Remarks on the bilious remittent fever of Africa : its treatment and precautions to be used in dangerous localities / by Horace Waller.

  • Waller, Horace, 1833-1896.
Date:
1885
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Licence: Public Domain Mark

Credit: Remarks on the bilious remittent fever of Africa : its treatment and precautions to be used in dangerous localities / by Horace Waller. Source: Wellcome Collection.

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    experience of the Tinctura Warburgi, is warranted in giving it his “ strong recommendation,” . . “it is the most powerful sudorific known. . . After opening the bowels half an ounce of tincture is administered, undiluted, all drink being withheld; a second dose is given in three hours.”* Dr. Laws informs me that on Lake Nyasa he has frequently followed Livingstone’s treatment of fever, as described above. Without great biliary disturbance, he avoids the use of calomel, administering a simple purgative followed in the case of men only by five to ten grains of quinine, according to the state of the patient and the severity of the attack, and subsequently by additions of small doses of quinine. After a few months’ residence in the country, there is usually some biliary disturbance, and then the treat¬ ment is most effectually begun by a “ Houser ” dose, followed by doses of from one to two grains of quinine every hour till the “ears sing,” or other symptoms of its action set in. He is strongly of opinion that injections of quinine under the skin, properly administered in severe cases, must prove very valuable, and intends to give this process a thorough trial on his return. I may add that he considers that miasmatic poison is thrown off from the system in three different forms of disease : Firstly, as “an attack of fever Secondly, as hemorrhage from the mucous membrane, (a) of the nose, (b) of the stomach, or (c) of the bowels, i.e. dysentery, the tendency to which may, however, stop short at diarrhoea; or, Thirdly, an outbreak of ulcers. There are yet one or two more useful memoranda for those who may have to watch over a sick comrade. The first is—never let him faint. In a long-continued attack keep a vigilant watch for any approach of faintness, which will be indicated by a small and very rapid pulse, too quick to count; and if with intermissions in the beats, so much the worse. Champagne should be given at once, and by the by, this and bitter ale should be positively in the surgery of every doctor in these campaigns, not in the mere medical-comfort list as a thing perhaps to be omitted. Stronger stimulants, Chloric Aether and Brandy, should be available, and no exertion must be spared to save collapse, for it is the most desperate symptom, and the comatose state once established, death may be looked on as certain to ensue in nearly every case. Bitter ale will be retained on the stomach when everything else is rejected. The time has arrived to set aside all notions of what * Quain’s “Dictionary of Medicine,” p. 735.