tongue would become black, sometimes rH chopped and dry, and teeth covered ill dark sordes and the patient lie with ttery appearance of immediate dissolu tion being at hand. The pulse, in every "Stance where to be felt, was clear and ,re in its beats but soft and feeble irreg and much accelerated. In one case ct this kind the stupor was periodical, and absent there was an unusual bril- -fc-cy of ideas and of the eye, and when tr?sent, the pupil dilated so as to ob trjct vision entirely, and occupy the of the cornea ; in another instance Wt3-re there was but little fever from the c3!mncement, a green matter was drawn ,rra the breasts instead of milk by the e of the glasses, the lady giving suck at time. There are few diseases on i!jh the faculty have split more than !t3 present, strange1 as it may appear. nartv rrmsidprinir it an inflam. Gll0ry bilious remittent j the other as Cumberland moaniainniuacw;v death foiowfed. In another instan naci ,rrr r ,u,.Mr;erai sympioms oi putresence ca i i,. vii on r anrjenauuiJ w , ;32uc -uti - . - . . me I M KilllAMO r ruin 1I1C 1 a bilioustyphus or typhus leterodes. i neir practice has been maae-10 corres- pond with their ideas of the nature of the disease, and it has been fatal in the sec- tion of the country where it has prevailed most beyond example, and particularly in the county of Lunenburg. 1 hat it owes its origin to those causes which are pro ductive of intermittent and remittent fe vers there can be no doubt: favored in all probability by some peculiar and in explicable state of the atmosphere, and '. think on a careful, diligent and impartial view of its symptoms and terminations there can be as litttle of its typhoia and t r puma coaracier. in one instance i saw n : ,l- a patient in which the disease terminated m the abscess of the parotid glands, this was imprudently opened, gangrene ensu ed, followed by purple spots over the whole body; the flesh sioughed off the are and ce gen- me on, nteguments over the os sacrum j sloughed off leaving the rectum for seve ral days exposed to view, the ball of the right eye swelled, projected beyond the lid, bursted and sunk before death look r-' U4II1C VII iJ IX lIXI llri ULI3 tu-r was extracted from a lady's breast smaH m s- . . aDDarent ood nea'th and yet with the utmost difficulty gangrene was prevented irom in another case a young man laboring under femoral aneurism, in otherwise ap- paient perfect health, had the aneurismal sack bursted, the blood was effused be tween the muscles, intepuments, &c. in less than 48 hours there were appearan ces of gangrene, purple sppts were seen and the leg became black cold and in sensmie ; in a iew days amputation was resorted to, when purple spots, vellices, &c. immediately attacked the other leg, which continuing spread until half of the foot sloughed off, when the whole frame shewed the most convincing: proofs of general putresency and the stump began to discharge a bloody saines and death ensuea. in very many instances ot ca ses which have terminated fatally, evident symptoms of mortification have piece ded, and in a few hours after the death the face and breast were perfectly black and large quantities of blood were discharged from the mouth and nose, and often death accompanied with a swelling of the corpse almost to bursting, with a very offensive smell. That the bilious remittent should assume this type under an inexplicable siate oi me atmosphere, is not at all re markable. It is a fact well known a . mongsi an onservant medical men, tnat a disease rarely makes its appearance a like at different seasons, or yields exactly to the same mode of treatment at all times. It is also a well known fact that there is generally some one reigning dis ease to which all others in some degree assimilate themselves. It is also a well established fact that during the prevalence of putrid diseases wounds heal unkindly and are in an unusual degree fatal, &Jsuch has on former occasions been the strong tendency to putrid diseases that bark and wine have be? ii found essential to the cure of erysipelas. Even the com mon pleurisy, perhaps the most genuinely inflammatory , of all diseases, will neither require nor safely bear every year the same free use: of the lancet. With these facts before me and a close attentive ob servation of several hundred cases within J the last three years, I can with unhesita ting confidence pronounce the fever now ravaging the counties aforesaid, in 18 out of every 20 cases, a genuine typhoia re mittent feverv The inexperienced phy sician as well as the one who is afraid to part from his book, and think for him self, and who labouring under the influ ence of prejudice and former habits of practice still persists in the free use of the lancet, must and will of necessity con tir.ue to lose- a large proportion of his pa tients. A few having a hot skin and tol- j erable strength of pulse bled in a few days after the attack may survive it; but it is subjecting them to an unnecessary and improper hazard of their lives. Those who are so unfortunate as to have a vein opened in one of the cold cases, or who falls suddenly and is bled freely from a belief that there is depression of the pulse and congestion of the brain or other im portant organ, must calculate on deaths ensuing in 15 out of every 20 cases, and I believe 19 out of 20 ; for I have never known but two violent attacks from the commencement where the lancet was free ly used but terminated fatally, and those were preserved by the use of siimulants to an extent never before used in any coun try. I have known many instances even in cases most favorable for the use of the lancet (judging from the pulse) in which its use was succeeded by the most alar ming fainting) and tedious convalescence, and in two instances where the patient became senseless and speechless in two ..... " J l T, i r. t hoars; and died so in less than forty,- eigni ; ana a mira ia wmcn ne tainted away for several hours when but a small quantity of blood was drawn, and died in three to four days afterwards. I have seen many, very many of those cases in j which the inexperienced practitioner would have incautiously used the lancet, reduced to such a state of debility by the operation of a single emetic or catharic as to require support under it; and wiat would have been their situation had fie tawvci. uccu picmiscu ; xci me as aiyiune paiieni. in inese cases Detween the impartial candid physician to examue the egesta from the operation of empties and cathartics,! and say af ter thrs cxami nation what probability there is of effec ting good by the use of the lancet J Ev ery reasonable man must know that the vital principle cannot be sustained in a body so completely filled with corrupt and vitiated bile ; every drop of blood that is lost renders the system less; able to bear the operation of emetics or cathar tics essential for the expulsion of this bile. That if the secretion of this inordinate quantity of bile is dependent on inflam mation: at all of the liver, it is not an in flammation of the ordinary kind ; else it would take in every case of hepatitis i That it is dependent on causes different from inflamatioh I take for granted be- cause as far as my observation extends jt is neither subdued nor lessened by those means which subdue hepatitis, either in its acute or chronic stage. Also I am futher satisfied from the' belief that if the fever was in such violent inflammation as to be the cause of such an immense secre - tion of life, as I have seen discharged by one patient ounng one niness, inai ei-; unaer n, ano in some iew cases sucnis ine ther death would speedily take place in j extreme debility and prostration present, those not profusely bled or the most ob- j that the judicious practitouer will defer stinate hepatic -obstructions would take altogether the administration of the emetic place in such a vast majority of cases as I or cathartic for a while, and use freely to leave no doubt of the character of the j bark and wine toddy with sinapisms, till disease. I attended a gentleman in this ' watching a favorable opportunity, he will disease in 1819 who for 8 days in! sue- j procure the discharge of the bile. In cession took in the forenoon a dose of these extreme cold eases St cannbt be to tart. ant. and in the. afternoon one of ja- j strongly impressed on the practitioner, lap and calomel, both of which did their ( that for the salvation of his patient he duty, and yet in the intervals between j must neither weigh out his bark in drachms them he would spit out the bile as easily nor measure his spirits, by half pints; and plentifully as -ambier while chewing if he does, his patient is infallibly lost. -tobacco; he was supported under their In one of these violent cases, no man operation with strong mint toddy, and id ; can take enough by the mouth to preserve the intervals with bark and toddy: he his life : the stomach partaking of the gen recovered and is now living. I en ti,!iility of the system ejects what is Again, in inflammatory diseases, 1 be- lieve theie is not much loss of sensibility or susceptibility to impressions, and par ticularly from medicines, and every gen tleman conversant with the prevailing fe ver, will admit that if frequently requires 8 and 10 times the usual quantities of med icines, to produce their ordinary effects, I have myself given as high as seventy five grains tart. lant. before it would puke, and in the summer 1819, 30and 40raias was quite a common dose, and cathartics in similar proportions : in one case, I gave 9 drachms- of calomel in eight days with a proportionable quantity of ialap. oil and salts, and it never produced any sensioie euect eitner emetic cathartic or sialagogue, and the patient recovered by the plentiful use of bark, toddy and cam phor. The cases that occured of pleuri tic character in January 18,18, were the first 16 treated in the usual way for pleu risies, the nrst o or terminated fataily. As the pain was very severe, and the skin hot, it was conjectured, blood was too Paingly taken in the commencement and accordingly, tne alter ases were blooded more freely ; they also termi- nated fatally. This did not occur in ray own practice, but within the sphere of rry observation ; but I too bled some with a little want of success. Finding that success did not attend the coursepur sued, and that as the disease progressed, subsultus and occasionally bilious stools took place, I altered the practice, and when I found a patient with a hard strong nulse I took awav a little blood, then blistered the pain and gave an emetic followed by a dose of jalap and calomel. whichproduced large discharges of yel low, green and dark bile; the cathartic was repeated according to indication, and wine-whey and camphor julep completed the cure ; the same treatment with eraet ics and cathartics, &c. was followed wken bleeding was not premised, all pain of the chest being previously removed iby, blistering ; as an expectorant Barton's brown mixture, leaving out the opiite, ,was used ; the recoveries were almost universal and rapid. When I was called in to the fever about mid-summer, and found the smallest tension in the pulse, I gave to a male adult 10 grains calomel, 30 of jallap and i2 tart. ant. . This gener ally brought on a severe discharge both upward and downward of yellow, green,, and dark bile, sometimes looking like tarjj sometimes indigo mud, sometimes chop ped ispinage, and sometimes spring moss in immense quantities ; that from the stoj mach frequently looking like blueing an indigo water, but mostly yellow and fre- quently green. If the strength was suf ficient, 1 repeated the calomel! with oil. ; or salts, sometimes I preferred1 repeating me emeuc, u tne aiscnarge from the sto mach was large and very vitiated, aiid in this way I continued the emetics ana ca thartics as long as the pulse and strength would justify, and it is inconceivable what quantities of bile a single patient ! would discharge. I verily believe I have j seen from 10 to 12 gallons discharged ; by emetics and cathartics if there is a fever, 1 prescribe wine whey every 20 minutes, with five grains camphor, repeated every hour till perspiration "co ines on, and the fever sabsides, when the cure is comple ted by the aid of bark, Colombo and wine or toddy and ' camphor. In those cases where there is a coldness of the exterrr.i ties from the commencement! or where tie patient falls suddenly from I being ! in apparent health, great care and caution are requisite in the administration of ei ther emetics or cathartics; for by the se vere operation of either, be vital stream is like the water of a mill pond with the flood gates open, it is ready to rush out of the body, and nothing but the most prompt, vigorous and decided measures can arrest it. Here is a field for the ex ercise of skill , and sound discretion. The physician is aware of the quantity of bile pent up in the stomach and bowels of his patient, he knows it should be dis charged, and , to effect it safely fhe must 1 either work off the emetic or cathartic by 1 large drafts of strong toddy after each evacuation or his patient irrevocably sinks J taken, a profound stupor ensues, univer sal coldness and sweat come "on with sub sultus, and life is held only by the tenure of skill in the physician. Strong mint toddy with bark and camphor must now be taken every half hour, the head is to be covered with a blister, and sinapisms applied to the extremities and breast and -changed every hour;, one! to two ounces bark, tvhh one to two gills of good rum or French brandy, and 60 to 80 drops laudanum thrown up by way of injection every 2, 3 or 4 hours, as the urgency 'of the symptoms of coldness and sweat may indicate, and continued till there is sore ness and fullness complained of iii the ab domen, after which the extremities begin to grow warm and the coma to cease. Injections are now to be administered to procure 2 or 3 stGols, when bark injec tions are again to be used at such inter vals as may be necessary to keep ofjj the cold sweat. In this way ! have frequent ly used from 10 to 12 ounces bark in 24 hours with the happiest efiectjj in the desperate cases 30 grams camphor and 20 grains vol. alkali were thrown iup with each injection. In another 2 table spoon fulls of bark, two of rum and two of a mixture of equal parts spts. harts, sulph. eth. and tinct. camphor were thrown up every hour for 30 hours, with the very best effects. Thus patient was attacked suddehlyj and when 'I first saw him was to all appearance expiring. An icy cold ness with profuse sweat was on him, his pulse imperceptible, his eyes sunk and his countenance haggard. in the extreme, with cramp of the arms and legs. In one hour he took 6 drachms paregoric, 80 drops laudanum, 150 dropsspiiits harts, 1 ounce sulph. eth. 90 grains camphor and a pint of rum. His extremities were covered with sinapisms, also the trunk of the body, and the mustard not drawing readily, cloths rung out of boiling water were applied to him, and the mustard af ter them, and by the use of barU injec tions as above, in four days he was out of danger.. It will appear incredible to any nerson who has never been mucn con versant with the formidable disease, how much bark and spirit are absolutely ne cessary to preserve life in many j instan ces. With many it is in disrepute, first, because the quantity is unusual ; 2d, be cause the practice is unusual ; 3d, because all do not recover under H ; 4th, because the proper remedies frequently fall from novJDeing given m auuivtuu iuauiitics , thbecanse they are lrequei)Uy given before sufficient evacuation, are - premised, and Oth, because their indhcr&iinauj use is not suited to every case of the fever, f know one gentleman now living, who for 2 or 3 weeks drank two bottles port .wine and a quart of rum' every 24 hours, and took from 6 to 8 ounces of bark per 24 hours during the time ; and it is not unusual for a man to require from 1 to 2 quarts rum per day in addition to the bark injection, to keep up the pulse, and indeed this must be done without re gard to quantity intoxication is almost' impossible. An extensive practice In the fever. for the last three' years, in which time I have witnessed the result of seve ral hundred cases, induces uie to speak with confidence of a line of practice unu sual, except with a few, but daily, becom ing more general from the success atten ding it. Should its publicity be the means (and I know it will if followed) of pre serving the lives of my fellow-citizens, I shall be gratified and content. t One patient drank 7 gallons spiritp in 8 days was fairly convalescent on it, but being reduced by a purge and put to a -quart in the absence of this physician, he died from its insufficiency to support him. ! - MEDICUS. August 27, 1821. ; FOREIGN. OS& DAY LATER FROM LONDON. , ; Boston, Sept. 8. By the General Green, Halifax pa pers to 29th tilt, have been received from our- correspondent. They mention the arrival at Halifax of the Sandwich pack et from Falmouth, with London dates to the 17th July, being one day later than was received by the Tuscarora at Phila delphia. The final preparations for the Coronation were; making,' which was to .take place on Thursday, J9th July. LONDON, JULY 17. THE QUEEN. Tiae report that the Queen has taken a house in Great George-street seems not to be true. -We were willing fo credit it, because, that street being within all the barriers, sht might proceed from it, on the morning of the Coronation, to make whatsoever claim of t admission she plea ?es, without I hazzarding the public tran quility. All that is alleged to be requir ed of her feelings all tjhat might be held too humble in a voluntary absence from a ceremony, of which the Privy Council has declared that she had no right to form a part whatsoever might be rep resented as disadvantageous in so deco rous a submission. All this might be prevented;, all her claims might be fully made and formally recorded, with ease to herself and others. k No alteration of the Queen's intention has yet been announced. A former col umn contains some statements upon this subject. Yesterday, as if the ample Re ports, iven by the newspapers of Mr. Brougham's argument on her claim to be crowned were not sufficient, what is cal led " an official publication", of it was made, to. which the following precise 'no- lice was affixed. . , " Her Majesty has been pleased to command that the grounds of her clafms to be crowned, as stated by Her Majes ty's Attorney-General before the Lords of the Privy Council, should be made public. ' ! (Signed) "HOOD.", " Queen's-house, July 10, 1821." Paris papers of the 13th contain but little intelligence of any interest. The journals of opposite politics have, skir mished a little upon the character and fame of Bonaparte. But we find nothing worty extracting. The cancer contro versy is also I noticed, and the following medical opinion given upon its charac ter, from the' Dictionary of Medical Sci ences " Climate has no influence on can- cer its two usual causes are, deep and . protracted sorrow and excess of drinking " spirituous liquors." A mail ha arrived from Hamburg with papers to the 6th inst. A t eport is said to haveprevailed at Vienna, that Rus sian troops had entered Moldavia upon the ground of the Tuiks having violated the existing treaties, by occupying Wali- chia without the consent of the Russian government. Pajs papers of' the 14th inst. reached us this day. The King continues to take nis airings near ji- x and Toulon great activity is stated to. prevail. Scarcely do any vessels of the royal navy arrive, without being speedily equipped for new expeditions. The Cleopatra frigate has sailed for India and China ; the uaccnanie gainot is to join . ' the Normande, which is on her voyage for Madagascar, Vice Admiral Halgin : has been appointed to the command of the squadron in the Levant. - 'I