Wednesday, 9 March 2011

Treating Nagpore fever

There are times I'm glad I don't live in the 19th century. Dodgy medical treatments is very high on my list of reasons. Bleeding and mercury. Great combination. But I think I'll stick with antibiotics.

"When our European troops were first marched into the Nerbada and Nagpore territories, through the Bundlekund States and the Deccan, on the breaking out of the Mahratta and Pindarree wars in 1817, our surgeons treated the fever which assailed so many of the men, as they had been accustomed to do the bilious remittents of the Bengal province.

The attack was ushered in with symptoms analogous to that peculiar disorder, and the lancet with calomel were for ever in requisition. But the patients died. So violent were the inflammatory indications at the onset of the fever, that copious and, frequently, repeated bleedings were absolutely necessary; yet when the febrile excitement was subdued, the patient, instead of remaining tranquil and composed, to allow of his system being brought gradually under the influence of mercury, which was the practice in Lower Hindustan, here lost at once his presence of mind; and, in the course of three or four days, from the commencement of the disorder, would fall from a state of high excitement into one of extreme exhaustion; after which came a muttering delirium, terminating in death.

This result was, unfortunately, so general that the subject very soon became one of serious and most anxious consideration. Among the medical officers themselves a great diversity of opinion existed. Some attributed the mortality to the malignity of the fever rather than to any essential difference in its nature, while others as stoutly maintained that it was a disorder sui generis, and christened it, by way of distinction, the Nagpore fever. However disposed each party were to defend their respective notions on this point, the entire medical staff were tolerably unanimous in the belief that, to work a cure, a totally new plan of treatment must be resorted to.

The consequence was the resumption once more of the exploded doctrines of Brown. The violent inflammatory action which always characterized the attack was subdued, as before, by copious depletion and antiphlogistic diet. It was in the second stage of the fever that the innovation on the ordinarily received opinions of the schools was made. Instead of administering calomel merely, and trusting to the natural powers of the constitution, as heretofore, immediate recourse was had to diffusable stimulants, and the nervous depression overcome by frequent and full draughts of bottled ale or negus*. The result amply justified the experiment.

The prostration in some cases has been so excessive, that to keep the heart in action, I have known as many as six bottles (a pint and a half each) of pale ale given to a patient in the course of twenty-four hours, and he has afterwards recovered. Without it he must have died. Again, when the pulse has become no longer perceptible at the wrist, and respiration scarcely discernible, bottled beer poured down the throat has restored the power of the circulation and saved the patient. By this plan of treatment the pulse acquires strength, the delirium subsides, and about the end of the fourth or fifth day the patient enjoys some natural sleep. Danger may then be said to be at an end, but only when the convalescence is watched with the utmost vigilance. The neglect of this important stage is sometimes fatal.

* There is a pale thin ale brewed expressly for the Indian climate by some of the London houses. It is highly impregnated with the bitter principle of the hop plant, and is a very favourite beverage all over India."
"Modern India, vol. 1" by Henry H. Spry, 1837, pages 197 - 199.

I think, given the choice, I'd go for the Pale Ale rather than the mercury.

Wondering why I've selected this text? No, it isn't just a morbid fascination with ham-fisted and probably counterproductive cures. You should know me by now. My attention is drawn by details. Details about beer. The reason I chose this fragment is because of the detail about bottled Pale Ale: the bottle size of a pint and a half. I've come across bucket-loads of references to bottled Pale Ale, but never any mention of their size.

Was a pint and a half the standard bottle size in India? Perhaps. I need more references to be sure.

Returning for a moment to the poor febrile patient, that's quite a bit of booze he knocked back. Nine and a half pints in 24 hours. Just as well Pale Ale wasn't a strong beer.

According to the online dictionary negus is "a beverage made of wine and hot water, with sugar, nutmeg, and lemon."

1 comment:

Thomas Barnes said...

Another possible source for figuring out old bottle sizes might be reports from modern archaeological digs on sites dating to the 18th and 19th centuries. There are usually lots of old bottles and bottle fragments, loving dug from the clay, carefully inventoried and (sometimes) stuck back together and described.