The theory and treatment of fevers

Front matter

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Dedication

To the people of the United States, more particularly that portion of them, with whom I have had a personal acquaintance, and from whom I have always received a cordial welcome and generous support; and also to all that portion of the medical profession, who can so far divest themselves of the prejudice of education as to give to the following pages an unbiassed and impartial perusal, is this work inscribed by its author.

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Peet ale xi 2 i am ery 4 he i ow yingonha. 18 )

Preface

AT the present era of the world, in proportion as mental illumination is advancing in the different portions o1 the earth, just so is the opinion becoming prevalent, that that individual who renders the greatest service to the human family is entitled to the highest honours.

History informs us that warriors, statesmen, and philosophers have ever been justly regarded as competitors for the highest distinctions, and the greatest honours.

And although the summit heights of usefulness cannot — be reached by all, still this consideration should not discourage the rest of mankind from doing whatever may be in their power to ameliorate the sufferings, and better the condition of the human race.

It has been our lot to toil in that department of human investigation, which has for its especial object the prevention and the cure of all those ills that necessarily arise out of the frailties and imperfections. inherent in the physical organization of man.

Now he who advances the just knowledge of his physical nature, and a knowledge of the modifying powers of any of the physical agents that act on his varied sensibilities and impressibilities, we consider as achieving an important step in the science of human happiness.

The author of this work has not the vanity to believe, nor does he wish it to be understood, that he considers himself as having claims above all others upon the great mass of mankind for anything that he has done, or that he may do. Yet he cannot resist the impression that

XV1 i PREFACE.

the treatise which he now presents to the public will be found, upon a fair trial, to contain the most certain, speedy, and effectual plan, for the cure of fevers, that has hitherto been offered to the public.

As this treatise is designed more for the benefit of the public than the profession, the author has studiously endeavoured to avoid technicalities, and to present it in the most simple and plain language that he could possibly employ, so that every reader may clearly and fully understand and comprehend his views on every subject that he may treat.

This work will be found to differ from the theories and practice of the present time, and indeed from all that have preceded it, upon the nature and treatment of fevers.

For whilst almost every physician is of opinion that the different forms of fever are dissimilar in their nature from the beginning, and that notwithstanding this dissimilarity in them, that they all have a more or less inflammatory tendency, the author of this work believes them to depend upon a uniform law of nature, which establishes a unity of disease, in accordance with the unity of vitality, and that they have their origin and progress in debility.

While the larger number of physicians consider depletion, either by bleeding, puking, or purging, or by the use of nauseating medicines, and sometimes by all of these means combined, as indispensably necessary for the cure of fevers, the author has limited their use very much, disapproves of their use entirely in the last stages, and relies almost exclusively on tonics and their auxiliaries to effect the same desirable object.

PREFACE. XVil

He also believes that all pukes and purgatives are irritants and not stimulants, and that fever proper is a disease of irritation, and that it never runs up into active inflammation. He likewise believes that the Peruvian bark or quinine is a tonic, and not a stimulant, as is generally supposed.

Although he was himself trained to the theory and practice of medicine as commonly taught in the schools in the days of his pupilage, and in part imbibed them, yet the result of his observation and experience, in an extensive practice for nearly fifty years, has fully satisfied him of the great superiority of this practice, over that of either the depletory or the stimulant.

For while this plan of treatment effects a speedy and more certain cure without prostration, the two systems -hat are based upon opposite extremes often prolong disease and suffering. Or if a cure be effected at all, it is done in despite of such treatment, and not unfrequently so impairing the constitution, that the unfortunate being remains an invalid throughout the balance of his life.

The author is well aware of the responsibility he has assumed in daring to offer to the public a work of this kind, differing as it does from all published opinions on the theory and treatment of fevers. He is also aware of the unkind feelings it will probably excite among the medical profession towards him. .

While he continued to ride and to practise medicine he was often accused of empiricism, because he dared to differ from a theory and practice that has been impressed on their minds, and the minds of the community as orthodox; and when, too, in justification of his prac-

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XViii PREFACE, tice, he in the main supported the same physiological doctrines that they themselves did, and now do, as will appear in the body of this work.

_ He thinks he might say, without doing them injustice, or without having any unkind feelings for them as men, that there are very many of them, who, (no matter what a man’s acquirements or success in practice might be) if he dared to differ from them, or from their favourite leaders in the schools, would either treat him with cold, silent contempt, or attempt slily to defame his character.

This seems to be the effect of deep-rooted feelings, probably based on natural organization, and, I suppose, being regarded as the result of fixed prime causes and the circumstances of education, ought therefore to be excused.

But the author, knowing the success of his practice from his own experience and observation, contrasted with that of any other, fully justifies himself in the opinion, that he hazards nothing as a man, or as a physician, in asserting that it is the safest, most speedy, and successful practice extant for the cure of fevers.

This opinion is further confirmed by the unexampled success attending the administration of his Anti-Fever Pills throughout a large portion of the United States, both North and South, for the last eight or ten years. He, therefore, considers himself called upon to present both his theory and practice to the public in the manner that he has adopted, in. order to afford them a full and fair opportunity of testing it for themselves, and by their decision is he willing to stand or fall.

Contents

PAGE

PP PRTACELS Bath hes cc oi ST awa R OO ees sce 8S Chapter I—The author’s reasons why he has departed from the practice of the old school physicians, and all others, in the treatment and cure of NC ie oa alin Hand cdaw ea sees dei de dae 21 Chapter II.—A short outline of the animal economy, 29 Chapter II].—The author’s views and opinions in relation to the inconsistency and irrationality of attempting to cure fevers principally by depletion, 51 Chapter [V.—The author’s practice and treatment in the-cure! of fovereys si ee CSREES eee as 76 Chapter V.—The author’s views on the subject of the NET OU OVERS o's, 0.0 51602 's,5. 05.0.8 « Gam « isis «/<% 85

Chapter VI.—Of intermittent, or ague and fever,... 92 Chapter VII.—Of common bilious, or bilious-remit-

CHAPTER FIRST. THE opinion has been long since entertained, and by

some eminent medical philosophers expressed, that a theory founded upon nature, a theory “that should bind together the scattered facts of medical knowledge, and converge into one point of view the laws of organic life, would thus on many accounts contribute to the interest of society. It would capacitate men of moderate abilities to practise the art of healing with real advantage to the public; it would enable every one of literary acquirements to distinguish the genuine disciples of medicine from those of boastful effrontery or of wily address; and would teach mankind in some important situations the knowledge of themselves.” —DaRrwin’s ZOONOMIA. |

As I have long since departed from the theory and practice in which I was principally taught, and am now engaged in writing against them, it may be proper that I should give my reasons to the public for so doing.

I commenced the study of medicine about the time that Cullin and Rush, at the head of their respective schools, were lecturing and promulgating to the world th ‘views on blood-letting and other modes of depletion, the n adopte d by the followers of the depletive or anti- phlogistiaameoriés. I was instructed i in those doctrines, and after having prac- | tised with my preceptor for about five years, who was a scientific and experienced practitioner, and who was in- |

22 | THEORY AND TREATMENT iy? clined to the Brunonian and Darwinian doctrines, using tonics and stimulants earlier and more generally than was common, [| entered on the duties of my profession on my own responsibility, and was at least as successful as those | around me. .

But not being satisfied ial the result of my own practice, and less so with that of others, which was chiefly that of bleeding and acting on the stomach and bowels with emetics and cathartics, as long as we thought the patients could bear them; then treating the case principally with what we called cooling anti-phlogistic medicines, and which indeed was of little or no use, until the patients died, or recovered by the mere sanative operations of the constitution. After having practised medicine several years, and having undergone a considerable change in my views and opinions relative to the nature and character of some diseases and some remedies, I attended a course of medical lectures in the University at Philadelphia, where I became confirmed in the opinion that I was reasonably acquainted with the different theories and practices of the day, but which only served to confirm me of their error In very many particulars.

It is a serious evil in society and much to be regretted, that the ruling or dominant party in medicine, like that of bigots in religion, are always willing to wage an exterminating warfare against any theory or practice that is new, or that differs from their views of propriety, without investigating the principles upon which it is based, or knowing the result of the practice in scarcely any way whatever.

Being aware of this fact, and believing that I had made a valuable discovery in medicine, or that I had more fully developed the properties of an article of the Materia __. Medica that had long been in use, but was still very im-

perfectly understood, I was unwilling that it should be lost

to society.

I therefore prepared and sent forth to the public large quantities of my Anti-Fever Pills, and at the same time _ concealing their composition that they might acquire a __ © reputation upon their own intrinsic worth. mT “é a i

. . e ap OF FEVERS. 23

Now that the virtue of these pills to the amount of at _ least one million of boxes has been tested by the people of ‘the United States, and of the Republic of Texas, and up to this date have maintained an improving reputation ; thereby sustaining the correctness of my theory, for the mystery is not more in the drug than in the use I have made of it; I presume that the public will begin to see how strangely and unjustly the medicinal properties of the Peruvian bark and its preparations have been perverted, and that instead of its being injurious when taken in the hot stage of fevers, as has been frequently said of it, it is - hot only entirely safe and beneficial in that or any other ' stage, but it is the best febrifuge, tonic and antiseptic known.

The truth of my position is still further maintained by the facts, that since the distribution of my anti-fever pills (now ten years or more) announcing the facts that their virtues resided in their tonic properties, and further that they did not contain any arsenic, many apothecaries and physicians have endeavoured to imitate them, and have sai vended the same or some similar tonic remedies to be used in all stages of fever.

Now when I had established the fact that tonics might with safety and with efficacy be used in all fevers, it was not a difficult task for practitioners to select the particular 4 drug best calculated to meet the indications, hence all of “4 them no doubt have had more or less of quinine in their 4 nostrums. I ain led to these remarks from an apprehen- L sion that so’soon as these pages shall be presented to the | public eye, that the practitioners of medicine and) the venders of fever nostrums may not attempt to harass the a public mind by refusing to acknowledge the fact, that qui- _ nine or some other vegetable tonic constituted the basis of their specifics for fever.

Not long after I commenced: the practice of medicine, an old pamphlet fell into my hands giving an account of the accidental discovery of the medicinal properties of the Peruvian bark, which was to the best of my recollection as follows :

A sect of religious persons, known by the name of Jesuits, in their intercourse with the inhabitants of South America, in passing through the province of Peru, were necessitated to drink and to use for cooking the waters of certain ponds on their way. The water in some of these ponds was strongly impregnated with the properties of the bark of certain trees that grew in or around them.

Other ponds in their route which: had none of those trees in or about them, were in like manner resorted to for water.

Those persons who happened to fall sick at the latter ponds, either died or remained there until the tardy efforts of nature and a good constitution enabled them so far to recover of their illness as to continue their journey ; while but few of those persons who became sick of fevers at the former ponds, where the trees grew, and who were compelled to use for all purposes the water of these ponds, were rarely detained more than a few days before

_ they were cured, and enabled to pursue their journey.

This fact became so notorious, the cases of cure so numerous, that it caused much enquiry and investigation; when it was ascertained satisfactorily that these cures were effected by the water, in consequence of its being impregnated with the medicinal property of the bark of these trees. Hence the first knowledge that we have of the bark of these trees, is under the name of Jesuit’s, or Peruvian bark.

Many of these unfortunate people were stricken down, at various times, by fever; and in that hot climate it is reasonable to suppose that many were of the lowest grade and most malignant character.

It is said there was a time when the Peruvian bark (not the sulphate of quinine) sold for its own weight in gold, which is a proof of its once esteemed value.

Since my knowledge of medicine, the best quality of bark has sold in Philadelphia at from five to ten dollars per pound. But, for the last twenty-five or thirty years, it has varied from fifty cents to a dollar per pound. From

_ these facts we might infer that the use of it had been very

Wine Mtestricted in that short space of time, and that calomel, and other poisonous and prostrating medicines, had been substituted in its stead.

Although I read this account given of the bark in the pamphlet, with much interest and a good share of faith,— although I had myself experienced the good effects of it.

in the height of fevers,—yet it was some years before I could entirely rid myself of the prejudice which I had acquired against it.

Many times have I sat by the bedside of my patients for days together, giving it, anxiously waiting to see the effect it would have upon them ; at the same time amusing their minds, and the minds of their attendants, by giving some placebo that I knew to be harmless and useless. I found no increased heat in the skin, no increased thirst, no increased arterial action, nor any other aggravated symptom, that I could ascribe-to the bark.

On the-contrary, in a few hours, or a few days at most, the skin would become soft and moist; or perhaps a free and generous flow of perspiration ed ensue, the thirst abate, the fretful and irritated condition of the pulse would _ moderate, and the feverish heat and restless anxiety (always more or less attendant on fevers) subside, in much less time than by any other course of treatment [ had ever seen, and the patients recover their health more speedily, and with less prostration or debility.

I have taken the bark myself, (in good health—for mere experiment,) in ounce doses, which is equal to ten or twelve grains of quinine, and although it produced some dizziness or swimming in the head, there was no increased heat in the skin, or increased action in the pulse.

I presume that it acts more directly on the brain and the nervous system, but produces no such effects as an over-portion of intoxicating liquors, or the preparations of opium do, nor does languor or prostration follow as a natural consequence, as is the case with the use of stimulants proper.

We think it more than probable that the bark would never have lost the reputation it promised to obtain at the time of its first introduction, if we had then known, as we now do, how to separate its active medicinal properties from its cortical and inert matter. The irritating and supposed stimulating effects ascribed to it by the older practitioners, may, in our opinions, be more justly assignable to its bulk, and the presence of the cortical matter with which it was encumbered, than to its salt, in which modern chemistry has shown its virtues to reside.

Before the improved condition and highly concentrated preparation of the bark, in the form of quinine, was known, I was, on many occasions, much inconvenienced, and sometimes defeated in getting as much taken as I wished.

Partly owing to ae prejudices of the people, causing them to fear that it would increase their fevers, and partly to the fact that, in some instances, the stomach would not retain it, or that it would pass off on the bowels as a purgative,—in either event my object was more or less defeated,

The names of Pelletier and Caventou, who first separated the pure alkaline salt, called quina, from the bulky and inert mass in which nature had placed it, deserve to be remembered with gratitude by all mankind.

Since that fortunate era in medicine, I have been enabled to administer the bark at any stage, and in any quantities that | might think advisable, without fear of injury to my patients, or exciting any fear in their minds. ‘This discovery has not only afforded me heart-felt gratification,—for the reason that it enabled me to give more prompt and certain relief to the sick,—but it has been instrumental in giving to mea character and standing in my profession, well calculated to excite the envy of the physicians around me. But this I desired not; for I did not conceal from them, in our consultations, my views on either the theory or practice which gave me such superior success. It seemed that the most melancholy experience was not sufficient to convince them of their errors, and they still, from the mere force of education, considered my practice as empirical. |

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Far be it from us to censure any one for tenaciously adhering to the prejudices of education, however erroneous such prejudices may be; let the Jew be Jew still—let the Rushite be Rushite: for we deem it a wise provision in the economy of nature to have it thus. We only seek to apologize for the course that we, as individual laborers in the cause of humanity, have pursued.

Every philosophic mind must know that all innovations have to work their way to popular favor on their owa intrinsic merits. The discovery of truth is alike open to all men: it is the exclusive property of no one—it is a part of the eternal bounty of nature, and was, from the beginning, designed for all. ‘Then let all seek, and let no one be debarred the privilege of proclaiming whatever he may have found.

We are well aware of the necessity and the importance of well-endowed, well-regulated establishments, for the purposes of mental, moral and manual discipline, in every department of human thought, and of human action.

We know, also, that one of the marked characteristics, one of the marked advantages of civilization, consists in the division of labor. Such division tends, unquestionably, to the perfection of science, and to the perfection of skill in the manipulations of the arts. -

Hence, in the earlier periods of the world,—as we see from the records of Egyptian, of Babylonian, Grecian, Roman, and other historians,—resulted the establishment under state authorities; the laws of castes, of trades, of professions, and of privileged orders in society.

Now, such laws, such regulations, such usages, may have been rendered nécessary at those epochs of time, from the nature of the elements of humanity then under progress of development. But it is easy to trace in the downfall of those states the deleterious influence of castes, and of chartered privileges, and protection upon the various branches of human occupancy. In proportion as trades and professions are fostered by law, in the same proportion do their votaries become indolent, and the wholesome spirit of emulation dies away.

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The check thus given to the freedom of thought, causes the spirit, the true science of law, divinity, medicine and the arts, to dwindle, to lose its vitality, and the minds of men to become fixed, and, as it were, stereotyped into settled formularies.

We have been led into the preceding train of thought from the manifestations given by many of the states of this union, in their legislative enactments, chartering, either directly or indirectly, sectarian colleges calculated to foster partisan religionists.

Also laws entitled acts to regulate the practice of medicine; many of these contrary to the spirit of this government, and calculated to promote the interest of a particular class, to the detriment of others.

The effect of the one is to fetter, to stagnate the advancement of the study of the spiritual nature and the spiritual happiness of man; while that of the other retards the progressive knowledge of the laws of his physical nature, and the true mode of i improving his condition, his happiness, as based in his physical nature and influenced by physical causes,

What better evidence could be desired of the error and the selfishness of all these petitions and petitioners for protection, than the universal fact that they sprung from the professions, and not from the people whose welfare they hypocritically profess to guard and serve,

“Tis strange! ’tis passing strange!” at this enlightened day, at this half rational era of the world ; in this free, this new, this self-created republic; that the people, the true, the only legitimate sovereigns of the earth, should not know what they needed, what they wanted, what they desired, what was best for them, as well as the self-styled guardians of their bodies and their souls.

We do not wish to be understood as finding fault with, or objecting to, any thing that now is, or that has trans- _pired. O’er the past and the present man has no control. Whatever has been, has been; whatever is, is; and whether right or wrong, we cannot change it. Let us, then, gather lessons of wisdom frem a knowledge of the present and the past, by which to direct our own future destinies, over which alone an indulgent Providence has willed to man a modifying influence.

Chapter II. Containing A Brief Outline Of The Animal Economy

Tat the general reader may have some idea of the offices of some of the most important organs of the human system, and that members of the profession may conceive more readily of the manner in which I suppose diseases are.contracted, and the most natural and speedy way by which they may be cured, I deem it proper that I should give a short account of the. functions of those organs which are supposed to be mostly involved in fevers, as well as most other diseases.

It is the office of the stomach to receive all the ingesta, both solid and fluid, designed for the nourishment and growth of the whole body. It is by the very peculiar action of this organ and its secretions that the first process, an important part of digestion, is performed.

So soon as the stomach shall have performed its office on the varied aliments and drinks taken in, then the whole of the residual mass passes on to the first portion of the intestinal canal, called the duodenum, where the ingesta in its present state of preparation comes in contact with the peculiar fluids secreted by the liver and the pancreas, called bile, and pancreatic juice. ‘Through the agency of these secretions is the nutritious matter called chyle supposed to be elaborated from the food ; and now the lacteals and absorbents situated in this particular portion of the canal, stimulated by its presence, take it up to carry it into the general circulation for the nourishment and the support of the whole body.

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The digestion being thus principally performed by the stomach and duodenum, the food continues. its passage downwards through the remaining small and large intestines, to make its exit from the bowels by stool ; being no longer fit for the purposes of the economy ; however, affording more or less matter for the absorbents throughout its whole extent,

The lacteals and absorbents above- mentioned having carried the nutritious portion of that which was taken into the stomach, the chyle, into the receptacle of the chyle, where, assuming a white or milky appearance, it is carried through this duct to be emptied into the left subclavian vein, ‘at or near its junction with the internal jugular, and there mixing with the venous blood, is carried into the great descending vein called vena cava; from thence into the two cavities of the heart, (the right auricle and the right ventricle,) from which latter it is propelled into the pulmonary arteries, and carried by the various ramifications of the same through the lungs, in which it is. properly prepared by the action of the air for the subsequent uses of the system. Being thus assimilated, it is carried back by the pulmonary veins to the left auricle, from thence to the left ventricle, and from thence it is propelled into the great artery on the spine called aorta, and from thence is distributed through its numerous branches to

»every part of the body. Having passed through this routine of elaboration and circulation, and attained its highest state of vitality, it reaches its final destination in the capillary tissues, the fine net-work to be found in the parenchymee of all the glands, as well as all the-surfaces, both internal and external, called surfaces of relation, the most considerable of which is the external cutaneous surface.

Now the objects to be accomplished in the animal economy by the circulation of the blood (which has been justly called the vital fluid) are manifold: but for our present purposes it will only be necessary to dwell on two of them; the one is the deposition of atomic molecules,— in other words, nutrition,—the other is the performance of the offices of depuration, or the elimination of useless or i OF FEVERS. 3l redundant matter from the system. In this latter capacity the skin and its auxiliary, the lungs, by their respective processes of sensible and insensible perspiration, and halitus, or exhalations, have duties assigned them more extended, and equally important and imperious, as any of the functions of the whole animal economy. !

That portion of the blood not expended or eliminated in the capillaries, is returned to the heart and lungs for further preparation, or retained and preserved in the circulation for the future wants of the economy, and not returned to the stomach and bowels, where it was first received and where it was first elaborated.

It has been long since demonstrated by many physiologists, that there is more recrementitious matter cast off through the pores of the skin, and by its auxiliary, the lungs, (for these surfaces, in point of depuration, perform very analogous offices,) than by stool, by urine, and by all the other outlets of the human body united. ‘This fact should never be lost sight of, for on it rests an important step toward the knowledge and treatment of disease.

There are many persons, individuals who enjoy good health,—usually of good digestion, too,—the exhalations from whose bodies partake of the fcetor of the excrementitious matter of the bowels. ‘There are others, again, whose perspiration has a decided urinous odor. In such persons, perspiration is usually abundant; while their healthy habits are, to urinate but little, and to defecate but seldom.