A compendium of medical science, or Fifty years' experience in the art of healing ...

Front matter

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Dedication

Authors ask permission, or assume the liberty, to dedicate their publications to illustrious patrons, with the hope of deriving additional personal dignity, or of procuring for their works a greater number of readers. We frankly acknowledge the influence of both these emulations ; and in the spirit of becoming courtesy, dedicate the Compend of Medical Science to the Intelligent, the Humane, and the Benevolent, of all classes, in our vast community.

To the Intelligent first, because they will perceive the intention of the writer is, to introduce his readers to such an acquaintance with medical science, as will enable accurate observers, and close thinkers, to a very useful extent, to become, what great physicians, great statesmen, great jurists, great agriculturalists, or great merchants, always were, and must continue to be, self-taught.

They will perceive, that our work is intended to show to all candid readers, that the art of healing is not necessarily beclouded with inexplicable mystery. That the medical philosopher is not the enemy of his fellow citizens ; nor the intelligent practicer of his profession, a curse to the human family.

Chapter I

Treats of vitality, as it is apparently inherent in the animal fibre ; — as it is modified for special purposes, and manifest in the organs of sensation ; — and as it is related to a more general and transient sensorial influence, and made dependent on the circulation of the blood.

Of sensorial influence as associated with vitality in preserving the vital motions and functions of the system ; its accumulation under circumstances calculated to produce violent disease, and of its deficiency in diseases with prostration.

Of the same influence as it is associated with excitement and promptly obedient to stimulants and irritants ; of course as being especially concerned in the production of irritation and inflammation.

Of excitants as manifest in the actions and functions of the system, in the condition of health and disease.

Of stimulants and their agency in the production of excite-

CONTENTS.

ment, whether natural and healthful or excessive and morbid.

Of vital heat as an agent requiring special medical attention; and of artificial heat as affording a means for exerting a vast amount of control over incipient disease. 41

Chapter II

Details and explains the circumstances developed by an experiment which may be conveniently and satisfactorily made by any one, and shows how important it is, to have a due regard to temperature 52

Chapter III

Description and explanation of disease, when consequent on exposure to cold or inclement weather ; demonstrates what disease is, when it is thus suddenly induced in persons previously in good health and in healthful climates 55

Chapter IV

Explains idiopathic fever, or fever properly so called. The most important elements, for the establishment of which this work is intended, are brought into view as they exist and are exhibited in a case of acute inflammation of the lungs;. and the same are proved to be, equally the elements which are concerned in the production of a case of intermitent fever 58

CHAPTER v

Theories of fever — Cullen, Brown, Stokes, Baine, Clanny, Clutterbuck, Broussais and Smith, are briefly noticed : concluding with what the author considers to be an approximation to the true one 71

Chapter VI

Demonstrates the philosophical propriety and necessity of blood-letting, as the most efficient means of arresting fever in its forming state, and the most effectual and trustworthy remedy, if timely and judiciously employed, for the cure, when by oversight or neglect it shall have been established , .... ,..•.. 81

Chapter I

Defines the legitimate objects and powers of therapeutics, admits the universal concurrence of the recuperative power of nature, in effecting the retirement of disease ; whilst it exposes the absurdity and danger of committing to nature, unaided by art, the disorganizing tendencies of acute disease, or of expecting from her the correction of any organic mischief, the common result of disease when permitted to run its own course 159

Chapter II

Explains what is meant by a therapeutic indication : shews that a philosophic physician makes up his prescription, contemplating some definite effect, either in regard to the general system, or some particular organ — disparages nosological systems of nomenclature, by insisting on the absolute necessity of being guided by physiology and pathology in forming an intention to cure, and refusing to be embarrassed by the name of the disease . . 171

Chapter IV

In forming therapeutic intentions, scientific reference must be had to the anatomy and physiology of the organ affected by disease, and to the diagnostic symptoms, as settled and confirmed by pathology 177

CAAPTER V.

Considerations in respect to age, temperaments, &c 185

Concluding remarks, 500

Appendix

Hydropathy, or Water Cure 503

A Synoptical Table of Materia Medica, 509

Descent, Procidentia, Retroversion, and Prolapsus Uteri, . 520 y

Toxicology — Remedies in cases of poisoning, &c 533 \

Accidents- — Apparent death, suspendeded animation, &c. 563

Medical prescriptions, 578 \f

A patient receiving the bath, 582 v

Index, 587

Preface

The author having completed a medical work, the fundamental principles of which have been under review for the space of forty years, regards it as a duty which he owes to his friends and the public, to submit it to their consideration. He believes it to be the policy as well as the duty of the profession to popularize the science of medicine. The public mind needs to be fortified against the flood of domestic and foreign impositions, under the name of remedies, which are the result of mercenary ignorance, and pernicious to human health and life. With this conviction, it is his earnest desire, before he closes his labors and his life, to leave to posterity his testimony concerning health and disease, prevention and cure ; — -subjects to which his reflections have been devoted for more than half a century.

He flatters himself, that h«is junior brethren in the profession, will find interest and profit, in perusing the lessons which he has learned in the school of experience ; — lessons not taught by text books, nor often made intelligible, except at the bed side of the sick ; and he hopes, that so far as he shall gain access to the community, his work will have a tendency to correct many erroneous opinions, and prevent much injurious practice ; whilst it will serve to elevate in the public estimation, a profession, which, though it often

IS PREFACE.

fails to be appreciated and rewarded, by the ignorant and thoughtless, is, nevertheless, justly entitled to the homage and respect, the affection and confidence, of the intelligent and candid, to an extent beyond the claims of any other merely human vocation.

Feeling the high responsibilities of men of our profession, more than forty years ago, he entered upon a course of vigilant observation, determined, if possible, to detect any existing error which might obtain in the science of medicine, and to make some improvement, however small it might prove to be.

Two whole years were spent, without having acquired, any thing worthy of public notice. Not long afterwards,- however, he was called to attend a number of cases of fever, of unusual type, difficult to manage, attended with symptoms of atony of the superficial capillaries, such as called for spe-: cial attention to the external surface of the patient. During: this service, he found it necessary, in addition to the use o£ ordinary rubefacients, to employ the external application of artificial heat. In marking the effect of this practice, he formed a number of conjectural opinions, which afterwards were tested by additional experience, and corrected or established, as facts directed.

In the years 1806-7, a similar fever prevailed, to an extent never before known in that district of country. Great numbers of the sick were intrusted to his management, affording ample opportunity for repeating his observations. In the course of this labor, his inquiries assumed a more systematic form ; and from that period, to a considerable extent, he has been guided in his practice, by principles which he then began to understand, and which he now holds to be true.

For the space of forty years, he thinks he has paid more attention to the surfaces of his patients, than has been the custom of any other physician of whose practice he has had any knowledge ; and has been in habits of making more than ordinary use of artificial heat. The steam of boiling water at first, often served him a valuable purpose ; when the sick could sit erect to receive it. When his patient was much enfeebled, he found this to be impracticable. Besides, he had learned by repeated experiments made on his' own person, and by similar experiments and observations made on a great number of patients, that dry heat could be employed advantageously, at a degree of temperature which, if made by the steams of water, would inevitably scald the patient to death ; and that in cases where a lower degree of heat might suffice, if steam were used, it universally produced so much moisture of the bed clothes and linen, as in a great degree to counteract his intention.

So far as he is informed on the subject, he first ascertained that dry heat, made to impinge upon the naked skin, by placing the patient, uncovered, near a brisk fire, or by holding a shovel of burning coals as near to the place affected as it could be borne, if sufficiently repeated, is the most speedy and effectual agent for correcting erysipelatous or phlegmonous inflammation ; the mostim portant auxiliary in the treatment of an anthrax or an inflamed wound ; and a remedy most decisive in treating inflammatory fever. From time to time he had tried various devices for the production and application of heat -of high temperature, so as neither to scald the patient nor leave him wrapped in wet clothes. The various devices were more or less beneficial, according to the facility and extent of his approximation to the desired object. At length a perfect method of applying dry heat, became to him a very great desideratum. Afterwards he had the hap-

20 PBEFACE.

piness to hit upon the use of burning alcohol, and finally he invented an apparatus for conducting heat so generated, to the naked body of his patient

During the whole course of this pursuit, he had no other design than that of improving his own practice. But the facility with which he has since been able to manage every grade of fever with which he has met, in at least four different States of the Union r has been such, that he cannot reconcile it to his obligations to humanity, to withhold from the public the result of his observations. He has therefore prepared the following treatise, in which the principles and doctrines, the origin of which he has thus- briefly stated, will be found so associated and incorporated with some of the most important elements of the profession, and so elucidated by their practical application to a sufficient number of diseases, as to make his design intelligible.

By the employment of the apparatus, contrived as above stated, he soon learned that* heat so generated and applied r with very little, and sometimes with no other aid, is effectual for correcting predisposition to disease j that by the same method, recent disease, when actually formed, is cured in the same decisive way ,- that the treatment thus far requires no considerable part of skill r but the necessary decision ; no caution, but such as common sense will dictate ; and that in the hands of physicians it places within the reach of the healing art, many cases of disease which for ages have been a reproach to the profession. To extend the knowledge of these facts, he made application to the patent office of the United States, and obtained a patent.

As the first and most promising step for bringing it before the public, he determined to introduce it into the army of the United States, then at war with Great Britain,

Having the advantage of a personal acquaintance with the Hon. Thomas Gholson, a member of Congress, he forwarded to him a letter, signifying the beneficial effect it would have, in ithe treatment of disease as incident to the army.

Doctor James Tilton, physician and surgeon general of the armies of the United States, happened to lodge in the same house with Mr. Gholson, and was made acquainted with the author's views. In a few days the physician general obtained permission from the honorable secretary of war, and he was invited to the seat of government. On his arrival, he had the satisfaction to find that preparatory measures w t ere already in train for the accomplishment of his wishes. The final arrangement and result of the proceeding, will be seen in the sequel.

Washington City, April 7, 1814.

Dear Sir — Conformably to the orders of the secretary of , war, you will be pleased to accompany doctor Adam Hays f an hospital surgeon, to Norfolk, in Virginia, and communicate to him and the surgeons generally of that post, not only the principles of your newly invented bath, but the method of application ; taking care not only to show the cases in which it may be applied with advantage, with the manner, duration, &c, but especially to guard them against the misapplication, so as not to bring an useful remedy into discredit.

Agreeably to the secretary's order, your account for expenses, &c, may be presented at any time. «I am, dear sir, very respectfully,

Your most obedient servant.

Norfolk, May 5, 1814 This may certify, that in obedience to an order of the honorable secretary of war, and in conformity to the instructions of the physician and surgeon general of the United States. Dr. Sanrl K. Jennings has accompanied me at the post ' 6f Norfolk. Virginia, and satisfactorily demonstrated "to me the principles and mode of making the application of his newly invented method of curing disease in a summary way,. by means of his hot bath.

A. Hats. Hospital Surgeon,

Wilmington. (Delaware.) July 16, 1814.

Dear Sir — Agreeably to your request, I have no hesitation in giving you my sense of the utility of your newly invented hot bath, in the cure of diseases. I can only speak in general terms on a subject so novel; and, perhaps, the best method I can take for communicating my thoughts and reflections on the subject, is, by recounting the me^ures taken by the hospital department for the investigation of its usefulness.

By a special order from the secretary of war. I was directed to make the necessary arrangements for your admission to the hospital at Norfolk. By the same order, I was directed to send Dr. Hays, an hospital surgeon of great respectability, to assist and be witness at the experiments. The doctor reported favorably, and in that correct manner which gratified the secretary of war, as well as myself. He particularly recommends it in regimental practice, "frorn the opportunity it affords of meeting disease in its early stages. ; ' He recommends it in fevers, languid excitement of the surface, and diseases produced by suppressed perspiration. The doctor made experiments on about thirty cases, very much to his satisfaction, but has not exhausted the subject.

I have seen the bath applied in a few instances, and have had it applied to my own person. The ease and facility of the application, and the delightful sensations it affords, are greatly in favor of its general use. And when we consider the nervous and sensitive quality of the skin, and the importance of this emunctory, a flood of argument must arise, for the application of remedies to the surface of the body. In the promised edition of your explanations, &c. ? besidesthe theory and direction for correct application, permit me to request, that you will, by every possible precaution, guard us against the wrong application of so important a remedy. With great respect, I am, dear sir,

Your friend and humble servant,

Doctor S. K. Jennings.

Having performed this service, the author determined on a visit to Philadelphia and New York. With this intention he addressed a note to the President of the United States, and obtained the following letter in duplicate — the one copy addressed to Dr. Physic, the other to Dr. Samuel L. Mitchell :

Washington City, August, 1814.

Dear Sir — Dr. Jennings has a medical invention, in the value of which he feels so much confidence, that he is anxious to present it to the consideration of the most enlightened of the profession. Although a departure in some measure from an established rule, I cannot refuse a line which may promote an opportunity for the explanations by which he wishes his invention to be tested. His benevolent character is a further apology for the liberty I take.

Accept assurances of my great esteem and friendly respect.

James Madison.

Dr. Physic.

Doctor Physic was in ill health, and unable to attend to the practice. He favored the author with an interview, however, and spoke very favorably of his invention.

Dr. Mitchell, without having received his letter, and without solicitation, enclosed under cover to the physician general the following :

Neio York, March 27, 1815.

To Dr. Jennings :

I this day, excellent sir, wrote to the physician general of the United States, my opinion of your mode of applying heat

PREFACE.

to the external surface of the human body ; and on Portio's method of directing its action upon the stomach and internal parts.

I have caused several experiments to be made with the alcoholic vapor, on the patients of the New York hospital. I am inclined to believe it is an efficacious and valuable remedy. It is remarkably neat. Nothing can be more handy. And really it in some sort enables you to place your patient beyond the climates, where snow and frost exercise their chilling influence, to the regions where solar warmth is more uniform and elevated.

It is a most important part of your heated air, that it is free from all smoke, soot and ashes.

I have considered the spirituous decomposition chemically. I have examined the metallic apparatus mechanically. And I have witnessed the action of the rarified vapors re medially.

Considering a torpor of the skin to be a cause or accompaniment of many diseases, and that heat is the best of all excitants, I am well satisfied that your method of applying caloric to stimulate the cuticular surface, is happily calculated to give relief in such cases j and produce extensive advantages to the sick and disabled, in many other maladies.

Samuel L. Mitchell.*

About six months after the receipt of the above highly satisfactory letter, Dr. Mitchell again honored him with the following most definite testimony :

New York, 29th October, 1815.

Dr. Samuel K. Jennings :

Dear Sir— Since I wrote to you and General Tilton about the vapor bath, I have had many opportunities of trying its practical efficacy. I am more and more satisfied with the value of the remedy. It is so neat, so cheap, so handy, and so within the reach of every body, that it surpasses every thing with which I am acquainted, for applying caloric to the external surface of the human body. It is so capable of

* Dr. Mitchell was the very learned Senator of the City of New York.

conveying heat, so susceptible of a higher or lower temperature, and withall so well adapted to a longer or shorter continuance, that its power to be beneficial is considerably enlarged.

But above all, the caloric may be directed to a part of the body, or to the whole body, to a robust person or to one in the lowest debility, to an adult, or to an infant, with so much ease ancft>enefit, that I really consider it one of the most happy expedients that a practitioner can employ.

For chills, torpors, and that apathy and langour of the cuticular surface, so often the forerunner or companion of fevers, it is preferrable to any other mode of applying heat. The warm bath, warm fomentations, and the vapors of hot water are very inferior to it.

The patients in our hospital are exceedingly pleased with it, and for myself, I explain it, I order it, and I recommend it.

Accept the assurances of my high esteem and regard,

Samuel L. Mitchell.

Woodstock, (Vt.) February 20, 1816.

Dear Sir — I have not the pleasuse of a personal acquaintance with you, which might be agreeable ; but I have become acquainted with your writings and^ -improvements in the medical department, by the politeness of Mr. Strong, the former representative from this district. He sent me your apparatus for conveying the heat of burning alcohol to the bodies of the diseased, for which I feel very thankful to him and yourself. The very first reflection on the subject carried conviction to my mind of its utility, and I could but be astonished, that the use of it had never occurred to me before, considering I have been so intent on the subject of applying heat to the surface, for a series of years. I have made various trials of it, in different diseases, and find it a very valuable improvement.

At the time it was presented to me, I was engaged in writing on the epidemic diseases of this State, viz : in the summer and autumn of 1814. I have made favorable mention of your improvement in several places in the work, as a duty

I owed to society ; and my acknowledgements of gratitude I now tender you.

The work I have alluded to. was printed last summer, at Boston, containing four hundred and twenty octavo pages. It is entitled, u Sketches of Epidemic Diseases in the State of Vermont, from its first settlement to the year 181 5 : with a consideration of their causes, phenomena; and treatment : to which are added, remarks on pulmonary consumptiAs."" cVc.

I was astonished to discover from your writings, the similarity of object and result, from different trains of reflection and investigation, and in remote parts of the union. Perhaps I am going too far in saying very different modes of investigation, they seemed in many respects similar.

It would indeed, be very desirable to me. if your apparatus could be circulated in this quarter.

Dear sir. with wishes for your prosperity and happiness. I am with due respect.

Your ob't and very humble servant;

Joseph A. Gallup. K. D.

The following is from Dr. Thacher. a very eminent physician of Plymouth; Massachusetts; who is the author of a work, entitled the •" American New Dispensatory.'' as also of another, " Observations on Hydrophobia.'' both of which have done him honor. He was then engaged in the publication of a work entitled "American Domestic Medicine." which had much excited public expectation, and proved to be a very respectable production.

Plymouth. (Mass.) March. 17. 1S16.

Sir — Having been apprized that you have invented a method of communicating heat by means of a spirituous vapor bath. I take the liberty of addressing you on the subject, and the enclosed prospectus will explain my views. I am solicitous to make my intended publication a medium of every improvement and discovery relative to practical medicine: and if consistent with vour arransements. to favor me with a short sketch of the principles and utility of your method, within a few weeks, to be inserted in the appendix of my work ; it will be very gratefully received, as it may premote the views of us both, and at the same time prove highly advantageous to the public.

From report, I am of opinion that your invention is extremely well calculated for the purpose intended, and that it ought to be more generally known in this part of the country. I have not been fortunate enough to meet with either your publication or apparatus, and if any arrangement could be made for the purpose, it might be in my power to extend the employment of it in this vicinity.

I am, respectfully,

Your obedient servant,

James Thacher.

Dr. $. Jennings.

A sketch of the author's views was forwarded and published in the appendix of the American Domestic Medicine.

Three of his fellow citizens, very respectable physicians, unsolicited, favored him with the following letters :

Lynchburg, March 1, 1814.

Dear Sir — I take a pleasure in informing you, that for the last five or six weeks, I have applied your hot bath with evident good effect, on a great number of my patients — indeed I think it a most valuable acquisition to the .catalogue of medical agents. • The principles upon which it is used, only want to be known, to bring it into esteem and general use. Out of the many cases to which I applied it, for brevity's sake, 1 will select the following :

1. A case of hepatic state of fever.* — This was a lady, who, before I was called on, had been treated in the usual way, by her attending physicians — bleeding, cathartics, a blister on the part affected, antimonial mixtures, &c. had been tried. I found her with cold extremities and surface ; fixed pain about the region of the liver, attended with cough,

* Dr. Cabell was a pupil of Dr. Rush.

PREFACE.

general debility, and a feeble pulse. By the use of your bath, and a few small doses of calomel, with pectoral febrifuges, she was soon restored to perfect health.

2. A case of inflammation of the stomach and bowels. — It was a desperate one. This too was a female case, whom I found on visiting her, with cold extremities and surface, violent pain about, the region of the stomach and upper bowels, with langour, faintness, and scarcely a perceiveable pulse in the radial artery. In this situation she continued nearly two days, notwithstanding cordials, opiates and cathartics, were administered, and a large blister was drawn upon the region of the stomach, and two upon the extremities. No passage could be procured, or general excitement raised on the surface. I applied your bath, and continued its application till a general diaphoresis was produced, and kept up for some hours, soon after which a passage was effected by ordinary means. I then used it periodically, so as to keep up the excitement on the surface till the patient was relieved. I confidently believe this woman would have died, had it not been for the aid of your bath.

Yours, respectfully,

John I. Cabell, M. D.

Ly?ichbnrg, April 3, 1814.

Dear Sir — Having used your bath with decisive advantage to several patients, I cannot but regret that any one should so far mistake" your object as to suppose that you consider it a specific. Having for four years past received frequent communications from you, explanatory of your experiments and observations upon the surface, and of the probable benefits to be derived from a more perfect method of applying heat, I am in duty bound to offer you my little influence in opposition to such illiberal insinuation. I, know that your invention is the result of much philosophical inquiry, and promises great good to the community, as one powerful auxiliary in the cure of disease. And I know, moreover, that it may be so used, as, in many instances, pleasantly to supersede the use of other agents, which are loathsome in their administration, and, more or less, deleterious in their effects upon the system. Permit me to narrate the circumstances which attended a single case, which I treated upon your principles. It was an instance of a most painful dismenorrhagia, protracted to the length of five days, with frequent faintings,, and continued watchfulness. On the fith day she became perfectly delirious, with a pulse beating one hundred and twenty in the minute, and her extremities cold. At this stage I was called in. I immediately exhibited an anodyne, which was rejected. An attempt was then made to compose her stomach with cordials, intended to be preparatory to the trial of another opiate. The attempt proved abortive. By this time three hours had passed away in painful anxiety, every moment hoping to see the stomach prepared to receive such agents as appeared to be necessary. Under these circumstances, I most willingly availed myself of the genial heat of your bath j first applying it to her lower extremities j and so soon as her feet were well warmed, removing it* to her stomach, where its powers were concentrated, until a general but moderate diaphoresis was induced. Before the operation was ended, the delirium went off, and the patient dropped into a pleasant sleep, and rested composedly for the space of two hours.

An opiate was then exhibited, which was retained by the stomach. Medicines, such as are ordinarily used in these cases, were afterwards advised, and the bath was repeated the following evening. In ten minutes after the repetition of the bath, the patient broke out uncommonly thick with the measles.

I was informed that she had been exposed to the cold for twelve hours, about the time she expected to be in delicate health, and the immediate effect was such as I have described. Till convinced by the fact, her friends were fully of opinion that she had had the measles years ago. It is worthy of notice, that so completely was the surface abandoned by the excitement, so extensively was it locked up in the system, that she had none of the ordinary appearances which usher in the measles. Neither high fever, cough, nor sore throat attended her case. There was indeed, an alarming deficiency of animal heat — and 1 am confident, without the influence of artificial heat, to that extent, and with that decision which your bath only could have furnished, this patient would have died, and no one would have suspected the true nature of the disease by which her dissolution would have been effected.