October 18, 1985

The Medical Milieu of Daniel Drake

Author Affiliations

From the American Medical Association, Chicago.

JAMA. 1985;254(15):2126-2128. doi:10.1001/jama.1985.03360150102035

Of the various ailments that physicians had to treat in the early 19th century, fever and inflammation were especially important. Today both of these conditions have quite precise meanings but to understand the medical environment of Daniel Drake (1785-1852) we must ignore the present and enter into the meanings prevalent during his lifetime.

Both inflammation and fever had been clearly recognized in antiquity, although their nature was a matter of conjecture and speculation. Hippocrates had admirably described examples of febrile diseases, with such accuracy that in many instances we can make a clinical diagnosis today from his descriptions. And the cardinal signs of inflammation—the tumor, rubor, calor, and dolor that medical students still religiously memorize—were already enunciated by Celsus in the first century AD.

Physicians could easily identify inflammation on the surface of the body and infer its presence in the internal organs. Yet the alleged causes, phrased in the