Sunday Dispatch

An Interesting Medical Paper.
Sore Throat, Remittent and Typhoid Fevers.
These diseases are to a considerable extent
prevailing, and with some fatality. Any remarks
about the treatment which tends to cure them
will be of service to the people.

Some time ago, a lecture was delivered at the
Medical College in 20th street, by Dr. Sherrill, on
the epidemic sore-throat distemper. It was published in the Christian Messenger. In the remarks made, it was assumed and shown that the
throat disease was purely of an inflammatory
nature; that the symptoms of Typhus, Gangrene, or what is called Diphtheria, are effects of
inflammation, and very likely may be avoided by
active and suitable means early used to check
such an inflammation. To effect this, all irritating stimulants and alcoholic mixtures are not
advisable and are injurious. A great many facts
and authorities are introduced to sustain this
thereby: it is stated that by the mode of treatment detailed in this essay, more than 200 cases,
in various states and stages, have been treated,
and that with two exceptions all recovered.

In illustration of this subject, it is stated that
a Typhus or gangrenous condition has been represented to have taken place in the throat disease, from which opinion stimulant and alcoholic
articles have been recommended and given. It
appears that a state of Typhus is preceded by
fever of an inflammatory nature, as it is in this
case, and also in Remittent fever which precedes
a Typhoid state when it takes place; and that in
the first stage it is of an inflammatory or congestive type. This is a very interesting position to
take; and, if it is correct, may or ought to have
an important influence on the treatment. It
may be a means of inducing prescribers to avoid
the free use of stimulants and alcohol, which are
frequently used. There are many authorities
named in favor of these statements. The address will further explain on this subject by an
extract:

"It is doubtful whether in this climate any
febrile disease, in its incipient stage, is of a Typhus condition, so as to be benefitted early by
stimulant or alcoholic articles. The state of
Typhus which takes place according to the
writer's observations, has been the sequence of
an inflammatory or congestive state of the body
not arrested in the early stage."

Typhus was considered to be preceded by, and
be the result of an inflammation of some of the
inner organs, by Clutterbuck, Armstrong, Broussais, Rush, Donaldson and Maygrier, and that at
first the treatment should be to relieve and cure
such a condition of the body. Remittent fevers
which prevail in Summer and Autumn, in the
first stage are of an inflammatory or congestive
state, and a depleting and refrigerant course of
treatment is always the most successful. This
will be a means of checking the progress of the
case and preventing a state of Typhus from
taking place, and the case may be cured in much
less time than those cases are generally cured.
A great many years of observation and practice
in treating and curing many hundred of such
cases justifies these statements.

The following sketches are taken from a collection of essays on epidemic diseases collected
by Dr. H. Sherrill.

In 1825 the Remittent and Typhus fever prevailed in many places along the Hudson River in
an epidemic form, and more than commonly
severe. Some sketches of a history of it was
read at the annual meeting of the Dutchess
County Society that fall. An abstract from it is
here made: "generally the cases exhibited inflammatory action, but in many instances there
was a small flaccid pulse, like that which often
took place in the epidemic of 1812. There was
dull or intense headache, dull appearance of the
eyes— a lurid face— a tired aching of the limbs
the tongue was contracted, pointed, and very
red, in some cases there was great prostration
and congestion when the disease was not checked early, a state of Typhus set in and this might
be tedious, obstinate or fatal.

The most suitable treatment was, in the early
stage, to use active means to remove congestion
and an inflammatory state—for this purpose free
blood-letting was the most useful remedy—all
the after symptoms were shaped or controlled by
the use or omission of this remedy—in those
cases where there was great depression or congestion, and the pulse was small and flaccid, as
it generally is in such a state of disease, the portion of blood taken at first was small, and the
operation repeated, as was practiced in the epidemic of 1812 and in that of 1793, as recommended and used by Dr. Rush—in such a condition the pulse always on bleeding raises and is more
full and firm—the blood was very black; the
medicine used was of a refrigerating, sudorific
nature. There was as many as 25 cases treated
in this way, (which was large for a sparse settled
country district,) the fever run out, and a crisis
formed by the ninth day; there was no stimulants given till after the crisis, and very little
then—nourishment was mostly relied upon to
restore the strength. Many of the cases assumed a typhus state, but it was soon controlled
—there was not one case fatal.

In many instances and in most places, from information received and reports made, attempts
were made to cure this disease by alexipharmic
remedies, such as mercury, opium, sudorific
cordial and alcoholic mixtures, and those were
freely used; in this way a long tedious illness
ensued, the case run on three, four, five or six
weeks, the patient got a black tongue and teeth,
stupor, delirium, nervous irritation, and a train
of those symptoms called Typhus—frequently
the case terminated in death.

It is a fair inference to make, that under similar treatment corresponding results would occur
at this time.

Cases similar to those detailed, it appears, at
this time may be cured or prove tedious and
fatal according to the mode of treatment, as the
following may show :

R. I., Dec. 20, 1861.
Took a cold, which increased so that on the
28th he took to bed with fever pain in the head,
nausea, soreness and aching of the limbs, rather
prostrated pressure of the chest. Jan. 2, 1862.
When I first saw him he was inclining to stupor
tongue contracted and red—bowels costive—
he appeared to have forming congestion of the
brain or lung—pulse compressible, a beginning
of the state called typhoid.

From the arm 16 ounces of blood was taken:
it was black, and deprived of a required quantity of vital air—it soon was as firm as liver—means
were used to open the bowels— he was put upon
the use of homeopathic medicine, these were
varied from time to time to operate on the symptoms presented. After the use of the first remedies, the pulse became more full and firm. This
was the case, by such means, in the epidemic of
1812. and in the epidemic cholera. He was given
as much cold water as he would take—he took
no nourishment, except gruel or the like—all
stimulant and alcoholic articles were excluded
the fever and disease gradually abated. On the
10th the fever subsided and a crisis formed so
that on the 12th he set up, and for a short time
read the news the tongue retained a redness,
attended with flushes of fever, so that remedies
were still given to remove these symptoms of a
trail of inflammatory actions— even nourishment
was sparingly given, and no alcoholic mixtures
were allowed. He regularly improved, daily
walked the room, and by the 20th went down
stairs, fully cured.

MEDICUS.

The following case took place about the same
time as the preceding one. It was communicated
by the nursery attendants:

A. B. was attacked precisely like the other.
After about 10 days lingering was taken to bed
with symptoms similar to the preceding case. In
four days he was greatly prostrated and distressed; the tongue was very red and pointed; it
was now around that he had Typhoid fever; before the fever ended or a crisis formed, he was
given beef tea, and was soon put upon the use of
port wine; he soon inclined to stupor and indifference; by the advice of several doctors, called
respectable prescribers, the stimulants were increased: a black scurf formed on the tongue and
teeth, the edges of the tongue retaining a lively
redness. To keep him from running down and
sinking, brandy was added to the other means;
he was very uneasy; attended with nervous irritation and an impaired mind. In this way he
struggled along for five weeks and then died.

In a history of the epidemic of 1812, as it appeared in Dutchess county, which was described
as a Remitting Bilious Fever, in many cases it
was attended with inflammation and congestion
of some of the internal organs. When not early
checked or relieved, it was strongly inclined to
pass into a state of Typhus or gangrene. In a
township containing 2,400 inhabitants, there were
about 150 cases. It was generally looked upon
by the people and the medical men, as a state of
direct weakness and of a typhoid tendency, and
recourse was had to a free use of a great variety
of stimulants and alcoholic mixtures, to keep from
"typhus, "to keep the patient from running down
into typhus and gangrene." A clergyman of the
place set down the names of those who died. It
footed 63—one half!

In another district, of about the same population, there were about 150 cases of the same epidemic. They were treated by free blood-letting
and refrigerant remedies. No alcohol was used
until the congestion and fever were removed and
a crisis formed. Of these it is stated that ninety-four per cent. were cured.

Several years afterward the work of Surgeon-General Mann and Professor Gallup appeared,
which treated on this epidemic of 1812. They
advocated and recommended the same doctrine
and practice which has just been mentioned, by
which it appeared that in the army the proportion cured was over ninety per cent.

In those essays of Messrs. Mann and Gallup it
is stated that in the vicinity of the army, among
the people, a stimulant treatment for the epidemic frequently was used, and that one-fourth
to one-half the cases were fatal.

In a report from Dr. Lovell, it is stated that in
one village and vicinity where the stimulant
practice was freely used, in the month of January, 1812, there were seventy-three deaths.
During this time there were one hundred cases
in the army, which were treated by blood-letting,
&c., of which only three proved fatal.

With such glaring statements before us, is it
not surprising that a great and obstinate prejudice against bleeding exists in the community?
By it, no doubt, many a one has lost his life. If
the Sanitary Board of the army could be induced
to review the facts, and they could be made to
produce a fair influence on the general mind.
many of the soldiers might have their lives preserved, who now fall victims to typhus, quinine
and alcohol, and the Government might save the
immense sums which these popular drugs cost.