Report of Dr C. B. Greenfield

Buenos Aires, 1871

PRO FO118/145 pp.256-70

This document is the original report by Dr C. B. Greenfield. It has at sometime in the past been damaged. At the least, the final page is lacking; there are also some pages of which the final line is torn away.

Buenos Ayres
May 20th 1871

Sir

The Epidemic which has been desolating this city having ceased, I beg to forward a report of the Medical Assistance rendered to the English poor on behalf of the British Legation.

On the 24th March in accordance with instructions received therefrom, I placed myself in communication with the Revd Father Leahy, the Irish pastor, and the Revds Messrs Ashe, Lett and Smith, with a view to obtaining information as to pauper members of their various congregations who might stand in need of Medical Assistance.

Through the valuable aid of these gentlemen, especially the hearty co-operation of the Revd Mr Lett, I was enabled to carry out the object in view, and the result is shown by the appended list.

According to your desire, Sir, that I should give a slight sketch of the nature of the disease, I may state that I believe it differed in no respect from the same disease as witnessed in other parts of the world. Of course there were cases of every degree of intensity from those of the mildest form to others of the most malignant character, in which Black Vomit, haemorrhages from the nose, gums, bowels, &c, deep orange colour of the skin, suppression of urine &c were one or all present. Many of the cases which I have classed in my list as cases of Febricula might by some physicians have been placed under the head of Yellow fever, but the symptoms were so slight that I have preferred to separate them.

I may state that in addition to those on my list I prescribed for many poor English, of whom I was unable from press of work to make any note.

As regards the treatment of the disease, Emetics, in universal repute among the foreign physicians (line missing) at all used by the English practitioners. I did not use one during the whole course of my practice. It is very easy to produce vomiting but it is a very difficult thing often to allay irritability of the stomach when once started.

Purgatives were extensively used, and to keep the bowels freely open was found one of the greatest safeguards against the occurrence of severe gastric irritation. After the preliminary strong purge of Calomel or Calomel & Jalap & Castor oil, the favourite medicine for gently keeping up the effect was the Limonade Rogé, a French preparation of Citrate of Magnesia, which answered (line missing).

In addition to the Emetics used by some practitioners & the preliminary purge, a hot bath with mustard was nearly always administered at the outset, where practicable & the patient put at once into blankets in order to excite diaphoresis. Needless to say, that in my pauper practice, such a proceeding was in no case feasible though I saw the beneficial effect of it amongst my patients of other classes.

Of Antiseptic remedies used internally, a solution of Chlorince (Chlorine?) & a mixture containing Sulpho Carbolate of Soda with Glycerine were both extensively exhibited. I made use of the former in a large number of cases. The patients in spite of its strong, pungent odour in most cases spoke of it as refreshing, & it always remained on the stomach, even when everything else was rejected. As to any marked effect produced on the course of the disease by its use, I saw none, & latterly used it much less. Gastric irritation I relieved in various cases by the exhibition of Chloroform on Sugar.

Haemoptysis, Epistaxis & Haematemisis were in various cases checked by the administration of the Tincture of the Perchloride of Iron. Pills containing Acetate of Lead and opium were used with great success by some practitioners, in cases where the state of the urine would allow it, to check the Black Vomit.

Opiates however, were in the majority of cases inadmissible. On the occurrence of suppression of urine, frequent enemata of Castor oil & Turpentine, the application of Turpentine stupes externally or frictious with a liniment containing Spirit of Mustard & Compound Camphor liniment were the most generally adopted means and they were attended in some cases with success, but too frequently proved of no avail.

Light diet, administered in small quantities could alone be borne on account of the gastric irritation.

I further enclose a few remarks suggested by the appended list and an account of small sums disbursed to needy persons. The amount expended in charity has been small, because in all cases abundant pecuniary aid was afforded by the clergy.

I remain
Sir
Your most Obedient Servant

C. B. Greenfield

H. G. MacDonnell Esqre
H. B. M. Chargé d`Affaires
Buenos Aires

List of Poor patients attended on behalf of the British Legation
during the Epidemic of Yellow Fever between March 24th — May 15th 1871
 
 NameAgeResidenceDiseaseResult
1 Ed. Gannon27 143 Brazil Yellow Fever cured
2 John Smith43  ditto Lazaretto
3 Ed McMore34 255 Balcarce ditto Died
4 Thos. Crozier36 255 Balcarce ditto Died
5 Jas. Orquote Loghlen26 175 Balcarce ditto cured
6 Wm. Tweedle26 175 Balcarce ditto Died
7 John Cooney26 175 Balcarce ditto cured
8 Mrs Wilks48 260 Temple ditto cured
9 Mary Tallon27 326 Independencia ditto cured
10 Mrs Smith30 285 San Martín ditto cured
11 Mrs Hill70 286 San Juan ditto cured
12 Jane Hill13 286 San Juan ditto cured
13 Caroline Hill10 286 San Juan ditto cured
14 Mrs Fowell53 228 Temple ditto cured
15 William Matthews14 326 Independencia ditto cured
16 Alf. Schroeder32 332 San Martín ditto cured
17 Eliza Schroeder29 332 San Martín ditto cured
18 Otto Seaman22 175 Balcarce ditto Died
19 John Hill45 286 San Juan ditto Died
20 Thos. Cusack7 177 Balcarce ditto cured
21 Sam. Tapling28 25 Tucumán Y.F. & Del. Trem Died
22 Chas. James75 226 25 de Mayo Yellow Fever Died
23 Mrs Roberts40 Calle Nueva ditto cured
24 Mary Parkinson30 59 Paraguay ditto cured
25 Robt. Tallon12 399 Buen Orden ditto cured
26 John Sinnott38 Calle Nueva ditto Died
27 Mrs Sinnott27 Calle Nueva ditto cured
28 John Hill18 286 San Juan ditto Died
29 William Barrett35 158¾ 25 de Mayo ditto cured
30 Bridget Barrett27 158¾ 25 de Mayo ditto cured
31 Thos. Hayden38 206 25 de Mayo ditto cured
32 Mary E Parkinson16 59 Paraguay ditto cured
33 Jos. Crane24 Independencia ditto cured
34 William Greenslade30 Railways Cars ditto cured
35 Fanny Fowell20 228 Temple ditto cured
36 Chas. Woodley19 327 Estados Unidos ditto Died
37 Harriet Woodley13 327 Estados Unidos ditto cured
38 Arthur Woodley15 327 Estados Unidos ditto cured
39 Alex. Woodley17 327 Estados Unidos ditto cured
40 Harry Thompson38 327 Estados Unidos ditto cured
41 Wm. Cross40 156 Balcarce ditto cured
42 J. Thompson37 156 Balcarce ditto Died
43 J Stanton34 156 Balcarce ditto cured
44 Mrs Emery40 Railway Cars ditto cured
45 Matilda Tallon15 399 Buen Orden ditto cured
46 Emilia Matthews9 399 Buen Orden ditto cured
47 Robert Tallon11 399 Buen Orden ditto cured
48 Harriet Nunes15 158 25 de Mayo ditto cured
49 Peter Duffey20 102 Paseo de Julio ditto cured
50 Alice Parkinson4 59 Paraguay ditto cured
51 William Heley24 46 Potosí ditto Died
52 Lily Wilks16 260 Temple ditto cured
53 Eliza Williams7 91 Santa Fe ditto cured
54 Jane Kelly16 27 Tucumán ditto cured
55 John Harper51 Barracas ditto Died
56 John Chandler40 Calle Nueva ditto cured
57 Mrs Chandler31 Calle Nueva ditto cured
58 Denis Rickord27 Calle Defensa ditto cured
59 Wm. Foster  111 25 de Mayo ditto Died
60 Geo. Walker28 158¾ 25 de Mayo ditto cured
61 Chas. Monroe38 177 Balcarce ditto Died
62 Eliza Comley30 156 Balcarce ditto cured
63 Mrs Coote27 32 Paraguay Y.F. & Uterine Dis. Refused Treatment
64 William Wilkinson25 14 Venezuela Yellow Fever Died
65 Thos. Hennedy40 139 25 de Mayo ditto Died
66 Charlotte Mowles6 276 Maipú ditto cured
67 Robt. Erskine24 206 25 de Mayo ditto cured

1 Mrs Gannon 26 143 Brazil Rheumatism cured
2 Jno. Metcalfe 25 175 Balcarce Febricula cured
3 (data missing) (data missing) Convulsions Died
4 (data missing) (data missing) (data missing) Died
5 Mary Forrest 28 260 Temple Tonsilitis cured
6 John Davison 35 158¾ 25 de Mayo Debility to Lazaretto by landlord
7 Martin Burke 25 177 Balcarce Catarrh cured
8 Mary Preston 23 17 México Debility relieved
9 Emma Emery 18 Railway Cars Catarrh cured
10 J. Williams 40 Calle Pozos Diarrhoea cured
11 John Duffey 18 102 Paseo de Julio Dyspepsia cured
12 Marg. Issendorf 27 Quinta Febricula cured
13 Miss Clarke 50 91 Parque Debility cured
14 Jas. Wyatt 43 183 Charcas Diarrhoea cured
15 Geo Mitchell 30 158 25 de Mayo Volvuluscured
16 Chas. Berg 31 158 25 de Mayo Chron. Bronchitis relieved
17 Wm. Scolbin 40 32 Parque Phthisis Died
18 Mrs Lynn 35 Barracas Debility relieved
19 Geo. Lynn 7 Barracas Small Pox Died
20 D. Bretherton 25 Calle Nueva Tonsilitis relieved
21 Adeline Williams 3 228 Temple Febricula cured
22 Jas. Wilson 30 183 Charcas Rheumatism relieved
23 Rd. Hall 25 206 25 de Mayo Febricula cured
24 Jas. Maguire 26 175 Balcarce Febricula cured
25 Jas. Riley 26 158¾ 25 de Mayo Rheumatism relieved
26 Chas. Shields 28 158¾ 25 de Mayo Debility after Y.F. cured
27 Wm. Harkins 26 158¾ 25 de Mayo Syph. Ulcus relieved
28 Alf. Jones 34 158¾ 25 de Mayo Synovitis relieved
29 John Dalton 40 170 Balcarce Phthisis Died
30 John Welch 25 158¾ 25 de Mayo Febricula cured
31 Mrs Hayden 30 206 25 de Mayo Debility cured
32 dau. Lynn 4 Barracas Small Pox cured
33 Mrs Williams 27 91 Santa Fe Catarrh cured
34 Thos. Mullins 25 158¾ 25 de Mayo Dyspepsia cured
35 Chas. Pressley 27 91 Santa Fe Orchitis relieved

 CuredDeathsTotal
Yellow Fever501767
Various diseases30 535

Remarks

Nos. 3 & 4 Yellow Fever were neglected cases. They were in the same room, almost utterly without attendance.

17 Was one of the worst female cases I had and at one time I despaired of her life.

21 A man of very intemperate habits. The fever was complicated with Delirium Tremens.

19 & 28 Father and son. Very malignant cases of short duration. All the female members of the family passed through disease in a comparatively mild form.

34 Was a very bad case, but terminated favourably.

36 A very malignant case.

41, 42, 43 were all seized by the disease in the same house on the same day. 42 succumbed rapidly. 41 remained for some days in a critical state.

51 A neglected case died the same day that he was visited.

59 A neglected case died shortly before I entered the house.

61 Was a case of relapse.

Of the various diseases there is little to remark:

3 & 4 died from infantile diseases of common occurrence.

17 & 29 Cases of Phthisis in men who had been much exposed & led irregular lives.

19 A case of Confluent Small Pox complicated with Bronchitis.

Remarks
The influence of Age & Sex

The average of the ages of those who died was about 35 years. That the greatest mortality from this disease has occurred among men in the prime of life, has I believe been the experience of most medical practitioners during the Epidemic. Hale and active men have, of course, been compelled to remain in the city engaged in their various avocations, while women and those past an age to be actively employed fled to the camp. Of Aged persons who were attacked by the disease the proportion that perished was very large.

The greater number of poor English in this city are able bodied men in the prime of life; but sufficient instances of females who were attacked are shown in the list to demonstrate how much less risk they run. Of 67 cases 40 are males, 27 women & girls. Not one female died, but of the men 17, or 42.5 per cent, perished. This is perhaps unusual. It does not accord entirely with my experience in my Parish practice, but it is too striking not to call forth remark & to awaken thought.

It will be further remarked what a large proportion of cases & the number of deaths that occurred in Calle Balcarce. Case 64 in Venezuela & the Railway Cars are all down there. It is one of the oldest portions of the city, lying (line missing) (the remaining section of the text of the report is missing).

The Rev T.E. Ash`s report is rather more fulsome.
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