79. RELAXATION OF TREATMENT TOWARDS THE END OF THE THIRD PERIOD—CONTINUATION OF PACKS DURING AND AFTER DESQUAMATION.

When the patient is through the first part of the period of efflorescence the symptoms decrease, and he will be easier. Under the treatment prescribed, the time when the excitement is highest, is much abridged, and usually the treatment can be relaxed in less than twenty-four hours. When the patient is easier, the treatment may be given as in the milder form of scarlatina anginosa, with due regard to the state of the throat. In proportion as the heat abates, the packs should not be repeated so often, the sheet not changed; the patient should stay longer in the packs, and the baths should be shorter. The sitz-bath would then be out of season. The packing should be repeated whenever the symptoms increase again; but even if they should not, one pack and bath a day are necessary.

80. During and after desquamation, the treatment should be continued as indicated in milder cases, except the throat continue troublesome, when more packs should be used. If the throat is well, the patient may leave his room by the sixteenth day, under the precautions given above.

81.—3. TREATMENT OF TORPID FORMS OF SCARLATINA—DIFFERENCE IN THE TREATMENT POINTED OUT.

When the reaction is torpid, the pulse small, weak, quick, the skin dry, the rash slow to appear, and when it appears in small, pale, livid spots, instead of bright scarlet patches (16-25); the treatment ought to be calculated to produce a short, but powerful, stimulus upon the surface of the body, after which a long pack should assist the organism in producing a slow, continuous and increasing reaction. If in violent reaction a repetition of short packs and long cooling baths is indicated,—in torpid reaction, cold and short tonic baths or affusions and long packs are required, in proportion to the degree of the reactive power of the patient. Therefore the packing sheet should be very cold, but thin and well wrung out, so as to make a strong, but transitory, impression, soon overcome by the reaction it calls forth, upon which all our success depends. The patient stays in the pack till he becomes quite warm and tired. Perspiration is seldom produced; if it is, it may be considered a favorable symptom. I have had patients stay in the pack for four, five, six and seven hours, and almost always, when I took them out, their skin was covered with eruption. The only phenomenon, which should induce the physician to relieve the patient of the pack before he becomes perfectly warm, is increased delirium, which in torpid reaction, indicates a tendency to a typhoid character of the disease, when the warm and moist atmosphere of the long pack would be more favorable to the disease than to the patient, by weakening the nerves still more. In that case, a long half-or sitz-bath is required, the former, under constant rubbing, from 15 to 20 minutes, the latter from 30 to 40 minutes; the temperature of either from 65 deg. to 70 deg..

82. LENGTH OF PACK.

Usually it is time for the patient to come out from his pack, when the pulse becomes fuller and stronger, the face begins to flush and the head to be affected. Frequently he sleeps till awakened by the increasing heat. A drink of cold water will quiet him for a while, which may be administered by means of a glass tube (julep-tube), in order not to disarrange the pack by lifting him up. As long as the head is not affected, there is no danger of his staying too long. The longer he can stay, the surer the eruption will appear.

83. COLD AFFUSIONS AND RUBBING.

After the pack, the patient is placed in an empty bathing or wash-tub, and cold water (of 65 deg.-60 deg. Fahr., only with very young and delicate children a little higher, with adults rather lower) is thrown over him in quick succession by means of a dipper, whilst he is well rubbed all over his body, especially the extremities. Not too much water should be poured over the head; however, the head should be always wetted first. This process should not last longer than a minute or two, except the patient continue very warm during it, in which case it should be prolonged, as the perfect cooling of the body is necessary to prevent the fever from coming on soon after and the patient continuing weak. After the bath, he should be rubbed dry, first with the bare hands of the attendants, and then with a dry sheet, and put to bed again, or, if he feel inclined to stay up, dressed warmly and be induced to walk about as long as he can.

84. ICE-WATER AND SNOW-BATH IN MALIGNANT CASES.

If no rash appear during the first pack, which will scarcely fail, the proceeding should be repeated, and the patient stay longer in the pack than the first time. In very bad cases, when the patient fails at once under the action of the poison (malignant scarlet-fever) iced water or snow may be resorted too. I know several instances of patients, having been given up by their physicians, reviving again under the influence of a snow-bath, which produced a healthy reaction, when nothing else was of avail. I have never had occasion myself to resort to such extremes, cold water having always answered my purposes; but I would not hesitate a minute to use snow and ice in a case where I could think it useful and necessary. Such proceedings look cruel; but it is decidedly more cruel to let the patient's life be destroyed from want of timely assistance. I distinctly remember a case, which occurred in Cassel, when the physician objected to "tormenting the poor boy," and wanted the father to "let him die in peace." But the father,[33] who had some knowledge of, and a great deal of confidence in hydriatics, put the little patient, a boy of 8 or 9 years, into a bathing-tub filled for the greater part with snow, covered him over with the cold material, and left him there till he became conscious; then he was rubbed all over, placed in a dry pack (without a sheet), and left to perspire, which ensued and brought out the rash. The patient was out of danger in four hours' time, and Dr. S., on calling again in the evening, was quite astounded at seeing him alive, out of bed, and covered with a tolerably bright eruption.

85. WINE AND WATER, IF NO REACTION CAN BE OBTAINED.

Should the patient remain cold in his pack for longer than an hour,—a case, which will seldom occur,—a little wine and water may be given him to assist the organism in producing a reaction; and, in case of need, the dose may be repeated once or twice in intervals of half an hour. The quantity should be adapted to the age and constitution of the patient, and by no means sufficient to affect the head. Instead of water, it may also be mixed with warm broth or tea, or hot water and sugar, to make it agreeable to the little patient.

86. ABLUTIONS AND RUBBING WITH ICED WATER OR SNOW.

In a few very obstinate cases, when no rash would appear after two or three long packs, I have succeeded by washing the patient with ice-water or snow, rubbing him dry with my bare hands, and then packing him in a dry blanket. After staying there for several hours, more or less eruption always appeared.

87. WET COMPRESS.

The wet compress on the throat in torpid cases should not be changed often, but left till it becomes almost dry. Should the feet of the patient be cold, a bottle filled with hot water and wrapped in a piece of blanket or a sheet should be placed near them, either within the pack, or out of it, when the patient is lying in bed. The feet should always be kept warm.

88. VENTILATION ALL-IMPORTANT.

If the circulation of air is necessary in any other form of scarlet-fever, it is all-important in torpid reaction, especially when it inclines to a typhoid type. We should never forget that it is the oxygen of the air that nourishes the process of combustion going on in every living body, and that in the same manner as no fire can burn bright without a sufficient supply of air, the combustion within the patient will be slower in proportion as there is less pure air in the sick-room, and consequently his reaction will be weaker, and vice versa. A sick-room, filled with a number of people, and with a large fire in it, or fed with the corrupted air of a furnace, without the access of pure air, will always prove a dangerous place for a patient in torpid fever, the fire and every living soul in it absorbing the oxygen indispensable to his recovery. And if the case become typhoid, there is little hope of saving the patient's life without plenty of pure air.

89. CONTINUATION OF PACKS—CONVALESCENCE.

Whether the eruption appear or not, the packs should be continued during the whole course of the disorder, and as long as the throat continues troublesome; and one pack and bath a day should be given during some ten or twelve days, after every symptom has disappeared. The patient, during convalescence should not go out, except after his bath and in fine sunny weather, till he feels quite well. However, he should not be kept unnecessarily too long in-doors either, as exercise in the open air will assist him in regaining his strength. If the weather is clear and bright, the low temperature of the air need not be minded. I never saw any one take cold after a pack and bath that walked out warmly dressed in clear and cold weather.

90. MINERAL ACIDS, IN CASE OF SEVERE SORE-THROAT.

In case the throat be very troublesome, there cannot be any objection to using the mineral acid, as I have indicated above (35), except homoeopathic remedies should be thought preferable and found to afford sufficient relief. Some good may, and no harm can be done by either.

91. PUTRID SYMPTOMS—GARGLE—SOLUTION OF CHLORIDE OF SODA—DRINK: CHLORATE OF POTASS—LIQUOR CALCII-CHLORIDI.

Should putrid symptoms make their appearance (21), I would strongly advise the acid in full and repeated doses, as well as the frequent repetition of the packs. In putrid cases, not only the syrup, but also the gargle will do good service. Gargling is so much the more advisable as the putrid matter should be frequently removed. If nothing else can be had, pure water or water and vinegar may be used. The temperature of the gargle should be about 70 deg.-75 deg. Fahrenheit. For the same purpose, the aqua chlorina, and the chloride of soda have been strongly recommended.[34] A few drops of the solution may be used, also, on the compress outside.

92. TREATMENT OF AFFECTIONS OF THE NERVOUS CENTRES.

In affections of the nervous centres, the brain, the cerebellum, and the spine (see 17-19), the danger which threatens the patient's life is principally averted by the sitz-bath. The nervous system needs support, and the circulation must be regulated. In every case where the packs do not relieve the symptoms in the head and spine, the sitz-bath is probably the only remedy to remove the danger. It should be about 70 deg., and the patient should stay in it till relieved, which will probably be in half an hour or there about. After the sitz-bath, if the patient feel quite easy and inclined to sleep, he may be put to bed; if he continues restless and still complains of pain, he should be put in a wet pack of about 65 deg.. There he should stay till he complains of more pain, when he should take his bath and repeat the sitz-bath. Thus he should alternate till he becomes entirely relieved.

93. SITZ-BATH, ANCHOR OF SAFETY.

If there be much delirium, the sitz-bath may be required longer, and the pack shorter, as indicated above (81). In all such cases the packs and sitz-baths, alternately, ought to be continued, till the nervous symptoms disappear altogether, and should they make their appearance again, the treatment must be resumed without delay.

94. I repeat that in such cases, the sitz-bath is the only anchor of safety I know of. I have tried to remove these dangerous symptoms by packs, affusions, baths, but almost always in vain; whilst the sitz-bath has never failed to insure success. As I am the only writer on hydriatic treatment of scarlatina (as far as I know), who mentions the virtue of the sitz-bath in those cases, and as I am probably the first who ventured to use it, with one of my own children, in 1836, when all seemed to fail, I shall corroborate my advice by a couple of cases.

95. CASES.

During an epidemic of scarlatina in 1836 two of my children were attacked by the disease, a boy of about eight, and another of five years, the younger one two days after the older one. I ordered them to be packed, and all seemed to go well, when, during my absence from the city (of Freiberg) a medical friend, who called, persuaded my wife to desist from continuing the hydriatic treatment, and use some remedies of his instead. On my return, I found the elder boy (the other began only to show some slight symptoms) in a very bad state: the cerebellum and spine were distinctly affected by the contagious poison; the patient complained of insupportable pain in the back of his head, the spine and all over his body, so that no one dared to touch him. The fact of the packs having been discontinued during twenty-four hours being concealed from me, and the boy being subject to herpes and inclined to scrofula, I began to fear that the treatment would not be applicable in such cases, and became really alarmed about my child. I was then almost a novice in Priessnitz's practice, at least in the treatment of acute diseases, which seldom occurred at Graefenberg, and, had I had more confidence in blood-letting and drugs, I would probably have resorted to them. For a while I was doubtful about the course I should pursue, when Dr. B., my medical friend, made his appearance and I learned what had happened during my absence. Instead, however, of giving way to his earnest solicitations to rely on the old practice, I at once became encouraged by his confession, and declared I would persevere in my own practice, which was quite new to him, and in which no physician of the place as yet believed. He assured me, from the symptoms, that the boy could not live twenty-four hours, unless he be bled, and that even then he would not answer for his life. Having lost six children before under allopathic treatment, and having never had much confidence in drugs during the time I had been connected myself with the practice, I firmly refused to allow either bleeding or drugging, and expressed my resolution to see what water could do, resigning myself to the possibility of a bad issue of the case. I need scarcely assure my readers, that my feelings were far from agreeable, and that my resolution required all the reminiscence of the bad success of allopathic treatment of former cases in my family, and the confidence I had in Priessnitz and his system, to support it. I tried the pack again, which did little or no good. Judging from the effects of the sitz-bath in cases of affection of the brain during continued fevers, that it might be of service also in the present case (Priessnitz's directions did not go so far, nor had I treated a similar case since my return from Graefenberg), I put my boy with great care into a sitz-bath of 70 deg. F. and left him there for a little over half an hour, when he felt greatly relieved. He was taken to his bed and allowed to become warm, when he began to complain again. I then packed him, seemingly without much effect; therefore the sitz-bath was repeated and proved quite successful. I then packed the patient immediately after the sitz-bath and left him two hours in the pack, where he slept almost all the time. When he awoke, he complained again of pain in his head, which partly yielded to the half-bath. About three hours after the bath, he complained more of the pain in his head and spine, and I repeated the sitz-bath and the pack. He slept in the pack for about three hours, and when I took him out, he was covered with red spots. Feeling pretty well, he was dressed and permitted to stay up. In the forenoon, my friend called to see whether our patient were still living, and could hardly believe his own eyes when, on cautiously putting his head in at the door, he saw the boy walking up and down the room to warm his feet. In the afternoon, the pain returned and the rash faded. I repeated the pack, and the pain not yielding entirely, I gave him one more sitz-bath in the evening and a pack after it, in which he stayed asleep almost all the time, nearly four hours, upon which the rash stood out finely and never disappeared until desquamation set in. I managed to keep him in bed after the relapse mentioned, till desquamation was over. I need scarcely say that I continued to pack him (twice a day) till after desquamation, when the packs were given once a day for about a week longer. On the seventeenth day (which was the fifteenth with the younger boy, who had the fever in a very mild form, and was treated accordingly) the two scarlet-convalescents were seen playing in the street, throwing snowballs at each other; a fact, which increased not a little the sensation caused by this miraculous cure. Although my friend was not converted to the new method, this case had a very decided encouraging influence upon myself, and, I am convinced, became the means of salvation for many hundred lives afterwards, treated partly by myself directly, partly by other physicians, or the parents of the patients, after my prescriptions. I felt the importance of my success in this difficult case of scarlatina, and warmly thanked Providence for having assisted me in saving my child for the benefit of many others.[35]

96. The circumstance that, at the same time my two boys were taken sick with scarlatina, a servant of mine became afflicted with small-pox, my daughter with varioloids, and my mother and wife with influenza, afforded me an ample opportunity of trying the effects of the water-cure and my own courage and skill in the new method. The servant was cured, chiefly by long packs, in twelve days, so that she was able to resume her household duties, and though she had been covered with pocks all over, not the slightest mark remained on her body; my little girl was out of doors in a fortnight, and a few days were sufficient to rid the ladies of influenza. The complete success I had in the treatment of all these cases, contributed not a little to encourage me to employ the method upon others, with whom I have ever since been equally successful, with one single exception, which I shall mention hereafter.

97. One of the last cases of affection of the brain in torpid scarlatina I treated, was that of a scrofulous little boy of six years, from Williamsburgh, N. Y., who was at my establishment, with his mother and sisters, taking treatment for scrofulous ulceration of the parotid glands, and other symptoms of that dangerous disease. The reaction was torpid, and the brain became affected almost from the commencement. There was a little rash coming out, but in small dark purple spots, looking much more like measles than scarlet-fever. The delirium increased during the period of efflorescence, instead of giving way. The spine evidently sympathized in the suffering of the brain and cerebellum. Homoeopathic remedies, which were earnestly asked for by the mother, had no effect whatever; acids only produced a slight relief of the inflammation of the throat; the packs increased the symptoms in the head and spine. The appearance of the tongue, the peculiar kind of delirium, the small quick pulse, &c. showed, that the case was going to take a typhoid turn; when I ordered a sitz-bath, which almost immediately relieved the head and improved the pulse, I then, proceeded in about the same manner as described above in my son's case, with the difference, that I allowed longer intervals. The patient, according to the severity of the symptoms, took one or two packs a day, and the same number of sitz-baths, had wet compresses on his ears and throat, and was kept in bed with very few exceptions, when the nurse would take him on her knees, wrapt in a blanket. The good effect of the sitz-bath was so obvious, that the child's father, who had been informed by telegraph of the critical condition of his son, asked himself for a repetition of it, when he found that neither medicines nor packs produced the slightest change. The child always became quiet and slept after the bath. Not only was his life saved, but he also escaped all the dreaded consequences of the disease. I am confident, that under any other kind of treatment, he would have lost his life, or at least he would have lost his hearing. But, far from increasing, the affection of his ears was rather improved when he left, and his general health a great deal better than when he was first placed under my care. I had a great deal of trouble with that little patient, not only because he did not allow me a night's rest for a week, and the case produced quite an estampeda in the establishment,[36] but also, and chiefly, because of the interference of a half-bred Irish woman, who had brought him up, and who, on account of the mother's bad health, acted in the double quality of a nurse and a governess towards the children. This woman, being averse to the treatment and the place, which gave her little pleasure, and to the rules of which she would not submit, procured all sort of dainties and excited the child by her foolish remonstrances against any application I found necessary, making at the same time an unfavorable impression on the simple minds of the family, by telling lies and tales, thereby not only placing difficulties in my way, in a case which was difficult in itself, but even preventing the parents from acknowledging by one word of thanks the sacrifices of time and health I had cheerfully made. What a blessing it would be for physicians and patients, could unnecessary and unreasonable people be kept away from persons afflicted with painful and dangerous diseases!—

98. IMPOSSIBILITY OF ANSWERING FOR THE ISSUE OF EVERY TYPHOID CASE.

Although a typhoid character of scarlatina will rarely set in, when the patient has been subject to the packs from the beginning of the disease, there will be cases when water-treatment can neither prevent such an event or even save the life of the patient afflicted by scarlet-fever. There will be a case, now and then, to baffle any mode of treatment, and the physician must not be blamed for losing a patient of scarlatina occasionally, but it is not necessary that people should continue to die of this disease in such numbers, as they have been destroyed till now.

99. Any case, where typhoid symptoms set in (16-25), is dangerous, and the physician and his mode of treatment deserve commendation, if the patient is saved by it; and it is in such cases, also, that the hydriatic physician requires the most skill, experience and courage.

100. IS WATER APPLICABLE IN ALL TYPHOID CASES?

The question has been raised, whether in typhoid cases, and in cases of torpid reaction in general, water is at all applicable? I can answer the question only in the affirmative; but I must add, that the treatment of such cases requires more than confidence and courage: it requires a nice discrimination to know the exact moment, when water may be applied, what should be its temperature, how long the bath should last, what kind of baths should be given, whether the pack will be of service, &c.

101. RULES FOR THE APPLICATION OF WATER IN TYPHOID CASES.

As a general rule, in typhoid cases, bathing should form one of the principal features of the treatment; i. e. the patient should have more baths than packs in proportion to the treatment of other cases.

102. The temperature of the baths should be in proportion to the reactive power of the body; i. e. the longer the patient has been sick, and the weaker he is, the higher should be the temperature of the water, but never so high as to have rather a weakening than a strengthening effect upon the nervous system. The highest temperature which may be used should not exceed 75 deg. F.

103. When the delirium is active, the patient restless, almost raging, the water should be used colder; when the delirium is more passive, the patient weak, muttering, the water should be warmer: in the former case, the water may be between 50 and 60 deg., in the latter, between 60 and 70 deg..

104. When the skin is hot and dry, a wet-sheet pack will produce relief, and assist in bringing out the rash. After the pack, a half-bath should be given, the duration of which must be regulated by the condition of the brain. If the delirium continues, the bath should be prolonged.

105. The patient should not leave the bath before his head is clearer. It may be necessary for the patient to stay in the bath for more than half an hour.

106. In a low condition, with passive delirium, the packs should not be continued very long, as they will be apt to increase the bad condition of the brain. In that case they should be used only to prepare the body for the bath following it.

107. When the skin is cool and moist, neither a bath nor a pack is indicated. When the skin is rather cool and dry, an affusion of cold water and frictions with the bare hands should be used, and the patient packed afterwards in a dry blanket, to assist in producing a reaction. In such cases I have found very cold water to be of more service than water of a warmer temperature. When the patient has not been too much weakened already, a rash is likely to be produced by the proceeding, and in consequence of repeated baths, the nervous system to be relieved and a healthier reaction to be obtained.

108. Should putrid symptoms appear, I would advise the use of mineral acids and chloride of lime, in addition to hydriatic treatment.

109. In no case would I advise a hydriatic practitioner to overdo, either in regard to the temperature or to the quantity of the baths. The state of the brain and of the skin should always guide him. The increase of delirium will require a bath, and the dryness and heat of the skin a pack. If both symptoms exist, the bath is to be preferred, as the condition of the nervous system should always command the principal attention of the physician. When the nervous system is supported, the whole of the organism is, and the condition of the skin usually improves with the former.

110. ILLUSTRATIONS.

I shall give a couple of illustrations:

In the winter of 1845-46, during an epidemic, which ravaged the city of Dresden and the neighboring villages, I was called to see a child, belonging to a tradesman, blessed with a large family, but without sufficient means to support them. I found the whole family crammed together in a room of moderate size, the patient lying in a bed near the window. There was a large fire in a sheet-iron stove, upon which the mother was preparing the scanty dinner of the family. The air was filled with the exhalations of the living, beside the smell from the potatoes and sourkrout, which was undergoing the cooking process, the sundry boots and shoes lying around or being under repair in the hands of the father, and a few pieces of linen hanging behind the stove for the purpose of drying. In an adjoining alcove lay the body of a little boy, who had expired the day before, a victim of scarlet-fever.

I found the patient, a fair-haired little girl of about eight years, in a state of sopor, which had lasted a day and a half; there had been delirium for two or three days, during which time the child had never had a clear moment. There was a purple rash all over the body. The temperature of the body I found 112 F., on placing my pocket-thermometer under the pit of the arm; the pulse was small, but exceedingly quick. There was considerable inflammation of the throat and swelling of the face; the breath was very bad. There was a blister on the throat and a mustard plaster on each of the soles of the feet.

I sent for a large wash-tub and water, which I mixed with some warm water, so as to make it about 65 deg.. I had the child undressed, and placed in the empty tub, after removing the blister and mustard; then I poured the water slowly over her head, shoulders and the rest of the body. The second pail brought her to consciousness, but only for a moment. As the delirium returned, I continued to pour water over her; till the tub was filled about nine inches, when I used the water from the bath. In fifteen minutes, I found the heat of the body diminished about five degrees. Soon after, the child became conscious, and its mind cleared off more and more, as she continued in the bath. In thirty minutes, the heat was 103, and the pulse, which first could not be counted, 135, when I removed her from the bath and put her in a wet-sheet pack, where she fell asleep. The pulse continuing slower, coming down to 126, and the heat not increasing, I left her in the pack for an hour and three quarters, when I observed an increase of heat, a quickening of the pulse and a return of delirium.

The water of the first bath still standing in the room, but having become warmer, and it being found troublesome to carry much water up-stairs to a fifth story; I sent for a pail more of fresh water, lowering the temperature of the bath to 71 deg., and, placing the child in the bath, threw water over it, as I had done before. This time the bath produced a beneficial effect much sooner, and I removed the patient from it in about twelve minutes. The heat of the body had gone down to 101, the pulse was 118, and the patient was perfectly conscious, complaining a good deal of her throat. I placed a wet compress on the throat and chest and had her put to bed, but ordered the bed to be removed further from the window, and the latter partly to be kept open. I need scarcely say, that I had opened it soon after entering the room.

When I returned in about five hours, I found the patient covered with a thick feather-bed, the window closed, the air of the room as bad as before; the patient was delirious, the heat 110, the pulse upwards of 150.

I repeated the bath as before, but continued only twenty minutes; then I packed her again, placed a wet compress on her head, opened the window entirely, and left, promising to be back in an hour.

This time, on my return, I found the window open, the air better, the child conscious in her pack. I left her a quarter of an hour longer; then placed her in a bath of fresh water, of 70 deg., kept her there five minutes, and put her back to bed. It being late in the evening, I recommended changing the compress on the throat and placing another on the stomach, and in case of renewed delirium, a cold compress on the head, to be changed frequently.

When I called in the morning, I found the patient again in delirium, the heat 110 deg., the pulse 140.

The bath was repeated for twenty-five minutes, when the heat went down to 100 deg., and the pulse to 120. The patient being conscious, I had her packed again and left her about two hours in the pack. When I returned, I found her head almost clear; the bath of 70 deg. for ten minutes brightened her very much. Her throat continued very troublesome, one of the submaxillary glands was very much swollen, and broke afterwards, on the fifth day of my treatment, discharging fetid matter. Also the parotid gland on the same side became seriously affected, swoll considerably and looked as if the ear might be endangered. The patient developing heat enough, I used nothing but wet compresses, and water and vinegar for a gargle.

The heat and delirium returning, the patient was bathed and packed twice more the same day; the pack lasting only an hour to an hour and a quarter. The night was pretty good; there was little delirium.

The third day, the patient was packed twice, and had four baths, and the bowels being costive, an injection of tepid water in the evening.

The fourth day, the rash having disappeared, and the heat being down to 98, whilst the pulse continued weak and quick, and the patient still had some delirium, I gave her a pack in the forenoon, without a bath previous, of an hour and a half, and a short bath after it; and in the afternoon, the patient having more delirium, the half-bath of 70 deg. was repeated, and the patient kept in it for twenty minutes.

On the fifth day the ulcerating gland burst outside and the parotid gland became relieved. Pack and baths as the day before. In the evening the patient complaining of pain in the bowels, a sitz-bath of 70 deg. for twenty minutes was administered, and an injection after it, which relieved her.

The rest of the time, one pack and bath in the morning, and a bath in the afternoon were deemed sufficient. On the eighteenth day of my treatment the patient left the house for the first time, and continued improving from day to day, the packs being continued for about two weeks longer on account of the broken gland, which continued to discharge. I tried to persuade the parents to continue the packs till the gland was healed, but they found it too much trouble.

The patient drank a good deal of water during the whole of the treatment, ate very little and only light food, principally water-soup or panada, and gruel, and kept in bed almost entirely the first ten or twelve days. Her deceased little brother had the same symptoms, and I am confident, she would have followed him, had she not come under hydriatic treatment.

111. A later case, to which I have alluded before, was the following: The driver of a lady, who was under my care in Florence, attending to one of the lady's maids, who was sick with typhoid scarlatina, was taken ill. Like most uneducated people, he could not understand how water could do any good for diseases, and went to the village-store to buy some patent medicine, which he took. The remedy producing no good effect, he bought some other medicine—purgative pills, as I understood—and took it. Some friends of the village, which, like other villages, especially in America, was full of doctors—brought him nostrums and popular remedies, which he took for some days, till he could not leave the bed any more, delirium set in, and I was at last applied for. I found him with all the symptoms of typhus, and scarcely any of scarlatina, except the tongue, which seemed to struggle between a typhoid and scarlatinous appearance, but soon took all the form and color of the former. There was no rash, not much of a sore-throat, but constant delirium and rapid sinking of the strength of the patient.

Under these circumstances, I believed I must treat him more for typhus than for scarlatina, and used cold baths; in which course I was encouraged by the fine reaction ensuing after every bath, and the slight clearing off of his mind for a few minutes. Internally, I used the muriatic-acid in the forms mentioned above (39), and the solution of chloride of lime, which was also used for a wash and sprinkled about the room. In order to draw the eruption towards the skin—provided there be any of the scarlatinous poison in his system,—I tried a few packs, but without avail. He grew weaker and weaker, though his skin continued to become red after every bath, and on the sixth day early in the morning, when we were about changing his linen, and I was holding him sitting up in bed, he expired in my arms. This is the only case of scarlet-fever, I lost under hydriatic treatment; and it is yet doubtful whether it can be considered as belonging to that disease. I have always considered it, and continue to do so now, a case of typhus, partly communicated by the typhoid exhalations of the other servant, and partly created in his own body, as he complained for more than a fortnight before, of nervous and feverish symptoms, which indicated a serious disease threatening him. The contagion of scarlatina may have made the case more dangerous by complicating it; but, be this as it may, it is certain that the symptoms were such from the beginning that a cure must have appeared most improbable at first sight to any physician of any school; and if there was a possibility of saving his life, it could only be done by the course I took; a course which had proved successful in several cases of typhus I had treated before, and which looked about as bad, and even worse than that of poor William McNought.

112. The young woman, who apparently communicated the typhoid contagion to William, was in quite as critical a condition as her fellow-servant; and for a while I doubted of her recovery. She continued delirious for more than a fortnight, and there were distinct putrid symptoms, her throat and glands ulcerating, and breaking in two places outside. For longer than a week she had not a lucid moment, became extenuated and powerless. We had to lift her into the baths and out; involuntary discharges from the bowels and the bladder took place; petechiae appeared, and every thing indicated a steady decay. Neither acids nor chloride of lime seemed to have any effect; the only thing, which revived her, was the tepid half-bath, of 70 deg., which she took twice a day for about twenty minutes. She was usually carried into the bath-room near by, and was commonly able to walk back assisted by the nurses. She took a pack occasionally for an hour or an hour and a half, as long as a few spots of the rash made their appearance. Her skin peeled off but imperfectly (there was not an appearance of desquamation on the driver's person, although he died about the tenth day after the disease had manifested itself). The patient not producing much heat, I used a poultice of hemlock-leaves and bran on her glands, the gargle of muriatic-acid, and ablutions of water and vinegar externally, when the skin was not prepared for a bath. Although of a weak, scrofulous habit, and having always been sickly, not only her life was saved, but her health became afterwards stronger, and her looks much better than they ever were before. The gland kept discharging for three or four months longer, and I have no doubt, to her great benefit.

With this patient, I never found the heat to exceed 100 deg. Fahr. and the delirium never had a very active character. For the greater part of the time, her skin was more cool than warm, and sometimes even clammy.

FOOTNOTES:

[7] Elements of Medicine, Vol. I. London, 1836.

[8] J. Armstrong, Practical Illustrations of the scarlet-fever, measles, &c. London, 1818.

[9] W. Withering. An account of the scarlet-fever, &c. London, 1779.

[10] Hamilton, in Edinburgh Journal.

[11] F. Jahn, in Hufeland's Journal, 1829.

[12] J. Wendt, das Wesen, die Bedeutung und aerztl. Behandl. des Scharlachs. Breslau, 1819.

[13] F. A. G. Berndt, D. Scharlachepidemie im Kuestriner Kreise, 1817-19, &c. Berlin, 1820.—The same, Bemerk. ueber das Scharlachfieber, &c. Greifswalde, 1827.

[14] Peart, Practical informations on malignant scarlet-fever and sore-throat, in which a new mode of treatment is freely communicated. London, 1802.

[15] J. B. Brown, On scarlatina, and its successful treatment by the Acidum-aceticum-dilutum of the Pharmacopaeia. London, 1846.

[16] The forms in which I have given this acid are the following:

Take three ounces of raspberry syrup and fifteen drops of muriatic acid. Rub the whole of the acid with two or three spoonfuls of syrup in a porcelain mortar (or, if there is none, in a soup-plate with the foot of a wine-glass, or a tumbler) for a minute or two; then add some more of the syrup and rub again, and thus continue till the acid is well divided and mixed up with the syrup. Of this mixture give the patient a teaspoonful every hour or two, or oftener, according to the symptoms.

An other form for a gargle is this:

Take a cup of coarse pearl-barley (or of rice), roast it till yellow; then boil it with one quart of water for ten minutes; add one teaspoonful of muriatic-acid, and four or six tablespoonfuls of honey; mix it well and use it for a gargle, tepid. The decoction should be passed through some linen, or a sieve, before the acid and honey are added, to keep back the barley or rice-grains.

The syrup should be used for inflammation of the tonsils; the gargle for inflammation of the fauces or pharynx.

[17] Schnitzlein, das Scharlachfieber, seine Geschichte, Erkenntniss und Heilung: Muenchen, 1851.

[18] Schneemann, die sichere Heilung der Scharlachkrankheit durch eine neue, voellig gefahrlose Heilmethode. Hannover, 1848.

[19] Lindsley, Boston Med. and Surg. Journal, May, 1850.

[20] C. A. W. Richter, das Wasserbuch. Berlin, 1856.

[21] Berend, Oppenheimer Zeitschrift. April, 1848.

[22] Hauner, Deutsche Klinik, 1850, No. 41.

[23] Hufeland, Hedenus, Burdach, Berndt, Cramer, Maclure, Feron, &c.

[24] Lehmann, Harnier, Wagner, Vogel, Steimmig, Schwartze, Cock, Pfaff, Baumgaertner, Belitz, &c.

[25] Currie, on the effects of cold and tepid water. London.

[26] Kolbany, Beobacht. ueber den Nutzen des lauen und kalten Wassers im Scharlachf. Pressburg, 1808.

[27] Reuss, d. Wesen der Exantheme. Nuernberg, 1818. Vol. III.

[28] A. Edler von Froehlichsthal, Abhandl. ueber d. kraeftige, sichere und schnelle Wirkung der Uebergiessungen &c. im Faul-, Nerven-, Gallen-, Brenn- und Scharlachfieber. Wien, 1842.

[29] L. Hesse, in Rust's Magaz. Vol. XXVII. 1.

[30] R. Steimmig, Erfahr. und Betracht. ueber d. Scharlachfieber und seine Behandl. Karler., 1828.

[31] P. ex. Reich, who kept the sick-room quite cold, and made his scarlet-patients walk out in any weather; he assures us that he cured his patients in five days, an interesting fact, for the correctness of which, however, the Doctor alone is responsible.

[32] A visit at my establishment of a gentleman, a short time ago, whom I treated for scarlatina anginosa in the city of New-York in February, 1851, reminds me of the sensation caused among his friends by our walking out together on the tenth day in a snow-storm, to take dinner at a restaurant's, where we consumed a partridge and sundry other articles, after which we took a further walk of half an hour. Some physicians of my acquaintance told me "I was killing the man," to which I replied, I would let them know, when he was dead. However, he never experienced the slightest inconvenience from his early exposure; on the contrary, he felt bright and strong on coming home, and has been in pretty good health ever since. He saved, last year, the life of a nephew, who had been given up, by packing him, in scarlet-fever, whilst two of the patient's sisters were allowed to die soon after—unpacked!—Their uncle had been compelled to leave the place of their residence, and the parents had neither courage nor confidence in the water-cure to repeat the process, though their son—whom I saw a few weeks afterwards in vigorous health,—had been saved by it. They had more confidence in drugs which had done nothing for him.

[33] Mr. Rossteuscher, who became afterwards proprietor of a water-cure-establishment near Cassel.

[34] "And something may be done by way of gargles, to correct the state of the throat, and to prevent the distressing and perilous consequences, which would otherwise be likely to flow from it. A weak solution of the chloride of soda may be employed for this purpose; and if the disease occur in a child that is not able to gargle, this solution may be injected into the nostrils and against the fauces, by means of a syringe or elastic bottle. The effect of this application is sometimes most encouraging. A quantity of offensive sloughy matter is brought away; the acid discharge is rendered harmless; the running from the nose and diarrhoea cease, &c."

"From several distinct and highly respectable sources, chlorine itself has been strongly pressed upon my notice, as a most valuable remedy in the severest forms of scarlet-fever." Watson, Principles and Practice of Physic.

Dr. Watson also recommends a drink, prepared of a drachm of chlorate of potass to a pint of water, and has found great improvement from the use of a pint to a pint and a half of this solution daily.

Brown gives his scarlet-patients the pure liquor calcii chloridi, or the aqua oxymuriatica in quantities of one teaspoonful every two or three hours and considers this remedy as almost a specific. A solution of the same remedy may be used as a gargle, and also as a wash; and if used internally, I would rather recommend it in preference to the pure liquor, in the hands of persons not used to medical practice. In putrid cases, also the packing sheet may be dipped in a thin solution of chloride.—From an aversion to drugs—very natural in a hydriatic physician—I have never tried medicated sheets, getting along very nicely without them, but I think they must have sufficient virtue to recommend themselves to physicians and parents, who would like to try them.

[35] Captain Claridge, who communicated the above case to the English, and by reprint also to the American public, erroneously reported it a case of measles. How he could have made the mistake, I do not know, as the word "Scharlachfieber" in German does not resemble "measles" at all, the latter being called "Masern" in my mother-tongue; but the thought that many a case, which had a bad issue, might have been treated, these twenty-one years, after my method, and many a life might have been saved, but for the mistake of C. C., has often distressed me.

[36] Nothing is more dangerous to the interest of an establishment, where many people are promiscuously collected, than a case of contagious disease, such as small-pox, scarlatina, measles, typhus, &c. I remember a hydriatic establishment in Pennsylvania being broken up entirely, and the physician deprived for a time of the means of subsistence, by his honest and well-founded confidence in the hydriatic treatment of small-pox, and by the generous steps he took in taking a friendless patient, afflicted with that dreaded disease, to his own house, to cure him. He anticipated the pleasure it would procure him to show how quickly and how safely he would dispose of the case, and exulted in being able to communicate the fact to his patients. Alas, he little knew, how feeble their confidence in the water-cure was as yet, and how much more they thought of their own safety, than of the water-cure, their physician and the life and health of a poor destitute fellow-creature. They all left him—part of them came to Florence—and long before he had cured his small-pox patient, he had not one of his old patients left to witness the cure! However impolitic it may appear, I cannot but express my admiration of Dr. S.'s noble conduct on the occasion, who proved himself not only an honest adherer to our excellent mode of treatment, but also a kind and generous man, worthy of more encouragement than he received at the time.

With that event before me and with a number of some thirty-five or forty patients in the house, I, of course, tried to make them as easy as I could, and confiding in the power of my treatment, sent my own two children, Paul, about eight and a half, and Eliza, about four years old, to play with the little scarlet-patient, to show how little I was afraid of the disease. In doing so, I, at the same time, satisfied my own heart, by insuring the possibility of treating my darlings myself for scarlatina, which I might not be able to do, were I to let the opportunity escape. Both were taken by the disease, and finding their reaction rather torpid, and the whole process of the disease not without danger, I was glad—when all was over—that I had been able to treat them myself.

I am happy to declare, that none of my patients were frightened away, and that all those who were attacked by the contagion, came off in a very short time and without the least bad consequences. The only exception, in the case of a person who was not a patient, and who came under my hands, after other remedies had been tried on him, I shall communicate hereafter.



PART III.

113. TREATMENT OF OTHER ERUPTIVE FEVERS.

The treatment as prescribed for scarlatina in this pamphlet, is applicable also for other eruptive fevers, such as small-pox, varioloids, chicken-pocks, measles, miliaria, urticaria, zoster, rubeola, erysipelas, erythema, &c., its principal feature being the wet-sheet pack, which may always be safely employed, even by an inexperienced hand. It is not the object of this treatise to discuss all these different diseases in full: I shall do so in a larger work on the water-cure, which I intend to publish in English as soon as I find leisure enough to finish it. But I shall give, in the meanwhile, a few hints sufficient to guide the reader in their treatment.

114. SMALL-POX.

Small-pox, by far the most dangerous of them, has found a barrier in its destructive progress in Dr. Jenner's discovery. Vaccination is an almost sure prophylactic against it; but, notwithstanding, many, with whom the preservative was neglected or with whom it proved powerless, have fallen victims to its ravages. There is no remedy in the drug-stores to diminish the danger to which the life, health and appearance of those afflicted with this terrible disease are exposed. The only safe remedy is the wet-sheet pack.

The water for the sheet should be between sixty-five and seventy degrees, and the bath after the pack, from 70 to 75 deg.. Colder water is only applicable before the appearance of the eruption, which may be favored by frictions with bare hands dipped in it. These frictions may be repeated twice a day for the first two days. On the third day a long pack will call forth the eruption. If the patient can be kept in it, he may stay from three to five hours; adults even longer. No harm can be done by it, as the patient produces comparatively little heat, and the longer the pack the surer it will be to bring out the pocks. A short pack will have little effect.

As soon as the pocks appear, rubbing must be avoided till the scabs are entirely gone. The patient should be packed two, three, and even four times a day, according to the condition of the skin and the height of the fever. There is nothing able to relieve the patient as much as the dampness of the wet pack. During the period of eruption and efflorescence, the patient should spend the greater part of his time in the wet-sheet, which not only relieves the general symptoms, but especially the inflammation of the skin, and makes the poison less virulent, by constantly absorbing part of it, and by communicating part of its moisture to the small ulcers.

To protect the face, a kind of mask may be made of several thicknesses of linen, covering the whole of it, leaving openings only for the mouth, nostrils and eyes. The latter may be covered separately. This compress should be covered with one or two thicknesses of flannel, to keep its temperature as even as possible, for which purpose it should be changed as often as it becomes uncomfortably warm.

To draw the poison away from the face and eyes, it will be a good plan to put a thick wet compress on the back of the neck and between the shoulders, and cover it thickly, so as to create a great deal of heat in that region. It will bring out the pocks densely. It should be changed only when it becomes dry.

The stomach should be covered also with a wet compress, as that organ is almost always in a bad state during the whole course of the disorder. If pus is received into the blood, the thick matter which is filtered through the kidneys frequently causes retention of urine. In that case the wet bandage should go around the body, and the patient should drink a good deal of water to attenuate the blood and the urine, and favor the discharge. In case of need, a sitz-bath of 75 deg.—or with weak patients of a higher temperature, 80 to 90 deg.—will remove the difficulty.

During convalescence, the baths should be made gradually colder, to invigorate the skin and the rest of the organism, and prepare the patient for going out, which may safely be permitted on the tenth or twelfth day. The packs ought to be continued for a week at least after the drying and falling off of the scabs.

By following this treatment, the patient will be safe from any bad consequences of the disease. I have never seen any of the usual sequelae after packs.

115. VARIOLOIDS AND CHICKEN-POCKS.

Varioloids and Chicken-pocks, are treated in the same manner, but require less treatment. If well attended to, neither small-pox, nor varioloids or chicken-pocks, will leave any marks.

116. MEASLES.

Measles, which may be easily distinguished from scarlatina, by the symptoms I have given under 29, are to be treated like the mildest forms of scarlet-fever, and, in most cases, require no treatment at all. Nervous affections are treated like those of scarlet-fever (92, &c.).—As measles are more dangerous to adults than to children, whose skin is much more active, they had better take packs, without waiting for an increase of the symptoms.

117. URTICARIA, ZOSTER, RUBEOLA.

Urticaria, Zoster and Rubeola, are treated in the same manner as measles: the main feature, however, is the pack.

118. ERYSIPELAS.

Erysipelas being commonly the reflexion of an internal disease with a peculiar tendency towards the skin, should not be treated locally alone, but with due regard for the original disease. If possible, the patient should perspire freely in long packs, whilst a wet compress relieves the local inflammation. The compress, without the pack, would be apt to cause a metastasis to a vital organ. Sometimes a derivative compress, as mentioned under small-pox (114), will draw the inflammation away from a very painful and dangerous spot. It is advisable to try it, if the seat of the inflammation is the face or head. The water for the sheet, compress and bath should not be lower than 65 deg.. I know several cases of rapid cures of erysipelas, by throwing a profusion of cold water on the parts affected. But, although I do not remember any harm done by such a process, I can scarcely recommend it, as long as there are milder and safer remedies at our disposal.[37]

119. ERYTHEMA.

Erythema may be considered an exceedingly mild form of erysipelas, and yields to gentle treatment, as it is given in measles.

120. ADDITIONAL RULES FOR THE TREATMENT OF ERUPTIVE DISEASES.

In all these eruptive diseases, especially small-pox, all I have said, in speaking of scarlatina, about ventilation, air, diet, &c., ought to be duly observed. In small-pox, a constant renovation of the air is indispensable, as the morbid exhalations from the body of the patient are most offensive, and the contagious poison most virulent.

121. The temperature of the room, however, should be a few degrees higher than in scarlatina, as none of these other eruptive diseases shows the same degree of fever and heat. This is particularly advisable in the treatment of measles, when exposure is very apt to cause the rash to disappear, an occurrence which is dangerous in any eruptive disease.

122. CONCLUSIVE REMARKS.—OBSTACLES.

Before concluding my article, I shall attempt to remove a few objections and obstacles, which are usually raised against the practice of the hydriatic system in families.

123. WANT OF WATER.

One of the obstacles is the want of a sufficient quantity of water in some houses, and the difficulty of procuring it.

This obstacle is easily removed.

If you cannot procure water enough for a half-bath—for there cannot be a difficulty in procuring a pailful for wetting the sheet—give your patient a dripping sheet instead, which, in most cases, will do as well; or, should there be a want of a wash-tub to give it in, a rubbing sheet may supply the bath.

124. DRIPPING SHEET, SUBSTITUTE FOR THE HALF-BATH.

To apply the dripping sheet, a tin bathing hat or a large wash-tub is placed near the patient's bed, and a pail of water on the brim of the hat, or close by the tub. Dip a linen sheet into it, and leave it there till you wish to take the patient out of his pack, but dispose it so that you can easily find the two corresponding corners. As soon as the patient steps into the hat or tub, seize the sheet by these corners and throw it over his head and body from behind, and rub him all over, head and all, whilst somebody else is supporting him, or whilst he is supporting himself by taking hold of one of the bed-posts. When the sheet becomes warm, empty part of your pail over the patient's head, by which means the water in the sheet is renewed, and rub again. Then repeat the same operation, and when all your water is gone, before the body of the patient is sufficiently cool, take water from the hat or tub and use it for the same purpose, till he is quite cooled down. Then dry him with another sheet, or a towel, and put him to bed again, if necessary.

125. RUBBING SHEET, SUBSTITUTE FOR THE HALF-BATH.

It cannot be difficult to procure a wash-tub. Should you be so situated, however, as not to be able to procure even this, you will be compelled to make shift with a rubbing sheet. For that purpose, a sheet and a pail of water are all you need. The sheet is wetted in the pail and slightly wrung out. The patient steps on a piece of oil-cloth or carpet, and you throw your wet-sheet over him and rub, as before indicated. When the sheet is warm, you dip it in the pail again, and repeat the process, and thus you go on, till the patient is sufficiently cooled.

If you can have two pails of water, it will be better than one, as the water becomes warm after having changed the sheet a couple of times.

126. WHERE THERE IS A WILL, THERE IS A WAY!

I have been frequently compelled to resort to these milder applications, when there were no bathing utensils in families or boarding-houses, or no servants to carry the water for a bath; and they have always answered very well. In cases where a sitz-bath or a half-bath is indispensable, to save the life of a patient, you will find the means of procuring bathing utensils and the necessary quantity of water.

Where there is a will, there is a way!—I am sure that when once your mind is made up to use the treatment, it will not be difficult for you to find the means for it. There is always water, and there are always hands enough, where there is resolution. And who would mind a little trouble, when he can save a fellow creature's, perhaps a darling child's life and health? As for the rest, the few days' trouble, which the hydriatic mode of treatment gives, is largely recompensed by the much shorter duration of the disease, and by the immediate relief the patient derives from almost every application of water.

I have generally found that those parents who had confidence in the treatment, had also the courage to resort to it. Confidence and courage create resolution, and when once you have begun to treat your patient, you will be sure to persevere. Il n'y a que le premier pas qui coute, as the French say: only the first step is difficult.

127. PREJUDICE OF PHYSICIANS AGAINST THE WATER-CURE.

The greatest, and the most serious, difficulty lies in the prejudice of physicians against the Water-Cure. This prejudice, although in the treatment of the diseases before us, it is founded on no other reasons but ignorance, lack of courage and the habit of travelling the old trodden path—the same regular path which thousands and millions have travelled not to return—neither you, dear reader, nor I, shall be able to conquer by words. But we may succeed by actions. Take the matter in your own hands, before it is too late. Do not plead your want of knowledge and experience: a whip in the hand of a child is less dangerous than a double-edged sword in the hand of a fencing-master. I have known many a mother to treat her child for scarlet-fever, measles, small-pox, croup, &c., after my books, or after prescriptions received in Graefenberg and other hydriatic establishments, and I scarcely remember a case of accident, whilst those treated in the usual mode by the best physicians would die in numbers. I repeat it: there is no danger in the wet-sheet pack, and should a patient die under the treatment prescribed by me, you may be sure, he would not have lived under any other mode of treatment.

128. REBELLION!

This is preaching rebellion!

I know it is, and it is with great reluctance that I preach it, as I am by no means in favor of taking medical matters out of the hands where they belong, to place them into the hands of such as have had no medical education. I despise quackery, and I wish physicians could be prevailed upon to take the matter in their own hands. But, the following anecdote will enable you to judge what we may expect in that quarter, and whether I am justified in preaching rebellion against the old routine—for I deny going against science and the profession—and for a new practice which has proved to be safer than any hitherto adopted.

129. FACTS.

In 1845-46 there was an epidemic in Dresden, a city of 100,000 inhabitants, where I then resided. Its ravages in the city and the densely peopled country around it, were dreadful. We had excellent physicians of different schools, who exerted themselves day and night to stop the progress of extermination, but all was in vain. Dying children and weeping mothers were found in some house of every street, and whenever you entered a dry-goods store, you were sure to find people buying mourning. At last, as poverty will frequently produce dispute and quarrel in families, there arose, from similar reasons, a dispute between the different sects of physicians in the papers, which became more and more animated and venomous, without having any beneficial influence upon the dying patients. Sad with the result of the efforts, and disgusted with the quarrel of the profession, I gathered facts of my own and other hydriatic physicians' practice, by which it was shown that I alone, in upwards of one hundred cases of scarlatina, I had treated, had not lost a patient, and that, in general, not a case of death of scarlet-fever treated hydriatically was on record. These facts, with some observations about the merits of the respective modes of treatment, I published in the same papers, offering to give the list of the patients, I had treated, and to teach my treatment, gratis, to any physician who would give himself the trouble of calling.—What do you think was the result of my communication and offer?

The quarrel in the papers was stopped at once; not a line was published more; no one attempted to contradict me or to show that I had lost patients also; all was dead silence; and of the one hundred and fifty physicians of the city, one called, and, not finding me at home, never returned. And the patients? Well, the patients were treated and killed—after the occurrence I thought I had the right to use the word—as before, and the practice was continued in every epidemy afterwards.

Perhaps my communications would have had a better result in America, where physicians, though much less learned upon an average, are more accessible to new ideas?—

130. I have tried, several years ago, to have an article on the subject inserted in one or two of the New-York papers, which have the largest circulation in the country, but, although there were at the time 150 deaths of scarlet-fever per week in the city, they had so much to say about slavery and temperance that there was no room for my article, and when I published it in the Water-Cure Journal, it was, of course, scarcely noticed.—Scarlet-patients have continued to be treated and to die as before, and when I published a couple of months ago an extract from this pamphlet in the Boston Medical World, there were thirty cases of death per week from scarlatina in that city.

These are facts, upon which you may make your own comments. But the following are facts also:

131. MORE FACTS!

I have been treating several hundred cases of eruptive fevers during twenty-one years, and except the one mentioned above (111.) never lost a patient. I have known similar results, in the practice of other hydriatic physicians who employed a similar method. I scarcely remember a bad result of hydriatic treatment undertaken by the parents and relations of the patient, without the assistance of any physician at all. I know of several cases of death, in scarlatina, where physicians attempted to employ Currie's method, without packing;[38] and I have frequently seen the learning of regular physicians interfere with our simple practice and produce different results, whilst people without medical knowledge, by strictly adhering to my prescriptions, would always be successful. I have been so successful, and am so confident in the treatment, as described, that I have not only neglected to vaccinate my children (till last year, when it was done by a friend in my absence), but that I have sent them to a scarlet-patient to take the disease, in order that I might be able to treat them myself, and know them to be protected in future.

132. CONCLUSION: HELP YOURSELVES, IF YOUR PHYSICIANS WILL NOT HELP YOU!

And I am none of your water-enthusiasts, who pretend to cure everything and any thing with water. My confidence in the hydriatic treatment of eruptive fevers, however, is almost unlimited, because it is founded on an experience of many years of happy results with scarcely any exception, and on the fact that no other method can show a similar result.

I have always been considered an honest man, dear reader, and always anxious to serve my fellow-men; and what selfish view could I have in thus attempting to persuade you to save your children's lives by adopting my method of treatment? I shall neither make friends with the members of the profession by thus exciting you to rebel against the old routine, nor shall I augment the number of the patients of my establishment; for we cannot very well carry patients with scarlet-fever and small-pox to a distant institution. Believe me, I have no other object in publishing this pamphlet, than that of saving the life and health of as many human beings as possible, which otherwise would perish. In publishing this pamphlet, I intend to perform a sacred duty, without any regard to making a pleasant or unpleasant impression upon my brother physicians, and consequently without any regard to my own interest.

The fact that I exposed my own youngest children, the pleasure, and the support in spe, of my declining age, to the contagion of scarlatina, during an epidemic which had rather a malignant character, proves more than any thing my honest confidence in my own remedy. Ask your physician, if he is adverse to the hydriatic method, whether he knows a remedy in which he has so much confidence as to be willing to imitate my example. There is no such remedy in the apothecary's shop, and there is no physician who would expose his own children to the contagion of scarlatina from the confidence he has in the curative or protective powers of any drug.

I hope, my brother-physicians will believe me, when I assure them, that I do not mean any disrespect to the profession, in thus introducing a new sound method for the weak old routine. Perhaps, my exposition of the principles of my practice, and the attempt at a systematic arrangement of the materials at my disposal, may gain a few converts. If I am not mistaken, this pamphlet is the first that treats the subject systematically and to some extent. I am aware that it might be better written and more perfect. But, I trust that it will do some good, and hope it will pave the way for a better production, based on a more extensive practice and enriched with new discoveries on the part of American physicians, whose genius and activity are not inferior to those of any other nation.

When the Hydriatic System becomes more and more a part of the practice of educated and enlightened practitioners, it will become a much greater benefit to the human race, not only with regard to the cure of eruptive fevers, but of that of all diseases to which it can be adapted, beside the happy reform it will assist in bringing about in our effeminate and luxurious way of living, which, at all times, has been a source of ruin for individuals, families and nations.

But as long as the profession continues in its old routine, I can give you no other advice than that of following my prescriptions and of helping yourselves:—

"Aide-toi, et le ciel t'aidera!"

FOOTNOTES:

[37] I speak here of the true erysipelas, of course, and not of the chronic eruption of the face, &c., erroneously called erysipelas by many.

[38] I think of the obstinacy of a medical friend, who refused to take a lesson from Priessnitz, and constantly looked for advice, in cases of need, in works written by learned practitioners. He lost three patients in one family from scarlatina anginosa, which would certainly have been cured by the packs. In two other cases I was called to his assistance, when he insisted upon putting ice upon the head of the patients to remove the affection of the brain (the reaction was sthenic! See 50). I told him that in the cases before us, repeated packing was the only safe application, and we had a few unpleasant words, when I yielded, promising him that he would come round to my opinion within a few hours. And so it was; the patients grew worse and worse, with their heads shaved and ice upon them, till my good friend requested me to take the rudder in my own hand, with the promise not to interfere any more. By packing, the patients improved visibly and were out of danger within two days.



CATALOGUE OF HOMOEOPATHIC BOOKS,

FOR SALE BY WILLIAM RADDE, 300 BROADWAY, NEW-YORK, Between Duane and Reade-sts., (late No. 822 Broadway,)

PUBLISHER OF HOMOEOPATHIC BOOKS AND SOLE AGENT FOR THE LEIPZIG CENTRAL HOMOEOPATHIC PHARMACY.

HOMOEOPATHIC MEDICINES.

WM. RADDE, 300 Broadway, New-York, respectfully informs the Homoeopathic Physicians and the friends of the System, that he is the sole Agent for the Leipzig Central Homoeopathic Pharmacy, and that he has always on hand a good assortment of the best Homoeopathic Medicines, in complete sets or by single vials, in Tinctures, Dilutions, and Triturations; also Pocket Cases of Medicines; Physicians' and Family Medicine Chests to Laurie's Domestic (60 to 82 Remedies).—EPP'S (60 Remedies).—HERING'S (60 to 102 Remedies).—Small Pocket Cases at $3, with Family Guide and 27 Remedies.—Cases containing 415 Vials, with Tinctures and Triturations for Physicians.—Cases with 268 Vials of Tinctures and Triturations to Jahr's New Manual, or Symptomen-Codex.—Physicians' Pocket Cases with 60 Vials of Tinctures and Triturations.—Cases from 200 to 300 Vials, with low and high dilutions of medicated pellets.—Cases from 50 to 80 Vials of low and high dilutions, &c. &c. Homoeopathic Chocolate. Refined Sugar of Milk, pure Globules, &c. Arnica Tincture, the best specific remedy for bruises, sprains, wounds, &c. Arnica Plaster, the best application for Corns. Arnica salve, Urtica urens, tincture and salve, and Dr. Reisig's Homoeopathic Pain Extractor are the best specific remedies for Burns. Canchilagua, a Specific in Fever and Ague. Also Books, Pamphlets and Standard Works on the System in the English, French, Spanish and German Languages.

—> Physicians ordering medicines will please mark after each one its strength and preparation as:

moth. tinct. for mother tincture. 1. trit. or 3. trit. for first or third trituration. 6. in liq. or 30 in liq. for sixth or thirtieth attenuation in liquid. 3. in glob. or 30 in glob. for third or thirtieth attenuation in globules.

Hartmann, Dr. F., Diseases of Children and their Homoeopathic Treatment. Translated, with notes, and prepared for the use of the American and English Profession, by Charles J. Hempel, M. D. 1853. Bound, $2.00.

Jahr, Dr. G. H. G., The Homoeopathic Treatment on the diseases of females. Translated from the French by Charles J. Hempel, M.D. large 8 vo. 1856. 422 Pages. Bound, $2.00.

Becker, Dr. A. C., On Constipation. Translated from the German, Bound, 38 cts.

Becker, Dr. A. C., On Consumption. Translated from the German, Bound. 38 cts.

Becker, Dr. A. C., On Dentition. Translated from the German, Bound, 38 cts.

Becker, Dr. A. C., On Diseases of the Eye. Translated from the German, Bound, 38 cts.

—> The above four works by Dr. A. C. Becker, can be have bound in one volume, at $1.

Bryant, Dr. J., A Pocket Manual or Repertory of Homoeopathic Medicines alphabetically and neologically arranged; which may be used as the physician's Vade-Mecum, the traveller's Medical Companion, or the Family Physician: containing the principal remedies for the most important diseases, symptoms, sensations, characteristics of diseases, &c.; with the principal pathogenetic effects of the medicines on the most important organs and functions of the body; together with diagnosis, explanation of technical terms, directions for the selection and exhibition of remedies, rules of diet, &c., &c. Compiled from the best homoeopathic authorities. Bound, $1.25.

Caspari's Homoeopathic Domestic Physician, edited by F. Hartmann, M.D., "Author of the Acute and Chronic Diseases." Translated from the eighth German edition, and enriched by a Treatise on Anatomy and Physiology, embellished with 30 illustrations, by W. Esrey, M.D. With additions and a preface by C. Hering, M.D. Containing also a Chapter on Mesmerism and Magnetism; directions for patients living some distance from a homoeopathic physician, to describe their symptoms; a Tabular Index of the medicines and the diseases in which they are used; and a Sketch of the Biography of Dr. Samuel Hahnemann, the Founder of Homoeopathy. Bound $1.25.

Chepmell, Dr. E. C., Domestic Homoeopathy restricted to its legitimate sphere of practice, together with rules for diet and regimen. First American edition, with additions and improvements by Samuel B. Barlow, M.D., Bound, 50 cts.

Curtis, J. T., M.D., and J. Lillie, M.D., Epitome of Homoeopathic Practice. Compiled chiefly from Jahr, Rueckert, Beauvais, Boeninghausen, &c. Second enlarged edition. Bound, 75 cts.

Douglas, Dr. J. S., Homoeopathic Treatment of Intermittent Fevers. 1853, 38 cts.

Dudgeon's Lectures on the Theory and Practice of Homoeopathy. Delivered at the Hahnemann Hospital School of Homoeopathy, by R. E. Dudgeon, M.D. Manchester, 1854. Bound, (565 pages) $2.50.

Gollmann, Wm. M.D., The Homoeopathic Guide, in all Diseases of the Urinary and Sexual Organs, including the derangements caused by Onanism and Sexual Excesses; and accompanied by an Appendix on the use of Electro-Magnetism in the Treatment of these diseases. Translated with Additions by Ch. J. Hempel. 1855. Bound, $1.50.

Guernsey, Dr. Egbert, The Gentleman's Hand-Book of Homoeopathy; especially for travellers, and for Domestic Practice. 1855. Bound, 75 cts.

Hahnemann, Dr. Samuel, The lesser Writings of, collected and translated by R. E. Dudgeon, M.D. With a Preface and Notes by E. E. Marcy, M.D., With a beautiful steel engraving of Hahnemann, from the Statue by Steinhaeuser. Bound, one large volume (784 pages). $3.00.

—> This valuable work contains a large number of Essays of great interest to laymen as well as medical men, upon diet, the prevention of diseases, ventilation of dwellings, &c. As many of these papers were written before the discovery of the Homoeopathic theory of cure, the reader will be enabled to peruse in this volume the ideas of a gigantic intellect when directed to subjects of general and practical interest.

"The Lesser Writings MUST BE READ by every student of Homoeopathy who wishes to become acquainted with the Master-mind." R. E. DUDGEON, M.D.

Hahnemann, Dr. Samuel, Materia Medica Pura. Translated by C. J. Hempel, M.D. 4 vols. Bound, $6.00.

Hahnemann, Dr. Samuel, The Chronic Diseases, their Specific Nature and Homoeopathic Treatment. Translated and edited by C. J. Hempel, M.D., with a Preface by C. Hering, M.D., 5 vols. Bound, $7.00.

Hahnemann, Dr. Samuel, Organon of Homoeopathic Medicine, third American edition, with Improvements and additions, from the last German edition, and Dr. C. Hering's introductory remarks. Bound, $4.00.

—> The above four works of Dr. Samuel Hahnemann, are and will forever be the greatest treasures of Homoeopathy; they are the most necessary works for Homoeopathicd Practitioners, and should grace the library of every Homoeopathic Physician.

Hempel, Dr. Charles Julius, A Treatise on the use of Arnica, in cases of Contusions, Wounds, Sprains, Lacerations of the Solids, Concussions, Paralysis, Rheumatisms, Soreness of the Nipples, &c., &c., with a number of cases, illustrative of the use of that drug. 19 cts.

Hempel, Dr. Charles Julius, Complete Repertory of the Homoeopathic Materia Medica. 1224 pages. 1853. Bound, $6.00.

—> We have now before us the result of Dr. Hempel's incessant labors in the shape of a portly volume of upwards of 1200 pages, for which he deserves the best thanks of the homoeopathic body at large. This volume will be a great acquisition to all practitioners of our art, as it will facilitate very much their search for the appropriate remedy.—We have already made extensive use of it; thanking Dr. Hempel most heartily for his repertory, we commend it confidently to our English colleagues. It will be found useful by all, whether they possess the two volumes of the Symptomen-Codex or no; and, it will in many cases guide the practitioner to the ready discovery of an appropriate remedy, when all the other works hitherto published in our language would leave him in the lurch.—From the British Journal of Homoeopathy, No XLIV.

I use it almost daily in my practice, and have frequently been able to find the symptom or group of symptoms wished for, in a few minutes on its pages, after having for a much longer time searched in vain through the older repertories.

Philadelphia. M. WILLIAMSON, M.D.

I have ever found it reliable, and since becoming familiar with its arrangement, I regard it the best practical guide yet offered to the homoeopathic profession in this country.

Philadelphia. A. E. SMALL, M.D.

I consider it a work of merit and decidedly of use to Physicians commencing the practice of Homoeopathy.

Philadelphia. JAMES KITCHEN, M.D., 215 Spruce-street.

Ever since your Repertory was issued, it has been my daily adviser, has never failed to assist me and has also saved me a great deal of time.

Philadelphia. GEO. DUHRING, M.D.

I place a high estimation upon the entire work, and shall consider it a safe guide to govern me in my prescriptions to the sick.

Philadelphia. RICHARD GARDINER, M.D.

I can with truth say, that I consider it by very far the best Repertory I have ever used or seen, and that, I would by no means be without it. It has saved me many hours of research, and has very seldom failed to satisfy my expectations.

Philadelphia. J. R. COXE, JR. M.D.

I deem it an act of justice to say that I believe it to be the best work of the kind in the English language,—and that it will be not only a valuable aid to the student, but greatly facilitate the practitioner of Homoeopathy in the selection of remedies in the treatment of disease. The profession are under great obligation to Dr. Hempel for furnishing them with so valuable a work.

Philadelphia. WM. STILES, M.D.

I have examined your new "Repertory" with much care, and I am happy to recommend it as a work eminently calculated to facilitate the labors of students as well as of practicing physicians in referring both to particular symptoms and the remedies calculated to meet those symptoms.

I believe it to be unequalled in this by any work of the kind published in America.

Philadelphia. M. SEMPLE, M.D., Prof. Chem. and Tox. Hom. Med. Col. Pa.

I have been requested to give my opinion of "Dr. Hempel's Repertory." It supplies, in my estimation, a desideratum, which entitles its author and publisher to the thanks of the whole Homoeopathic school, and exhibits an amount of labor and research, which few men beside the indefatigable author would have been willing to undertake. I should consider no Homoeopathic Library complete without it.

Philadelphia. ROBT. T. EVANS, JR. M.D.

I have frequently consulted the "Repertory of the Homoeopathic Materia Medica," so ably compiled by Dr. Hempel, and do not hesitate to commend it to the attention of the adherents of Homoeopathy.

New-York. A. GERALD HULL, M.D.

Dr. Hempel's Repertory is an elaborate practical index to the Materia Medica and the only complete work of the kind in our language.

New-York. J. T. CURTIS, M.D.

I have used Hempel's Repertory almost from the first day of its publication, and I am more and more pleased with it, the more I use it. I make frequent reference to it, not only for assistance against the daily exigencies of medical practice, but in the composition of the medical work in which I have been for some time engaged, I am almost always sure to find the very information that I require. I have frequently quoted in my Treatises on Headache, Apoplexy, and Diseases of Females, and shall continue to quote in the forthcoming books.

The industry, and command of the English language possessed by Dr. Hempel, are truly wonderful.

New-York. J. C. PETERS, M.D.

Jahr's New Manual; originally published under the name of Symptomen Codex. (Digest of Symptoms.) This work is intended to facilitate a comparison of the parallel symptoms of the various Homoeopathic agents, thereby enabling the practitioner to discover the characteristic symptoms of each drug, and to determine with ease and correctness what remedy is most Homoeopathic to the existing group of symptoms. Translated, with important and extensive additions from various sources, by Charles Julius Hempel, M.D., assisted by James M. Quinn, M.D., with revisions and clinical notes by John F. Gray, M.D.; contributions by Dr. A. Gerald Hull, George W. Cook, and Dr. B. F. Joslin, of New-York; and Drs. C. Hering, J. Jeanes, C. Neidhard, W. Williamson, and J. Kitchen of Philadelphia; with a Preface by Constantine Hering, M.D., 2 vols., bound $14.00.

The third volume is issued as a separate work, under the title of Complete Repertory of the Homoeopathic Materia Medica. By Charles J. Hempel, M.D. 1224 pages. Price $6, or all three volumes at $20.

Jahr's New Manual of Homoeopathic Practice; edited, with Annotations, by A. Gerald Hull, M.D. From the last Paris edition. This is the fourth American edition of a very celebrated work, written in French by the eminent Homoeopathic Professor Jahr, and it is considered the best practical compendium of this extraordinary science that has yet been composed. After a very judicious and instructive introduction, the work presents a Table of the Homoeopathic Medicines, with their names in Latin, English and German; the order in which they are to be studied, with their most important distinctions and clinical illustrations of their symptoms and effects upon the various organs and functions of the human system. The second volume embraces an elaborate of Analysis of the indications in disease, of the medicine adapted to cure, and a Glossary of the technics used in the work, arranged so luminously as to form an admirable guide to every medical student. The whole system is here displayed with a modesty of pretension, and a scrupulosity in statement, well calculated to bespeak candid investigation. This laborious work is indispensable to the students and practitioners of Homoeopathy, and highly interesting to medical and scientific men of all classes. Complete Symptomatology and Repertory, 2 vols., bound, $6.00.

Jahr's, Dr. G. H. G. and Possart's New Manual of the Homoeopathic Materia Medica, arranged with reference to well authenticated observations at the sick-bed, and accompanied by an alphabetical Repertory, to facilitate and secure the selection of a suitable remedy in any given case. 4th edition, enlarged by the Author. SYMPTOMATOLOGY and REPERTORY. Translated and edited by C. J. Hempel, M.D. Bound, $3.50.

Joslin, Dr. B. F., Principles of Homoeopathia, In a series of lectures. Bound, 75 cts.

Joslin, Dr. B. F., Homoeopathic Treatment of Cholera including Repertories for this disease and for Summer-Complaints. Third edition with Additions. 1854. Bound, $1.

Homoeopathic Cookery. Second edition, with additions, by the Lady of an American Homoeopathic Physician. Designed chiefly for the use of such persons as are under Homoeopathic treatment. 50 cts.

Laurie, Dr. J., The Parent's Guide. Containing the Diseases of Infancy and Childhood and their Homoeopathic Treatment. To which is added a Treatise on the Method of rearing Children from their earliest Infancy; comprising the essential branches of Moral and Physical Education. Edited, with Additions by Walter Williamson, M.D., Professor of Matera Medica and Therapeutics in the Homoeopathic Medical College of Pennsylvania (460 pages.) 1854. Bound, $1.00.

Laurie's Homoeopathic Domestic Medicine. Arranged as a practical work for Students. Containing the treatment of Diseases and a Glossary of medical terms. Sixth American edition, enlarged and improved, by A. Gerald Hull, M.D. 1853. With full description of the dose to each single case. (800 pages.) Fourteenth thousand. Bound, $1.50.



Transcriber's Note: Page iv enthusisam changed to enthusiasm Page x Choride changed to Chloride Page 19 SCALATINA changed to SCARLATINA Page 28 emeties changed to emetics Page 28 inserted missing word "to" Page 34 removed extra word "the" Page 47 increase changed to increases Page 66 feellings changed to feelings Page 70 und changed to and Page 78 removed extra word "and" Page 80 has changed to had Page 80 chicken-pox changed to chicken-pocks Page 93 noeologically changed to neologically Page 95 imformation changed to information Page 95 Manuel changed to Manual

THE END