On the arrest of typhus fever by quinine / by Robert Dundas.

  • Dundas, Robert, active 19th century.
Date:
[1851]
Catalogue details

Licence: Public Domain Mark

Credit: On the arrest of typhus fever by quinine / by Robert Dundas. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    had found that the head symptoms had prevented his using it. He thought that there had been some change in the type of the fever. The only drawback that I see to the use of the large doses of quinine, is the necessity for frequently visiting the patients, say several times a-day, which is almost impossible in country practice, and very difficult in town when one is much occupied, and patients may con- sider such frequent visits to arise from the ?iim{a diligentia meclici, when the danger is over, and perhaps hardly apparent. The above statement needs little comment. Of the eight hospital cases of typhus gravior, the treatment was conclusively satisfactory in seven; the exceptional case was also valuable, as proving the perfect safety of the remedy in those individuals where some peculiar condi- tion or idiosyncracy interferes with its curative power. In one case, Dr. Goolden pushed the remedy, not only with perfect safety, but with entire success, beyond what I have ever done, or found necessary; and this fact is very important. The case of the private patient is highly instructive, as proving, beyond all rational doubt, the specific poAver of quinine in arresting, toithin the short period of eight hours, the most formidable and alarm- ing symptoms incident to typhus fever: and it is especially important in another sense,—had the fever been prolonged, considering the patient's constitutional tendency, fatal disease of the lungs was inevit- able. No other form of treatment, I firmly believe, could have saved this youth's life. Though deficient in the necessary details, the report of Mr. Hine will fix attention; and I trust that this gentleman, as well as others, who enjoy such extensive and favourable opportunities for observation, ■svill favour the profession with the results of their future experience. I must not pass over the only drawback'^ urged by Dr. Goolden against the quinine treatment of typhus—and its practical difficulty is indisputable—namely, the necessity for frequently visiting the patient. To ensure success, he should, undoubtedly, be frequently seen, whilst the large doses are being administered; and this, as Dr. Goolden observes, is almost impossible in country practice, and very inconve- nient to the well-employed town physician. This difficulty, however, affects in no degree the intrinsic value of the quinine system of practice, or the rationality and truth of the theory on which it is based. At the same time, it must be admitted, that the efficacy of this method of treatment cannot be fairly and fully tried, unless the practitioner, or some competent substitute, exercise a frequent, even though an incon- venient, supervision. Neither in my own experience, nor in that of others, so far as I am aware, have the large doses of quinine caused congestion of any im- portant organ. On the contrary, by cutting short, or moderating the febrile excitement, they prevent all such congestions, and in this con- sists the great value of the treatment; seeing that the vast majority of fever cases are earned off by these local affections. In the event of any important organ being involved, I have, Avith great advantage, resorted to extensive dry cupping, either alone, or followed by a blister. When the first large doses of quinine have failed to produce their usual curative effect, and the practitioner is obliged to discontinue them, an emetic ought to be administered, as formerly pointed out; and if, after this, the febrile excitement still continue, a full dose of