« ZurückWeiter »
blotches, resembling the ecchymosis occasioned by a bruise, began to appear on his legs, arms, thighs, and other parts of his body, These, added to a fetid breath, exciting alarm in the mind of a very amiable lady who had the care of the child, a fine boy seven years of age, I was sent for on the 29th of March last; and, at the first view (indeed from the lady's own previous description) recognized that disease, with which, at a very early period of my professional engagements, I had an opportunity of being well acquainted* I immediately pronounced the disorder to be the true marine scurvy, and could not help expressing surprise at meeting with it where I was well assured the patient had not been ex posed to what I have always believed, and what is generally allowed, to be the most frequent occasional cause, viz. a diet of salted animal food. He had been as little exposed to every other occasional cause generally enumerated; but, I was informed that he had an uncommon propensity to eating of salt; that he had been in the habit of devouring it with his pudding, and whenever he could conveniently get it, notwithstanding he had been repeatedly checked for so doing. But the family not being aware of any particular bad consequences, had never thought it necessary to have recourse to coercion,
The juice of lemons and oranges, with such vegetables as the season would afford, were recommended to be administered with a liberal hand; yet, very much to my surprise, instead of finding, as I expected, in 48 hours, the purple spots to be a little fainter in their colour, I had the chagrin to perceive them somewhat increased ; and on the 3d of April, a bleeding from the nose came on with such violence, as, under the peculiar circumstances of the case, to excite some degree of alarm. I was this day fortunate enough to discover, that the very amiable woman, who had the management of the child, had imbibed a notion that acids would impoverish and thin the blood; and, consequently, notwithstanding my earnest desire to have them administered with freedoın, had been using them with a trembling hand; trusting more to the efficacy of the bark, which I had also prescribed. Now, judging it prudent to set aside every kind of officinal composition, I positively enjoined a liberal
* Viz, in the years 1769, 70, and 71, when a surgeon in the service of the Honourable East India Company; during which period I wrote my treatise, intituled, “Cursory Observations on the Nature and Cause of the Marine Scurry;" published by R. Baldwin, Paternoster Row.
use of the vegetable acids, which from this time were given freely. But it was not till.two days more had elapsed, when the sore on the ancle had assumed a better
aspect, and the bleeding from that and the nose had ceased, that this good lady acknowledged herself to be thoroughly convinced of the propriety of using them. They were now administered with as much ardour and alacrity as I could wish; and the spots and blotches continued to change every day from a deep purple to a pale liver, or dusky red colour; and at last gradually disappeared.
The symptoms and the mode of cure, establish the true nature of the disorder beyond the possibility of a doubt. I was happy, however, in having an opportunity, on the eleventh day of my attendance, to point out the case, while the characteristic marks of the disease were still visible, as an object of curiosity, to Dr. Wilkinson, an ingenious and skilful physician in this place.
A doubt may possibly remain in your mind respecting the imputed occasional cause; to remove which I beg leave to call your attention to another instance of a similar nature.
On the 9th of March, 1796, George Hatchet, the son of a labouring man in the service of Edmund Armstrong, Esq. of Forty-hall, was brought to me on account of a constant bleeding from his gums, which were sore and tender. He had a fetid breath, and a profusion of deep-coloured purple spots of different forms and sizes in various parts of his body, The first question which occurred to me upon the view of this patient was, to ask if he had been living upon salted animal food: the answer was in the negative, and decisive; that he seldom had an opportunity of even tasting a bit of meat of any kind ; that he had lived like the other children chiefly upon bread and pudding, and such like; and, besides, that they were plentifully supplied with milk from Fortyhall. This account, added to an examination of the other children, who were in the highest possible state of health and strength, suppressed the next natural supposition, that the disease might have arisen from the same cause as that in the two patients, whose cases are so well related by you in the second volume of the Medical Transactions.
The true nature of the disease, and the indications of cure, were evident; and I had the pleasure, in a day or two after, to have them confirmed by Dr. Wilkinson, who kindly supplied the patient with such vegetables as his garden at that time afforded. As an object of curiosity, I also pointed out the disease to Messrs. Strachans, at the academy near
the place where the patient lived. It is hardly necessary to say that the cure was rapid.
It was not till the second day of my attendance on this patient that I was completely and satisfactorily relieved from my embarrassment in assigning a sufficient cause for so formidable a disease; but the mother now removed the difficulty in a moment, by telling me that, when I first inquired about the salted meat, she was so much confused, she did not then think of mentioning that the boy was very much given to eating salt; that it was with difficulty she could keep his fingers out of the salt-box.
When these two cases are added to that mentioned by Dr. Huxham, of a young lady who, from being in a state of health, perfectly free of this malady, was, by drinking every morning one pint of sea-water, rendered so highly scorbutic in ten days, that she had a profuse discharge of the menses, constantly spit blood from her lungs, and had petechial spots on her body; that her pulse became quick and full, her face pale, and somewhat bloated, and ber flesh soft and tender ; that she was faint; and, in short, so remarkably scorbutic, that, when venæsection was (ignorantly and absurdly) used, to stop the hæmorrhage from her gums, blood ouzed from the orifice for several days; and that she at last expired by a bleeding from the nose; and, to sum up the whole, that her blood was dense and firm some weeks before she began the use of the sea water;* it must be evident to every one, that common salt, uncombined with animal food, has the power of scorbuticising the human system. And the following will farther shew that, when salt is combined with animal food, it will produce the same effect in the absence of all the other circumstances which have been generally considered as occasional causes. To me, indeed, it appears to be of little consequence in what vebicle the salt is communicated. Were it administered even in essence of malt,+ I have no doubt but it would produce the same effect, though possibly not quite so soon as in the form of salted meat.
Mrs. Rolfe, daughter of Mr. Bell, a farmer, at Cattlegate, on Enfield Chace, consulted me on the 13th of April,
* Cursory Remarks on the Nature and Cause of the Marine Scurvy, p. 32.
+ Essence of malt is sweet-wort boiled to the consistence of honey; and is dcemed so great an antiscorbutic, that the British Navy is supplied with largo quantities of it at a very heavy expence,
1792. She was a young married woman, of fair complexion, agreeable countenance, and the most delicate skin, which on almost every part of her body, but more particularly her legs and thighs, was sprinkled with purple spots of different forms and
sizes: the contrast betwixt the deep purple of the maculæ scorbutice and the other parts of her delicate skin formed a striking spectacle. To the usual question, whether or not she had been living on salted animal food, she readily answered in the negative; which I mention in order to shew the necessity of a cautious inquiry into circumstance of this kind; for, the mother, who was present, after some little hesitation, very properly declared, that it was wrong to attempt to deceive the doctor; “Sir, she has lived almost entirely upon salted pork during the last winter; she has scarcely eaten any thing else.” The cure was performed with astonishing rapidity by the use of bark and muriatic acid, as medicine; and vegetables, with the juice of lemons and oranges, as food.
In the course of 25 years, one other case of scurvy bas occurred in my practice. A poor woman, respecting whom I have no memorandum, but whose illness I perfectly recollect to have happened early in spring, like the other cases already mentioned, applied to me on account of a strange disorder in her mouth; that part of the gum situated betwixt the teeth sticking out in a grostesque manner, of the colour and consistence of bullock's liver. This was the only pathognomonic symptom, but it was one so very strong and characteristic, that I had no hesitation in pronouncing the case to be scurvy. There was a reserve in this woman's answers, respecting the kind of food on which she had subsisted during the winter, which I could not conquer, and therefore cannot communicate. Bark and an antiscorbutic regimen effected a speedy cure.
After this narrative of facts, it will not be doubted that we þave it in our power at any time, by the use of salt, or salted animal food, to scorbuticise, or muriaticate, the human machine with ease. And it will, I think, also appear evident, that salivation is a process not more within our power and management. Happy would it be for mankind should it hereafter, like salivation, be found capable of conquering some obstinate, or hitherto incurable diseases. No one could a priori have supposed that salivation, which in itself is a very troublesome as well as Joathsome and dangerous distemper, could have answered the many salutary purposes which it has done; or, rather, that the poison capable
of producing that effect, should be also administered with ad. vantages in many diseases, 1798, Feb.
C. The Efficacy of Yeast in Putrid Fevers.
MR. URBAN, IN this philosophic age, when diseases so often change their appearance from what physicians had any former experience of, it is a pleasing reflection, that the study of medicine has of late been so much simplified, and almost every distemper incident to the human body so fully explained, as to come within the common apprehension of mankind. The following fact, communicated to the world by the Rev. Mr. Cartwright, affords an antidote for the most dangerous disease with which the human body can be afflicted: so that it is hoped one of the most crowded avenues to the grave is at length in a great measure closed.
“ Seventeen years ago I went," says this benevolent elergyman, “to reside at Brampton, a populous village near Chesterfield. I had not been there many months before a putrid fever broke out among us. Finding by far the greater number of my parishioners too poor to afford themselves medical assistance, I undertook, by the help of such books on the subject of medicine as were in my possession, to prescribe for them. I early attended a boy about 14 years of age, who was attacked by the fever. He had not been ill many days before the symptoms were unequivocally putrid, I then administered bark, wine, and such other remedies as my books directed. My exertions were, however, of no avail; his disorder grew every day more untractable and malignant, so that I was in hourly expectation of his dissolution. Being under the necessity of taking a journey, before I set off I went to see him, as I thought, for the last time; and I prepared his parents for the event of his death, which I considered as inevitable, and reconciled them, in the best manner I was able, to a loss which I knew they would feel severely. While I was in conversation on this distressing subject with his mother, I observed, in a small corner of the room, 4 tub of wort working. The sight