The American Plague - Molly Caldwell Crosby [29]
As is often the case in heroic medicine, the treatment for yellow fever could be as bad as the symptoms themselves. Calomel is mercury based and could cause mercury poisoning if given in the wrong doses or not followed with a saline enema to flush the remaining mercury from the body. And quinine, a derivative of the South American cinchona tree, the fever tree, had long been used as a treatment. Unknown to the doctors at that time, quinine is toxic to many bacteria and plasmodium, like in the case of malaria, but has no effect on a virus like yellow fever. Instead, given in high doses, quinine could produce many of the same symptoms as yellow fever: delirium, photosensitivity and nausea.
Though Mitchell desperately needed doctors, he was finally forced to send someone to the train station to turn away volunteers from the North. They did not survive in Memphis but for a few days before becoming patients themselves. The burden was too much.
At night, the physicians gathered to compare notes from the day and perform autopsies in search of clues to the epidemic. The liver, it was recorded, might be the color of boxwood, while the spleen was enlarged and kidneys completely congested. One doctor described the bodies of the freshly dead, which might run temperatures as high as 110 degrees, as having blood that steamed and organs that felt as though dipped in boiling water.
Yellow fever, unlike any other disease, carried a mysterious horror to it. Its attack was acute and quick, its duration painful. In addition to its gruesome symptoms, the fever could cause lacerations and bruises on the skin to openly bleed. Pregnant women spontaneously miscarried. In a testament to the ignorance toward both the fever and women’s health, one man wrote that the fever caused women well past their childbearing years to suddenly begin menstruating again. In reality, the hemorrhagic fever led to uterine bleeding just as it did all other types of internal and external hemorrhaging. For the doctors and nurses, the fever’s most disturbing symptom must have been the mental decline. In mild cases, it surfaced as irritability and inability to stay still. In severe cases, it bordered on maniacal. Patients ran yellow eyed and delirious into the streets, screamed, thrashed and had to be physically restrained.
William James Armstrong, a thirty-nine-year-old physician, had moved his practice from the country to Memphis in 1873, only a few months before that yellow fever epidemic. New to Memphis, he sent his family away and chose to stay behind in the city during the 1873 epidemic hoping to earn the respect of friends and colleagues. After all, he had a wife and children who depended on his fledgling practice. As a profession in the mid-nineteenth century, medicine was not a lucrative one, nor a highly respected one. In fact, for an educated man with connections, choosing medicine was often seen as throwing away his future. No standard schooling or licensing was required. Most American doctors relied not on science, but on the ability to please patients. In order to build a practice, they established personal, long-standing relationships with families, offering personal advice and treating husbands, wives, children and babies. He might be called in during a complicated childbirth, but even that was handled primarily by midwives and women family members. Physicians in the 1870s had to find a way to remain relevant or necessary to everyday life. When yellow fever struck in 1878, Armstrong again decided to stay in Memphis, sending his wife, Lula, and their eight children to Columbia, Tennessee.
Will Armstrong had a heavy, dark beard and a tender nature. He had married his bride on her sixteenth birthday in the midst of the Civil War, he played the violin and he called his youngest daughter, only a few weeks old, his “dear little pig.” As a physician, Armstrong must have seemed gentle, even a little timid.
Though Armstrong had served in earlier epidemics,