Colonial North America: Countway Library of Medicine

170

Materia Medica

Tonics

or by its tonic power increase the symptom of fever. I have bled a patient eight times before I thought it proper to administer the bark and in billious fevers weeks have passed before the barks could be used, after it was the only remidy of efficacy. I think we should do well to precede the bark with some evacuant, but there is no need to excite the stomach actively by the use of Emetics, it is the activity of the stomach that prevents the use of many medicines. Emetics are improper when there is any disposition to vomit or where there is a determination of blood to the head, they often increase the irritability which is a verry difficult to manage. Since the fever of 1793 of this City Emetics have been given less frequently than before. Should any evacuants be thought necessary I should use cathartics, the following I have found most useful, Calomel either alone or combined with rhubarb, the root of May Apple the Padophyllum peltatum of Linneus is a verry gentle cathartic and may be advantageously combined with calomel, the dose of both is about ℈i [1 scruple]. Jallap is generally preferred, I seldom employ it as it is verry apt to excite nausea. I do not wish to exclude emetics entirely as a remedy in fevers they are sometimes verry serviceable. Evacuants have not only been of service in the commencement and

179

Diaphoretics

Tonic, and Diaphoretic. In the Yellow Fever of 1793 when bloodletting came to be deserted even by Dr Benjamin Rush himself, he poposed the sweating plan by means of this medicine of which he gave large quantities. I have since used it and with the happiest effects. Dr Hossack of New York also speaks verry highly of its use in intermittants. I cannot speak so confidently from my own experience tho I have succeeded in affecting cures. In many parts of the United States it supplies the place of the bark and hence the name Ague Weed. Here it acts as a tonic and prevents the recurrence of the fever, when you wish its

182

Materia Medica

Tonics

in Typhus, the bark would be improper in the first stage, Dever says the plague was always of an inflamitory nature, Martin relates a verry singular disease when bleeding it is as injurious, he used blisters, bark, mineral acids, snake root, and at the same time supporting the system with camphor and other stimulants, many authors relate cases of the same kind in which they found the bark usefull.

Yellow fever. This is placed among the continued fevers, but there are often well marked intermissions, where it assumes an intermittent form the bark is proper, in 1793 this fever was supposed to be of a putrid nature, and the treatment of some physicians coresponded with this Idea, with the success of this practice you are already acquainted, after the debilitating plan was had recourse to with more success though it often failed, the bark was employed after the fullness of the pulse, pain &c, were removed, the bark was recommended in the exanthema, these fevers in the first stage are often inflamitory in which the bark must be injurious, but again they are often attended with symptoms of debility and here the bark is of service, it has been recommended verry strenuously in the dysentary this disease originates from