Cases of intermittent fever, in which bleeding was employed in the cold stage / [John Mackintosh].

  • Mackintosh, John, -1837
Date:
[1828]
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Licence: Public Domain Mark

Credit: Cases of intermittent fever, in which bleeding was employed in the cold stage / [John Mackintosh]. Source: Wellcome Collection.

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    could be obtained until the congestions which had been formed in these important organs were either lessened or removed.” And even Cullen also talks of a phlogistic diathesis prevailing in the system and of congestions fixed in the abdominal viscera. (Par. 234.) Secondly, Medical men who have practised in marshy districts are aware of the existence of the kind of fever which Dr Arm¬ strong has appropriately denominated “ congestive fever,” in which the animal heat and the heart’s action are rather under than above the natural standard. This is not the proper place to pronounce a eulogium on Dr Armstrong’s professional cha¬ racter ; but I may state, without impropriety, that he deserves great credit for bringing this matter before the profession, and for illustrating it so beautifully. His views have improved the treatment of fevers generally, and this form of fever particularly, more than‘could have been expected from the talents and exer¬ tions of any one individual. This is the form of fever in which brandy, wine, and bark have been so much employed to obviate debility and putridity, without reference to the true pathology of the disease. This is the form of fever which is very fre¬ quent in aguish districts, and it is confessedly very fatal; but bleeding in the cold stage, assisted by the application of heat, and even sometimes by the use of brandy, may be successfully employed. Again, when the rigor takes place, whether severe or slight, there is no telling what mischief is to happen—-The patient may die in the cold stage ; * or the reaction may run high, and may not be succeeded by the sweating stage. In that case the disease is said to be a fever of some particular type, as a continued, remittent, or bilious remittent. Or in¬ flammation may take place in some internal organ. Often, in warm climates have I seen the oldest and the ablest practitioners of the day perplexed and disconcerted by the occurrence of such circumstances in the course of intermittents under the usual treat¬ ment. Sir John Pringle states at page 14, “ many of the remit¬ tents degenerated into continued fevers, and were often fatal; and the intermittents, by being stopped before the proper evacua¬ tions were made, or not secured against relapses, changed like¬ wise into continued fevers, or ended in dangerous obstructions of the viscera.” Bleeding in the cold stage in a majority of cases, if employed in time, will, I am persuaded, diminish the chance of such evils, by assisting the efforts of nature in remov¬ ing venous congestion and easing the circulation, while the hot * It has unfortunately happened sometimes that the disease has been so insidi¬ ous, that the second paroxysm, after an imperfect intermission, has completely over¬ whelmed the patient, and put an end to his existence.—-Vide Chisholm, p. 51, 3