Yorkshire Almanac For want of a bathroom, T. Clifford Allbutt almost loses a feverish patient

13 August 1877: For want of a bathroom, T. Clifford Allbutt almost loses a feverish patient

T. Clifford Allbutt. 1877/11/10. Acute Rheumatism, Hyperpyrexia, Recovery. British Medical Journal. London: British Medical Association. Get it:

Unedited excerpt

If an excerpt is used in the book, it will be shorter, edited and, where applicable, translated.

ACUTE RHEUMATISM: HYPERPYREXIA: RECOVERY.
BY T. CLIFFORD ALLBUTT, M.A., M.D.,
Physician to the General Infirmary, Leeds.

MR. W., aged about 25, was attacked in August last with acute rheumatism. The disease pursued a favourable course, without heart-complication. Salicylate of soda was administered on Friday, August 10th. During apparent improvement, the perspiration suddenly ceased: a phenomenon which caused some anxiety to his medical attendant, Mr. Oxley of Pontefract. On Saturday, Mr. Oxley was still more uneasy on finding that all pain had entirely vanished, the limbs being thrown easily about in bed. The temperature also was found to be two degrees higher than the day before. Salicylate of soda was recommended in considerable and frequent doses; but the temperature continued to rise all that day and during Sunday. On Sunday night, there was much delirium; and early on Monday morning a message was despatched to me. On my arrival at about 9.30 A.M., the patient was lying on his back; his face was deeply flushed; and he tossed his head uneasily from side to side in delirium, or sank into stupor. The delirium and stupor alternated every few minutes. The temperature was now found to be about 107 deg., and was increasing every hour. Unconsciousness was complete, or nearly so. The pulse was very rapid, and the respirations also, though no accurate note of these symptoms was preserved. There was no visible swelling or redness of any part.

It was at once decided to place the patient in a cold bath. Unfortunately, the house, a large country residence, had been built before bath-rooms were in fashion, and a row of morning tubs could only be offered. Pontefract was some miles away, and time was pressing. An express was sent off for a full-length bath, and meanwhile an active housemaid discovered an old-fashioned slipper-bath, or rather boot-bath, in a garret. This was brought to the bedside, and a row of servants was placed upon the staircase to pass pails of hot and cold water. The bath was filled with water at 80 deg.; and the patient, a heavy man, was lifted from bed and his legs with difficulty thrust into the foot of the boot, so that he rested in a sitting posture upon a shelf within the heel. The rim of the bath reached the patient’s waist. Regardless of floors and ceilings, very cold water was now poured upon the patient’s head, who was held up in the bath, and whose temperature was now exceeding 107 deg. The difficulties of bathing and attention to the temperature of the water diverted the skilled observers from the patient, except so far as observation of the pulse was concerned. In five or six minutes, however, it was seen that he was quite conscious, and he had repeatedly expressed the intense relief afforded to him by the bath. In ten minutes, he was joking with his friends, and enjoying himself thoroughly. The water in the bath was so continuously heated by the body of the patient, that it was with difficulty lowered to 70 deg. and to 60 deg. by constant baling out. With the recovery of the patient’s consciousness, the use of the thermometer in the mouth became possible, and it was found that the upward movement of the temperature had been arrested. In this bath, cold affusions being poured continuously over the head and shoulders, the patient remained for forty-five minutes, when the thermometer had fallen slowly to 101.5 deg. He was still very comfortable and had no chill. He was now removed to bed, placed in a warm dry blanket, and a bottle put to his feet. His aspect and manner had for some time been perfectly natural, and his pulse and respirations were scarcely excessive. During the few hours which followed the bath, the temperature slowly fell to the normal. From this time forward, recovery was steady, and may have been aided by a few liberal doses of quinine, given with a view of preventing any renewal of the fever. It is but fair to add that the efforts of the medical men were admirably seconded by a nurse from the Bradford Institution, upon whom much necessarily devolved, and who carefully watched and recorded the temperatures throughout.

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To facilitate reading, the spelling and punctuation of elderly excerpts have generally been modernised, and distracting excision scars concealed. My selections, translations, and editions are copyright.

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I am struggling to visualise the bath in question.

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Comment

I am struggling to visualise the bath in question.

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19 September 1866: Ostentatiously breaking with medical tradition, Clifford Allbutt, physician, and Claudius Galen Wheelhouse, surgeon, cooperate at Leeds Infirmary to cure a pericarditis

9 July 1903: Clifford Allbutt, late of Leeds, tells a Bradford sanitary congress to reject the view that (preventive) medicine is antagonistic to the survival of the fittest

31 July 1881: Underway to the Bicycle Touring Club’s annual August meet, a London rider struggles on the road from Doncaster to Harewood via Pontefract and Leeds

26 February 1787: William Butterworth of Leeds arrives at Grenada (West Indies) from Calabar (West Africa) on the Hudibras (Liverpool) with the survivors of a cargo of 360 slaves

25 June 1808: Dr Campbell, lodging above a chandler’s on Leeds Kirkgate, advertises the results of his treatment of anorexia, Napoleonic wounds, and all other known illnesses

19 October 1909: Opening a nurses’ home in Dewsbury, Clifford Allbutt describes their predecessors in the Leeds fever hospital in the 1860s

29 June 1876: Uplifted, Harrogate parish church awaits the monstrous £1,800 Schulze organ from Thomas Stuart Kennedy’s Meanwood Towers, Leeds

2 June 1867: Dr Clifford Allbutt tells the Epidemiological Society that the market will not provide decent housing for Leeds’s poorest

20 December 1868: The Leeds authorities try to make Eliza Thurkill calmly admit she is dying so that, under English law, her hearsay statement may later hang her abortionist

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Comment

Wikipedia:

In the law of evidence, a dying declaration is testimony that would normally be barred as hearsay but may in common law nonetheless be admitted as evidence in criminal law trials because it constituted the last words of a dying person. The rationale is that someone who is dying or believes death to be imminent would have less incentive to fabricate testimony, and as such, the hearsay statement carries with it some reliability.

Laura Eliza(beth) Thurkill/Thirkill died aged 21 and was interred on 30 December in Beckett Street Cemetery.

Sarah Barrett, the midwife, was acquitted by the jury at the spring assizes (Bradford Observer 1869/03/30). The date I’ve taken – 20 December – is based on that article and Allbutt’s testimony.

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