Biliary Fever Research Articles

Dutch Settlers at Voorzorg in Suriname Decimated by 1845 Epidemic: A Multifaceted Approach to Unravel Mystery about Etiologic Microbial Agent

Background. In 1845, an attempt at Dutch farmer colonization of the overseas colony of Suriname failed because within weeks of the arrival of 384 colonists, an outbreak occurred that killed half of them. The outbreak at plantation Voorzorg was identified as ‘gastric biliary fever’, which was later interpreted as typhoid fever. However, sparse data support this diagnosis. Herein, we took a multifaceted approach to characterize the outbreak and establish the likely microbiological cause. Methods. Archival research was combined with identification and excavation of a burial site, analysis of aDNA of skeletal remains as well as modelling of the outbreak on epidemiological findings. Results. A timeline of events constructed from archival records revealed that the 1845 febrile illness affected >95% of the 384 colonists, likely transmitted human-to-human and was characterized by fever, nausea, vomiting, in cases abundant often bloody diarrhea, and progressed into delirium and stupor (‘Typhus’). Within 1-2 weeks of symptom onset, half of the affected persons died (189 of 384) with overrepresentation from the young and elderly. A few postmortems had revealed multiple small, purulent colonic ulcerations. We discovered a burial ground and uncovered 17 skeletal remains presumed to be colonists. Subsequently, metagenomic testing did not reveal a pathogenic microorganism fitting the disease description, but typing mitochondrial DNA (possible in 15 of 17) showed that the skeletal remains sampled likely did not originate from Europe. Mathematical modelling of epidemic curves depicting cumulative mortality of those arriving by subsequent ships revealed that transmission characteristics of bacillary dysentery rather than typhoid fever fitted the epidemiological findings the best. Conclusion. A multifaceted approach revealed that the 1845 outbreak at Voorzorg among Dutch colonists was probably caused by bacillary dysentery and not typhoid fever. Likely, the high mortality was a consequence of dehydration that in tropical conditions particularly affected the young and elderly. This outbreak contributed to the failed colonization attempt.

Necropolis: Disease, Power, and Capitalism in the Cotton Kingdom by Kathryn Olivarius

Reviewed by: Necropolis: Disease, Power, and Capitalism in the Cotton Kingdom by Kathryn Olivarius Savannah L. Williamson (bio) Necropolis: Disease, Power, and Capitalism in the Cotton Kingdom. By Kathryn Olivarius. (Cambridge: Belknap Press, 2022. Pp. 352. $35.00 cloth; $19.25 ebook) Approximately every two to three years during much of the nineteenth century, yellow fever epidemics terrorized the city of New Orleans. Without a clear understanding of the disease, the only sure way a person was protected from future yellow fever outbreaks was to survive infection. Once an individual was acclimated, they were no longer a stranger to the city and used their immunity as a source of social, economic, and political status, which Olivarius terms "immunocapital." This bio-social currency, which was denied to Black survivors of the disease, allowed the white residents of New Orleans to enter and strengthen the city's strict racial hierarchy and exacerbated inequality in an already violent and rigid slave society. Throughout the tropical Atlantic, Aedes aegypti mosquitoes—which thrive in tropical and subtropical climates—carried the viral disease and transmitted the infection to humans through a bite. The disease presents with fever, chills, body aches, nausea, headaches, appetite loss, abdominal and back pain, black vomit, and kidney and liver damage that can cause the skin to appear yellow—hence the name "yellow fever." In antebellum New Orleans, roughly half of those infected (or 8 percent of the population) died from an outbreak. By the end of the nineteenth century, yellow fever epidemics were responsible for as many as 150,000 deaths in the Crescent City. Rather than invest in public health initiatives, white elites profited from the chaos and instability caused by yellow fever outbreaks. Epidemics of malaria, yellow, and bilious fevers have often been called "great equalizers" because they undermine the privileges afforded to whiteness, making all demographics equal in the face of possible death. Olivarius argues that yellow fever epidemics did not weaken or dismantle the existing hierarchies of race and class. Instead, antebellum New Orleans became increasingly stratified between whites with immunity, whites who were not acclimated to the disease, and [End Page 78] free and enslaved Black populations. Surviving yellow fever was practically a requirement for white citizens hoping to enter elite society. For those with immunity, outbreaks were a source of economic opportunity to which white people felt entitled, since they viewed their survival as evidence of racial superiority. They monopolized on the fear, chaos, and instability caused by outbreaks to consolidate their power and wealth at the top of the cotton market, enact policies that furthered systematic inequality, enhance white supremacy, undercut the majority population, and weave epidemiological discrimination into law. Whereas immunity for white individuals provided prospects and social standing, "immunocapital" did not extend to Black individuals. Although they were protected from future yellow fever infections, their immunity provided social and economic opportunity to their white owners, rather than themselves. Antebellum whites argued, falsely, that Blacks were naturally immune to yellow fever infections to justify policies and laws that promoted slavery, racial and class inequality, and white supremacy. Necropolis provides a detailed and fascinating account of why so many unacclimated strangers died of yellow fever in nineteenthcentury New Orleans. Unlike other epidemics, which acted as socioeconomic equalizers, outbreaks of yellow fever, bilious fever, and malaria made for greater inequality. These diseases did not undermine existing hierarchies of class and race but served as the very foundation of such hierarchical structures. As yellow fever epidemics occurred more frequently throughout the nineteenth century, they contributed to greater racial and class stratification between "acclimated" whites with immunity, "unacclimated" strangers, and free and enslaved Blacks whose immune status provided social, economic, and political benefits to others, rather than themselves. "Immunocapitalism," therefore, highlights the ways in which antebellum political, economic, social, environmental, and immunological forces contributed to greater mortality and inequality in the Crescent City. [End Page 79] Savannah L. Williamson SAVANNAH L. WILLIAMSON is a historian at Sul Ross State University. Copyright © 2022 Kentucky Historical Society

Trichosanthes cucumerina: A perspective on various medicinal uses or activities

In Sri Lankan and Indian traditional systems of medicine, Trichosanthes cucumerina Linn. (Family: Cucurbitaceae) is one of the medicinal plants frequently utilised to create formulations to treat a range of illnesses and conditions. Along with other plant components, the aerial parts of T. cucumerina are used to treat indigestion, bilious fevers, boils, sores, and skin eruptions like eczema, dermatitis, psoriasis, inflammation, ulcers, and diabetes. The research on T. cucumerina’s pharmacology and toxicology is summarised in the current review.

Saqmunia (Convolvulus scammonia L.), an important drug used in Unani system of medicine: A review

Background: Saqmunia, a resin obtained from the root of Convolvulus scammonia L. is widely used in Unani system of medicine for the treatment of several body ailments. This important medicinal plant is belonging to Convolvulaceae family, and is commonly grown in Mediterranean regions.
 Purpose of the review: The core objective of this appraisal is to emphasize the different characteristics of Saqmunia (Convolvulus scammonia L.) viz. botanical description, pharmacological and therapeutic properties, folklore uses, temperament, dose, scientific studies, etc, as mentioned in Unani and botanical literature that will be helpful in the rationale use of this botanical drug.
 Materials and methods: This review was done after going through ample of literature survey of Unani and botanical texts, and published articles related to Saqmunia (Convolvulus scammonia L.). The botanical names of drugs mentioned in this review have been validated through ‘World Flora’ (http://www.worldfloraonline.org).
 Results: The Unani physicians prescribe Saqmunia for the treatment of skin diseases, chronic headache, bilious fever, conjunctivitis, jaundice, etc. This drug is also added in many compound Unani formulations such as Habb-i-Kotwali, Safoof-i-Suranjan, Habb-i-Banafsha, Ayarij-i-Kabir, Tiryaq-i-Zahab, Habb-i-Saqmunia, Majun-i-Anjeer, etc which are used for various therapeutic purposes. The phytochemical analysis of the root of Convolvulus scammonia L. has been reported that it contains 8% resin along with beta-methyl-esculetin, dihydroxy cinnamic acid, ipuranol, sucrose, reducing sugar, starch, etc. The resin yields glycosides mainly scamonin which is pharmacologically active. Some scientific reports showed that this important medicinal plant possesses certain potential pharmacological activities. The significant anticancer property of aqueous and alkaline extracts of Convolvulus scammonia L. has been identified in mice.
 Conclusion: Although, the resin of Convolvulus scammonia L. is extensively used in Unani medicine. But, sufficient studies regarding its pharmacognosy, phytochemistry, pharmacology and toxicology are still lacking. Hence, it is suggested that extensive studies by using modern scientific parameters may be carried out to explore the every aspect of this important botanical drug.
 Keywords: Saqmunia; Convolvulus scammonia L.; Unani medicine; Resin

The Pharmacognostic Standardisation of Medicinally Important Notorious Weed-Lantana camera

Background: The species Lantana camera is an important medicinal, ornamental, as well as essential oil-producing herb from the family Verbenaceae. It is also known as red sage and is used as a popular ornamental plant in gardens. L. camara grows in tropical, subtropical, and temperate regions at a high altitude up to 2000 m. In India, L. camera is considered a poisonous plant and included in the top ten invasive weeds. Invasive weeds are nothing but a species that is not native to the ecosystem under consideration and whose introduction causes economic or environmental harm or human harm. Due to its invasive nature, L. camera is lagging behind in the list of medicinal plants for their uses in drug preparation. However, it is listed as one of the most significant medicinal plants in the world. The plant extracts have been used in folk medicine for the treatment of cancers, chicken pox, measles, asthma, ulcers, swellings, eczema, tumors, high blood pressure, bilious fevers, and catarrhal infections, tetanus, rheumatism and malaria. Despite significant ethnomedicinal properties of L. camera few investigations have been carried out in respect of the Pharmacognostic standardization of complete plant. The work performed related to Pharmacognostic study so far is not sufficient. Therefore, the main objective of the present review is to create awareness about L. camera as one of the useful weeds in society by studying it from a pharmacognosy point of view.
 Results: With respect to the above, the present work deals with the Pharmacognostic and phytochemical studies of leaves, stems and fruits of L. camera. The details study of Macroscopy, Microscopy, physicochemical and phytochemical parameters demonstrated the various diagnostic features of L. camera.
 Conclusions: The overall outcome of the macroscopical, microscopical, physicochemical and phytochemical study will be helpful in the correct identification and establishment of standardization parameters for the leaves, stem and fruits of medicinally important notorious weed.

Protective Effects of Lantana camara (aculeata) in Rheumatoid arthritis using in vitro and in vivo Complete Freund’s Adjuvant induced arthritis in rats

The main objective of the present work is to evaluate the potential of Lantana camara (aculeata) for anti-arthritic activity using in vitro and in vivo study. L. camara is an important medicinal, ornamental, and essential oil-producing herb from family Verbenaceae. Different parts of L. camara have been used for the treatment of various human ailments such as itches, cuts, ulcers, swellings, bilious fever, eczema, tetanus, malaria, tumor, rheumatism, and headache. The anti-arthritic activities of pet ether, ethyl acetate, ethanol, and aqueous extracts of L. camara were initially evaluated using in vitro model of arthritis. The ethanolic and aqueous extracts were found to be better among all the extract in in vitro study and hence subjected for further in vivo anti-arthritic study using complete Freund’s adjuvant (CFA) model in rats for 28 days. Both the extracts at 200 and 400 mg/kg were evaluated in rats for different parameters. The paw volume displacement, changes in body weight, arthritic index, alteration in serum biomarker, alteration in hematological parameters, secondary lesions changes as noticed from the radiograph, and histopathology study were measured as a mark of antiarthritic activity. The results indicate that L. camara protects rats remarkably against the primary and secondary arthritic lesions, body weight changes, serum biomarker changes, radiological, histopathological, and hematological perturbations induced by CFA in dose-dependent manner. However, the effect of the ethanolic extract at the dose of 400 mg/kg was more significant, superior, and pronounced than aqueous extract and also it is comparable to the standard drug.

A review article on

These are well-known health benefits of papaya (Carica papaya Linn.). Ayurveda, for example, recognises papaya's therapeutic value. Herbalists have used it to cure bilious fever, gonorrhoea, eczema, rheumatism and headaches. It took four decades of amazing research to identify a critical nutraceutical compound. It is antibacterial, antipyretic, insecticidal, antimicrobial, and antimolluscan. Leaves have been studied using phytoextraction of heavy metals and phytoremediation of particle pollution. Long-term research on phytoconstituents and leaf composition. Malaria, dengue fever, inflammation, and skin infections are all treated by Carica papaya. C. papaya flowers were first tested for antioxidant and antibacterial properties using TLC and UV spectroscopy. Our tests included TLC and UV-visible spectroscopy. The methanol extract had the most alkaloids, flavonoids, saponins, and tannins. N-hexane had steroids and flavonoids while chloroform had saponins and tannins. In it, there were flavonoids and phenolic compounds.

Phytochemical, Pharmacognostical and Pharmacological Activities of Carica papaya

The nutritional and medicinal benefits of papaya (Carica papaya Linn.) have long been known. Many traditional medical systems, such as Ayurveda, recognise papaya's medicinal potential. Traditional literature has used it to treat fever, swellings, bilious fever, gonorrhoea, eczema, rheumatism, headache, whooping cough, asthma, chickenpox, and bronchitis. A vital nutraceutical agent has been identified after four decades of remarkable research on its biological activity and medical applications. The leaf of Carica papaya Linn. has antibacterial, antipyretic, insecticidal, antimicrobial, and antimolluscan effects. Phytoextraction of heavy metals, phytoremediation of particle pollution, and other modern approaches have been utilised to study leaves. Phytoconstituents and leaf composition have been studied for decades. Carica papaya is used to cure a variety of diseases including malaria, dengue fever, inflammation, and skin infections. The antioxidant and antibacterial activity of C. papaya flowers were first assessed using TLC screening and UV spectroscopy. The extracts were also analysed by TLC and UV-visible spectroscopy. The methanol extract included the greatest alkaloids, flavonoids, saponins, and tannins, according to the screening results. Both chloroform and n-hexane extracts had saponins and tannins, while n-hexane also had steroids and flavonoids. It had flavonoids, tannins, saponins, and phenolic chemicals.

Phytochemical Analysis and Antimicrobial Studies of Lantana camara L.

Lantana camara is considered as a notorious weed and a popular ornamental plant. It has been observed since ancient times because the plants are an excellent source of medicine. Lantana camara has long been considered one of the most important medicinal plants in the world. Lantana camara is used in traditional medicine to treat cuts, swelling, ulcers, cataracts, biliary fever, itching, eczema and rheumatism. Different parts of the Lantana camara plant are used to treat colds, headaches, whooping cough, asthma, chicken pox, bronchitis, eye lesions, and high blood pressure. Lantana camara has been scientifically studied for various therapeutic activities like antibacterial, antioxidant, antipyretic, insecticidal, antimicrobial, wound healing etc. Various literatures have reported the phytoconstituents present in all parts of Lantana camara. In the current study, phytochemical analysis and antimicrobial activity of leaves and stem of Lantana camara were studied. The phytochemical analysis using chloroform and ethanol extracts for phenolic acids (Gallic acid) and flavonoids (Quercetin, Myricetin) by HPLC method in stem and leaves of Lantana camara. The present study evaluated the antimicrobial activity of ethanol and chloroform leaves extract against some pathogenic bacteria and fungi by using agar well diffusion method. This study can be concluded that Lantana camara of steam and leaves are comprised of bioactive compounds which possess antimicrobial activity against pathogenic bacteria and fungi.

Comparative analysis of two Himalayan Aconitum species for their phytopharmaceutical properties

IntroductionBhutanese Sowa Rigpa Medicine (BSM) uses two species of Aconitum in 25 important multi-ingredient formulations. The formulations are used for treating chronic disoders, parasitic and microbial infections, inflammatory diseases, bilious fever, or high fever related to bile disorders, including colds and flu. Some Aconitum species are toxic, and there is a need for stringent quality control measures. Materials and methodsAconitum orochryseum Stapf and Aconitum laciniatum (Bruehl) Stapf, were collected from Lingzhi, which is geographically located under Thimphu district, Bhutan, between the altitudes of 4000–4900 meters above sea level (masl), between July and September. Their comparative pharmacognostic properties were evaluated by: 1) using physicochemical parameters, such as foreign matter and moisture contents, total ash, acid-insoluble ash and alcohol-soluble extracts values and loss on drying of individual crude drugs; 2) developing a comparative High-Performance Thin Layer Chromatography (HPTLC) fingerprint, at Menjong Sorig Pharmaceuticals Corporation Limited (MSCPL), - Bhutan and 3) conducting a literature review to identify the nature and toxicity of alkaloids present in two Aconitum species. ResultsTwo Aconitum species possess distinct macros- and micros-copic characteristic features (including colour, taste, smell, appearance, and shape). The physicochemical analysis and the HPTLC fingerprinting of their methanol extracts yielded adequate data to differentiate and validate these two species’ identities, before adding them to 25 essential traditional medicine drugs (ETMDs) or polyherbal formulations in BSM. A literature review revealed that the two Aconitum species contained two distinct types of alkaloids. ConclusionsTwo Aconitum species could be differentiated based on their botanical features, macros- and micros-copic characteristics, physicochemical values and HPTLC fingerprint profiles. These pharmacognostic properties can be used as quality control parameters to confirm the two species' identity, thereby ensuring the quality and safety of BSM.

Post-Quinine Bilious Hemoglobin Fever in an 8-Year-Old Child Monitored for Severe Malaria at the Yalosase Health Center, Isangi, DR Congo

It has been known since March 2013 that Artesunate is considered the gold standard treatment for severe malaria [1] [2] [3]. However, in our regions, the drug of choice available to treat patients with severe malaria remains quinine until today. However, frequent and sequential use of quinine is associated with the occurrence of hemoglobinuria [2]. We report a probable case of bilious hemoglobin fever (BHF) in an 8-year-old child. This was an 8-year-old child with a history of frequent and recent treatment with quinine, received in consultation for coca-cola urine emission with rapid diagnostic test (RDT) positive. In search of a particular terrain, the retroviral and syphilitic serologies were negative. Considering the context, the diagnosis of post-quinine hemoglobin bilious fever (BHF) was retained and the patient had progressed well after administration of artemisinin and its derivatives. The child was followed, on an outpatient basis, without any sequelae. It would therefore be prudent for the time being to avoid them in prophylaxis and self-medication.

First Report of a Disease by Rhazes 10 Centuries Ago.

Introduction:Abu Bakr Mohammad Ibn Zakariya Al-Razi (865–925 CE), who was known as “Rhazes” in the west, was a famous scientist of medieval ages. He has more than 200 books and treatises. His masterpiece on medicine “Kitab Al-Hawi Fi Al-Tibb” contains around 900 case reports. Some of the diseases which seem to be recently reported have been stated previously, but not well described. Considering symptoms of the patient described at that time, differential diagnosis will be discussed.Case presentation:Rhazes described a patient with bilious fever. He had developed bloody urine and stool on the fourth day and fatigue. Subsequently, the patient's urine and stool color turned into dark and black, respectively, and died the following day. According to Rhazes attitude, it was malignant measles. Meyerhof in his book has referred to post-measles acute glomerulonephritis, but more appropriate differential diagnoses are compatible with this patient.Discussion:One of the best diagnoses for this case can be Weil's syndrome. Presence of fever, icterus, hemorrhage and renal injury, all suggest Weil's syndrome without pulmonary involvement. The other probable diagnosis is thrombotic thrombocytopenic purpura (TTP). Meningococcal sepsis is the other possible diagnosis.Conclusion:To sum up, as three compatible diseases with the case; have been described more than a thousand years after Rhazes (Weil's syndrome 1886, TTP 1925 and meningococcemia 1805); if the case is either Weil's or TTP or meningococcal sepsis, it is the first report of the disease in the world by Rhazes.

Effect of Argemone mexicana active principles on inhibiting viral multiplication and stimulating immune system in Pacific white leg shrimp Litopenaeus vannamei against white spot syndrome virus

Argemone mexicana called as Mexican prickly poppy is a species of poppy found in Mexico and now widely naturalized in many parts of the world with broad range of bioactivities including anthelmintic, cures lepsory, skin-diseases, inflammations and bilious fevers. Plant parts of A. mexicana were serially extracted with hexane, ethyl acetate, methanol and performed antiviral and immunostimulant screening against WSSV and Vibrio harveyi respectively. The control groups succumbed to death 100% within three days, whereas the mortality was significantly (P < 0.5) reduced to 17.43 and 7.11 in the ethyl acetate extracts of stem and root treated shrimp group respectively. The same trend was reflected in the immunostimulant screening also. Different diets were prepared by the concentrations of 100 (AD-1), 200 (AD-2), 300 (AD-3) and 400 (AD-4) mg kg−1 using A. mexicana stem and root ethyl acetate extracts and fed to Pacific white leg shrimp Litopenaeus vannamei weighed about 9.0 ± 0.5 g for 30 days. The control groups fed with the normal diets devoid of A. mexicana extracts. The antiviral screening results revealed that, the ethyl acetate extract of the stem and root were effectively suppressed the WSSV and it reflected in the lowest cumulative mortality of treated shrimps. After termination of feeding trials, group of shrimps from control and each experimental group were challenged with virulent WSSV by intramuscular (IM) injection and studied cumulative mortality, molecular diagnosis by quantitative real time PCR (qRT-PCR), biochemical, haematological and immunological parameters. Control group succumbed to 100% death within four days, whereas the survival was significantly (P < 0.001) increased to 30, 45, 75 and 79% in AD1, AD-2, AD-4 and AD-5 diets fed shrimp groups respectively. qRT PCR results with positive correlation analysis revealed that, the WSSV copies were gradually decreased when increasing the A. mexicana extracts in the diets. The highest concentrations (300 and 400 mg g−1) of A. mexicana extracts in the diets helped to reduce the protein level significantly (P < 0.05) after WSSV challenge. The diets AD-3 and AD-4 also helped to decrease the coagulation time of maximum 64–67% from control groups and maintained the normal level of total haemocyte, oxyhaemocyanin level after WSSV challenge. The proPO level was significantly increased (Column: F = 35.93; P ≤ 0.001 and Row: F = 37.14; P ≤ 0.001) in the AD1-AD-4 diet fed groups from the control diet fed groups. The lowest intra-agar lysozyme activity of 1.63 mm found in control diet fed group and the activity were significantly (P < 0.05) increased to 4.86, 7.89, 9.12 and 10.45 mm of zone of inhibition respectively in AD1 to AD4 diet fed groups.

Bogs of Death: Slavery, the Brazilian Flour Trade, and the Mystery of the Vanishing Millpond in Antebellum Virginia

“Were I living in the neighborhood of a millpond,” wrote a planter in the pages of Virginia's Farmer's Register, “I should consider the right of property in [my land] no more than that of a tame bear, that was devouring my child.” The unfortunate landowner whose property abutted one of the upper South's thousands of millponds (which were used to power small gristmills) was forced “to calmly sit by and see all one's children and dear companion pale as corpses,” spectral victims of a “violent disease” that would drive them to early graves. “To know that all those heartrending sufferings arise from the malaria of the various millponds in your neighborhood,” the writer reflected, “must evince [in the planter] a degree of forbearance beyond Christian, and an obduracy of heart, in the owner of mills, almost equal to that of cold-blooded murder.”1 Having equated the planter to a submissively bleating lamb of God and denounced the country miller as a villain of near-homicidal proportions, the correspondent declared that he would “accept the dictatorship of a country” if he knew such a government would have “the power to constrain the inhabitants in the bilious fever region to remove all stagnant waters from it.” Recent research shows that many elite antebellum slaveholders were strong advocates of the expansion of the federal government, particularly in its military guises. In light of that scholarship, a southern planter claiming to welcome an intrusive central government is perhaps not as surprising as it might once have been. Nevertheless, the writer's rhetorical excess suggests the degree to which rural millponds in the ante­bellum South had come to be viewed as “bogs of death”: sickly scars on the landscape signifying an imperfect subduing of nature.2

Triterpenoidal Secondary Metabolites from Lantana camara Linn.

AbstractChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.

Cuban Confederate Colonel: The Life of Ambro sio José Gonzales. By Antonio Rafael de la Cova. (Columbia: University of South Carolina Press, 2003. xxx, 537 pp. $59.95, ISBN 1- 57003-496-6.)

Most scholarship on United States-Cuban relations concentrates on the century after 1898 and emphasizes how United States influence grew on the island. The numerous contributions nineteenth-century Cuban expatriates made to North American politics, economy, and culture are all but forgotten. Antonio Rafael de la Cova's book offers an important correction through an examination of the life of one such expatriate, Ambrosio José Gonzales. Born in 1818 in Matanzas, Cuba, and educated in New York City and Havana, like many elite young men Gonzales became alienated from an arbitrary and repressive Spanish regime. By the 1840s, he and his fellow conspirators in the Havana Club actively supported Narciso López's filibustering ambitions. Gonzales rose in rank to become López's second in command, but when López sailed on his last, fatal expedition in 1851 Gonzales was sidelined with a bout of bilious fever. Under a death sentence in Cuba, Gonzales remained in the United States and spent the 1850s unsuccessfully pursuing a political appointment in the Franklin Pierce and James Buchanan administrations. In 1856, he married Harriet Rutledge Elliott, from a prominent South Carolina family, whom he met though his political and Masonic connections with her father. With the outbreak of the Civil War, Gonzales placed himself at the service of his adopted state. A brilliant military strategist, he developed a siege train that allowed him to defend Charleston, which he did successfully until the last days of the war. The Charlestonians adored their adopted leader and called him General Gonzales, but military accolades and an advanced rank eluded him.

Survey of canine babesiosis in South Africa.

A questionnaire, designed to obtain qualitative information on a number of variables concerning canine babesiosis (biliary fever) in South Africa, was sent to 510 veterinary practices in late 1993. Of the 157 practices that responded, all were presented with cases of babesiosis and most were situated in Gauteng, the Western Cape and KwaZulu-Natal. Apart from the Western Cape, a winter-rainfall region, the prevalence of babesiosis cases in dogs was highest in summer. Most of the respondent practices treated between 1,000 and 5,000 sick dogs that included 100 to 500 babesiosis cases each year. Respondents identified cerebral babesiosis, enterorrhagia, 'red' or haemoconcentrated babesiosis, acute renal failure and pulmonary babesiosis or 'shock lung', amongst others, as the most prevalent forms of complicated ('atypical') babesiosis. Diminazene, imidocarb and trypan blue were the most popular antibabesials. Trypan blue was most often used in shocked patients, whereas diminazene and imidocarb were preferred when there was a high parasitaemia in the absence of shock. At least 19 antibabesial treatment regimens were used in practices. These comprised the use of single doses of antibabesial drugs; split doses with repeat injections, and combined drug variations, some of which are undesirable due to possible sterilisation of Babesia infection or potential toxicity. Side-effects were most commonly associated with imidocarb use. Ninety-six percent of respondents used supportive treatment (e.g. corticosteroids, vitamins and 'liver support') in all cases of babesiosis. The use of blood transfusion as supportive treatment varied according to practice and severity of the case. Most practices never cross-matched blood to be transfused, and transfusion reactions were rare. Diminazene was most frequently incriminated in cases where drug 'resistance' or relapses occurred. Cerebral and 'red' cases resulted in high mortality. Treatment of babesiosis costs the dog-owning public in South Africa more than R20 million each year. Information on the distribution and possible complicating role of Ehrlichia canis was obtained. Development of a vaccine was the first research priority identified.

Clinical science in the age of reason.

CLINICAL SCIENCE IN THE AGE OF REASON CHRISTOPHER C. BOOTH* Eighteenth-century medicine is traditionally associated with the lancet and the purge. There was no greater enthusiast than Dr. Benjamin Rush of Philadelphia for these hallowed methods of treatment. He thought that there was only one disease process and that was "irregular convulsive or wrong action of the system affected." Treatment was therefore to reduce convulsive and wrong action by depletion, and this entailed a murderous regimen of bleeding and purgation [I]. Joseph Priestley, visiting Philadelphia at the end of 1800, had the misfortune to encounter Benjamin Rush who diagnosed his malady as a "bilious fever" with pleurisy; seven profuse bleedings did much to prolong his recovery [2]. The influence of Rush probably hastened Washington's end the year before, though it had been the president himself who had insisted, against his wife's better judgement, that he be bled [3]. Since Rush had learned his medicine in Europe, it is not surprising that patients fared little better on the other side of the Atlantic where the old mad king suffered countless indignities at the hands of his physicians. England in the eighteenth century, as portrayed by Hogarth, Fielding, and Smollett, was unwashed and unsavoury, and much of its medicine was little better. It was the England of Tom Jones, the Rake's Progress, or Marriage à la Mode. The upper classes—powdered, rouged, and bewigged—flirted at masked balls, played cards until daylight, recited scandal to each other, and then retired to take the waters of the Spa where Beau Nash presided over the gaming table and the doctors, obFitzpatrick Lecture delivered at the Royal College of Physicians of London, December 5, 1979. The author particularly thanks Dr. W. F. Bynum of the Wellcome Unit for the History of Medicine at University College, London, for his kindness in providing reading lists for the preparation of this lecture and for his generosity in lending a copy of his invaluable paper, then unpublished, "Enlightenment Medicine and Physiology." Mr. H. Davenport, Assistant Librarian at the College Library, has given much patient help, both with books and illustrations, and Miss Terry Parker has searched the College Archives. The Librarian and Archivist at the Library of the Royal Society have also been most helpful; and a special thanks to Dr. George W. Corner for his advice. ?Clinical Research Centre, Watford Road, Harrow, Middlesex HAI 3UJ, England.© 1981 by The University of Chicago. All rights reserved 003 1 -5982/82/250 1 -0244$01 .00 Perspectives in Biology and Medicine · Autumn 1981 | 93 sequious and guinea collecting, hovered discreetly. Old theories, derived from the humoral concepts of ancient times, permeated clinical practice. Evil humors had to be removed from both blood and bowel. The inadequacies of medicine provided endless opportunities for the quack whose patent remedies were officially encouraged by the new patent laws and widely advertised in the newly developing newspaper trade. It is perhaps for these reasons that many medical historians have dismissed the eighteenth century as a fallow period "sandwiched between two centuries of intellectual excitement" or as the darkness before the dawn. Others have followed Richard Shryock in concluding that modern medicine had its origins in the medical renaissance that followed the revolutionary reforms in France in the 1790s [1, p. 129]. D'Arcy Power was one of the few who saw things differently, believing that SamuelJohnson had witnessed the replacement of the old medical order by the new [4]. It is doubtful whether in his final illness Johnson himself, reaching surreptitiously beneath the blankets with a scalpel in a vain attempt to relieve his swollen and dropsical legs, could have thought that medicine in 1 784 had much more to offer than when he was born in the early years of the century [5]. Lewis Thomas has written perhaps the most severe indictment of the era preceding the nineteenth century. "The history of medicine," he wrote, "has never been a particularly attractive subject in medical education and one reason for this is that it is so unrelievably deplorable. . . . bleeding, purging, cupping and the administration of infusions of every known plant, solutions of every known metal, every conceivable diet including total fasting...

Scene in Print: Despite Their Best Efforts

Comments and Corrections1 July 1973Scene in Print: Despite Their Best EffortsLEO TOLSTOYLEO TOLSTOYSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-79-1-142_4 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPierre, as is generally the case, felt the whole burden of his physical deprivations and the long strain to which he had been subjected while a prisoner, only when the strain and the privations were at an end.After his liberation he went to Orel; and on the second day after his arrival, just as he was about to start for Kiev; he fell ill, and remained in Orel for three months.He had what the doctors called bilious fever. The doctors treated him, bled him, and made him swallow drugs; nevertheless he recovered.... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 July 1973Volume 79, Issue 1Page: 142-142KeywordsDrugsFevers ePublished: 1 December 2008 Issue Published: 1 July 1973 PDF downloadLoading ...

NOAH WEBSTER INFORMS SCHOOL CHILDREN ABOUT THE ACUTE AND CHRONIC DISEASES OF THE UNITED STATES

Noah Webster's (1758-1843) talents were eclectic. Not only was he a superb lexicographer, a prolific writer of schoolbooks, but also a surprisingly keen epidemiologist. School children of the 1830's who read his History of the United States learned the following about acute and chronic diseases: Diseases of the United States. The ordinary diseases of the United States are the same as those which invade mankind in all similar climates. The usual epidemics are hooping cough (sic), measles, influenza, scarlet fever, with some milder eruptive diseases. These diseases are periodical, though the periods are not exactly uniform. The autumnal diseases are chiefly dysentery and bilious fevers of all grades, from slight intermittents to the malignant fever, which is denominated pestilence. The dysentery appears, in scattered cases every year; but in some autumns becomes epidemic with great mortality. It however never invades large cities with such general mortality, as it does particular parts of the country. The malignant bilious fever occurs occasionally, but chiefly in large towns on the sea coast, or on rivers, or near lakes and stagnant water. Chronic Diseases. In the northern region of the United States, and especially on the sea shore, the consumption is the most general and fatal chronic complaint; carrying off in some places, a fifth of the inhabitants. In the middle region it is prevalent, but in a less degree; and in the southern, is still less destructive. Rheumatic complaints, gout, and hypochondriac affections are common. In the country west of the mountains, between the Ohio and the lakes, the goiter, or swelling upon the throat, is very prevalent among the whites, but not among the natives.1