Correspondence and editorial comments on the points at issue between Dr. Tweedie & Dr. Murchison concerning identical passages in their respective works on fever.

  • Murchison, Charles, 1830-1879.
Date:
1863
Catalogue details

Licence: Public Domain Mark

Credit: Correspondence and editorial comments on the points at issue between Dr. Tweedie & Dr. Murchison concerning identical passages in their respective works on fever. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    8/36 (page 8)
    Dr. Murchison. One of the main arguments, if not the principal one, urged by Dr. Chris- tison, in favour of a change in the type of fever is, that in the epidemic of 1817-20, the practice of bleeding largely, so far from being injurious, as it would undoubtedly be in the fever which of late years has been most prevalent, was followed by the most favourable results. Thus he re- marks, after speaking of drawing “ a legitimate allowance of thirty ounces (of blood) in all:” “ And let it be re- membered that we did by no means slay our patients by such blood- thirstiness. On the contrary, the mor- tality from the whole forms of fever collectively in that epidemic, did not exceed 1 in 22 at any period, and was reduced to 1 in 30 as the epidemic spread, and the remedy became more and more familiar. — Edin. Medical Journal, Jan. 7, 1858, p. 587.” “ It is well known, however, and acknowledged by Dr. Christison him- self, that the fever which character- ised this epidemic, was that which is now familiar to many members of the profession, under the designation of relapsing fever.” “ What I maintain is, that this relapsing fever, which seems only to occur in the epidemic form at lengthened intervals, has been at all times remarkable for its small mortality as compared with that of the ordinary typhus, and that when no bleeding has been resorted to, the mortality has been even smaller than under the heroic practice, which was resorted to in Edinburgh during the epidemic of 1817-20.” “Several epi- demics of relapsing fever have oc- curred subsequently to that of 1817-20; and although venesection has consti- tuted little or no part of the treat- ment, the mortality has not exceeded, or has been considerably less than, that observed during the period just alluded to.” “ Thus, in 1843, relapsing fever was again epidemic in Edinburgh, and was made the subject of a monograph by Dr. Eose Cormack (Nat. His- tory, Pathology aud Treatment of the Epidemic Fever at present prevailing in Edinburgh and other Towns. By John Eose Cormack, M.D. Edinburgh, 1843), and of a lengthened series of papers in the Medical Gazette by Dr. Wardell (London Medical Gazette, Dr. Tweedie. The great argument adduced by those who support the doctrine of “ change of type” is, the favourable results in the Edinburgh epidemic of 1817-20 (which I had the opportunity of witnessing) of large indiscriminate bleedings, in diminishing the morta- lity. We are told, somewhat exult- ingly, that under the unnecessarily profuse phlebotomy, the mortality did not exceed 1 in 22 at any period of the disease, and was reduced so low as 1 in 30 as the epidemic spread. This argument, however, loses much of its intended effect, when it is considered that by much the larger number of cases consisted of relapsing fever—a form the mortality of which has already been shown to be exceed- ingly small under opposite modes of treatment, and in which the death- rate has been even less when no blood was abstracted at all. For example, in that of 1843, the history of which has been given by Dr. Cormack, the death-rate was 1 in 16; of the cases recorded by Dr. Wardell (1843-4), it was 1 in 20;