Report on the etiology and prevention of yellow fever / by George M. Sternberg.

  • Sternberg, George Miller, 1838-1915.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Report on the etiology and prevention of yellow fever / by George M. Sternberg. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    formula which contains a proper amount of water, to be administered at short inter- vals, instead of leaving the administration of thisllnid to the judgment of the nurse, or the desires of the patient. In this way, also, the whole treatment becomes ex- tremely simple and is easily carried out, no small advantage for the busy practitioner during the prevalence of an epidemic. In view of these considerations and of the experience of Dr. Sollace Mitchell with increased doses of the two ingredients contained in my original formula, I would suggest for further trial the following: li Sodii bicarb., grammes xvi (3 iv)- Hyd. chlor. corros., centigrammes iii (gr. i). Aqua3 PuriB, litre 1 (1 quart). M. Sig: 50 grammes (about 1| ounces) every hour; to be given ice cold. Naturally the amount given should vary according to the age of the patient, and perhaps, also, with reference to the severity of the case. Thus a mild case might have two tablespoonfuls every hour during the day and every two hours at night, while a case, which at the outset appeared to be of a grave character, might take 2 fluid ounces of the mixture every hour day and night. Experience may show that the dose of bicarbonate of sodium may be still further increased in severe cases with benelit to the I'atieut, but I doubt, in view of the evidence above recorded, whether there would be any advantage lit increasing the dose of mercuric chloride. It would be a mistake to attempt to substitute a potassium salt for the bicarbonate of sodium in the above formula. The mercuric chloride, which remains in solution in presence of sodium bicarbonate in the proportions prescribed, would be precipitated by potassium car- bonate. Moreover, the potassium salts are directly contraindicated in a disease in which there is a great tendency to suppression of urine, and ur;cmic poisoning. The experiments of Zelz and Eitter, and of Bouchard, show that in ur;emia the toxic symptoms are largely due to the retention of potassium salts rather than to urea. Bouchard especially, as a result of his extended experiments, insists upon the great importance of limiting potassium salts, both in food and medicine, in the treatment of uraemia. I may add that a rather extended trial of carbonate of potassium in full doses, made by one of the physicians of Decatur during the recent epidemic, was attended with a high rate of mortality, and that the physician referred to himself fell a victim to the disease, although his case at the outset appeared to be rather a mild one. How far the treatment influenced the result it is, of course, impossible to determine, but suppression of urine and black vomit occurred on the fourth day, and death quickly followed. Havanna, April 6, 1889. During the past summer (1889), Dr. D. M. Burgess, Uuitecl States sanitary inspector at Havana, has treated all of his yellow-fever cases with the alkaline and bichloride method. He reports as follows in a letter dated Havana, December 29, 1889: I have to report that I have had this season up to date 25 private cases of yellow fever; they were all given Sternberg's treatment, and while many of them were severe cases, all recovered. The results of the trial of this treatment, made in the Charity Hospital at Havana by Dr. Yincente de la Guardia and Dr. Emilio Martinez during the past summer, are given in a paper by the last-named gentleman, published in the Eevista de Ciencias Medicas, of Sep- tember 5, 1889. This report is especially valuable because Dr. La Guardia has bad an extended experience in the same hospital with similar cases occurring during preceding years, and because he had