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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    I shall now submit the valuable evidence of Dr. Goolden, who has also touched on some practical points, to which I shall afterwards briefly advert. In answer to my letter, requesting him to communicate to me the result of his experience of the quinirse treatment in typhus fever, he replies :— I have only to state that it is so satisfactory, that I should not feel myself justified in treating any serious case of typhus without it. Of eight cases admitted under my care in St. Thomas's in one week— five adults and three children—all with the characteristics of typhus gravior, with one exception, the efi'ect was well marked. Each dose of quinine produced a sensible efiect; ten grains in solution, every two hours, to an adult, produced some giddiness and deafness in about thirty-six hours, when it was discontinued; and it was only necessary to give a few doses of nitre and a slight aperient, and nothing remained of the fever but slight debility—debility varied according to the pre- vious duration of the disease. In one case in the hospital, there was so much headache and excitement after each dose, that after the third time it was discontinued, but there was no permanent ill efi'ect; and I am satisfied the course is quite safe to adopt. I have met with several opportunities of trying it in private practice. In one case, a young gentleman had been travelling with his tutor in Germany, and, when at Giessen, was observed to be out of health; he had loss of appetite, shivering, debility, thirst, and feverish nights. Still, he was able to make the journey home. When at home, he was attacked with severe typhoid symptoms, and I visited him vnth. his medical attendant. I found him Avith a black dry tongue^ hot dry skin, petechice, pulse 140 and full, delirium, deafness, and diarrhcea. He had been in this state several days, when 1 suggested the large doses of quinine. After an emetic, he took eight grains every two hours. I saw him after the fourth dose, and found him sensible, but rather deaf, the skin bathed i?i perspiration, pulse sunk dotvn to 80, and the diarrhcea checked. The medicine was continued dm-ing the night, and discontinued the next morning, as the surgeon in attendance had had no experience in the quinine treatment, and did not like to carry it on upon his own responsibility. I saw him two days afterwards, and found that he had had no sleep, and the diarrhoea was returning. He took some opium, and repeated the quinine in smaller doses. After a good sleep he awoke much better, and was apparently going on well, when after some days I was sent for, in consequence of a congested state of the left bmg, and slight cough. The apex of that lung was quite dull on percussion; no respiratory movement was observed on that side, and bronchophony was distinct, and much large moist cre- pitation, which made me fear the result, as his mother was the only one of a large family who had not died of consumption. A blister was applied under the clavicle, and he was ordered port wine and nutritious food ; and I am happy to say that he is now quite recovered, and the lung perfectly sound. I do not attribute the congested lung to the quinine, but to the fever; but I should be wrong to omit it in making a report. I requested the opinion of Mr. Hine, who has the care of the servants of the Great Western Railway at Swindon, including 2,000 families of artizans, etc., among whom typhus is prevalent,—perhaps from want of drainage in the new town,—and his report to inc was, that for some time the result was nmsf salislaclory; but latterly he