Exploring Illness
Time and Place

c u l t u r e s


s y m p t o m s

Fevers and Chills

An Injured Limb

Swollen Sores

Fevers and Chills in the Late 20th Century United States

Patients presenting at a doctor's office in the late 20th century in the United States with periodic fevers, excessive sweating, and nausea would be treated in the following way.

First, the patient (who could be male or female) would speak to a receptionist (probably female) and fill out a form describing his height and weight, his health insurance, his allergies, his medical history, and perhaps his family's medical history. Next, he would sit in a waiting room, either adopting the clinical gaze or reading an out-of-date magazine, until called by a nurse (again probably female). The nurse would lead him to an examining room, and perform some initial tests, such as taking his blood pressure, counting his pulse, taking his temperature, and asking him to describe what was wrong with him. She would write this information on a chart and take it to the doctor (probably, but not necessarily, male).

Some minutes later, the doctor would enter the examining room. He would ask again about the symptoms the patient was experiencing. He would be particularly interested in how often the fevers recurred, how well the person felt between feverish episodes, and what other symptoms occurred during the fevers. He would ask to feel the patient's belly, paying special attention to the spleen. Using a stethoscope, he might listen to the heart and count the heart rate. He might also look for at the color of the skin for either jaundice or cyanosis. In order to rule out various diseases, he might request a blood sample, which would be taken by a nurse and analyzed in a laboratory. Depending upon the laboratory results, an American doctor would ask where the patient was from, and if he had recently traveled into a tropical country, or been bitten by mosquitoes. If the patient answered affirmatively, the doctor might diagnose the patient's disease as malaria.

Following diagnosis, the doctor would prescribe particular drugs, possibly one, or sometimes a cocktail of two or more. The doctor would caution his patient to drink plenty of fluids, rest until he felt better, and take his drugs exactly as directed. If doctor decided the species of malarial pathogen was falciparum, he might admit his patient to a nearby hospital. Otherwise, he would give the prescription to the patient and send him to the billing department. After leaving the clinic, the patient would take his written prescription to be filled at a pharmacy, usually a few blocks away from the doctor's office. The doctor might telephone or ask to see the patient again in several days, sooner if the patient began to feel more ill.

Several months later, after the patient was feeling healthy again, he would begin trying to resolve the $2,000 billing mistake made by his health insurance plan.

Primary Sources

Personal accounts by patients experiencing illness in the late twentieth century can be easily found, unlike for other periods in the history of medicine. In the following source, one man's experience with falciparum malaria is startling both for the drama of experience, and for the nonchalance he expresses regarding medical treatment that is truly extraordinary, at least in historical perspective. True Story: Malaria

Substantial amounts of medical information were easily available in the late 20th century United States. For an excellent primer on malaria, see the Centers for Disease Control Information for Travelers page. Take note of the disclaimer at the bottom of the page. Even though the CDC was a highly respected official Government medical establishment, it did not attempt to substitute itself for a visit to the doctor.

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