The Correspondence of Thomas Jefferson

By Subject

KNOWLEDGE / MEDICAL

I am sorry to hear of the situation of your family, and the more so as that species of fever is dangerous in the hands of our medical boys. I am not a physician and still less a quack but I may relate a fact. While I was at Paris, both my daughters were taken with what we formerly called a nervous fever, now a typhus, distinguished very certainly by a thread-like pulse, low, quick and every now and then fluttering. Doctor Gem, an English physician, old and of great experience, and certainly the ablest I ever met with, attended them. The one was about five or six weeks ill, the other, ten years old, was eight or ten weeks. He never gave them a single dose of physic. He told me it was a disease which tended with certainty to wear itself off, but so slowly that the strength of patient might first fail if not kept up. That this alone was the object to be attended to by nourishment and stimulus. He forced them to eat a cup of rice, or panada, or gruel, or of some of the farinaceous substances of easy digestion every two hours and to drink a glass of Madeira. The youngest took a pint of Madeira a day without feeling it, and that for many weeks. For costiveness, injections were used; and he observed that a single dose of medicine taken into the stomach and consuming any of the strength of the patient was often fatal. He was attending a grandson of Madame Helvetius, of ten years old, at the same time, and under the same disease. The boy got so low that the old lady became alarmed and wished to call in another physician for consultation. Gem consented, that physician gave a gentle purgative, but it exhausted what remained of strength, and the patient expired in a few hours.

I have had this fever in my family three or four times since I have lived at home, and have carried between twenty and thirty patients through it without losing a single one, by a rigorous observance of Doctor Gem's plan and principle. Instead of Madeira I have used toddy of French brandy about as strong as Madeira. Brown preferred this stimulus to Madeira. I rarely had a case, if taken in hand early, to last above one, two, or three weeks, except a single one of seven weeks, in whom when I thought him near his last, I discovered a change in his pulse to regularity, and in twelve hours he was out of danger. I vouch for these facts only, not for their theory. You may on their authority, think it expedient to try a single case before it has shewn signs of danger.

P. S. I should have observed that the same typhus fever prevailed in my neighborhood at the same time as in my family, and that it was very fatal in the hands of our Philadelphia tyros.

to James Madison, 13 January 1821