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10/31/1867: How Dr. Mudd Treated Yellow Fever
Source: Surgeon General's Office papers referring to cholera and yellow fever in the Army, 1867-69, Call Number: MS C 18, History of Medicine Division, National Library of Medicine, National Institutes of Health, Bethesda, Maryland.
When Dr. Edward Thomas arrived at Fort Jefferson to replace Dr. Whitehurst, he wrote a brief report entitled Treatment Remarks to describe how patients had been treated before his arrival by Drs. Mudd and Whitehurst, and changes he instituted. Although Dr. Thomas notes in the report that no one died after his arrival, the yellow fever epidemic was essentially over by the time he arrived. Samuel Arnold wrote: “The fever having abated through the want of more subjects, a contract physician from New York arrived at the post and relieved Dr. Whitehurst of his duties. When the new doctor took charge there were but two or three sick, and they were in a state of convalescence.”
Dr. Mudd was credited with using a procedure called blanketing. Fort Jefferson’s commander, Major George P. Andrews, wrote to Dr. Mudd that “Your changing the mode of treatment and ‘blanketing’ patients so as to bring the period of fever under your full control, was regarded by the medical gentlemen with whom I conversed as a bold and valuable alteration, and seems to have produced the very best results.” Blanketing was a technique used to break a fever by raising a patient’s body temperature. The patient was first submerged to his chin in a hot bath until he sweated profusely, and then put into bed between blankets.
Medicines used by Drs. Mudd and Whitehurst included powdered opium (Dover’s Powder) and powdered mercury (Calomel). Although standard at the time, they would not be used to treat yellow fever today. Following is Dr. Thomas' report:
Treatment Remarks
From Special Report on Yellow Fever at Fort Jefferson, sent Oct 31,1867
The treatment pursued here before my arrival, as I am informed, consisted in the administration of 10 gr. Calomel & 10 gr. Dover's Powder when the patient was first taken with the fever. Afterward, the sick were allowed to drink freely of warm teas, such as Boneset, fever plant, & hyson. Cold water & ice was peremptorily and uniformly denied them. During the progress of the fever in cases of great restlessness and hot, dry skin, spirit of nitre ether & Dover's Powder were occasionally administered. In convalescence, ale, porter & other stimulants were used.
My treatment has been substantially as follows: At the outset, a brisk cathartic, composed of ten grains of calomel, ten of jalap, and one of podophyllin. Sometimes the podophyllin was omitted, as the case seemed to require. After the bowels had been thoroughly cleansed out, the following was given: Chlorate of potassa, a drachm and a half to the ounce of water; dose, a tablespoonful, in half a tumbler of water, every four hours. The patients have been allowed all the ice and cold water that they wanted. Limeade and lemonade also has been given them ad libitum, whenever they desired it. In cases of a marked typhoid character, even in the height of the fever, ale and porter has been freely used until sweating was induced. The principal aim in the treatment has been to keep the skin moist and the kidneys active. So soon as convalescence set in, ale, porter, and milk punch were administered two, three, or four times a day, as the case required.
The underclothing of the patients has been changed twice a week; they have also, occasionally, been changed from bed to bed. Their quarters have been thoroughly cleansed, with a thin solution of chloride of lime, from time to time. The chambers, after being used, had chloride of lime sprinkled in them. In cases of delirium ice poultices to the head and mustard plasters to the stomach were used.
This has been, substantially, the treatment which I have pursued, and not a single death has occurred since its adoption.
From all that I can learn the disease was brought here from Key West on the schooner Matchless, one of the little vessels used by the Quartermaster's Dept. here.
Edward Thomas
AA Surgeon, USA in charge
From Special Report on Yellow Fever at Fort Jefferson, sent Oct 31,1867
The treatment pursued here before my arrival, as I am informed, consisted in the administration of 10 gr. Calomel & 10 gr. Dover's Powder when the patient was first taken with the fever. Afterward, the sick were allowed to drink freely of warm teas, such as Boneset, fever plant, & hyson. Cold water & ice was peremptorily and uniformly denied them. During the progress of the fever in cases of great restlessness and hot, dry skin, spirit of nitre ether & Dover's Powder were occasionally administered. In convalescence, ale, porter & other stimulants were used.
My treatment has been substantially as follows: At the outset, a brisk cathartic, composed of ten grains of calomel, ten of jalap, and one of podophyllin. Sometimes the podophyllin was omitted, as the case seemed to require. After the bowels had been thoroughly cleansed out, the following was given: Chlorate of potassa, a drachm and a half to the ounce of water; dose, a tablespoonful, in half a tumbler of water, every four hours. The patients have been allowed all the ice and cold water that they wanted. Limeade and lemonade also has been given them ad libitum, whenever they desired it. In cases of a marked typhoid character, even in the height of the fever, ale and porter has been freely used until sweating was induced. The principal aim in the treatment has been to keep the skin moist and the kidneys active. So soon as convalescence set in, ale, porter, and milk punch were administered two, three, or four times a day, as the case required.
The underclothing of the patients has been changed twice a week; they have also, occasionally, been changed from bed to bed. Their quarters have been thoroughly cleansed, with a thin solution of chloride of lime, from time to time. The chambers, after being used, had chloride of lime sprinkled in them. In cases of delirium ice poultices to the head and mustard plasters to the stomach were used.
This has been, substantially, the treatment which I have pursued, and not a single death has occurred since its adoption.
From all that I can learn the disease was brought here from Key West on the schooner Matchless, one of the little vessels used by the Quartermaster's Dept. here.
Edward Thomas
AA Surgeon, USA in charge
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