Tip:
Highlight text to annotate it
X
Advice to the people
ADVICE
to the
PEOPLE in General,
with
Regard to their Health:
But more particularly calculated for those, who,
by their Distance from regular Physicians, or
other very experienced Practitioners, are the
most unlikely to be seasonably provided with
the best Advice and Assistance, in acute
Diseases, or upon any sudden inward or outward
Accident.
WITH
A Table of the most cheap, yet effectual Remedies,
and the plainest Directions for preparing
them readily.
Translated from the French Edition of
Dr. Tissot's Avis au Peuple, &c.
Printed at Lyons; with all his own Notes; a few of
his medical Editor's at Lyons; and several occasional
Notes, adapted to this English Translation,
By J. Kirkpatrick, M. D.
In the Multitude of the People is the Honour of a King; and
for the Want of People cometh the Destruction of the Prince.
Proverbs xiv, 28.
LONDON:
Printed for T. Becket and P. A. De Hondt, at
Tully's Head, near Surry-Street, in the Strand.
M DCC LXV.
the Translator's PREFACE.
hough the great Utility of those
medical Directions, with which the
following Treatise is thoroughly
replenished, will be sufficiently evident
to every plain and sensible
Peruser of it; and the extraordinary Reception
of it on the Continent is recited in the very worthy
Author's Preface; yet something, it should
seem, may be pertinently added, with Regard
to this Translation of it, by a Person who has
been strictly attentive to the Original: a Work,
whose Purpose was truly necessary and benevolent;
as the Execution of it, altogether, is very
happily accomplished.
It will be self evident, I apprehend, to every
excellent Physician, that a radical Knowledge of
the Principles, and much Experience in the Exercise,
of their Profession, were necessary to accommodate
such a Work to the Comprehension
of those, for whom it was more particularly calculated.
Such Gentlemen must observe, that
the certain Axiom of Nature's curing Diseases,
which is equally true in our Day, as it was in
that of Hippocrates, so habitually animates
this Treatise, as not to require the least particular
Reference. This Hippocratic Truth as certain
(though much less subject to general Observation)
as that Disease, or Age, is finally prevalent
over all sublunary Life, the most attentive Physicians
discern the soonest, the most ingenuous
readily confess: and hence springs that wholesome
Zeal and Severity, with which Dr. Tissot
encounters such Prejudices of poor illiterate Persons,
as either oppose, or very ignorantly precipitate,
her Operations, in her Attainment of Health.
These Prejudices indeed may seem, from this
Work, to be still greater, and perhaps grosser too,
in Swisserland than among ourselves; though it
is certain there is but too much Room for the
Application of his salutary Cautions and Directions,
even in this Capital; and doubtless abundantly
more at great Distances from it. It may
be very justly supposed, for one Instance, that in
most of those Cases in the Small Pocks, in which
the Mother undertakes the Cure of her Child,
or confides it to a Nurse, that Saffron, in a
greater or less Quantity, and Sack or Mountain
Whey, are generally still used in the Sickening
before Eruption; to accelerate that very Eruption,
whose gradual Appearance, about the
fourth Day, from that of Seizure inclusive, is so
favourable and promising to the Patient; and the
Precipitation of which is often so highly pernicious
to them. Most of, or rather all, his other
Cautions and Corrections seem equally necessary
here, as often as the Sick are similarly circumstanced,
under the different acute Diseases in
which he enjoins them.
Without the least Detraction however from
this excellent Physician, it may be admitted that
a few others, in many other Countries, might
have sufficient Abilities and Experience for the
Production of a like Work, on the same good
Plan. This, we find, Dr. Hirzel, principal
Physician of Zurich, had in Meditation, when
the present Treatise appeared, which he thought
had so thoroughly fulfilled his own Intention,
that it prevented his attempting to execute it.
But the great Difficulty consisted in discovering a
Physician, who, with equal Abilities, Reputation
and Practice, should be qualified with that
much rarer Qualification of caring so much more
for the Health of those, who could never pay
him for it, than for his own Profit or Ease, as
to determine him to project and to accomplish so
necessary, and yet so self-denying, a Work. For
as the Simplicity he proposed in the Style and
Manner of it, by condescending, in the plainest
Terms, to the humblest Capacities, obliged him
to depress himself, by writing rather beneath the
former Treatises, which had acquired him the
Reputation of medical Erudition, Reasoning and
Elegance; we find that the Love of Fame itself,
so stimulating even to many ingenuous Minds,
was as impotent as that of Wealth, to seduce
him from so benign, so generous a Purpose.
Though, upon Reflection, it is by no Means
strange to see wise Men found their Happiness,
which all [however variously and even oppositely]
pursue, rather in Conscience, than on Applause;
and this naturally reminds us of that
celebrated Expression of Cato, or some other
excellent Ancient, “that he had rather be good,
than be reputed so.”
However singular such a Determination may
now appear, the Number of reputable medical
Translators into different Languages, which this
original Work has employed on the Continent,
makes it evident, that real Merit will, sooner or
later, have a pretty general Influence; and induce
many to imitate that Example, which they either
could not, or did not, propose. As the truly
modest Author has professedly disclaimed all
Applause on the Performance, and contented
himself with hoping an Exemption from Censure,
through his Readers' Reflection on the peculiar
Circumstances and Address of it; well
may his best, his faithfullest Translators, whose
Merit and Pains must be of a very secondary Degree
to his own, be satisfied with a similar Exemption:
especially when joined to the Pleasure,
that must result from a Consciousness of having
endeavoured to extend the Benefits of their Author's
Treatise, to Multitudes of their own Country
and Language.
For my own Particular, when after reading
the Introduction to the Work, and much of the
Sequel, I had determined to translate it; to be
as just as possible to the Author, and to his
English Readers, I determined not to interpolate
any Sentiment of my own into the Text, nor to
omit one Sentence of the Original, which, besides
its being Detraction in its literal Sense, I
thought might imply it in its worst, its figurative
one; for which there was no Room. To conform
as fully as possible to the Plainness and Perspicuity
he proposed, I have been pretty often
obliged in the anatomical Names of some Parts,
and sometimes of the Symptoms, as well as in
some pretty familiar, though not entirely popular
Words, to explain all such by the most common
Words I have heard used for them; as after
mentioning the Diaphragm, to add, or Midriff—the
Trachæa—or Windpipe—acrimonious,
or very sharp, and so of many others. This may
a little, though but a little, have extended the
Translation beyond the Original; as the great
Affinity between the French and Latin, and between
the former and many Latin Words borrowed
from the Greek, generally makes the
same anatomical or medical Term, that is technical
with us, vernacular or common with them.
But this unavoidable Tautology, which may be
irksome to many Ears, those medical Readers,
for whom it was not intended, will readily forgive,
from a Consideration of the general Address
of the Work: while they reflect that meer
Style, if thoroughly intelligible, is least essential
to those Books, which wholly consist of very
useful, and generally interesting, Matter.
As many of the Notes of the Editor of Lyons,
as I have retained in this Version (having translated
from the Edition of Lyons) are subscribed
E. L. I have dispensed with several, some, as
evidently less within Dr. Tissot's Plan, from
tending to theorize, however justly or practically,
where he must have had his own Reasons for
omitting to theorize: a few others, as manifestly
needless, from what the Author had either
premised, or speedily subjoined, on the very
same Circumstance: besides a very few, from
their local Confinement to the Practice at Lyons,
which lies in a Climate somewhat more different
from our own than that of Lausanne. It is
probable nevertheless, I have retained a few
more than were necessary in a professed Translation
of the original Work: but wherever I have
done this, I have generally subjoined my Motive
for it; of whatever Consequence that may appear
to the Reader. I have retained all the Author's
own Notes, with his Name annexed to them;
or if ever the Annotator was uncertain to me, I
have declared whose Note I supposed it to be.
Such as I have added from my own Experience
or Observation are subscribed K, to distinguish
them from the others; and that the Demerit
of any of them may neither be imputed to
the learned Author, nor to his Editor. Their
principal Recommendation, or Apology is, that
whatever Facts I have mentioned are certainly
true. I have endeavoured to be temperate in
their Number and Length, and to imitate that
strict Pertinence, which prevails throughout the
Author's Work. If any may have ever condescended
to consider my Way of writing, they
will conceive this Restraint has cost me at least as
much Pains, as a further Indulgence of my own
Conceptions could have done. The few Prescriptions
I have included in some of them, have
been so conducted, as not to give the Reader the
least Confusion with Respect to those, which the
Author has given in his Table of Remedies, and
which are referred to by numerical Figures,
throughout the Course of his Book.
The moderate Number of Dr. Tissot's Prescriptions,
in his Table of Remedies, amounting
but to seventy-one, and the apparent Simplicity
of many of them, may possibly disgust some
Admirers of pompous and compound Prescription.
But his Reserve, in this important Respect,
has been thoroughly consistent with his
Notion of Nature's curing Diseases; which suggested
to him the first, the essential Necessity of
cautioning his Readers against doing, giving, or
applying any thing, that might oppose her healing
Operations (a most capital Purpose of his
Work) which important Point being gained, the
mildest, simplest and least hazardous Remedies
would often prove sufficient Assistants to her.
Nevertheless, under more severe and tedious
Conflicts, he is not wanting to direct the most
potent and efficacious ones. The Circumstances
of the poor Subjects of his medical Consideration,
became also a very natural Object to him, and
was in no wise unworthy the Regard of the
humane Translator of Bilguer on Amputations,
or rather against the crying Abuse of
them; an excellent Work, that does real Honour
to them both; and which can be disapproved
by none, who do not prefer the frequently
unnecessary Mutilation of the afflicted, to the
Consumption of their own Time, or the Contraction
of their Employment.
Some Persons may imagine that a Treatise of
this Kind, composed for the Benefit of labouring
People in Swisserland, may be little applicable to
those of the British Islands: and this, in a very
few Particulars, and in a small Degree, may
reasonably be admitted. But as we find their
common Prejudices are often the very same; as
the Swiss are the Inhabitants of a colder Climate
than France, and generally, as Dr. Tissot often
observes, accustomed to drink (like ourselves)
more strong Drink than the French Peasantry;
and to indulge more in eating Flesh too, which
the Religion of Berne, like our own, does not restrain;
the Application of his Advice to them will
pretty generally hold good here. Where he forbids
them Wine and Flesh, all Butchers Meat,
and in most Cases all Flesh, and all strong Drink
should be prohibited here: especially when we
consider, that all his Directions are confined to
the Treatment of acute Diseases, of which the
very young, the youthful, and frequently even
the robust are more generally the Subjects. Besides,
in some few of the English Translator's
Notes, he has taken the Liberty of moderating
the Coolers, or the Quantities of them (which
may be well adapted to the great Heats and violent
Swiss Summers he talks of) according to the
Temperature of our own Climate, and the general
Habitudes of our own People. It may be
observed too, that from the same Motive, I have
sometimes assumed the Liberty of dissenting from
the Text in a very few Notes, as for Instance, on
the Article of Pastry, which perhaps is generally
better here than in Swisserland (where it may be
no better than the coarse vile Trash that is hawked
about and sold to meer Children) as I have frequently,
in preparing for Inoculation, admitted
the best Pastry (but not of Meat) into the limited
Diet of the Subjects of Inoculation, and constantly
without the least ill Consequence. Thus
also in Note Page , , I have presumed
to affirm the Fact, that a strong spirituous Infusion
of the Bark has succeeded more speedily in
some Intermittents, in particular Habits, than
the Bark in Substance. This I humbly conceive
may be owing to such a Menstruum's extracting
the Resin of the Bark more effectually (and so
conveying it into the Blood) than the Juices of
the Stomach and of the alimentary Canal did, or
could. For it is very conceivable that the Crasis,
the Consistence, of the fibrous Blood may sometimes
be affected with a morbid Laxity or Weakness,
as well as the general System of the muscular
Fibres.
These and any other like Freedoms, I am
certain the Author's Candour will abundantly
pardon; since I have never dissented for Dissention's
Sake, to the best of my Recollection; and
have the Honour of harmonizing very generally
in Judgment with him. If one useful Hint or
Observation occurs throughout my Notes, his
Benevolence will exult in that essential Adherence
to his Plan, which suggested it to me:
While an invariable ecchoing Assentation throughout
such Notes, when there really was any salutary
Room for doubting, or for adding (with
Respect to ourselves) would discover a Servility,
that must have disgusted a liberal manly Writer.
One common good Purpose certainly springs from
the generous Source, and replenishes the many
Canals into which it is derived; all the Variety
and little Deviations of which may be considered
as more expansive Distributions of its Benefits.
Since the natural Feelings of Humanity generally
dispose us, but especially the more tender
and compassionate Sex, to advise Remedies to
the poor Sick; such a Knowledge of their real
Disease, as would prevent their Patrons, Neighbours
and Assistants from advising a wrong Regimen,
or an improper or ill-timed Medicine, is
truly essential to relieving them: and such we
seriously think the present Work is capable of
imparting, to all commonly sensible and considerate
Perusers of it. A Vein of unaffected Probity,
of manly Sense, and of great Philanthropy,
concur to sustain the Work: And whenever the
Prejudices of the Ignorant require a forcible Eradication;
or the crude Temerity and Impudence
of Knaves and Impostors cry out for their own
Extermination, a happy Mixture of strong Argument,
just Ridicule, and honest Severity, give
a poignant and pleasant Seasoning to the Work,
which renders it occasionally entertaining, as it is
continually instructive.
A general Reader may be sometimes diverted
with such Customs and Notions of the Swiss Peasants,
as are occasionally mentioned here: and
possibly our meerest Rustics may laugh at the
brave simple Swiss, on his introducing a Sheep
into the Chamber of a very sick Person, to save
the Life of the Patient, by catching its own
Death. But the humblest Peasantry of both
Nations are agreed in such a Number of their
absurd unhealthy Prejudices, in the Treatment
of Diseases, that it really seemed necessary to
offer our own the Cautions and Counsels of this
principal Physician, in a very respectable Protestant
Republick, in Order to prevent their Continuance.
Nor is it unreasonable to presume, that
under such a Form of Government, if honestly
administered upon its justest Principles, the People
may be rather more tenderly regarded, than
under the Pomp and Rage of Despotism, or the
Oppression of some Aristocracies.
Besides the different Conditions of Persons,
to whom our Author recommends the Patronage
and Execution of his Scheme, in his Introduction,
it is conceived this Book must be serviceable to
many young Country Practitioners, and to great
Numbers of Apothecaries, by furnishing them
with such exact and striking Descriptions of each
acute Disease and its Symptoms, as may prevent
their mistaking it for any other; a Deception
which has certainly often been injurious, and
sometimes even fatal: for it is dreadful but to
contemplate the Destruction or Misery, with
which Temerity and Ignorance, so frequently
combined, overwhelm the Sick. Thus more
Success and Reputation, with the Enjoyment of
a better Conscience, would crown their Endeavours,
by a more general Recovery of, or Relief
to, their Patients. To effect this, to improve
every Opportunity of eschewing medical Evil,
and of doing medical Good, was the Author's
avowed Intention; which he informs us in his
Preface, he has heard, from some intelligent and
charitable Persons, his Treatise had effected, even
in some violent Diseases. That the same good
Consequences may every where attend the numerous
Translations of it, must be the fervent Wish
of all, except the Quacks and Impostors he so justly
characterizes in his thirty-third Chapter! and
particularly of all, who may be distinguishably
qualified, like himself, to,
—Look through Nature up to Nature's GOD!
The AUTHOR's DEDICATION.
To the most Illustrious, the most
Noble and Magnificent Lords,
the Lords President and Counsellors
of the Chamber of
Health, of the City and Republick
of Berne.
Most honourable Lords,
hen I first published
the following Work,
my utmost Partiality to
it was not sufficient to
allow me the Confidence of
addressing it to Your Lordships.
But Your continual Attention
to all the Objects, which have
any Relation to that important
Part of the Administration of the
State, which has been so wisely
committed to Your Care, has
induced You to take Notice of
it. You have been pleased to
judge it might prove useful, and
that an Attempt must be laudable,
which tends to the Extermination
of erroneous and inveterate
Prejudices, those cruel
Tyrants, that are continually opposing
the Happiness of the People,
even under that Form and
Constitution of Government,
which is the best adapted to establish
and to increase it.
Your Lordships Approbation,
and the splendid Marks of Benevolence,
with which You have
honoured me, have afforded me
a juster Discernment of the Importance
of this Treatise, and
have inclined me to hope, most
Illustrious, most Noble,
and Magnificent Lords, that
You will permit this new Edition
of it to appear under the Sanction
of your Auspices; that while the
Publick is assured of Your general
Goodness and Beneficence, it
may also be informed of my profoundly
grateful Sense of them,
on the same Occasion.
May the present Endeavour
then, in fully corresponding to my
Wishes, effectually realize Your
Lordships utmost Expectations
from it; while You condescend
to accept this small Oblation, as
a very unequal Expression of that
profound Respect, with which I
have the Honour to be,
Most Illustrious, Most Noble,
and Magnificent Lords,
Your most humble
And most
Obedient Servant,
TISSOT.
Lausanne,
Dec. 3, 1762.
THE AUTHOR's PREFACE.
f Vanity too often disposes many
to speak of themselves, there are
some Occasions, on which a total
Silence might be supposed to result
from a still higher Degree of it:
And the very general Reception of the Advice
to the People has been such, that there would
be Room to suspect me of that most shocking
Kind of Pride, which receives Applause with
Indifference (as deeming its own Merit Superior
to the greatest) if I did not appear to be
strongly impressed with a just Sense of that
great Favour of the Publick, which has been
so very obliging, and is so highly agreable, to me.
Unfeignedly affected with the unhappy Situation
of the poor Sick in Country Places in
Swisserland, where they are lost from a Scarcity of
the best Assistance, and from a fatal Superfluity
of the worst, my sole Purpose in writing this
Treatise has been to serve, and to comfort them.
I had intended it only for a small Extent of
Country, with a moderate Number of Inhabitants;
and was greatly surprized to find, that
within five or six Months after its Publication,
it was become one of the most extensively published
Books in Europe; and one of those Treatises,
on a scientific Subject, which has been
perused by the greatest Number of Readers of
all Ranks and Conditions. To consider such
Success with Indifference, were to have been
unworthy of it, which Demerit, at least on
this Account, I cannot justly be charged with;
since Indifference has not been my Case, who have
felt, as I ought, this Gratification of Self-love;
and which, under just and prudent Restrictions,
may perhaps be even politically cherished; as the
Delight naturally arising from having been approved,
is a Source of that laudable Emulation,
which has sometimes produced the most essential
good Consequences to Society itself. For my own
particular, I can truly aver, that my Satisfaction
has been exquisitely heightened on this Occasion,
as a Lover of my Species: since judging
from the Success of this Work (a Success which
has exceeded my utmost Expectations) of the
Effects that may reasonably be expected from it,
I am happily conscious of that Satisfaction, or
even Joy, which every truly honest Man must
receive, from rendering essential good Offices to
others. Besides which, I have enjoyed, in its
utmost Extent, that Satisfaction which every
grateful Man must receive from the Approbation
and Beneficence of his Sovereign, when I
was distinguished with the precious Medal,
which the illustrious Chamber of Health of the
Republick of Berne honoured me with, a few
Months after the Publication of this Treatise;
together with a Letter still more estimable, as
it assured me of the extraordinary Satisfaction
the Republick had testified on the Impression of
it; a Circumstance, which I could not avoid
this publick Acknowledgement of, without the
greatest Vanity and Ingratitude. This has also
been a very influencing Motive with me, to exert
my utmost Abilities in perfecting this new
Edition, in which I have made many Alterations,
that render it greatly preferable to the
first; and of which Amendments I shall give a
brief Account, after saying somewhat of the
Editions, which have appeared elsewhere.
The first is that, which Messrs. Heidegger,
the Booksellers published in the German Language
at Zurich, about a Year since. I should
have been highly delighted with the meer Approbation
of M. Hirzel, first Physician of the
Canton of Zurich, &c. whose superior and universal
Talents; whose profound Knowledge in the
Theory of Physick; and the Extent and Success
of whose Practice have justly elevated him among
the small Number of extraordinary Men of our
own Times; he having lately obtained the Esteem
and the Thanks of all Europe, for the History
of one of her Sages. But I little expected
the Honour this Gentleman has done me, in
translating the Advice to the People into his
own Language. Highly sensible nevertheless as
I am of this Honour, I must always reflect
with Regret, that he has consumed that important
Time, in rendering my Directions intelligible
to his Countrymen, which he might have
employed much more usefully, in obliging the
World with his own.
He has enriched his Translation with an excellent
Preface, which is chiefly employed in a
just and beautiful Portrait and Contrast of
the true, and of the false Physician; with
which I should have done myself the Pleasure
to have adorned the present Edition; if the
Size of this Volume, already too large, had not
proved an Obstacle to so considerable an Addition;
and if the Manner, in which Mr. Hirzel
speaks of its Author, had permitted me with Decency
to publish his Preface. I have been informed
by some Letters, that there have been two
other German Translation of it; but I am not
informed by whom. However, M. Hirzel's Preface,
his own Notes, and some Additions with
which I have furnished him, renders his Edition
preferable to the first in French, and to the
other German Translations already made.
The Second Edition is that, which the younger
Didot, the Bookseller, published towards the
End of the Winter at Paris. He had requested
me to furnish him with some Additions to
it, which I could not readily comply with.
The Third Edition is a Dutch Translation of
it, which will be very speedily published by M.
Renier Aremberg, Bookseller at Rotterdam.
He had begun the Translation from my first
Edition; but having wrote to know whether
I had not some Additions to make, I desired
him to wait for the Publication of this. I
have the good Fortune to be very happy in my
Translators; it being M. Bikker, a celebrated
Physician at Rotterdam (so very advantagiously
known in other Countries, by his beautiful
Dissertation on Human Nature, throughout which
Genius and Knowledge proceed Hand in Hand)
who will present his Countrymen with the Advice
to the People, in their own Language:
and who will improve it with such Notes, as
are necessary for a safe and proper Application
of its Contents, in a Climate, different from
that in which it was wrote. I have also heard,
there has been an Italian Translation of it.
After this Account of the foreign Editions,
I return to the present one, which is the second
of the original French Treatise. I shall
not affirm it is greatly corrected, with Respect
to fundamental Points: for as I had advanced
nothing in the first, that was not established
on Truth and Demonstration, there was
no Room for Correction, with Regard to any
essential Matters. Nevertheless, in this I have
made, 1, a great Number of small Alterations
in the Diction, and added several Words,
to render the Work still more simple and perspicuous.
2, The typographical Execution of this
is considerably improved in the Type, the Paper
and Ink, the Spelling, Pointing, and Arrangement
of the Work. 3, I have made some
considerable Additions, which are of three Kinds.
Not a few of them are new Articles on some
of the Subjects formerly treated of; such as
the Articles concerning Tarts and other Pastry
Ware; the Addition concerning the Regimen
for Persons, in a State of Recovery from
Diseases; the Preparation for the Small Pocks;
a long Note on the Jesuits Bark; another
on acid Spirits; one on the Extract of Hemlock:
besides some new Matter which I have
inserted; such as an Article with Regard to
proper Drinks; one on the Convulsions of Infants;
one on Chilblains; another on Punctures
from Thorns; one upon the Reason of the
Confidence reposed in Quacks, and the thirty-first
Chapter entirely: in which I have extended
the Consideration of some former Articles, that
seemed to me a little too succinct and short.
There are some Alterations of this last, this
additional, Kind, interspersed almost throughout
the whole Substance of this Edition; but especially
in the two Chapters relating to Women and
Children.
The Objects of the are such
as require immediate Assistance, viz. Swoonings,
Hæmorrhages, that is, large spontaneous
Bleedings; the Attacks of Convulsions, and of
Suffocations; the Consequences of Fright and
Terror; Disorders occasioned by unwholesome
or deadly Vapours; the Effects of Poison, and
the sudden Invasions of excessive Pain.
The Omission of this Chapter was a very
material Defect in the original Plan of this
Work. The Editor of it at Paris was very
sensible of this Chasm, or Blank, as it may
be called, and has filled it up very properly:
and if I have not made Use of his Supplement,
instead of enlarging myself upon the
Articles of which he has treated, it has only
been from a Purpose of rendering the whole
Work more uniform; and to avoid that odd
Diversity, which seems scarcely to be avoided
in a Treatise composed by two Persons. Besides
which, that Gentleman has said nothing
of the Articles, which employ the greatest Part
of that Chapter, viz. the Swoonings, the
Consequences of great Fear, and the noxious
Vapours.
Before I conclude, I ought to justify myself,
as well as possible, to a great Number of very
respectable Persons both here and abroad, (to
whom I can refuse nothing without great Chagrine
and Reluctance) for my not having made
such Additions as they desired of me. This
however was impossible, as the Objects, in
which they concurred, were some chronical Distempers,
that are entirely out of the Plan, to
which I was strictly attached, for many Reasons.
The first is, that it was my original
Purpose to oppose the Errors incurred in Country
Places, in the Treatment of acute Diseases;
and to display the best Method of conducting such,
as do not admit of waiting for the Arrival
of distant Succour; or of removing the Patients
to Cities, or large Towns. It is but too
true indeed, that chronical Diseases are also
liable to improper Treatment in small Country
Places: but then there are both Time and Convenience
to convey the Patients within the Reach
of better Advice; or for procuring them the
Attendance of the best Advisers, at their own
Places of Residence. Besides which, such Distempers
are considerably less common than those
to which I had restrained my Views: and
they will become still less frequent, whenever acute
Diseases, of which they are frequently the Consequences,
shall be more rationally and safely
conducted.
The second Reason, which, if alone, would
have been a sufficient one, is, that it is impossible
to subject the Treatment of chronical Distempers
to the Capacity and Conduct of Persons, who are
not Physicians. Each acute Distemper generally
arises from one Cause; and the Treatment of it is
simple and uniform; since those Symptoms, which
manifest the Malady, point out its Cause and
Treatment. But the Case is very differently circumstanced
in tedious and languid Diseases; each
of which may depend on so many and various
Causes (and it is only the real, the true Cause,
which ought to determine us in selecting its proper
Remedies) that though the Distemper and its Appellation
are evidently known, a meer By-stander
may be very remote from penetrating into its true
Cause; and consequently be incapable of chusing
the best Medicines for it. It is this precise and
distinguishing Discernment of the real particular
Cause [or of the contingent Concurrence of more
than one] that necessarily requires the Presence of
Persons conversant in the Study and the Practice
of all the Parts of Physick; and which Knowledge
it is impossible for People, who are Strangers
to such Studies, to arrive at. Moreover, their
frequent Complexness; the Variety of their Symptoms;
the different Stages of these tedious Diseases
[not exactly attended to even by many competent
Physicians] the Difficulty of ascertaining the different
Doses of Medicines, whose Activity may
make the smallest Error highly dangerous, &c.
&c. are really such trying Circumstances, as render
the fittest Treatment of these Diseases sufficiently
difficult and embarrassing to the most experienced
Physicians, and unattainable by those who are not
Physicians.
A third Reason is, that, even supposing all
these Circumstances might be made so plain and
easy, as to be comprehended by every Reader, they
would require a Work of an excessive Length; and
thence be disproportioned to the Faculties of those,
for whom it was intended. One single chronical
Disease might require as large a Volume as the
present one.
But finally, were I to acknowledge, that this
Compliance was both necessary and practicable, I
declare I find it exceeds my Abilities; and that I
am also far from having sufficient Leisure for the
Execution of it. It is my Wish that others would
attempt it, and may succeed in accomplishing it;
but I hope these truly worthy Persons, who have
honoured me by proposing the Achievement of it to
myself, will perceive the Reasons for my not complying
with it, in all their Force; and not ascribe
a Refusal, which arises from the very Nature of
the thing, either to Obstinacy, or to any Want of
an Inclination to oblige them.
I have been informed my Citations, or rather
References, have puzzled some Readers. It was
difficult to foresee this, but is easy to prevent it
for the future. The Work contains Citations only
of two Sorts; one, that points to the Remedies
prescribed; and the other, which refers to some
Passage in the Book itself, that serves to illustrate
those Passages in which I cite. Neither of these
References could have been omitted. The first is
marked thus, Nº. with the proper Figure to it,
as 1, 2, &c. This signifies, that the Medicine I
direct is described in the Table of Remedies, according
to the Number annexed to that Character.
Thus when we find directed, in any Page of the
Book, the warm Infusion ; in some other,
the Ptisan ; or in a third, the Almond
Milk, or Emulsion , it signifies, that such
Prescriptions will be found at the Numbers 1, 2,
and 4; and this Table is printed at the End of
the Book.
If, instead of forming this Table, and thus referring
to the Prescriptions by their Numbers, I
had repeated each Prescription as often as I directed
it, this Treatise must have been doubled in
Bulk, and insufferably tiresome to peruse. I must
repeat here, what I have already said in the former
Edition, that the Prices of the Medicines,
or of a great Number of them, are those at which
the Apothecaries may afford them, without any
Loss, to a Peasant in humble Circumstances. But
it should be remembered, they are not set down at
the full Prices which they may handily demand;
since that would be unjust for some to insist on
them at. Besides, there is no Kind of Tax in
Swisserland, and I have no Right to impose one.
The Citations of the second Kind are very
plain and simple. The whole Work is divided
into numbered Paragraphs distinguished by the
Mark §. And not to swell it with needless
Repetitions, when in one Place I might have
even pertinently repeated something already observed,
instead of such Repetition at Length,
I have only referred to the Paragraph, where
it had been observed. Thus, for Example when
we read Page , —When the Disease is so
circumstanced as we have described, ,— this
imports that, not to repeat the Description already
given, I refer the Reader to that last § for it.
The Use of these Citations is not the least Innovation,
and extremely commodious and easy: but
were there only a single Reader likely to be puzzled
by them, I ought not to omit this Explanation of
them, as I can expect to be generally useful, only
in Proportion as I am clear: and it must be obvious,
that a Desire of being extensively useful is the
sole Motive of this Work. I have long since had
the Happiness of knowing, that some charitable
and intelligent Persons have applied the Directions
it contains, with extraordinary Success, even in
violent Diseases: And I shall arrive at the
Height of my Wishes, if I continue to be informed,
that it contributes to alleviate the Sufferings,
and to prolong the Days, of my rational
Fellow Creatures.
N. B. A Small Blank occurring conveniently
here in the Impression, the Translator of this
Work has employed it to insert the following
proper Remark, viz.
Whenever the Tea or Infusion of the Lime-tree
is directed in the Body of the Book, which
it often is, the Flowers are always meant, and
not the Leaves; though by an Error of the Press,
or perhaps rather by an Oversight of the Transcribers
of this Version, it is printed Leaves instead
of Flowers P. , as noted and corrected
in the . These Flowers are easily procurable
here, meerly for gathering, in most
Country Places in July, as few Walks, Vistas,
&c. are without these Trees, planted for the
pleasant Shade they afford, and to keep off the
Dust in Summer, though the Leaf drops rather
too early for this Purpose. Their Flowers have
an agreeable Flavour, which is communicated to
Water by Infusion, and rises with it in Distillation.
They were, to the best of my Recollection,
an Ingredient in the antiepileptic Water of
Langius, omitted in our late Dispensatories of the
College. They are an Ingredient in the antiepileptic
Powder, in the List of Medicines in the
present Practice of the Hotel Dieu at Paris: and
we think were in a former Prescription of our
Pulvis de Gutteta, or Powder against Convulsions.
Indeed they are considered, by many
medical Writers, as a Specific in all Kinds of
Spasms and Pains; and Hoffman affirms, he
knew a very tedious Epilepsy cured by the Use
of an Infusion of these Flowers.
I also take this Opportunity of adding, that as
this Translation is intended for the Attention and
the Benefit of the Bulk of the Inhabitants of the
British Empire, I have been careful not to admit
any Gallicisms into it; as such might render
it either less intelligible, or less agreeable to its
Readers. If but a single one occurs, I either
have printed it, or did intend it should be printed,
distinguishably in Italics. K.
Introduction.
he Decrease of the Number of Inhabitants,
in most of the States of
Europe, is a Fact, which impresses
every reflecting Person, and is become
such a general Complaint, as
is but too well established on plain Calculations.
This Decrease is most remarkable in Country
Places. It is owing to many Causes; and I
shall think myself happy, if I can contribute to
remove one of the greatest of them, which is
the pernicious Manner of treating sick People
in Country Places. This is my sole Object,
tho' I may be excused perhaps for pointing out
the other concurring Causes, which may be all
included within these two general Affirmations;
That greater Numbers than usual emigrate from
the Country; and that the People increase less
every where.
There are many Sorts of Emigration. Some
leave their Country to enlist in the Service of
different States by Sea and Land; or to be
differently employ'd abroad, some as Traders, others
as Domestics, &c.
Military Service, by Land or Sea, prevents
Population in various Respects. In the first
Place, the Numbers going abroad are always
less, often much less, than those who return.
General Battles, with all the Hazards and Fatigues
of War; detached Encounters, bad Provisions,
Excess in drinking and eating, Diseases
that are the Consequences of Debauches, the Disorders
that are peculiar to the Country; epidemical,
pestilential or contagious Distempers, caused
by the unwholsome Air of Flanders, Holland,
Italy and Hungary; long Cruises, Voyages to
the East or West Indies, to Guinea, &c. destroy
a great Number of Men. The Article of Desertion
also, the Consequences of which they dread
on returning home, disposes many to abandon
their Country for ever. Others, on quitting the
Service, take up with such Establishments, as it
has occasionally thrown in their Way; and which
necessarily prevent their Return. But in the
second Place, supposing they were all to come
back, their Country suffers equally from their
Absence; as this very generally happens during
that Period of Life, when they are best adapted
for Propagation; since that Qualification on their
Return is impaired by Age, by Infirmities and
Debauches: and even when they do marry, the
Children often perish as Victims to the Excesses
and Irregularities of their Fathers: they are weak,
languishing, distempered, and either die young,
or live incapable of being useful to Society. Besides,
that the prevailing Habit of Libertinage,
which many have contracted, prevents several of
them from marrying at all. But notwithstanding
all these inconvenient Consequences are real and
notorious; yet as the Number of those, who
leave their Country on these Accounts, is limited,
and indeed rather inconsiderable, if compared
with the Number of Inhabitants which must remain
at home: as it may be affirmed too, that
this relinquishing of their Country, may have
been even necessary at some Times, and may
become so again, if the Causes of Depopulation
should cease, this kind of Emigration is doubtless
the least grievous of any, and the last which may
require a strict Consideration.
But that abandoning of their Country, or Expatriation,
as it may be termed, the Object of
which is a Change of the Emigrants Condition,
is more to be considered, being more numerous.
It is attended with many and peculiar Inconveniencies,
and is unhappily become an epidemical
Evil, the Ravages of which are still increasing;
and that from one simple ridiculous Source,
which is this; that the Success of one Individual
determines a hundred to run the same Risque,
ninety and nine of whom may probably be disappointed.
They are struck with the apparent
Success of one, and are ignorant of the Miscarriage
of others. Suppose a hundred Persons
might have set out ten Years ago, to seek their
Fortune, as the saying is, at the End of six Months
they are all forgotten, except by their Relations;
but if one should return the same Year, with
more Money than his own Fortune, more than
he set out with; or if one of them has got a
moderate Place with little Work, the whole
Country rings with it, as a Subject of general Entertainment.
A Croud of young People are seduced
by this and sally forth, because not one reflects,
that of the ninety nine, who set out with
the hundredth Person, one half has perished, many
are miserable, and the Remainder come back,
without having gained any thing, but an Incapacity
to employ themselves usefully at home,
and in their former Occupations: and having
deprived their Country of a great many Cultivaters,
who, from the Produce of the Lands, would
have attracted considerable Sums of Money, and
many comfortable Advantages to it. In short,
the very small Proportion who succeed, are continually
talked of; the Croud that sink are perpetually
forgot. This is a very great and real
Evil, and how shall it be prevented? It would
be sufficient perhaps to publish the extraordinary
Risque, which may be easily demonstrated: It
would require nothing more than to keep an exact
yearly Register of all these Adventurers, and,
at the Expiration of six, eight, or ten Years, to
publish the List, with the Fate, of every Emigrant.
I am greatly deceived, or at the End of
a certain Number of Years, we should not see
such Multitudes forsake their native Soil, in which
they might live comfortably by working, to go
in Search of Establishments in others; the Uncertainty
of which, such Lists would demonstrate
to them; and also prove, how preferable
their Condition in their own Country would have
been, to that they have been reduced to. People
would no longer set out, but on almost certain
Advantages: fewer would undoubtedly
emigrate, more of whom, from that very Circumstance,
must succeed. Meeting with fewer
of their Country-men abroad, these fortunate
few would oftner return. By this Means more
Inhabitants would remain in the Country, more
would return again, and bring with them more
Money to it. The State would be more populous,
more rich and happy; as the Happiness of
a People, who live on a fruitful Soil, depends
essentially on a great Number of Inhabitants,
with a moderate Quantity of pecuniary Riches.
But the Population of the Country is not only
necessarily lessened, in Consequence of the Numbers
that leave it; but even those who remain
increase less, than an equal Number formerly
did. Or, which amounts to the same Thing,
among the same Number of Persons, there are
fewer Marriages than formerly; and the same
Number of Marriages produce fewer Christenings.
I do not enter upon a Detail of the Proofs,
since merely looking about us must furnish a sufficient
Conviction of the Truth of them. What
then are the Causes of this? There are two capital
ones, Luxury and Debauchery, which are
Enemies to Population on many Accounts.
Luxury compells the wealthy Man, who
would make a Figure; and the Man of a moderate
Income, but who is his equal in every
other Respect, and who will imitate him, to be
afraid of a numerous Family; the Education
of which must greatly contract that Expence he
had devoted to Parade and Ostentation: And besides,
if he must divide his Estate among a great
many Children, each of them would have but a
little, and be unable to keep up the State and the
Train of the Father's. Since Merit is unjustly
estimated by exterior Shew and Expence, one
must of Course endeavour to attain for himself,
and to leave his Children in, a Situation capable
of supporting that Expence. Hence the fewer
Marriages of People who are not opulent, and
the fewer Children among People who marry.
Luxury is further prejudicial to the Increase
of the People, in another Respect. The irregular
Manner of Life which it introduces, depresses
Health; it ruins the Constitutions, and
thus sensibly affects Procreation. The preceding
Generation counted some Families with more
than twenty Children: the living one less than
twenty Cousins. Very unfortunately this Way
of thinking and acting, so preventive of Increase,
has extended itself even into Villages: and they
are no longer convinced there, that the Number
of Children makes the Riches of the Countryman.
Perhaps the next Generation will scarcely
be acquainted with the Relation of Brotherhood.
A third Inconvenience of Luxury is, that the
Rich retreat from the Country to live in Cities;
and by multiplying their Domestics there, they
drain the former. This augmented Train is prejudicial
to the Country, by depriving it of Cultivaters,
and by diminishing Population. These
Domestics, being seldom sufficiently employed,
contract the Habit of Laziness; and they
prove incapable of returning to that Country Labour,
for which Nature intended them. Being
deprived of this Resource they scarcely ever marry,
either from apprehending the Charge of Children,
or from their becoming Libertines; and
sometimes, because many Masters will not employ
married Servants. Or should any of them
marry, it is often in the Decline of Life, whence
the State must have the fewer Citizens.
Idleness of itself weakens them, and disposes
them to those Debauches, which enfeeble them
still more. They never have more than a few
Children, and these sickly; such as have not
Strength to cultivate the Ground; or who, being
brought up in Cities, have an Aversion to
the Country.
Even those among them who are more prudent,
who preserve their Morals, and make some
Savings, being accustomed to a City Life, and
dreading the Labour of a Country one (of the
Regulation of which they are also ignorant)
chuse to become little Merchants, or Tradesmen;
and this must be a Drawback from Population, as
any Number of Labourers beget more Children
than an equal Number of Citizens; and also by
Reason, that out of any given Number, more
Children die in Cities, than in the Country.
The same Evils also prevail, with Regard to
female Servants. After ten or twelve Years
Servitude, the Maid-Servants in Cities cannot
acquit themselves as good Country Servants: and
such of them as chuse this Condition, quickly
fail under that Kind or Quantity of Work, for
which they are no longer constituted. Should
we see a Woman married in the Country, a
Year after leaving Town, it is easy to observe,
how much that Way of living in the Country
has broke her. Frequently their first Child-bed,
in which Term they have not all the Attendance
their Delicacy demands, proves the Loss of their
Health; they remain in a State of Languor, of
Feebleness, and of Decay: they have no more
Children; and this renders their Husbands unuseful
towards the Population of the State.
Abortions, Infants carried out of their Country
after a concealed Pregnancy, and the Impossibility
of their getting Husbands afterwards, are frequently
the Effects of their Libertinage.
It is to be apprehended too these bad Effects
are rather increasing with us; since, either for
want of sufficient Numbers, or from oeconomical
Views, it has become a Custom, instead of
Women Servants, to employ Children, whose
Manners and whole Constitutions are not yet
formed; and who are ruined in the same
Manner, by their Residence in Town, by their Laziness,
by bad Examples, and bad Company.
Doubtless much remains still unsaid on these
important Heads; but besides my Intention
not to swell this Treatise immoderately, and the
many Avocations, which prevent me from launching
too far into what may be less within the
Bounds of Medicine, I should be fearful of digressing
too far from my Subject. What I have
hitherto said however, I think cannot be impertinent
to it; since in giving Advice to the People,
with Regard to their Health, it was necessary to
display to them the Causes that impaired it:
though what I might be able to add further on
this Head, would probably be thought more remote
from the Subject.
I shall add then but a single Hint on the Occasion.
Is it not practicable, in Order to remedy
those Evils which we cannot prevent, to select
some particular Part or Canton of the Country,
wherein we should endeavour by Rewards, 1st.
Irremoveably to fix all the Inhabitants. 2dly. To
encourage them by other Rewards to a plentiful
and legitimate Increase. They should not be permitted
to go out of it, which must prevent them
from being exposed to the Evils I have mentioned.
They should by no means intermarry with any
Strangers, who might introduce such Disorders
among them. Thus very probably this Canton,
after a certain Time, would become even over-peopled,
and might send out Colonies to the
others.
One Cause, still more considerable than those
we have already mention'd, has, to this very Moment,
prevented the Increase of the People in
France. This is the Decay of Agriculture. The
Inhabitants of the Country, to avoid serving in the
Militia; to elude the Days-Service impos'd by
their Lords, and the Taxes; and being attracted
to the City by the Hopes of Interest, by Laziness
and Libertinage, have left the Country nearly deserted.
Those who remain behind, either not
being encouraged to work, or not being sufficient
for what there is to do, content themselves with
cultivating just as much as is absolutely necessary
for their Subsistence. They have either lived
single, or married but late; or perhaps, after the
Example of the Inhabitants of the Cities, they
have refused to fulfil their Duty to Nature, to the
State, and to a Wife. The Country deprived of
Tillers, by this Expatriation and Inactivity, has
yielded nothing; and the Depopulation of the
State has daily increased, from the reciprocal
and necessary Proportion between Subsistence and
Population, and because Agriculture alone can
increase Subsistence. A single Comparison will
sufficiently evince the Truth and the Importance
of these Principles, to those who have not seen
them already divulged and demonstrated in the
Works of the Friend of Man.
“An old Roman, who was always ready to
return to the Cultivation of his Field, subsisted
himself and his Family from one Acre of Land.
A Savage, who neither sows nor cultivates,
consumes, in his single Person, as much Game
as requires fifty Acres to feed them. Consequently
Tullus Hostilius, on a thousand Acres,
might have five thousand Subjects: while a
Savage Chief, limited to the same Extent of
Territory, could scarcely have twenty: such
an immense Disproportion does Agriculture
furnish, in Favour of Population. Observe
these two great Extremes. A State becomes
dispeopled or peopled in that Proportion, by
which it recedes from one of these Methods,
and approaches to the other.” Indeed it is
evident, that wherever there is an Augmentation
of Subsistence, an Increase of Population will soon
follow; which again will still further facilitate
the Increase of Provisions. In a State thus circumstanced
Men will abound, who, after they
have furnished sufficient Numbers for the Service
of War, of Commerce, of Religion, and for Arts
and Professions of every kind, will further also
furnish a Source for Colonies, who will extend
the Name and the Prosperity of their Nation to
distant Regions. There will ensue a Plenty of
Commodities, the Superfluity of which will be
exported to other Countries, to exchange for other
Commodities, that are not produced at home;
and the Balance, being received in Money, will
make the Nation rich, respectable by its Neighbours,
and happy. Agriculture, vigorously pursued,
is equal to the Production of all these Benefits;
and the present Age will enjoy the Glory of
restoring it, by favouring and encouraging Cultivaters,
and by forming Societies for the Promotion
of Agriculture.
I proceed at length to the fourth Cause of Depopulation,
which is the Manner of treating sick
People in the Country. This has often affected
me with the deepest Concern. I have been a
Witness, that Maladies, which, in themselves,
would have been gentle, have proved mortal from
a pernicious Treatment: I am convinced that
this Cause alone makes as great a Havock as the
former; and certainly it requires the utmost Attention
of Physicians, whose Duty it is to labour
for the Preservation of Mankind. While we are
employing our assiduous Cares on the more polished
and fashionable Part of them in Cities, the
larger and more useful Moiety perish in the
Country; either by particular, or by highly epidemical,
Diseases, which, within a few Years
past, have appeared in different Villages, and made
no small Ravages. This afflicting Consideration
has determined me to publish this little Work,
which is solely intended for those Patients, who,
by their Distance from Physicians, are deprived of
their Assistance. I shall not give a Detail of my
Plan, which is very simple, in this Part; but
content myself with affirming, I have used my
utmost Care to render it the most useful I possibly
could: and I dare hope, that if I have not fully
displayed its utmost Advantages, I have at least
sufficiently shewn those pernicious Methods of
treating Diseases, that should incontestably be
avoided. I am thoroughly convinced, the Design
might be accomplished more compleatly
than I have done it; but those who are so capable
of, do not attempt, it: I happen to be
less timid; and I hope that thinking Persons will
rather take it in good part of me, to have published
a Book, the composing of which is rather
disagreeable from its very Facility; from the minute
Details, which however are indispensable;
and from the Impossibility of discussing any Part
of it (consistently with the Plan) to the Bottom of
the Subject; or of displaying any new and useful
Prospect. It may be compared, in some Respects,
to the Works of a spiritual Guide, who
was to write a Catechism for little Children.
At the same time I am not ignorant there have
already been a few Books calculated for Country
Patients, who are remote from Succour: but
some of these, tho' published with a very good
Purpose, produce a bad Effect. Of this kind are
all Collections of Receipts or Remedies, without
the least Description of the Disease; and of Course
without just Directions for the Exhibition,
or Application, of them. Such, for Example,
is the famous Collection of Madam Fouquet,
and some more in the same manner.
Some others approach towards my Plan;
but many of them have taken in too many
Distempers, whence they are become too voluminous.
Besides, they have not dwelt sufficiently
upon the Signs of the Diseases; upon their Causes;
the general Regimen in them, and the
Mismanagement of them. Their Receipts are not
generally as simple, and as easy to prepare, as
they ought to be. In short, the greater Part of
their Writers seem, as they advanced, to have
grown tired of their melancholy Task, and to
have hurried them out too expeditiously. There
are but two of them, which I must name with
Respect, and which being proposed on a Plan
very like my own, are executed in a superior Manner,
that merits the highest Acknowlegements
of the Publick. One of these Writers is M.
Rosen, first Physician of the Kingdom of Sweden;
who, some Years since, employed his just
Reputation to render the best Services to his
Country Men. He has made them retrench from
the Almanacs those ridiculous Tales; those extraordinary
Adventures; those pernicious astrological
Injunctions, which there, as well as here,
answer no End, but that of keeping up Ignorance,
Credulity, Superstition, and the falsest Prejudices
on the interesting Articles of Health, of Diseases,
and of Remedies. He has also taken Care to
publish simple plain Treatises on the most popular
Distempers; which he has substituted in the
Place of the former Heap of Absurdities. These
concise Works however, which appear annually
in their Almanacs, are not yet translated from the
Swedish, so that I was unqualified to make any
Extracts from them. The other is the Baron
Van Swieten, first Physician to their Imperial
Majesties, who, about two Years since, has effected
for the Use of the Army, what I now attempt
for sick People in the Country. Though my
Work was greatly advanced, when I first saw
his, I have taken some Passages from it: and had
our Plans been exactly alike, I should imagine I
had done the Publick more Service by endeavouring
to extend the Reading of his Book, than by
publishing a new one. Nevertheless, as he is
silent on many Articles, of which I have treated
diffusively; as he has treated of many Distempers,
which did not come within my Plan; and has
said nothing of some others which I could not
omit; our two Works, without entering into the
Particulars of the superior Merit of the Baron's,
are very different, with Regard to the Subject of
the Diseases; tho' in such as we have both considered,
I account it an Honour to me to find, we
have almost constantly proceeded upon the same
Principles.
The present Work is by no means addressed
to such Physicians, as are thoroughly accomplished
in their Profession; yet possibly, besides my
particular medical Friends, some others may read
it. I beg the Favour of all such fully to consider
the Intention, the Spirit, of the Author, and not
to censure him, as a Physician, from the Composition
of this Book. I even advise them here
rather to forbear perusing it; as a Production,
that can teach them nothing. Such as read, in
order to criticize, will find a much greater Scope
for exercising that Talent on the other Pamphlets
I have published. It were certainly unjust that a
Performance, whose sole abstracted Object is the
Health and Service of my Countrymen, should
subject me to any disagreeable Consequences:
and a Writer may fairly plead an Exemption
from any Severity of Censure, who has had the
Courage to execute a Work, which cannot pretend
to a Panegyric.
Having premised thus much in general, I
must enter into some Detail of those Means, that
seem the most likely to me, to facilitate the beneficial
Consequences, which, I hope, may result
to others, from my present Endeavours. I
shall afterwards give an Explanation of some
Terms which I could not avoid using, and which,
perhaps, are not generally understood.
The Title of Advice to the People, was not
suggested to me by an Illusion, which might persuade
me, this Book would become a Piece of
Furniture, as it were, in the House of every Peasant.
Nineteen out of twenty will probably
never know of its Existence. Many may be unable
to read, and still more unable to understand,
it, plain and simple as it is. I have principally
calculated it for the Perusal of intelligent
and charitable Persons, who live in the Country;
and who seem to have, as it were, a Call from
Providence, to assist their less intelligent poor
Neighbours with their Advice.
It is obvious, that the first Gentlemen I have
my Eye upon, are the Clergy. There is not a
single Village, a Hamlet, nor even the House of
an Alien in the Country, that has not a Right
to the good Offices of some one of this Order;
And I assure myself there are a great Number of
them, who, heartily affected with the Distress
of their ailing Flocks, have wished many hundred
Times, that it were in their Power to give their
Parishioners some bodily Help, at the very Time
they were disposing them to prepare for Death;
or so far to delay the Fatality of the Distemper,
that the Sick might have an Opportunity of living
more religiously afterwards. I shall think
myself happy, if such truly respectable Ecclesiastics
shall find any Resources in this Performance,
that may conduce to the Accomplishment
of their beneficent Intentions. Their Regard,
their Love for their People; their frequent Invitations
to visit their principal Neighbours; their
Duty to root out all unreasonable Prejudices, and
Superstition; their Charity, their Learning; the
Facility, with which their general Knowlege in
Physics, qualifies them to comprehend thoroughly
all the medical Truths, and Contents of this
Piece, are so many Arguments to convince me,
that they will have the greatest Influence to procure
that Reformation, in the Administration of
Physick to poor Country People, which is so necessary,
so desirable, an Object.
In the next Place, I dare assure myself of the
Concurrence of Gentlemen of Quality and Opulence,
in their different Parishes and Estates, whose
Advice is highly regarded by their Inferiors; who
are so powerfully adapted to discourage a wrong,
and to promote a right Practice, of which they
will easily discern all the Advantages. The many
Instances I have seen of their entering, with
great Facility, into all the Plan and Conduct of
a Cure; their Readiness and even Earnestness to
comfort the Sick in their Villages; and the Generosity
with which they prevent their Necessities,
induce me to hope, from judging of these I
have not the Pleasure to know, by those whom I
have, that they will eagerly embrace an Opportunity
of promoting a new Method of doing good
in their Neighbourhood. Real Charity will apprehend
the great Probability there is of doing
Mischief, tho' with the best Intention, for want
of a proper Knowledge of material Circumstances;
and the very Fear of that Mischief may
sometimes suspend the Exercise of such Charity;
notwithstanding it must seize, with the most
humane Avidity, every Light that can contribute
to its own beneficent Exertion.
Thirdly, Persons who are rich, or at least in
easy Circumstances, whom their Disposition, their
Employments, or the Nature of their Property,
fixes in the Country, where they are happy in
doing good, must be delighted to have some proper
Directions for the Conduct and Effectuation
of their charitable Intentions.
In every Village, where there are any Persons,
of these three Conditions, they are always readily
apprized of the Distempers in it, by their poor
Neighbours coming to intreat a little Soup, Venice
Treacle, Wines, Biscuits, or any thing they imagine
necessary for their sick Folks. In Consequence
of some Questions to the Bystanders, or
of a Visit to the sick Person, they will judge at
least of what kind the Disease is; and by their prudent
Advice they may be able to prevent a Multitude
of Evils. They will give them some Nitre
instead of Venice Treacle; Barley, or sweet
Whey, in lieu of Soup. They will advise them
to have Recourse to Glysters, or Bathings of their
Feet, rather than to Wine; and order them Gruel
rather than Biscuits. A man would scarcely
believe, 'till after the Expiration of a few Years,
how much Good might be effected by such proper
Regards, so easily comprehended, and often
repeated. At first indeed there may be some
Difficulty in eradicating old Prejudices, and inveterately
bad Customs; but whenever these were
removed, good Habits would strike forth full
as strong Roots, and I hope that no Person would
be inclined to destroy them.
It may be unnecessary to declare, that I have
more Expectation from the Care and Goodness
of the Ladies, than from those of their Spouses,
their Fathers, or Brothers. A more active Charity,
a more durable Patience, a more domestic
Life; a Sagacity, which I have greatly admired
in many Ladies both in Town and Country, that
disposes them to observe, with great Exactness;
and to unravel, as it were, the secret Causes of
the Symptoms, with a Facility that would do
Honour to very good Practioners, and with a Talent
adapted to engage the Confidence of the Patient:—All
these, I say, are so many characteristical
Marks of their Vocation in this important and
amicable Duty; nor are there a few, who fulfil
it with a Zeal, that merits the highest Commendation,
and renders them excellent Models for
the Imitation of others.
Those who are intrusted with the Education of
Youth, may also be supposed sufficiently intelligent
to take some Part in this Work; and I am
satisfied that much Good might result from their
undertaking it. I heartily wish, they would not
only study to distinguish the Distemper (in which
the principal, but by no means an insuperable
Difficulty consists; and to which I hope I have
considerably put them in the Way) but I would
have them learn also the Manner of applying Remedies.
Many of them have; I have known
some who bleed, and who have given Glysters
very expertly. This however all may easily
learn; and perhaps it would not be imprudent,
if the Art of bleeding well and safely were reckoned
a necessary Qualification, when they are
examined for their Employment. These Faculties,
that of estimating the Degree of a Fever,
and how to apply and to dress Blisters, may be
of great Use within the Neighbourhood of their
Residence. Their Schools, which are not frequently
over-crouded, employ but a few of their
daily Hours; the greater part of them have no
Land to cultivate; and to what better Use can
they apply their Leisure, than to the Assistance
and Comfort of the Sick? The moderate Price
of their Service may be so ascertained, as to incommode
no Person; and this little Emolument
might render their own Situation the more agreeable:
besides which, these little Avocations might
prevent their being drawn aside sometimes, by
Reason of their Facility and frequent Leisure, so
as to contract a Habit of drinking too often.
Another Benefit would also accrue from accustoming
them to this kind of Practice, which
is, that being habituated to the Care of sick People,
and having frequent Occasions to write, they
would be the better qualify'd, in difficult Cases,
to advise with those, who were thought further
necessary to be consulted.
Doubtless, even among Labourers, there may
be many, for some such I have known, who being
endued with good natural Sense and Judgment,
and abounding with Benevolence, will
read this Book with Attention, and eagerly extend
the Maxims and the Methods it recommends.
And finally I hope that many Surgeons, who
are spread about the Country, and who practice
Physic in their Neighbourhood, will peruse it;
will carefully enter into the Principles established
in it, and will conform to its Directions; tho'
a little different perhaps from such as they may
have hitherto practiced. They will perceive a
Man may learn at any Age, and of any Person;
and it may be hoped they will not think it too
much Trouble to reform some of their Notions
in a Science, which is not properly within their
Profession (and to the Study of which they were
never instituted) by those of a Person, who is
solely employed in it, and who has had many
Assistances of which they are deprived.
Midwives may also find their Attendance more
efficacious, as soon as they are thoroughly disposed
to be better informed.
It were heartily to be wished, that the greater
Part of them had been better instructed in the
Art they profess. The Instances of Mischief
that might have been avoided, by their being
better qualify'd, are frequent enough to make us
wish there may be no Repetition of them, which
it may be possible to prevent. Nothing seems
impossible, when Persons in Authority are zealously
inclined to prevent every such Evil; and it is
time they should be properly informed of one
so essentially hurtful to Society.
The Prescriptions I have given consist of the
most simple Remedies, and I have adjoined the
Manner of preparing them so fully, that I hope
no Person can be at any Loss in that Respect.
At the same time, that no one may imagine they
are the less useful and efficacious for their Simplicity,
I declare, they are the same I order in the
City for the most opulent Patients. This Simplicity
is founded in Nature: the Mixture, or rather
the Confusion, of a Multitude of Drugs is ridiculous.
If they have the very same Virtues, for
what Purpose are they blended? It were more
judicious to confine ourselves to that, which is the
most effectual. If their Virtues are different,
the Effect of one destroys, or lessens, the Effect of
the other; and the Medicine ceases to prove a
Remedy.
I have given no Direction, which is not very
practicable and easy to execute; nevertheless it
will be discernible, that some few are not calculated
for the Multitude, which I readily grant.
However I have given them, because I did not
lose Sight of some Persons; who, tho' not strictly
of the Multitude, or Peasantry, do live in the
Country, and cannot always procure a Physician
as soon, or for as long a Time, as they gladly
would.
A great Number of the Remedies are entirely
of the Country Growth, and may be prepared
there; but there are others, which must be had
from the Apothecaries. I have set down the
Price at which I am persuaded all the Country
Apothecaries will retail them to a Peasant, who
is not esteemed a rich one. I have marked the
Price, not from any Apprehension of their being
imposed on in the Purchase, for this I do not apprehend;
but, that seeing the Cheapness of the
Prescription, they may not be afraid to buy it.
The necessary Dose of the Medicine, for each
Disease, may generally be purchased for less Money
than would be expended on Meat, Wine,
Biscuits, and other improper things. But should
the Price of the Medicine, however moderate,
exceed the Circumstances of the Sick, doubtless
the Common Purse, or the Poors-Box will defray
it: moreover there are in many Country Places
Noblemens Houses, some of whom charitably
contribute an annual Sum towards buying of
Medicines for poor Patients. Without adding
to which Sum, I would only intreat the Favour
of each of them to alter the Objects of it, and
to allow their sick Neighbours the Remedies and
the Regimen directed here, instead of such as
they formerly distributed among them.
It may still be objected, that many Country
Places are very distant from large Towns;
from which Circumstance a poor Peasant is incapable
of procuring himself a seasonable and necessary
Supply in his Illness. I readily admit, that,
in Fact, there are many Villages very remote
from such Places as Apothecaries reside in. Yet,
if we except a few among the Mountains, there
are but very few of them above three or four
Leagues from some little Town, where there always
lives some Surgeon, or some Vender of Drugs.
Perhaps however, even at this Time, indeed,
there may not be many thus provided; but they
will take care to furnish themselves with such
Materials, as soon as they have a good Prospect
of selling them, which may constitute a small,
but new, Branch of Commerce for them. I have
carefully set down the Time, for which each Medicine
will keep, without spoiling. There is a
very frequent Occasion for some particular ones,
and of such the School-masters may lay in a
Stock. I also imagine, if they heartily enter into
my Views, they will furnish themselves with
such Implements, as may be necessary in the
Course of their Attendance. If any of them
were unable to provide themselves with a sufficient
Number of good Lancets, an Apparatus
for Cupping, and a Glyster Syringe (for want of
which last a Pipe and Bladder may be occasionally
substituted) the Parish might purchase them,
and the same Instruments might do for the succeeding
School-master. It is hardly to be expected,
that all Persons in that Employment
would be able, or even inclined, to learn the
Way of using them with Address; but one Person
who did, might be sufficient for whatever
Occasions should occur in this Way in some contiguous
Villages; with very little Neglect of
their Functions among their Scholars.
Daily Instances of Persons, who come from
different Parts to consult me, without being capable
of answering the Questions I ask them, and
the like Complaints of many other Physicians on
the same Account, engaged me to write the last
Chapter of this Work. I shall conclude this
Introduction with some Remarks, necessary to facilitate
the Knowledge of a few Terms, which
were unavoidable in the Course of it.
The Pulse commonly beats in a Person in
good Health, from the Age of eighteen or twenty
to about sixty six Years, between sixty and
seventy Times in a Minute. It sometimes comes
short of this in old Persons, and in very young
Children it beats quicker: until the Age of three
or four Years the Difference amounts at least to
a third; after which it diminishes by Degrees.
An intelligent Person, who shall often touch
and attend to his own Pulse, and frequently to
other Peoples, will be able to judge, with sufficient
Exactness, of the Degree of a Fever in a sick
Person. If the Strokes are but one third above
their Number in a healthy State, the Fever is
not very violent: which it is, as often as it amounts
to half as many more as in Health. It
is very highly dangerous, and may be generally
pronounced mortal, when there are two Strokes
in the Time of one. We must not however
judge of the Pulse, solely by its Quickness, but
by its Strength or Weakness; its Hardness or
Softness; and the Regularity or Irregularity of
it.
There is no Occasion to define the strong and
the feeble Pulse. The Strength of it generally
affords a good Prognostic, and, supposing it too
strong, it may easily be lowered. The weak
Pulse is often very menacing.
If the Pulse, in meeting the Touch, excites
the Notion of a dry Stroke, as though the Artery
consisted of Wood, or of some Metal, we term it
hard; the opposite to which is called soft, and generally
promises better. If it be strong and yet
soft, even though it be quick, it may be considered
as a very hopeful Circumstance. But if it is
strong and hard, that commonly is a Token of
an Inflammation, and indicates Bleeding and the
cooling Regimen. Should it be, at the same
time, small, quick and hard, the Danger is indeed
very pressing.
We call that Pulse regular, a continued Succession
of whole Strokes are made in equal Intervals
of Time; and in which Intervals, not a
single Stroke is wanting (since if that is its State,
it is called an intermitting Pulse.) The Beats or
Pulsations are also supposed to resemble each other
so exactly in Quality too, that one is not strong,
and the next alternately feeble.
As long as the State of the Pulse is promising;
Respiration or Breathing is free; the Brain does
not seem to be greatly affected; while the Patient
takes his Medicines, and they are attended
with the Consequence that was expected; and
he both preserves his Strength pretty well, and
continues sensible of his Situation, we may reasonably
hope for his Cure. As often as all, or
the greater Number of these characterizing
Circumstances are wanting, he is in very considerable
Danger.
The Stoppage of Perspiration is often mentioned
in the Course of this Work. We call the
Discharge of that Fluid which continually passes
off through the Pores of the Skin, Transpiration;
and which, though invisible, is very considerable.
For if a Person in Health eats and drinks to the
Weight of eight Pounds daily, he does not discharge
four of them by Stool and Urine together,
the Remainder passing off by insensible Transpiration.
It may easily be conceived, that if so
considerable a Discharge is stopt, or considerably
lessened; and if this Fluid, which ought to transpire
through the Skin, should be transfered to
any inward Part, it must occasion some dangerous
Complaint. In fact this is one of the most
frequent Causes of Diseases.
To conclude very briefly—All the Directions
in the following Treatise are solely designed for
such Patients, as cannot have the Attendance of
a Physician. I am far from supporting, they
ought to do instead of one, even in those Diseases,
of which I have treated in the fullest Manner;
and the Moment a Physician arrives, they
ought to be laid aside. The Confidence reposed
in him should be entire, or there should be none.
The Success of the Event is founded in that. It
is his Province to judge of the Disease, to select
Medicines against it; and it is easy to foresee
the Inconveniences that may follow, from proposing
to him to consult with any others, preferably
to those he may chuse to consult with; only because
they have succeeded in the Treatment of
another Patient, whose Case they suppose to have
been nearly the same with the present Case.
This were much the same, as to order a Shoemaker
to make a Shoe for one Foot by the Pattern
of another Shoe, rather than by the Measure
he has just taken.
N. B. Though a great Part of this judicious Introduction is
less applicable to the political Circumstances of the British Empire,
than to those of the Government for which it was calculated;
we think the good Sense and the unaffected Patriotism
which animate it, will supersede any Apology for our translating
it. The serious Truth is this, that a thorough Attention
to Population seems never to have been more expedient
for ourselves, than after so bloody and expensive, though such a
glorious and successful War: while our enterprizing Neighbours,
who will never be our Friends, are so earnest to recruit their
Numbers; to increase their Agriculture; and to force a Vent
for their Manufactures, which cannot be considerably effected,
without a sensible Detriment to our own. Besides which, the
unavoidable Drain from the People here, towards an effectual
Cultivation, Improvement, and Security of our Conquests, demands
a further Consideration. K.
ADVICE TO THE PEOPLE,
With Respect to their HEALTH.
Chapter I.
Of the most usual Causes of popular Maladies.
Sect. 1.
he most frequent Causes of Diseases
commonly incident to Country
People are, 1. Excessive Labour,
continued for a very considerable
Time. Sometimes they sink down
at once in a State of Exhaustion and Faintness,
from which they seldom recover: but they are
oftener attacked with some inflammatory Disease;
as a Quinsey, a Pleurisy, or an Inflammation of
the Breast.
There are two Methods of preventing these
Evils: one is, to avoid the Cause which
produces them; but this is frequently impossible.
Another is, when such excessive Labour has been
unavoidable, to allay their Fatigue, by a free
Use of some temperate refreshing Drink; especially
by sweet Whey, by Butter-milk, or by Water, to a Quart of which a Wine-glass of
Vinegar may be added; or, instead of that, the
expressed Juice of Grapes not fully ripe, or even
of Goosberries or Cherries: which wholesome
and agreeable Liquors are refreshing and cordial.
I shall treat, a little lower, of inflammatory Disorders.
The Inanition or Emptiness, though accompanied
with Symptoms different from the
former, have yet some Affinity to them with
Respect to their Cause, which is a kind of general
Exsiccation or Dryness. I have known some
cured from this Cause by Whey, succeeded by
tepid Baths, and afterwards by Cow's Milk: for
in such Cases hot Medicines and high Nourishment
are fatal.
§ 2. There is another Kind of Exhaustion or
Emptiness, which may be termed real
Emptiness, and is the Consequence of great Poverty,
the Want of sufficient Nourishment, bad Food,
unwholesome Drink, and excessive Labour. In
Cases thus circumstanced, good Soups and a little
Wine are very proper. Such happen however
very seldom in this Country: I believe they are
frequent in some others, especially in many Provinces
of France.
§ 3. A second and very common Source of
Disorders arises, from Peoples' lying down and
reposing, when very hot, in a cold Place. This
at once stops Perspiration, the Matter of which
being thrown upon some internal Part, proves
the Cause of many violent Diseases, particularly
of Quinseys, Inflammations of the Breast, Pleurisies,
and inflammatory Cholics. These Evils,
from this Cause, may always be avoided by avoiding
the Cause, which is one of those that destroy
a great Number of People. However, when it
has occurred, as soon as the first Symptoms of
the Malady are perceiveable, which sometimes
does not happen till several Days after, the Patient
should immediately be bled; his Legs should
be put into Water moderately hot, and he should
drink plentifully of the tepid Infusion marked
No. 1. Such Assistances frequently prevent the
Increase of these Disorders; which, on the contrary,
are greatly aggravated, if hot Medicines are
given to sweat the Patient.
§ 4. A third Cause is drinking cold Water,
when a Person is extremely hot. This acts in
the same Manner with the second; but its
Consequences are commonly more sudden and violent.
I have seen most terrible Examples of it,
in Quinseys, Inflammations of the Breast, Cholics,
Inflammations of the Liver, and all the Parts of
the Belly, with prodigious Swellings, Vomitings,
Suppressions of Urine, and inexpressible Anguish.
The most available Remedies in such Cases, from
this Cause, are, a plentiful Bleeding at the Onset,
a very copious Drinking of warm Water, to
which one fifth Part of Whey should be added;
or of the Ptisan No. 2, or of an Emulsion of
Almonds, all taken warm. Fomentations of
warm Water should also be applied to the Throat,
the Breast and Belly, with Glysters of the same,
and a little Milk. In this Case, as well as in the
preceding one, (.) a Semicupium, or Half-bath
of warm Water has sometimes been attended
with immediate Relief. It seems really astonishing,
that labouring People should so often
habituate themselves to this pernicious Custom,
which they know to be so very dangerous to
their very Beasts. There are none of them, who
will not prevent their Horses from drinking
while they are hot, especially if they are just going
to put them up. Each of them knows, that
if he lets them drink in that State, they might
possibly burst with it; nevertheless he is not
afraid of incurring the like Danger himself. However,
this is not the only Case, in which the
Peasant seems to have more Attention to the
Health of his Cattle, than to his own.
§ 5. The fourth Cause, which indeed affects
every Body, but more particularly the Labourer,
is, the Inconstancy of the Weather. We
shift all at once, many times a Day, from Hot
to Cold, and from Cold to Hot, in a more remarkable
Manner, and more suddenly, than in
most other Countries. This makes Distempers
from Defluxion and Cold so common with us:
and it should make us careful to go rather a
little more warmly cloathed, than the Season may
seem to require; to have Recourse to our Winter-cloathing
early in Autumn, and not to part with
it too early in the Spring. Prudent Labourers,
who strip while they are at Work, take care
to put on their Cloaths in the Evening when
they return home. Those, who from Negligence,
are satisfied with hanging them upon their
Country Tools, frequently experience, on their
Return, the very unhappy Effects of it. There
are some, tho' not many Places, where the Air
itself is unwholsome, more from its particular
Quality, than from its Changes of Temperature,
as at Villeneuve, and still more at Noville, and
in some other Villages situated among the Marshes
which border on the Rhone. These Countries
are particularly subject to intermitting Fevers; of
which I shall treat briefly hereafter.
§ 6. Such sudden Changes are often attended
with great Showers of Rain, and even cold
Rain, in the Middle of a very hot Day; when
the Labourer who was bathed, as it were, in a
hot Sweat, is at once moistened in cold Water;
which occasions the same Distempers, as the sudden
Transition from Heat to Cold, and requires
the same Remedies. If the Sun or a hot Air
succeed immediately to such a Shower, the Evil
is considerably lighter: but if the Cold continues,
many are often greatly incommoded by it.
A Traveller is sometimes thoroughly and unavoidably
wet with Mud; the ill Consequence
of which is often inconsiderable, provided he
changes his Cloaths immediately, when he sets
up. I have known fatal Pleurisies ensue from
omitting this Caution. Whenever the Body or
the Limbs are wet, nothing can be more useful
than bathing them in warm Water. If the Legs
only have been wet, it may be sufficient to bath
them. I have radically, thoroughly, cured Persons
subject to violent Cholics, as often as their
Feet were wet, by persuading them to pursue this
Advice. The Bath proves still more effectual,
if a little Soap be dissolved in it.
§ 7. A fifth Cause, which is seldom attended
to, probably indeed because it produces less violent
Consequences, and yet is certainly hurtful,
is the common Custom in all Villages, of having
their Ditches or Dunghills directly under their
Windows. Corrupted Vapours are continually
exhaling from them, which in Time cannot fail
of being prejudicial, and must contribute to produce
putrid diseases. Those who are accustomed
to the Smell, become insensible of it: but the
Cause, nevertheless, does not cease to be unwholesomly
active; and such as are unused to it
perceive the Impression in all its Force.
§ 8. There are some Villages, in which, after
the Curtain Lines are erased, watery marshy Places
remain in the Room of them. The Effect of this
is still more dangerous, because that putrify'd
Water, which stagnates during the hot Season,
suffers its Vapours to exhale more easily, and more
abundantly, than that in the Curtain Lines did.
Having set out for Pully le Grand, in 1759, on
Account of an epidemical putrid Fever which
raged there, I was sensible, on traversing the
Village, of the Infection from those Marshes; nor
could I doubt of their being the Cause of this
Disease, as well as of another like it, which had
prevailed there five Years before. In other Respects
the Village is wholesomly situated. It
were to be wished such Accidents were obviated
by avoiding these stagnated Places; or, at least,
by removing them and the Dunghils, as far as
possible from the Spot, where we live and lodge.
§ 9. To this Cause may also be added the
Neglect of the Peasants to air their Lodgings. It
is well known that too close an Air occasions the
most perplexing malignant Fevers; and the poor
Country People respire no other in their own
Houses. Their Lodgings, which are very small,
and which notwithstanding inclose, (both Day and
Night) the Father, Mother, and seven or eight
Children, besides some Animals, are never kept
open during six Months in the Year, and very
seldom during the other six. I have found the
Air so bad in many of these Houses, that I am
persuaded, if their Inhabitants did not often go
out into the free open Air, they must all perish
in a little Time. It is easy, however, to prevent
all the Evils arising from this Source, by opening
the Windows daily: so very practicable a Precaution
must be followed with the happiest Consequences.
§ 10. I consider Drunkenness as a sixth Cause,
not indeed as producing epidemical Diseases, but
which destroys, as it were, by Retail, at all
times, and every where. The poor Wretches,
who abandon themselves to it, are subject to
frequent Inflammations of the Breast, and to
Pleurisies, which often carry them off in the
Flower of their Age. If they sometimes escape
through these violent Maladies, they sink, a long
Time before the ordinary Approach of old Age,
into all its Infirmities, and especially into an
Asthma, which terminates in a Dropsy of the
Breast. Their Bodies, worn out by Excess, do
not comply and concur, as they ought, with the
Force or Operation of Remedies; and Diseases
of Weakness, resulting from this Cause, are almost
always incurable. It seems happy enough,
that Society loses nothing in parting with these
Subjects, who are a Dishonour to it; and whose
brutal Souls are, in some Measure, dead, long
before their Carcases.
§ 11. The Provisions of the common People
are also frequently one Cause of popular Maladies.
This happens 1st, whenever the Corn,
not well ripened, or not well got in, in bad
Harvests, has contracted an unwholesome Quality.
Fortunately however this is seldom the
Case; and the Danger attending the Use of it,
may be lessened by some Precautions, such as
those of washing and drying the Grain completely;
of mixing a little Wine with the Dough, in
kneading it; by allowing it a little more Time to
swell or rise, and by baking it a little more. 2dly,
The fairer and better saved Part of the Wheat is
sometimes damaged in the Farmers House; either
because he does not take due Care of it, or
because he has no convenient Place to preserve it,
only from one Summer to the next. It has often
happened to me, on entering one of these bad
Houses, to be struck with the Smell of Wheat
that has been spoiled. Nevertheless, there are
known and easy Methods to provide against this
by a little Care; though I shall not enter into a
Detail of them. It is sufficient to make the People
sensible, that since their chief Sustenance consists
of Corn, their Health must necessarily be
impaired by what is bad. 3dly, That Wheat,
which is good, is often made into bad Bread, by
not letting it rise sufficiently; by baking it too
little, and by keeping it too long. All these Errors
have their troublesome Consequences on those
who eat it; but in a greater Degree on Children
and Valetudinarians, or weakly People.
Tarts or Cakes may be considered as an Abuse
of Bread, and this in some Villages is increased
to a very pernicious Height. The Dough is almost
constantly bad, and often unleavened, ill
baked, greasy, and stuffed with either fat or sour
Ingredients, which compound one of the most indigestible
Aliments imaginable. Women and
Children consume the most of this Food, and
are the very Subjects for whom it is the most
improper: little Children especially, who live
sometimes for many successive Days on these
Tarts, are, for the greater Part, unable to digest
them perfectly. Hence they receive a Source
of Obstructions in the Bowels of the Belly, and
of a slimy Viscidity or Thickishness, throughout
the Mass of Humours, which throws them into
various Diseases from Weakness; slow Fevers, a
Hectic, the Rickets, the King's Evil, and Feebleness;
for the miserable Remainder of their Days.
Probably indeed there is nothing more unwholesome
than Dough not sufficiently leavened, ill-baked,
greasy, and soured by the Addition of
Fruits. Besides, if we consider these Tarts in an
oeconomical View, they must be found inconvenient
also for the Peasant on that Account.
Some other Causes of Maladies may also be
referred to the Article of Food, tho' less grievous
and less frequent, into a full Detail of which it is
very difficult to enter: I shall therefore conclude
that Article with this general Remark; that it
is the Care which Peasants usually take in eating
slowly, and in chewing very well, that very
greatly lessens the Dangers from a bad Regimen:
and I am convinced they constitute one of the
greatest Causes of that Health they enjoy. We
may further add indeed the Exercise which
the Peasant uses, his long abiding in the open Air,
where he passes three fourths of his Life; besides
(which are also considerable Advantages) his
happy Custom of going soon to Bed, and of rising
very early. It were to be wished, that in these
Respects, and perhaps on many other Accounts,
the Inhabitants of the Country were effectually
proposed as Models for reforming the Citizens.
§ 12. We should not omit, in enumerating
the Causes of Maladies among Country People,
the Construction of their Houses, a great many
of which either lean, as it were, close to a
higher Ground, or are sunk a little in the Earth.
Each of these Situations subjects them to considerable
Humidity; which is certain greatly to
incommode the Inhabitants, and to spoil their
Provisions, if they have any Quantity in Store;
which, as we have observed, is another, and
not the least important, Source of their Diseases.
A hardy Labourer is not immediately sensible of
the bad Influence of this moist and marshy Habitation;
but they operate at the long Run, and
I have abundantly observed their most evident
bad Effects, especially on Women in Child-bed,
on Children, and in Persons recovering of a preceding
Disease. It would be easy to prevent
this Inconvenience, by raising the Ground on
which the House stood, some, or several, Inches
above the Level of the adjacent Soil, by a
Bed of Gravel, of small Flints, pounded Bricks,
Coals, or such other Materials; and by avoiding
to build immediately close to, or, as it were,
under a much higher Soil. This Object,
perhaps, may well deserve the Attention of the
Publick; and I earnestly advise as many as do
build, to observe the necessary Precautions on
this Head. Another, which would cost still
less Trouble, is to give the Front of their
Houses an Exposure to the South-East. This
Exposure, supposing all other Circumstances of
the Building and its Situation to be alike, is
both the most wholesome and advantageous. I
have seen it, notwithstanding, very often neglected,
without the least Reason being assigned
for not preferring it.
These Admonitions may possibly be thought
of little Consequence by three fourths of the People.
I take the Liberty of reminding them,
however, that they are more important than they
may be supposed; and so many Causes concur to
the Destruction of Men, that none of the Means
should be neglected, which may contribute to
their Preservation.
§ 13. The Country People in Swisserland
drink, either 1, pure Water, 2, some Wine, 3,
Perry, made from wild Pears, or sometimes Cyder
from Apples, and, 4, a small Liquor which
they call Piquette, that is Water, which has
fermented with the Cake or Husks of the
Grapes, after their Juice has been expressed.
Water however is their most general Drink;
Wine rarely falling in their Way, but when
they are employed by rich Folks; or when they
can spare Money enough for a Debauch. Fruit
Wines and the Piquettes are not used in all
Parts of the Country; they are not made in all
Years; and keep but for some Months.
Our Waters in general, are pretty good; so
that we have little Occasion to trouble ourselves
about purifying them; and they are well known
in those Provinces where they are chiefly and
necessarily used. The pernicious Methods
taken to improve or meliorate, as it is falsely
called, bad Wines, are not as yet sufficiently
practiced among us, for me to treat of them here:
and as our Wines are not hurtful, of themselves,
they become hurtful only from their Quantity.
The Consumption of made Wines and Piquettes
is but inconsiderable, and I have not hitherto
known of any ill Effects from them, so that our
Liquors cannot be considered as Causes of Distempers
in our Country; but in Proportion to
our Abuse of them by Excess. The Case is differently
circumstanced in some other Countries;
and it is the Province of Physicians who
reside in them, to point out to their Country-Men
the Methods of preserving their Health; as
well as the proper and necessary Remedies in
their Sickness.
Chapter II.
Of the Causes which aggravate the Diseases of the People. General Considerations.
Sect. 14.
he Causes already enumerated in
the first Chapter occasion Diseases;
and the bad Regimen, or Conduct of
the People, on the Invasion of them,
render them still more perplexing, and very often
mortal.
There is a prevailing Prejudice among them,
which is every Year attended with the Death of
some Hundreds in this Country, and it is this—That
all Distempers are cured by Sweat; and
that to procure Sweat, they must take Abundance
of hot and heating things, and keep themselves
very hot. This is a Mistake in both Respects,
very fatal to the Population of the State; and it
cannot be too much inculcated into Country
People; that by thus endeavouring to force Sweating,
at the very Beginning of a Disease, they are
with great Probability, taking Pains to kill themselves.
I have seen some Cases, in which the
continual Care to provoke this Sweating, has as
manifestly killed the Patient, as if a Ball had
been shot through his Brains; as such a precipitate
and untimely Discharge carries off the thinner Part
of the Blood, leaving the Mass more dry, more viscid
and inflamed. Now as in all acute Diseases (if we
except a very few, and those too much less frequent)
the Blood is already too thick; such a
Discharge must evidently increase the Disorder,
by co-operating with its Cause. Instead of forcing
out the watery, the thinner Part of the
Blood, we should rather endeavour to increase it.
There is not a single Peasant perhaps, who does
not say, when he has a Pleurisy, or an Inflammation
of his Breast, that his Blood is too thick, and
that it cannot circulate. On seeing it in the
Bason after Bleeding, he finds it black, dry, burnt;
these are his very Words. How strange is it
then, that common Sense should not assure him,
that, far from forcing out the Serum, the watery
Part, of such a Blood by sweating, there is a Necessity
to increase it?
§ 15. But supposing it were as certain, as it is
erroneous, that Sweating was beneficial at the
Beginning of Diseases, the Means which they
use to excite it would not prove the less fatal.
The first Endeavour is, to stifle the Patient with
the Heat of a close Apartment, and a Load of
Covering. Extraordinary Care is taken to prevent
a Breath of fresh Air's squeezing into the Room;
from which Circumstance, the Air already in it
is speedily and extremely corrupted: and such a
Degree of Heat is procured by the Weight of the
Patient's Bed-cloaths, that these two Causes alone
are sufficient to excite a most ardent Fever, and
an Inflammation of the Breast, even in a healthy
Man. More than once have I found myself
seized with a Difficulty of breathing, on entering
such Chambers, from which I have been immediately
relieved, on obliging them to open all
the Windows. Persons of Education must find
a Pleasure, I conceive, in making People understand,
on these Occasions, which are so frequent,
that the Air being more indispensably necessary
to us, if possible, than Water is to a Fish,
our Health must immediately suffer, whenever
that ceases to be pure; in assuring them
also, that nothing corrupts it sooner than those
Vapours, which continually steam from the Bodies
of many Persons inclosed within a little
Chamber, from which the Air is excluded.
The Absurdity of such Conduct is a self-evident
Certainty. Let in a little fresh Air on these
miserable Patients, and lessen the oppressing Burthen
of their Coverings, and you generally see
upon the Spot, their Fever and Oppression, their
Anguish and Raving, to abate.
§ 16. The second Method taken to raise a
Sweat in these Patients is, to give them nothing
but hot things, especially Venice Treacle, Wine,
or some Faltranc, the greater Part of the Ingredients
of which are dangerous, whenever there is
an evident Fever; besides Saffron, which is still
more pernicious. In all feverish Disorders we
should gently cool, and keep the Belly moderately
open; while the Medicines just mentioned
both heat and bind; and hence we may easily
judge of their inevitable ill Consequences. A
healthy Person would certainly be seized with an
inflammatory Fever, on taking the same Quantity
of Wine, of Venice Treacle, or of Faltranc,
which the Peasant takes now and then, when he
is attacked by one of these Disorders. How
then should a sick Person escape dying by them?
Die indeed he generally does, and sometimes with
astonishing Speed. I have published some dreadful
Instances of such Fatality some Years since,
in another Treatise. In fact they still daily occur,
and unhappily every Person may observe
some of them in his own Neighbourhood.
§ 17. But I shall be told perhaps, that Diseases
are often carried off by Sweat, and that we ought
to be guided by Experience. To this I answer,
it is very true, that Sweating cures some particular
Disorders, as it were, at their very Onset, for
Instance, those Stitches that are called spurious
or false Pleurisies, some rheumatic Pains, and
some Colds or Defluxions. But this only happens
when the Disorders depend solely and simply
on stopt or abated Perspiration, to which such
Pain instantly succeeds; where immediately,
before the Fever has thickened the Blood, and
inflamed the Humours; and where before any
internal Infarction, any Load, is formed, some
warm Drinks are given, such as Faltranc and
Honey; which, by restoring Transpiration,
remove the very Cause of the Disorder. Nevertheless,
even in such a Case, great Care should
be had not to raise too violent a Commotion in
the Blood, which would rather restrain, than promote,
Sweat, to effect which Elder-flowers are
in my Opinion preferable to Faltranc. Sweating
is also of Service in Diseases, when their Causes
are extinguished, as it were, by plentiful Dilution:
then indeed it relieves, by drawing off,
with itself, some Part of the distempered Humours;
after which their grosser Parts have passed
off by Stool and by Urine: besides which, the
Sweat has also served to carry off that extraordinary
Quantity of Water, we were obliged to
convey into the Blood, and which was become
superfluous there. Under such Circumstances,
and at such a Juncture, it is of the utmost Importance
indeed, not to check the Sweat, whether
by Choice, or for Want of Care. There might
often be as much Danger in doing this, as there
would have been in endeavouring to force a
Sweat, immediately upon the Invasion of the
Disorder; since the arresting of this Discharge,
under the preceding Circumstances, might frequently
occasion a more dangerous Distemper, by
repelling the Humour on some inward vital
Part. As much Care therefore should be taken
not to check, imprudently, that Evacuation by
the Skin, which naturally occurs towards the
Conclusion of Diseases, as not to force it at their
Beginning; the former being almost constantly
beneficial, the latter as constantly pernicious.
Besides, were it even necessary, it might be very
dangerous to force it violently; since by heating
the Patients greatly, a vehement Fever is excited;
they become scorched up in a Manner, and the
Skin proves extremely dry. Warm Water, in
short, is the best of Sudorifics.
If the Sick are sweated very plentifully for a
Day or two, which may make them easier for
some Hours; these Sweats soon terminate, and
cannot be excited again by the same Medicines.
The Dose thence is doubled, the Inflammation is
increased, and the Patient expires in terrible Anguish,
with all the Marks of a general Inflammation.
His Death is ascribed to his Want of
Sweating; when it really was the Consequence
of his Sweating too much at first; and of his
taking Wine and hot Sudorifics. An able Swiss
Physician had long since assured his Countrymen,
that Wine was fatal to them in Fevers; I
take leave to repeat it again and again, and wish it
may not be with as little Success.
Our Country Folks, who in Health, naturally
dislike red Wine, prefer it when Sick;
which is wrong, as it binds them up more than
white Wine. It does not promote Urine as well;
but increases the Force of the circulating Arteries,
and the Thickness of the Blood, which
were already too considerable.
§ 18. Their Diseases are also further aggravated
by the Food that is generally given them.
They must undoubtedly prove weak, in Consequence
of their being sick; and the ridiculous Fear
of the Patients' dying of Weakness, disposes their
Friends to force them to eat; which, increasing
their Disorder, renders the Fever mortal. This
Fear is absolutely chimerical; never yet did a
Person in a Fever die merely from Weakness.
They may be supported, even for some Weeks,
by Water only; and are stronger at the End of
that Time, than if they had taken more solid
Nourishment; since, far from strengthening
them, their Food increases their Disease, and
thence increases their Weakness.
§ 19. From the first Invasion of a Fever, Digestion
ceases. Whatever solid Food is taken
corrupts, and proves a Source of Putridity, which
adds nothing to the Strength of the Sick, but
greatly to that of the Distemper. There are in
fact a thousand Examples to prove, that it becomes
a real Poison: and we may sensibly perceive
these poor Creatures, who are thus compelled
to eat, lose their Strength, and fall into
Anxiety and Ravings, in Proportion as they swallow.
§ 20. They are also further injured by the
Quality, as well as the Quantity, of their Food.
They are forced to sup strong Gravey Soups,
Eggs, Biscuits, and even Flesh, if they have but
just Strength and Resolution to chew it. It seems
absolutely impossible for them to survive all this
Trash. Should a Man in perfect Health be
compelled to eat stinking Meat, rotten Eggs,
stale sour Broth, he is attacked with as violent
Symptoms, as if he had taken real Poison, which,
in Effect, he has. He is seized with Vomiting,
Anguish, a violent Purging, and a Fever, with
Raving, and eruptive Spots, which we call the
Purple Fever. Now when the very same Articles
of Food, in their soundest State, are given
to a Person in a Fever, the Heat, and the morbid
Matter already in his Stomach, quickly putrify
them; and after a few Hours produce all
the abovementioned Effects. Let any Man judge
then, if the least Service can be expected from
them.
§ 21. It is a Truth established by the first of
Physicians, above two thousand Years past, and
still further ratified by his Successors, that as long
as a sick Person has a bad Humour or Ferment
in his Stomach, his Weakness increases, in Proportion
to the Food he receives. For this being
corrupted by the infected Matter it meets there,
proves incapable of nourishing, and becomes a
conjunct or additional Cause of the Distemper.
The most observing Persons constantly remark,
that whenever a feverish Patient sups, what is
commonly called some good Broth, the Fever gathers
Strength and the Patient Weakness. The giving
such a Soup or Broth, though of the freshest
soundest Meat, to a Man who has a high Fever,
or putrid Humours in his Stomach, is to do him
exactly the same service, as if you had given him,
two or three Hours later, stale putrid Soup.
§ 22. I must also affirm, that this fatal Prejudice,
of keeping up the Patients' Strength by
Food, is still too much propagated, even among
those very Persons, whose Talents and whose
Education might be expected to exempt them
from any such gross Error. It were happy for
Mankind, and the Duration of their Lives would
generally be more extended, if they could be
thoroughly persuaded of this medical, and so
very demonstrable, Truth;—That the only
things which can strengthen sick Persons are
those, which are able to weaken their Disease;
but their Obstinacy in this Respect is inconceivable:
it is another Evil superadded to that of the
Disease, and sometimes the more grievous one.
Out of twenty sick Persons, who are lost in the
Country, more than two Thirds might often have
been cured, if being only lodged in a Place defended
from the Injuries of the Air, they were
supplied with Abundance of good Water. But
that most mistaken Care and Regimen I have
been treating of, scarcely suffers one of the twenty
to survive them.
§ 23. What further increases our Horror at
this enormous Propensity to heat, dry up, and
cram the sick is, that it is totally opposite to what
Nature herself indicates in such Circumstances.
The burning Heat of which they complain; the
Dryness of the Lips, Tongue and Throat; the
flaming high Colour of their Urine; the great
Longing they have for cooling things; the Pleasure
and sensible Benefit they enjoy from fresh
Air, are so many Signs, or rather Proofs, which
cry out with a loud Voice, that we ought to attemperate
and cool them moderately, by all
means. Their foul Tongues, which shew the
Stomach to be in the like Condition; their Loathing,
their Propensity to vomit, their utter Aversion
to all solid Food, and especially to Flesh; the
disagreeable Stench of their Breath; their Discharge
of fetid Wind upwards and downwards,
and frequently the extraordinary Offensiveness of
their Excrements, demonstrate, that their Bowels
are full of putrid Contents, which must corrupt
all the Aliments superadded to them; and that
the only thing, which can prudently be done, is
to dilute and attemper them by plentiful Draughts
of refreshing cooling Drinks, which may promote
an easy Discharge of them. I affirm it
again, and I heartily wish it may be thoroughly
attended to, that as long as there is any Taste of
Bitterness, or of Putrescence; as long as there is
a Nausea or Loathing, a bad Breath, Heat and
Feverishness with fetid Stools, and little and high-coloured
Urine; so long all flesh, and Flesh-Soup,
Eggs, and all kind of Food composed of them,
or of any of them, and all Venice Treacle, Wine,
and all heating things are so many absolute Poisons.
§ 24. I may possibly be censured as extravagant
and excessive on these Heads by the
Publick, and even by some Physicians: but the true
and enlightened Physicians, those who attend to
the Effects of every Particular, will find on the
contrary, that far from exceeding in this Respect,
I have rather feebly expressed their own Judgment,
in which they agree with that of all the
good ones, who have existed within more than
two thousand Years; that very Judgment which
Reason approves, and continual Experience confirms.
The Prejudices I have been contending
against have cost Europe some Millions of Lives.
§ 25. Neither should it be omitted, that even
when a Patient has very fortunately escaped
Death, notwithstanding all this Care to obtain it,
the Mischief is not ended; the Consequences of
the high Aliments and heating Medicines being,
to leave behind the Seed, the Principle, of some
low and chronical Disease; which increasing insensibly,
bursts out at length, and finally procures
him the Death he has even wished for, to put an
End to his tedious Sufferings.
§ 26. I must also take Notice of another dangerous
common Practice; which is that of purging,
or vomiting a Patient, at the very Beginning of a
Distemper. Infinite Mischiefs are occasioned by
it. There are some Cases indeed, in which evacuating
Medicines, at the Beginning of a Disease,
are convenient and even necessary. Such Cases
shall be particularly mentioned in some other
Chapters: but as long as we are unacquainted
with them, it should be considered as a general
Rule, that they are hurtful at the Beginning; this
being true very often; and always, when the Diseases
are strictly inflammatory.
§ 27. It is hoped by their Assistance, at that
Time, to remove the Load and Oppression of the
Stomach, the Cause of a Disposition to vomit, of
a dry Mouth, of Thirst, and of much Uneasiness;
and to lessen the Leaven or Ferment of the Fever.
But in this Hope they are very often deceived;
since the Causes of these Symptoms are seldom
of a Nature to yield to these Evacuations. By the
extraordinary Viscidity or Thickness of the Humours,
that foul the Tongue, we should form our
Notions of those, which line the Stomach and
the Bowels. It may be washed, gargled and
even scraped to very little good Purpose. It does
not happen, until the Patient has drank for many
Days, and the Heat, the Fever and the great Siziness
of the Humours are abated, that this Filth
can he thoroughly removed, which by Degrees
separates of itself. The State of the Stomach
being conformable to that of the Tongue, no
Method can effectually scour and clean it at the
Beginning: but by giving refreshing and diluting
Remedies plentifully, it gradually frees itself; and
the Propensity to vomit, with its other Effects and
Uneasinesses, go off naturally, and without Purges.
§ 28. Neither are these Evacuations only negatively
wrong, merely from doing no Good;
for considerable Evil positively ensues from the
Application of those acrid irritating Medicines,
which increase the Pain and Inflammation; drawing
the Humours upon those Parts that were already
overloaded with them; which by no means
expel the Cause of the Disease, that not being at this
time fitted for Expulsion, as not sufficiently concocted
or ripe: and yet which, at the same Time,
discharge the thinnest Part of the Blood, whence
the Remainder becomes more thick; in short
which carry off the useful, and leave the hurtful
Humours behind.
§ 29. The Vomit especially, being given in
an inflammatory Disease, and even without any
Distinction in all acute ones, before the Humours
have been diminished by Bleeding, and diluted by
plentiful small Drinks, is productive of the greatest
Evils; of Inflammations of the Stomach, of
the Lungs and Liver, of Suffocations and Frenzies.
Purges sometimes occasion a general Inflammation
of the Guts, which terminates in
Death. Some Instances of each of these terrible
Consequences have I seen, from blundering Temerity,
Imprudence and Ignorance. The Effect
of such Medicines, in these Circumstances, are
much the same with those we might reasonably
expect, from the Application of Salt and Pepper
to a dry, inflamed and foul Tongue, in Order to
moisten and clean it.
§ 30. Every Person of sound plain Sense is
capable of perceiving the Truth of whatever I
have advanced in this Chapter: and there would
be some Degree of Prudence, even in those who
do not perceive the real good Tendency of my
Advice, not to defy nor oppose it too hardily.
The Question relates to a very important Object;
and in a Matter quite foreign to themselves,
they undoubtedly owe some Deference to the
Judgment of Persons, who have made it the
Study and Business of their whole Lives. It is
not to myself that I hope for their Attention, but
to the greatest Physicians, whose feeble Instrument
and Eccho I am. What Interest have any
of us in forbidding sick People to eat, to be stifled,
or to drink such heating things as heighten their
Fever? What Advantage can accrue to us from
opposing the fatal Torrent, which sweeps them
off? What Arguments can persuade People, that
some thousand Men of Genius, of Knowledge,
and of Experience, who pass their Lives among
a Croud and Succession of Patients; who are entirely
employed to take Care of them, and to observe
all that passes, have been only amusing and
deceiving themselves, on the Effects of Food, of
Regimen and of Remedies? Can it enter into
any sensible Head, that a Nurse, who advises
Soup, an Egg, or a Biscuit, deserves a Patient's
Confidence, better than a Physician who forbids
them? Nothing can be more disagreeable to the
latter, than his being obliged to dispute continually
in Behalf of the poor Patients; and to be in
constant Terror, lest this mortally officious Attendance,
by giving such Food as augments all
the Causes of the Disease, should defeat the Efficacy
of all the Remedies he administers to remove
it; and should fester and aggravate the Wound,
in Proportion to the Pains he takes to dress it.
The more such absurd People love a Patient, the
more they urge him to eat, which, in Effect, verifies
the Proverb of killing one with Kindness.
Chapter III.
Of the Means that ought to be used, at the Beginning of Diseases; and of the Diet in acute Diseases.
Sect. 31.
have clearly shewn the great Dangers
of the Regimen, or Diet, and of
the principal Medicines too generally
made Use of by the Bulk of the People,
on these Occasions. I must now point out
the actual Method they may pursue, without any
Risque, on the Invasion of some acute Diseases,
and the general Diet which agrees with them all.
As many as are desirous of reaping any Benefit
from this Treatise, should attend particularly to
this Chapter; since, throughout the other Parts
of it, in Order to avoid Repetitions, I shall say
nothing of the Diet, except the particular Distemper
shall require a different one, from that of
which I am now to give an exact Detail. And
whenever I shall say in general, that a Patient
is to be put upon a Regimen, it will signify, that
he is to be treated according to the Method prescribed
in this Chapter; and all such Directions
are to be observed, with Regard to Air, Food,
Drink and Glysters; except when I expressly order
something else, as different Ptisans, Glysters,
&c.
§ 32. The greater Part of Diseases (by which
I always understand acute and feverish ones) often
give some Notice of their Approach a few
Weeks, and, very commonly, some Days before
their actual Invasion; such as a light Lassitude,
or Weariness, Stiffness or Numbness; less
Activity than usual, less Appetite, a small Load
or Heaviness at Stomach; some Complaint in
the Head; a profounder Degree of Sleep, yet
less composed, and less refreshing than usual;
less Gayety and Liveliness; sometimes a light
Oppression of the Breast, a less regular Pulse;
a Propensity to be Cold; an Aptness to sweat;
and sometimes a Suppression of a former Disposition
to sweat. At such a Term it may be practicable
to prevent, or at least considerably to mitigate,
the most perplexing Disorders, by carefully
observing the four following Points.
1. To omit all violent Work or Labour, but
yet not so, as to discontinue a gentle easy Degree
of Exercise.
2. To bring the Complainant to content himself
without any, or with very little, solid Food;
and especially to renounce all Flesh, Flesh-broth,
Eggs and Wine.
3. To drink plentifully, that is to say, at least
three Pints, or even four Pints daily, by small
Glasses at a Time, from half hour to half hour,
of the Ptisans and , or even of warm Water,
to each Quart of which may be added half a
Glass of Vinegar. No Person can be destitute of
this very attainable Assistance. But should there
be a Want even of Vinegar, a few Grains of
common Salt may be added to a Quart of warm
Water for Drink. Those who have Honey will
do well to add two or three Spoonfuls of it to the
Water. A light Infusion of Elder Flowers, or
of those of the Linden, the Lime-tree, may also
be advantageously used, and even well settled
and clear sweet Whey.
4. Let the Person, affected with such previous
Complaints, receive Glysters of warm Water,
or the Glyster . By pursuing these
Precautions some grievous Disorders have often
been happily rooted out: and although they
should not prove so thoroughly efficacious, as to
prevent their Appearance, they may at least be
rendered more gentle, and much less dangerous.
§ 33. Very unhappily People have taken the
directly contrary Method. From the Moment
these previous, these forerunning Complaints are
perceived, they allow themselves to eat nothing
but gross Meat, Eggs, or strong Meat-Soups.
They leave off Garden-Stuff and Fruits, which
would be so proper for them; and they drink
heartily (under a Notion of strengthening the
Stomach and expelling Wind) of Wine and
other Liquors, which strengthen nothing but the
Fever, and expel what Degree of Health might
still remain. Hence all the Evacuations are restrained;
the Humours causing and nourishing
the Diseases are not at all attempered, diluted,
nor rendered proper for Evacuation. Nay, on the
very contrary, they become more sharp, and
more difficult to be discharged: while a sufficient
Quantity of diluting refreshing Liquor, asswages
and separates all Matters foreign to the Blood,
which it purifies; and, at the Expiration of some
Days, all that was noxious in it is carried off by
Stool, by Urine, or by Sweat.
§ 34. When the Distemper is further advanced,
and the Patient is already seized with that
Coldness or Shuddering, in a greater or less Degree,
which ushers in all Disease; and which is
commonly attended with an universal Oppression,
and Pains over all the Surface of the Body;
the Patient, thus circumstanced, should be put to
Bed, if he cannot keep up; or should sit down
as quietly as possible, with a little more Covering
than usual: he should drink every Quarter
of an Hour a small Glass of the Ptisan, or
, warm; or, if that is not at Hand, of some
one of those Liquids I have recommended .
§ 35. These Patients earnestly covet a great
Load of covering, during the Cold or Shivering;
but we should be very careful to lighten them as
soon as it abates; so that when the succeeding
Heat begins, they may have no more than their
usual Weight of Covering. It were to be wished
perhaps, they had rather less. The Country
People lie upon a Feather-bed, and under a downy
Coverlet, or Quilt, that is commonly extremely
heavy; and the Heat which is heightened and
retained by Feathers, is particularly troublesome
to Persons in a Fever. Nevertheless, as it is
what they are accustomed to, this Custom may
be complied with for one Season of the Year:
but during our Heats, or whenever the Fever is
very violent, they should lie on a Pallet (which
will be infinitely better for them) and should
throw away their Coverings of Down, so as to
remain covered only with Sheets, or something
else, less injurious than Feather-Coverings. A
Person could scarcely believe, who had not been,
as I have, a Witness of it, how much Comfort
a Patient is sensible of, in being eased of his former
Coverings. The Distemper immediately
puts on a different Appearance.
§ 36. As soon as the Heat after the Rigor, or
Coldness and Shuddering, approaches, and the
Fever is manifestly advanced, we should provide
for the Patient's Regimen. And
1, Care should be taken that the Air, in the
Room where he lies, should not be too hot, the
mildest Degree of Warmth being very sufficient;
that there be as little Noise as possible, and that
no Person speak to the Sick, without a Necessity
for it. No external Circumstance heightens the
Fever more, nor inclines the Patient more to a
Delirium or Raving, than the Persons in the
Chamber, and especially about the Bed. They
lessen the Spring, the elastic and refreshing Power,
of the Air; they prevent a Succession of fresh
Air; and the Variety of Objects occupies the
Brain too much. Whenever the Patient has
been at Stool, or has made Urine, these Excrements
should be removed immediately. The
Windows should certainly be opened Night and
Morning, at least for a Quarter of an Hour each
Time; when also a Door should be opened, to
promote an entire Renovation or Change of the
Air in the Room. Nevertheless, as the Patient
should not be exposed at any Time to a Stream
or Current of Air, the Curtains of his Bed should
be drawn on such Occasions; and, if he lay
without any, Chairs, with Blankets or Cloaths
hung upon them, should be substituted in the
Place of Curtains, and surround the Bed; while
the Windows continued open, in Order to defend
the Patient from the Force of the rushing Air.
If the Season, however, be rigidly cold, it will be
sufficient to keep the Windows open, but for a
few Minutes, each Time. In Summer, at least
one Window should be set open Day and Night.
The pouring a little Vinegar upon a red-hot
Shovel also greatly conduces to restore the
Spring, and correct the Putridity, of the Air.
In our greatest Heats, when that in the Room
seems nearly scorching, and the sick Person
is sensibly and greatly incommoded by it, the
Floor may be sprinkled now and then; and
Branches of Willow or Ash-trees dipt a little in
Pails of Water may be placed within the Room.
§ 37. 2. With Respect to the Patient's Nourishment,
he must entirely abstain from all Food;
but he may always be allowed, and have daily
prepared, the following Sustenance, which is one
of the wholesomest, and indisputably the simplest
one. Take half a Pound of Bread, a Morsel of
the freshest Butter about the Size only of a Hazel
Nut (which may even be omitted too) three
Pints and one quarter of a Pint of Water. Boil
them 'till the Bread be entirely reduced to a thin
Consistence. Then strain it, and give the Patient
one eighth Part of it every three, or every four,
Hours; but still more rarely, if the Fever be vehemently
high. Those who have Groats,
Barley, Oatmeal, or Rice, may boil and prepare them
in the same Manner, with some Grains of Salt.
§ 38. The Sick may also be sometimes indulged,
in lieu of these different Spoon-Meats,
with raw Fruits in Summer, or in Winter with
Apples baked or boiled, or Plumbs and Cherries
dried and boiled. Persons of Knowledge and
Experience will be very little, or rather not at all,
surprized to see various Kinds of Fruit directed
in acute Diseases; the Benefit of which they may
here have frequently seen. Such Advice can
only disgust those, who remain still obstinately attached
to old Prejudices. But could they prevail
on themselves to reflect a little, they must perceive,
that these Fruits which allay Thirst; which
cool and abate the Fever; which correct and attemper
the putrid and heated Bile; which gently
dispose the Belly to be rather open, and promote
the Secretion and Discharge of the Urine, must
prove the properest Nourishment for Persons in
acute Fevers. Hence we see, as it were by a
strong Admonition from Nature herself, they express
an ardent Longing for them; and I have
known several, who would not have recovered,
but for their eating secretly large Quantities of
those Fruits they so passionately desired, and were
refused. As many however, as are not convinced
by my Reasoning in this Respect, may at least
make a Tryal of my Advice, on my Affirmation
and Experience; when I have no doubt but their
own will speedily convince them of the real Benefit
received from this Sort of Nourishment. It
will then be evident, that we may safely and
boldly allow, in all continual Fevers, Cherries
red and black, Strawberries, the best cured Raisins,
Raspberries, and Mulberries; provided that
all of them be perfectly ripe. Apples, Pears and
Plumbs are less melting and diluting, less succulent,
and rather less proper. Some kinds of
Pears however are extremely juicy, and even
watery almost, such as the Dean or Valentia
Pear, different Kinds of the Buree Pear; the St.
Germain, the Virgoleuse; the green sugary Pear,
and the Summer Royal, which may all be allowed;
as well as a little Juice of very ripe Plumbs,
with the Addition of Water to it. This last I
have known to asswage Thirst in a Fever, beyond
any other Liquor. Care should be taken,
at the same Time, that the Sick should never be
indulged in a great Quantity of any of them at
once, which would overload the Stomach, and
be injurious to them; but if they are given a little
at a Time and often, nothing can be more salutary.
Those whose Circumstances will afford
them China Oranges, or Lemons, may be regaled
with the Pulp and Juice as successfully; but
without eating any of their Peel, which is hot and
inflaming.
§ 39. 3. Their Drink should be such as allays
Thirst, and abates the Fever; such as dilutes, relaxes,
and promotes the Evacuations by Stool,
Urine and Perspiration. All these which I have
recommended in the preceding Chapters, jointly
and severally possess these Qualities. A Glass or
a Glass and a half of the Juice of such Fruits as I
have just mentioned, may also be added to three
full Pints of Water.
§ 40. The Sick should drink at least twice or
thrice that Quantity daily, often, and a little
at once, between three or four Ounces, every
Quarter of an Hour. The Coldness of the
Drink should just be taken off.
§ 41. 4. If the Patient has not two Motions
in the 24 Hours; if the Urine be in small Quantity
and high coloured; if he rave, the Fever
rage, the Pain of the Head and of the Loins be
considerable, with a Pain in the Belly, and a Propensity
to vomit, the Glyster should be
given at least once a Day. The People have
generally an Aversion to this kind of Remedy;
notwithstanding there is not any more useful in
feverish Disorders, especially in those I have just
recounted; and one Glyster commonly gives
more Relief, than if the Patient had drank four
or five Times the Quantity of his Drinks. The
Use of Glysters, in different Diseases, will be properly
ascertained in the different Chapters, which
treat of them. But it may be observed in this
Place, that they are never to be given at the very
Time the Patient is in a Sweat, which seems to
relieve him.
§ 42. 5. As long as the Patient has sufficient
Strength for it, he should sit up out of Bed one
Hour daily, and longer if he can bear it; but at
least half an Hour. It has a Tendency to lessen
the Fever, the Head-ach, and a Light-headiness,
or Raving. But he should not be raised, while
he has a hopeful Sweating; though such Sweats
hardly ever occur, but at the Conclusion of Diseases,
and after the Sick has had several other Evacuations.
§ 43. 6. His Bed should be made daily while
he sits up; and the Sheets of the Bed, as well as
the Patient's Linen, should be changed every
two Days, if it can be done with Safety. An unhappy
Prejudice has established a contrary, and
a really dangerous, Practice. The People about
the Patient dread the very Thought of his rising
out of Bed; they let him continue there in nasty
Linen loaden with putrid Steams and Humours;
which contribute, not only to keep up the Distemper,
but even to heighten it into some Degree
of Malignity. I do again repeat it here, that
nothing conduces more to continue the Fever
and Raving, than confining the Sick constantly
to Bed, and witholding him from changing his
foul Linen: by relieving him from both of
which Circumstances I have, without the Assistance
of any other Remedy, put a Stop to a continual
Delirium of twelve Days uninterrupted
Duration. It is usually said, the Patient is too
weak, but this is a very weak Reason. He must
be in very nearly a dying Condition, not to be
able to bear these small Commotions, which, in
the very Moment when he permits them, increase
his Strength, and immediately after abate
his Complaints. One Advantage the Sick gain
by sitting up a little out of Bed, is the increased
Quantity of their Urine, with greater Facility in
passing it. Some have been observed to make
none at all, if they did not rise out of Bed.
A very considerable Number of acute Diseases
have been radically, effectually, cured by this
Method, which mitigates them all. Where it
is not used, as an Assistance at least, Medicines
are very often of no Advantage. It were to be
wished the Patient and his Friends were made to
understand, that Distempers were not to be expelled
at once with rough and precipitate Usage;
that they must have their certain Career or
Course; and that the Use of the violent Methods
and Medicines they chuse to employ, might indeed
abridge the Course of them, by killing the
Patient; yet never otherwise shortened the Disease;
but, on the contrary, rendered it more perplexing,
tedious and obstinate; and often entailed such
unhappy Consequences on the Sufferer, as left
him feeble and languid for the rest of his Life.
§ 44. But it is not sufficient to treat, and, as
it were, to conduct the Distemper properly.
The Term of Recovery from a Disease requires
considerable Vigilance and Attention, as it is always
a State of Feebleness, and, thence, of
Depression and Faintness. The same Kind of
Prejudice which destroys the Sick, by compelling
them to eat, during the Violence of the Disease,
is extended also into the Stage of Convalescence,
or Recovery; and either renders it troublesome
and tedious; or produces fatal Relapses, and often
chronical Distempers. In Proportion to the
Abatement, and in the Decline, of the Fever, the
Quantity of Nourishment may be gradually increased:
but as long as there are any Remains of
it, their Qualities should be those I have already
recommended. Whenever the Fever is compleatly
terminated, some different Foods may be
entered upon; so that the Patient may venture
upon a little white Meat, provided it be tender;
some Fish; a little Flesh-Soup, a few Eggs at
times, with Wine property diluted. It must be
observed at the same Time, that those very proper
Aliments which restore the Strength, when taken
moderately, delay the perfect Cure, if they exceed
in Quantity, tho' but a little; because the
Action of the Stomach being extremely weakened
by the Disease and the Remedies, is capable
only, as yet, of a small Degree of Digestion; and
if the Quantity of its Extents exceed its Powers,
they do not digest, but become putrid. Frequent
Returns of the Fever supervene; a continual
Faintishness; Head-achs; a heavy Drowsiness
without a Power of Sleeping comfortably; flying
Pains and Heats in the Arms and Legs; Inquietude;
Peevishness; Propensity to Vomit; Looseness;
Obstructions, and sometimes a slow Fever,
with a Collection of Humours, that comes to
Suppuration.
All these bad Consequences are prevented, by
the recovering Sick contenting themselves, for
some Time, with a very moderate Share of proper
Food. We are not nourished in Proportion to
the Quantity we swallow, but to that we digest.
A Person on the mending Hand, who eats moderately,
digests it and grows strong from it.
He who swallows abundantly does not digest it,
and instead of being nourished and strengthened,
he withers insensibly away.
§ 45. We may reduce, within the few following
Rules, all that is most especially to be
observed, in Order to procure a compleat, a perfect
Termination of acute Diseases; and to prevent
their leaving behind them any Impediments
to Health.
1. Let these who are recovering, as well as
those who are actually sick, take very little
Nourishment at a time, and take it often.
2. Let them take but one sort of Food at
each Meal, and not change their Food too often.
3. Let them chew whatever solid Victuals they
eat, very carefully.
4. Let them diminish their Quantity of Drink.
The best for them in general is Water, with
a fourth or third Part of white Wine. Too great
a Quantity of Liquids at this time prevents the
Stomach from recovering its Tone and Strength;
impairs Digestion; keeps up Weakness; increases
the Tendency to a Swelling of the Legs;
sometimes even occasions a slow Fever; and
throws back the Person recovering into a languid
State.
5. Let them go abroad as often as they are
able, whether on Foot, in a Carriage, or on
Horseback. This last Exercise is the healthiest
of all, and three fourths of the labouring People
in this Country, who have it in their Power to
procure it without Expense, are in the wrong to
neglect it. They, who would practice it, should
mount before their principal Meal, which should
be about Noon, and never ride after it. Exercise
taken before a Meal strengthens the Organs
of Digestion, which is promoted by it. If the
Exercise is taken soon after the Meal, it impairs
it.
6. As People in this State are seldom quite as
well towards Night, in the Evening they should
take very little Food. Their Sleep will be the
less disturbed for this, and repair them the more,
and sooner.
7. They should not remain in Bed above seven,
or eight Hours.
8. The Swelling of the Legs and Ancles,
which happens to most Persons at this time, is
not dangerous, and generally disappears of itself;
if they live soberly and regularly, and take moderate
Exercise.
9. It is not necessary, in this State, that they
should go constantly every Day to Stool; though
they should not be without one above two or
three. If their Costiveness exceeds this Term,
they should receive a Glyster the third Day, and
even sooner, if they are heated by it, if they
feel puffed up, are restless, and have any Pains
in the Head.
10. Should they, after some time, still continue
very weak; if their Stomach is disordered;
if they have, from time to time, a little irregular
Fever, they should take three Doses daily of the
Prescription . which fortifies the Digestions,
recovers the strength, and drives away the
Fever.
11. They must by no means return to their Labour
too soon. This erroneous Habit daily prevents
many Peasants from ever getting perfectly well,
and recovering their former Strength. From
not having been able to confine themselves to
Repose and Indolence for some Days, they never
become as hearty hardy Workmen as they had
been: and this premature hasty Labour makes
them lose in the Consequence, every following
Week of their Lives, more time than they ever
gained, by their over-early resuming of their Labour.
I see every Day weakly Labourers, Vineroons,
and other Workmen, who date the
Commencement of their Weakness from that of
some acute Disease, which, for want of proper
Management through the Term of their Recovery,
was never perfectly cured. A Repose of
seven or eight Days, more than they allowed
themselves, would have prevented all these Infirmities;
notwithstanding it is very difficult to
make them sensible of this. The Bulk, the
Body of the People, in this and in many other
Cases, look no further than the present Day;
and never extend their Views to the following
one. They are for making no Sacrifice to Futurity;
which nevertheless must be done, to render
it favourable to us.
Chapter IV.
Of an Inflammation of the Breast.
Sect. 46.
he Inflammation of the Breast, or
Peripneumony, or a Fluxion upon the
Breast, is an Inflammation of the Lungs,
and most commonly of one only, and
consequently on one Side. The Signs by which
it is evident, are a Shivering, of more or less
Duration, during which the Person affected is
sometimes very restless and in great Anguish, an
essential and inseparable symptom; and which
has helped me more than once to distinguish
this Disease certainly, at the very Instant of its
Invasion. Besides this, a considerable Degree of
Heat succeeds the Shivering, which Heat, for a
few ensuing Hours, is often blended as it were,
with some Returns of Chilliness. The Pulse is
quick, pretty strong, moderately full, hard and
regular, when the Distemper is not very violent;
but small, soft and irregular, when it is
very dangerous. There is also a Sensation of
Pain, but rather light and tolerable, in one Side
of the Breast; sometimes a kind of straitning or
Pressure on the Heart; at other times Pains
through the whole Body, especially along the
Reins; and some Degree of Oppression, at
least very often; for sometimes it is but very
inconsiderable. The Patient finds a Necessity of
lying almost continually upon his Back, being
able to lie but very rarely upon either of his
Sides. Sometimes his Cough is dry, and then
attended with the most Pain; at other times it is
accompanied with a Spitting or Hawking up,
blended with more or less Blood, and sometimes
with pure sheer Blood. There is also some
Pain, or at least a Sensation of Weight and
Heaviness in the Head: and frequently a Propensity
to rave. The Face is almost continually
flushed and red: though sometimes there is a
Degree of Paleness and an Air of Astonishment,
at the Beginning of the Disease, which portend
no little Danger. The Lips, the Tongue, the
Palate, the Skin are all dry; the Breath hot;
the Urine little and high coloured in the first
Stage: but more plentiful, less flaming, and
letting fall much Sediment afterwards. There
is a frequent Thirst, and sometimes an Inclination
to vomit; which imposing on the ignorant
Assistants, have often inclined them to give the
Patient a Vomit, which is mortal, especially at
this Juncture. The Heat becomes universal.
The Symptoms are heightened almost every Night,
during which the Cough is more exasperated,
and the Spitting or Expectoration in less Quantity.
The best Expectoration is of a middling
Consistence, neither too thin, nor too hard and
tough, like those which are brought up at the
Termination of a Cold; but rather more yellow,
and mixed with a little Blood, which gradually
becomes still less, and commonly disappears entirely,
before the seventh Day. Sometimes the
Inflammation ascends along the Wind-pipe, and in
some Measure suffocates the Patient, paining
him considerably in Swallowing, which makes
him think he has a sore Throat.
§ 47. Whenever the Disease is very violent at
first, or increases to be such, the Patient cannot
draw his Breath, but when he sits up. The
Pulse becomes very small and very quick; the
Countenance livid, the Tongue black; the Eyes
stare wildly; and he suffers inexpressible Anguish,
attended with incessant Restlessness and
Agitation in his Bed. One of his Arms is sometimes
affected with a sort of Palsy; he raves without
Intermission; can neither thoroughly wake
nor sleep. The Skin of his Breast and of his
Neck is covered (especially in close sultry
Weather, and when the Distemper is extremely
violent) with livid Spots, more or less remarkable,
which should be called petechial ones, but are improperly
termed the pourpre, or purple. The
natural Strength becomes exhausted; the Difficulty
of breathing increases every Moment; he
sinks into a Lethargy, and soon dies a terrible
Death in Country Places, by the very Effects of
the inflaming Medicines they employ on such
Occasions. It has been known in Fact, that the
Use of them has raised the Distemper to such a
Height, that the very Heart has been rent open,
which the Dissection of the Body has demonstrated.
§ 48. If the Disease rushes on at once, with
a sudden and violent Attack; if the Horror, the
Cold and Shivering last many Hours, and are followed
with a nearly scorching Degree of Heat;
if the Brain is affected from the very Onset; if
the Patient has a small Purging, attended with a
Tenesinus, or straining to Stool, often termed a
Needy; if he abhors the Bed; if he either sweat
excessively, or if his Skin be extremely dry; if
his natural Manner and Look are considerably
changed; and if he spits up with much Difficulty,
the Disease is extremely dangerous.
§ 49. He must directly, from the first Seizure
in this State, be put upon a Regimen, and his
Drink must never be given cold. It should
either be the Barley Water , the Almond
Emulsion , or that of . The Juices
of the Plants, which enter into the last of these
Drinks, are excellent Remedies in this Case; as
they powerfully attenuate, or melt down, the viscid
thick Blood, which causes the Inflammation.
The Advantage of Bleeding:
As long as the Fever keeps up extremely violent;
while the Patient does not expectorate sufficiently;
continues raving; has a violent Head-ach,
or raises up pure Blood, the Glyster
must be given thrice, or at least twice, in twenty
four Hours. However the principal Remedy is
Bleeding. As soon as ever the preceding cold
Assault is over, twelve Ounces of Blood must be
taken away at once; and, if the Patient be young
and strong, fourteen or even sixteen. This plentiful
Bleeding gives him more Ease, than if twenty
four Ounces had been drawn, at three different
Times.
§ 50. When the Disease is circumstanced as
described () that first Bleeding makes the
Patient easy for some Hours; but the Complaint
returns; and to obviate its Violence, as much as
possible, we must, except things promise extremely
well, repeat the Bleeding four Hours
after the first, taking again twelve Ounces of
Blood, which pretty often proves sufficient. But
if, about the Expiration of eight or ten Hours, it
appears to kindle up again, it must be repeated a
third, or even a fourth Time. Yet, with the Assistance
of other proper Remedies, I have seldom
been obliged to bleed a fourth Time, and have
sometimes found the two first Bleedings sufficient.
If the Disease has been of several Days Duration,
when I have first been called; if the Fever
is still very high; if there be a Difficulty of
Breathing; if the Patient does not expectorate at
all, or brings up too much Blood; without being
too solicitous about the Day of the Disease, the
Patient should be bled, though it were on the
tenth.
§ 51. In this, and in all other inflammatory
Diseases, the Blood is in a very thick viscid State:
and almost immediately on its being drawn, a
white tough Skin, somewhat like Leather, is
formed on its Top, which most People have seen,
and which is called the pleuritic Crust. It is
thought a promising Appearance, when at each
Bleeding it seems less hard, and less thick, than it
was at the preceding ones: and this is very generally
true, if the Sick feels himself, at the same Time,
sensibly better: but whoever shall attend solely
to the Appearance of the Blood, will find himself
often deceived. It will happen, even in the
most violent Inflammation of the Breast, that
this Crust is not formed, which is supposed to be
a very unpromising Sign. There are also, in
this Respect, many odd Appearances, which
arise from the smallest Circumstances; so that we
must not regulate the Repetitions of our bleeding,
solely by this Crust: and in general we must
not be over credulous in supposing, that the Appearances
in the Blood, received into the Bason,
can enable us to determine, with Certainty, of
its real State in the Body.
§ 52. When the sick Person is in the Condition
described () the Bleeding is not only unattended
with Ease; but sometimes it is also pernicious,
by the sudden Weakness to which it reduces
him. Generally in such a Case all Medicines
and Means are insignificant: and it is a very
bad Sign in this Disease, when this Discharge is
not attended with Ease and Benefit to the Sick;
or when there are some Circumstances, which
oblige us to be sparing of it.
§ 53. The Patient's Legs should every Day,
for one half Hour, be put into a Bath of warm
Water, wrapping him up closely; that the Cold
may not check that Perspiration, which the
Bath promotes.
§ 54. Every two Hours he should take two
Spoonfuls of the Mixture , which promotes
all the Discharges, and chiefly that of Expectoration.
§ 55. When the Oppression and Straitness are
considerable, and the Cough dry, the Patient
may receive the Vapour of boiling Water, to which
a little Vinegar has been added. There are two
ways of effecting this; either by placing below
his Face, after setting him up, a Vessel filled with
such boiling hot Water, and covering the Patient's
Head and the Vessel with a Linen Cloth,
that may inclose the Steam; or else by holding
before his Mouth a Spunge dipped in the same
boiling Liquor. This last Method is the least
effectual, but it fatigues the Patient considerably
less. When this bad Symptom is extremely
pressing, Vinegar alone should be used without
Water; and the Vapour of it has often saved
Patients, who seemed to have one Foot in the
Grave: but it should be continued for several
Hours.
§ 56. The outward Remedies directed in
are also applied with Success to the Breast,
and to the Throat.
§ 57. When the Fever is extremely high,
the Sick should take every Hour, a Spoonful of
the Mixture . in a Cup of the Ptisan
but without diminishing on this Account the
usual Quantity of his other Drinks, which may
be taken immediately after it.
§ 58. As long as the Patient shall grow worse,
or only continue equally bad, the same Medicines
are to be repeated. But if on the third Day
(tho' it rarely happens so soon) or fourth, or
fifth, the Disease takes a more favourable Turn;
if the Exasperation returns with less Violence; the
Cough be less severe; the Matter coughed up
less bloody: if Respiration becomes easier; the
Head be less affected; the Tongue not quite so
dry; if the high Colour of the Urine abates, and
its Quantity be increased, it may be sufficient
then to keep the Patient carefully to his Regimen,
and to give him a Glyster every Evening.
The Exasperation that occurs the fourth Day is
often the highest.
§ 59. This Distemper is most commonly terminated
and carried off by Expectoration, and
often by Urine, which on the seventh, the ninth,
or the eleventh Day, and sometimes on the Days
between them, begins to let fall a plentiful Sediment,
or Settling, of a pale red Colour, and sometimes
real Pus or ripe Matter. These Discharges
are succeeded by Sweats, which are as serviceable
then, as they were injurious at the Beginning of
the Disease.
§ 60. Some Hours before these Evacuations
appear, there come on, and not seldom, some
very alarming Symptoms, such as great Anguish;
Palpitations, some Irregularity in the Pulse; an
increased Oppression; convulsive Motions (this
being what is called the Crisis, the Height, or
Turn of the Distemper) but they are no ways
dangerous, provided they do not occasion any improper
Treatment. These Symptoms depend on
the morbid and purulent Matter, which, being
dislodged, circulates with the Humours,
and irritates different Parts, until the Discharge
of it has fairly begun; after which all such Symptoms
disappear, and Sleep generally ensues. However
I cannot too strongly insist on the Necessity
of great Prudence in such Circumstances. Sometimes
it is the Weakness of the Patient, and at
other times Convulsions, or some other Symptoms,
that terrify the By-standers. If, which is
most generally the Case, the absurd Practice of
directing particular Remedies for such Accidents
takes place, such as spirituous Cordials, Venice
Treacle, Confections, Castor and Rue; the Consequence
is, that Nature being disturbed in her
Operations, the Crisis or Turn is not effected;
the Matter which should be discharged by Stool,
by Urine, or by Sweat, is not discharged out of
the Body; but is thrown upon some internal or
external part of it. Should it be on some inward
part, the Patient either dies at once; or
another Distemper succeeds, more troublesome
and incurable than the first. Should it be expelled
to some outward part, the Danger indeed
is less; and as soon as ever such a Tumour appears,
ripening Pultices should be apply'd to
bring it to a Head, after which it should immediately
be opened.
§ 61. In order to prevent such unhappy Consequences,
great Care must be taken, whenever
such terrifying Symptoms come on, [about the
Time of the Crisis] to make no Change in the
Diet, nor in the Treatment of the Patient; except
in giving him the loosening Glyster ;
and applying every two Hours a Flannel, squeezed
out of warm Water, which may cover all the
Belly, and in a Manner go round the Body behind
the Reins. The Quantity of his Drink
may also be increased a little; and that of his
Nourishment lessened, as long as this high and
violent State continues.
§ 62. I have not spoken of Vomits or Purges, as
being directly contrary to the Nature of this Disease.
Anodynes, or Opiates, to procure Sleep are also,
in general, very improper. In a few Cases, however,
they may possibly be useful; but these
Cases are so very difficult to be sufficiently distinguished,
that Opiates should never be admitted
in this Disease, without the Presence and Advice
of a Physician. I have seen many Patients, who
have been thrown into an incurable Hectic, by
taking them improperly. When the Disease is
not received in a mortal Degree, nor has been injudiciously
treated, and proceeds in a benign regular
Manner, the Patient may be called very
well and safe by the fourteenth Day; when he
may, if he has an Appetite, be put upon the
Diet of People who are recovering. But if he
still retains an Aversion to Food; if his Mouth is
foul and furred, and he is sensible of some Heaviness
in his Head, he should take the purging
Potion .
§ 63. Bleedings from the Nose occur sometimes
naturally in this Disease, even after repeated
Bleedings by Art; these are very benign and favourable,
and are commonly attended with more
Ease and Relief than artificial Bleedings. Such
voluntary Discharges may sometimes be expected,
when the Patient is sensibly mended in many
Respects after the Use of the Lancet; and yet
complains of a great Pain in his Head, accompanied
with quick sparkling Eyes, and a Redness
of the Nose. Nothing should be done to stop
these voluntary Bleedings, since it would be very
dangerous: For when Nature has fulfilled her
Intention by them, they cease of themselves.
At other times, but more rarely, the Distemper
is carried off by a natural Purging, attended with
moderate Pain, and the Discharge of bilious
Matter.
§ 64. If the Expectoration, or hawking up
of Matter, stops very suddenly, and is not
speedily attended with some other Evacuation;
the Oppression and Anguish of the Patient immediately
return, and the Danger is great and
pressing. If the Distemper, at this Juncture,
is not of many Days standing; if the Patient is
a strong Person; if he has not as yet been plentifully
bled; if there be still some Blood mixed
with the Humour he expectorates; or if the Pulse
be strong and hard, he should be bled immediately
in the Arm; and constantly receive the
Steam of hot Water and Vinegar by the Mouth,
and drink plentifully of the Ptisan , something
hotter than ordinary. But if his Circumstances,
after this Suppression, are different from
these just mentioned; instead of bleeding him,
two Blisters should be applied to the Legs; and
he should drink plentifully of the Ptisan .
The Causes which oftenest produce this Suppression
of his Expectoration are, 1, a sharp and
sudden cold Air. 2, too hot a one. 3, over
hot Medicines. 4, excessive Sweating. 5, a
Purge prematurely and injudiciously timed. and 6,
some immoderate Passion of the Mind.
§ 65. When the Sick has not been sufficiently
bled, or not soon enough; and even sometimes,
which I have seen, when he has been greatly
weakened by excessive Bleeding; so that the
Discharges by Stool, Urine, Expectoration and
Perspiration, have not been sufficiently made;
when these Discharges have been confused by
some other Cause; or the Disease has been injudiciously
treated; then the Vessels that have
been inflamed, do not unload themselves of the
Humours, which stuff up and oppress them: but
there happens in the Substance of the affected
Lung, the same Circumstance we see daily occur
on the Surface of the Body. If an inflammatory
Tumour or Swelling does not disperse itself, and
disappears insensibly, it forms an Imposthume or
Abscess. Thus exactly also in the inflamed
Lung, if the Inflammation is not dissipated, it
forms an Abscess, which, in that part, is called a
Vomica: and the Matter of that Abscess, like
the external ones, remains often long inclosed in
its Sac or Bag, without bursting open its Membrane
or Case, and discharging the Matter it contains.
§ 66. If the Inflammation was not very deeply
seated in the inward Substance of the diseased
Lung; but was extended to its Surface, that is,
very near the Ribs, the Sac will burst on the
Surface of the Lung; and the Matter contained
in it must be discharged into the Cavity, or Hollowness
of the Breast, between the Lung, the
Ribs, and the Diaphragm or Midriff, which is
the Membrane that divides the Breast and the
Belly. But when the Inflammation is considerably
deeper, the Imposthume bursts withinside
of the Lung itself. If its Orifice, or Opening is
so small, that but little can get out at once; if
the Quantity of all the Matter be inconsiderable,
and the Patient is at the same Time pretty strong,
he coughs up the Matter, and is very sensibly relieved.
But if this Vomica be large, or if its Orifice
is wide, and it throws out a great Quantity of
Matter at once; or if the Patient is very weak,
he dies the Moment it bursts, and that sometimes
when it is least expected. I have seen one Patient
so circumstanced expire, as he was conveying
a Spoonful of Soup to his Mouth; and another,
while he was wiping his Nose. There was
no present Symptom in either of these Cases,
whence a Physician might suppose them likelier
to die at that Instant, than for some Hours before.
The Pus, or Matter, is commonly discharged
through the Mouth after Death, and
the Bodies very soon become putrified.
§ 67. We call that Vomica which is not burst,
an occult or hidden, and that which is, an evident
or open one. It is of considerable Importance
to treat exactly and clearly of this Topic; as a
great Number of Country People die of these
Imposthumes, even without a Suspicion of the
Cause of their Death. I had an Instance of it
some Days since, in the School-master of a Village.
He had an occult and very considerable
Vomica in the left Lung, which was the
Consequence of an Inflammation of the Breast, that
had been treated improperly at the Beginning.
He seemed to me not likely to live twenty four
Hours; and really died in the Night, after inexpressible
Anguish.
§ 68. Whatever Distemper is included within
the Breast of a living Patient, is neither an Object
of the Sight or Touch whence these Vomicas,
these inward Tumours, are so often unknown,
and indeed unsuspected. The Evacuations
that were necessary for the Cure, or sometimes
for the Prevention, of them, have not
taken place, during the first fourteen Days. At
the End of this Term, the Patient, far from being
cured, is not very considerably relieved; but,
on the contrary, the Fever continues to be pretty
high, with a Pulse continually quick; in general
soft and weak; though sometimes pretty
hard, and often fluctuating, or, as it were, waving.
His Breathing is still difficult and oppressed;
with small cold Shudderings from Time
to Time; an Exasperation of the Fever; flushed
Cheeks, dry Lips, and Thirst.
The Increase of these Symptoms declare, that
Pus or Matter is thoroughly formed: the Cough
then becomes more continual; being exasperated
with the least Motion; or as soon as ever the
Patient has taken any Nourishment. He can
repose only on the Side affected. It often happens
indeed, that he cannot lie down at all;
but is obliged to be set up all Day; sometimes
even without daring to lean a little upon his
Loins, for fear of increasing the Cough and Oppression.
He is unable to sleep; has a continual
Fever, and his Pulse frequently intermits.
The Fever is not only heightened every Evening;
but the smallest Quantity of Food, the
gentlest Motion, a little Coughing, the lightest
Agitation of the Mind, a little more than usual
Heat in the Chamber, Soup either a little too
strong, or a little too salt, increase the Quickness
of his Pulse the Moment they occur, or are given.
He is quite restless, has some short Attacks of
the most terrible Anguish, accompanied and
succeeded by Sweatings on his Breast, and from
his whole Countenance. He sweats sometimes
the whole Night; his Urine is reddish, now
frothy, and at other times oily, as it were. Sudden
Flushings, hot as Flames, rise into his whole
Visage. The greater Number of the Sick are
commonly sensible of a most disagreeable Taste
in their Mouth; some of old strong Cheese;
others of rotten Eggs; and others again of stinking
Meat, and fall greatly away. The Thirst of
some is unquenchable; their Mouths and Lips
are parched; their Voice weak and hoarse;
their Eyes hollow, with a kind of Wildness in
their Looks. They have a general Disgust to all
Food; and if they should ask for some particular
Nourishment without seeing it, they reject it the
Moment it is brought them; and their Strength
at length seems wholly exhausted.
Besides these Symptoms, a little Inflation, or
Bloatedness, as it were, is sometimes observed on
the Breast, towards the Side affected; with an
almost insensible Change of Colour. If the Vomica
be situated at the Bottom of the affected
Lobe of the Lungs, and in its internal Part, that is,
nearly in the Middle of the Breast, some Puffiness
or light Swelling may be perceived in some
Bodies, by gently pressing the Pit of the Stomach;
especially when the Patient coughs. In
short, according to the Observations of a German
Physician, if one strike the open Hand on
the Breast, covered only with a Shirt, it retains
in the Spot, which is directly opposite to the Vomica,
a flat heavy Sound, as if one struck a Piece
of Flesh; while in striking on the other Side it
gives a clear loud Sound, as from a Drum. I
still doubt however, whether this Observation
will generally hold true; and it would be hazardous
to affirm there is no Abscess in a Breast,
which does not return this heavy Sound.
§ 69. When a Vomica is formed, as long as
it is not emptied, all the Symptoms I have already
enumerated increase, and the Vomica grows
in Size: the whole Side of the Lung affected
sometimes becomes a Bag or Sac of Matter.
The sound Side is compressed; and the Patient
dies after dreadful Anguish, with the Lung full of
Pus, and without having ever brought up any.
To avoid such fatal Consequences, it is necessary
to procure the Rupture and Discharge of
this inward Abscess, as soon as we are certain of
its Existence: And as it is safer it should break
within the Lobe affected, from whence it may
be discharged by hawking up; than that it should
burst and void itself into the Cavity of the Breast,
for Reasons I shall give hereafter, we must endeavour,
that this Rupture may be effected within
the internal Substance of the Lungs.
§ 70. The most effectual Methods to procure
this are, 1. To make the Patient continually
receive, by his Mouth, the Vapour of warm Water.
2. When by this Means that part of the
Sac or Abscess is softened, where we could wish
the Rupture of it to happen, the Patient is to
swallow a large Quantity of the most emollient
Liquid; such as Barley Water, Almond Milk,
light Veal Broth, or Milk and Water. By this
Means the Stomach is kept always full: so that
the Resistance to the Lungs being considerable
on that Side, the Abscess and its Contents will
naturally be pressed towards the Side of the
Wind-pipe, as it will meet with less Resistance
there. This fulness of the Stomach will also
incline the Patient to cough, which may concur
to produce a good Event. Hence, 3, we should
endeavour to make the Patient cough, by making
him smell to some Vinegar, or even snuff up a
little; or by injecting into his Throat, by the
Means of a small Syringe or Pipe, such as Children
make out of short Pieces of Elder-Boughs,
a little Water or Vinegar. 4. He should be advised
to bawl out aloud, to read loud, or to laugh
heartily; all which Means contribute to burst
open the Abscess, as well as those two following
ones. 5. Let him take every two Hours a Soup-Ladle
of the Potion . 6. He should be put
into a Cart, or some other Carriage; but not before
he has drank plentifully of such Liquors as
I have just mentioned: after which the Shaking
and Jolting in the Carriage have sometimes immediately
procured that Rupture, or breaking of the
Bag or Abscess, we wished for.
§ 71. Some Years since I saw a Country Maid
Servant, who was left in a languishing Condition
after an Inflammation of the Breast; without any
Person's suspecting her Ailment. This Woman
being put into a Cart, that was sent for a Load of
Hay; one of the Wheels run violently against a
Tree: she swooned away, and at the same Time
brought up a great Quantity of digested Matter.
She continued to bring up more; during which
I was informed of her Case, and of the Accident,
which effectually cured her.
A Swiss Officer, who served in Piedmont, had
been in a languid State of Health for some
Months; and returned home to set himself
down as easily as he could, without conceiving
any considerable Hopes of Recovery.
Upon entering into his own Country, by the
Way of Mount Bernard; and being obliged to
go some Paces on Foot, he fell down; and remained
in a Swoon above a Quarter of an Hour:
during which Time he threw up a large Quantity
of Matter, and found himself that very Moment
very greatly relieved. I ordered him a proper
Diet, and suitable Medicines: his Health became
perfectly established; and the Preservation of his
Life was principally owing to this lucky Fall.
Many Persons afflicted with a Vomica, faint
away the very Instant it breaks. Some sharp
Vinegar should be directly held to their Nose.
This small Assistance is generally sufficient,
where the bursting of it is not attended with
such Appearances as shew it to be mortal, in
which Case every Application is insignificant.
§ 72. If the sick Person was not extremely
weak before the Bursting of the Abscess; if the
Matter was white, and well conditioned; if the
Fever abates after it; if the Anguish, Oppression
and Sweats terminate; if the Cough is less violent;
if the Patient is sensibly easier in his Situation or
Posture; if he recovers his Sleep and Appetite;
if his usual Strength returns; if the Quantity he
expectorates, or brings up, becomes daily and
gradually less; and if his Urine is apparently
better, we may have Room to hope, that by the
Assistance of these Remedies I shall immediately
direct, he may be radically, compleatly cured.
§ 73. But if on the contrary; when his
Strength is exhausted before the bursting of the
Abscess; when the Matter is too thin and transparent,
brown, green, yellow, bloody and of an
Offensive Smell; if the Pulse continues quick
and weak; if the Patient's Appetite, Strength
and Sleep do not improve, there remains no hope
of a Cure, and the best Medicines are ineffectual:
Nevertheless we ought to make some Tryal
of them.
§ 74. They consist of the following Medicines
and Regulations. 1. Give every four Hours a
little Barley or Rice Cream. 2. If the Matter
brought up is thick and glewy, so that it is very
difficult to be loosened and discharged, give every
two Hours a Soup-ladle of the Potion ;
and between the giving these two, let the Patient
take every half Hour a Cup of the Drink .
3. When the Consistence of the Matter is such,
that there is no Occasion for these Medicines to
promote the Discharge of it, they must be omitted;
tho' the same Sort and Quantity of Food are
to be continued; but with the Addition of an
equal Quantity of Milk; or, which would be
still more beneficial, instead of this Mixture, we
should give an equal Quantity of sweet Milk, taken
from a good Cow, which, in such a Case,
may compose the whole Nourishment of the
Patient. 4. He should take four Times a Day,
beginning early in the Morning, and at the Distance
of two Hours, a Dose of the Powder ,
diluted in a little Water, or made into a Bolus,
or Morsel, with a little Syrup or Honey.
His common Drink should be Almond Emulsion,
commonly called Almond Milk, or Barley
Water, or fresh Water with a fourth part Milk.
5. He should air and exercise every Day on
Horseback, or in a Carriage, according as his
Strength and his Circumstances will allow him.
But of all Sorts of Exercise, that upon a trotting
Horse is, beyond all Comparison, the very best,
and the easiest to be procured by every Body;
provided the Disease be not too far advanced;
since in such a Situation, any Exercise, that was
only a little violent, might prove pernicious.
§ 75. The Multitude, who are generally illiterate,
seldom consider any thing as a Remedy,
except they swallow it. They have but little
Confidence in Regimen, or any Assistance in the
Way of Diet, and consider Riding on Horseback
as wholly useless to them. This is a dangerous
Mistake, of which I should be glad to undeceive
them: since this Assistance, which appears so
insignificant to them, is probably the most effectual
of any: it is that in Fact, without which
they can scarcely expect a Cure, in the highest
Degrees of this Disease: it is that, which perhaps
alone may recover them, provided they take no
improper Food. In brief it is considered, and
with Reason, as the real Specific for this Disease.
§ 76. The Influence of the Air is of more
Importance in this Disorder, than in any others;
for which Reason great Care should be taken to
procure the best, in the Patient's Chamber.
For this Purpose it should often be ventilated, or
have an Admission of fresh Air, and be sweetened
from Time to Time, tho' very lightly, with a
little good Vinegar; and in the Season it should
be plentifully supplied with agreeable Herbs,
Flowers and Fruits. Should the Sick be unfortunately
situated, and confined in an unwholsome
Air, there can be but little Prospect of
curing him, without altering it.
§ 77. Out of many Persons affected with these
Disorders, some have been cured by taking nothing
whatsoever but Butter-milk; others by
Melons and Cucumbers only; and others again
by Summer Fruits of every Sort. Nevertheless,
as such Cases are singular, and have been but
few, I advise the Patient to observe the Method I
have directed here, as the surest.
§ 78. It is sufficient if he have a Stool once
in two, or even in three, Days. Hence, there
is no Reason for him, in this Case, to accustom
himself to Glysters: they might excite a Looseness,
which may be very dangerous.
§ 79. When the Discharge of the Matter from
the Breast diminishes, and the Patient is perceivably
mended in every Respect, it is a Proof
that the Wound in the Abscess is deterged, or
clean, and that it is disposed to heal up gradually.
If the Suppuration, or Discharge, continues in
great Quantity; if it seems but of an indifferent
Consistence; if the Fever returns every Evening,
it may be apprehended, that the Wound, instead
of healing, may degenerate into an Ulcer, which
must prove a most embarrassing Consequence.
Under such a Circumstance, the Patient would
fall into a confirmed Hectic, and die after some
Months Sickness.
§ 80. I am not acquainted with any better
Remedy, in such a dangerous Case, than a Perseverance
in these already directed, and especially
in moderate Exercise on Horseback. In some of
them indeed Recourse may be had to the sweet
Vapours of some vulnerary Herbs in hot Water,
with a little Oil of Turpentine, as directed .
I have seen them succeed; but the safest Way is
to consult a Physician, who may examine and
consider, if there is not some particular Circumstance
combined with the Disease, that proves an
Obstacle to the Cure of it. If the Cough prevents
the Patient from Sleeping, he may take in
the Evening two or three Table Spoonfuls of the
Prescription , in a Glass of Almond Milk
or Barley Water.
§ 81. The very same Causes which suddenly
suppress the Expectoration, in an Inflammation of
the Breast, may also check the Expectoration
from a Vomica already begun: in which Circumstance
the Patient is speedily afflicted with an
Oppression and Anguish, a Fever and evident
Feebleness. We should immediately endeavour
to remove this Stoppage, by the Vapour of hot
Water; by giving a Spoonful of the Mixture
every Hour; by a large Quantity of the
Ptisan , and by a proper Degree of Motion
or Exercise. As soon as ever the Expectoration
returns, the Fever and the other Symptoms disappear.
I have seen this Suppression in strong
Habits quickly followed with an Inflammation
about the Seat of the Vomica, which has obliged
me to bleed, after which the Expectoration immediately
returned.
§ 82. It happens sometimes, that the Vomica
is entirely cleansed; the Expectoration is entirely
finished, or drained off, the Patient seems well,
and thinks himself compleatly cured: but soon
after, the Uneasiness, Oppression, Cough and
Fever are renewed, because the Membrane or
Bag of the Vomica fills again: again it empties
itself, the Patient expectorates for some Days,
and seems to recover. After some Time however,
the same Scene is repeated; and this Vicissitude,
or Succession, of moderate and of bad
Health, often continues for some Months and
even some Years. This happens when the Vomica
is emptied, and is gradually deterged; so
that its Membranes, or Sides touch or approach
each other; but without cicatrizing or healing
firmly; and then there drops or leaks in very
gradually fresh Matter. For a few Days this
seems no ways to incommode the Patient; but
as soon as a certain Quantity is accumulated, he
is visited again with some of the former Symptoms,
'till another Evacuation ensues. People
thus circumstanced, in this Disease, sometimes
appear to enjoy a tolerable Share of Health. It
may be considered as a kind of internal Issue,
which empties and cleanses itself from Time to
Time; pretty frequently in some Constitutions,
more slowly in others; and under which some
may attain a good middling Age. When it arrives
however at a very considerable Duration,
it proves incurable. In its earliest State, it gives
way sometimes to a Milk-diet, to riding on
Horseback; and to the Medicine .
§ 83. Some may be surprized, that in treating
of an Abscess of the Lungs, and of the Hectic,
which is a Consequence of it, I say nothing of
those Remedies, commonly termed Balsamics,
and so frequently employed in them, for Instance,
Turpentines, Balsam of Peru, of Mecca, Frankincense,
Mastich, Myrrh, Storax and Balsam
of Sulphur. I shall however say briefly here
(because it is equally my Design to destroy the
Prejudice of the People, in favour of improper
Medicines, and to establish the Reputation of
good ones) that I never in such Cases made use
of these Medicines; because I am convinced,
that their Operation is generally hurtful in such
Cases; because I see them daily productive of
real Mischief; that they protract the Cure, and
often change a slight Disorder into an incurable
Disease. They are incapable of perfect Digestion,
they obstruct the finest Vessels of the Lungs,
whose Obstructions we should endeavour to remove;
and evidently occasion, except their Dose
be extremely small, Heat and Oppression. I
have very often seen to a Demonstration, that
Pills compounded of Myrrh, Turpentine and
Balsam of Peru, have, an Hour after they were
swallowed, occasioned a Tumult and Agitation
in the Pulse, high Flushings, Thirst and Oppression.
In short it is demonstrable to every
unprejudiced Person, that these Remedies, as
they have been called, are truly prejudicial in
this Case; and I heartily wish People may be
disabused with Respect to them, and that they
may lose that Reputation so unhappily ascribed
to them.
I know that many Persons, very capable in
other Respects, daily make use of them in these
Distempers: such however cannot fail of disusing
them, as soon as they shall have observed their
Effects, abstracted from the Virtues of the other
Medicines to which they add them, and which
mitigate the Danger of them. I saw a Patient,
whom a foreign Surgeon, who lived at Orbe, attempted
to cure of a Hectic with melted Bacon,
which aggravated the Disease. This Advice seemed,
and certainly was, absurd; nevertheless the
Balsamics ordered in such Cases are probably not
more digestible than fat Bacon. The Powder
possesses whatever these Balsamics pretend
to: it is attended with none of the Inconveniencies
they produce; and has all the good Qualities
ascribed to them. Notwithstanding which,
it must not be given while the Inflammation
exists; nor when it may revive again; and no
other Aliment should be mixed with the Milk.
The famous Medicine called the Antihectic,
(Antihecticum Poterii) has not, any more than
these Balsamics, the Virtues ascribed to it in
such Cases. I very often give it in some obstinate
Coughs to Infants with their Milk, and
then it is very useful: but I have seldom seen it
attended with considerable Effects in grown Persons;
and in the present Cases I should be fearful
of its doing Mischief.
§ 84. If the Vomica, instead of breaking within
the Substance of the Lungs affected, should
break without it, the Pus must be received into
the Cavity of the Breast. We know when that
has happened, by the Sensation or Feeling of the
Patient; who perceives an uncommon, a singular
kind of Movement, pretty generally accompanied
with a Fainting. The Oppression and
Anguish cease at once; the Fever abates; the
Cough however commonly continues, tho' with
less Violence, and without any Expectoration.
But this seeming Amendment is of a short Duration,
since from the daily Augmentation of the
Matter, and its becoming more acrid or sharp, the
Lungs become oppressed, irritated and eroded.
The Difficulty of Breathing, Heat, Thirst, Wakefulness,
Distaste, and Deafness, return, with many
other Symptoms unnecessary to be enumerated,
and especially with frequent Sinkings and Weakness.
The Patient should be confined to his
Regimen, to retard the Increase of the Disease as
much as possible; notwithstanding no other effectual
Remedy remains, except that of opening
the Breast between two of the Ribs, to discharge
the Matter, and to stop the Disorder it occasions.
This is called the Operation for the Empyema. I
shall not describe it here, as it should not be undertaken
but by Persons of Capacity and Experience,
for whom this Treatise was not intended.
I would only observe, it is less painful than terrifying;
and that if it is delayed too long, it proves
useless, and the Patient dies miserably.
§ 85. We may daily see external
Inflammations turn gangrenous, or mortify. The same
Thing occurs in the Lungs, when the Fever is
excessive, the Inflammation either in its own
Nature, extremely violent, or raised to such a
Height by hot Medicines. Intolerable Anguish,
extreme Weakness, frequent Faintings, Coldness
of the Extremities, a livid and fœtid thin Humour
brought up instead of concocted Spitting,
and sometimes blackish Stripes on the Breast,
sufficiently distinguish this miserable State. I
have smelt in one Case of this Kind, where the
Patient had been attacked with this Disease (after
a forced March on Foot, having taken some Wine
with Spices to force a Sweat) his Breath so horribly
stinking, that his Wife had many Sinkings
from attending him. When I saw him, I could
discern neither Pulse nor Intellect, and ordered
him nothing. He died an Hour afterwards,
about the Beginning of the third Hour.
§ 86. An Inflammation may also become hard,
when it forms what we call a Scirrhus, which is
a very hard Tumour, indolent, or unpainful.
This is known to occur, when the disease has not
terminated in any of those Manners I have represented;
and where, tho' the Fever and the other
Symptoms disappear, the Respiration, or Breathing,
remains always a little oppressed; the Patient
still retains a troublesome Sensation in one
Side of his Breast; and has from Time to Time
a dry Cough, which increases after Exercise, and
after eating. This Malady is but seldom cured;
though some Persons attacked with it last many
Years, without any other considerable Complaint.
They should avoid all Occasions of over-heating
themselves; which might readily produce a new
Inflammation about this Tumour, the Consequences
of which would be highly dangerous.
§ 87. The best Remedies against this Disorder,
and from which I have seen some good Effects,
are the medicated Whey , and the
Pills . The Patient may take twenty Pills,
and a Pint and a half of the Whey every Morning
for a long Continuance; and receive inwardly,
now and then, the Vapour of hot Water.
§ 88. Each Lung, in a perfect State of Health,
touches the Pleura, the Membrane, that lines
the Inside of the Breast; though it is not connected
to it. But it often happens, after an Inflammation
of the Breast, after the Pleurisy, and
in some other Cases, that these two Parts adhere
closely to each other, and are never afterwards
separated. However this is scarcely to be considered
as a Disease; and remains commonly unknown,
as the Health is not impaired by it, and
nothing is ever prescribed to remove it. Nevertheless
I have seen a few Cases, in which this Adhesion
was manifestly prejudicial.
Chapter V.
Of the Pleurisy.
Sect. 89.
he Pleurisy, which is chiefly known by
these four Symptoms, a strong Fever, a
Difficulty of Breathing, a Cough, and
an acute Pain about the Breast; the
Pleurisy, I say, is not a different Malady from
the Peripneumony, or Inflammation of the Breast,
the Subject of the preceding Chapter; so that
I have very little to say of it, particularly, or
apart.
§ 90. The Cause of this Disease then is exactly
the same with that of the former, that is,
an Inflammation of the Lungs; but an Inflammation,
that seems rather a little more external.
The only considerable Difference in the Symptoms
is, that the Pleurisy is accompanied with a
most acute Pain under the Ribs, and which is
commonly termed a Stitch. This Pain is felt indifferently
over every Part of the Breast; though
more commonly about the Sides, under the more
fleshy Parts of the Breast, and oftenest on the
right Side. The Pain is greatly increased whenever
the Patient coughs or draws in the Air in
breathing; and hence a Fear of increasing it,
by making some Patients forbear to cough or respire,
as much as they possibly can; and that
aggravates the Disease, by stopping the Course of
the Blood in the Lungs, which are soon overcharged
with it. Hence the Inflammation of
this Bowel becomes general; the Blood mounts
up to the Head; the Countenance looks deeply
red, or as it were livid; the Patient becomes
nearly suffocated, and falls into the State described
.
Sometimes the Pain is so extremely violent,
that if the Cough is very urgent at the same
Time, and the Sick cannot suppress or restrain
it, they are seized with Convulsions, of which I
have seen many Instances, but these occur almost
always to Women; though they are much less
subject than Men to this Disease, and indeed to
all inflammatory ones. It may be proper however
to observe here, that if Women should be
attacked with it, during their monthly Discharges,
that Circumstance should not prevent the repeated
and necessary Bleedings, nor occasion any Alteration
in the Treatment of the Disease. And
hence it appears, that the Pleurisy is really an
Inflammation of the Lungs, accompanied with
acute Pain.
§ 91. I am sensible that sometimes an Inflammation
of the Lungs is communicated also to that
Membrane, which lines the Inside of the Breast;
and which is called the Pleura; and from thence
to the Muscles, the fleshy Parts, over and between
the Ribs. This however is not very frequently
the Case.
§ 92. Spring is commonly the Season most
productive of Pleurisies: in general there are few
in Summer: notwithstanding that in the Year
1762, there were a great many during the hottest
Season, which then was excessively so. The
Disease usually begins with a violent Shivering,
succeeded by considerable Heat, with a Cough,
an Oppression, and sometimes with a sensible
Straitning, or Contraction, as it were, all over
the Breast; and also with a Head-ach, a Redness of
the Cheeks, and with Reachings to vomit. The
Stitch does not always happen at the very first
Onset; often not 'till after several Hours from
the first Complaint; sometimes not before the
second, or even the third Day. Sometimes the
Patient feels two Stitches, in different Parts of
the Side; though it seldom happens that they are
equally sharp, and the lightest soon ceases. Sometimes
also the Stitch shifts its Place, which promises
well, if the Part first attacked by it continues
perfectly free from Pain: but it has a bad
Appearance, if, while the first is present, another
also supervenes, and both continue. The Pulse
is usually very hard in this Distemper; but in the
dreadful Cases described and , it becomes
soft and small. There often occur at, or very
quickly after, the Invasion, such an Expectoration,
or hawking up, as happens in an Inflammation
of the Breast; at other Times there is not the
least Appearance of it, whence such are named
dry Pleurisies, which happen pretty often. Sometimes
the Sick cough but little, or not at all.
They often lie more at Ease upon the Side affected,
than on the sound one. The Progress
of this Disease advances exactly like that described
in the preceding Chapter: for how can
they differ considerably? and the Treatment of
both is the same. Large Hæmorrhages, or Bleedings
from the Nose, frequently happen, to the
great Relief of the Patient; but sometimes such
Discharges consist of a kind of corrupted Blood,
when the Patient is very ill, and these portend
Death.
§ 93. This Distemper is often produced by
drinking cold Water, while a Person is hot;
from which Cause it is sometimes so violent, as
to kill the Patient in three Hours. A young
Man was found dead at the Side of the Spring,
from which he had quenched his Thirst: neither
indeed is it uncommon for Pleurisies to prove
mortal within three Days.
Sometimes the Stitch disappears, whence the
Patient complains less; but at the same Time
his Countenance changes; he grows pale and
sad; his Eyes look dull and heavy, and his Pulse
grows feeble. This signifies a Translation of the
Disease to the Brain, a Case which is almost constantly
fatal.
There is no Disease in which the critical
Symptoms are more violent, and more strongly
marked, than in this. It is proper this should
be known, as it may prevent or lessen our excessive
Terror. A perfect Cure supervenes sometimes,
at the very Moment when Death was
expected.
§ 94. This Malady is one of the most common
and the most destroying kind, as well from
its own violent Nature, as through the pernicious
Treatment of it in Country Places. That
Prejudice, which insists on curing all Diseases
by Sweating, entirely regulates their Conduct in
treating a Pleurisy; and as soon as a Person is
afflicted with a Stitch, all the hot Medicines are
immediately set to Work. This mortal Error
destroys more People than Gunpowder; and it
is by so much the more hurtful, as the Distemper
is of the most violent kind; and because,
as there is commonly not a Moment to be lost,
the whole depends on the Method immediately
recurred to.
§ 95. The proper Manner of treating this
Disease, is exactly the same in all Respects, with
that of the Peripneumony; because, I again affirm,
it is the very same Disease. Hence the
Bleedings, the softening and diluting Drinks, the
Steams, the Glysters, the Potion , and the
emollient Poultices are the real Remedies. These
last perhaps are still more effectual in the Pleurisy;
and therefore they should be continually
applied over the very Stitch.
The first Bleeding, especially if there has been
a considerable Discharge, almost constantly abates
the Stitch, and often entirely removes it: though
it more commonly returns, after an Intermission of
some Hours, either in the same Spot, or sometimes
in another. This shifting of it is rather favourable,
especially if the Pain, that was first
felt under the Breast, shifts into the Shoulders,
to the Back, the Shoulder-blade, or the Nape of
the Neck.
When the Stitch is not at all abated, or only
a little; or if, after having abated, it returns as
violently as at first, and especially if it returns in
the same Spot, and the Height of the other Symptoms
continue, Bleeding must be repeated. But
if a sensible Abatement of the Stitch continues;
and if, though it returns, it should be in a smaller
Degree, and by Intervals, or in these Places I
have mentioned above; if the Quickness, or the
Hardness of the Pulse, and all the other Symptoms
are sensibly diminished, this repeated Bleeding
may sometimes be omitted. Nevertheless, in
a very strong Subject, it seems rather prudent not
to omit it, since in such Circumstances it can do
no Mischief; and a considerable Hazard may
sometimes be incurred by the Omission. In very
high and dangerous Pleurisies a frequent Repetition
of bleeding is necessary; except some Impediment
to it should arise from the particular
Constitution of the Patient, or from his Age, or
some other Circumstances.
If, from the Beginning of the Disease, the
Pulse is but a little quicker and harder than in a
healthy State; if it is not manifestly strong; if
the Head-ach and the Stitch are so moderate as
to prove supportable; if the Cough is not too
violent; if there is no sensible Oppression or
Straitness, and the Patient expectorate, or cough
up, Bleeding may be omitted.
With Respect to the administering of other
Remedies, the same Directions are to be exactly
followed, which have been already given in the
preceding Chapter, to which the Reader is referred
from to .
§ 96. When the Disease is not very acute and
pressing, I have often cured it in a very few Days
by a single Bleeding, and a large Quantity of a
Tea or Infusion of Elder-flowers, sweetened with
Honey. It is in some Cases of this kind, that
we often find the Water Faltranc succeed, with
the Addition of some Honey, and even of Oil:
though the Drink I have just directed is considerably
preferable. That Drink which is compounded
of equal Quantities of Wine and Water,
with the Addition of much Venice Treacle, annually
destroys a great Number of People in the
Country.
§ 97. In those dry Pleurisies, in which the
Stitch, the Fever, and the Head-ach are strong
and violent; and where the Pulse is very hard
and very full, with an excessive Dryness of the
Skin and of the Tongue, Bleeding should be frequently
repeated, and at small Intervals from
each other. This Method frequently cures the
Disease effectually, without using any other Evacuation.
§ 98. The Pleurisy terminates, like any other
inward Inflammation, either by some Evacuation;
by an Abscess; in a Mortification; or in a Scirrhosity
or hard Tumour; and it often leaves Adhesions in
the Breast.
The Gangrene or Mortification sometimes appears
on the third Day, without having been preceded
by very vehement Pains. In such Cases
the dead Body often looks very black, especially
in the Parts near the Seat of the Disease: and in
such the more superstitious ascribe it to some supernatural
Cause; or draw some unhappy Presage
from it, with Respect to those who are yet
unattacked by it. This Appearance however is
purely a natural Consequence, quite simple, and
cannot be otherwise; and the hot Regimen and
Medicines are the most prevailing Causes of it.
I have seen it thus circumstanced in a Man in the
Flower of his Age, who had taken Venice Treacle
in Cherry Water, and the Ingredients of
Faltranc infused in Wine.
§ 99. Vomicas are sometimes the Consequences
of Pleurisies; but their particular Situation
disposes them more to break outwardly; which
is the most frequent Cause of an Empyema .
“To prevent this, it is highly proper to apply,
at the first Invasion of the Disease, to the Spot
where the Pain chiefly rages, a small Plaister,
which may exactly fit it; since if the Pleurisy
should terminate in an Abscess or Imposthume,
the purulent Matter will be determined to that
Side.
“As soon then as it is foreseen that an Abscess
is forming (see ) we should erode, by a
light Caustic, the Place where it is expected;
and as soon as it is removed, Care should be
taken to promote Suppuration there. By this
Means we may entertain a reasonable Hope,
that the Mass of Matter will incline its Course
to that Spot, where it will meet with the least
Resistance, and be discharged from thence.
For this Heap of Matter is often accumulated
between the Pleura, and the Parts which adhere
to it.”
This is the Advice of a very great Physician;
but I must inform the Reader, there are many
Cases, in which it can be of no Service; neither
ought it to be attempted, but by Persons of undoubted
Abilities.
With Regard to the Scirrhosity, or Hardness,
and to the Circumstances of Adhesions, I can add
nothing to what I have said in and .
§ 100. It has been observed that some Persons,
who have been once attacked by this Disease,
are often liable to Relapses of it, especially
such as drink hard. I knew one Man, who
reckoned up his Pleurisies by Dozens. A few
Bleedings, at certain proper Intervals, might prevent
these frequent Returns of it; which, joined
to their excessive Drinking, make them languid
and stupid, in the very Flower of their Age.
They generally fall into some Species of an Asthma,
and from that into a Dropsy, which proves
the melancholy, though not an improper, Conclusion
of their Lives. Such as can confine themselves
to some proper Precautions, may also prevent
these frequent Returns of this Disease, even
without bleeding; by a temperate Regimen; by
abstaining from Time to Time, from eating Flesh
and drinking Wine; at which Times they should
drink Whey, or some of those Diet-Drinks ,
, ; and by bathing their Legs sometimes in
warm Water; especially in those Seasons, when
this Disease is the most likely to return.
§ 101. Two Medicines greatly esteemed in
this Disease among the Peasantry, and even extolled
by some Physicians, are the Blood of a
wild He Goat, and the Soot in an Egg. I do
not contest the Cure or Recovery of many Persons,
who have taken these Remedies; notwithstanding
it is not less true, that both of them, as
well as the Egg in which the Soot is taken, are
dangerous: For which Reason it is prudent, at
least, never to make use of them; as there is
great Probability, they may do a little Mischief;
and a Certainty that they can do no Good. The
Genipi, or Wormwood of the Alps, has also
acquired great Reputation in this Disease, and occasioned
many Disputes between some very zealous
Ecclesiastics, and a justly celebrated Physician.
It seems not difficult however to ascertain
the proper Use of it. This Plant is a powerful
Bitter; it heats and excites Sweat: it seems
clear, that, from such Consequences, it should
never be employed in a Pleurisy, while the Vessels
are full, the Pulse hard, the Fever high, and
the Blood inflamed. In all such Circumstances
it must aggravate the Disease; but towards the
Conclusion of it, when the Vessels are considerably
emptied, the Blood is diluted, and the Fever
abated, it may then be recurred to; but with a
constant Recollection that it is hot, and not to be
employed without Reflection and Prudence.
Chapter VI.
Of the Diseases of the Throat.
Sect. 102.
he Throat is subject to many Diseases:
One of the most frequent and the most
dangerous, is that Inflammation of it,
commonly termed a Quinsey. This
in Effect is a Distemper of the same Nature with
an Inflammation of the Breast; but as it occurs
in a different Part, the Symptoms, of Course,
are very different. They also vary, not a very
little, according to the different Parts of the
Throat which are inflamed.
§ 103. The general Symptoms of an Inflammation
of the Throat are, the Shivering, the
subsequent Heat, the Fever, the Head-ach, red
high-coloured Urine, a considerable Difficulty,
and sometimes even an Impossibility, of swallowing
any thing whatever. But if the nearer Parts
to the Glottis, that is, of the Entrance into the
Windpipe, or Conduit through which we breathe,
are attacked, Breathing becomes excessively difficult;
the Patient is sensible of extreme Anguish,
and great Approaches to Suffocation; the Disease
is then extended to the Glottis, to the Body of
the Wind-pipe, and even to the Substance of the
Lungs, whence it becomes speedily fatal.
The Inflammation of the other Parts is attended
with less Danger; and this Danger becomes
still less, as the Disease is more extended
to the outward and superficial Parts. When the
Inflammation is general, and seizes all the internal
Parts of the Throat, and particularly the
Tonsils or Almonds, as they are called, the
Uvula, or Process of the Palate, and the Basis,
or remotest deepest Part of the Tongue, it is one
of the most dangerous and dreadful Maladies.
The Face is then swelled up and inflamed; the
whole Inside of the Throat is in the same Condition;
the Patient can get nothing down; he
breathes with a Pain and Anguish, which concur,
with a Stuffing or Obstruction in his Brains,
to throw him into a kind of furious Delirium,
or Raving. His Tongue is bloated up, and is
extended out of his Mouth; his Nostrils are dilated,
as tho' it were to assist him in his Breathing;
the whole Neck, even to the Beginning of the
Breast, is excessively tumified or swelled up;
the Pulse is very quick, very weak, and often intermits;
the miserable Patient is deprived of all
his Strength, and commonly dies the second or
third Day. Very fortunately this Kind, or Degree
of it, which I have often seen in Languedoc,
happens very rarely in Swisserland, where the
Disease is less violent; and where I have only
seen People die of it, in Consequence of its
being perniciously treated; or by Reason of some
accidental Circumstances, which were foreign to
the Disease itself. Of the Multitude of Patients
I have attended in this Disorder, I have known
but one to fail under it, whose Case I shall mention
towards the Close of this Chapter.
§ 104. Sometimes the Disease shifts from the
internal to the external Parts: the Skin of the
Neck and Breast grows very red, and becomes painful,
but the Patient finds himself better.
At other Times the Disorder quits the Throat;
but is transferred to the Brain, or upon the Lungs.
Both these Translations of it are mortal, when
the best Advice and Assistance cannot be immediately
procured; and it must be acknowledged,
that even the best are often ineffectual.
§ 105. The most usual kind of this Disease is
that which affects only the Tonsils (the Almonds)
and the Palate; or rather its Process, commonly
called the Palate. It generally first invades one
of the Tonsils, which becomes enlarged, red and
painful, and does not allow the afflicted to swallow,
but with great Pain. Sometimes the Disorder
is confined to one Side; but most commonly
it is extended to the Uvula, (the Palate)
from whence it is extended to the other Tonsil.
If it be of a mild kind, the Tonsil first affected
is generally better, when the second is attacked.
Whenever they are both affected at once, the
Pain and the Anguish of the Patient are very considerable;
he cannot swallow, but with great
Difficulty and Complaint; and the Torment of
this is so vehement, that I have seen Women affected
with Convulsions, as often as they endeavoured
to swallow their Spittle, or any other Liquid.
They continue, even for several Hours
sometimes, unable to take any thing whatever;
all the upper inward Part of the Mouth, the
Bottom of the Palate, and the descending Part
of the Tongue become lightly red, or inflamed.
A considerable Proportion of Persons under
this Disease swallow Liquids more difficultly than
Solids; by Reason that Liquids require a greater
Action of some Part of the Muscles, in order to
their being properly directed into their Conduit
or Chanel. The Deglutition (the Swallowing)
of the Spittle is attended with still more Uneasiness
than that of other Liquids, because it is a
little more thick and viscid, and flows down with
less Ease. This Difficulty of swallowing, joined
to the Quantity thence accumulated, produces
that almost continual hawking up, which oppresses
some Patients so much the more, as the
Inside of their Cheeks, their whole Tongue, and
their Lips are often galled, and even flead as it
were. This also prevents their Sleeping, which
however seems no considerable Evil; Sleep being
sometimes but of little Service in Diseases attended
with a Fever; and I have often seen those,
who thought their Throats almost entirely well
in the Evening, and yet found them very bad after
some Hours Sleep.
The Fever, in this Species of the Disease, is
sometimes, very high; and the Shivering often
endures for many Hours. It is succeeded by considerable
Heat, and a violent Head-ach, which
yet is sometimes attended with a Drowsiness.
The Fever is commonly pretty high in the Evening,
though sometimes but inconsiderable, and
by the Morning perhaps there is none at all.
A light Invasion of this Disease of the Throat
often precedes the Shivering; though most commonly
it does not become manifest 'till after it,
and at the same Time when the Heat comes
on.
The Neck is sometimes a little inflated, or
puffed up; and many of the Sick complain of
a pretty smart Pain in the Ear of that Side, which
is most affected. I have but very seldom observed
that they had it in both.
§ 106. The Inflammation either disappears by
Degrees, or an Abscess is formed in the Part
which was chiefly affected. It has never happened,
at least within my Knowledge, that this
Sort of the Disease, prudently treated, has ever
terminated either in a Mortification, or a Scirrhus:
but I have been a Witness to either of these
supervening, when Sweating was extorted in the
Beginning of it, by hot Medicines.
It is also very rare to meet with those highly
dangerous Translations of this Disease upon the
Lungs, such as are described in that Species of
it from , . It is true indeed it does
not occur more frequently, even in that Species,
whenever the Disease is thrown out upon the
more external Parts.
§ 107. The Treatment of the Quinsey, as
well as of all other inflammatory Diseases, is the
same with that of an Inflammation of the Breast.
The Sick is immediately to be put upon a Regimen;
and in that Sort described , Bleeding
must be repeated four or five Times within
a few Hours; and sometimes there is a Necessity
to recur still oftner to it. When it assaults the
Patient in the most vehement Degree, all Medicines,
all Means, are very generally ineffectual;
they should be tried however. We should give
as much as can be taken of the Drinks and
. But as the Quantity they are able to swallow
is often very inconsiderable; the Glyster
should be repeated every three Hours; and their
Legs should be put into a Bath of warm Water,
thrice a Day.
§ 108. Cupping Glasses, with Scarification,
applied about the Neck, after bleeding twice or
thrice, have often been experienced to be highly
useful. In the most desperate Cases, when the
Neck is excessively swelled, one or two deep Incisions
made with a Razor, on this external Tumour,
have sometimes saved a Patient's Life.
§ 109. In that kind, and those Circumstances,
of this Disease described we must have
very frequent Recourse to Bleeding; and it should
never be omitted, when the Pulse is very perceivably
hard and full. It is of the utmost Consequence
to do it instantaneously; since it is the
only Means to prevent the Abscess, which forms
very readily, if Bleeding has been neglected, only
for a few Hours. Sometimes it is necessary to
repeat it a second Time, but very rarely a third.
This Disease is frequently so gentle and mild,
as to be cured without Bleeding, by the Means
of much good Management. But as many as
are not Masters of their own Time, nor in such
an easy Situation, as to be properly attended,
ought, without the least Hesitation, to be bled
directly, which is sometimes sufficient to remove
the Complaint; especially if, after Bleeding, the
Patient drinks plentifully of the Ptisan .
In this light Degree of the Disease, it may suffice
to bathe the Legs, and to receive a Glyster,
once a Day each; the first to be used in the
Morning, and the last in the Evening. Besides
the general Remedies against Inflammations, a
few particular ones, calculated precisely for this
Disease, may be applied in each kind or Degree
of it. The best are, first the emollient Poultices,
, laid over the whole Neck. Some have
highly extolled the Application of Swallows
Nests in this Disease; and though I make no
Objection to it, I think it certainly less efficacious
than any of those which I direct.
2. Of the Gargarisms () a great Variety
may be prepared, of pretty much the same
Properties, and of equal Efficacy. Those I
direct here are what have succeeded best with me
and they are very simple.
3. The Steam of hot Water, as directed ,
should be repeated five or six Times a Day; a
Poultice should be constantly kept on, and often
renewed; and the Patient should often gargle.
There are some Persons, besides Children,
who cannot gargle themselves: and in fact the
Pain occasioned by it makes it the more difficult.
In such a Case, instead of gargling, the same
Gargarism () may be injected with a small
Syringe. The Injection reaches further than Gargling,
and often causes the Patient to hawk up a
considerable Quantity of glarey Matter (which
has grown still thicker towards the Bottom of the
Throat) to his sensible Relief. This Injection
should be often repeated. The little hollowed
Pipes of Elder Wood, which all the Children in
the Country can make, may be conveniently
employed for this Purpose. The Patient should
breathe out, rather than inspire, during the Injection.
§ 110. Whenever the Disease terminates without
Suppuration, the Fever, the Head-ach, the
Heat in the Throat, and the Pain in swallowing,
begin to abate from the fourth Day, some
times from the third, often only from the fifth;
and from such Period that Abatement increases at
a great Rate; so that at the End of two, three,
or four Days, on the sixth, seventh, or eighth,
the Patient is entirely well. Some few however
continue to feel a light Degree of Pain, and that
only on one Side, four or five Days longer, but
without a Fever, or any considerable Uneasiness.
§ 111. Sometimes the Fever and the other
Symptoms abate, after the Bleeding and other
Remedies; without any subsequent Amendment
in the Throat, or any Signs of Suppuration. In
such Cases we must chiefly persist in the Gargarisms
and the Steams; and where an experienced
and dexterous Surgeon can be procured, it
were proper he should scarify the inflamed
Tonsils. These discharge, in such Cases, a moderate
Quantity of Blood; and this Evacuation
relieves, very readily, as many as make use of
it.
§ 112. If the Inflammation is no ways disposed
to disperse, so that an Abscess is forming,
which almost ever happens, if it has not been
obviated at the Invasion of the Disease; then the
Symptoms attending the Fever continue, though
raging a little less after the fourth Day: the Throat
continues red, but of a less florid and lively Redness:
a Pain also continues, though less acute, accompanied
sometimes with Pulsations, and at other
Times intirely without any; of which it is proper
to take Notice: the Pulse commonly grows
a little softer; and on the fifth or sixth Day, and
sometimes sooner, the Abscess is ready to break.
This may be discovered by the Appearance of a
small white and soft Tumour, when the Mouth
is open, which commonly appears about the
Centre or Middle of the Inflammation. It bursts
of itself; or, should it not, it must be opened.
This is effected by strongly securing a Lancet to
one End of a small Stick or Handle, and enveloping,
or wrapping up the whole Blade of it,
except the Point and the Length of one fourth or
a third of an Inch, in some Folds of soft Linnen;
after which the Abscess is pierced with the Point
of this Lancet. The Instant it is opened, the
Mouth is filled with the Discharge of a Quantity
of Pus, of the most intolerable Savour and Smell.
The Patient should gargle himself after the Discharge
of it with the detersive, or cleansing Gargarism
. It is surprising sometimes to see
the Quantity of Matter discharged from this Imposthumation.
In general there is but one; though
sometimes I have seen two of them.
§ 113. It happens, and not seldom, that the
Matter is not collected exactly in the Place, where
the Inflammation appeared, but in some less exposed
and less visible Place: whence a Facility of
swallowing is almost entirely restored; the Fever
abates; the Patient sleeps; he imagines he is
cured, and that no Inconvenience remains, but
such as ordinarily occurs in the earliest Stage of
Recovery. A Person who is neither a Physician,
nor a Surgeon, may easily deceive himself, when
in this State. But the following Signs may enable
him to discover that there is an Abscess, viz.
A certain Inquietude and general Uneasiness; a
Pain throughout the Mouth; some Shiverings
from Time to Time; frequently sharp, but short
and transient, Heat: a Pulse moderately soft,
but not in a natural State; a Sensation of Thickness
and Heaviness in the Tongue; small white
Eruptions on the Gums, on the Inside of the
Cheek, on the Inside and Outside of the Lips,
and a disagreeable Taste and Odour.
§ 114. In such Cases Milk or warm Water
should frequently be retained in the Mouth; the
Vapour of hot Water should be conveyed into
it; and emollient Cataplasms may be applied
about the Neck. All these Means concur to the
softening and breaking of the Abscess. The
Finger may also be introduced to feel for its Situation;
and when discovered, the Surgeon may
easily open it. I happened once to break one
under my Finger, without having made the least
Effort to do it. Warm Water may be injected
pretty forcibly, either by the Mouth or the Nostrils:
this sometimes occasions a kind of Cough,
or certain Efforts which tend to break it. I have
seen this happen even from laughing. As to the
rest, the Patient should not be too anxious or uneasy
about the Event. I never saw a single Instance
of a Person's dying of a Quinsey of this
kind, after the Suppuration is truly effected; neither
has it happened perhaps after the Time it is
forming for Suppuration.
§ 115. The glairy Matter with which the
Throat is over-charged, and the very Inflammation
of that Part, which, from its Irritation,
produces the same Effect, as the Introduction of a
Finger into it, occasions some Patients to complain
of incessant Propensities to vomit. We
must be upon our Guard here, and not suppose
that this Heart-Sickness, as some have called it,
results from a Disorder of, or a Load within, the
Stomach, and that it requires a Vomit for its Removal.
The giving one here would often prove
a very unfortunate Mistake. It might, in a high
Inflammation, further aggravate it; or we might
be obliged (even during the Operation of the
Vomit) to bleed, in order to lessen the Violence of
the Inflammation. Such Imprudence with its
bad Consequences, often leaves the Patient, even
after the Disease is cured, in a State of Languor
and Weakness for a considerable Time. Nevertheless,
there are some particular Disorders of
the Throat, attended with a Fever, in which
a Vomit may be prudently given. But this can
only be, when there is no Inflammation, or after
it is dispersed; and there still remains some
putrid Matter in the first Passages. Of such Cases
I shall speak hereafter.
§ 116. We often see in Swisserland a Disorder
different from these of the Throat, of which we
have just treated; though, like these, attended
with a Difficulty of swallowing. It is termed in
French the Oreillons, and often the Ourles, or
swelled Ears. It is an Overfulness and Obstruction
of those Glands and their Tubes, which are
to furnish the Saliva or Spittle; and particularly
of the two large Glands which lie between the
Ear and the Jaw; which are called the Parotides;
and of two under the Jaw, called the Maxillares.
All these being considerably swelled in this Disease,
do not only produce a great Difficulty of
swallowing; but also prevent the Mouth from
opening; as an Attempt to do it is attended with
violent Pain. Young Children are much more
liable to this Disease than grown Persons. Being
seldom attended with a Fever, there is no Occasion
for Medicines: It is sufficient to defend the
Parts affected from the external Air; to apply some
proper Poultice over them; to lessen the Quantity
of their Food considerably, denying them Flesh
and Wine; but indulging them plentifully in
some light warm Liquid, to dilute their Humours
and restore Perspiration. I cured myself
of this Disorder in 1754, by drinking nothing,
for four Days, but Balm Tea, to which I added
one fourth part Milk, and a little Bread. The
same Regimen has often cured me of other light
Complaints of the Throat.
§ 117. In the Spring of 1761, there were an
astonishing Number of Persons attacked with
Disorders of the Throat, of two different Kinds.
Some of them were seized with that common
Sort which I have already described. Without
adding any thing more particularly, in Respect
to this Species, it happened frequently to grown
Persons, who were perfectly cured by the Method
already recited. The other Species, on which I
shall be more particular in this Place (because I
know they have abounded in some Villages, and
were very fatal) invaded Adults, or grown Persons
also, but especially Children, from the Age
of one Year, and even under that, to the Age of
twelve or thirteen.
The first Symptoms were the same with those
of the common Quinsey, such as the Shivering,
the ensuing Heat or Fever, Dejection, and a
Complaint of the Throat: but the following
Symptoms distinguished these from the common
inflammatory Quinseys.
1. The Sick had often something of a Cough,
and a little Oppression.
2. The Pulse was quicker, but less hard, and
less strong, than generally happens in Diseases of
the Throat.
3. The Patients were afflicted with a sharp,
stinging and dry Heat, and with great Restlessness.
4. They spat less than is usual in a common
Quinsey; and their Tongues were extremely
dry.
5. Though they had some Pain in swallowing,
this was not their principal Complaint, and
they could drink sufficiently.
6. The Swelling and Redness of the Tonsils,
of the Palate, and of its Process were not considerable;
but the parotid and maxillary Glands,
and especially the former, being extremely swelled
and inflamed, the Pain they chiefly complained
of, was this outward one.
7. When the Disease proved considerably dangerous,
the whole Neck swelled; and sometimes
even the Veins, which return the Blood from the
Brain, being overladen, as it were, the Sick had
some Degree of Drowsiness, and of a Delirium,
or Raving.
8. The Paroxysms, or Returns, of the Fever
were considerably irregular.
9. The Urine appeared to be less inflamed,
than in other Diseases of the Throat.
10. Bleeding and other Medicines did not relieve
them, as soon as in the other kind; and the
Disease itself continued a longer Time.
11. It did not terminate in a Suppuration like
other Quinsies, but sometimes the Tonsils were
ulcerated.
12. Almost every Child, and indeed a great
many of the grown Persons assaulted with this
Disease, threw out, either on the first Day, or on
some succeeding one, within the first six Days, a
certain Efflorescence, or Eruptions, resembling
the Measles considerably in some, but of a less
lively Colour, and without any Elevation, or
rising above the Skin. It appeared first in the
Face, next in the Arms, and descended to the
Legs, Thighs and Trunk; disappearing gradually
at the End of two or three Days, in the
same Order it had observed in breaking out. A
few others (I have seen but five Instances of it)
suffered the most grievous Symptoms before the
Eruption; and threw out the genuine purpura,
or white miliary Eruption.
13. As soon as these Efflorescences or Eruptions
appeared, the Sick generally found themselves
better. That, last mentioned, continued
four, five, or six Days, and frequently went off
by Sweats. Such as had not these Ebullitions,
which was the Case of many Adults, were not
cured without very plentiful Sweats towards the
Termination of the Disease: those which occurred
at the Invasion of it being certainly unprofitable,
and always hurtful.
14. I have seen some Patients, in whom the
Complaint of the Throat disappeared entirely,
without either Eruptions or Sweats: but such
still remained in very great Inquietude and Anguish,
with a quick and small Pulse. I ordered
them a sudorific Drink, which being succeeded
by the Eruption, or by Sweating, they found
themselves sensibly relieved.
15. But whether the Sick had, or had not,
these external Rednesses or Eruptions, every one
of them parted with their Cuticle or Scarf Skin,
which fell off, in large Scales, from the whole
Surface of the Body: so great was the Acrimony
or Sharpness of that Matter, which was to be
discharged through the Skin.
16. A great Number suffered a singular Alteration
in their Voice, different from that which
occurs in common Quinsies, the Inside of their
Nostrils being extremely dry.
17. The Sick recovered with more Difficulty
after this, than after the common Quinsies: and
if they were negligent or irregular, during their
Recovery; particularly, if they exposed themselves
too soon to the Cold, a Relapse ensued, or
some different Symptoms; such as a Stuffing
with Oppression, a Swelling of the Belly, windy
Swellings in different Parts; Weakness, Loathings,
Ulcerations behind the Ears, and something
of a Cough and Hoarseness.
18. I have been sent for to Children, and also
to some young Folks, who, at the End of several
Weeks, had been taken with a general Inflammation
of the whole Body, attended with great
Oppression, and a considerable Abatement of
their Urine, which was also high-coloured and turbid,
or without Separation. They seemed also
in a very singular State of Indifference, or Disregard,
with Respect to any Object, or Circumstance.
I recovered every one of them entirely
by Blisters, and the Powder . The first
Operation of this Medicine was to vomit them:
to this succeeded a Discharge by Urine, and at
last very plentiful Sweating, which compleated
the Cure. Two Patients only, of a bad Constitution,
who were a little ricketty, and disposed to
glandular Scirrhosity or Knottiness, relapsed and
died, after being recovered of the Disease itself
for some Days.
§ 118. I have bled some adult Persons, and
made Use of the cooling Regimen, as long as
there was an evident Inflammation: it was necessary
after this to unload the first Passages; and
at last to excite moderate Sweats. The same
Powders have often effected both these
Discharges, and with entire Success. In other
Cases I have made Use of Ipecacuanha, as directed
.
In some Subjects there did not appear any inflammatory
Symptom; and the Distemper resulted
solely from a Load of putrid Matter in the
first Passages. Some Patients also discharged
Worms. In such Cases I never bled; but the
Vomit had an excellent Effect, at the very Onset
of the Disease; it produced a perceivable Abatement
of all the Symptoms; Sweating ensued
very kindly and naturally, and the Patient recovered
entirely a few Hours after.
§ 119. There were some Places, in which no
Symptom or Character of Inflammation appeared;
and in which it was necessary to omit Bleeding,
which was attended with bad Consequences.
I never directed Infants to be bled. After
opening the first Passages, Blisters and diluting
Drinks proved their only Remedies. A simple
Infusion of Elder Flowers, and those of the Lime
Tree, has done great Service to those who drank
plentifully of it.
§ 120. I am sensible that in many Villages a
great Number of Persons have died, with a prodigious
Inflation or Swelling of the Neck. Some
have also died in the City, and among others a
young Woman of twenty Years of Age, who had
taken nothing but hot sweating Medicines and
red Wine, and died the fourth Day, with violent
Suffocations, and a large Discharge of Blood from
the Nose. Of the great Number I have seen in
Person, only two died. One was a little Girl of
ten Months old. She had an Efflorescence which
very suddenly disappeared: at this Time I was
called in; but the Humour had retreated to the
Breast, and rendered her Death inevitable. The
other was a strong Youth from sixteen to seventeen
Years old, whose sudden Attack from the
Disease manifested, from the very Beginning, a
violent Degree of it. Nevertheless, the Symptoms
subsiding, and the Fever nearly terminating,
the Sweats which approached would probably
have saved him. But he would not suffer them
to have their Course, continually stripping himself
quite naked. The Inflammation was immediately
repelled upon the Lungs, and destroyed
him within the Space of thirty Hours. I never
saw a Person die with so very dry a Skin. The
Vomit affected him very little upwards, and
brought on a purging. His own bad Conduct
seems to have been the Occasion of his Death;
and may this serve as one Example of it.
§ 121. I chose to expatiate on this Disease, as
it may happen to reach other Places, where it
may be useful to have been apprized of its Marks,
and of its Treatment, which agrees as much
with that of putrid Fevers, of which I shall speak
hereafter, as with that of the inflammatory Diseases
I have already considered: since in some Subjects
the Complaint of the Throat has evidently
been a Symptom of a putrid Fever, rather than
of the chiefly apparent Disease, a Quinsey.
§ 122. Disorders of the Throat are, with
Respect to particular Persons, an habitual Disease
returning every Year, and sometimes oftner than
once a Year. They may be prevented by the
same Means, which I have directed for the
Preservation from habitual Pleurisies ; and
by defending the Head and the Neck from the
Cold; especially after being heated by Hunting,
or any violent Exercise, or even by singing long
and loud, which may be considered as an extraordinary
Exercise of some of the Parts affected in
this Disease.
Chapter VII.
Of Colds.
Sect. 123.
here are many erroneous Prejudices,
with Regard to Colds, all of which
may be attended with pernicious Consequences.
The first is, that a Cold is
never dangerous; an Error which daily destroys
the Lives of many. I have already complained
of it for many Years past; and I have since beheld
a Multitude of such Examples of it, as have
but too sufficiently warranted my Complaints.
No Person however, it is certain, dies merely
of a Cold, as long as it is nothing but a Cold
simply; but when, from Inattention and Neglect,
it is thrown upon, and occasions Distempers of
the Breast, it may, and often does, prove mortal.
Colds destroy more than Plagues, was the Answer
of a very sagacious and experienced Physician to
one of his Friends, who, being asked, how he
was in Health, replied, Very well, I have nothing
but a Cold.
A second erroneous Prejudice is, that Colds
require no Means, no Medicines, and that they
last the longer for being nursed, or tampered
with. The last Article may be true indeed, with
Respect to the Method, in which the Person affected
with them treats them; but the Principle
itself is false. Colds, like other Disorders, have
their proper Remedies; and are removed with
more or less Facility, as they are conducted better
or worse.
§ 124. A third Mistake is, that they are not
only considered as not dangerous, but are even
supposed wholesome too. Doubtless a Man had
better have a Cold than a more grievous Disease;
though it must be still better to have neither of
them. The most that can reasonably be said and
admitted on this Point, is, that when a checked,
or an obstructed Perspiration becomes the Cause
of a Distemper, it is fortunate that it produces
rather a Cold, than any very dreadful Disease,
which it frequently does: though it were to be
wished, that neither the Cause, nor its Effect existed.
A Cold constantly produces some Disorder
or Defect in the Functions of some Part or Parts
of the Body, and thus becomes the Cause of a
Disease. It is indeed a real Disorder itself, and
which, when in a violent Degree, makes a very
perceivable Assault upon our whole Machine.
Colds, with their Defluxions, considerably weaken
the Breast, and sooner or later considerably
impair the Health. Persons subject to frequent
Colds are never robust or strong; they often sink
into languid Disorders; and a frequent Aptitude
to take Cold is a Proof, that their Perspiration may
be easily checked and restrained; whence the
Lungs become oppressed and obstructed, which
must always be attended with considerable Danger.
§ 125. We may be convinced of the Weakness
and Fallacy of these Prejudices, by considering
attentively the Nature of Colds; which are
nothing else than the very Diseases already described
in the three preceding Chapters, though
in their greatest Degree only.
A Cold in Truth is almost constantly an inflammatory
Disease; a light Inflammation of the
Lungs, or of the Throat; of the Membrane or
very thin Skin, which lines the Nostrills, and
the Inside of certain Cavities in the Bones of the
Cheeks and Forehead. These Cavities communicate
with the Nose, in such a Manner, that
when one Part of this Membrane is affected with
an Inflammation, it is easily communicated to
the other Parts.
§ 126. It is scarcely necessary to describe the
Symptoms of a Cold, and it may be sufficient to
remark, 1. That their chief Cause is the same
with that, which most commonly produces the
Diseases already treated of, that is, an obstructed
Perspiration, and a Blood somewhat inflamed.
2. That whenever these Diseases affect great
Numbers, many Colds prevail at the same Time.
3. That the Symptoms which manifest a violent
Cold, greatly resemble those which precede
or usher in these Diseases. People are rarely attacked
by great Colds, without a shivering and
Fever; which last sometimes continues for many
Days. There is a Cough, a dry Cough, for some
Time; after which some Expectoration ensues;
which allays the Cough, and lightens the Oppression;
at which Time the Cold may be said
to be maturated, or ripe. There are pretty often
slight Stitches, but unfixed or flying about, with
a little Complaint of the Throat. When the
Nostrills happen to be the Seat of the Disorder,
which is then very improperly termed a Cold of
the Brain, it is often attended with a vehement
Head-ach; which sometimes depends on an Irritation
of the Membrane, that lines the Cavities
in the Bone of the Forehead, or the maxillary
Sinusses, that is, the Cavities in the Jaws: At
first the Running from the Nose is very clear;
thin and sharp; afterwards, in Proportion to
the Abatement of the Inflammation, it becomes
thicker; and the Consistence and Colour of it
resemble those of what others cough up. The
Smell, the Taste and the Appetite are commonly
impaired by it.
§ 127. Colds seem to be of no certain Duration
or Continuance. Those of the Head or
Brain generally last but a few Days; of the
Breast longer. Some Colds nevertheless terminate
in four or five Days. If they extend beyond
this Term they prove really hurtful. 1. Because
the Violence of the Cough disorders the
whole Machine; and particularly, by forcing up
the Blood to the Head. 2. By depriving the
Person afflicted of his usual Sleep, which is
almost constantly diminished by it. 3. By impairing
the Appetite, and confusing the Digestion,
which is unavoidably lessened by it. 4. By weakening
the very Lungs, by the continual Agitations
from Coughing; whence all the Humours
being gradually determined towards them, as the
weakest Part, a continual Cough subsists. Hence
also they become overcharged with Humours,
which grow viscid there; the Respiration is overloaded
and oppressed; a slow Fever appears;
Nutrition almost ceases; the Patient becomes
very weak; sinks into a Wasting; an obstinate
Wakefulness and Anguish, and often dies in a
short Time. 5. By Reason that the Fever,
which almost constantly accompanies great Cold,
concurs to wear the body down.
§ 128. Wherefore, since a Cold is a Disease
of the same kind with Quinsies, Peripneumonies
and Inflammations of the Breast, it ought to be
treated in the same Manner. If it is a violent
one, Blood should be taken from the Arm, which
may considerably shorten its Duration: and this
becomes most essentially necessary, whenever the
Patient is of a sanguineous ruddy Complexion,
abounds with Blood, and has a strong Cough,
and great Head-ach. The Drinks , , , ,
should be very plentifully used. It is advantagious
to bathe the Feet in warm Water every Night
at going to Bed. In a Word, if the Patient
is put into a Regimen, the Cure is very speedily
effected.
§ 129. The Disorder indeed, however, is often
so very slight, that it may be thought to require
very little, if any, medical Treatment, and
may be easily cured without Physick, by abstaining
from Flesh, Eggs, Broth, and Wine; from all
Food that is sharp, fat and heavy; and by dieting
upon Bread, Pulse, Fruit, and Water; particularly
by eating little or no Supper; and drinking,
if thirsty, a simple Ptisan of Barley, or an
Infusion of Elder Flowers, with the Addition of
a third or fourth Part of Milk. Bathing the
Feet, and the Powder contribute to dispose
the Patient to sleep. Five Tea-Cups of an
Infusion of the Red, or wild Poppy Leaves may
also be ventured on safely.
§ 130. When the Fever, Heat and Inflammation
wholly disappear; when the Patient has kept
to his Regimen for some Days, and his Blood is
well diluted, if the Cough and Want of Sleep
still continues, he may take in the Evening a
Dose of Storax Pill, or of Venice Treacle with
Elder Flower Tea, after bathing his Feet.
These Remedies by stilling the Cough, and restoring
Perspiration, frequently cure the Cold in
the Space of one Night. I confess at the same
Time, I have seen bad Consequences from such
Opiates, when given too early in the Complaint.
It is also necessary, when they are given, that the
Patient should have supt but very moderately,
and that his Supper should be digested.
§ 131. An immense Number of Remedies
are cried up for the Cure of Colds; such as Ptisans
of Apples or Pippins, of Liquorice, of dry
Raisins, of Figs, of Borage, of Ground-Ivy, of
Veronica or Speedwell, of Hysop, of Nettles,
&c. &c. I have no Design to depreciate them;
as all of them may possibly be useful: But unfortunately,
those who have seen any particular
one of them succeed in one Case, readily conclude
it to be the most excellent of them all;
which is a dangerous Error, because no one Case
is a sufficient Foundation to decide upon: which
besides none are qualified to do, who have not
often seen a great Number of such Cases; and
who do not so attentively observe the Effects of
different Medicines, as to determine on those
which most frequently agree with the Disorder;
and which, in my Judgment, are those I have just
enumerated. I have known a Tea or Infusion of
Cherry Stalks, which is not a disagreeable Drink,
to cure a very inveterate Cold.
§ 132. In Colds of the Head or Brain, the
Steam of warm Water alone, or that in which
Elder Flowers, or some other mild aromatic
Herbs, have been boiled, commonly afford a
pretty speedy Relief. These are also serviceable
in Colds fallen on the Breast. See .
It has been a Practice, though of no very long
standing, to give the Fat of a Whale in these
Cases; but this is a very crude indigestible kind
of Fat, and greasy oily Medicines seldom agree
with Colds. Besides, this Whales' Fat is very disagreeable
and rancid, that is rank; so that it were
better to forbear using it: I have sometimes seen
ill Effects from it, and rarely any good ones.
§ 133. Such Persons as abate nothing of the
usual Quantity of their Food, when seized with
a Cold, and who swallow down large Quantities
of hot Water, ruin their Health. Their Digestion
ceases; the Cough begins to affect the
Stomach, without ceasing to afflict the Breast;
and they incur a Chance of sinking into the
Condition described , Nº. 4.
Burnt Brandy and spiced Wine are very
pernicious in the Beginning of Colds, and the Omission
of them must be a very prudent Omission.
If any good Effects have ever been known to attend
the Use of them, it has been towards the
going off of the Cold; when the Disorder maintained
its Ground, solely from the Weakness of
the Patient. Whenever this is the Case, there is
not the least Room for farther Relaxation; but
the Powders , should be taken every Day
in a little Wine; and should the Humours seem
likely to be thrown upon the Lungs, Blisters
ought to be applied to the fleshy Part of the Legs.
§ 134. Drams, or Liqueurs, as they are called
in French, agree so very little in this last State,
that frequently a very small Quantity of them
revives a Cold that was just expiring. There
really are some Persons who never drink them
without taking Cold, which is not to be wondered
at, as they occasion a light Inflammation in the
Breast, which is equivalent to a Cold or Distillation.
Nevertheless, People in this Disorder should not
expose themselves to violent cold Weather, if
there is a Possibility of avoiding it: though they
should equally guard too against excessive Heat.
Those, who inclose themselves in very hot Rooms,
never get quite cured; and how is it possible they
should be cured in such a Situation? Such Rooms,
abstracted from the Danger of coming out of
them, produce Colds in the same Manner that
Drams do, by producing a light inflammation in
the Breast.
§ 135. Persons subject to frequent Colds, which
Habits are sometimes termed fluxionary, or liable
to Distillations, imagine, they ought to keep themselves
very hot. This is an Error which thoroughly
destroys their Health. Such a Disposition
to take Cold arises from two Causes; either because
their Perspiration is easily impaired; or
sometimes from the Weakness of the Stomach or
the Lungs, which require particular Remedies.
When the Complaint arises from the Perspiration's
being easily disturbed and lessened, the hotter
they keep themselves, the more they sweat,
and increase their Complaint the more. This
incessantly warm Air lets down and weakens the
whole Machine, and more particularly the Lungs;
where the Humours finding less Resistance, are
continually derived, and are accumulated there.
The Skin, being constantly bathed in a small Sweat,
becomes relaxed, soft, and incapable of compleating
its Functions: from which Failure the slightest
Cause produces a total Obstruction of Perspiration;
and a Multitude of languid Disorders
ensue.
These Patients thus circumstanced, redouble
their Precautions against the Cold, or even the
Coolness of the Air, while their utmost Cautions
are but so many effectual Means to lower their
Health; and this the more certainly, as their
Dread of the free Air necessarily subjects them to
a sedentary Life, which increases all their Symptoms;
while the hot Drinks they indulge in,
compleat their Severity. There is but one
Method to cure People thus situated; that is, by accustoming
them gradually to the Air; to keep
them out of hot Chambers; to lessen their
Cloathing by Degrees; to make them sleep cool;
and to let them eat or drink nothing but what
is cold, Ice itself being wholesome in their Drink:
to make them use much Exercise; and finally,
if the Disorder be inveterate, to give them for a
considerable Time the Powder , and make
them use the cold Bath. This Method succeeds
equally too with those, in whom the Disease originally
depended on a Weakness of the Stomach,
or of the Lungs: and in fact, at the End
of a certain Period, these three Causes are always
combined. Some Persons who have been subject,
for many Years, to catch Colds throughout
the Winter; and who, during that Season, never
went out, and drank every thing warm, have
been evidently the better, during the Winter of
1761, and 1762, for the Direction I have given
here. They now walk out every Day; drink
their Liquids cold; and by this Means entirely
escape Colds, and enjoy perfect Health.
§ 136. It is more customary indeed in Town,
than in the Country, to have different Troches,
and Compositions in the Mouth. I am not for
excluding this Habit; though I think nothing is
so efficacious as Juice of Liquorice; and provided
a sufficient Dose be taken, it affords certain
Relief. I have taken an Ounce and a half in
one Day, and have felt the good Consequences
of it very remarkably.
Chapter VIII.
Of Diseases of the Teeth.
Sect. 137.
he Diseases of the Teeth, which are
sometimes so tedious and so violent, as
to cause obstinate Wakefulness, a considerable
Degree of Fever, Raving, Inflammations,
Abscesses, Rottenness of the Bones,
Convulsions and Faintings, depend on three principal
Causes. 1. On a Caries or Rottenness of
the Teeth. 2. On an Inflammation of the
Nerves of the Teeth, or of the Membrane which
invests and covers them; and which affects the
Membrane of the Gums. 3. A cold Humour
or Defluxion that is determined to the Teeth,
and to their Nerves and Membrane.
§ 138. In the first of these Cases, the Caries
having eat down to, and exposed the naked
Nerve, the Air, Food and Drink irritate, or, as
it were sting it; and this irritation is attended
with Pain more or less violent. Every thing
that increases the Motion or Action of the affected
Part, as Exercise, Heat or Food, will be attended
with the same Consequence.
When the Tooth is greatly decayed, there is
no other Cure besides that by extracting it, without
which the Pain continues; the Breath becomes
very offensive; the Gum is eat down;
the other Teeth, and sometimes even the Jaw-bone,
are infected with the Rottenness: besides,
that it prevents the Use of the other Teeth, which
are infected with a kind of tartarous Matter, and
decay.
But when the Disorder is less considerable, the
Progress of it may sometimes be restrained, by
burning the Tooth with a hot Iron, or by filling
it with Lead, if it is fitted to receive and to retain
it. Different corroding Liquids are sometimes
used on these Occasions, Aqua fortis itself, and
Spirit of Vitriol: but such Applications are highly
dangerous, and ought to be excluded. When
the Patients, from Dread, reject the Operations
just mentioned, a little Oyl of Cloves may be applied,
by introducing a small Pellet of Cotton, dipt in
it, to the rotten hollow Tooth; which often affords
considerable Ease, and Respite. Some
make use of a Tincture of ***, or Laudanum,
after the same Manner; and indeed these
two Medicines may be used together in equal
Quantities. I have often succeeded with Hoffman's
mineral anodyne Liquor; which seemed
indeed, for a few Moments, to increase the Pain;
but Ease generally ensues after spitting a little
Time. A Gargarism made of the Herb Argentina;
that is Silver-weed or wild Tansey, in
Water, frequently appeases the Pain that results
from a Caries of the Teeth: and in such Cases
many People have found themselves at Ease,
under a constant Use of it. It certainly is an
Application that cannot hurt, and is even beneficial to
the Gums. Others have been relieved by rubbing
their Faces over with Honey.
§ 139. The second Cause is the Inflammation
of the Nerve within the Substance, or of the
Membrane on the Outside, of the Tooth. This
is discovered by the Patient's Temperament, Age
and Manner of living. They who are young,
sanguine, who heat themselves much, whether
by Labour, by their Food, their Drink, by sitting
up late, or by any other Excess: they who have
been accustomed to any Discharges or Eruptions
of Blood, whether natural or artificial, and who
cease to have them as usual, are much exposed to
the Tooth-ach, from this Cause.
This Pain, or rather Torment, if in an acute
Degree, commonly happens very suddenly, and
often after some heating Cause. The Pulse is
strong and full; the Countenance considerably
red; the Mouth extremely hot: there is often a
pretty high Fever, and a violent Head-ach. The
Gums, or some Part of them, become inflamed,
swelled, and sometimes an Abscess appears. At
other times the Humours throw themselves upon
the more external Parts; the Cheek swells, and
the Pain abates. When the Cheek swells, but
without any Diminution of the Pain, it then becomes
an Augmentation, but no essential Change,
of the Disorder.
§ 140. In this Species of the Disease, we must
have Recourse to the general Method of treating
inflammatory Disorders, and direct Bleeding,
which often produces immediate Ease, if performed
early. After Bleeding, the Patient should
gargle with Barley Water, or Milk and Water;
and apply an emollient Cataplasm to the Cheek.
If an Abscess or little Imposthume appears, the
Suppuration or ripening of it is to be promoted,
by holding continually in the Mouth some hot
Milk, or Figs boiled in some Milk: and as soon
as ever it seems ripe, it should be opened, which
may be done easily, and without any Pain. The
Disorder, when depending on this Cause, is sometimes
not so violent, but of a longer Duration,
and returns whenever the Patient heats himself;
when he goes to Bed; when he eats any heating
Food, or Drink, Wine or Coffee. In this Case
he should be bled, without which his other Medicines
will have little Effect; and he should
bathe his Feet in warm Water for some Evenings
successively, taking one Dose of the Powder .
Entire Abstinence from Wine and Meat,
especially at Night, has cured several Persons of
inveterate and obstinate Maladies of the Teeth.
In this Species of Tooth-ach, all hot Remedies
are pernicious; and it often happens that ***,
Venice Treacle, and Storax Pills, are so far from
producing the Relief expected from them, that
they have aggravated the Pain.
§ 141. When the Disease arises from a cold
Distillation, or Humour, tending to these Parts,
it is commonly (though equally painful) attended
with less violent Symptoms. The Pulse is
neither strong, full nor quick; the Mouth is less
heated, and less swelled. In such Cases, the afflicted
should be purged with the Powder ,
which has sometimes perfectly cured very obstinate
Complaints of this Sort. After purging
they should make Use of the Diet Drink of the
Woods . This has cured Tooth-achs,
which have baffled other Attempts for many
Years; but it must be added, this Drink would
be hurtful in the Disease from a different Cause.
Blisters to the Nape of the Neck, or elsewhere,
it matters not greatly where, have often extraordinary
good Effects, by diverting the Humour,
and restoring a compleat Perspiration. In short
in this Species, we may employ, not only with
Safety, but with Success (especially after due
purging) Pills of Storax, *** and Venice
Treacle. Acrid sharp Remedies, such as hard
spun Tobacco, Root of Pellitory of Spain, &c.
by exciting much Spitting, discharge part of the
Humour which causes the Disease, and hence
diminish the Pain. The Smoke of Tobacco also
succeeds now and then in this Disorder, whether
this happens from the Discharge of the Rheum
or Spittle it occasions; or whether it is owing to
any anodyne Efficacy of this Plant, in which it
resembles ***.
§ 142. As this last Cause is often the Consequence
of a Weakness in the Stomach, it daily
happens that we see some People, whose Disorder
from this Cause is augmented, in Proportion
as they indulge in a cooling, refreshing Way of
living. The Increase of the Disorder disposes
them to increase the Dose of what they mistake
for its Remedy, in Proportion to which their
Pain only increases. There is a Necessity that
such Persons should alter this Method; and
make use of such Medicines as are proper to
strengthen the Stomach, and to restore Perspiration.
The Powder . has often produced
the best Consequences, when I have ordered it
in these Cases; and it never fails to dissipate the
Tooth-ach very speedily, which returns periodically
at stated Days and Hours. I have also
cured some Persons who never drank Wine, by
advising them to the Use of it.
§ 143. But besides the Diseases of the Teeth,
that are owing to these three principal Causes,
which are the most common ones; there are
some very tedious and most tormenting Disorders
of them, that are occasioned by a general Acrimony,
or great Sharpness, of the Mass of Blood,
and which are never cured by any other Medicines
but such, as are proper to correct that Acrimony.
When it is of a scorbutic Nature, the
wild Horse-radish (Pepperwort) Water Cresses,
Brooklime, Sorrel, and Wood-sorrell correct and
cure it. If it is of a different Nature, it requires
different Remedies. But very particular Details
do not come within the Plan of this Work. As
the Malady is of the chronical or tedious kind,
it allows Time to consider and consult more
particularly about it.
The Gout and the Rheumatism are sometimes
transferred to the Teeth, and give Rise to the
most excruciating Pains; which must be treated
like the Diseases from which they arise.
§ 144. From what has been said on this Disorder,
the Reader will discern, in what that imaginary
Oddness may consist, which has been ascribed
to it, from the same Application's relieving
one Person in it, and not affording the least Relief
to another. Now the plain Reason of this
is, that these Applications are always directed,
without an exact Knowledge of the particular
Cause of the Disease, in different Subjects and
Circumstances; whence the Pain from a rotten
Tooth, is treated like that from an Inflammation;
that from an Inflammation, like the Pain from a
cold Humour or Fluxion; and this last like a
Pain caused by a scorbutic Acrimony: so that
the Disappointment is not in the least surprizing.
Perhaps Physicians themselves do not always attend
distinctly enough to the Nature of each
particular Disorder: and even when they do,
they content themselves with directing some of
the less potent Medicines, which may be inadequate
to accomplish the necessary Effect. If the
Distemper truly be of an inflammatory Disposition,
Bleeding is indispensible to the Cure.
It happens in Fact, with Regard to the Diseases
of the Teeth, as well as to all other Diseases,
that they arise from different Causes; and if these
Causes are not opposed by Medicines suited to
them, the Disease, far from being cured, is aggravated.
I have cured violent Tooth-achs, of the lower
Jaw, by applying a Plaister of Meal, the White of
an Egg, Brandy and Mastich, at the Corner of that
Jaw, over the Spot where the Pulsation of the
Artery may be perceived: and I have also mitigated
the most excruciating Pains of the Head,
by applying the same Plaister upon the temporal
Artery.
Chapter IX.
Of the Apoplexy.
Sect. 145.
very Person has some Idea of the
Disease termed an Apoplexy, which is
a sudden Privation or Loss of all Sense,
and of all voluntary Motion; the Pulse
at the same Time being kept up, but Respiration
or Breathing, being oppressed. I shall treat of
this Disease only in a brief Manner, as it is not
common in our Country Villages; and as I have
expatiated on it in a different Manner in a Letter
to Dr. Haller, published in 1761.
§ 146. This Disease is generally distinguished
into two Kinds, the sanguineous and serous Apoplexy.
Each of them results from an Overfulness
of the Blood Vessels of the Brain, which presses
upon, and prevents or impairs the Functions of
the Nerves. The whole Difference between these
two Species consists in this, that the sanguineous
Apoplexy prevails among strong robust Persons,
who have a rich, heavy, thick and inflammable
Blood, and that in a large Quantity; in which
Circumstance it becomes a genuine inflammatory
Distemper. The serous, or humoral Apoplexy
invades Persons of a less robust Constitution;
whose Blood is more dilute or watery; and rather
viscid, or lightly gelatinous, than heavy or rich;
whole Vessels are in a more relaxed State; and
who abound more in other Humours than in red
Blood.
§ 147. When the first kind of this Disease
exists in its most violent Degree, it is then sometimes
termed, an apoplectic Stroke, or thundering
Apoplexy, which kills in a Moment or instantaneously,
and admits of no Remedies. When
the Assault is less violent, and we find the Patient
with a strong, full and raised Pulse, his Visage
red and bloated, and his Neck swelled up;
with an oppressed and loud hoarse Respiration;
being sensible of nothing, and capable of no
other Motions, except some Efforts to vomit, the
Case is not always equally desperate. We must
therefore immediately,
1. Entirely uncover the Patient's Head, covering
the rest of his Body but very lightly; procure
him instantly very fresh free Air, and leave his
Neck quite unbound and open.
2. His Head should be placed as high as may
be, with his Feet hanging down.
3. He must lose from twelve to fifteen Ounces
of Blood, from a free open Orifice in the Arm:
the Strength or Violence with which the Blood
sallies out, should determine the Surgeon to take
a few Ounces more or less. It should be repeated
to the third or fourth Time, within the Space
of three or four Hours; if the Symptoms seem to
require it, either in the Arm, or in the Foot.
4. A Glyster should be given of a Decoction
of the first emollient opening Herbs that can be
got, with four Spoonfuls of Oil, one Spoonful
of Salt: and this should be repeated every three
Hours.
5. If it is possible, he should be made to swallow
Water plentifully, in each Pot of which
three Drams of Nitre are to be dissolved.
6. As soon as the Height and Violence of the
Pulse abates; when his Breathing becomes less
oppressed and difficult, and his Countenance less
inflamed, he should take the Decoction ;
or, if it cannot be got ready in Time, he should
take three Quarters of an Ounce of Cream of
Tartar, and drink Whey plentifully after it. This
Medicine succeeded extremely well with me in a
Case, where I could not readily procure any
other.
7. He should avoid all strong Liquor, Wine,
distilled Spirit, whether inwardly or by outward
Application, and should even be prevented from smelling them.
8. The Patient should be stirred, moved, or
even touched, as little as it is possible: in a Word
every Thing must be avoided that can give him
the least Agitation. This Advice, I am sensible,
is directly contrary to the common Practice;
notwithstanding which it is founded in Reason,
approved by Experience, and absolutely necessary.
In Fact, the whole Evil results from the Blood
being forced up with too much Force, and in
too great a Quantity, to the Brain; which being
thence in a State of Compression, prevents every
Movement and every Influence of the Nerves.
In Order, therefore, to re-establish these Movements,
the Brain must be unloaded, by diminishing
the Force of the Blood. But strong Liquors,
Wines, Spirits, volatile Salts, all Agitation
and Frictions augment it, and by that very
Means increase the Load, the Embarrassment of
the Brain, and thus heighten the Disease itself.
On the contrary, every Thing that calms the Circulation,
contributes to recall Sensation and voluntary
Motion the sooner.
9. Strong Ligatures should be made about the
Thighs under the Ham: By this Means the
Blood is prevented in its Ascent from the Legs,
and less is carried up to the Head.
If the Patient seems gradually, and in Proportion
as he takes proper Medicines, to advance into a
less violent State, there may be some Hopes. But
if he rather grows worse after his earliest Evacuations,
the Case is desperate.
§ 148. When Nature and Art effect his Recovery,
his Senses return: though there frequently
remains a little Delirium or Wandering for
some Time; and almost always a paralytic Defect,
more or less, of the Tongue, the Arm, the
Leg, and the Muscles of the same Side of the
Face. This Palsy sometimes goes off gradually,
by the Help of cooling Purges from Time to
Time, and a Diet that is but very moderately and
lightly nourishing. All hot Medicines are extremely
hurtful in this Case, and may pave the
Way to a repeated Attack. A Vomit might be
even fatal, and has been more than once so. It
should be absolutely forbidden; nor should we
even promote, by Draughts of warm Water, the
Efforts of the Patient to vomit. They do not
any ways depend on any Humour or Mass in the
Stomach; but on the Oppression and Embarrassment
of the Brain: and the more considerable
such Efforts are, the more such Oppression is increased:
by Reason that as long as they continue,
the Blood cannot return from the Head, by which
Means the Brain remains overcharged.
§ 149. The other Species of Apoplexy is attended
with the like Symptoms, excepting the
Pulse not being so high nor strong; the Countenance
being also less red, sometimes even pale;
the Breathing seems less oppressed; and sometimes
the Sick have a greater Facility to vomit,
and discharge more upwards.
As this Kind of the Disease attacks Persons
who abound less in Blood; who are less strong,
and less heated or inflamed, Bleeding is not often
at all necessary: at least the Repetition of it
is scarcely ever so: and should the Pulse have but
a small Fulness, and not the least unnatural Hardness,
Bleeding might even be pernicious.
1. The Patient however should be placed as
was directed in the former Mode of this Disease;
though it seems not equally necessary here.
2. He should receive a Glyster, but without
Oil, with double the Quantity of Salt, and a Bit
of Soap of the Size of a small Egg; or with four
or five Sprigs of Hedge Hyssop. It may be repeated
twice a Day.
3. He should be purged with the Powder
.
4. His common Drink may be a Strong Infusion
of Leaves of Balm.
5. The Purge should be repeated the third
Day.
6. Blisters should immediately be applied to
the fleshy Part of the Legs, or between the
Shoulder Blades.
7. Should Nature seem disposed to relieve herself
by Sweatings, it should be encouraged; and I
have often known an Infusion of the Carduus benedictus,
or blessed Thistle, produce this Effect very
successfully. If this Method be entered upon,
the Sweat ought to be kept up (without stirring
if possible) for many Days. It has then sometimes
happened, that at the End of nine Days,
the Patient has been totally freed from the Palsy,
which commonly succeeds this Species of the
Apoplexy, just as it does the other.
§ 150. Persons who have been attacked with
either kinds of this Disease are liable to subsequent
ones; each of which is more dangerous
than that preceding: whence an Endeavour
to obviate or prevent such Relapses becomes of
the utmost Importance. This is to be effected in
each Sort by a very exact, and rather severe Diet,
even to diminishing the usual Quantity of the
Patient's Food; the most essential Precaution, to
be observed by any who have been once assaulted
with it, being entirely to leave off Suppers.
Indeed those, who have been once attacked with
the first, the sanguineous Apoplexies, should be still
more exact, more upon their Guard, than the
others. They should deny themselves whatever
is rich and juicy, hot or aromatic, sharp, Wine,
distilled Liquors and Coffee. They should chiefly
confine themselves to Garden-Stuff, Fruits and
Acids; such should eat but little Flesh, and only
those called white; taking every Week two
or three Doses of the Powder , in a
Morning fasting, in a Glass of Water. They
should be purged twice or thrice a Year with
the Draught ; use daily Exercise; avoid
very hot Rooms, and the violent Heat of the
Sun. They should go to Bed betimes, rise early,
never lie in Bed above eight Hours: and if it is
observed that their Blood increases considerably,
and has a Tendency towards the Head, they
should be bled without Hesitation: and for some
Days restrain themselves entirely to a thin and low
Regimen, without taking any solid Food. In these
Circumstances warm Bathings are hurtful. In
the other, the serous, Apoplexy, instead of purging
with , the Patient should take the
Purge .
§ 151. The same Means, that are proper to
prevent a Relapse, might also obviate or keep off
a primary or first Assault, if employed in Time:
for notwithstanding it may happen very suddenly,
yet this Disease foreshews itself many Weeks,
sometimes many Months, nay even Years beforehand,
by Vertigos, Heaviness of the Head; small
Defects of the Tongue or Speech; short and
momentary Palsies, sometimes of one, sometimes
of another, Part: sometimes by Loathings and
Reachings to vomit; without supposing any Obstruction
or Load in the first Passages, or any
other Cause in the Stomach, or the adjoining
Parts. There happens also some particular
Change in the Looks and Visage not easy to be described:
sharp and short Pains about the Region
of the Heart; an Abatement of the Strength,
without any discernible Cause of it. Besides there
are still some other Signs, which signify the
Ascent of the Humours too much to the Head,
and shew, that the Functions of the Brain are
embarrassed.
Some Persons are liable to certain Symptoms
and Appearances, which arise from the same Cause
as an Apoplexy; and which indeed may be considered
as very light benign Apoplexies, of which
they sustain many Attacks, and yet without any
considerable Annoyance of their Health. The
Blood, all at once as it were, flushes up to their
Heads: they appear heedless or blundering; and
have sometimes Disgusts and Nauseas, and yet
without any Abatement of their Understanding,
their Senses, or Motion of any Sort. Tranquillity
of Mind and Body, once Bleeding, and a few
Glysters usually carry it off soon after its Invasion.
The Returns of it may be prevented by the Regimen
directed ; and especially by a frequent
Use of the Powder . At the long
Run however, one of these Attacks commonly
degenerates into a mortal Apoplexy: though this
may be retarded for a very long Time by an exact
Regimen, and by avoiding all strong Commotions
of the Mind, but especially that of Anger
or violent Rage.
Chapter X.
Of the violent Influence, or Strokes, of the Sun.
Sect. 152.
his Appellation is applied to those
Disorders, which arise from too violent
an Influence of the Heat of the Sun,
immediately upon the Head; and
which in one Word may be termed Insolation.
If we consider that Wood, Stone and Metals,
when long exposed to the Sun, become very hot,
and that even in temperate Climates, to such a
Degree, that they can scarcely be touched without
some Sensation of burning, we may easily
conceive the Risk a Person undergoes, in having
his Head exposed to the same Degree of Heat.
The Blood-Vessels grow dry, the Blood itself
becomes condensed or thickened, and a real
Inflammation is formed, which has proved mortal
in a very little Time. It was this Distemper, a
Stroke of the Sun, which killed Manasses the
Husband of Judith. ‘For as he was among the
Labourers who bound up the Sheafs in the
Fields, the Heat struck upon his Head, and
he was taken ill; he went to Bed and he died.’
The Signs which precede and attend this Disease
are, being exposed in a Place where the Sun
shines forth with great Force and Ardour; a violent
Head-ach, attended with a very hot and
extremely dry Skin: the Eyes are also dry and
red, being neither able to remain open, nor yet
to bear the Light; and sometimes there is a kind
of continual and involuntary Motion in the Eyelid;
while some Degree of Relief is perceivable
from the Application of any cooling Liquor. It
often happens that some cannot possibly sleep;
and at other times they have a great Drowsiness,
but attended with outrageous Wakenings: there
is a very strong Fever; a great Faintness, and a
total Disrelish and Loathing. Sometimes the
Patient is very thirsty, and at other times not at
all: and the Skin of his Face often looks as
though it were burnt.
§ 153. People may be affected with the Disease
from this Cause, at two different Seasons of
the Year; that is, either in the Spring, or during
the very raging Heats; but their Events are very
different. Country People and Labourers are
but little liable to the former. They chiefly affect
the Inhabitants of Cities, and delicate Persons,
who have used very little Exercise in the
Winter, and abound with superfluous Humours.
If thus circumstanced they expose themselves to
the Sun, as even in the Spring he attains a
considerable Force; and, by the Course of Life
they have led, their Humours are already much
disposed to mount to the Head; while the Coolness
of the Soil, especially when it has rained,
prevents their Feet from being so easily warmed;
the Power of the Sun acts upon their Head like
a Blister, attracting a great Quantity of Humours
to it. This produces excruciating Pains of the
Head, frequently accompanied with quick and
violent Shootings, and with Pain in the Eyes;
notwithstanding this Degree of the Malady is
seldom dangerous. Country People, and even
such Inhabitants of Cities and Towns, as have not
forbore to exercise themselves in Winter, have
no Sort of Dread of these Strokes of the Sun, in
the Spring of the Year. Its Summer Strokes are
much more vehement and troublesome, and assault
Labourers and Travellers, who are for a
long Time exposed to the Fervour of it. Then
it is that the Disease is aggravated to its highest
Pitch, those who are thus struck often dying
upon the Spot. In the hot Climates this Cause
destroys many in the very Streets, and makes
dreadful Havock among Armies on the March,
and at Sieges. Some tragical Effects of it, on
such Occasions, are seen even in the temperate
Countries. After having marched a whole Day
in the Sun, a Man shall fall into a Lethargy, and
die within some Hours, with the Symptoms of
raving Madness. I have seen a Tyler in a very
hot Day, complaining to his Comrade of a violent
Pain in his Head, which increased every Moment
almost; and at the very Instant when he purposed
to retire out of the Sun, he sunk down dead, and
fell down from the House he was slating. This
same Cause produces very often in the Country
some most dangerous Phrenzies, which are called
there hot or burning Fevers. Every Year furnishes
but too many of them.
§ 154. The Vehemence of the Sun is still
more dangerous to those, who venture to sleep
exposed to it. Two Mowers who fell asleep on a
Haycock, being wakened by some others, immediately
on waking, staggered, and pronouncing
a few incoherent unmeaning Words, died. When
the Violence of Wine and that of the Sun are
combined, they kill very suddenly: nor is there
a single Year in which Peasants are not found
dead on the Highroads; who being drunk endeavoured
to lie down in some Corner, where
they perished by an Apoplexy, from the Heat of
the Sun and of strong Drink. Those of them who
escape so speedy and premature a Death, are subject
for the Remainder of their Lives, to chronical, or
tedious Head-achs; and to suffer some little Disorder
and Confusion in their Ideas. I have seen
some Cases, when after violent Head-achs of
some Days Continuance, the Disease has been
transferred to the Eyelids, which continued a
long Time red and distended, so that they could
not be kept asunder or open. It has also
been known, that some Persons have been struck
by the Sun into a Delirium or Raving, without
a Fever, and without complaining of a Head-ach.
Sometimes a Gutta Serena has been its Consequence;
and it is very common to see People,
whose long Continuance under the strong Light
and Influence of the Sun, has made such an Impression
upon the Eyes, as presents them with different
Bodies flying about in the Air, which distract
and confuse their Sight.
A Man of forty two Years of Age, having
been exposed for several Hours to the violent
Heat of the Sun, with a very small Cap or Bonnet;
and having past the following Night in the
open Air, was attacked the next Day with a most
severe Head-ach, a burning Fever, Reachings to
vomit, great Anguish, and red and sparkling
Eyes. Notwithstanding the best Assistance of
several Physicians, he became phrenitic on the
fifth Day, and died on the ninth. Suppurated
Matter was discharged from his Mouth, one of
his Nostrils, and his right Ear, a few Hours before
his Death; upon Dissection a small Abscess
was found within the Skull; and the whole
Brain, as well as all the Membranes inclosing it,
were entirely corrupted.
§ 155. In very young Children, who are not,
or never should be, exposed for any long Time
to such excessive Heat (and whom a slight Cause
will often affect) this Malady discovers itself by a
heavy deep Drowsiness, which lasts for several
Days; also by incessant Ravings mingled with
Rage and Terror, much the same as when they
are affected with violent Fear: and sometimes
by convulsive Twitchings; by Head-achs which
returned at certain Periods, and continual Vomitings.
I have seen Children, who, after a Stroke
of the Sun, have been harrassed a long Time with
a little Cough.
§ 156. Old Men who often expose themselves
imprudently to the Sun, are little apprized of all
the Danger they incur by it. A certain Person,
who purposely sunned himself for a considerable
Time, in the clear Day of an intermitting tertian
Fever, underwent the Assault of an Apoplexy,
which carried him off the following Day. And
even when the Disease may not be so speedy and
violent, yet this Custom (of sunning in hot Weather)
certainly disposes to an Apoplexy, and to
Disorders of the Head. One of the slightest Effects
of much solar Heat upon the Head is, to
cause a Defluxion from the Brain, a Swelling of
the Glands of the Neck, and a Dryness of the
Eyes, which sometimes continues for a considerable
Term after it.
§ 157. The effect of too much culinary, or
common Fire, is of the same Quality with that of
the Sun. A Man who fell asleep with his Head
directly opposite, and probably, very near to the
Fire, went off in an Apoplexy, during his Nap.
§ 158. The Action of too violent a Sun is
not only pernicious, when it falls upon the Head;
but it is also hurtful to other Parts; and those
who continue long exposed to it, though their
Heads should not be affected, experience violent
Pains, a disagreeable Sensation of Heat, and a
considerable Stiffness in the Parts that have been,
in some Manner, parched by it; as in the Legs,
the Knees, the Thighs, Reins and Arms; and
sometimes they prove feverish.
§ 159. In contemplating the Case of a Patient,
Sun-struck, as we may term it, we must endeavour
to distinguish, whether there may not be also
some other joint Causes concurring to the Effect.
A Traveller, a labouring Man, is often as much
affected by the Fatigue of his Journey, or of his
Labour, as he is by the Influence of solar Heat.
§ 160. It is necessary to set about the Cure of
this Disease, as soon as ever we are satisfied of its
Existence: for such as might have been easily
preserved by an early Application, are considerably
endangered by a Neglect of it. The Method
of treating this is very much the same, with that
of the inflammatory Diseases already mentioned;
that is, by Bleeding, and cooling Medicines of
various Kinds in their Drinks, by Bathings, and
by Glysters. And 1. If the Disease be very high
and urgent, a large Quantity of Blood should be
taken away, and occasionally repeated. Lewis
the XIV. was bled nine Times to prevent the
Fatality of a Stroke of the Sun, which he received
in Hunting in 1658.
2. After Bleeding, the Patient's Legs should
be plunged into warm Water. This is one of the
Applications that affords the most speedy Relief;
and I have seen the Head-ach go off and return
again, in Proportion to the Repetition, and the
Duration, of these Bathings of the Legs. When
the Disorder is highly dangerous, it will be
necessary to treat the Patient with Semicupia, or
warm Baths, in which he may sit up to his Hips;
and in the most dangerous Degrees of it, even to
bathe the whole Body: but the Water in this
Case, as well as in Bathings of the Feet, should
be only sensibly warm: the Use of hot would
be highly pernicious.
3. Glysters made from a Decoction of any of
the emollient Herbs are also very effectual.
4. The Patient should drink plentifully of Almond
Emulsion ; of Limonade, which is a
Mixture of the Juice of Lemons and Water, (and
is the best Drink in this Disease) of Water and
Vinegar, which is a very good Substitute for Limonade;
and of, what is still more efficacious,
very clear Whey, with the Addition of a little
Vinegar. These various Drinks may all be taken
cold; Linen Cloths dipt in cold Water and Vinegar
of Roses may be applied to the Forehead,
the Temples, or all over the Head, which is
equivalent to every other Application used upon
such Occasions. Those which are the most cried
up, are the Juice of Purslain, of Lettuce, of
Houseleek, and of Vervain. The Drink
is also serviceable, taken every Morning fasting.
§ 161. Cold Baths have sometimes recovered
Persons out of such violent Symptoms, from this
Cause, as have been almost quite despaired of.
A Man twenty Years of Age, having been a
very long Time exposed to the scorching Sun,
became violently delirious, without a Fever, and
proved really mad. After repeated Bleedings,
he was thrown into a cold Bath, which was also
frequently repeated; pouring cold Water, at the
same Time, upon his Head. With such Assistance
he recovered, though very gradually.
An Officer who had rode Post for several Days
successively, in very hot Weather, swooned away,
immediately on dismounting; from which he
could not be recovered by the ordinary Assistance
in such Cases. He was saved however, in Consequence
of being plunged into a Bath of freezing
Water. It should be observed however, that
in these Cases the cold Bath should never be recurred
to, without previous Bleeding.
§ 162. It is past Doubt, that if a Person stands
still in the violent Heat of the Sun, he is more
liable to be struck with it, than if he walks about;
and the Use of white Hats, or of some Folds of
clean white Paper under a black one, may sensibly
contribute to prevent any Injury from the
considerable Heat of the Sun; though it is a very
incompetent Defence against a violent Degree
of it.
The natural Constitution, or even that Constitution,
which has been formed from long Custom
and Habit, make a very great Difference between
the Effects of solar Heat on different Persons.
People insensibly accustom themselves to
the Impressions of it, as they do to those of all the
other Bodies and Elements, which are continually
acting upon us; and by Degrees we arrive at a
Power of sustaining his violent Heat with Impunity:
just as others arrive at the Hardiness of
bearing the most rigid Colds, with very little
Complaint or Inconvenience. The human Body
is capable of supporting many more Violences
and Extremes, than it commonly does. Its natural
Force is scarcely ever ascertained among civilized
Nations; because their Education generally
tends to impair and lessen it, and always succeeds
in this Respect. If we were inclined
to consider a purely natural, a simply physical
Man, we must look for him among savage Nations;
where only we can discover what we are
able to be, and to bear. We certainly could not
fail of being Gainers, by adopting their corporal
Education; neither does it seem as yet to have
been infallibly demonstrated, that we should be
great Losers in commuting our moral Education
for theirs.
Chapter XI.
Of the Rheumatism.
Sect. 163.
he Rheumatism may exist either with
or without a Fever. The first of these
may be classed among the Diseases, of
which I have already treated; being an
Inflammation which is manifested by a violent
Fever, preceded by Shivering, a subsequent Heat,
hard Pulse, and a Head-ach. Sometimes indeed
an extraordinary Coldness, with general Uneasiness
and Inquietude, exists several Days before
the Fever is perceived. On the second or third
Day, and sometimes even on the first, the Patient
is seized with a violent Pain in some Part of
his Body, but especially about the Joints, which
entirely prevents their Motion, and which is often
accompanied with Heat, Redness and a Swelling
of the Part. The Knee is often the first
Part attacked, and sometimes both the Knees at
once. When the Pain is fixed, an Abatement
of the Fever frequently happens; though in some
other Persons it continues for several Days, and
increases every Evening. The Pain diminishes
in one Part after a Duration of some Days, and
then invades some other. From the Knee it
descends to the Foot, or mounts to the Hip, to the
Loins, the Shoulder-blades, Elbow, Wrist, the
Nape of the Neck, and frequently is felt in the
intermediate Parts. Sometimes one Part is quite
free from Pain, when another is attacked; at
other Times many Parts are seized nearly at the
same Instant; and I have sometimes seen every
Joint afflicted at once. In this Case the Patient
is in a very terrible Situation, being incapable of
any Motion, and even dreading the Assistance of
his Attendants, as he can scarcely admit of touching,
without a sensible Aggravation of his Pains.
He is unable to bear even the Weight of the
Bed-clothes, which must be, as it were, arched
over his Limbs by a proper Contrivance, to prevent
their Pressure: and the very walking across
the Chamber increases his Torments. The Parts
in which they are the most excruciating, and obstinate,
are the Region of the Loins, the Hips,
and the Nape or hinder Part of the Neck.
§ 164. This Disease is also often extended
over the Scalp and the Surface of the Head; and
there the Pains are excessive. I have seen them
affect the Eyelids and the Teeth with inexpressible
Torment. As long as the Distemper is
situated in the more external Parts, the Patient,
however painful his Situation may prove, is in no
great Danger, if he be properly treated: but if
by some Accident, some Error, or by any latent
Cause, the Disease be repelled upon an internal
Part or Organ, his Case is extremely dangerous.
If the Brain is attacked, a frantic raging Delirium
is the Consequence; if it falls upon the Lungs,
the Patient is suffocated: and if it attacks the
Stomach or the Bowels, it is attended with the
most astonishing Pains, which are caused by the
Inflammation of those Parts, and which Inflammation,
if violent, is speedily fatal. About two
Years since I was called to a robust Man, whose
Guts were already in a gangrenous State, which
was the Consequence of a Rheumatism, that
first attacked one Arm and one Knee; the Cure
of which had been attempted by sweating the
Patient with some hot Remedies. These indeed
brought on a plentiful Sweat; but the inflammatory
Humour seized the Intestines, whose Inflammation
degenerated into a Gangrene, after a
Duration of the most acute Pain for thirty-six
Hours; his Torments terminating in Death two
Hours after I saw him.
§ 165. This Malady however is often in a less
violent Degree; the Fever is but moderate, and
ceases entirely when the Pain begins; which is
also confined to one, or not more than two
Parts.
§ 166. If the Disease continues fixed, for a
considerable Time, in one Joint, the Motion of
it is impaired for Life. I have seen a Person,
who has now a wry Neck, of twenty Years standing,
in Consequence of a Rheumatism in the
Nape of the Neck; and I also saw a poor young
Man from Jurat, who was Bed-ridden, and who
had lost the Motion of one Hip and both Knees.
He could neither stand nor sit, and there were
but a few Postures in which he could even lie in
Bed.
§ 167. An obstructed Perspiration, an inflammatory
Thickness of the Blood, constitute the
most general Cause of the Rheumatism. This
last concurring Cause is that we must immediately
encounter; since, as long as that subsists, Perspiration
cannot be perfectly re-established, which
follows of Course, when the Inflammation is
cured. For which Reason this Distemper must
be conducted like the other inflammatory ones,
of which I have already treated.
§ 168. As soon as it is sufficiently manifest,
the Glyster , should be injected; and twelve
Ounces of Blood be taken from the Arm an Hour
after. The Patient is to enter upon a Regimen,
and drink plentifully of the Ptisan , and of
Almond Milk or Emulsion . As this last
Medicine may be too costly in Country Places
for the poor Peasantry; they may drink, in Lieu
of it, very clear Whey, sweetened with a little
Honey. I have known a very severe Rheumatism
cured, after twice bleeding, without any
other Food or Medicine, for the Space of thirteen
Days. The Whey also may be happily used by
Way of Glyster.
§ 169. If the Distemper is not considerably
asswaged by the first Bleeding, it should be repeated
some Hours after. I have ordered it four
Times within the first two Days; and some
Days after I have even directed a fifth Bleeding.
But in general the Hardness of the Pulse becomes
less after the second: and notwithstanding the
Pains may continue as severe as before, yet the
Patient is sensible of less Inquietude. The Glyster
must be repeated every Day, and even twice
a Day, if each of them is attended only with a
small Discharge; and particularly if there be a
violent Head-ach. In such Cases as are excessively
painful, the Patient can scarcely dispose
himself into a proper Attitude or Posture to receive
Glysters: and in such Circumstances his
Drinks should be made as opening as possible;
and a Dose of the Cream of Tartar should
be given Night and Morning. This very Medicine,
with the Assistance of Whey, cured two
Persons I advised it to, of rheumatic Pains, of
which they had been infested with frequent Returns
for many Years, and which were attended
with a small Fever.
Apples coddled, Prunes stewed, and well ripened
Summer Fruits are the properest Nourishment
in this Disease.
We may save the Sick a good deal of Pain,
by putting one strong Towel always under their
Back, and another under their Thighs, in order
to move them the more easily. When their
Hands are without Pain, a third Towel hung
upon a Cord, which is fastened across the Bed,
must considerably assist them in moving themselves.
§ 170. When the Fever entirely disappears,
and the Hardness of the Pulse is removed, I have
ordered the Purge with a very good Effect;
and if it is attended with five or six Motions,
the Patient is very sensibly relieved. The
Day but one after it may be repeated successfully,
and a third Time, after an Interval of a
greater Number of Days.
§ 171. When the Pains are extremely violent,
they admit of no Application: Vapour-Baths
however may be employed, and provided they
are often used, and for a considerable Time, they
prove very efficacious. The Purpose of these
Baths is only to convey the Steam of boiling Water
to the Parts affected; which may always easily
be effected, by a Variety of simple and easy
Contrivances; the Choice of which must depend
on the different Circumstances and Situation of
the Sick.
Whenever it is possible, some of the emollient
Applications , should be continually employed.
A half Bath, or an entire Bath of warm
Water, in which the Patient should remain an
Hour, after sufficient Bleedings and many Glysters,
affords the greatest Relief. I have seen a
Patient, under the most acute Pains of the Loins,
of the Hips, and of one Knee, put into one. He
continued still under extreme Torment in the
Bath, and on being taken out of it: but an Hour
after he had been put to Bed, he sweated, to an
incredible Quantity, for thirty six Hours, and
was cured. The Bath should never be made use
of, until after repeated Bleedings, or at least other
equivalent Evacuations: for otherwise timed, it
would aggravate the Disease.
§ 172. The Pains are generally most severe in
the Night; whence it has been usual to give
composing soporific Medicines. This however
has been very erroneous, as Opiates really augment
the Cause of the Disease, and destroy the
Efficacy of the proper Remedies: and, even not
seldom, far from asswaging the Pains, they increase
them. Indeed they agree so little in this Disease,
that even the Patient's natural Sleep at the Invasion
of this Complaint, is rather to his Detriment.
They feel, the very Moment they are
dropping asleep, such violent Jirks as awaken
them with great Pain: or if they do sleep a few
Minutes, the Pains are stronger when they awake.
§ 173. The Rheumatism goes off either by
Stool, by turbid thick Urine which drops a great
Proportion of a yellowish Sediment, or by Sweats:
and it generally happens that this last Discharge
prevails towards the Conclusion of the Disease.
It may be kept up by drinking an Infusion of
Elder Flowers. At the Beginning however
Sweating is pernicious.
§ 174. It happens also, though but very seldom,
that Rheumatisms determine by depositing
a sharp Humour upon the Legs; where it forms
Vesications, or a kind of Blisterings; which burst
open and form Ulcers, that ought not to be
healed and dried up too hastily; as this would
occasion a speedy Return of the rheumatic Pains.
They are disposed to heal naturally of themselves,
by the Assistance of a temperate regular Diet,
and a few gentle Purges.
§ 175. Sometimes again, an Abscess is formed
either in the affected Part, or in some neighbouring
one. I have seen a Vineyard Dresser, who
after violent Pains of the Loins, had an Abscess
in the upper Part of the Thigh, which he neglected
for a long Time. When I saw him, it
was of a monstrous Size. I ordered it to be opened,
when at once above three Pots of Matter
rushed out of it: but the Patient, being exhausted,
died some Time after it.
Another Crisis of the Rheumatism has happened
by a kind of Itch, which breaks out upon
all the Parts adjacent to the Seat of this Disease.
Immediately after this Eruption the Pains vanish;
but the Pustules sometimes continue for several
Weeks.
§ 176. I have never observed the Pains to last,
with considerable Violence, above fourteen Days,
in this Species of the Rheumatism; though there
remains a Weakness, Numbness, and some Inflation,
or Puffing, of the adjoining Parts: and
it will also be many Weeks, and sometimes even
Months; especially if the Distemper attacked
them in the Fall, before the Sick recover their
usual Strength. I have known some Persons,
who, after a very painful Rheumatism, have been
troubled with a very disagreeable Sensation of
Lassitude; which did not go off till after a great
Eruption, all over the Body, of little Vesications
or Blisterings, full of a watery Humour; many
of them burst open, and others withered and
dried up without bursting.
§ 177. The Return of Strength into the Parts
affected may be promoted by Frictions Night and
Morning, with Flannel or any other woollen
Stuff; by using Exercise; and by conforming
exactly to the Directions given in the Chapter on
Convalescence, or Recovery from acute Diseases.
The Rheumatism may also be prevented by the
Means I have pointed out, in treating of Pleurisies
and Quinsies.
§ 178. Sometimes the Rheumatism, with a
Fever, invades Persons who are not so sanguine,
or abounding in Blood; or whose Blood is not so
much disposed to Inflammation; those whose
Flesh and Fibres are softer; and in whose Humours
there is more Thinness and Sharpness,
than Viscidity and Thickness. Bleeding proves
less necessary for Persons so constituted, notwithstanding
the Fever should be very strong. Some
Constitutions require more Discharges by Stool;
and after they are properly evacuated, some Blisters
should be applied, which often afford them
a sensible Relief as soon as ever they begin to
operate. Nevertheless they should never be used
where the Pulse is hard. The Powder
answers very well in these Cases.
§ 179. There is another Kind of Rheumatism,
called chronical, or lasting. It is known by the
following Characters or Marks. 1. It is commonly
unattended with a Fever. 2. It continues
a very long Time. 3. It seldom attacks so many
Parts at once as the former. 4. Frequently no
visible Alteration appears in the affected Part,
which is neither more hot, red, or swelled than
in its healthy State; though sometimes one or
other of these Symptoms is evident. 5. The former,
the inflammatory, Rheumatism assaults
strong, vigorous, robust Persons: but this rather
invades People arrived at a certain Period of Life,
or such as are weak and languishing.
§ 180. The Pain of the chronical Rheumatism,
when left to itself, or injudiciously treated,
lasts sometimes many Months, and even Years.
It is particularly and extremely obstinate, when it
is exerted on the Head, the Loins, or on the Hip,
and along the Thighs, when it is called the Sciatica.
There is no Part indeed which this Pain
may not invade; sometimes it fixes itself in a
small Spot, as in one Corner of the Head; the
Angle of the Jaw; the Extremity of a Finger;
in one Knee; on one Rib, or on the Breast,
where it often excites Pains, which make the Patient
apprehensive of a Cancer. It penetrates
also to the internal Parts. When it affects the
Lungs, a most obstinate Cough is the Consequence;
which degenerates at length into very
dangerous Disorders of the Breast. In the Stomach
and Bowels it excites most violent Pains
like a Cholic; and in the Bladder, Symptoms so
greatly resembling those of the Stone, that Persons,
who are neither deficient in Knowlege nor
Experience, have been more than once deceived
by them.
§ 181. The Treatment of this chronical Rheumatism
does not vary considerably from that of
the former. Nevertheless, in the first Place, if
the Pain is very acute, and the Patient robust, a
single Bleeding at the Onset is very proper and
efficacious. 2. The Humours ought to be diluted,
and their Acrimony or Sharpness should be diminished,
by a very plentiful Use of a Ptisan of
Burdock Roots . 3. Four or five Days after
drinking abundantly of this, the purging
Powder may be taken with Success. In
this Species of the Rheumatism, a certain Medicine
is sometimes found serviceable. This has
acquired some Reputation, particularly in the
Country, where they bring it from, Geneva; under
the Title of the *** for the Rheumatism, tho'
I cannot say for what Reason; as it is indeed
neither more nor less than the Electuary Caryocostinum,
which may be procured at our Apothecaries.
I shall observe however, that this Medicine
has done Mischief in the inflammatory
Rheumatism, and even in this, as often as the
Persons afflicted with it are feeble, thin and of
a hot Temperament; and either when they have
not previously taken diluting Drinks, or when it
has been used too long. For, in such a Circumstance,
it is apt to throw the Patient into an
irrecoverable Weakness. The Composition consists
of the hottest Spices, and of very sharp Purgatives.
§ 182. When general Remedies have been
used, and the Disorder still continues, Recourse
should be had to such Medicines, as are available
to restore Perspiration; and these should be persisted
in for a considerable Time. The Pills
, with a strong Infusion of Elder Flowers, have
often succeeded in this Respect: and then after
a long Continuance of diluting Drinks, if the
Fever is entirely subdued; if the Stomach exerts
its Functions well; the Patient is no ways costive;
if he is not of a dry Habit of Body; and
the Part affected remains without Inflammation,
the Patient may safely take the Powder ,
at Night going to Bed, with a Cup or two of an
Infusion of Carduus benedictus, or the blessed
Thistle, and a Morsel of Venice Treacle of the
Size of a Hazel Nut, or a Filberd. This Remedy
brings on a very copious Sweating, which
often expells the Disease. These Sweats may
be rendered full more effectual, by wrapping up
the affected Part in a Flanel dipt in the Decoction
.
§ 183. But of all these Pains, the Sciatica is
one of the most tedious and obstinate. Nevertheless
I have seen the greatest Success, from the
Application of seven or eight Cupping-Glasses
on the tormented Part; by which, without the
Assistance of any other Remedy, I have cured,
in a few Hours, Sciaticas of many Years standing,
which had baffled other Remedies. Blisters,
or any such stimulating Plaisters, as bring
on a Suppuration and Discharge from the afflicted
Part, contribute also frequently to the Cure; tho'
less effectually than Cupping, which should be
repeated several Times. Green Cere-cloth, commonly
called Oil-cloth, (whether the Ingredients
be spread on Taffety or on Linen) being applied to
the diseased Part, disposes it to sweat abundantly,
and thus to discharge the sharp Humour which
occasions the Pain. Sometimes both these
Applications, but especially that spread on Silk
(which may be applied more exactly and closely
to the Part, and which is also spread with a different
Composition) raise a little Vesication on
the Part as Blisters do. A Plaister of Quicklime
and Honey blended together has cured inveterate
Sciaticas. Oil of Eggs has sometimes succeeded
in such Cases. A Seton has also been successfully
made in the lower Part of the Thigh.
Finally some Pains, which have not yielded to any of
these Applications, have been cured by actual burning,
inflicted on the very Spot, where the most
violent Pain has been felt; except some particular
Reason, drawn from an anatomical Knowlege
of the Part, should determine the Surgeon not to
apply it there. The Scull or Head should never
be cauterized with a burning Iron.
§ 184. The hot Baths of Bourbon, Plombiers,
Aix-la-Chapelle and many others are often very
efficacious in these chronical Pains: notwithstanding
I really think, there is no rheumatic
Pain that may not be cured without them. The
common People substitute to these a Bath made
of the Husk of Grapes, after their Juice is expressed,
which cures some by making them sweat
abundantly. Cold Baths however are the best to
keep off this Disease; but then they cannot always
be safely ventured on. Many Circumstances
render the Use of them impracticable to
particular Persons. Such as are subject to this
chronical Rheumatism, would do very well to
rub their whole Bodies every Morning, if they
could, but especially the afflicted Parts, with
Flanel. This Habit keeps up Perspiration beyond
any other Assistance; and indeed sometimes even
increases it too much. It would be serviceable
too, if such Subjects of this cruel Disease wore
Flanel all over their Skin, during the Winter.
After a violent Rheumatism, People should
long be careful to avoid that cold and moist Air,
which disposes them to relapse.
§ 185. Rheumatic People have too frequent a
Recourse to very improper and hurtful Medicines,
in this Distemper, which daily produce very
bad Consequences. Such are spirituous Medicines,
Brandy, and Arquebusade Water. They either
render the Pain more obstinate and fixed, by
hardening the Skin; or they repell the Humour
to some inward Part. And Instances are not wanting
of Persons who have died suddenly, from the
Application of Spirit of Wine upon the Parts, that
were violently afflicted with the Rheumatism. It
also happens sometimes that the Humour, having
no Outlet through the Skin, is thrown internally
on the Bone and affects it. A very singular
Fact occurred in this Respect, an Account of
which may be serviceable to some Persons afflicted
with the Disease. A Woman at Night was
chaffing the Arm of her Husband, who had the
Rheumatism there, with Spirit of Wine; when
a very lucky Accident prevented the Mischief she
might have occasioned by it. The Spirit of Wine
took Fire from the Flame of the Candle she made
use of, and burned the diseased Part. It was
drest of Course, and the Suppuration that attended
it, entirely cured the Rheumatism.
Sharp and greasy Unctions or Ointments produce
very bad Effects, and are equally dangerous.
A Caries, a Rottenness of the Bones, has
ensued upon the Use of a Medicine called, The
Balsam of Sulphur with Turpentine. I was consulted
in 1750, three Days before her Decease,
about a Woman, who had long endured acute
rheumatic Pains. She had taken various Medicines,
and, among the rest, a considerable Quantity
of a Ptisan, in which Antimony was blended
with some purging Medicines, and a greasy spirituous
Balsam had been rubbed into the Part.
The Fever, the Pains, and the Dryness of the
Skin soon increased; the Bones of the Thighs and
Arms became carious: and in moving the Patient
no more than was necessary for her Relief
and Convenience, without taking her out of her
Bed, both Thighs and one Arm broke. So
dreadful an Example should make People cautious
of giving or applying Medicines inconsiderately,
even in such Diseases, as appear but trifling
in themselves. I must also inform the Readers,
there are some rheumatic Pains, which admit
of no Application; and that almost every
Medicine aggravates them. In such Cases the afflicted
must content themselves with keeping the
Parts affected from the Impressions of the Air, by
a Flanel, or the Skin of some Animal with the
Fur on.
It is also more advisable sometimes to leave a
sufferable and inveterate Pain to itself, especially
in old or weakly People, than to employ too
many Medicines, or such violent ones, as should
affect them more importantly than the Pains
did.
§ 186. If the Duration of the Pains fixed in
the same Place, should cause some Degree of
Stiffness in the Joint affected, it should be exposed
twice a Day to the Vapour of warm Water,
and dried well afterwards with hot Linen:
then it should be well chaffed, and lastly touched
over with Ointment of Marsh-mallows. Pumping,
if superadded to this Vapour, considerably
increases its Efficacy. I directed, for a Case of this
Sort, a very simple Machine of white Tin, or
Lattin, which combined the Application of the
Steam and the Pump.
§ 187. Very young Children are sometimes
subject to such violent and extended Pains, that
they cannot bear touching in any Part, without
excessive Crying. We must be careful to avoid
mistaking these Cases, and not to treat them like
Rheumatisms. They sometimes are owing to
Worms, and go off when these have been discharged.
Chapter XII.
Of the Bite of a mad Dog.
Sect. 188.
en may contract the particular and
raging Symptom, which is very generally
peculiar to this Disease from this
Cause, and even without any Bite; but
this happens very rarely indeed. It is properly a
Distemper belonging to the canine Genus, consisting
of the three Species of Dogs, Wolves, and Foxes,
to whom only it seems inherent and natural;
scarcely ever arising in other Animals, without
its being inflicted by them. Whenever there occurs
one of them who breeds it, he bites others,
and thus the Poison, the Cause of this terrible
Disease, is diffused. Other Animals besides the
canine Species, and Men themselves being exposed
to this Accident, do sometimes contract
the Disease in all its Rage and Horror: though it
is not to be supposed, that this is always an unfailing
Consequence.
§ 189. If a Dog who used to be lively and active,
becomes all at once moapish and morose; if he
has an Aversion to eat; a particular and unusual
Look about his Eyes; a Restlessness, which appears
from his continually running to and fro, we
may be apprehensive he is likely to prove mad;
at which very Instant he ought to be tied up securely,
that it may be in our Power to destroy him
as soon as the Distemper is evident. Perhaps
it might be even still safer to kill him at once.
Whenever the Malady is certain, the Symptoms
heighten pretty soon. His Aversion to Food,
but especially to Drink, grows stronger. He no
longer seems to know his Master, the Sound of
his Voice changes; he suffers no Person to handle
or approach him; and bites those who attempt it.
He quits his ordinary Habitation, marching on
with his Head and his Tail hanging downwards;
his Tongue lolling half out, and covered with
Foam or Slaver, which indeed not seldom happens
indifferently to all Dogs. Other Dogs scent
him, not seldom at a considerable Distance,
and fly him with an Air of Horror, which
is a certain Indication of his Disease. Sometimes
he contents himself with biting only those who
happen to be near him: while at other Times
becoming more enraged, he springs to the right
and left on all Men and Animals about him.
He hurries away with manifest Dread from whatever
Waters occur to him: at length he falls
down as spent and exhausted; sometimes he rises
up again, and drags himself on for a little
Time, commonly dying the third, or, at the
latest, on the fourth Day after the manifest Appearance
of the Disease, and sometimes even
sooner.
§ 190. When a Person is bit by such a Dog,
the Wound commonly heals up as readily, as if
it was not in the least poisonous: but after the
Expiration of a longer or shorter Term, from
three Weeks to three Months; but most commonly
in about six Weeks, the Person bitten begins
to perceive, in the Spot that was bit, a certain
dull obtuse Pain. The Scar of it swells, inflames,
bursts open, and weeps out a sharp, fœtid,
and sanious, or somewhat bloody Humour.
At the same Time the Patient becomes sad and
melancholy: he feels a kind of Indifference,
Insensibility, and general Numbness; an almost
incessant Coldness; a Difficulty of breathing; a
continual Anguish, and Pains in his Bowels.
His Pulse is weak and irregular, his sleep restless,
turbid, and confused with Ravings; with starting
up in Surprize, and with terrible Frights.
His Discharges by Stool are often much altered
and irregular, and small cold Sweats appear at
very short Intervals. Sometimes there is also a
slight Pain or Uneasiness in the Throat. Such is
the first Degree of this Disease, and it is called
by some Physicians the dumb Rage, or Madness.
§ 191. Its second Degree, the confirmed or
downright Madness, is attended with the following
Symptoms. The Patient is afflicted with a
violent Thirst, and a Pain in drinking. Soon
after this he avoids all Drink, but particularly
Water, and within some Hours after, he even
abhors it. This Horror becomes so violent, that
the bringing Water near his Lips, or into his
Sight, the very Name of it, or of any other Drink;
the Sight of Objects, which, from their Transparence,
have any Resemblance of Water, as a
Looking Glass, &c. afflicts him with extreme
Anguish, and sometimes even with Convulsions.
They continue however still to swallow (though
not without violent Difficulty) a little Meat or
Bread, and sometimes a little Soup. Some even
get down the liquid Medicines that are prescribed
them, provided there be no Appearance of Water
in them; or that Water is not mentioned to them,
at the same Time. Their Urine becomes thick and
high-coloured, and sometimes there is a Suppression
or Stoppage of it. The Voice either grows hoarse,
or is almost entirely abolished: but the Reports
of the bitten barking like Dogs are ridiculous
and superstitious Fictions, void of any Foundation;
as well as many other Fable, that have been
blended with the History of this Distemper. The
Barking of Dogs however is very disagreeable to
them. They are troubled with short Deliriums
or Ravings, which are sometimes mixed with
Fury. It is at such times that they spit all around
them; that they attempt also to bite, and sometimes
unhappily effect it. Their Looks are fixed,
as it were, and somewhat furious, and their
Visage frequently red. It is pretty common for
these miserable Patients to be sensible of the Approach
of their raging Fit, and to conjure the Bystanders
to be upon their Guard. Many of them
never have an Inclination to bite. The increasing
Anguish and Pain they feel become
inexpressible: they earnestly wish for Death; and
some of them have even destroyed themselves,
when they had the Means of effecting it.
§ 192. It is with the Spittle, and the Spittle
only, that this dreadful Poison unites itself. And
here it may be observed, 1, That if the Wounds
have been made through any of the Patient's
Cloaths, they are less dangerous than those inflicted
immediately on the naked Skin. 2, That
Animals who abound in Wool, or have very
thick Hair, are often preserved from the mortal
Impression of the Poison; because in these various
Circumstances, the Cloaths, the Hair, or the
Wool have wiped, or even dried up, the Slaver
of their Teeth. 3, The Bites inflicted by an infected
Animal, very soon after he has bitten
many others, are less dangerous than the former
Bites, because their Slaver is lessened or exhausted.
4, If the Bite happens in the Face, or in
the Neck, the Danger is greater, and the Operation
of the Venom is quicker too; by Reason the
Spittle of the Person so bit is sooner infected. 5,
The higher the Degree of the Disease is advanced,
the Bites become proportionably more dangerous.
From what I have just mentioned here
it may be discerned, why, of many who have
been bitten by the same Sufferer, some have been
infected with this dreadful Disease, and others
not.
§ 193. A great Number of Remedies have
been highly cried up, as famous in the Cure of
this Disease; and, in Swisserland particularly, the
Root of the Eglantine or wild Rose, gathered at
some particular times, under the favorable Aspects
of the Moon, and dried with some extraordinary
Precautions. There is also the of calcined Egg Shells, that of the
Lichen terrestris, or Ground Liverwort, with one
third Part of Pepper, a Remedy long celebrated
in England; Powder of Oyster-Shells; of Vervain;
bathing in Salt Water; St. Hubert's Key,
&c. &c. But the Death of a Multitude of those
who have been bitten, notwithstanding their taking
the greatest Part of all these boasted Antidotes;
and the Certainty of no one's escaping,
who had been attacked with the high raging
Symptom, the Hydrophobia, have demonstrated
the Inefficacy of them all, to all Europe. It is
incontestable that to the Year 1730, not a single
Patient escaped, in whom the Disease was indisputably
manifest; and that every Medicine then
employed against it was useless. When Medicines
had been given before the great Symptom
appeared, in some of those who took them, it afterwards
appeared, in others not. The same different
Events occurred also to others who were
bitten, and who took not the least Medicine; so
that upon the whole, before that Date, no Medicine
seemed to be of any Consequence. Since
that Time, we have had the Happiness to be informed
of a certain Remedy, which is Mercury,
joined to a few others.
§ 194. In short there is a Necessity for destroying
or expelling the Poison itself, which Mercury
effects, and is consequently the Counter-poison of
it. That poison produces a general Irritation of
the Nerves; this is to be removed or asswaged
by Antispasmodics: so that in Mercury, or
Quicksilver, joined to Antispasmodics, consists
the whole that is indicated in the Cure of this
Disease. There really have been many Instances
of Persons cured by these Medicines, in whom
the Distemper had been manifest in its Rage and
Violence; and as many as have unfortunately received
the Cause of it in a Bite, should be firmly
persuaded, that in taking these Medicines, and
using all other proper Precautions, they shall be
entirely secured from all its ill Consequences.
Those also in whom the Rage and Fury of this
Distemper is manifest, ought to use the same
Medicines, with entire Hope and Confidence,
which may justly be founded on the many Cures
effected by them. It is acknowledged however,
that they have proved ineffectual in a few Cases;
but what Disease is there, which does not sometimes
prove incurable?
§ 195. The very Moment after receiving the
Bite, is it happens to be in the Flesh, and if it
can safely be effected, all the Part affected should
be cut away. The Ancients directed it to be
cauterized, or burnt with a red hot Iron (meer
Scarification being of very little Effect) and this
Method would very probably prove effectual. It
requires more Resolution, however, than every
Patient is endued with. The Wound should be
washed and cleansed a considerable Time with
warm Water, with a little Sea-Salt dissolved in it.
After this into the Lips and Edges of the Wound,
and into the Surface of the Part all about it,
should be rubbed a Quarter of an Ounce of the
Ointment ; and the Wound should be
dressed twice daily, with the soft lenient Ointment
, to promote Suppuration; but that
of is to be used only once a Day.
In point of Regimen, the Quantity of Nourishment
should be less than usual, particularly in the
Article of Flesh: he should abstain from Wine,
spirituous Liquors, all Sorts of Spices and hot inflaming
Food. He should drink only Barley-Water,
or an Infusion of the Flowers of the
Lime-tree. He should be guarded against Costiveness
by a soft relaxing Diet, or by Glysters,
and bathe his Legs once a Day in warm Water.
Every third Day one Dose of the Medicine
should be taken; which is compounded of Mercury,
that counterworks the Poison, and of Musk
which prevents the Spasms, or convulsive Motions.
I confess at the same Time that I have less
Dependance on the Mercury given in this Form,
and think the rubbing in of its Ointment considerably
more efficacious, which I should hope
may always prevent the Fatality of this dreadful,
surprizing Disease.
§ 196. If the raging Symptom, the Dread of
Water, has already appeared, and the Patient is
strong, and abounds with Blood, he should, 1, be
bled to a considerable Quantity, and this may be
repeated twice, thrice, or even a fourth Time, if
Circumstances require it.
2, The Patient should be put, if possible, into
a warm Bath; and this should be used twice
daily.
3, He should every Day receive two, or even
three of the emollient Glysters .
4, The Wound and the Parts adjoining to it
should be rubbed with the Ointment ,
twice a Day.
5, The whole Limb which contains the Wound
should be rubbed with Oil, and be wrapped up
in an oily Flanel.
6, Every three Hours a Dose of the Powder
, should be taken in a Cup of the Infusion
of Lime-tree and Elder Flowers.
7, The Prescription , is to be given
every Night, and to be repeated in the Morning,
if the Patient is not easy, washing it down with
the same Infusion.
8, If there be a great Nauseousness at Stomach,
with a Bitterness in the Mouth, give the Powder
, which brings up a copious Discharge of
glewy and bilious Humours.
9, There is very little Occasion to say any thing
relating to the Patient's Food, in such a Situation.
Should he ask for any, he may be allowed Panada,
light Soup, Bread, Soups made of farinaceous
or mealy Vegetables, or a little Milk.
§ 197. By the Use of these Remedies the
Symptoms will be observed to lessen, and to disappear
by Degrees; and finally Health will be
re-established. But if the Patient should long
continue weak, and subject to Terrors, he may
take a Dose of the Powder , thrice a
Day.
§ 198. It is certain that a Boy, in whom the
raging Symptom of This Disease had just appeared,
was perfectly cured, by bathing all about
the wounded Part with Sallad-Oil, in which
some Camphire and *** were dissolved; with
the Addition of repeated Frictions of the Ointment
, and making him take some Eau de
luce with a little Wine. This Medicine, a Coffee-Cup of
which may be given every four Hours,
allayed the great Inquietude and Agitation of the
Patient; and brought on a very plentiful Sweat,
on which all the Symptoms vanished.
§ 199. Dogs may be cured by rubbing in a
triple Quantity of the same Ointment directed for
Men, and by giving them the Bolus . But
both these Means should be used as soon as ever
they are bit. When the great Symptom is manifest,
there would be too much Danger in attempting
to apply one, or to give the other; and they
should be immediately killed. It might be well
however to try if they would swallow down the
Bolus, on its being thrown to them.
As soon as ever Dogs are bit, they should be
safely tied up, and not let loose again, before
the Expiration of three or four Months.
§ 200. A false and dangerous Prejudice has
prevailed with Regard to the Bites from Dogs,
and it is this—That if a Dog who had bit any
Person, without being mad at the Time of his
biting, should become mad afterwards, the Person
so formerly bitten, would prove mad too at
the same Time. Such a Notion is full as absurd,
as it would be to affirm, that if two Persons had
slept in the same Bed, and that one of them
should take the Itch, the Small-Pocks, or any
other contagious Disease, ten or twelve Years afterwards,
that the other should also be infected
with that he took, and at the same Time too.
Of two Circumstances, whenever a Person is
bit, one must certainly be. Either the Dog which
gives the Bite, is about to be mad himself, in
which Case this would be evident in a few Days;
and then it must be said the Person was bitten by
a mad Dog: Or else, that the Dog was absolutely
sound, having neither conceived, or bred in
himself, nor received from without the Cause,
the Principle, of Madness: in which last Case I
ask any Man in his Senses, if he could communicate
it. No Person, no Thing imparts what
it has not. This false and crude Notion excites
those who are possessed with it to a dangerous
Action: they exercise that Liberty the Laws
unhappily allow them of killing the Dog; by
which Means they are left uncertain of his State,
and of their own Chance. This is a dreadful
Uncertainty, and may be attended with embarrassing
and troublesome Consequences, independant
of the Poison itself. The reasonable
Conduct would be to secure and observe the Dog
very closely, in Order to know certainly whether
he is, or is not, mad.
§ 201. It is no longer necessary to represent
the Horror, the Barbarity and Guilt of that cruel
Practice, which prevailed, not very long since, of
suffocating Persons in the Height of this Disease,
with the Bed-cloaths, or between Matrasses. It
is now prohibited in most Countries; and doubtless
will be punished, or, at least ought to be,
even in those where as yet it is not.
Another Cruelty, of which we hope to see no
repeated Instance, is that of abandoning those
miserable Patients to themselves, without the
least Resource or Assistance: a most detestable
Custom even in those Times, when there was
not the least Hope of saving them; and still more
criminal in our Days, when they may be recovered
effectually. I do again affirm, that it is
not very often these afflicted Patients are disposed
to bite; and that even when they are,
they are afraid of doing it; and request the Bystanders
to keep out of their Reach: So that no
Danger is incurred; or where there is any, it
may easily be avoided by a few Precautions.
Chapter XIII.
Of the Small-Pocks.
Sect. 202.
he Small-Pocks is the most frequent,
the most extensive of all Diseases; since
out of a hundred Persons there are not
more than four or five exempted from
it. It is equally true however, that if it attacks almost
every Person, it attacks them but once, so
that having escaped through it, they are always
secure from it. It must be acknowleged, at
the same Time, to be one of the most destructive
Diseases; for if in some Years or Seasons, it
proves to be of a very mild and gentle Sort, in
others it is almost as fatal as the Plague: it being
demonstrated, by calculating the Consequences of
its most raging, and its gentlest Prevalence, that
it kills one seventh of the Number it attacks.
§ 203. People generally take the Small-Pocks
in their Infancy, or in their Childhood. It is
very seldom known to attack only one Person in
one Place: its Invasions being very generally epidemical,
and seizing a large Proportion of those
who have not suffered it. It commonly ceases
at the End of some Weeks, or of some Months,
and rarely ever appears again in the same Place,
until four, five or six Years after.
§ 204. This Malady often gives some Intimation
of its Approach, three or four Days before
the Appearance of the Fever, by a little Dejection;
less Vivacity and Gaiety than usual; a great
Propensity to sweat; less Appetite; a slight Alteration
of the Countenance, and a kind of pale
livid Colour about the Eyes: Notwithstanding
which, in Children of a lax and phlegmatic Constitution,
I have known a moderate Agitation of
their Blood, (before their Shivering approached)
give them a Vivacity, Gaiety, and a rosy Improvement
of their Complexion, beyond what Nature
had given them.
Certain short Vicissitudes of Heat or Coldness
succeed the former introductory Appearances, and
at length a considerable Shivering, of the Duration
of one, two, three or four Hours: This is
succeeded by violent Heat, accompanied with
Pains of the Head, Loins, Vomiting, or at least
with a frequent Propensity to vomit.
This State continues for some Hours, at the
Expiration of which the Fever abates a little in a
Sweat, which is sometimes a very large one:
the Patient then finds himself better, but is notwithstanding
cast down, torpid or heavy, very
squeamish, with a Head-ach and Pain in the Back,
and a Disposition to be drowsy. The last Symptom
indeed is not very common, except in Children,
less than seven or eight Years of Age.
The Abatement of the Fever is of small Duration;
and some Hours after, commonly towards
the Evening, it returns with all its Attendants,
and terminates again by Sweats, as before.
This State of the Disease lasts three or four
Days; at the End of which Term, and seldom
later, the first Eruptions appear among the Sweat,
which terminates the Paroxysm or Return of the
Fever. I have generally observed the earliest
Eruption to appear in the Face, next to that on
the Hands, on the fore Part of the Arms; on
the Neck, and on the upper Part of the Breast.
As soon as this Eruption appears, if the Distemper
is of a gentle Kind and Disposition, the Fever
almost entirely vanishes: the Patient continues to
sweat a little, or transpire; the Number of Eruptions
increases, others coming out on the Back,
the Sides, the Belly, the Thighs, the Legs, and
the Feet. Sometimes they are pushed out very
numerously even to the Soles of the Feet; where,
as they increase in Size, they often excite very
sharp Pain, by Reason of the great Thickness
and Hardness of the Skin in these Parts.
Frequently on the first and second Day of Eruption
(speaking hitherto always of the mild
Kind and Degree of the Disease) there returns
again a very gentle Revival of the Fever about
the Evening, which, about the Termination of
it, is attended with a considerable and final Eruption:
though as often as the Fever terminates perfectly
after the earliest Eruption, a very distinct and
very small one is a pretty certain Consequence.
For though the Eruption is already, or should
prove only moderate, the Fever, as I have before
said, does not totally disappear; a small Degree
of it still remaining, and heightening a little
every Evening.
These Pustules, or Efflorescences, on their
first Appearance, are only so many very little red
Spots, considerably resembling a Flea-bite; but
distinguishable by a small white Point in the
Middle, a little raised above the rest, which gradually
increases in Size, with the Redness extended
about it. They become whiter, in Proportion
as they grow larger; and generally upon the
sixth Day, including that of their first Eruption,
they attain their utmost Magnitude, and are full
of Pus or Matter. Some of them grow to the
Size of a Pea, and some still a little larger; but
this never happens to the greatest Number of
them. From this Time they begin to look yellowish,
they gradually become dry, and fall off
in brown Scales, in ten or eleven Days from their
first Appearance. As their Eruption occurred on
different Days, they also wither and fall off successively.
The Face is sometimes clear of them,
while Pustules still are seen upon the Legs, not
fully ripe, or suppurated: and those in the Soles
of the Feet often remain much longer.
§ 205. The Skin is of Course extended or
stretched out by the Pustules; and after the Appearance
of a certain Quantity, all the Interstices,
or Parts between the Pustules, are red and
bright, as it were, with a proportionable Inflation
or Swelling of the Skin. The Face is the first
Part that appears bloated, from the Pustules there
first attaining their utmost Size: and this inflation
is sometimes so considerable, as to look monstrous;
the like happens also to the Neck, and
the Eyes are entirely closed up by it. The Swelling
of the Face abates in Proportion to the scabbing
and drying up of the Pustules; and then the
Hands are puffed up prodigiously. This happens
successively to the Legs, the Tumour or Swelling,
being the Consequence of the Pustules attaining
their utmost Size, which happens by Succession,
in these different Parts.
§ 206. Whenever there is a very considerable
Eruption, the Fever is heightened at the Time of
Suppuration, which is not to be wondered at;
one single Boil excites a Fever: How is it possible
then that some hundred, nay some thousand
of these little Abscesses should not excite
one? This Fever is the most dangerous Period,
or Time of the Disease, and occurs between the
ninth and the thirteenth Days; as many Circumstances
vary the Term of Suppuration, two
or three Days. At this painful and perilous Season
then, the Patient becomes very hot, and
thirsty: he is harrassed with Pain; and finds it
very difficult to discover a favourable easy Posture.
If the Malady runs very high, he has no Sleep;
he raves, becomes greatly oppressed, is seized
with a heavy Drowsiness; and when he dies, he
dies either suffocated or lethargic, and sometimes
in a State compounded of both these Symptoms.
The Pulse, during this Fever of Suppuration,
is sometimes of an astonishing Quickness, while
the Swelling of the Wrists makes it seem, in
some Subjects, to be very small. The most critical
and dangerous Time is, when the Swellings
of the Face, Head and Neck are in their highest
Degree. Whenever the Swelling begins to fall,
the Scabs on the Face to dry [supposing neither
of these to be too sudden and premature, for the visible
Quantity of the Pustules] and the Skin to
shrivel, as it were, the Quickness of the Pulse
abates a little, and the Danger diminishes. When
the Pustules are very few, this second Fever is
so moderate, that it requires some Attention to
discern it, so that the Danger is next to none.
§ 207. Besides those Symptoms, there are
some others, which require considerable Attention
and Vigilance. One of these is the Soreness
of the Throat, with which many Persons in the
Small-Pocks are afflicted, as soon as the Fever
grows pretty strong. It continues for two or
three Days; feels very strait and troublesome in
the Action of Swallowing; and whenever the
Disease is extremely acute, it entirely prevents
Swallowing. It is commonly ascribed to the
Eruption of Pustules in the Throat; but this is a
Mistake, such Pustules being almost constantly
imaginary. It begins, most frequently, before
the Eruption appears; if this Complaint is
in a light Degree, it terminates upon the Eruption;
and whenever it revives again in the Course
of the Disease, it is always in Proportion to the
Degree of the Fever. Hence we may infer it
does not arise from the Pustules, but is owing to
the Inflammation; and as often as it is of any
considerable Duration, it is almost ever attended
with another Symptom, the Salivation, or a Discharge
of a great Quantity of Spittle. This Salivation
rarely exists, where the Disease is very
gentle, or the Patient very young; and is full as
rarely absent, where it is severe, and the Patient
is past seven or eight Years old: but when the
Eruption is very confluent, and the Patient adult,
or grown up, the Discharge is surprizing. Under
these Circumstances it flows out incessantly, allowing
the afflicted Patient no Rest or Respite;
and often incommodes him more than any other
Symptom of the Distemper; and so much the
more, as after its Continuance for some Days,
the Lips, the Inside of the Cheeks, the Tongue,
and the Roof of the Mouth are entirely peeled
or flead, as it were. Nevertheless, however
painful and embarrassing this Discharge may
prove, it is very important and salutary. Meer
Infants are less subject to it, some of them having
a Looseness, in Lieu of it: and yet I have
observed even this last Discharge to be considerably
less frequent in them, than a Salivation is in
grown People.
§ 208. Children, to the Age of five or six
Years, are liable to Convulsions, before Eruption:
these however are not dangerous, if they
are not accompanied with other grievous and
violent Symptoms. But such Convulsions as supervene,
either when Eruption having already
occurred, suddenly retreats, or strikes in, according
to the common Phrase; or during the Course
of the Fever of Suppuration, are greatly more
terrifying.
Involuntary Discharges of Blood from the
Nose often occur, in the first Stage of this Distemper,
which are extremely serviceable, and
commonly lessen, or carry off, the Head-ach.
Meer Infants are less subject to this Discharge;
though they have sometimes a little of it: and I
have known a considerable Stupor or Drowsiness,
vanish immediately after this Bleeding.
§ 209. The Small-Pocks is commonly distinguished
into two Kinds, the confluent and the
distinct, such a Distinction really existing in Nature:
but as the Treatment of each of them is
the same; and as the Quantity or Dose of the
Medicines is only to be varied, in Proportion to
the Danger of the Patient (not to enter here into
very tedious Details, and such as might exceed
the Comprehension of many of our Readers;
as well as whatever might relate particularly
to the malignant Small-Pocks) I shall limit
myself within the Description I have premised,
which includes all the Symptoms common to
both these Kinds of the Small-Pocks. I content
myself with adding here, that we may expect a
very confluent and dangerous Pock, is, at the very
Time of seizure, the Patient is immediately attacked
with many violent Symptoms; more especially
if his Eyes are extremely quick, lively, and
even glistening, as it were; if he vomits almost
continually; if the Pain of his Loins be violent;
and if he suffers at the same Time great Anguish
and Inquietude: If in Infants there is great Stupor
or Heaviness; if Eruption appears on the third
Day, and sometimes even on the second: as the
hastier Eruptions in this Disease signify the most
dangerous Kind and Degree of it; and on the
contrary, the slower Eruption is, it is the safer
too; supposing this Slowness of the Eruption not
to have been the Consequence of great Weakness,
or of some violent inward Pain.
§ 210. The Disorder is sometimes so very
mild and slight, that Eruption appears with
scarcely any Suspicion of the Child's having the
least Ailment, and the Event is as favourable as
the Invasion. The Pustules appear, grow large,
suppurate and attain their Maturity, without confining
the Patient to his Bed, or lessening either
his Sleep, or Appetite.
It is very common to see Children in the Country
(and they are seldom more than Children who
have it so very gently) run about in the open Air,
through the whole Course of this Disease, and
feeding just as they do in Health. Even those
who take it in a somewhat higher Degree, commonly
go out when Eruption is finished, and
give themselves up, without Reserve, to the Voracity
of their Hunger. Notwithstanding all this
Neglect, many get perfectly cured; though such
a Conduct should never be proposed for Imitation,
since Numbers have experienced its pernicious
Consequences, and several of these Children have
been brought to me, especially from Jurat, who
after such Neglect, in the Course of the mild
and kindly Sort of this Distemper, have contracted
Complaints and Infirmities of different
Kinds, which have been found very difficult to
subdue.
§ 211. This still continues to be one of these
Distempers, whose Danger has long been increased
by its improper Treatment, and especially by
forcing the Patients into Sweats; and it still continues
to be increased, particularly among Country
People. They have seen Eruption appear,
where the Patient sweats, and observed he found
himself better after its Appearance: and hence
they conclude that, by quickening and forcing
out this Eruption, they contribute to his Relief;
and suppose, that by increasing the Quantity of his
Sweats, and the Number of his Eruptions, the
Blood is the better cleared and purified from the
Poison. These are mortal Errors, which daily
Experience has demonstrated, by their tragical
Consequences.
When the Contagion or Poison, which generates
this Disease, has been admitted into the Blood,
it requires a certain Term to produce its usual
Effects: at which Time the Blood being tainted
by the Venom it has received, and by that which
such Venom has formed or assimilated from it,
Nature makes an Effort to free herself of it, and
to expell it by the Skin, precisely at the Time
when every Thing is predisposed for that Purpose.
This Effort pretty generally succeeds, being
very often rather too rapid and violent, and
very seldom too weak. Hence it is evident, that
whenever this Effort is deficient, it ought not to
be heightened by hot Medicines or Means, which
make it too violent and dangerous: for when it
already exceeds in this Respect, a further Increase
of such Violence must render it mortal. There
are but few Cases in which the Efforts of Nature,
on this Occasion, are too languid and feeble, especially
in the Country; and whenever such rare
Cases do occur, it is very difficult to form a just
and proper Estimation of them: for which Reason
we should be very reserved and cautious in the
Use of heating Medicines, which are so mortally
pernicious in this Disease.
Wine, Venice Treacle, cordial Confections,
hot Air, and Loads of Bed-cloths, annually
sweep off Thousands of Children, who might
have recovered, if they had taken nothing but
warm Water: and every Person who is interested
in the Recovery of Patients in this Distemper,
ought carefully to prevent the smallest Use of
such Drugs; which, if they should not immediately
aggravate it to a fatal Degree, yet will
certainly increase the Severity and Torment of it,
and annex the most unhappy and tragical Consequences
to it.
The Prejudice in this Point is so strongly rooted,
that a total Eradication of it must be very difficult:
but I only desire People would be convinced
by their own Eyes, of the different Success
of the hot Regimen, and of that I shall propose.
And here indeed I must confess, I found
more Attention and Docility, on this Point, among
the Inhabitants of the City, and especially in the
last epidemical spreading of the Small-Pocks, than
I presumed to hope for. Not only as many as
consulted me on the Invasion of it, complied exactly
with the cooling Regimen I advised them;
but their Neighbours also had Recourse to it,
when their Children sickened: and being often
called in when it had been many Days advanced,
I observed with great Pleasure, that in many
Houses, not one heating Medicine had been given;
and great Care had been taken to keep the
Air of the Patient's Chamber refreshingly cool
and temperate. This encourages me to expect,
that this Method hereafter will become general
here. What certainly ought most essentially to
conduce to this is, that notwithstanding the Diffusion
or spreading of this Disease was as numerous
and extensive as any of the former, the Mortality,
in Consequence of it, was evidently less.
§ 212. At the very Beginning of the Small-Pocks
(which may be reasonably suspected, from
the Presence of the Symptoms I have already described;
supposing the Person complaining never
to have had it, and the Disease to prevail near
his Residence) the Patient is immediately to be
put on a strict Regimen, and to have his Legs
bathed Night and Morning in warm Water.
This is the most proper and promising Method to
lessen the Quantity of Eruption in the Face and
Head, and to facilitate it every where else on the
Surface. Glysters also greatly contribute to
abate the Head-ach, and to diminish the Reachings
to vomit, and the actual Vomitings, which
greatly distress the Patient; but which however
it is highly absurd and pernicious to stop by any
stomachic cordial Confection, or by Venice Treacle;
and still more dangerous to attempt removing
the Cause of them, by a Vomit or Purge,
which are hurtful in the beginning of the Small-Pocks.
If the Fever be moderate, the Bathings of the
Legs on the first Day of sickening, and one Glyster
may suffice then. The Patient must be restrained
to his Regimen; and instead of the
Ptisan , , , a very young Child should
drink nothing but Milk diluted with two thirds
of Elder Flower or Lime-tree Tea, or with Balm
Tea, if there be no perceivable Fever; and in
short, if they have an Aversion to the Taste of
them all, with only the same Quantity of good
clear Water. An Apple coddled or baked
may be added to it; and if they complain of
Hunger, a little Bread may be allowed; but they
must be denied any Meat, or Meat Broth, Eggs and
strong Drink; since it has appeared from Observations
frequently repeated, that Children who had
been indulged with such Diet proved the worse
for it, and recovered more slowly than others.
In this early Stage too, clear Whey alone may
serve them instead of every other Drink, the
good Effects of which I have frequently been a
Witness to; or some Buttermilk may be allowed.
When the Distemper is of a mild Species, a perfect
Cure ensues, without any other Assistance or
Medicine: but we should not neglect to purge
the Patient as soon as the Pustules are perfectly
scabbed on the greater Part of his Face, with the
Prescription , which must be repeated six
Days after. He should not be allowed Flesh 'till
after this second Purge; though after the first he
may he allowed some well-boiled Pulse, or Garden-stuff
and Bread, and in such a Quantity, as
not to be pinched with Hunger, while he recovers
from the Disease.
§ 213. But if the Fever should be strong, the
Pulse hard, and the Pain of the Head and Loins
should be violent, he must, 1. immediately lose
Blood from the Arm; receive a Glyster two
Hours after; and, if the Fever continues, the
Bleeding must be repeated. I have directed a
Repetition of it even to the fourth Time, within
the two first Days, to young People under the
Age of eighteen; and it is more especially necessary
in such Persons as, with a hard and full
Pulse, are also affected with a heavy Drowsiness
and a Delirium, or Raving.
2. As long as the Fever continues violently,
two, three, and even four Glysters should be
given in the 24 Hours; and the Legs should be
bathed twice.
3. The Patient is to be taken out of Bed, and
supported in a Chair as long as he can tolerably
bear it.
4. The Air of his Chamber should frequently
be renewed, and if it be too hot, which it often is
in Summer, in Order to refresh it, and the Patient,
the Means must be employed which are directed
.
5. He is to be restrained to the Ptisans
or ; and if that does not sufficiently moderate the
Fever, he should take every Hour, or every two
Hours, according to the Urgency of the Case, a
Spoonful of the Mixture ; mixed with a
Cup of Ptisan. After the Eruption, the Fever
being then abated, there is less Occasion for Medicine;
and should it even entirely disappear,
the Patient may be regulated, as directed, .
§ 214. When, after a Calm, a Remission or
Intermission of some Days, the Process of
Suppuration revives the Fever, we ought first,
and especially, to keep the Body very open. For
this Purpose, a an Ounce of Catholicon should be
added to the Glysters; or they might be simply
made of Whey, with Honey, Oil and Salt. b
Give the Patient three times every Morning, at
the Interval of two Hours between each, three
Glasses of the Ptisan . c Purge him after
two Days, with the Potion , but on that
Day he must not take the Ptisan .
2. He must, if the Distemper be very violent,
take a double Dose of the Mixture .
3. The Patient should be taken out of Bed,
and kept up in a Room well aired Day and
Night, until the Fever has abated. Many Persons
will probably be surprized at this Advice; nevertheless
it is that which I have often experienced
to be the most efficacious, and without which
the others are ineffectual. They will say, how
shall the Patient sleep at this Rate? To which it
may be answered, Sleep is not necessary, nay, it
is hurtful in this State and Stage of the Disease.
Besides, he is really unable to sleep: the continual
Salivation prevents it, and it is very necessary
to keep up the Salivation; which is facilitated
by often injecting warm Water and Honey
into his Throat. It is also of considerable Service
to throw some up his Nostrils, and often thus to
cleanse the Scabs which form within them. A
due Regard to these Circumstances not only contributes
to lessen the Patient's Uneasiness, but very
effectually also to his Cure.
4. If the Face and Neck are greatly swelled,
emollient Cataplasms are to be applied to the
Soles of the Feet; and if these should have very
little Effect, Sinapisms should be applied. These
are a kind of Plaister or Application composed of
Yeast, Mustard-flower, and some Vinegar. They
sometimes occasion sharp and almost burning Pain,
but in Proportion to the Sharpness and Increase
of these Pains, the Head and Neck are remarkably
relieved.
§ 215. The Eyelids are puffed up and swelled
when the Disease runs high, so as to conceal the
Eyes, which are closed up fast for several Days.
Nothing further should be attempted, with Respect
to this Circumstance, but the frequent
moistening of them with a little warm Milk and
Water. The Precautions which some take to
stroke them with Saffron, a gold Ducat, or Rose-water
are equally childish and insignificant.
What chiefly conduces to prevent the Redness
or Inflammation of the Eyes after the Disease,
and in general all its other bad Consequences, is
to be content for a considerable Time, with a
very moderate Quantity of Food, and particularly
to abstain from Flesh and Wine. In the
very bad Small Pocks, and in little Children, the
Eyes are closed up from the Beginning of the
Eruption.
§ 216. One extremely serviceable Assistance,
and which has not been made use of for a
long Time past, except as a Means to preserve
the Smoothness and Beauty of the Face; but yet
which has the greatest Tendency to preserve Life
itself, is the Opening of the Pustules, not only
upon the Face, but all over the Body. In the
first Place, by opening them, the Lodgment or
Retention of Pus is prevented, which may be
supposed to prevent any Erosion, or eating down,
from it; whence Scars, deep Pitts and other Deformities
are obviated. Secondly, in giving a
Vent to the Poison, the Retreat of it into the
Blood is cut off, which removes a principal
Cause of the Danger of the Small-Pocks. Thirdly,
the Skin is relaxed; the Tumour of the Face
and Neck diminish in Proportion to that Relaxation;
and thence the Return of the Blood from
the Brain is facilitated, which must prove a great
Advantage. The Pustules should be opened
every where, successively as they ripen. The
precise Time of doing it is when they are entirely
white; when they just begin to turn
but a very little yellowish; and when the red
Circle surrounding them is quite pale. They
should be opened with very fine sharp-pointed
Scissars; this does not give the Patient the
least Pain; and when a certain Number of them
are opened, a Spunge dipt in a little warm Water
is to be repeatedly applied to suck up and
remove that Pus, which would soon be dried
up into Scabs. But as the Pustules, when emptied
thus, soon fill again, a Discharge of this fresh
Matter must be obtained in the same Manner
some Hours after; and this must sometimes be
repeated five or even six Times successively.
Such extraordinary Attention in this Point may
probably be considered as minute, and even trivial,
by some; and is very unlikely to become a general Practice: but I do again affirm it to be
of much more Importance than many may imagine;
and that as often as the Fever attending
Suppuration is violent and menacing, a very
general, exact and repeated opening, emptying,
and absorbing of the ripened Pustules, is a Remedy
of the utmost Importance and Efficacy; as
it removes two very considerable Causes of the
Danger of this Disease, which are the Matter
itself, and the great Tension and Stiffness of the
Skin.
§ 217. In the Treatment of this Disease, I
have said nothing with Respect to Anodynes, or
such Medicines as procure Sleep, which I am
sensible are pretty generally employed in it, but
which I scarcely ever direct in this violent Degree
of the Disease, and the Dangers of which
Medicine in it I have demonstrated in the Letter to
Baron Haller, which I have already mentioned.
For which Reason, wherever the Patient is
not under the Care and Direction of a Physician,
they should very carefully abstain from the Use of
Venice Treacle, Laudanum, Diacodium, that is
the Syrup of white Poppies, or even of the wild
red Poppy; Syrup of Amber, Pills of Storax, of
Cynoglossum or Hounds-tongue, and, in one Word,
of every Medicine which produces Sleep. But still
more especially should their Use be entirely banished,
throughout the Duration of the secondary
Fever, when even natural Sleep itself is dangerous.
One Circumstance in which their Use may
sometimes be permitted, is in the Case of weakly
Children, or such as are liable to Convulsions,
where Eruption is effected not without Difficulty.
But I must again inculcate the greatest Circumspection,
in the Use of such Medicines,
whose Effects are fatal, when the Blood-vessels
are turgid or full; whenever there is Inflammation,
Fever, a great Distension of the Skin; whenever
the Patient raves, or complains of Heaviness
and Oppression; and when it is necessary that
the Belly should be open; the Urine plentifully
discharged; and the Salivation be freely promoted.
§ 218. If Eruption should suddenly retreat,
or strike in, heating, soporific, spirituous and volatile
Remedies should carefully be avoided: but
the Patient may drink plentifully of the Infusion
pretty hot, and should be blistered on
the fleshy Part of the Legs. This is a very
embarrassing and difficult Case, and the different
Circumstances attending it may require different
Means and Applications, the Detail and Discussion
of which are beyond my Plan here. Sometimes
a single Bleeding has effectually recalled Eruption
at once.
§ 219. The only certain Method of surmounting
all the Danger of this Malady, is to inoculate.
But this most salutary Method, which ought to
be regarded as a particular and gracious Dispensation
of Providence, can scarcely be attainable
by, or serviceable to, the Bulk of the People, except
in those Countries, where Hospitals are
destined particularly for Inoculation. In these
where as yet there are none, the only Resource
that is left for Children who cannot be inoculated
at home, is to dispose them happily for the Distemper,
by a simple easy Preparation.
§ 220. This Preparation consists, upon the
whole, in removing all Want of, and all Obstructions
to, the Health of the Person subject to
this Disease, if he have any such; and in bringing
him into a mild and healthy, but not into
a very robust and vigorous, State; as this Distemper
is often exceedingly violent in this last.
It is evident, that since the Defects of Health
are very different in different Bodies, the Preparations
of them must as often vary; and that a
Child subject to some habitual Disorder, cannot
be prepared in the same Method with another
who has a very opposite one. The Detail
and Distinctions which are necessary on this important
Head, would be improper here, whether
it might be owing to their unavoidable Length;
or to the Impossibility of giving Persons, who
are not Physicians, sufficient Knowlege and Information
to qualify them for determining on,
and preferring, the most proper Preparation in
various Cases. Nevertheless I will point out
some such as may be very likely to agree, pretty generally,
with Respect to strong and healthy Children.
The first Step then is an Abatement of their
usual Quantity of Food. Children commonly
eat too much. Their Limitation should be in
Proportion to their Size and Growth, where we
could exactly ascertain them: but with Regard
to all, or to much the greater Number of them,
we may be allowed to make their Supper very
light, and very small.
Their second Advantage will consist in the
Choice of their Food. This Circumstance is less
within the Attainment of, and indeed less necessary
for, the common People, who are of Course
limited to a very few, than to the Rich, who
have Room to make great Retrenchments on this
Account. The Diet of Country People being of
the simplest Kind, and almost solely consisting of
Vegetables and of Milk-meats, is the most proper
Diet towards preparing for this Disease. For
this Reason, such Persons have little more to attend
to in this Respect, but that such Aliments
be sound and good in their Kind; that their
Bread be well baked; their Pulse dressed without
Bacon, or rancid strong Fat of any sort; that
their Fruits should be well ripened; that their
Children should have no Cakes or Tarts, [But
see Note , P. , .] and but little Cheese.
These simple Regulations may be sufficient, with
Regard to this Article of their Preparation.
Some Judgment may be formed of the good
Consequences of their Care on these two Points,
concerning the Quantity and Quality of the Childrens
Diet, by the moderate Shrinking of their
Bellies; as they will be rendered more lively
and active by this Alteration in their living; and
yet, notwithstanding a little less Ruddiness in
their Complexion, and some Abatement of their
common Plight of Body, their Countenances,
upon the whole, will seem improved.
The third Article I would recommend, is to
bathe their Legs now and then in warm Water,
before they go to Bed. This promotes Perspiration,
cools, dilutes the Blood, and allays the
Sharpness of it, as often as it is properly timed.
The fourth Precaution, is the frequent Use of
very clear Whey. This agreeable Remedy,
which consists of the Juices of Herbs filtred
through, and concocted, or as it were, sweetened
by the Organs of a healthy Animal, answers
every visible Indication (I am still speaking here
of sound and hearty Children). It imparts a Flexibility,
or Soupleness to the Vessels; it abates the
Density, the heavy Consistence and Thickness of
the Blood; which being augmented by the Action
of the poisonous Cause of the Small-Pocks,
would degenerate into a most dangerous inflammatory
Viscidity or Thickness. It removes all
Obstructions in the Viscera, or Bowels of the
lower Cavity, the Belly. It opens the Passages
which strain off the Bile; sheaths, or blunts, its
Sharpness, gives it a proper Fluidity, prevents its
Putridity, and sweetens whatever excessive Acrimony
may reside throughout the Mass of Humours.
It likewise promotes Stools, Urine and
Perspiration; and, in a Word, it communicates
the most favourable Disposition to the Body, not
to be too violently impressed and agitated by the
Operation of an inflammatory Poison: And with
Regard to such Children as I have mentioned,
for those who are either sanguine or bilious, it is
beyond all Contradiction, the most effectual
preparatory Drink, and the most proper to make
them amends for the Want of Inoculation.
I have already observed, that it may also be
used to great Advantage, during the Course of
the Disease: but I must also observe, that however
salutary it is, in the Cases for which I have
directed it, there are many others in which it
would be hurtful. It would be extremely pernicious
to order it to weak, languishing, scirrhous,
pale Children, subject to Vomitings, Purgings,
Acidities, and to all Diseases which prove their
Bowels to be weak, their Humours to be sharp:
so that People must be very cautious not to regard
it as an universal and infallible Remedy,
towards preparing for the Small-Pocks. Those
to whom it is advised, may take a few Glasses
every Morning, and even drink it daily, for their
common Drink; they may also sup it with Bread
for Breakfast, for Supper, and indeed at any
Time.
If Country People will pursue these Directions,
which are very easy to observe and to comprehend,
whenever the Small-Pocks rages, I am
persuaded it must lessen the Mortality attending
it. Some will certainly experience the Benefit
of them; such I mean as are very sensible and
discreet, and strongly influenced by the truest
Love of their Children. Others there are Alas!
who are too stupid to discern the Advantage of
them, and too unnatural to take any just Care of
their Families.
Chapter XIV.
Of the Measles.
Sect. 221.
he Measles, to which the human Species
are as generally liable, as to the
Small-Pocks, is a Distemper considerably
related to it; though, generally
speaking, it is less fatal; notwithstanding which,
it is not a little destructive in some Countries. In
Swisserland we lose much fewer, immediately in
the Disease, than from the Consequences of it.
It happens now and then that the Small-Pocks
and the Measles rage at the same Time,
and in the same Place; though I have more frequently
observed, that each of them was epidemical
in different Years. Sometimes it also happens
that both these Diseases are combined at
once in the same Person; and that one supervenes
before the other has finished its Course,
which makes the Case very perilous.
§ 222. In some Constitutions the Measles
gives Notice of its Approach many Days before
its evident Invasion, by a small, frequent and dry
Cough, without any other sensible Complaint:
though more frequently by a general Uneasiness;
by Successions of Shivering and of Heat; by a severe
Head-ach in grown Persons; a Heaviness in
Children; a considerable Complaint of the
Throat; and, by what particularly characterizes
this Distemper, an Inflammation and a considerable
Heat in the Eyes, attended with a Swelling
of the Eye-lids, with a Defluxion of sharp Tears,
and so acute a Sensation, or Feeling of the Eyes,
that they cannot bear the Light; by very frequent
Sneezings, and a Dripping from the Nose
of the same Humour with that, which trickles
from the Eyes.
The Heat and the Fever increases with Rapidity;
the Patient is afflicted with a Cough, a Stuffing,
with Anguish, and continual Reachings to
vomit; with violent Pains in the Loins; and
sometimes with a Looseness, under which Circumstance
he is less persecuted with Vomiting.
At other times, and in other Subjects, Sweating
chiefly prevails, though in less Abundance than
in the Small-Pocks. The Tongue is foul and
white; the Thirst is often very high; and the
Symptoms are generally more violent than in the
mild Small-Pocks.
At length, on the fourth or fifth Day, and
sometimes about the End of the third, a sudden
Eruption appears and in a very great Quantity,
especially about the Face; which in a few Hours
is covered with Spots, each of which resembles a
Flea-bite; many of them soon joining form red
Streaks or Suffusions larger or smaller, which
inflame the Skin, and produce a very perceivable
Swelling of the Face; whence the very Eyes are
sometimes closed. Each small Spot or Suffusion
is raised a little above the Surface, especially in
the Face, where they are manifest both to the
Sight and the Touch. In the other Parts of the
Body, this Elevation or Rising is scarcely perceivable
by any Circumstance, but the Roughness of
the Skin.
The Eruption, having first appeared in the
Face, is afterwards extended to the Breast, the
Back, the Arms, the Thighs and Legs. It generally
spreads very plentifully over the Breast
and the Back, and sometimes red Suffusions are
found upon the Breast, before any Eruption has
appeared in the Face.
The Patient is often relieved, as in the Small-Pocks,
by plentiful Discharges of Blood from
the Nose, which carry off the Complaints of the
Head, of the Eyes, and of the Throat.
Whenever this Distemper appears in its mildest
Character, almost every Symptom abates after
Eruption, as it happens in the Small-Pocks;
though, in general, the Change for the better is
not as thoroughly perceivable, as it is in the
Small-Pocks. It is certain the Reachings and
Vomitings cease almost entirely; but the Fever,
the Cough, the Head-ach continue; and I have
sometimes observed that a bilious Vomiting, a
Day or two after the Eruption, proved a more
considerable Relief to the Patient than the Eruption
had. On the third or fourth Day of the Eruption,
the Redness diminishes; the Spots, or very
small Pustules, dry up and fall off in very little
branny Scales; the Cuticle, or superficial Skin
also shrivels off; and is replaced by one succeeding
beneath it. On the ninth Day, when the
Progress of the Malady has been speedy, and on
the eleventh, when it has been very slow, no
Trace of the Redness is to be found; and the
Surface immediately resumes its usual Appearance.
§ 223. Notwithstanding all which the Patient
is not safe, except, during the Course of the
Distemper, or immediately after it, he has had
some considerable Evacuation; such as the Vomiting
I have just mentioned; or a bilious Looseness;
or considerable Discharges by Urine; or
very plentiful Sweating. For when any of these
Evacuations supervene, the Fever vanishes; the
Patient resumes his Strength, and perfectly recovers.
It happens sometimes too, and even
without any of these perceivable Discharges, that
insensible Perspiration expels the Relics of the
poisonous Cause of this Disease, and the Patient
recovers his Health. Yet it occurs too often,
that this Venom not having been entirely expelled
(or its internal Effects not having been thoroughly
effaced) it is repelled upon the Lungs, where it
produces a slight Inflammation. In Consequence
of this the Oppression, the Cough, the Anguish,
and Fever return, and the Patient's Situation
becomes very dangerous. This Outrage is frequently
less vehement, but it proves tedious and chronical,
leaving a very obstinate Cough behind it,
with many Resemblances of the Whooping-Cough.
In 1758 there was an epidemic State of
the Measles here extremely numerous, which affected
great Numbers: Almost all who had it,
and who were not very carefully and judiciously
attended, were seized in Consequence of it with
that Cough, which proved very violent and obstinate.
§ 224. However, notwithstanding this be the
frequent Progress and Consequence of this Disease,
when left entirely to itself, or erroneously
treated, and more particularly when treated with
a hot Regimen; yet when proper Care was taken
to moderate the Fever at the Beginning, to dilute,
and to keep up the Evacuations, such unhappy
Consequences have been very rare.
§ 225. The proper Method of conducting
this Distemper is much the same with that of
the Small-Pocks.
1, If the Fever be high, the Pulse hard, the
Load and Oppression heavy, and all the Symptoms
violent, the Patient must be bled once or
twice.
2, His Legs must be bathed, and he must
take some Glysters: the Vehemence of the Symptoms
must regulate the Number of each.
3, The Ptisans or must be taken, or
a Tea of Elder and Lime-tree Flowers, to which
a fifth Part Milk may be added.
4, The Vapour, the Steam of warm Water
should also be employed, as very conducive to
asswage the Cough; the Soreness of the Throat,
and the Oppression the Patient labours under.
5, As soon as the Efflorescence, the Redness
becomes pale, the Patient is to be purged with
the Draught .
6, He is still to be kept strictly to his Regimen,
for two Days after this Purge; after which
he is to be put upon the Diet of those who are
in a State of Recovery.
7, If during the Eruption such Symptoms
supervene as occur [at the same Term] in the
Small-Pocks, they are to be treated in the Manner
already directed there.
§ 226. Whenever this Method has not been observed,
and the Accidents described supervene,
the Distemper must be treated like an Inflammation
in its first State, and all must be done
as directed . If the Disease is not vehement, Bleeding may be omitted. If it is of
some standing in gross Children, loaded with
Humours, inactive, and pale, we must add to
the Medicines already prescribed the Potion
, and Blisters to the Legs.
§ 227. It often happens from the Distance of
proper Advice, that the Relics, the Dregs as it
were, of the Disease have been too little regarded,
especially the Cough; in which Circumstance it
forms a real Suppuration in the Lungs, attended
with a slow Fever. I have seen many Children
in Country Villages destroyed by this Neglect.
Their Case is then of the same Nature with that
described and , and terminates in the
same Manner in a Looseness, (attended with very
little Pain) and sometimes a very fœtid one, which
carries off the Patient. In such Cases we must
recur to the Remedies prescribed , Article 3,
4, 5; to the Powder ; and to Milk and
Exercise. But it is so very difficult to make
Children take the Powder, that it may be sometimes
necessary to trust to the Milk without it,
which I have often seen in such Situations accomplish
a very difficult Cure. I must advise the
Reader at the same Time, that it has not so compleat
an Effect, as when it is taken solely
unjoined by any other Aliment; and that it is of the
last Importance not to join it with any, which has
the least Acidity or Sharpness. Persons in easy
Circumstances may successfully take, at the same
Time, Pfeffer, Seltzer, Peterstal, or some other
light Waters, which are but moderately loaded
with mineral Ingredients. These are also successfully
employed in all the Cases, in which the
Cure I have mentioned is necessary.
§ 228. Sometimes there remains, after the
Course of the Measles, a strong dry Cough, with
great Heat in the Breast, and throughout the
whole Body, with Thirst, an excessive Dryness
of the Tongue, and of the whole Surface of the
Body. I have cured Persons thus indisposed after
this Distemper, by making them breathe in the
Vapour of warm Water; by the repeated Use of
warm Baths; and by allowing them to take nothing
for several Days but Water and Milk.
Before I take leave of this Subject, I assure the
Reader again, that the contagious Cause of the
Measles is of an extremely sharp and acrid Nature.
It appears to have some Resemblance to
the bilious Humour, which produces the Erisipelas,
or St. Anthony's Fire; and thence it demands
our particular Attention and Vigilance; without
which very troublesome and dangerous Consequences
may be apprehended. I have seen, not
very long since, a young Girl, who was in a very
languid State after the Measles, which she had
Undergone three Years before: It was at length
attended with an Ulceration in her Neck, which
was cured, and her Health finally restored by
Sarsaparilla with Milk and Water.
§ 229. The Measles have been communicated
by Inoculation in some Countries, where it is
of a very malignant Disposition; and that Method
might also be very advantageous in this.
But what we have already observed, with Respect
to the Inoculation of the Small-Pocks, viz. That
it cannot be extended to the general Benefit of the
People, without the Foundation of Hospitals for
that very Purpose, is equally applicable to the
Inoculation of the Measles.
Chapter XV.
Of the ardent or burning Fever.
Sect. 230.
he much greater Number of the Diseases
I have hitherto considered, result
from an Inflammation of the Blood,
combined with the particular Inflammation
of some Part, or occasioned by some Contagion
or Poison, which must be evacuated. But
when the Blood is solely and strongly inflamed,
without an Attack on any particular Part, this
Fever, which we term hot or burning, is the
Consequence.
§ 231. The Signs which make it evident are,
a Hardness and Fulness of the Pulse in a higher
Degree than happens in any other Malady; an
excessive Heat; great Thirst; with an extraordinary
Dryness of the Eyes, Nostrils, Lips, of
the Tongue, and of the Throat; a violent Head-ach;
and sometimes a Raving at the Height of
the Paroxysm, or Increase of the Fever, which
rises considerably every Evening. The Respiration
is also somewhat oppressed, but especially
at the Return of this Paroxysm, with a Cough
now and then; though without any Pain in the
Breast, and without any Expectoration, or coughing
up. The Body is costive; the Urine very
high coloured, hot, and in a small Quantity.
The Sick are also liable to start sometimes, but
especially when they seem to sleep; for they have
little sound refreshing Sleep, but rather a kind of
Drowsiness, that makes them very little attentive
to, or sensible of, whatever happens about them,
or even of their own Condition. They have
sometimes a little Sweat or Moisture; though
commonly a very dry Skin; they are manifestly
weak, and have either little or no Smell or Taste.
§ 232. This Disease, like all other inflammatory
ones, is produced by the Causes which
thicken the Blood, and increase its Motion; such
as excessive Labour, violent Heat, Want of Sleep,
the Abuse of Wine or other strong Liquors; the
long Continuance of a dry Constitution of the
Air, Excess of every kind, and heating inflaming
Food.
§ 233. The Patient, under these Circumstances,
ought, 1, immediately to be put upon a Regimen;
to have the Food allowed him given
only every eight Hours, and, in some Cases, only
twice a Day: and indeed, when the Attack is
extremely violent, Nourishment may be wholly
omitted.
2, Bleeding should be performed and repeated,
'till the Hardness of the Pulse is sensibly abated.
The first Discharge should be considerable, the
second should be made four Hours after. If the
Pulse is softened by the first, the second may be
suspended, and not repeated before it becomes
sufficiently hard again, to make us apprehensive
of Danger: but should it continue strong and
hard, the Bleeding may be repeated on the same
Day to a third Time, which often happens to
be all the Repetitions that are necessary.
3, The Glyster should be given twice,
or even thrice, daily.
4, His Legs are to be bathed twice a Day in
warm Water: his Hands may be bathed in the
same Water. Linen or Flanel Cloths dipt in
warm Water may be applied over the Breast,
and upon the Belly; and he should regularly
drink the Almond Milk and the Ptisan
. The poorest Patients may content themselves
with the last, but should drink very plentifully
of it; and after the Bleeding properly repeated,
fresh Air and the plentiful Continuance
of small diluting Liquors generally establish the
Health of the Patient.
5, If notwithstanding the repeated Bleedings,
the Fever still rages highly, it may be lessened by
giving a Spoonful of the Potion every Hour,
till it abates; and afterwards every three Hours,
until it becomes very moderate.
§ 234. Hæmorrhages, or Bleedings, from the
Nose frequently occur in this Fever, greatly to the
Relief and Security of the Patient.
The first Appearances of Amendment are a
softening of the Pulse, (which however does not
wholly lose all its Hardness, before the Disease
entirely terminates) a sensible Abatement of the
Head-ach; a greater Quantity of Urine, and that
less high coloured; and a manifestly approaching
Moisture of the Tongue. These favourable
Signs keep increasing in their Degree, and there
frequently ensue between the ninth and the fourteenth
Day, and often after a Flurry of some
Hours Continuance, very large Evacuations by
Stool; a great Quantity of Urine, which lets fall
a palely reddish Sediment; the Urine above it
being very clear, and of a natural Colour; and
these accompanied with Sweats in a less or greater
Quantity. At the same Time the Nostrils and
the Mouth grow moist: the brown and dry Crust
which covered the Tongue, and which was hitherto
inseparable from it, peels off of itself; the
Thirst is diminished; the Clearness of the Faculties
rises; the Drowsiness goes off, it is succeeded
by comfortable Sleep, and the natural Strength
is restored. When Things are evidently in this
Way, the Patient should take the Potion ,
and be put upon the Regimen of those who are
in a State of Recovery. It should be repeated at
the End of eight or ten Days. Some Patients
have perfectly recovered from this Fever, without
the least Sediment in their Urine.
§ 235. The augmenting Danger of this Fever
may be discerned, from the continued Hardness
of the Pulse, though with an Abatement of its
Strength; if the Brain becomes more confused;
the Breathing more difficult; if the Eyes, Nose,
Lips and Tongue become still more dry, and the
Voice more altered. If to these Symptoms there
be also added a Swelling of the Belly; a Diminution
of the Quantity of Urine; a constant Raving;
great Anxiety, and a certain Wildness of
the Eyes, the Case is in a manner desperate; and
the Patient cannot survive many Hours. The
Hands and Fingers at this Period are incessantly
in Motion, as if feeling for something upon the
Bed-Cloths, which is commonly termed, their
hunting for Flies.
Chapter XVI.
Of putrid Fevers.
Sect. 236.
aving treated of such feverish Distempers,
as arise from an Inflammation
of the Blood, I shall here treat of those
produced by corrupt Humours, which
stagnate in the Stomach, the Guts, or other Bowels
of the lower Cavity, the Belly; or which
have already passed from them into the Blood.
These are called putrid Fevers, or sometimes bilious
Fevers, when a certain Degeneracy or Corruption
of the Bile seems chiefly to prevail in the
Disease.
§ 237. This Distemper frequently gives Notice
of its Approach, several Days before its manifest
Attack; by a great Dejection, a Heaviness
of the Head; Pains of the Loins and Knees; a
Foulness of the Mouth in the Morning; little Appetite;
broken Slumber; and sometimes by an excessive
Head-ach for many Days, without any other
Symptom. After this, or these Disorders, a Shivering
comes on, followed by a sharp and dry Heat:
the Pulse, which was small and quick during the
Shivering, is raised during the Heat, and is often
very strong, though it is not attended with the
same Hardness, as in the preceding Fever; except
the putrid Fever be combined with an inflammatory
one, which it sometimes is. During
this Time, that is the Duration of the Heat, the
Head-ach is commonly extremely violent; the
Patient is almost constantly affected with Loathings,
and sometimes even with Vomiting; with
Thirst, disagreeable Risings, a Bitterness in the
Mouth; and very little Urine. This Heat continues
for many Hours, frequently the whole
Night; it abates a little in the Morning, and the
Pulse, though always feverish, is then something
less so, while the Patient suffers less, though still
greatly dejected.
The Tongue is white and furred, the Teeth
are foul, and the Breath smells very disagreeably.
The Colour, Quantity and Consistence of the
Urine, are very various and changeable. Some
Patients are costive, others frequently have small
Stools, without the least Relief accruing from
them. The Skin is sometimes dry, and at other
Times there is some sensible Perspiration, but
without any Benefit attending it. The Fever
augments every Day, and frequently at unexpected
irregular Periods. Besides that great Paroxysm
or Increase, which is perceivable in all
the Subjects of this Fever, some have also other
less intervening ones.
§ 238. When the Disease is left to itself, or
injudiciously treated; or when it proves more powerful
than the Remedies against it, which is by no
Means seldom the Case, the Aggravations of it
become longer, more frequent and irregular.
There is scarcely an Interval of Ease. The Patient's
Belly is swell'd out like a Foot-ball; a Delirium
or Raving comes on; he proves insensible
of his own Evacuations, which come away involuntarily;
he rejects Assistance, and keeps muttering
continually, with a quick, small, irregular
Pulse. Sometimes little Spots of a brown, or
of a livid Colour appear on the Surface, but
particularly about the Neck, Back and Breast. All
the Discharges from his Body have a most fœtid
Smell: convulsive Motions also supervene, especially
in the Face; he lies down only on his
Back, sinks down insensibly towards the Foot
of the Bed, and picks about, as if catching
Flies; his Pulse becomes so quick and so small,
that it cannot be perceived without Difficulty,
and cannot be counted. His Anguish seems
inexpressible: his Sweats stream down from
Agony: his Breast swells out as if distended by
Fullness, and he dies miserably.
§ 239. When this Distemper is less violent, or
more judiciously treated, and the Medicines succeed
well, it continues for some Days in the State
described , without growing worse, though
without abating. None of these Symptoms however
appear, described ; but, on the contrary,
all the Symptoms become milder, the Paroxysms,
or Aggravations, are shorter and less violent, the
Head-ach more supportable; the Discharges by
Stool are less frequent, but more at once, and attended
with Relief to the Patient. The Quantity
of Urine is very considerable, though it varies at
different Times in Colour and Consistence, as before.
The Patient soon begins to get a little
Sleep, and grows more composed and easy. The
Tongue disengages itself from its Filth and Furriness,
and Health gradually, yet daily, advances.
§ 240. This Fever seems to have no critical
Time, either for its Termination in Recovery, or
in Death. When it is very violent, or very
badly conducted, it proves sometimes fatal on the
ninth Day. Persons often die of it from the
eighteenth to the twentieth; sometimes only
about the fortieth; after having been alternately
better and worse.
When it happens but in a light Degree, it is
sometimes cured within a few Days, after the
earliest Evacuations. When it is of a very different
Character, some Patients are not out of Danger
before the End of six Weeks, and even still later.
Nevertheless it is certain, that these Fevers, extended
to this Length of Duration, often depend
in a great Measure on the Manner of treating
them; and that in general their Course must be
determined, some time from the fourteenth to the
thirtieth Day.
§ 241. The Treatment of this Species of Fevers
is comprized in the following Method and
Medicines.
1, The Patient must be put into a Regimen;
and notwithstanding he is far from costive, and
sometimes has even a small Purging, he should
receive one Glyster daily. His common Drink
should be Lemonade, (which is made of the
Juice of Lemons, Sugar and Water) or the Ptisan
. Instead of Juice of Lemons, Vinegar
may be occasionally substituted, which, with
Sugar and Water, makes an agreeable and very
wholesome Drink in these Fevers.
2, If there be an Inflammation also, which
may be discovered by the Strength and the Hardness
of the Pulse, and by the Temperament and
Complexion of the Patient; if he is naturally
robust, and has heated himself by any of the
Causes described, , he should be bled once,
and even a second Time, if necessary, some
Hours after. I must observe however, that very
frequently there is no such Inflammation, and
that in such a Case, Bleeding would be hurtful.
3, When the Patient has drank very plentifully
for two Days of these Liquids, if his Mouth
still continues in a very foul State, and he has
violent Reachings to vomit, he must take the
Powder , dissolved in half a Pot of
warm Water, a Glass of it being to be drank
every half Quarter of an Hour. But as this Medicine
vomits, it must not be taken, except we
are certain the Patient is not under any Circumstance,
which forbids the Use of a Vomit: all
which Circumstances shall be particularly mentioned
in the Chapter, respecting the Use of such
Medicines, as are taken by way of Precaution, or
Prevention. If the first Glasses excite a plentiful
Vomiting, we must forbear giving another, and
be content with obliging the Patient to drink a
considerable Quantity of warm Water. But if
the former Glasses do not occasion Vomiting,
they must be repeated, as already directed until
they do. Those who are afraid of taking this
Medicine, which is usually called, the Emetic,
may take that of , also drinking warm
Water plentifully during its Operation; but the
former is preferable, as more prevalent, in dangerous
Cases. We must caution our Readers at
the same Time, that wherever there is an Inflammation
of any Part, neither of these Medicines
must be given, which might prove a real Poison
in such a Circumstance; and even if the Fever is
extremely violent, though there should be no
particular Inflammation, they should not be
given.
The Time of giving them is soon after the End of
the Paroxysm, when the Fever is at the lowest. The
Medicine generally purges, after it ceases
to make the Patient vomit: But is seldom
attended with the same Effect.
When the Operation of the Vomit is entirely
over, the Sick should return to the Use of the
Ptisan; and great Care must be taken to prohibit
them from the Use of Flesh Broth, under the
Pretext of working off a Purging with it. The
same Method is to be continued on the following
Days as on the first; but as it is of Importance
to keep the Body open, he should take
every Morning some of the Ptisan . Such,
as this would be too expensive for, may substitute,
in the room of it, a fourth Part of the Powder
in five or six Glasses of Water, of which
they are to take a Cup every two Hours, beginning
early in the Morning. Nevertheless, if the
Fever be very high, should be preferred
to it.
4, After the Operation of the Vomit, if the
Fever still continue, if the Stools are remarkably
fœtid, and if the Belly is tense and distended as it
were, and the Quantity of Urine is small, a
Spoonful of the Potion should be given
every two Hours, which checks the Putridity
and abates the Fever. Should the Distemper become
violent, and very pressing, it ought to be
taken every Hour.
5, Whenever, notwithstanding the giving all
these Medicines as directed, the Fever continues
obstinate; the Brain is manifestly disordered;
there is a violent Head-ach, or very great Restlessness,
two blistering Plaisters must be
applied to the inside and fleshy Part of the Legs,
and their Suppuration and Discharge should be
continued as long as possible.
6, If the Fever is extremely violent indeed,
there is a Necessity absolutely to prohibit the Patient
from receiving the least Nourishment.
7, When it is thought improper, or unsafe, to
give the Vomit, the Patient should take in the
Morning, for two successive Days, three Doses
of the Powder , at the Interval of one
Hour between each: This Medicine produces
some bilious Stools, which greatly abate the Fever,
and considerably lessen the Violence of all the
other Symptoms of the Disease. This may be
done with Success, when the excessive Height
of the Fever prevents us from giving the Vomit:
and we should limit ourselves to this Medicine,
as often as we are uncertain, what ever the Circumstances
of the Disease and the Patient will admit
of the Vomiting; which may thus be dispensed
with, in many Cases.
8, When the Distemper has manifestly and
considerably declined; the Paroxysms are more
slight; and the Patient continues without any
Fever for several Hours, the daily use of the
purging opening Drinks should be discontinued.
The common Ptisans however should be still
made use of; and it will be proper to give every
other Day two Doses of the Powder ,
which sufficiently obviates every ill Consequence
from this Disease.
9, If the Fever has been clearly off for a long
Part of the Day; if the Tongue appears in a
good healthy State; if the Patient has been well
purged; and yet one moderate Paroxysm of the
Fever returns every Day, he should take four
Doses of the Powder between the End of
one Return and the Beginning of the next, and
continue this Repetition some Days. People who
cannot easily procure this Medicine, may substitute,
instead of it, the bitter Decoction .
four Glasses of which may be taken at equal Intervals,
between the two Paroxysms or Returns
of the Fever.
10, As the Organs of Digestion have been
considerably weakened through the Course of
this Fever, there is a Necessity for the Patient's
conducting himself very prudently and regularly
long after it, with Regard both to the Quantity
and Quality of his Food. He should also use
due Exercise as soon as his Strength will permit,
without which he may be liable to fall into
some chronical and languishing Disorder, productive
of considerable Languor and Weakness.
Chapter XVII.
Of malignant Fevers.
Sect. 242.
hose Fevers are termed malignant,
in which the Danger is more than the
Symptoms would make us apprehensive
of: they have frequently a fatal
Event without appearing so very perilous; on
which Account it has been well said of this Fever,
that it is a Dog which bites without barking.
§ 243. The distinguishing Criterion or Mark
of malignant Fevers is a total Loss of the Patient's
Strength, immediately on their first Attack. They
arise from a Corruption of the Humours, which
is noxious to the very Source and Principle of
Strength, the Impairing or Destruction of which
is the Cause of the Feebleness of the Symptoms;
by Reason none of the Organs are strong enough
to exert an Opposition sufficiently vigorous, to
subdue the Cause of the Distemper.
If, for Instance or Illustration, we were to
suppose, that when two Armies were on the Point
of engaging, one of them should be nearly deprived
of all their Weapons, the Contest would
not appear very violent, nor attended with great
Noise or Tumult, though with a horrible Massacre.
The Spectator, who, from being ignorant
of one of the Armies being disarmed, would
not be able to calculate the Carnage of the Battle,
but in Proportion to its Noise and Tumult, must
be extremely deceived in his Conception of it.
The Number of the Slain would be astonishing,
which might have been much less (though the
Noise and Clangor of it had been greater) if
each Army had been equally provided for the
Combat.
§ 244. The Causes of this Disease are a long
Use of animal Food or Flesh alone, without
Pulse, Fruits or Acids; the continued Use of
other bad Provisions, such as Bread made of damaged
Corn or Grain, or very stale Meat. Eight
Persons, who dined together on corrupt Fish,
were all seized with a malignant Fever, which
killed five of them, notwithstanding the Endeavours
of the most able Physicians. These Fevers are
also frequently the Consequence of a great Dearth
or Famine; of too hot and moist an Air, or an Air,
which highly partakes of these two Qualities; so
that they happen to spread most in hot Years, in
Places abounding with Marshes and standing
Waters. They are also the Effect of a very close
and stagnant Air, especially if many Persons are
crouded together in it, this being a Cause that
particularly tends to corrupt the Air. Tedious
Grief and Vexation also contribute to generate
these Fevers.
§ 245. The Symptoms of malignant Fevers
are, as I have already observed, a total and sudden
Loss of Strength, without any evident preceding
Cause, sufficient to produce such a Privation
of Strength: at the same Time there is also an
utter Dejection of the Mind, which becomes almost
insensible and inattentive to every Thing,
and even to the Disease itself; a sudden Alteration
in the Countenance, especially in the Eyes:
some small Shiverings, which are varied throughout
the Space of twenty-four Hours, with little
Paroxysms or Vicissitudes of Heat; sometimes
there is a great Head-ach and a Pain in the
Loins; at other Times there is no perceivable
Pain in any Part; a kind of Sinkings or Faintings,
immediately from the Invasion of the Disease,
which is always very unpromising; not the
least refreshing Sleep; frequently a kind of half
Sleep, or Drowsiness; a light and silent or inward
Raving, which discovers itself in the unusual
and astonished Look of the Patient, who
seems profoundly employed in meditating on
something, but really thinks of nothing, or not
at all: Some Patients have, however, violent
Ravings; most have a Sensation of Weight or
Oppression, and at other Times of a Binding or
Tightness about, or around, the Pit of the Stomach.
The sick Person seems to labour under great
Anguish: he has sometimes slight convulsive Motions
and Twitchings in his Face and his Hands,
as well as in his Arms and Legs. His Senses
seem torpid, or as it were benumbed. I have
seen many who had lost, to all Appearance, the
whole five, and yet some of them recover. It is
not uncommon to meet with some, who neither
see, understand, nor speak. Their Voices change,
become weak, and are sometimes quite lost.
Some of them have a fixed Pain in some Part
of the Belly: this arises from a Stuffing or Obstruction,
and often ends in a Gangrene, whence
this Symptom is highly dangerous and perplexing.
The Tongue is sometimes very little altered
from its Appearance in Health; at other Times
covered over with a yellowish brown Humour;
but it is more rarely dry in this Fever than in the
others; and yet it sometimes does resemble a
Tongue that has been long smoaked.
The Belly is sometimes very soft, and at other
Times tense and hard. The Pulse is weak, sometimes
pretty regular, but always more quick than
in a natural State, and at some Times even very
quick; and such I have always found it, when
the Belly has been distended.
The Skin is often neither hot, dry, nor moist:
it is frequently overspread with petechial or eruptive
Spots (which are little Spots of a reddish
livid Colour) especially on the Neck, about the
Shoulders, and upon the Back. At other Times
the Spots are larger and brown, like the Colour
of Wheals from the Strokes of a Stick.
The Urine of the Sick is almost constantly
crude, that is of a lighter Colour than ordinary.
I have seen some, which could not be distinguished,
merely by the Eye, from Milk. A
black and stinking Purging sometimes attends
this Fever, which is mortal, except the Sick be
evidently relieved by the Discharge.
Some of the Patients are infested with livid
Ulcers on the Inside of the Mouth, and on the
Palate. At other Times Abscesses are formed in
the Glands of the Groin, of the Arm-pit, in those
between the Ears and the Jaw; or a Gangrene
may appear in some Part, as on the Feet, the
Hands, or the Back. The Strength proves entirely
spent, the Brain is wholly confused: the
miserable Patient stretched out on his Back, frequently
expires under Convulsions, an enormous
Sweat, and an oppressed Breast and Respiration.
Hæmorrhages also happen sometimes and are
mortal, being almost unexceptionably such in
this Fever. There is also in this, as in all other
Fevers, an Aggravation of the Fever in the
Evening.
§ 246. The Duration and Crisis of these malignant,
as well as those of putrid Fevers, are
very irregular. Sometimes the Sick die on the
seventh or eighth Day, more commonly between
the twelfth and the fifteenth, and not infrequently
at the End of five or six Weeks. These different
Durations result from the different Degree and
Strength of the Disease. Some of these Fevers
at their first Invasion are very slow; and during a
few of the first Days, the Patient, though very
weak, and with a very different Look and Manner,
scarcely thinks himself sick.
The Term or Period of the Cure or the Recovery,
is as uncertain as that of Death in this Distemper.
Some are out of Danger at the End of
fifteen Days, and even sooner; others not before
the Expiration of several Weeks.
The Signs which portend a Recovery are, a
little more Strength in the Pulse; a more concocted
Urine; less Dejection and Discouragement;
a less confused Brain; an equal kindly
Heat; a pretty warm or hot Sweat in a moderate
Quantity, without Inquietude or Anguish;
the Revival of the different Senses that were
extinguished, or greatly suspended in the Progress
of the Disease; though the Deafness is not a very
threatening Symptom, if the others amend while
it endures.
This Malady commonly leaves the Patient in
a very weak Condition; and a long Interval will
ensue between the End of it, and their recovering
their full Strength.
§ 247. It is, in the first place, of greater Importance
in this Distemper than in any other, both
for the Benefit of the Patients, and those who attend
them, that the Air should be renewed and
purified. Vinegar should often be evaporated
from a hot Tile or Iron in the Chamber, and
one Window kept almost constantly open.
2, The Diet should be light; and the Juice of
Sorrel may be mixed with their Water; the Juice
of Lemons may be added to Soups prepared from
different Grains and Pulse; the Patient may eat
sharp acid Fruits, such as tart juicy Cherries,
Gooseberries, small black Cherries; and those
who can afford them, may be allowed Lemons,
Oranges and Pomgranates.
3, The Patient's Linen should be changed
every two Days.
4, Bleeding is very rarely necessary, or even
proper, in this Fever; the Exceptions to which
are very few, and cannot be thoroughly ascertained,
as fit and proper Exceptions to the Omission
of Bleeding, without a Physician, or some
other very skilful Person's seeing the Patient.
5, There is often very little Occasion for Glysters,
which are sometimes dangerous in this Fever.
6, The Patient's common Drink should be
Barley Water made acid with the Spirit ,
at the Rate of one Quarter of an Ounce to at least
full three Pints of the Water, or acidulated agreeably
to his Taste. He may also drink Lemonade.
7, It is necessary to open and evacuate the Bowels,
where a great Quantity of corrupt Humours
is generally lodged. The Powder
may be given for this Purpose, after the Operation
of which the Patient generally finds himself
better, at least for some Hours. It is of Importance
not to omit this at the Beginning of the
Disease; though if it has been omitted at first, it
were best to give it even later, provided no particular
Inflammation has supervened, and the
Patient has still some Strength. I have given it,
and with remarkable Success, on the twentieth
Day.
8, Having by this Medicine expelled a considerable
Portion of the bad Humours, which
contribute to feed and keep up the Fever, the
Patient should take every other Day, during the
Continuance of the Disease, and sometimes
even every Day, one Dose of the Cream of
Tartar and Rhubarb . This Remedy
evacuates the corrupt Humours, prevents the
Corruption of the others; expells the Worms
that are very common in these Fevers, which
the Patient sometimes discharges upwards and
downwards; and which frequently conduce to
many of the odd and extraordinary Symptoms,
that are observed in malignant Fevers. In short
it strengthens the Bowels, and, without checking
the necessary Evacuations, it moderates the Looseness,
when it is hurtful.
9, If the Skin be dry, with a Looseness, and
that by checking it, we design to increase Perspiration,
instead of the Rhubarb, the Cream of
Tartar may be blended with the Ipecacuana,
, which, being given in small and frequent
Doses, restrains the Purging, and promotes Perspiration.
This Medicine, as the former, is to
be taken in the Morning; two Hours after, the
Sick must begin with the Potion , and repeat
it regularly every three Hours; until it be
interrupted by giving one of the Medicines
or : After which the Potion is to be repeated
again, as already directed, till the Patient grows
considerably better.
10, If the Strength of the Sick be very considerably
depressed, and he is in great Dejection
and Anguish, he should take, with every Draught
of the Potion, the Bolus, or Morsel . If
the Diarrhœa, the Purging is violent, there should
be added, once or twice a Day to the Bolus, the
Weight of twenty Grains, or the Size of a very
small Bean, of Diascordium; or if that is not
readily to be got, as much Venice Treacle.
11, Whenever, notwithstanding all this Assistance,
the Patient continues in a State of Weakness
and Insensibility, two large Blisters should
be applied to the fleshy Insides of the Legs, or a
large one to the Nape of the Neck: and sometimes,
if there be a great Drowsiness, with a
manifest Embarrassment of the Brain, they may
be applied with great Success over the whole
Head. Their Suppuration and Discharge is to
be promoted abundantly; and, if they dry up
within a few Days, others are to be applied, and
their Evacuation is to be kept up for a considerable
Time.
12, As soon as the Distemper is sufficiently
abated, for the Patient to remain some Hours
with very little or no Fever, we must avail ourselves
of this Interval, to give him six, or at least
five Doses of the Medicine , and repeat
the same the next Day, which may prevent the
Return of the Fever: after which it may be
sufficient to give daily only two Doses for a few
Days.
13, When the Sick continue entirely clear of
a Fever, or any Return, they are to be put into
the Regimen of Persons in a State of Recovery.
But if his Strength returns very slowly, or not at
all; in Order to the speedier Establishment and
Confirmation of it, he may take three Doses a
Day of the Theriaca Pauperum, or poor Man's
Treacle , the first of them fasting, and
the other twelve Hours after. It were to be
wished indeed, this Medicine was introduced into
all the Apothecaries Shops, as an excellent Stomachic,
in which Respect it is much preferable
to Venice Treacle, which is an absurd Composition,
dear and often dangerous. It is true it
does not dispose the Patients to Sleep; but when
we would procure them Sleep, there are better
Medicines than the Treacle to answer that
Purpose. Such as may not think the Expence
of the Medicine , too much, may take
three Doses of it daily for some Weeks, instead
of the Medicine , already directed.
§ 248. It is necessary to eradicate a Prejudice
that prevails among Country People, with
Regard to the Treatment of these Fevers; not only
because it is false and ridiculous, but even dangerous
too. They imagine that the Application
of Animals can draw out the Poison of the Disease;
in Consequence of which they apply Poultry,
or Pigeons, Cats or sucking Pigs to the Feet,
or upon the Head of the Patient, having first
split the living Animals open. Some Hours after
they remove their strange Applications, corrupted,
and stinking very offensively; and then
ascribe such Corruption and horrid Stink to the
Poison they suppose their Application to be charged
with; and which they suppose to be the Cause
of this Fever. But in this supposed Extraction
of Poison, they are grosly mistaken, since the
Flesh does not stink in Consequence of any such
Extraction, but from its being corrupted through
Moisture and Heat: and they contract no other
Smell but what they would have got, if they had
been put in any other Place, as well as on the Patient's
Body, that was equally hot and moist.
Very far from drawing out the Poison, they augment
the Corruption of the Disease; and it would
be sufficient to communicate it to a sound Person,
if he was to suffer many of these animal Bodies,
thus absurdly and uselessly butchered, to be applied
to various Parts of his Body in Bed; and to
lie still a long Time with their putrified Carcases
fastened about him, and corrupting whatever Air
he breathed there.
With the same Intention they fasten a living
Sheep to the Bed's-foot for several Hours; which,
though not equally dangerous, is in some Measure
hurtful, since the more Animals there are in a Chamber,
the Air of it is proportionably corrupted, or
altered at least from its natural Simplicity, by their
Respiration and Exhalations: but admitting this
to be less pernicious, it is equally absurd. It is
certain indeed, the Animals who are kept very
near the sick Person breathe in the poisonous, or
noxious Vapours which exhale from his Body,
and may be incommoded with them, as well as
his Attendants: But it is ridiculous to suppose
their being kept near the Sick causes such Poison
to come out of their Bodies. On the very contrary,
in contributing still further to the Corruption
of the Air, they increase the Disease. They
draw a false Consequence, and no Wonder, from
a false Principle; saying, if the Sheep dies, the
Sick will recover. Now, most frequently the
Sheep does not die; notwithstanding which the
Sick sometimes recover; and sometimes they
both die.
§ 249. The Cause of Malignant Fevers is, not
infrequently, combined with other Diseases, whose
Danger it extremely increases. It is blended for
Instance, with the Poison of the Small-Pocks,
or of the Measles. This may be known by the
Union of those Symptoms, which carry the Marks
of Malignity, with the Symptoms of the other
Diseases. Such combined Cases are extremely
dangerous; they demand the utmost Attention of
the Physician; nor is it possible to prescribe their
exact Treatment here; since it consists in general
of a Mixture of the Treatment of each Disease;
though the Malignity commonly demands the
greatest Attention.
Chapter XVIII.
Of intermitting Fevers.
Sect. 250.
ntermitting Fevers, commonly called
here, Fevers and Agues, are those,
which after an Invasion and Continuance
for some Hours, abate very perceivably,
as well as all the Symptoms attending
them, and then entirely cease; nevertheless, not
without some periodical or stated Return of
them.
They were very frequent with us some Years
since; and indeed might even be called epidemical:
but for the five or six last Years, they have
been much less frequent throughout the greater
Part of Swisserland: notwithstanding they still
continue in no small Number in all Places, where
the Inhabitants breathe the Air that prevails in all
the marshy Borders of the Rhone, and in some
other Situations that are exposed to much the
same humid Air and Exhalations.
§ 251. There are several Kinds of intermitting
Fevers, which take their different Names
from the Interval or different Space of Time, in
which the Fits return.
If the Paroxysm or Fit returns every Day, it
is either a true Quotidian, or a double Tertian
Fever: The first of these may be distinguished
from the last by this Circumstance, that in the
Quotidian, or one Day Fever, the Fits are long;
and correspond pretty regularly to each other in
Degree and Duration. This however is less frequent
in Swisserland. In the double Tertian,
the Fits are shorter, and one is alternately light,
and the other more severe.
In the simple Tertian, or third Day's Fever,
the Fits return every other Day; so that three
Days include one Paroxysm, and the Return of
another.
In a Quartan, the Fit returns every fourth
Day, including the Day of the first and that of
the second Attack: so that the Patient enjoys
two clear Days between the two sick ones.
The other kinds of Intermittents are much
rarer. I have seen however one true Quintan,
or fifth Day Ague, the Patient having three clear
Days between two Fits; and one regularly weekly
Ague, as it may be called, the Visitation of
every Return happening every Sunday.
§ 252. The first Attack of an intermittent
Fever often happens, when the Patient thought
himself in perfect Health. Sometimes however
it is preceded by a Sensation of Cold and a kind
of Numbness, which continue some Days before
the manifest Invasion of the Fit. It begins with
frequent Yawnings, a Lassitude, or Sensation of
Weariness, with a general Weakness, with Coldness,
Shivering and Shaking: There is also a
Paleness of the extreme Parts of the Body, attended
with Loathings, and sometimes an actual
Vomiting. The Pulse is quick, weak, and small,
and there is a considerable Degree of Thirst.
At the End of an Hour or two, and but seldom
so long as three or four Hours, a Heat succeeds,
which increases insensibly, and becomes
violent at its Height. At this Period the whole
Body grows red, the Anxiety of the Patient
abates; the Pulse is very strong and large, and
his Thirst proves excessive. He complains of a
violent Head-ach, and of a Pain in all his Limbs,
but of a different sort of Pain from that he was
sensible of, while his Coldness continued. Finally,
having endured this hot State, four, five
or six Hours, he falls into a general Sweat for a
few more: upon which all the Symptoms already
mentioned abate, and sometimes Sleep supervenes.
At the Conclusion of this Nap the Patient often
wakes without any sensible Fever; complaining
only of Lassitude and Weakness. Sometimes
his Pulse returns entirely to its natural State between
the two Fits; though it often continues
a little quicker than in perfect Health; and does
not recover its first Distinctness and Slowness, till
some Days after the last Fit.
One Symptom, which most particularly characterises
these several Species of intermitting
Fevers, is the Quality of the Urines which the
Sick pass after the Fit. They are of a reddish
Colour, and let fall a Sediment, or Settling,
which exactly resembles Brick-dust. They are
sometimes frothy too, and a Pellicle, or thin filmy
Skin, appears on the Top, and adheres to the
Sides of the Glass that contains them.
§ 253. The Duration of each Fit is of no
fixed Time or Extent, being various according
to the particular sort of Intermittents, and through
many other Circumstances. Sometimes they return
precisely at the very same Hour; at other Times
they come one, two, or three Hours sooner, and
in other Instances as much later than the former.
It has been imagined that those Fevers,
whose Paroxysms returned sooner than usual,
were sooner finally terminated: but there seems
to be no general Rule in this Case.
§ 254. Intermitting Fevers are distinguished
into those of Spring and Autumn. The former
generally prevail from February to June: the
latter are those which reign from July to January.
Their essential Nature and Characters are the
very same, as they are not different Distempers;
though the various Circumstances attending them
deserve our Consideration. These Circumstances
depend on the Season itself, and the Constitution
of the Patients, during such Seasons. The
Spring Intermittents are sometimes blended with
an inflammatory Disposition, as that is the Disposition
of Bodies in that Season; but as the Weather
then advances daily into an improving State,
the Spring Fevers are commonly of a shorter Duration.
The autumnal Fevers are frequently
combined and aggravated with a Principle of Putrefaction;
and as the Air of that Season rather
degenerates, they are more tedious and obstinate.
§ 255. The autumnal Fevers seldom begin
quite so early as July, but much oftner in August:
and the Duration to which they are often
extended, has increased the Terror which the
People entertain of Fevers that begin in that
Month. But that Prejudice which ascribes their
Danger to the Influence of August, is a very
absurd Error; since it is better they should set in
then than in the following Months; because
they are obstinate in Proportion to the Tardiness,
the Slowness of their Approach. They sometimes
appear at first considerably in the Form of
putrid Fevers, not assuming that of Intermittents
till some Days after their Appearance: but very
happily there is little or no Danger in mistaking
them for putrid Fevers, or in treating them like
such. The Brick-coloured Sediment, and particularly
the Pellicle or Film on the Surface of the
Urine, are very common in autumnal Intermittents,
and are often wanting in the Urine of putrid
Fevers. In these latter, it is generally less
high coloured, and leaning rather to a yellow, a
kind of Cloudiness is suspended in the Middle of
it. These also deposite a white Sediment, which
affords no bad Prognostic.
§ 256. Generally speaking, intermitting Fevers
are not mortal; often terminating in Health
of their own Accord (without the Use of any
Medicine) after some Fits. In this last Respect
Intermittents in the Spring differ considerably
from those in the Fall, which continue a long
Time, and sometimes even until Spring, if they
are not removed by Art, or if they have been
improperly treated.
Quartan Fevers are always more obstinate and
inveterate than Tertians; the former sometimes
persevering in certain Constitutions for whole
Years. When these Sorts of Fevers occur in
boggy marshy Countries, they are not only very
chronical or tedious, but Persons infested with
them are liable to frequent Relapses.
§ 257. A few Fits of an Intermittent are not
very injurious, and it happens sometimes, that
they are attended with a favourable Alteration of
the Habit in Point of Health; by their exterminating
the Cause or Principle of some languid and
tedious Disorder; though it is erroneous to consider
them as salutary. If they prove tedious
and obstinate, and the Fits are long and violent,
they weaken the whole Body, impairing all its
Functions, and particularly the Digestions: They
make the Humours sharp and unbalmy, and introduce
several other Maladies, such as the Jaundice,
Dropsy, Asthma and slow wasting Fevers.
Nay sometimes old Persons, and those who are
very weak, expire in the Fit; though such an
Event never happens but in the cold Fit.
§ 258. Very happily Nature has afforded us
a Medicine, that infallibly cures these Fevers:
this is the Kinkina, or Jesuits Bark; and as
we are possessed of this certain Remedy, the only
remaining Difficulty is to discover, if there be
not some other Disease combined with these
Fevers, which Disease might be aggravated by
the Bark. Should any such exist, it must be removed
by Medicines adapted to it, before the
Bark is given.
§ 259. In the vernal, or Spring-Fevers, if
the Fits are not very severe; if the Patient is evidently
well in their Intervals; if his Appetite, his
Strength, and his Sleep continue as in Health,
no Medicine should be given, nor any other Method
be taken, but that of putting the Person, under
such a gentle Intermittent, upon the Regimen
directed for Persons in a State of Recovery. This
is such a Regimen as pretty generally agrees with
all the Subjects of these Fevers: for if they
should be reduced to the Regimen proper in acute
Diseases, they would be weakened to no Purpose,
and perhaps be the worse for it. But at the same
Time if we were not to retrench from the Quantity,
nor somewhat to vary the Quality of their
usual Food in a State of Health; as there is not
the least Digestion made in the Stomach, during
the whole Term of the Fit; and as the Stomach
is always weakened a little by the Disease, crude
and indigested Humours would be produced,
which might afford a Fuel to the Disease. Not
the least solid Food should be allowed, for at
least two Hours before the usual Approach of the
Fit.
§ 260. If the Fever extends beyond the sixth,
or the seventh Fit; and the Patient seems to
have no Occasion for a Purge; which may be learned
by attending to the Chapter, which treats of
Remedies to be taken by Way of Precaution;
he may take the Bark, that is the Powder .
If it is a Quotidian, a daily Fever, or a
double Tertian, six Doses, containing three Quarters
of an Ounce, should be taken between the
two Fits; and as these Intermissions commonly
consist of but ten or twelve, or at the most of
fourteen or fifteen Hours, there should be an Interval
of only one Hour and a half between each
Dose. During this Interval the Sick may take
two of his usual Refreshments or Suppings.
When the Fever is a Tertian, an Ounce should
be given between the two Fits: which makes
eight Doses, one of which is to be taken every
three Hours.
In a Quartan I direct one Ounce and a half,
to be taken in the same Manner. It is meer
trifling to attempt preventing the Returns with
smaller Doses. The frequent Failures of the
Bark are owing to over small Doses. On such
Occasions the Medicine is cried down, and censured
as useless, when the Disappointment is
solely the Fault of those who do not employ it
properly. The last Dose is to be given two
Hours before the usual Return of the Fit.
The Doses, just mentioned, frequently prevent
the Return of the Fit; but whether it returns
or not, after the Time of its usual Duration
is past, repeat the same Quantity, in the
same Number of Doses, and Intervals, which
certainly keeps off another. For six Days following,
half the same Quantity must be continued,
in the Intervals that would have occurred between
the Fits, if they had returned: and during all
this Time the Patient should inure himself to as
much Exercise, as he can well bear.
§ 261. Should the Fits be very strong, the
Pain of the Head violent, the Visage red, the
Pulse full and hard; if there is any Cough; if,
even after the Fit is over, the Pulse still is perceivably
hard; if the Urine is inflamed, hot and
high-coloured, and the Tongue very dry, the
Patient must be bled, and drink plentifully of
Barley Water . These two Remedies generally
bring the Patient into the State described
: in which State he may take on a Day,
when the Fever is entirely off, three or four
Doses of the Powder , and then leave the
Fever to pursue its own Course for the Space of a
few Fits. But should it not then terminate of
itself, the Bark must be recurred to.
If the Patient, even in the Interval of the
Returns, has a fœtid, furred Mouth, a Loathing,
Pains in the Loins, or in the Knees, much
Anxiety, and bad Nights, he should be purged
with the Powder or the Potion , before
he takes the Bark.
§ 262. If Fevers in Autumn appear to be of
the continual kind, and very like putrid Fevers,
the Patients should drink abundantly of Barley
Water; and if at the Expiration of two or three
Days, there still appears to be a Load or Oppression
at the Stomach, the Powder or that of
is to be given (but see ): and if, after the
Operation of this, the Signs of Putridity continue,
the Body is to be opened with repeated Doses of
the Powder ; or, where the Patients are
very robust, with ; and when the Fever
becomes quite regular, with distinct Remissions at
least, the Bark is to be given as directed .
But as autumnal Fevers are more obstinate;
after having discontinued the Bark for eight Days;
and notwithstanding there has been no Return
of the Fever, it is proper to resume the Bark, and
to give three Doses of it daily for the succeeding
eight Days, more especially if it was a Quartan;
in which Species I have ordered it to be repeated,
every other eight Days, for six Times.
Many People may find it difficult to comply
with this Method of Cure, which is unavoidably
expensive, through the Price of the Bark. I
thought however this ought not to prevent me
from averring it to be the only certain one; since
nothing can be an equivalent Succedaneum or Substitute
to this Remedy, which is the only sure
and safe one in all these Cases. The World had
long been prepossessed with Prejudices to the contrary:
it was supposed to be hurtful to the Stomach;
to prevent which it has been usual to
make the Sick eat something an Hour after it.
Nevertheless, very far from injuring the Stomach,
it is the best Medicine in the Universe to strengthen
it; and it is a pernicious Custom, when a Patient
is obliged to take it often, to eat an Hour after it.
It had also been imagined to cause Obstructions,
and that it subjected Patients to a Dropsy: but at
present we are convinced, it is the obstinate and
inveterate Duration of the Intermittent, that
causes Obstructions, and paves the Way to a Dropsy.
The Bark, in Consequence of its speedily
curing the Fever, does not only prevent the former
Disease; but when it continues, through an
injudicious Omission of the Bark, a proper Use of
it is serviceable in the Dropsy. In a Word, if
there is any other Malady combined with the
Fever, sometimes that indeed prevents the Success
of the Bark, yet without rendering it hurtful.
But whenever the intermitting Fever is
simple and uncombined, it ever has, and ever
will render the Patient all possible Service. In
another Place I shall mention such Means and
Methods as may in some Degree, though but
imperfectly, be substituted instead of it.
After the Patient has begun with the Bark, he
must take no purging Medicine, as that Evacuation
would, with the greatest Probability, occasion
a Return of the Fever.
§ 263. Bleeding is never, or extremely seldom
indeed necessary in a Quartan Ague, which occurs
in the Fall oftner than in the Spring; and
with the Symptoms of Putridity rather than of
Inflammation.
§ 264. The Patient ought, two Hours before
the Invasion of the Fit, to drink a small Glass of
warm Elder Flower Tea, sweetened with Honey,
every Quarter of an Hour, and to walk about moderately;
this disposes him to a very gentle Sweat,
and thence renders the ensuing Coldness and the
whole Fit milder. He is to continue the same
Drink throughout the Duration of the cold Fit;
and when the hot one approaches, he may either
continue the same, or substitute that of ,
which is more cooling. It is not necessary however,
in this State, to drink it warm, it is sufficient
that it be not over cold. When the Sweat,
at the Termination of the hot Fit, is concluded,
the Patient should be well wiped and dried, and
may get up. If the Fit was very long, he may
be allowed a little Gruel, or some other such
Nourishment during the Sweat.
§ 265. Sometimes the first, and a few successive
Doses of the Bark purge the Patient. This
is no otherwise an ill Consequence, than by its
retarding the Cure; since, when it purges, it
does not commonly prevent the Return of the
Fever; so that these Doses may be considered as
to no Purpose, and others should be repeated,
which, ceasing to purge, do prevent it. Should
the Looseness notwithstanding continue, the Bark
must be discontinued for one entire Day, in order
to give the Patient half a Quarter of an Ounce of
Rhubarb: after which the Bark is to be resumed
again, and if the Looseness still perseveres, fifteen
Grains of Venice Treacle should be added to each
Dose, but not otherwise. All other Medicines
which are superadded, very generally serve only
to increase the Bulk of the Dose, while they lessen
its Virtue.
§ 266. Before our thorough Experience of
the Bark, other bitter Medicines were used for the
same Purpose: these indeed were not destitute of
Virtue in such Cases, though they were considerably
less available than the Bark. Under
, some valuable Prescriptions of that kind
may be seen, whose Efficacy I have often experienced:
though at other Times I have been
obliged to leave them off, and recur to the Bark
more successfully. Filings of Iron, which enter
into the third Prescription, are an excellent Febrifuge
in particular Cases and Circumstances.
In the Middle of the Winter 1753, I cured a
Patient of a Quartan Ague with it, who would
not be prevailed on to take the Bark. It must be
confessed he was perfectly regular in observing
the Regimen directed for him; and that, during
the most rigid Severity of the Winter, he got
every Day on Horseback, and took such a
Degree of other Exercise in the open Air, as disposed
him to perspire abundantly.
§ 267. Another very practicable easy Method,
of which I have often availed my Patients, under
tertian Fevers (but which succeeded with me
only twice in Quartans) was to procure the Sufferer
a very plentiful Sweat, at the very Time
when the Fit was to return, in its usual Course.
To effect this he is to drink, three or four Hours
before it is expected, an Infusion of Elder Flowers
sweetened with Honey, which I have already
recommended ; and one Hour before the
usual Invasion of the Shivering, he is to go into
Bed, and take, as hot as he can drink it, the
Prescription .
I have also cured some Tertians and even
Quartans, in 1751 and 1752, by giving them,
every four Hours between the Fits, the Powder
. But I must acknowledge that, besides
its having often failed me, and its never succeeding
so speedily as the Bark, I have found it weaken
some Patients; it disorders, or disagrees with,
their Stomachs: and in two Cases, where it had
removed the Fever, I was obliged to call in the
Bark for a thorough Establishment of the Patient's
Health. Nevertheless, as these Medicines
are very cheap and attainable, and often do succeed,
I thought I could not properly omit them.
§ 268. A Multitude of other Remedies are
cried up for the Cure of Fevers: though none
of them are equally efficacious with those I have
directed: and as many of them are even
dangerous, it is prudent to abstain from them. Some
Years since certain Powders were sold here, under
the Name of the Berlin Powders; these are
nothing but the Bark masqued or disguised (which
has sometimes been publickly discovered) and
have always been sold very dear: though the
Bark well chosen, and freshly powdered when
wanted, is greatly preferable.
§ 269. I have often known Peasants, who had
laboured for several Months under intermitting
Fevers; having made Use of many bad Medicines
and Mixtures for them, and observed no Manner
of Regimen. Such I have happily treated
by giving them the Remedies , or ;
and afterwards, for some Days, that of ;
at the End of which Time, I have ordered them
the Bark (See ) or other Febrifuges, as at
, ; and then finally ordered them
for some Days, to take Morsels of the poor Man's
Treacle (See ) to strengthen and
confirm their Digestions, which I have found very
weak and irregular.
§ 270. Some Intermittents are distinguished as
pernicious or malignant, from every Fit's being
attended with the most violent Symptoms. The
Pulse is small and irregular, the Patient exceedingly
dejected, and frequently swooning; afflicted
with inexpressible Anguish, Convulsions, a
deep Drowsiness, and continual Efforts to go to
Stool, or make Urine, but ineffectually. This
Disease is highly pressing and dangerous; the Patient
may die in the third Fit, and rarely survives
the sixth, if he is not very judiciously treated.
Not a Moment should be lost, and there is no
other Step to be taken, but that of giving the
Bark continually, as directed , to prevent
the succeeding Fits. These worst Kinds of Intermittents
are often combined with a great Load
of putrid Humours in the first Passages: and as
often as such an aggravating Combination is very
evident, we should immediately after the End of
one Fit, give a Dose of Ipecacuana , and,
when its Operation is finished, give the Bark.
But I chuse to enter into very few Details on this
Species of Intermittents, both as they occur but
seldom, and as the Treatment of them is too difficult
and important, to be submitted to the Conduct
of any one but a Physician. My Intention has
only been to represent them sufficiently, that they
may be so distinguished when they do occur, as
to apprize the People of their great Danger.
§ 271. The same Cause which produces these
intermitting Fevers, frequently also occasions Disorders,
which return periodically at the same
Hour, without Shivering, without Heat, and often
without any Quickness of the Pulse. Such
Disorders generally preserve the Intermissons of
quotidian or tertian Fevers, but much seldomer
those of Quartans. I have seen violent Vomittings,
and Reachings to vomit, with inexpressible
Anxiety; the severest Oppressions, the most racking
Cholics; dreadful Palpitations and excessive
Tooth-achs: Pains in the Head, and very often
an unaccountable Pain over one Eye, the Eyelid,
Eyebrow and Temple, on the same Side of the
Face; with a Redness of that Eye, and a continual,
involuntary trickling of Tears. I have also
seen such a prodigious Swelling of the affected
Part, that the Eye projected, or stood out, above
an Inch from the Head, covered by the Eyelid,
which was also extremely inflated or puffed up.
All these Maladies begin precisely at a certain
Hour; last about the usual Time of a Fit; and
terminating without any sensible Evacuation, return
exactly at the same Hour, the next Day, or
the next but one.
There is but one known Medicine that can effectually
oppose this Sort, which is the Bark, given
as directed . Nothing affords Relief in the
Fit, and no other Medicine ever suspends or puts
it off. But I have cured some of these Disorders
with the Bark, and especially those affecting the
Eyes, which happen oftner than the other Symptoms,
after their Duration for many Weeks, and
after the ineffectual Use of Bleeding, Purging,
Baths, Waters, Blisters, and a great Number of
other Medicines. If a sufficient Dose of it be given,
the next Fit is very mild; the second is
prevented; and I never saw a Relapse in these
Cases, which sometimes happens after the Fits of
common Intermittents seemed cured.
§ 272. In Situations where the Constitution of
the Air renders these Fevers very common, the
Inhabitants should frequently burn in their Rooms,
at least in their lodging Rooms, some aromatic
Wood or Herbs. They should daily chew some
Juniper Berries, and drink a fermented Infusion
of them. These two Remedies are very effectual
to fortify the weakest Stomachs, to prevent
Obstructions, and to promote Perspiration. And
as these are the Causes which prolong these Fevers
the most obstinately; nothing is a more certain
Preservation from them than these cheap and
obvious Assistances.
Chapter XIX.
Of the Erisipelas, and the Bites of Animals.
Sect. 273.
he Erisipelas, commonly called in
English, St. Anthony's Fire, and in
Swisserland the Violet, is sometimes but
a very slight Indisposition which appears
on the Skin, without the Person's being sensible
of any other Disorder; and it most commonly
breaks out either in the Face, or on the
Legs. The Skin becomes tense, or stiff, rough
and red; but this Redness disappears on pressing
the Spot with a Finger, and returns on removing
it. The Patient feels in the Part affected a burning
Heat, which makes him uneasy, and sometimes
hinders him from sleeping. The Disorder
increases for the Space of two or three Days;
continues at its Height one or two, and then
abates. Soon after this, that Part of the Skin
that was affected, falls off in pretty large Scales,
and the Disorder entirely terminates.
§ 274. But sometimes this Malady is considerably
more severe, beginning with a violent
Shivering, which is succeeded by a burning Heat,
a vehement Head-ach, a Sickness at Heart, as it is
commonly termed, or Reachings to vomit, which
continue till the Erisipelas appears, which sometimes
does not happen before the second, or even
the third Day. The Fever then abates, and the
Sickness goes off, though frequently a less Degree
of Fever, and of Sickness or Loathing remain,
during the whole Time, in which the
Disease is in its increasing State. When the
Eruption and Inflammation happen in the Face,
the Head-ach continues, until the Decline, or
going off, of the Disease. The Eyelid swells,
the Eye is closed, and the Patient has not the
least Ease or Tranquillity. It often passes from
one Cheek to the other, and extends successively
over the Forehead, the Neck, and the Nape of
the Neck; under which Circumstance the Disease
is of a more than ordinary Duration. Sometimes
also when it exists in a very high Degree,
the Fever continues, the Brain is obstructed and
oppressed; the Patient raves; his Case becomes
extremely dangerous; whence sometimes, if he is
not very judiciously assisted, he dies, especially if
of an advanced Age. A violent Erisipelas on the
Neck brings on a Quinsey, which may prove very
grievous, or even fatal.
When it attacks the Leg, the whole Leg
swells up; and the Heat and Irritation from it is
extended up to the Thigh.
Whenever this Tumour is considerable, the
Part it seizes is covered with small Pustules filled
with a clear watery Humour, resembling those
which appear after a Burn, and drying afterwards
and scaling off. I have sometimes observed,
especially when this Distemper affected
the Face, that the Humour, which issued from
these little Pustules, was extremely thick or
glewy, and formed a thick Scurf, or Scabs nearly
resembling those of sucking Children: they have
continued fast on the Face many Days before they
fell off.
When the Disease may be termed violent, it
sometimes continues eight, ten, twelve Days at
the same Height; and is at last terminated by a
very plentiful Sweat, that may sometimes be predicted
by a Restlessness attended with Shiverings,
and a little Anxiety of some Hours Duration.
Throughout the Progress of the Disease, the
whole Skin is very dry, and even the Inside of
the Mouth.
§ 275. An Erisipelas rarely comes to Suppuration,
and when it does, the Suppuration is always
unkindly, and much disposed to degenerate
into an Ulcer. Sometimes a malignant kind
of Erisipelas is epidemical, seizing a great Number
of Persons, and frequently terminating in
Gangrenes.
§ 276. This Distemper often shifts its Situation;
it sometimes retires suddenly; but the Patient
is uneasy and disordered; he has a Propensity
to vomit, with a sensible Anxiety and Heat:
the Erisipelas appears again in a different Part,
and he feels himself quite relieved from the preceding
Symptoms. But if instead of re-appearing
on some other Part of the Surface, the Humour
is thrown upon the Brain, or the Breast,
he dies within a few Hours; and these fatal
Changes and Translations sometimes occur, without
the least Reason or Colour for ascribing them
either to any Error of the Patient, or of his
Physician.
If the Humour has been transferred to the
Brain, the Patient immediately becomes delirious,
with a highly flushed Visage, and very quick
sparkling Eyes: very soon after he proves downright
frantic, and goes off in a Lethargy.
If the Lungs are attacked, the Oppression,
Anxiety, and Heat are inexpressible.
§ 277. There are some Constitutions subject
to a very frequent, and, as it were, to an habitual
Erisipelas. If it often affects the Face, it
is generally repeated on the same Side of it, and
that Eye is, at length, considerably weakened
by it.
§ 278. This Distemper results from two
Causes; the one, an acrid sharp Humour, which
is commonly bilious, diffused through the Mass
of Blood; the other consists in that Humour's
not being sufficiently discharged by Perspiration.
§ 279. When this Disease is of a gentle Nature,
such as it is described , it will be sufficient
to keep up a very free Perspiration, but
without heating the Patient; and the best Method
to answer this Purpose is putting him upon
the Regimen so often already referred to, with a
plentiful Use of Nitre in Elder Tea. Flesh,
Eggs and Wine are prohibited of Course, allowing
the Patient a little Pulse and ripe Fruits. He
should drink Elder Flower Tea abundantly, and
take half a Drachm of Nitre every three Hours;
or, which amounts to the same Thing, let three
Drachms of Nitre be dissolved in as much Infusion
of Elder Flowers, as he can drink in twenty-four
Hours. Nitre may be given too in a Bolus with
Conserve of Elder-berries. These Medicines keep
the Body open, and increase Urine and Perspiration.
§ 280. When the Distemper prevails in a severer
Degree, if the Fever is very high, and the
Pulse, at the same Time, strong or hard, it may
be necessary to bleed once: but this should never
be permitted in a large Quantity at a Time in this
Disease; it being more adviseable, if a sufficient
Quantity has not been taken at once, to bleed a
second Time, and even a third, if the Fever should
prove very high, as it often does, and that sometimes
in so violent a Degree, as to render it extremely
dangerous: and in some such Cases Nature
has sometimes saved the Patients by effecting
a large Hemorrhage, or Bleeding, to the Quantity
of four or five Pounds. This Conduct a
very intelligent and prudent Physician may presume
to imitate; but I dare not advise the same
Conduct to that Class of Physicians, for which
only I write: it being safer for them to use repeated
Bleedings in such Cases, than one in an
excessive Quantity. These erisipelatous Fevers
are often excited by a Person's being too long
over-heated.
After Bleeding the Patient is to be restrained to
his Regimen; Glysters are to be given until there
is a sensible Abatement of the Fever; and he
should drink the Barley Water freely, .
When the Fever is somewhat diminished, either
the Purge should be given, or a few
Doses every Morning of Cream of Tartar .
Purging is absolutely necessary to carry off the
stagnant Bile, which is generally the first Cause
of the violent Degrees of this Distemper. It may
sometimes be really necessary too, if the Disease is
very tedious; if the Loathing and Sickness at Stomach
is obstinate; the Mouth ill-favoured, and
the Tongue foul, (provided there be only a slight
Fever, and no Fear of an Inflammation) to give
the Medicines or , which, in Consequence
of the Agitation, the Shaking they occasion,
remove these Impediments still better than
Purges.
It commonly happens that this Disease is more
favourable after these Evacuations; nevertheless
it is sometimes necessary to repeat them the next
Day, or the next but one; especially if the Malady
affects the Head. Purging is the true Evacuation
for curing it, whenever it attacks this
Part. By carrying off the Cause of the Disease,
they diminish it, and prevent its worst Effects.
Whenever, even after these Evacuations, the
Fever still continues to be very severe, the Patient
should take every two Hours, or occasionally,
oftner, two Spoonfuls of the Prescription
, added to a Glass of Ptisan.
It will be very useful, when this Disease is
seated in the Head or Face, to bathe the Legs
frequently in warm Water; and where it is violent
there, also to apply Sinapisms to the Soles
of the Feet. I have seen this Application, in
about four Hours attract, or draw down an Erisipelas
to the Legs, which had spread over the Nose,
and both the Eyes. When the Distemper once
begins to go off by Sweating, this should be promoted
by Elder-flower Tea and Nitre (See ) and the Sweating may be encouraged to
Advantage for some Hours.
§ 281. The best Applications that can be made
to the affected Part are 1st, The Herb Robert, a
Kind of Geranium, or Crane's-Bill; or Chervil,
or Parsley, or Elder Flowers: and if the Complaint
be of a very mild Disposition, it may be
sufficient to apply a very soft smooth Linen over
it, which some People dust over with a little dry
Meal.
2, If there is a very considerable Inflammation,
and the Patient is so circumstanced as to be very
tractable and regularly attended, Flanels wrung
out of a strong Decoction of Elder-flowers and
applied warm, afford him the speediest Ease and
Relief. By this simple Application I have appeased
the most violent Pains of a St. Anthony's
Fire, which is the most cruel Species of an Erisipelas,
and has some peculiar Marks or Symptoms
extraordinary.
3, The Plaister of Smalt, and Smalt itself
, are also very successfully employed in
this Disease. This Powder, the farinaceous, or
mealy ones, or others cried up for it, agree best
when a thin watery Humour distills or weeps
from the little Vesications attending it, which it
is convenient to absorb by such Applications; without
which Precaution it might gall, or even ulcerate
the Part.
All other Plaisters, which are partly compounded
of greasy, or of resinous Substances, are very
dangerous: they often repel, or strike in the Erisipelas,
occasioning it to ulcerate, or even to gangrene.
If People who are naturally subject to
this Disease should apply any such Plaister to
their Skin, even in its soundest State, an Erisipelas
is the speedy Consequence.
§ 282. Whenever the Humour occasioning
the Distemper is repelled, and thrown upon the
Brain, the Throat, the Lungs, or any internal
Part, the Patient should be bled; Blisters must
be applied to the Legs; and Elder Tea, with
Nitre dissolved in it, should be plentifully drank.
§ 283. People who are liable to frequent Returns
of an Erisipelas, should very carefully avoid
using Milk, Cream, and all fat and viscid, or
clammy Food, Pies, brown Meat, Spices, thick
and heady Liquors, a sedentary Life, the more
active Passions, especially Rage, and, if possible,
all Chagrin too. Their Food should chiefly
consist of Herbage, Fruits, of Substances inclining
to Acidity, and which tend to keep the Body
open; they should drink Water, and some of the
light white Wines; by no Means omitting the
frequent Use of Cream of Tartar. A careful
Conformity to these Regulations is of real Importance,
as, besides the Danger of the frequent
Visitations of this Disease, they denote some
slight Indispositions of the Liver and the Gall-bladder;
which, if too little attended to, might in
Time prove very troublesome and pernicious.
Such mineral Waters as are gently opening are
very proper for these Constitutions, as well as
the Juice of Succory, and clarified Whey, of
which they should take about three Pints every
Morning, during the five or six Summer Months.
This becomes still more efficacious, if a little
Cream of Tartar and Honey be added to it.
Of the Stings, or little Wounds, by Animals.
§ 284. The Stings or little Bites of Animals,
frequently producing a kind of Erisipelas, I shall
add a very few Words concerning them in this
Place.
Of the Serpents in this Country none but the
Vipers are poisonous; and none of these are
found except at Baume, where there is a Viperary,
if we may be allowed that Word. We have no
Scorpions, which are somewhat poisonous; our
Toads are not in the least so: whence the only
Stings we are exposed to, are those of Bees, Wasps,
Hornets, Muskitos or Gnats, and Dragon Flies:
all of which are sometimes attended with severe
Pain, a Swelling, and a very considerable erisipelatous
Redness; which, if it happens in the
Face, sometimes entirely closes the Eyes up; occasioning
also a Fever, Pains of the Head, Restlessness,
and Sickness at Heart; and, when the
Pains are in a violent Degree, Faintings and Convulsions,
though always without any mortal Consequence.
These Symptoms go off naturally
within a few Days, without any Assistance: Nevertheless
they may either be prevented, diminished
in Degree, or shortned in Duration.
1, By extracting the Sting of the Animal, if it
is left behind.
2, By a continual Application of one of the
Remedies directed , Article 1 and 2, particularly
the Infusion of Elder-flowers, to which a
little Venice Treacle is added; or by covering the
Part affected with a Pultice, made of Crum of
Bread, Milk, Honey, and a little Venice Treacle.
3, By bathing the Legs of the Person stung
repeatedly in warm Water.
4, By retrenching a little of their customary
Food, especially at Night, and by making them
drink an Infusion of Elder-flowers, with the
Addition of a little Nitre. Oil, if applied very
quickly after the Sting, sometimes prevents the
Appearance of any Swelling, and from thence the
Pains that attend it.
Chapter XX.
Of spurious, or false Inflammations of the Breast, and of spurious, bilious, Pleurisies.
Sect. 285.
he Inflammation of the Breast and that
Pleurisy, which is called bilious, are the
same Disease. It is properly a putrid
Fever, attended with an Infarction or
Stuffing of the Lungs, though without Pain; in
which Circumstance it is called a putrid or bilious
Peripneumony: but when attended with
a Pain of the Side, a Stitch, it is called a spurious
or *** Pleurisy.
§ 286. The Signs which distinguish these Diseases
from the inflammatory ones of the same
Name, described Chap. IV and V, are a less
hard and less strong, but a quicker Pulse, though
unaccompanied with the same Symptoms which
constitute the inflammatory ones (See and
). The Mouth is foul, and has a Sensation
of Bitterness; the Patient is infested with a sharp
and dry Heat; he has a Feeling of Heaviness and
Anxiety all about his Stomach, with Loathings:
he is less flushed and red in these, than in the inflammatory
Diseases, but rather a little yellow.
He has a dejected wan Look; his Urine
resembles that in putrid Fevers, and not that of inflammatory
ones; and he has very often a small
bilious Looseness, which is extremely offensive.
The Skin is commonly very dry in this Disease;
the Humour spit up is less thick, less reddish,
and rather more yellow than in the inflammatory
Diseases of the same Names.
§ 287. They must be treated after the manner
of putrid Fevers, as in . Supposing
some little Degree of Inflammation to be combined
with the Disease, it may be removed by a
single Bleeding. After this the Patient is to
drink Barley Water , to make Use of Glysters;
and as soon as all Symptoms of any Inflammation
wholly disappear, he is to take the vomiting
and purging Draught . But the utmost
Caution must be taken not to give it, before
every Appearance of any Inflammation is totally
removed; as giving it sooner would be certain
Death to the Sick: and it is dreadful but to think
of agitating, by a Vomit, Lungs that are inflamed,
and overloaded with Blood, whose Vessels burst
and discharge themselves, only from the Force
of Expectoration. After an Interval of some
Days, he may be purged again with the Medicine
. The Prescription succeeds also
very well as a Vomit. If the Fever is violent, he
must drink plentifully of the Potion .
Blisters to the Legs are very serviceable, when
the Load and Oppression are not considerably
abated after general Evacuations.
§ 288. The false Inflammation of the Breast is
an Overfulness or Obstruction in the Lungs, accompanied
with a Fever; and it is caused by extremely
thick and tenacious Humours; and not
by a really inflammatory Blood, or by any putrid
or bilious Humour.
§ 289. This Distemper happens more frequently
in the Spring, than in any other Season. Old Men,
puny, ill-constitutioned Children, languid Women,
feeble young Men, and particularly such as
have worn their Constitutions out by drinking,
are the Subjects most frequently attacked by it;
especially if they have used but little Exercise
throughout the Winter: if they have fed on viscid,
mealy and fat Aliments, as Pastry, Chesnuts,
thick Milk or Pap, and Cheese. All their
Humours have contracted a thick glutinous Quality;
they are circulated with Difficulty, and
when Heat or Exercise in the Spring increases
their Motion at once, the Humours, already stuffing
up the Lungs, still more augment that Plenitude,
whence these vital Organs are fatally extended,
and the Patient dies.
§ 290. This Distemper is known to exist,
1, By the previous Existence of the Causes already
mentioned.
2, By the Symptoms which precede and usher
it in. For Example, the Patient many Days
before-hand has a slight Cough; a small Oppression
when he moves about; a little Restlessness,
and is sometimes a little choleric or fretful. His
Countenance is higher coloured than in Health;
he has a Propensity to sleep, but attended with
Confusion and without Refreshment, and has
sometimes an extraordinary Appetite.
3, When this State has continued for some
Days, there comes on a cold Shivering, though
more considerable for its Duration than its Violence;
it is succeeded by a moderate Degree of
Heat, but that attended with much Inquietude
and Oppression. The sick Person cannot confine
himself to the Bed; but walks to and fro in his
Chamber, and is greatly dejected. The Pulse is
weak and pretty quick; the Urine is sometimes
but little changed from that in Health; at other
Times it is discharged but in a small Quantity,
and is higher coloured: he coughs but moderately,
and does not expectorate, or cough up,
but with Difficulty. The Visage becomes very
red, and even almost livid; he can neither keep
awake, nor sleep well; he raves for some Moments,
and then his Head grows clear again.
Sometimes it happens, especially to Persons of
advanced Age, that this State suddenly terminates
in a mortal Swoon or Fainting: at other
Times and in other Cases, the Oppression and
Anguish increase; the Patient cannot breathe but
when sitting up, and that with great Difficulty
and Agony: the Brain is utterly disturbed and
embarrassed; this State lasts for some Hours,
and then terminates of a sudden.
§ 291. This is a very dangerous Distemper;
because, in the first Place, it chiefly attacks those
Persons whose Temperament and Constitution
are deprived of the ordinary Resources for Health
and Recovery: in the second Place, because it is
of a precipitate Nature, the Patient sometimes
dying on the third Day, and but seldom surviving
the seventh; while the Cause of it requires a
more considerable Term for its Removal or Mitigation.
Besides which, if some Indications present
for the Employment of a Remedy, there are
frequently others which forbid it; and all that
seems to be done is, as follows;
1, If the Patient has still a pretty good Share
of Health; if he is not of too advanced an Age;
if the Pulse has a perceivable Hardness, and yet
at the same Time some Strength; if the Weather
is dry, and the Wind blows from the North,
he should be bled once, to a moderate Quantity.
But if the greater Part of these Circumstances are
wanting, Bleeding would be very prejudicial.
Were we obliged to establish some general and
positive Rule in this Case, it were better to exclude
Bleeding, than to admit it.
2, The Stomach and the Bowels should be
unloaded from their viscid glutinous Contents;
and the Medicines which succeed the best in this
Respect are , when the Symptoms shew
there is a great Necessity for vomiting, and there
is no Inflammation; or the Prescription ,
which after vomiting, purges by Stool, promotes
Urine, breaks down and divides the viscid Humours
that occasion the Disease, and increase
Perspiration. When we are afraid of hazarding
the Agitation of a Vomit and its Consequences,
the Potion, may be given; but we must
be very cautious, in Regard to old Men, even
with this; as such may expire during the Operation
of it.
3, They should, from the Beginning of the
Disease, drink plentifully of the Ptisan ,
which is the best Drink in this Disease; or that of
, adding half a Dram of Nitre to every
Pint of it.
4, A Cup of the Mixture must be taken
every two Hours.
5. Blisters are to be applied to the Insides of
the Legs.
When the Case is very doubtful and perplexing,
it were best to confine ourselves to the three
last-mentioned Remedies, which have often been
successful in severe Degrees of this Disease; and
which can occasion no ill Consequence.
§ 292. When this Malady invades old People,
though they partly recover, they never recover
perfectly, entirely, from it: and if due Precaution
is not taken, they are very liable to fall into a Dropsy
of the Breast after it.
§ 293. The spurious or false Pleurisy is a Distemper
that does not affect the Lungs, but only
the Teguments, the Skin, and the Muscles
which cover the Ribs. It is the Effect of a rheumatic
Humour thrown upon these Parts, in which,
as it produces very sharp Pains resembling that
which is called a Stitch, it has from this Circumstance,
been termed a Pleurisy.
It is generally supposed by the meer Multitude,
and even by some of a different Rank,
that a false Pleurisy is more dangerous than a genuine,
a true one; but this is a Mistake. It is
often ushered in by a Shivering, and almost ever
attended with a little Fever, a small Cough, and
a slight Difficulty of breathing; which, as well
as the Cough, is occasioned from the Circumstance
of a Patient's (who feels Pain in Respiration,
or Breathing) checking Breathing as much
as he can; this accumulates a little too much
Blood in the Lungs; but yet he has no Anguish,
nor the other Symptoms of acute true Pleurisies.
In some Patients this Pain is extended, almost
over the whole Breast, and to the Nape of the
Neck. The sick Person cannot repose himself
on the Side affected.
This Disorder is not more dangerous than a
Rheumatism, except in two Cases; 1, When
the Pain is so very severe, that the Patient strongly
endeavours not to breathe at all, which brings
on a great Infarction or Stoppage in the Lungs.
2, When this Humour, like any other rheumatic
one, is transferred to some internal Part.
§ 294. It must be treated exactly like a Rheumatism.
See and .
After bleeding once or more, a Blister applied
to the affected Part is often attended with a very
good Effect: This being indeed the Kind of Pleurisy, in which it particularly agrees.
§ 295. This Malady sometimes gives Way to
the first Bleeding; often terminating on the third,
fourth or fifth Day, by a very plentiful Sweat,
and rarely lasting beyond the seventh. Sometimes
it attacks a Person very suddenly, after a
Stoppage of Perspiration; and then, if at once before
the Fever commences, and has had Time to
inflame the Blood, the Patient takes some Faltrank,
it effects a speedy Cure by restoring Perspiration.
They are such Cases as these, or that mentioned
, which have given this Composition the
Reputation it has obtained in this Disease: a Reputation
nevertheless, which has every Year proved
tragical in its Consequences to many Peasants,
who being deceived by some misleading Resemblances
in this Distemper, have rashly and ignorantly
made Use of it in true inflammatory Pleurisies.
Chapter XXI.
Of the Cholic and its different Kinds.
Sect. 296.
he Appellation of a Cholic is commonly
given to all Pains of the Belly
indiscriminately; but I apply it in this
Place only to such as attack the Stomach,
or the Intestines, the Guts.
Cholics may and do result from very many
Causes; and the greater Number of Cholics are
chronical or tedious Complaints, being more common
among the inactive Inhabitants of Cities,
and Workmen in sedentary Trades, than among
Country People. Hence I shall treat here only
of the small Variety of Cholics, which happen the
most usually in Villages. I have already proved
that the fatal Events of some Distempers were occasioned
by endeavouring to force the Patients into
Sweats; and the same unhappy Consequences
have attended Cholics, from accustoming the
Subjects of this Disease to Drams, and hot inflaming
spirituous Liquors, with an Intention to expel
the Wind.
Of the inflammatory Cholic.
§ 297. The most violent and dangerous kind
of Cholic is that, which arises from an Inflammation
of the Stomach, or of the Intestines. It
begins most commonly without any Shivering, by
a vehement Pain in the Belly, which gradually
becomes still more so. The Pulse grows quick
and hard; a burning Pain is felt through the
whole Region of the Belly; sometimes there is
a watery Diarrhœa, or Purging; at other Times
the Belly is rather costive, which is attended with
Vomiting, a very embarrassing and dangerous
Symptom: the Countenance becomes highly
flushed; the Belly tense and hard; neither can it
be touched scarcely without a cruel Augmentation
of the Patient's Pain, who is also afflicted
with extreme Restlessness; his Thirst is very great,
being unquenchable by Drink; the Pain often
extends to the Loins, where it proves very sharp,
and severe; little Urine is made, and that very
red, and with a kind of burning Heat. The
tormented Patient has not a Moment's Rest, and
now and then raves a little. If the Disease is not
removed or moderated, before the Pains rise to their
utmost Height and Violence, the Patient begins
at length to complain less; the Pulse becomes less
strong and less hard than before, but quicker:
his Face first abates of its Flush and Redness,
and soon after looks pale; the Parts under the
Eyes become livid; the Patient sinks into a low
stupid Kind of Delirium, or Raving; his Strength
entirely deserts him; the Face, Hands, Feet, and
the whole Body, the Belly only excepted, become
cold: the Surface of the Belly appears bluish;
extreme Weakness follows, and the Patient dies.
There frequently occurs, just a Moment before
he expires, an abundant Discharge of excessively
fœtid Matter by Stool; and during this Evacuation
he dies with his Intestines quite gangrened,
or mortified.
When the Distemper assaults the Stomach, the
Symptoms are the very same, but the Pain is felt
higher up, at the Pit of the Stomach. Almost
every thing that is swallowed is cast up again;
the Anguish of the tortured Patient is terrible,
and the Raving comes on very speedily. This
Disease proves mortal in a few Hours.
§ 298. The only Method of succeeding in the
Cure of it is as follows:
1, Take a very large Quantity of Blood
from the Arm; this almost immediately diminishes
the Violence of the Pains, and allays the
Vomiting: besides its contributing to the greater
Success of the other Remedies. It is often necessary
to repeat this Bleeding within the Space of
two Hours.
2, Whether the Patient has a Looseness, or
has not, a Glyster of a Decoction of Mallows, or
of Barley Water and Oil, should be given every
two Hours.
3, The Patient should drink very plentifully
of Almond Milk ; or a Ptisan of Mallow
Flowers, or of Barley, all which should be
warm.
4, Flanels dipt in hot, or very warm Water
should be continually applied over the Belly,
shifting them every Hour, or rather oftner; for
in this Case they very quickly grow dry.
5, If the Disease, notwithstanding all this,
continues very obstinate and violent, the Patient
should be put into a warm Water Bath, the extraordinary
Success of which I have observed.
When the Distemper is over, that is to say,
when the Pains have terminated, and the Fever
has ceased, so that the Patient recovers a little
Strength, and gets a little Sleep, it will be proper
to give him a Purge, but a very gentle one.
Two Ounces of Manna, and a Quarter of an
Ounce of Sedlitz Salt dissolved in a Glass of
clear Whey is generally sufficient, at this Period,
to purge the most robust and hardy Bodies. Manna
alone may suffice for more delicate Constitutions:
as all acrid sharp Purges would be highly
dangerous, with Regard to the great Sensibility
and tender Condition of the Stomach, and
of the Intestines after this Disease.
§ 299. It is sometimes the Effect of a general
Inflammation of the Blood; and is produced,
like other inflammatory Diseases, by extraordinary
Labour, very great Heat, heating Meats or
Drinks, &c. It is often the Consequence of
other Cholics which have been injudiciously treated,
and which otherwise would not have degenerated
into inflammatory ones; as I have many Times
seen these Cholics introduced after the Use of heating
Medicines; one Instance of which may be
seen .
§ 300. Ten Days after I had recovered a Woman
out of a severe Cholic, the Pains returned
violently in the Night. She, supposing them to
arise only from Wind, hoped to appease them by
drinking a deal of distilled Walnut Water; which,
far from producing any such Effect, rendered
them more outrageous. They soon were heightened
to a surprising Degree, which might reasonably
be expected. Being sent for very early in
the Morning, I found her Pulse hard, quick,
short; her Belly was tense and hard; she complained
greatly of her Loins: her Urine was almost
entirely stopt. She past but a few Drops,
which felt as it were scalding hot, and these with
excessive Pain. She went very frequently to the
Close-stool, with scarcely any Effect; her Anguish,
Heat, Thirst, and the Dryness of her
Tongue were even terrifying: and her wretched
State, the Effect of the strong hot Liquor she
had taken, made me very apprehensive for her.
One Bleeding, to the Quantity of fourteen Ounces,
somewhat abated all the Pains; she took several
Glysters, and drank off a few Pots of Orgeat in
a few Hours. By these Means the Disease was a
little mitigated; by continuing the same Drink
and the Glysters the Looseness abated; the Pain
of the Loins went off, and she passed a considerable
Quantity of Urine, which proved turbid, and
then let fall a Sediment, and the Patient recovered.
Nevertheless I verily believe, if the Bleeding had
been delayed two Hours longer, this spirituous
Walnut Water would have been the Death of
her. During the Progress of this violent Disease,
no Food is to be allowed; and we should never
be too inattentive to such Degrees of Pain, as sometimes
remain after their Severity is over; lest a
Scirrhus, an inward hard Tumour, should be generated,
which may occasion the most inveterate
and tedious Maladies.
§ 301. An Inflammation of the Intestines, and
one of the Stomach, may also terminate in an
Abscess, like an Inflammation of any other Part;
and it may be apprehended that one is forming,
when, though the Violence of the Pains abates,
there still remains a slow, obtuse, heavy Pain,
with general Inquietude, little Appetite, frequent
Shiverings; the Patient at the same Time not recovering
any Strength. In such Cases the Patient
should be allowed no other Drinks, but
what are already directed in this Chapter, and
some Soops made of Pulse, or other farinaceous
Food.
The Breaking of the Abscess may sometimes
be discovered by a slight Swoon or fainting Fit;
attended with a perceivable Cessation of a Weight
or Heaviness in the Part, where it was lately
felt: and when the Pus, or ripe Matter, is effused
into the Gut, the Patient sometimes has
Reachings to vomit, a Vertigo, or Swimming in
the Head, and the Matter appears in the next
Stools. In this Case there remains an Ulcer
within the Gut, which, if either neglected, or
improperly treated, may pave the Way to a
slow wasting Fever, and even to Death. Yet
this I have cured by making the Patient live
solely upon skimmed Milk, diluted with one
third Part Water, and by giving every other Day
a Glyster, consisting of equal Parts of Milk and
Water, with the Addition of a little Honey.
When the Abscess breaks on the Outside of the
Gut, and discharges its Contents into the Cavity
of the Belly, it becomes a very miserable Case,
and demands such further Assistance as cannot be
particularized here.
Of the bilious Cholic.
§ 302. The bilious Cholic discovers itself by
very acute Pains, but is seldom accompanied with
a Fever; at least not until it has lasted a Day or
two. And even if there should be some Degree
of a Fever, yet the Pulse, though quick, is neither
strong nor hard: the Belly is neither tense
or stretched as it were, nor burning hot, as in
the former Cholic: the Urine comes away with
more Ease, and is less high-coloured: Nevertheless
the inward Heat and Thirst are considerable;
the Mouth is bitter; the Vomiting or Purging,
when either of them attend it, discharge a
yellowish Humour or Excrement; and the Patient's
Head is often vertiginous or dizzy.
§ 303. The Method of curing this is,
1, By injecting Glysters of Whey and Honey;
or, if Whey is not readily procurable, by repeating
the Glyster, .
2, By making the Sick drink considerably of
the same Whey, or of a Ptisan made of the Root
of Dog's-Grass (the common Grass) and a little
Juice of Lemon, for want of which, a little Vinegar
and Honey may be substituted instead of
it.
3, By giving every Hour one Cup of the Medicine
; or where this is not to be had,
half a Drachm of Cream of Tartar at the same
short Intervals.
4, Fomentations of warm Water and Half-baths
are also very proper.
5, If the Pains are sharp and violent, in a robust
strong Person, and the Pulse is strong and
tense, Bleeding should be used to prevent an Inflammation.
6, No other Nourishment should be given,
except some maigre Soops, made from Vegetables,
and particularly of Sorrel.
7, After plentiful Dilution with the proper
Drink, if no Fever supervenes; if the Pains still
continue, and the Patient discharges but little by
Stool, he should take a moderate Purge. That
directed is a very proper one.
§ 304. This bilious Cholic is habitual to many
Persons; and may be prevented or greatly mitigated
by an habitual Use of the Powder ;
by submitting to a moderate Retrenchment in the
Article of Flesh-meat; and by avoiding heating
and greasy Food, and the Use of Milk.
Of Cholics from Indigestions, and of Indigestion.
§ 305. Under this Appellation I comprehend
all those Cholics, which are either owing to any
overloading Quantity of Food taken at once; or
to a Mass or Accumulation of Aliments formed by
Degrees in such Stomachs, as digest but very
imperfectly; or which result from noxious Mixtures
of Aliment in the Stomach, such as that
of Milk and Acids; or from Food either not
wholesome in its self, or degenerated into an
unwholesome Condition.
This kind of Cholic may be known from any
of these Causes having preceded it; by its Pains,
which are accompanied with great Restlessness,
and come on by Degrees, being less fixed than in
the Cholics before treated of. These Cholics
are also without any Fever, Heat or Thirst, but
accompanied with a Giddiness of the Head, and
Efforts to vomit, and rather with a pale, than a
high-coloured Visage.
§ 306. These Disorders, from these last Causes,
are scarcely ever dangerous in themselves; but
may be made such by injudicious Management,
and doing more than is necessary or proper: as
the only Thing to be done is to promote the Discharges
by warm Drinks. There are a considerable
Variety of them, which seem equally good,
such as warm Water, or even cold Water with a
Toast, with the Addition either of a little Sugar,
or a little Salt: a light Infusion of Chamomile,
or of Elder-flowers, common Tea, or Baum,
it imports little which, provided the Patient drink
plentifully of them: in Consequence of which
the offending Matter is discharged, either by vomiting,
or a considerable purging; and the speedier
and more in Quantity these Discharges are, the
sooner the Patient is relieved.
If the Belly is remarkably full and costive,
Glysters of warm Water and Salt should be injected.
The Expulsion of the obstructing Matter is
also facilitated, by rubbing the Belly heartily
with hot Cloths.
Sometimes the Humours, or other retained
Contents of the Belly, are more pernicious from
their Quality, than their Quantity; and then the
Malady may be dissipated without the former
Discharges, by the irritating sharp Humour being
diluted, or even drowned, as it were, in the
Abundance of small watery Drinks. When the
Pains invade first in the Stomach, they become
less sharp, and the Patient feels less Inquietude, as
soon as the Cause of the Pain has descended out
of the Stomach into the Intestines, whose Sensations
are something less acute than, or somewhat
different from, those of the Stomach.
It is often found that after these plentiful Discharges,
and when the Pains are over, there remains
a very disagreeable Taste in the Mouth,
resembling the Savour of rotten Eggs. This
may be removed by giving some Doses of the
Powder , and drinking largely of good
Water:
It is an essential Point in these Cases, to take no
Food before a perfect Recovery.
§ 307. Some have been absurd enough in
them, to fly at once to some heating Cordial
Confection, to Venice Treacle, Aniseed Water,
Geneva, or red Wine to stop these Evacuations;
but there cannot be a more fatal Practice: since
these Evacuations are the only Thing which can
cure the Complaint, and to stop them is to deprive
the Person, who was in Danger of drowning,
of the Plank which might save him. Nay
should this Endeavour of stopping them unhappily
succeed, the Patient is either thrown into a
putrid Fever, or some chronical tedious Malady;
unless Nature, much wiser than such a miserable
Assistant, should prevail over the Obstacles
opposed to her Recovery, and restore the obstructed
Evacuations by her own Oeconomy, in
the Space of a few Days.
§ 308. Sometimes an Indigestion happens,
with very little Pain or Cholic, but with violent
Reachings to vomit, inexpressible Anguish, Faintings,
and cold Sweats: and not seldom also the
Malady begins, only with a very sudden and unexpected
Fainting: the Patient immediately loses
all his Senses, his Face is pale and wan: he has
some Hickups rather than Reachings to vomit,
which joined to the Smallness of his Pulse, to the
Easiness of his respiring, or breathing, and to the
Circumstance of his being attacked immediately,
or very soon, after a Meal, makes this Disorder
distinguishable from a real Apoplexy. Nevertheless,
when it rises to this Height, with these
terrible Symptoms, it sometimes kills in a few
Hours. The first thing to be done is to throw
up a sharp Glyster, in which Salt and Soap are to
be dissolved; next to get down as much Salt and
Water as he can swallow; and if that is ineffectual,
the Powder is to be dissolved in
three Cups of Water; one half of which is to be
given directly; and, if it does not operate in a
Quarter of an Hour, the other half. Generally
speaking the Patient's Sense begins to return,
as soon as he begins to vomit.
Of the flatulent or windy Cholic.
§ 309. Every Particular which constitutes our
Food, whether solid or liquid, contains much
Air, but some of them more than others. If
they do not digest soon enough, or but badly,
which occasions a sensible Escape of such Air; if
they are such as contain an extraordinary Quantity
of Air; or if the Guts being straitened or
compressed any where in the Course of their Extent,
prevent that Air from being equally
diffused (which must occasion a greater Proportion
of it in some Places) then the Stomach and
the Guts are distended by this Wind; and this
Distention occasions these Pains, which are called
flatulent, or windy.
This Sort of Cholic rarely appears alone and
simple; but is often complicated with, or added, as
it were, to the other Sorts, of which it is a Consequence;
and is more especially joined with the
Cholic from Indigestions, whose Symptoms it
multiplies and heightens. It may be known,
like that, by the Causes which have preceded it,
by its not being accompanied either with Fever,
Heat, or Thirst; the Belly's being large and full,
though without Hardness, being unequal in its
Largeness, which prevails more in one Part of
it than in another, forming something like Pockets
of Wind, sometimes in one Part, sometimes
in another; and by the Patient's feeling some
Ease merely from the rubbing of his Belly, as it
moves the Wind about; which escaping either
upwards or downwards affords him still a greater
Relief.
§ 310. When it is combined with any different
Species of the Cholic, it requires no distinct
Treatment from that Species; and it is removed
or dissipated by the Medicines which cure the
principal Disease.
Sometimes however it does happen to exist
alone, and then it depends on the Windiness of
the solid and liquid Food of the Person affected
with it, such as the Must or new Wine, Beer, especially
very new Beer, certain Fruits and
Garden-stuff. It may be cured by a Glyster; by
chaffing the Belly with hot Cloths; by the Use
of Drink moderately spiced; and especially by
Camomile Tea, to which a little cordial Confection,
or even Venice Treacle, may be added.
When the Pains are almost entirely vanished,
and there is no Fever, nor any unhealthy Degree
of Heat; and if the Patient is sensible of a Weakness
at Stomach, he may take a little aromatic,
or spiced Wine, or even a small cordial stomachic
Dram. It should be observed, that these are not to
be allowed in any other Kind of Cholic.
§ 311. When any Person is frequently subject
to cholic-like Pains, it is a Proof that the digestive
Faculty is impaired; the restoring of which
should be carefully attended to; without which
the Health of the Patient must suffer considerably,
and he must be very likely to contract many
tedious and troublesome Disorders.
Of Cholics from Cold.
§ 312. When any Person has been very cold,
and especially in his Feet, it is not uncommon
for him to be attacked, within a few Hours after
it, with violent Cholic Pains, in which heating
and spirituous Medicines are very pernicious: but
which are easily cured by rubbing the Legs well
with hot Cloths; and keeping them afterwards
for a considerable Time in warm Water; advising
them at the same Time to drink freely of
a light Infusion of Chamomile or Elder-flowers.
The Cure will be effected the sooner, if the Patient
is put to Bed and sweats a little, especially
in the Legs and Feet.
A Woman who had put her Legs into a pretty
cool Spring, after travelling in the Height of Summer,
was very quickly after attacked with a most
violent Cholic. She took different hot Medicines;
she became still worse; she was purged,
but the Distemper was still further aggravated.
I was called in on the third Day, a few Hours
before her Decease.
In such Cases, if the Pain be excessive, it may
be necessary to bleed; to give a Glyster of warm
Water; to keep the Legs several Hours over the
Steam of hot Water, and afterwards in the Water;
to drink plentifully of an Infusion of the
Flowers of the Lime-tree, with a little Milk;
and if the Distemper is not subdued by these
Means, Blisters should be applied to the Legs,
which I have known to be highly efficacious.
§ 313. It appears, through the Course of this
Chapter, that it is necessary to be extremely on
our Guard, against permitting the Use of heating
and spirituous Medicines in Cholics, as they may
not only aggravate, but even render them mortal.
In short they should never be given, and when it
is difficult to discover the real Cause of the Cholic,
I advise Country People to confine themselves
to the three following Remedies, which cannot
be hurtful in any Sort of Cholic, and may remove
as many as are not of a violent Nature.
First then, let Glysters be frequently repeated.
2, Let the Patient drink warm Water plentifully,
or Elder Tea. 3, Let the Belly be often
fomented in pretty warm Water, which is
the most preferable Fomentation of any.
§ 314 I have said nothing here of the Use of
any Oils in this Disease, as they agree but in
very few Species of Cholics, and not at all in those
of which I have been treating. For this Reason
I advise a total Disuse of them, since they may
be of bad Consequence in many Respects.
§ 315. Chronical Diseases not coming within
the Plan of this Work, I purposely forbear treating
of any Kind of those tedious Cholics, which
afflict some People for many Years: but I think
it my Duty to admonish such, that their Torments
being very generally occasioned by Obstructions
in the Viscera, or different Bowels of
the Belly, or by some other Fault, and more
particularly in those Organs, which are intended
to prepare the Bile, they should, 1, avoid with the
greatest Care, the Use of sharp, hot, violent Medicines,
Vomits, strong Purges, Elixirs, &c. 2,
They should be thoroughly on their Guard against
all those, who promise them a very speedy Cure,
by the Assistance of some specific Remedy; and
ought to look upon them as Mountebanks, into
whose Hands it is highly dangerous to trust themselves.
3, They should be persuaded, or rather
convinced, that they can entertain no reasonable
Hope of being cured, without an exact Conformity
to a proper and judicious Regimen, and a
long Perseverance in a Course of mild and safe
Remedies. 4, They should continually reflect
with themselves, that there is little Difficulty in
doing them great Mischief; and that their Complaints
are of that Sort, which require the greatest
Knowledge and Prudence in those Persons, to
whom the Treatment and Cure of them are
confided.
Chapter XXII.
Of the Iliac Passion, and of the Cholera-morbus.
Sect. 316.
hese violent Diseases are fatal to many
Country People, while their Neighbours
are frequently so ignorant of the
Cause of their Death, that Superstition
has ascribed it to Poison, or to Witchcraft.
§ 317. The first of these, the Miserere, or
Iliac Passion, is one of the most excruciating
Distempers. If any Part of the Intestines, the
Cavity of the Guts is closed up, whatever may
have occasioned it, the Course or Descent of the
Food they contain is necessarily stopped; in which
Case it frequently happens, that that continual
Motion observed in the Guts of a living Animal
dissected, and which was intended to detrude, or
force their Contents downwards, is propagated
in a directly contrary Manner, from the Guts
towards the Mouth.
This Disease sometimes begins after a Constipation,
or Costiveness, of some Days; at other
Times without that Costiveness having been preceded
by Pains in any Part of the Belly, especially
around the Navel; but which Pains, gradually
increasing after their Commencement, at
length become extremely violent, and throw the
Patient into excessive Anguish. In some of these
Cases a hard Tumour may be felt, which surrounds
the Belly like a Cord. The Flatulences
within become very audible, some of them are
discharged upwards; in a little Time after, Vomitings
come on, which increase till the Patient
has thrown up all he had taken in, with a
still further Augmentation of the excessive Pain.
With the first of his Vomitings he only brings
up the last Food he had taken, with his Drink
and some yellowish Humour: but what comes
up afterwards proves stinking; and when the
Disease is greatly heightened, they have what is
called the Smell of Excrement or Dung; but
which rather resembles that of a putrid dead
Body. It happens too sometimes, that if the
Sick have taken Glysters composed of Materials
of a strong Smell, the same Smell is discernible
in the Matter they vomit up. I confess however
I never saw either real Excrements, or the Substance
of their Glysters, brought up, much
less the Suppositories that were introduced into
the Fundament: and were it credible that Instances
of this Kind had occurred, they must be
allowed very difficult to account for. Throughout
this whole Term of the Disease, the Patient
has not a single Discharge by Stool; the Belly is
greatly distended; the Urine not seldom suppressed,
and at other Times thick and fœtid. The
Pulse, which at first was pretty hard, becomes
quick and small; the Strength entirely vanishes;
a Raving comes on; a Hiccup almost constantly
supervenes, and sometimes general Convulsions;
the Extremities grow cold, the Pulse scarcely perceivable;
the Pain and the Vomiting cease, and
the Patient dies very quickly after.
§ 318. As this Disease is highly dangerous,
the Moment it is strongly apprehended, it is necessary
to oppose it by proper Means and Remedies:
the smallest Error may be of fatal Consequence,
and hot inflaming Liquids have been
known to kill the Patient in a few Hours. I
was called in the second Day of the Disease to a
young Person, who had taken a good deal of Venice
Treacle: Nothing could afford her any Relief,
and she died early on the third Day.
This Disease should be treated precisely in the
same Manner as an inflammatory Cholic; the
principal Difference being, that in the former
there are no Stools, but continual Vomitings.
1, First of all then the Patient should be plentifully
bled, if the Physician has been called in
early enough, and before the Sick has lost his
Strength.
2, He should receive opening Glysters made
of a Decoction of Barley Water, with five or six
Ounces of Oil in each.
3, We should endeavour to allay the violent
Efforts to vomit, by giving every two Hours a
Spoonful of the Mixture .
4, The Sick should drink plentifully, in very
small Quantities, very often repeated, of an appeasing,
diluting, refreshing Drink, which tends
at the same Time to promote both Stools and
Urine. Nothing is preferable to the Whey ,
if it can be had immediately: if not, give
simple clear Whey sweetened with Honey, and
the Drinks prescribed , Art. 3.
5, The Patient is to be put into a warm Bath,
and kept as long as he can bear it, repeating it
as often daily too, as his Strength will permit.
6, After Bleeding, warm Bathing, repeated
Glysters and Fomentations, if each and all of
these have availed nothing; the Fume or Smoak
of Tobacco may be introduced in the Manner of
a Glyster, of which I shall speak further, in the
Chapter on Persons drowned.
I cured a Person of this Disease, by conveying
him into a Bath, immediately after bleeding
him, and giving him a Purge on his going into
the Bath.
§ 319. If the Pain abates before the Patient
has quite lost his Strength; if the Pulse improves
at the same Time; if the Vomitings are less in
Number, and in the Quantity of the Matter
brought up; if that Matter seems in a less putrid
offensive State; if he feels some Commotion
and Rumbling in his Bowels; if he has some
little Discharge by Stool; and if at the same
Time he feels himself a little stronger than before,
his Cure may reasonably be expected; but
if he is otherwise circumstanced he will soon depart.
It frequently happens, a single Hour before
Death, that the Pain seems to vanish, and a
surprising Quantity of extremely fœtid Matter is
discharged by Stool: the Patient is suddenly seized
with a great Weakness and Sinking, falls into
a cold Sweat, and immediately expires.
§ 320. This is the Disease which the common
People attribute to, and term, the Twisting
of the Guts; and in which they make the Patients
swallow Bullets, or large Quantities of
Quick-silver. This twisting, tangling, or Knoting
of the Guts is an utter, an impossible Chimera;
for how can they admit of such a Circumstance,
as one of their Extremities, their Ends,
is connected to the Stomach, and the other irremoveably
fastened to the Skin of the Fork or
Cleft of the Buttocks? In Fact this Disease results
from a Variety of Causes, which have been discovered
on a Dissection of those who have died of it.
It were to be wished indeed this prudent Custom,
so extremely conducive to enrich, and to perfect,
the Art of Physick, were to prevail more generally;
and which we ought rather to consider as
a Duty to comply with, than a Difficulty to submit
to; as it is our Duty to contribute to the Perfection
of a Science, on which the Happiness of
Mankind so considerably depends. I shall not
enter into a Detail of these Causes; but whatever
they are, the Practice of swallowing Bullets in
the Disease is always pernicious, and the like Use
of Mercury must be often so. Each of these
pretended Remedies may aggravate the Disease,
and contribute an insurmountable Obstacle to the
Cure—Of that Iliac Passion, which is sometimes
a Consequence of Ruptures, I shall treat in another
Place.
Of the Cholera-morbus.
§ 321. This Disease is a sudden, abundant,
and painful Evacuation by vomiting and by
Stool.
It begins with much Flatulence, or Wind,
with Swelling and slight Pains in the Belly, accompanied
with great Dejection; and followed
with large Evacuations either by Stool or by Vomit
at first, but whenever either of them has
begun, the other quickly follows. The Matter
evacuated is either yellowish, green, brown,
whitish, or black; the Pains in the Belly violent;
the Pulse, almost constantly feverish, is sometimes
strong at first, but soon sinks into Weakness, in
Consequence of the prodigious Discharge. Some
Patients purge a hundred Times in the Compass
of a few Hours: they may even be seen to fall
away; and if the Disease exists in a violent Degree,
they are scarcely to be known within three
or four Hours from the Commencement of these
Discharges. After a great Number of them they
are afflicted with Spasms, or Cramps, in their
Legs, Thighs, and Arms, which torment them
as much as the Pains in the Belly. When the
Disease rages too highly to be asswaged, Hiccups,
Convulsions and a Coldness of the Extremities
approach; there is a scarcely intermitting Succession
of fainting, or swooning Fits, the Patient dying
either in one of them, or in Convulsions.
§ 322. This Disease, which constantly depends
on a Bile raised to the highest Acrimony, commonly
prevails towards the End of July and in
August: especially if the Heats have been very
violent, and there have been little or no Summer
Fruits, which greatly conduce to attempt: and
allay the putrescent Acrimony of the Bile.
§ 323. Nevertheless, however violent this Distemper
may be, it is less dangerous, and also less
tormenting than the former, many Persons recovering
from it.
1, Our first Endeavour should be to dilute, or
even to drown this acrid Bile, by Draughts, by
Deluges, of the most mitigating Drinks; the irritation
being so very great, that every Thing having
the least Sharpness is injurious. Wherefore
the patient should continually take in, by Drink,
and by Way of Glyster, either Barley-Water,
Almond-Milk, or pure Water, with one eighth
Part Milk, which has succeeded very well in my
Practice. Or he may use a very light Decoction,
or Ptisan, as it were, of Bread, which is
made by gently boiling a Pound of toasted Bread,
in three or four Pots of Water for half an Hour.
In Swisserland we prefer Oat bread. We also
successfully use pounded Rye, making a light
Ptisan of it.
A very light thin Soup made of a Pullet, a
Chicken, or of one Pound of lean Veal, in three
Pots of Water, is very proper too in this Disease.
Whey is also employed to good Purpose; and in
those Places, where it can easily be had, Butter-milk
is the best Drink of any. But, whichever
of these Drinks shall be thought preferable, it is
a necessary Point to drink very plentifully of it;
and the Glysters should be given every two
Hours.
2, If the Patient is of a robust Constitution,
and sanguine Complexion, with a strong Pulse
at the Time of the Attack, and the Pains are
very severe, a first, and in some Cases, a second
Bleeding, very early in the Invasion, asswages
the Violence of the Malady, and allows more
Leisure for the Assistance of other Remedies.
I have seen the Vomiting cease almost entirely,
after the first Bleeding.
The Rage of this Disease abates a little after
a Duration of five or six Hours: we must
not however, during this Remission or Abatement,
forbear to throw in proper Remedies;
since it returns soon after with great Force,
which Return however indicates no Alteration of
the Method already entered upon.
3, In general the warm Bath refreshes the Patient
while he continues in it; but the Pains frequently
return soon after he is taken out, which,
however, is no Reason for omitting it, since it
has frequently been found to give a more durable
Relief. The Patient should continue in it a
considerable Time, and, during that Time, he
should take six or seven Glasses of the Potion
, which has been very efficacious in this
Disease. By these Means the Vomiting has been
stopt; and the Patient, upon going out of the
Bath, has had several large Stools, which very
considerably diminished the Violence of the Disease.
4, If the Patient's Attendants are terrified by
these great Evacuations, and determine to check
them (however prematurely) by Venice Treacle,
Mint Water, Syrup of white Poppies, called Diacodium,
by *** or Mithridate, it either happens,
that the Disease and all its Symptoms are
heightened, to which I have been a Witness; or,
if the Evacuations should actually be stopt, the
Patient, in Consequence of it, is thrown into a
more dangerous Condition. I have been obliged
to give a Purge, in order to renew the Discharges,
to a Man, who had been thrown into a violent
Fever, attended with a raging Delirium, by
a Medicine composed of Venice Treacle, Mithridate
and Oil. Such Medicines ought not to be
employed, until the Smallness of the Pulse, great
Weakness, violent and almost continual Cramps,
and even the Insufficience of the Patient's Efforts
to vomit, make us apprehensive of his sinking
irrecoverably. In such Circumstances indeed he
should take, every Quarter or half Quarter of
an Hour, a Spoonful of the Mixture , still
continuing the diluting Drinks. After the first
Hour, they should only be given every Hour,
and that only to the Extent of eight Doses. But
I desire to insist upon it here, that this Medicine
should not be given too early in this Distemper.
§ 324. If the Patient is likely to recover, the
Pains and the Evacuations gradually abate; the
Thirst is less; the Pulse continues very quick, but
it becomes regular. There have been Instances
of their Propensity to a heavy kind of Drowsiness
at this Time; for perfect refreshing Sleep
advances but slowly after this Disease. It will
still be proper to persevere in the Medicines already
directed, though somewhat less frequently.
And now we may begin to allow the Patient a
few Soups from farinaceous mealy Substances;
and as soon as the Evacuations accompanying
this Disease are evidently ceased, and the Pains
are vanished; though an acute Sensibility and
great Weakness continues, beside such Soups, he
may be allowed some new-laid Eggs, very lightly
boiled, or even raw, for some Days. After
this he must be referred to the Regimen so frequently
recommended to Persons in a State of
Recovery: when the concurring Use of the
Powder , taken twice a Day, will greatly assist
to hasten and to establish his Health.
Chapter XXIII.
Of a Diarrhœa, or Looseness.
Sect. 325.
very one knows what is meant by a
Looseness or Purging, which the Populace
frequently call a Flux, and sometimes
a Cholic.
There are certain very chronical, or tedious
and obstinate ones, which arise from some essential
Fault in the Constitution. Of such, as foreign
to my Plan, I shall say nothing.
Those which come on suddenly, without any
preceding Disorder, except sometimes a slight
Qualm or short Loathing, and a Pain in the Loins
and Knees; which are not attended with smart
Pains nor a Fever (and frequently without any
Pain, or any other Complaint) are oftener of Service
than prejudicial. They carry off a Heap of
Matter that may have been long amassed and corrupted
in the Body; which, if not discharged,
might have produced some Distemper; and, far
from weakening the Body, such Purgings as
these render it more strong, light and active.
§ 326. Such therefore ought by no Means to
be stopped, nor even speedily checked: they generally
cease of themselves, as soon as all the
noxious Matter is discharged; and as they require
no Medicine, it is only necessary to retrench
considerably from the ordinary Quantity of Nourishment;
to abstain from Flesh, Eggs and Wine
or other strong Drink; to live only on some Soups,
on Pulse, or on a little Fruit, whether raw or
baked, and to drink rather less than usual. A
simple Ptisan with a little Syrup of Capillaire, or
Maiden-hair, is sufficient in these Purgings, which
require no Venice Treacle, Confection, nor any
Drug whatever.
§ 327. But should it continue more than five
or six Days, and manifestly weaken the Patient;
if the Pain attending it grows a little severe;
and especially if the Irritation, the urging to
Stool, proves more frequent, it becomes seasonable
to check, or to stop, it. For this Purpose
the Patient is to be put into a Regimen; and if
the Looseness has been accompanied with a great
Loathing, with Risings or Wamblings at Stomach,
with a foul furred Tongue, and a bad
Taste in the Mouth, he must take the Powder
. But if these Symptoms do not appear,
give him that of : and during the three
following Hours, let him take, every half Hour,
a Cup of weak light Broth, without any Fat
on it.
If the Purging, after being restrained by this
Medicine, should return within a few Days, it
would strongly infer, there was still some tough
viscid Matter within, that required Evacuation.
To effect this he should take the Medicines ,
or ; and afterwards take fasting, for
two successive Mornings, half the Powder, .
On the Evening of that Day when the Patient
took , or , or any other Purge, he
may take a small Dose of Venice Treacle.
§ 328. A Purging is often neglected for a long
Time, without observing the least Regimen, from
which Neglect they degenerate into tedious and as it
were habitual, perpetual ones, and entirely weaken
the Patient. In such Cases, the Medicine
should be given first; then, every other Day for
four Times successively, he should take :
during all which Time he should live on nothing
but Panada (See ) or on Rice boiled in weak
Chicken-broth. A strengthing stomachic Plaister
has sometimes been successfully applied, which
may be often moistened in a Decoction of Herbs
boiled in Wine. Cold and Moisture should be
carefully avoided in these Cases, which frequently
occasion immediate Relapses, even after the
Looseness had ceased for many Days.
Chapter XXIV.
Of the Dysentery, or Bloody-flux.
Sect. 329.
he Dysentery is a Flux or Looseness of
the Belly, attended with great Restlessness
and Anguish, with severe Gripings,
and frequent Propensities to go to Stool.
There is generally a little Blood in the Stools,
though this is not a constant Symptom, and is
not essential to the Existence of a Dysentery;
notwithstanding it may not be much less dangerous,
for the Absence of this Symptom.
§ 330. The Dysentery is often epidemical;
beginning sometimes at the End of July, though
oftner in August, and going off when the Frosts
set in. The great preceding Heats render the
Blood and the Bile acrid or sharp; and though,
during the Continuance of the Heat, Perspiration
is kept up (See Introduct. P. 28) yet as soon as
the Heat abates, especially in the Mornings and
Evenings, that Discharge is diminished; and by
how much the more Viscidity or Thickness the
Humours have acquired, in Consequence of the
violent Heats, the Discharge of the sharp Humour
by Perspiration being now checked, it is thrown
upon the Bowels which it irritates, producing
Pains in, and Evacuations from them.
This Kind of Dysentery may happen at all
Times, and in all Countries; but if other Causes,
capable of producing a Putridity of the Humours,
be complicated with it; such as the crouding up
a great Number of People into very little Room,
and very close Quarters, as in Hospitals, Camps,
or Prisons, this introduces a malignant Principle
into the Humours, which, co-operating with the
simpler Cause of the Dysentery, renders it the
more difficult and dangerous.
§ 331. This Disease begins with a general
Coldness rather than a Shivering, which lasts
some Hours; the Patient's Strength soon abates,
and he feels sharp Pains in his Belly, which
sometimes continue for several Hours, before the
Flux begins. He is affected with Vertigos, or
Swimmings in the Head, with Reachings to
vomit, and grows pale; his Pulse at the same
Time being very little, if at all, feverish, but
commonly small, and at length the Purging begins.
The first Stools are often thin, and yellowish;
but in a little Time they are mixt with a
viscid ropy Matter, which is often tinged with
Blood. Their Colour and Consistence are various
too, being either brown, greenish or black,
thinner or thicker, and fœtid: The Pains increase
before each of the Discharges, which grow
very frequent, to the Number of eight, ten,
twelve or fifteen in an Hour: then the Fundament
becomes considerably irritated, and the Tenesmus
(which is a great Urgency to go to Stool,
though without any Effect) is joined to the Dysentery
or Flux, and often brings on a Protrusion
or falling down of the Fundament, the Patient
being now most severely afflicted. Worms
are sometimes voided, and glairy hairy Humours,
resembling Pieces or Peelings of Guts, and sometimes
Clots of Blood.
If the Distemper rises to a violent Height, the
Guts become inflamed, which terminates either
in Suppuration or in Mortification; the miserable
Patient discharges Pus, or black and fœtid watery
Stools: the Hiccup supervenes; he grows
delirious; his Pulse sinks; and he falls into cold
Sweats and Faintings which terminate in Death.
A kind of Phrenzy, or raging Delirium, sometimes
comes on before the Minute of Expiration.
I have seen a very unusual Symptom accompany
this Disease in two Persons, which was
an Impossibility of swallowing, for three Days
before Death.
But in general this Distemper is not so extremely
violent; the Discharges are less frequent,
being from twenty-five to forty within a Day and
Night. Their Contents are less various and uncommon,
and mixed with very little Blood; the
Patient retains more Strength; the Number of
Stools gradually decrease; the Blood disappears;
the Consistence of the Discharges improves; Sleep
and Appetite return, and the Sick recovers.
Many of the Sick have not the least Degree of
Fever, nor of Thirst, which perhaps is less common
in this Disease, than in a simple Purging or
Looseness.
Their Urine sometimes is but in a small Quantity;
and many Patients have ineffectual Endeavours
to pass it, to their no small Affliction and
Restlessness.
§ 332. The most efficacious Remedy for this
Disease is a Vomit. That of , (when
there is no present Circumstance that forbids the
giving a Vomit) if taken immediately on the first
Invasion of it, often removes it at once; and always
shortens its Duration. That of is
not less effectual; it has been considered for a
long Time, even as a certain Specific, which it
is not, though a very useful Medicine. If the
Stools prove less frequent after the Operation of
either of them, it is a good Sign; if they are no
Ways diminished, we may apprehend the Disease
is like to be tedious and obstinate.
The Patient is to be ordered to a Regimen, abstaining
from all Flesh-meat with the strictest
Attention, until the perfect Cure of the Disease.
The Ptisan is the best Drink for him.
The Day after the Vomit, he must take the
Powder divided into two Doses: the
next Day he should take no other Medicine but
his Ptisan; on the fourth the Rhubarb must be
repeated; after which the Violence of the Disease
commonly abates: His Diet during the Disease
is nevertheless to be continued exactly for
some Days; after which he may be allowed to
enter upon that of Persons in a State of Recovery.
§ 333. The Dysentery sometimes commences
with an inflammatory Fever; a feverish, hard,
full Pulse, with a violent Pain in the Head and
Loins, and a stiff distended Belly. In such a
Case the Patient must be bled once; and daily
receive three or even four of the Glysters ,
drinking plentifully of the Drink .
When all Dread of an Inflammation is entirely
over, the Patient is to be treated in the
Manner just related; though often there is no
Necessity for the Vomit: and if the inflammatory
Symptoms have run high, his first Purge
should be that of , and the Use of the
Rhubarb may be postponed, till about the manifest
Conclusion of the Disease.
I have cured many Dysenteries, by ordering
the Sick no other Remedy, but a Cup of warm
Water every Quarter of an Hour; and it were
better to rely only on this simple Remedy, which
must be of some Utility, than to employ those,
of whose Effects Country People are ignorant,
and which are often productive of very dangerous
ones.
§ 334. It sometimes happens that the Dysentery
is combined with a putrid Fever, which
makes it necessary, after the Vomit, to give the
Purges or , and several Doses of ,
before the Rhubarb is given. is excellent
in this combined Case.
There was in Swisserland in the Autumn of
1755, after a very numerous Prevalence of epidemical
putrid Fevers had ceased, a Multitude of
Dysenteries, which had no small Affinity with,
or Relation to, such Fevers. I treated them first,
with the Prescription , giving afterwards
; and I directed the Rhubarb only to very
few, and that towards the Conclusion of the Disease.
By much the greater Number of them
were cured at the End of four or five Days. A
small Proportion of them, to whom I could not
give the Vomit, or whose Cases were more complicated,
remained languid a considerable Time,
though without Fatality or Danger.
§ 335. When the Dysentery is blended with
Symptoms of Malignity (See ) after premising
the Prescription , those of
and 39 may be called in successfully.
§ 336. When the Disease has already been of
many Days standing, without the Patient's having
taken any Medicines, or only such as were injurious
to him, he must be treated as if the Distemper
had but just commenced; unless some
Symptoms, foreign to the Nature of the Dysentery,
had supervened upon it.
§ 337. Relapses sometimes occur in Dysenteries,
some few Days after the Patients appeared
well; much the greater Number of which are
occasioned either by some Error in Diet, by cold
Air, or by being considerably over-heated. They
are to be prevented by avoiding these Causes of
them; and may be removed by putting the
Patient on his Regimen, and giving him one Dose
of the Prescription . Should it return
even without any such discoverable Causes, and if
it manifests itself to be the same Distemper renewed,
it must be treated as such.
§ 338. This Disease is sometimes combined
too with an intermitting Fever; in which Case the
Dysentery must be removed first, and the intermittent
afterwards. Nevertheless if the Access,
the Fits of the Fever have been very strong, the
Bark must be given as directed .
§ 339. One pernicious Prejudice, which still
generally prevails is, that Fruits are noxious in
a Dysentery, that they even give it, and aggravate
it; and this perhaps is an extremely ill-grounded
one. In truth bad Fruits, and such as have
not ripened well, in unseasonable Years, may
really occasion Cholics, a Looseness (though
oftner a Costiveness) and Disorders of the Nerves,
and of the Skin; but never can occasion an epidemical
Dysentery or Flux. Ripe Fruits, of whatever
Species, and especially Summer Fruits, are
the real Preservatives from this Disease. The
greatest Mischief they can effect, must result from
their thinning and washing down the Humours,
especially the thick glutinous Bile, if
they are in such a State; good ripe Fruits being
the true Dissolvents of such; by which indeed
they may bring on a Purging, but such a one, as
is rather a Guard against a Dysentery.
We had a great, an extraordinary Abundance
of Fruit in 1759 and 1760, but scarcely any
Dysenteries. It has been even observed to be
more rare, and less dangerous than formerly;
and if the Fact is certain, it cannot be attributed
to any thing more probably, than to the very numerous
Plantations of Trees, which have rendered
Fruit very plenty, cheap and common.
Whenever I have observed Dysenteries to prevail,
I made it a Rule to eat less Flesh, and Plenty of
Fruit; I have never had the slightest Attack of
one; and several Physicians use the same Caution
with the same Success.
I have seen eleven Patients in a Dysentery in
one House, of whom nine were very tractable;
they eat Fruit and recovered. The Grandmother
and one Child, whom she loved more than
the rest, were carried off. She managed the
Child after her own Fashion, with burnt Wine,
Oil, and some Spices, but no Fruit. She conducted
herself in the very same Manner, and both
died.
In a Country Seat near Berne, in the Year
1751, when these Fluxes made great Havock,
and People were severely warned against the Use
of Fruits, out of eleven Persons in the Family,
ten eat plentifully of Prunes, and not one of them
was seized with it: The poor Coachman alone
rigidly observed that Abstinence from Fruit injoined
by this Prejudice, and took a terrible Dysentery.
This same Distemper had nearly destroyed a
Swiss Regiment in Garrison in the South of
France; the Captains purchased the whole Crop of
several Acres of Vineyard; there they carried the
sick Soldiers, and gathered the Grapes for such as
could not bear being carried into the Vineyard;
those who were well eating nothing else: after
this not one more died, nor were any more even
attacked with the Dysentery.
A Clergyman was seized with a Dysentery,
which was not in the least mitigated by any Medicines
he had taken. By meer Chance he saw
some red Currans; he longed for them, and eat
three Pounds of them between seven and nine
o'Clock in the Morning; that very Day he became
better, and was entirely well on the next.
I could greatly enlarge the Number of such
Instances; but these may suffice to convince the
most incredulous, whom I thought it might be
of some Importance to convince. Far from forbidding
good Fruit, when Dysenteries rage, the
Patients should be encouraged to eat them freely;
and the Directors of the Police, instead of prohibiting
them, ought to see the Markets well
provided with them. It is a Fact of which Persons,
who have carefully informed themselves, do
not in the least doubt. Experience demonstrates
it, and it is founded in Reason, as good Fruit
counter-operates all the Causes of Dysenteries.
§ 340. It is important and even necessary, that
each Subject of this Disease should have a Close-stool
or Convenience apart to himself, as the
Matter discharged is extremely infectious: and if
they make Use of Bed-pans, they should be carried
immediately out of the Chamber, the Air of
which should be continually renewed, burning
Vinegar frequently in it.
It is also very necessary to change the Patient's
Linen frequently; without all which Precautions
the Distemper becomes more violent,
and attacks others who live in the same House.
Hence it is greatly to be wished the People in general
were convinced of these Truths.
It was Boerhaave's Opinion, that all the
Water which was drank, while Dysenteries were
epidemical, should be stummed, as we term it,
or sulphurized.
§ 341. It has happened, by some unaccountable
Fatality, that there is no Disease, for which
a greater Number of Remedies are advised, than
for the Dysentery. There is scarcely any Person
but what boasts of his own Prescription, in Preference
to all the rest, and who does not boldly
engage to cure, and that within a few Hours, a
tedious severe Disease, of which he has formed
no just Notion, with some Medicine or Composition,
of whose Operation he is totally ignorant:
while the poor Sufferer, restless and impatient,
swallows every Body's Recommendation, and
gets poisoned either through Fear, downright
Disgust or Weariness, or through entire Complaisance.
Of these many boasted Compositions,
some are only indifferent, but others pernicious.
I shall not pretend to detail all I know myself,
but after repeatedly affirming, that the only true
Method of Cure is that I have advised here, the
Purpose of which is evacuating the offending Matter;
I also affirm that all those Methods, which
have a different Scope or Drift, are pernicious;
but shall particularly observe, that the Method
most generally followed, which is that of stopping
the Stools by Astringents, or by Opiates,
is the worst of all, and even so mortal a one, as
to destroy a Multitude of People annually, and
which throws others into incurable Diseases. By
preventing the Discharge of these Stools, and inclosing
the Wolf in the Fold, it either follows, 1,
that this retained Matter irritates and inflames
the Bowels from which Inflammation excruciating
Pains arise, an acute inflammatory Cholic,
and finally a Mortification and Death; or a Schirrhus,
which degenerates into a Cancer, (of which
I have seen a dreadful Instance) or else an Abscess,
Suppuration and Ulcer. Or 2, this arrested Humour
is repelled elsewhere, producing a Scirrhus
in the Liver, or Asthmas, Apoplexy, Epilepsy,
or Falling Sickness; horrible rheumatic Pains, or
incurable Disorders of the Eyes, or of the Teguments,
the Skin and Surface.
Such are the Consequences of all the astringent
Medicines, and of those which are given to procure
Sleep in this Disease, as Venice Treacle,
Mithridate and Diascordium, when given too
early in Dysenteries.
I have been consulted on Account of a terrible
Rheumatism, which ensued immediately after
taking a Mixture of Venice Treacle and Plantain,
on the second Day of a Dysentery.
As those who advise such Medicines, are certainly
unaware of their Consequences, I hope
this Account of them will be sufficient, to prevent
their Repetition.
§ 342. Neither are Purges without their Abuse
and Danger; they determine the Course of all
the Humours more violently to the tender afflicted
Parts; the Body becomes exhausted; the Digestions
fail; the Bowels are weakened, and
sometimes even lightly ulcerated, whence incurable
Diarrhœas or Purgings ensue, and prove
fatal after many Years Affliction.
§ 343. If the Evacuations prove excessive, and
the Distemper tedious, the Patient is likely to
fall into a Dropsy; but if this is immediately
opposed, it may be removed by a regular and
drying Diet, by Strengthners, by Friction and
proper Exercise.
Chapter XXV.
Of the Itch.
Sect. 344.
he Itch is an infectious Disorder contracted
by touching infected Persons or
Cloaths, but not imbibed from the Air:
So that by carefully avoiding the Medium,
or Means of Contagion, the Disorder may
be certainly escaped.
Though any Part of the Body may be infested
with the Itch, it commonly shews itself on the
Hands, and chiefly between the Fingers. At
first one or two little Pimples or Pustules appear,
filled with a kind of clear Water, and excite a
very disagreeable Itching. If these Pustules are
broke by scratching them, the Water oozing
from them infects the neighbouring Parts. At
the Beginning of this Infection it can scarcely be
distinguished, if a Person is not well apprized of
its Nature; but in the Progress of it, the little
Pustules increase both in Number and Size; and
when they are opened by scratching, a loathsome
kind of Scab is formed, and the Malady
extends over the whole Surface. Where they
continue long, they produce small Ulcers, and
are at that Time highly contagious.
§ 345. Bad Diet, particularly the Use of Salt
Meat, bad unripe Fruit, and Uncleanliness occasion
this Disease; though it is oftnest taken by
Contagion. Some very good Physicians suppose
it is never contracted otherwise; but I must take
Leave to dissent, as I have certainly seen it exist
without Contagion.
When it happens to a Person, who cannot suspect
he has received it by Contact, his Cure should
commence with a total Abstinence from all Salt,
sour, fat and spicy Food. He should drink a
Ptisan of wild and bitter Succory, or that of ,
five or six Glasses of which may be daily
taken; at the End of four or five Days, he may
be purged with , or with an Ounce of
Sedlitz [or Epsom] Salt. His Abstinence, his
Regimen is to be continued; the Purge to be repeated
after six or seven Days; and then all the
Parts affected, and those very near them, are to be
rubbed in the Morning fasting, with a fourth
Part of the Ointment . The three following
Days the same Friction is to be repeated,
after which the same Quantity of Ointment is to
be procured, and used in the same Proportion;
but only every other Day. It happens but seldom
that this Method fails to remove this disagreeable
Malady; sometimes however it will return, in
which Case, the Patient must be purged again,
and then recur to the Ointment, whose good
Effects I have experienced, and continually do.
If the Disease has been very lately contracted,
and most certainly by Contact, the Ointment
may be fearlessly employed, as soon as it is discovered,
without taking any Purge before it. But
if, on the contrary, the Disease has been long
neglected, and has rose to a high Degree, it will
be necessary to restrain the Patient a long Time
to the Regimen I have directed; he must be repeatedly
purged, and then drink plentifully of the
Ptisan , before the Ointment is rubbed in.
When the Malady is thus circumstanced, I have
always begun with the Ointment , half a
Quarter of which is to be used every Morning.
I have also frequently omitted the Use of that
, having always found the former as certain,
but a little slower in its Effects.
§ 346. While these Medicines are employed,
the Patient must avoid all Cold and Wet, especially
if he makes Use of , in which
there is Quick-silver; which, if such Precautions
were neglected, might bring on a Swelling of the
Throat and Gums, and even rise to a Salivation.
Yet this Ointment has one Advantage in its having
no Smell, and being susceptible of an agreeable
one; while it is very difficult to disguise the
disagreeable Odour of the other.
The Linen of a Person in this Disease ought to
be often changed; but his upper Cloaths must not
be changed: because these having been infected,
might, when worn again, communicate the Itch
to the Wearer again, after he had been cured.
Shirts, Breeches and Stockings may be fumigated
with Sulphur, before they are put on; and
this Fumigation should be made in the open Air.
§ 347. If this Disorder becomes very inveterate
and tedious, it exhausts the Patient, in Consequence
of its not suffering him to sleep at
Nights, as well as by his restless Irritation; and
sometimes even brings on a Fever, so that he falls
away in Flesh, and his Strength abates.
In such a Case he must take, 1, a gentle Purge.
2, Make Use frequently of warm Baths.
3, He must be put on the Regimen of Persons
in a State of Recovery.
4, He must take Morning and Evening, fifteen
Days successively, the Powder , with the
Ptisan .
This Malady is often very obstinate, and then
the Medicines must be varied according to the
Circumstances, the Detail of which I avoid here.
§ 348. After giving repeated Purges in such
obstinate Cases, mineral Waters abounding with
Sulphur, such as those of Yverdun, &c. often
effect a Cure; and simple cold Bathings in Rivers
or Lakes have sometimes succeeded in very
inveterate Cases of this Disorder.
Nothing conduces more to the long Continuance
of this Malady, than the Abuse of hot
Waters, such as infusions of Tea, &c.
§ 349. I shall conclude this Chapter, with a
repeated Injunction not to be too free or rash in the
Use of the Ointment , and other outward
Remedies for extinguishing the Itch. There is
hardly any Complaint, but what has been found
to be the Consequence of too sudden a Removal
of this Disorder by outward Applications,
before due Evacuations have been made, and a
moderate Abatement of the Sharpness of the Humours
has been effected.
Chapter XXVI.
The Treatment of Diseases peculiar to Women.
Sect. 350.
esides all the preceding Diseases, to
which Women are liable in common
with Men, their Sex also exposes them
to others peculiar to it, and which depend
upon four principal Sources; which are their
monthly Discharges, their Pregnancy, their Labours
in Child-birth, and the Consequences of
their Labours. It is not my present Design to
treat professedly on each of the Diseases arising
from these Causes, which would require a larger
Volume than I have proposed; but I shall confine
myself to certain general Directions on these
four Heads.
§ 351. Nature, who intended Women for the
Increase, and the Nourishment of the human
Race at the Breast, has subjected them to a periodical
Efflux, or Discharge, of Blood: which
Circumstance constitutes the Source, from whence the
Infant is afterwards to receive his Nutrition and
Growth.
This Discharge generally commences, with us,
between the Age of sixteen and eighteen. Young
Maidens, before the Appearance of this Discharge,
are frequently, and many for a long Time,
in a State of Weakness, attended with various Complaints,
which is termed the Chlorosis, or Green
Sickness, and Obstructions: and when their Appearance
is extremely slow and backward, it occasions
very grievous, and sometimes even mortal
Diseases. Nevertheless it is too usual, though
very improper, to ascribe all the Evils, to which
they are subject at this Term of Life, solely to
this Cause; while they really often result from a
different Cause, of which the Obstructions themselves
are sometimes only the Effect; and this is
the natural, and, in some Degree, even necessary
Feebleness of the Sex. The Fibres of Women
which are intended to be relaxed, and to
give Way, when they are unavoidably extended
by the Growth of the Child, and its inclosing
Membranes (which frequently arise to a very
considerable Size) should necessarily be less stiff
and rigid, less strong, and more lax and yielding
than the Fibres of Men. Hence the Circulation
of their Blood is more slow and languid than
in Males; their Blood is less compact and dense,
and more watery; their Fluids are more liable to
stagnate in their different Bowels, and to form
Infarctions and Obstructions.
§ 352. The Disorders to which such a Constitution
subjects them might, in some Measure,
be prevented, by assisting that Languor or Feebleness
of their natural Movements, by such an Increase
of their Force, as Exercise might contribute
to: But this Assistance, which in some Manner
is more necessary for Females than Males, they
are partly deprived of, by the general Education
and Habitude of the Sex; as they are usually
employed in managing Household Business, and
such light sedentary Work, as afford them less
Exercise and Motion, than the more active Occupations
of Men. They stir about but little,
whence their natural Tendency to Weakness increases
from Habit, and thence becomes morbid
and sickly. Their Blood circulates imperfectly;
its Qualities become impaired; the Humours tend
to a pretty general Stagnation; and none of the
vital Functions are completely discharged.
From such Causes and Circumstances they begin
to sink into a State of Weakness, sometimes
while they are very young, and many Years before
this periodical Discharge could be expected.
This State of Languor disposes them to be inactive;
a little Exercise soon fatigues them, whence
they take none at all. It might prove a Remedy,
and even effect a Cure, at the Beginning of their
Complaint; but as it is a Remedy, that is painful
and disagreeable to them, they reject it, and
thus increase their Disorders.
Their Appetite declines with the other vital
Functions, and gradually becomes still less; the
usual salutary Kinds of Food never exciting it;
instead of which they indulge themselves in whimsical
Cravings, and often of the oddest and most
improper Substances for Nutrition, which entirely
impair the Stomach with its digestive Functions,
and consequently Health itself.
But sometimes after the Duration of this State
for a few Years, the ordinary Time of their
monthly Evacuations approaches, which however
make not the least Appearance, for two Reasons.
The first is, that their Health is too much
impaired to accomplish this new Function, at a
Time when all the others are so languid: and
the second is, that under such Circumstances,
the Evacuations themselves are unnecessary; since
their final Purpose is to discharge (when the Sex
are not pregnant) that superfluous Blood, which
they were intended to produce, and whose Retention
would be unhealthy, when not applied
to the Growth of the Fœtus, or Nourishment of
the Child: and this Superfluity of Blood does
not exist in Women, who have been long in a
very low and languishing State.
§ 353. Their Disorder however continues to
increase, as every one daily must, which does
not terminate. This Increase of it is attributed
to the Suppression or Non-appearance of their
monthly Efflux, which is often erroneous; since
the Disorder is not always owing to that Suppression,
which is often the Effect of their Distemperature.
This is so true, that even when the
Efflux happens, if their Weakness still continues,
the Patients are far from being the better for it,
but the reverse. Neither is it unusual to see
young Lads, who have received from Nature,
and from their Parents, a sort of feminine Constitution,
Education and Habitude, infested with
much the same Symptoms, as obstructed young
Women.
Country Girls, who are generally more accustomed
to such hardy Work and Exercise as
Country Men, are less subject to these Complaints,
than Women who live in Cities.
§ 354. Let People then be careful not to deceive
themselves on this important Account;
since all the Complaints of young Maidens are
not owing to the Want of their Customs. Nevertheless
it is certain there are some of them, who
are really afflicted from this Cause. For Instance,
when a strong young *** in full Health, who
is nearly arrived to her full Growth, and who
manifestly abounds with Blood, does not obtain
this Discharge at the usual Time of Life, then indeed
this superfluous Blood is the Fountain of very
many Disorders, and greatly more violent ones
than those, which result from the contrary Causes
already mentioned.
If the lazy inactive City Girls are more subject
to the Obstructions, which either arise from
the Weakness and Languor I have formerly taken
Notice of, or which accompany it; Country
Girls are more subject to Complaints from this
latter Cause (too great a Retention of superfluous
Blood) than Women who live in Cities: and it is
this last Cause that excites those singular Disorders,
which appear so supernatural to the common
People, that they ascribe them to Sorcery.
§ 355. And even after these periodical Discharges
have appeared, it is known that they
have often been suppressed, without the least unhealthy
Consequence resulting from that Suppression.
They are often suppressed, in the Circumstances
mentioned , by a Continuance of
the Disease, which was first an Obstacle or Retardment
to their Appearance; and in other Cases,
they have been suppressed by other Causes, such
as Cold, Moisture, violent Fear, any very strong
Passion; by too chilly a Course of Diet, with Indigestion;
or too hot and irritating Diet; by
Drinks cooled with Ice, by Exercise too long
continued, and by unusual Watching. The
Symptoms, occasioned by such Suppressions, are
sometimes more violent than those, which preceded
the first Appearance of the Discharge.
§ 356. The great Facility with which this
Evacuation may be suppressed, diminished, or
disordered, by the Causes already assigned; the
terrible Evils which are the Consequences of such
Interruptions and Irregularities of them, seem to
me very cogent Reasons to engage the Sex to use
all possible Care, in every Respect, to preserve
the Regularity of them; by avoiding, during
their Approach and Continuance, every Cause
that may prevent or lessen them. Would they
be thoroughly persuaded, not solely by my Advice,
but by that of their Mothers, their
Relations, their Friends, and by their own Experience,
of what great Importance it is to be very
attentive to themselves, at those critical Times,
I think there is not one Woman, who from the
first, to the very last Appearance of them, would
not conduct herself with the most scrupulous Regularity.
Their Demeanour, in these Circumstances,
very fundamentally interests their own Health,
as well as that of their Children; and consequently
their own Happiness, as well as that of
their Husbands and Families.
The younger and more delicate they are, Caution
becomes the more necessary for them. I am
very sensible a strong Country Girl is too negligent
in regulating herself at those critical Seasons,
and sometimes without any ill Consequence;
but at another Time she may suffer severely for
it: and I could produce a long List of many, who,
by their Imprudence on such Occasions, have
thrown themselves into the most terrible Condition.
Besides the Caution with which Females should
avoid these general Causes, just mentioned in the
preceding Section, every Person ought to remember
what has most particularly disagreed with her
during that Term, and for ever constantly to reject
it.
§ 357. There are many Women whose Customs
visit them without the slightest Impeachment
of their Health: others are sensibly disordered
on every Return of them; and to others
again they are very tormenting, by the violent
Cholics, of a longer or a shorter Duration, which
precede or accompany them. I have known
some of these violent Attacks last but some Minutes,
and others which continued a few Hours.
Nay some indeed have persisted for many Days,
attended with Vomiting, Fainting, with Convulsions
from excessive Pain, with Vomiting of Blood,
Bleedings from the Nose, &c. which, in short,
have brought them to the very Jaws of Death.
So very dangerous a Situation requires the closest
Attention; though, as it results from several and frequently
very opposite Causes, it is impossible
within the present Plan, to direct the Treatment
that may be proper for each Individual. Some
Women have the Unhappiness to be subject to
these Symptoms every Month, from the first Appearance,
to the final Termination, of these Discharges;
except proper Remedies and Regimen,
and sometimes a happy Child-birth, remove them.
Others complain but now and then, every second,
third, or fourth Month; and there are
some again, who having suffered very severely
during the first Months, or Years, after their
first Eruptions, suffer no more afterwards. A
fourth Number, after having had their Customs for
a long Time, without the least Complaint, find
themselves afflicted with cruel Pains, at every
Return of them; if by Imprudence, or some inevitable
Fatality, they have incurred any Cause,
that has suppressed, diminished, or delayed them.
This Consideration ought to suggest a proper
Caution even to such, as generally undergo these
Discharges, without Pain or Complaint: since all
may be assured, that though they suffer no sensible
Disorder at that Time, they are nevertheless
more delicate, more impressible by extraneous
Substances, more easily affected by the
Passions of the Mind, and have also weaker Stomachs
at these particular Periods.
§ 358. These Discharges may also be sometimes
too profuse in Quantity, in which Case the
Patients become obnoxious to very grievous Maladies;
into the Discussion of which however I
shall not enter here, as they are much less frequent
than those, arising from a Suppression of
them. Besides which, in such Cases, Recourse
may be had to the Directions I shall give hereafter,
when I treat of that Loss of Blood, which
may be expedient, during the Course of Gravidation
or Pregnancy. See .
§ 359. Finally, even when they are the most
regular, after their Continuance for a pretty certain
Number of Years (rarely exceeding thirty-five)
they go off of their own Accord, and necessarily,
between the Age of forty-five and fifty;
sometimes even sooner, but seldom continuing
longer: and this Crisis of their ceasing is generally
a very troublesome, and often a very dangerous,
one for the Sex.
§ 360. The Evils mentioned may be
prevented, by avoiding the Causes producing
them; and, 1, by obliging young Maidens to
use considerable Exercise; especially as soon as
there is the least Reason to suspect the Approach
of this Disorder, the Chlorosis, or Green Sickness.
2, By watching them carefully, that they eat
nothing unwholesome or improper; as there are
scarcely any natural Substances, even among such
as are most improper for them, and the most distasteful,
which have not sometimes been the Objects
of their sickly, their unaccountable Cravings.
Fat Aliments, Pastry, farinaceous or mealy, and
sour and watery Foods are pernicious to them.
Herb-Teas, which are frequently directed as a
Medicine for them, are sufficient to throw them
into the Disorder, by increasing that Relaxation
of their Fibres, which is a principal Cause of it.
If they must drink any such Infusions, as medicated
Drinks, let them be taken cold: but the
best Drink for them is Water, in which red hot
Iron has been extinguished.
3, They must avoid hot sharp Medicines, and
such as are solely intended to force down their
Terms, which are frequently attended with very
pernicious Consequences, and never do any good:
and they are still the more hurtful, as the Patient
is the younger.
4, If the Malady increases, it will be necessary
to give them some Remedies; but these should
not be Purges, nor consist of Diluters, and Decoctions
of Herbs, of Salts, and a Heap of other
useless and noxious Ingredients; but they should
take Filings of Iron, which is the most certain
Remedy in such Cases. These Filings Should be
of true simple Iron, and not from Steel; and Care
should be taken that it be not rusty, in which
State it has very little Effect.
At the Beginning of this Distemper, and to
young Girls, it is sufficient to give twenty Grains
daily, enjoining due Exercise and a suitable Diet.
When it prevails in a severer Degree, and the
Patient is not so young, a Quarter of an Ounce
may be safely ventured on: Certain Bitters or
Aromatics may be advantageously joined to the
Filings, which are numbered in the Appendix,
, , , and constitute the most effectual
Remedies in this Distemper, to be taken in the
Form of Powder, of vinous Infusion, or of Electary.
When there is a just Indication to bring
down the Discharge, the vinous Infusion
must be given, and generally succeeds: but I
must again repeat it (as it should carefully be
considered) that the Stoppage or Obstruction of
this Discharge is frequently the Effect, not the
Cause, of this Disease; and that there should be
no Attempt to force it down, which in such a
Case, may sometimes prove more hurtful than
beneficial; since it would naturally return of its
own Accord, on the Recovery, and with the
Strength, of the Patient: as their Return should
follow that of perfect Health, and neither can
precede Health, nor introduce it. There are
some Cases particularly, in which it would be
highly dangerous to use hot and active Medicines,
such Cases for Instance, as are attended with some
Degree of Fever, a frequent Coughing, a Hæmorrhage,
or Bleeding, with great Leanness and considerable
Thirst: all which Complaints should
be removed, before any hot Medicines are given
to force this Evacuation, which many very ignorantly
imagine cures all other female Disorders; an
Error, that has prematurely occasioned the Loss
of many Womens' Lives.
§ 361. While the Patient is under a Course
of these Medicines, she should not take any of
those I have forbidden in the preceding Sections;
and the Efficacy of these should also be furthered
with proper Exercise. That in a Carriage is very
healthy; Dancing is so too, provided it be not
extended to an Excess. In Case of a Relapse in
these Disorders, the Patient is to be treated, as if
it were an original Attack.
§ 362. The other Sort of Obstructions described
requires a very different Treatment.
Bleeding, which is hurtful in the former Sort,
and the Use, or rather Abuse, of which has
thrown several young Women into irrecoverable
Weaknesses, has often removed this latter Species,
as it were, in a Moment. Bathing of the
Feet, the Powders , and Whey have frequently
succeeded: but at other Times it is necessary
to accommodate the Remedies and the
Method to each particular Case, and to judge of it
from its own peculiar Circumstances and Appearances.
§ 363. When these Evacuations naturally
cease through Age (See ) if they stop
suddenly and all at once, and had formerly flowed
very largely, Bleeding must, 1, necessarily be
directed, and repeated every six, every four, or
even every three Months.
2, The usual Quantity of Food should be
somewhat diminished, especially of Flesh, of
Eggs and of strong Drink.
3, Exercise should be increased.
4, The Patient should frequently take, in a
Morning fasting, the Powder , which is
very beneficial in such Cases; as it moderately
increases the natural Excretions by Stool, Urine
and Perspiration; and thence lessens that Quantity
of Blood, which would otherwise superabound.
Nevertheless, should this total Cessation of the
monthly Discharge be preceded by, or attended
with, any extraordinary Loss of Blood, which is
frequently the Case, Bleeding is not so necessary;
but the Regimen and Powder just directed are
very much so; to which the Purge should
now and then be joined, at moderate Intervals.
The Use of astringent Medicines at this critical
Time might dispose the Patient to a Cancer of the
Womb.
Many Women die about this Age, as it is but
too easy a Matter to injure them then; a
Circumstance that should make them very cautious
and prudent in the Medicines they recur to. On
the other Hand it also frequently happens, that
their Constitutions alter for the better, after this
critical Time of Life; their Fibres grow stronger;
they find themselves sensibly more hearty and
hardy; many former slight Infirmities disappear,
and they enjoy a healthy and happy old Age. I
have known several who threw away their Spectacles
at the Age of fifty-two, or fifty-three,
which they had used five or six Years before.
The Regimen I have just directed, the Powder
, and the Potion , agree very well
in almost all inveterate Discharges (I speak of
the female Peasantry) at whatever Time of Life.
Of Disorders attending Gravidation, or the Term of going with Child.
§ 364. Gravidation is generally a less ailing or
unhealthy State in the Country, than in very populous
Towns. Nevertheless Country Women
are subject, as well as Citizens, to Pains of the
Stomach, to vomiting in a Morning, to Head-ach
and Tooth-ach; but these Complaints very
commonly yield to Bleeding, which is almost the
only Remedy necessary for pregnant Women.
§ 365. Sometimes after carrying too heavy
Burthens; after too much or too violent Work;
after receiving excessive Jolts, or having had a
Fall, they are subject to violent Pains of the
Loins, which extend down to their Thighs, and
terminate quite at the Bottom of the Belly; and
which commonly import, that they are in Danger
of an Abortion, or Miscarrying.
To prevent this Consequence, which is always
dangerous, they should, 1, immediately go to
Bed; and if they have not a Mattrass, they
should lie upon a Bed stuffed with Straw, a
Feather-bed being very improper in such Cases.
They should repose, or keep themselves quite
still in this Situation for several Days, not stirring,
and speaking as little as possible.
2, They should directly lose eight or nine
Ounces of Blood from the Arm.
3, They should not eat Flesh, Flesh-broth,
nor Eggs; but live solely on Soups made of
farinaceous or mealy Substances.
4, They should take every two Hours half a
Paper of the Powder ; and should drink
nothing but the Ptisan .
Some sanguine robust Women are very liable
to miscarry at a certain Time, or Stage, of their
Pregnancy. This may be obviated by their
bleeding some Days before that Time approaches,
and by their observing the Regimen I have advised.
But this Method would avail very little
for delicate Citizens, who miscarry from a very
different Cause; and whose Abortions are to be
prevented by a very different Treatment.
Of Delivery, or Child-birth.
§ 366. It has been observed that a greater
Proportion of Women die in the Country in, or
very speedily after, their Delivery, and that from
the Scarcity of good Assistance, and the great
Plenty of what is bad; and that a greater Proportion
of those in Cities die after their Labours are
effected, by a Continuance of their former bad
Health.
The Necessity there is for better instructed, better
qualified Midwives, through a great Part of
Swisserland, is but too manifest an Unhappiness,
which is attended with the most fatal Consequences,
and which merits the utmost Attention
of the Government.
The Errors which are incurred, during actual
Labour, are numberless, and too often indeed
are also irremediable. It would require a whole
Book, expressly for that Purpose (and in some
Countries there are such) to give all the Directions
that are necessary, to prevent so many Fatalities:
and it would be as necessary to form a sufficient
Number of well-qualified Midwives to
comprehend, and to observe them; which exceeds
the Plan of the Work I have proposed. I
shall only mark out one of the Causes, and the
most injurious one on this Occasion: This is the
Custom of giving hot irritating Things, whenever
the Labour is very painful, or is slow; such
as Castor, or its Tincture, Saffron, Sage, Rue,
Savin, Oil of Amber, Wine, Venice Treacle,
Wine burnt with Spices, Coffee, Brandy, Aniseed-Water,
Walnut-Water, Fennel-Water, and
other Drams or strong Liquors. All these Things
are so many Poisons in this Respect, which, very
far from promoting the Woman's Delivery, render
it more difficult by inflaming the Womb
(which cannot then so well contract itself) and
the Parts, through which the Birth is to pass, in
Consequence of which they swell, become more
straitened, and cannot yield or be dilated. Sometimes
these stimulating hot Medicines also bring
on Hæmorrhages, which prove mortal in a few
Hours.
§ 367. A considerable Number, both of Mothers
and Infants, might be preserved by the directly
opposite Method. As soon as a Woman
who was in very good Health, just before the Approach
of her Labour, being robust and well
made, finds her Travail come on, and that it is
painful and difficult; far from encouraging those
premature Efforts, which are always destructive;
and from furthering them by the pernicious Medicines
I have just enumerated, the Patient should
be bled in the Arm, which will prevent the Swelling
and Inflammation; asswage the Pains; relax
the Parts, and dispose every thing to a favourable
Issue.
During actual Labour no other Nourishment
should be allowed, except a little Panada every
three Hours, and as much Toast and Water, as
the Woman chuses.
Every fourth Hour a Glyster should be given,
consisting of a Decoction of Mallows and a little
Oil. In the Intervals between these Glysters she
should be set over a kind of Stove, or in a pierced
easy Chair, containing a Vessel in which there is
some hot Water: the Passage should be gently
rubbed with a little Butter; and Stapes wrung
out of a Fomentation of simple hot Water, which
is the most efficacious of any, should be applied
over the Belly.
The Midwives, by taking this Method, are
not only certain of doing no Mischief, but they
also allow Nature an Opportunity of doing Good:
as a great many Labours, which seem difficult at
time, terminate happily; and this safe and unprecipitate
Manner of proceeding at least affords Time
to call in further Assistance. Besides, the Consequences
of such Deliveries are healthy and happy;
when by pursuing the heating oppressing Practice,
even though the Delivery be effected, both
Mother and Infant have been so cruelly, though
undesignedly, tormented, that both of them frequently
perish.
§ 368. I acknowledge these Means are insufficient,
when the Child is unhappily situated in
the Womb; or when there is an embarrassing
Conformation in the Mother: though at least
they prevent the Case from proving worse, and leave
Time for calling in Men-Midwives, or other female
ones, who may be better qualified.
I beg leave again to remind the Midwives,
that they should be very cautious of urging their
Women to make any forced Efforts to forward the
Birth, which are extremely injurious to them, and
which may render a Delivery very dangerous
and embarrassing, that might otherwise have
been happily effected: and I insist the more
freely on the Danger attending these unreasonable
Efforts, and on the very great Importance of
Patience, as the other very pernicious Practice is
become next to universal amongst us.
The Weakness, in which the labouring Woman
appears, makes the By-standers fearful that
she will not have Strength enough to be delivered;
which they think abundantly justifies them
in giving her Cordials; but this Way of Reasoning
is very weak and chimerical. Their Strength,
on such Occasions, is not so very speedily
dissipated: the small light Pains sink them, but in
Proportion as the Pains become stronger, their
Strength arises; being never deficient, when there
is no extraordinary and uncommon Symptom;
and we may reasonably be assured, that in a
healthy, well formed Woman, meer Weakness
never prevents a Delivery.
Of the Consequences of Labour, or Childbirth.
§ 369. The most usual Consequences of Childbirth
in the Country are, 1, An excessive Hæmorrhage.
2, An Inflammation of the Womb.
3, A sudden Suppression of the Lochia, or usual
Discharges after Delivery. And, 4, the Fever
and other Accidents, resulting from the Milk.
Excessive Bleedings or Floodings, should be
treated according to the Manner directed :
and if they are very excessive, Folds of Linen,
which have been wrung out of a Mixture of
equal Parts of Water and Vinegar, should be applied
to the Belly, the Loins, and the Thighs:
these should be changed for fresh moist ones, as
they dry; and should be omitted, as soon as the
Bleeding abates.
§ 370. The Inflammation of the Womb is
discoverable by Pains in all the lower Parts of the
Belly; by a Tension or Tightness of the whole;
by a sensible Increase of Pain upon touching it; a
kind of red Stain or Spot, that mounts to the
Middle of the Belly, as high as the Navel;
which Spot, as the Disease increases, turns black,
and then is always a mortal Symptom; by a very
extraordinary Degree of Weakness; an astonishing
Change of Countenance; a light Delirium or
Raving; a continual Fever with a weak and hard
Pulse; sometimes incessant Vomitings; a frequent
Hiccup; a moderate Discharge of a reddish,
stinking, sharp Water; frequent Urgings to go
to Stool; a burning kind of Heat of Urine; and
sometimes an entire Suppression of it.
§ 371. This most dangerous and frequently
mortal Disease should be treated like inflammatory
ones. After Bleeding, frequent Glysters
of warm Water must by no Means be omitted;
some should also be injected into the Womb, and
applied continually over the Belly. The Patient
may also drink continually, either of simple
Barley-Water, with a Quarter of an Ounce of Nitre
in every Pot of it, or of Almond Milk .
§ 372. The total Suppression of the Lochia,
the Discharges after Labour, which proves a Cause
of the most violent Disorders, should be treated
exactly in the same Manner: but if unhappily
hot Medicines have been given, in order to force
them down, the Case will very generally prove a
most hopeless one.
§ 373. If the Milk-fever run very high, the
Barley Ptisan directed , and Glysters, with
a very light Diet, consisting only of Panada, or
made of some other farinaceous Substances, and
very thin, very generally remove it.
§ 374. Delicate infirm Women, who have
not all the requisite and necessary Attendance
they want; and such as from Indigence are
obliged to work too soon, are exposed to many
Accidents, which frequently arise from a Want
of due Perspiration, and an insufficient Discharge
of the Lochia; and hence, the Separation of the
Milk in their *** being disturbed, there are
milky Congestions, or Knots as it were, which
are always very painful and troublesome, and
especially when they are formed more inwardly.
They often happen on the Thighs, in which
Case the Ptisan is to be drank, and the
Pultices must be applied. These two
Remedies gradually dissipate and remove the
Tumour, if that may be effected without Suppuration.
But if that proves impossible, and Pus,
or Matter, is actually formed, a Surgeon must
open the Abscess, and treat it like any other.
§ 375. Should the Milk coagulate, or curdle
as it were, in the Breast, it is of the utmost Importance
immediately to attenuate or dissolve
that Thickness, which would otherwise degenerate
into a Hardness and prove a Scirrhus; and
from a Scirrhus in Process of Time a Cancer,
that most tormenting and cruel Distemper.
This horrible Evil however may be prevented
by an Application to these small Tumours, as
soon as ever they appear, For this Purpose nothing
is more effectual than the Prescriptions
and ; but under such menacing Circumstances,
it is always prudent to take the best Advice,
as early as possible.
From the Moment these hard Tumours become
excessively and obstinately so, and yet
without any Pain, we should abstain from every
Application, all are injurious; and greasy, sharp,
resinous and spirituous ones speedily change the
Scirrhus into a Cancer. Whenever it becomes
manifestly such, all Applications are also equally
pernicious, except that of . Cancers have
long been thought and found incurable; but
within a few Years past some have been cured by
the Remedy ; which nevertheless is not
infallible, though it should always be tried.
§ 376. The Nipples of Women, who give
Milk, are often fretted or excoriated, which proves
very severely painful to them. One of the best
Applications is the most simple Ointment, being
a Mixture of Oil and Wax melted together; or
the Ointment . Should the Complaint
prove very obstinate, the Nurse ought to be
purged, which generally removes it.
Chapter XXVII.
Medical Directions concerning Children.
Sect. 377.
he Diseases of Children, and every
Thing relating to their Health, are Objects
which generally seem to have been
too much neglected by Physicians;
and have been too long confided to the Conduct
of the most improper Persons for such a Charge.
At the same Time it must be admitted their
Health is of no little Importance; their Preservation
is as necessary as the Continuance of the
human Race; and the Application of the Practice
of Physick to their Disorders is susceptible of
nearer Approaches to Perfection, than is generally
conceived. It seems to have even some Advantage
over that Practice which regards grown
Persons; and it consists in this, that the Diseases
of Children are more simple, and less frequently
complicated than those of Adults.
It may be said indeed, they cannot make
themselves so well understood, and meer Infants
certainly not at all. This is true in Fact to a
certain Degree, but not rigidly true; for though
they do not speak our Language, they have one
which we should contrive to understand. Nay
every Distemper may be said, in some Sense, to
have a Language of its own, which an attentive
Physician will learn. He should therefore use
his utmost Care to understand that of Infants, and
avail himself of it, to increase the Means of rendering
them healthy and vigorous, and to cure
them of the different Distempers to which they
are liable. I do not propose actually to compleat
this Task myself, in all that Extent it may
justly demand; but I shall set forth the principal
Causes of their Distempers, and the general Method
of treating them. By this Means I shall at
least preserve them from some of the Mischiefs
which are too frequently done them; and the
lessening such Evils as Ignorance, or erroneous
Practice, occasions, is one of the most important
Purposes of the present Work.
§ 378. Nearly all the Children who die before
they are one Year, and even two Years,
old, die with Convulsions: People say they died
of them, which is partly true, as it is in Effect,
the Convulsions that have destroyed them. But
then these very Convulsions are the Consequences,
the Effects, of other Diseases, which
require the utmost Attention of those, who are
entrusted with the Care and Health of the little
Innocents: as an effectual Opposition to these
Diseases, these morbid Causes, is the only Means
of removing the Convulsions. The four principal
known Causes are, the Meconium; the Excrements
contained in the Body of the Infant, at
the Birth; Acidities, or sharp and sour Humours;
the Cutting of the Teeth, and Worms. I shall
treat briefly of each.
Of the Meconium.
§379. The Stomach and Guts of the Infant,
at its Entrance into the World, are filled with a
black Sort of Matter, of a middling Consistence,
and very viscid or glutinous, which is called the
Meconium. It is necessary this Matter should be
discharged before the Infant sucks, since it would
otherwise corrupt the Milk, and, becoming extremely
sharp itself, there would result from their
Mixture a double Source of Evils, to the Destruction
of the Infant.
The Evacuation of this Excrement is procured,
1, By giving them no Milk at all for the first
twenty-four Hours of their Lives. 2, By making
them drink during that Time some Water, to
which a little Sugar or Honey must be added,
which will dilute this Meconium, and promote
the Discharge of it by Stool, and sometimes by
vomiting.
To be the more certain of expelling all this
Matter, they should take one Ounce of Compound
Syrup of Succory, which should be
diluted with a little Water, drinking up this Quantity
within the Space of four or five Hours.
This Practice is a very beneficial one, and it is
to be wished it were to become general. This
Syrup is greatly preferable to all others, given in
such Cases, and especially to Oil of Almonds.
Should the great Weakness of the Child seem
to call for some Nourishment, there would be
no Inconvenience in allowing a little Biscuit well
boiled in Water, which is pretty commonly
done, or a little very thin light Panada.
Of Acidities, or sharp Humours.
§ 380. Notwithstanding the Bodies of Children
have been properly emptied speedily after
their Birth, yet the Milk very often turns sour
in their Stomachs, producing Vomitings, violent
Cholics, Convulsions, a Looseness, and even terminating
in Death. There are but two Purposes
to be pursued in such Cases, which are to carry
off the sour or sharp Humours, and to prevent
the Generation of more. The first of these Intentions
is best effected by the Syrup of Succory
just mentioned.
The Generation of further Acidities is prevented,
by giving three Doses daily, if the Symptoms
are violent, and but two, or even one only, if
they are very moderate, of the Powder ,
drinking after it Bawm Tea, or a Tea of Lime-tree
Leaves.
§ 381. It has been a Custom to load Children
with Oil of Almonds, as soon as ever they are infested
with Gripes: but it is a pernicious Custom,
and attended with very dangerous Consequences.
It it very true that this Oil sometimes immediately
allays the Gripes, by involving, or sheathing
up, as it were, the acid Humours, and somewhat
blunting the Sensibility of the Nerves. But
it proves only a palliative Remedy, or asswaging
for a Time, which, far from removing, increases
the Cause, since it becomes sharp and rancid itself;
whence the Disorder speedily returns, and
the more Oil the Infant takes, it is griped the
more. I have cured some Children of such Disorders,
without any other Remedy, except abstaining
from Oil, which weakens their Stomachs,
whence their Milk is less perfectly, and more
slowly digested, and becomes more easily soured.
Besides this Weakness of the Stomach, which
thus commences at that very early Age, has
sometimes an unhealthy Influence on the Constitution
of the Child, throughout the Remainder
of his Life.
A free and open Belly is beneficial to Children;
now it is certain that the Oil very often binds
them, in Consequence of its diminishing the
Force and Action of the Bowels. There is
scarcely any Person, who cannot observe this
Inconvenience attending it; notwithstanding they
all continue to advise and to give it, to obtain a
very different Purpose: But such is the Power
of Prejudice in this Case, and in so many others;
People are so strongly pre-possessed with a Notion,
that such a Medicine must produce such an Effect;
that its never having produced it avails nothing
with them, their Prejudice still prevails;
they ascribe its Want of Efficacy to the Smallness
of the Doses; these are doubled then, and notwithstanding
its bad Effects are augmented, their
obstinate Blindness continues.
This Abuse of the Oil also disposes their Child
to knotty hard Tumours, and at length often
proves the first Cause of some Diseases of the
Skin, whose Cure is extremely difficult.
Hence it is evident, this Oil should be used on
such Occasions but very seldom; and that it is
always very injudicious to give it in Cholics,
which arise from sharp and sour Humours in the
Stomach, or in the Bowels.
§ 382. Infants are commonly most subject to
such Cholics during their earliest Months; after
which they abate, in Proportion as their Stomachs
grow stronger. They may be relieved in
the Fit by Glysters of a Decoction of Chamomile
Flowers, in which a Bit of Soap of the Size of a
Hazel Nut is dissolved. A Piece of Flanel wrung
out of a Decoction of Chamomile Flowers, with
the Addition of some Venice Treacle, and applied
hot over the Stomach and on the Belly, is also
very beneficial, and relieving.
Children cannot always take Glysters, the Continuance
of which Circumstance might be dangerous
to them; and every one is acquainted with
the common Method of substituting Suppositories
to them, whether they are formed of the smooth
and supple Stalks of Vines, &c. of Soap, or of
Honey boiled up to a proper Consistence.
But one of the most certain Means to prevent
these Cholics, which are owing to Children's
not digesting their Milk, is to move and exercise
them as much as possible; having a due Regard
however to their tender Time of Life.
§ 383. Before I proceed to the third Cause
of the Diseases of Children, which is, the
Cutting of their Teeth, I must take Notice of
the first Cares their Birth immediately requires,
that is the Washing of them the first Time,
meerly to cleanse, and afterwards, to strengthen
them.
Of washing Children.
§ 384. The whole Body of an Infant just born
is covered with a gross Humour, which is occasioned
by the Fluids, in which it was suspended
in the Womb. There is a Necessity to cleanse
it directly from this, for which nothing is so proper
as a Mixture of one third Wine, and two
thirds Water; Wine alone would be dangerous.
This Washing may be repeated some Days successively;
but it is a bad Custom to continue to
wash them thus warm, the Danger of which is
augmented by adding some Butter to the Wine
and Water, which is done too often. If this
gross Humour, that covers the Child, seems
more thick and glutinous than ordinary, a Decoction
of Chamomile Flowers, with a little Bit of
Soap, may be used to remove it. The Regularity
of Perspiration is the great Foundation of
Health; to procure this Regularity the Teguments,
the Skin, must be strengthened; but warm
Washing tends to weaken it. When it is of a proper
Strength it always performs its Functions;
nor is Perspiration disordered sensibly by the Alteration
of the Weather. For this Reason nothing
should be omitted, that may fix it in this State;
and to attain so important an Advantage, Children
should be washed, some few Days after
their Birth, with cold Water, in the State it
is brought from the Spring.
For this Purpose a Spunge is employed, with
which they begin, by washing first the Face, the
Ears, the back Part of the Head (carefully
avoiding the Fontanelle, or Mould of the Head)
the Neck, the Loins, the Trunck of the Body,
the Thighs, Legs and Arms, and in short every
Spot. This Method which has obtained for so
many Ages, and which is practised at present by
many People, who prove very healthy, will appear
shocking to several Mothers; they would be
afraid of killing their Children by it; and would
particularly fail of Courage enough to endure
the Cries, which Children often make, the first
Time they are washed. Yet if their Mothers
truly love them, they cannot give a more substantial
Mark of their Tenderness to them, than
by subduing their Fears and their Repugnance,
on this important Head.
Weakly Infants are those who have the greatest
Need of being washed: such as are remarkably
strong may be excused from it; and it seems
scarcely credible (before a Person has frequently
seen the Consequences of it) how greatly this Method
conduces to give, and to hasten on, their
Strength. I have had the Pleasure to observe,
since I first endeavoured to introduce the Custom
among us, that several of the most affectionate
and most sensible Mothers, have used it with the
greatest Success. The Midwives, who have been
Witnesses of it; the Nurses and the Servants of
the Children, whom they have washed, publish
it abroad; and should the Custom become as
general, as every thing seems to promise it will, I
am fully persuaded, that by preserving the Lives
of a great Number of Children, it will certainly
contribute to check the Progress of Depopulation.
They should be washed very regularly every
Day, in every Season, and every Sort of Weather;
and in the fine warm Season they should be
plunged into a large Pail of Water, into the Basins
around Fountains, in a Brook, a River, or a
Lake.
After a few Days crying, they grow so well
accustomed to this Exercise, that it becomes one
of their Pleasures; so that they laugh all the Time
of their going through it.
The first Benefit of this Practice is, as I have
already said, the keeping up their Perspiration,
and rendering them less obnoxious to the Impressions
of the Air and Weather: and it is also in
Consequence of this first Benefit, that they are
preserved from a great Number of Maladies,
especially from knotty Tumours, often called
Kernels; from Obstructions; from Diseases of
the Skin, and from Convulsions, its general Consequence
being to insure them firm, and even robust
Health.
§ 385. But Care should be taken not to prevent,
or, as it were to undo, the Benefit this
Washing procures them, by the bad Custom of
keeping them too hot. There is not a more
pernicious one than this, nor one that destroys
more Children. They should be accustomed to
light Cloathing by Day, and light Covering by
Night, to go with their Heads very thinly covered,
and not at all in the Day-time, after their
attaining the Age of two Years. They should
avoid sleeping in Chambers that are too hot, and
should live in the open Air, both in Summer and
Winter, as much as possible. Children who
have been kept too hot in such Respects, are very
often liable to Colds; they are weakly, pale,
languishing, bloated and melancholy. They
are subject to hard knotty Swellings, a Consumption,
all Sorts of languid Disorders, and either die
in their Infancy, or only grow up into a miserable
valetudinary Life; while those who are
washed or plunged into cold Water, and habitually
exposed to the open Air, are just in the opposite
Circumstances.
§ 386. I must further add here, that Infancy
is not the only Stage of Life, in which cold
Bathing is advantagious. I have advised it with
remarkable Success to Persons of every Age,
even to that of seventy: and there are two Kinds
of Diseases, more frequent indeed in Cities than
in the Country, in which cold Baths succeed very
greatly; that is, in Debility, or Weakness of
the Nerves; and when Perspiration is disordered,
when Persons are fearful of every Breath of Air,
liable to Defluxions or Colds, feeble and languishing,
the cold Bath re-establishes Perspiration;
restores Strength to the Nerves; and by
that Means dispels all the Disorders, which arise
from these two Causes, in the animal Oeconomy.
They should be used before Dinner. But in the
same Proportion that cold Bathing is beneficial,
the habitual Use, or rather Abuse, of warm Bathing
is pernicious; they dispose the Persons addicted
to them to the Apoplexy; to the Dropsy;
to Vapours, and to the hypochondriacal Disease:
and Cities, in which they are too frequently used,
become, in some Measure, desolate from such
Distempers.
Of the Cutting of the Teeth.
§ 387. Cutting of the Teeth is often very tormenting
to Children, some dying under the severe
Symptoms attending it. If it proves very painful,
we should during that Period, 1, Keep
their Bellies open by Glysters consisting only of
a simple Decoction of Mallows: but Glysters are
not necessary, if the Child, as it sometimes happens
then, has a Purging.
2, Their ordinary Quantity of Food should be
lessened for two Reasons; first, because the
Stomach is then weaker than usual; and next, because
a small Fever sometimes accompanies the
Cutting.
3, Their usual Quantity of Drink should be
increased a little; the best for them certainly is
an Infusion of the Leaves or Flowers, of the
Lime or Linden-tree, to which a little Milk may
be added.
4, Their Gums should frequently be rubbed
with a Mixture of equal Parts of Honey, and
Mucilage of Quince-seeds; and a Root of March-Mallows,
or of Liquorice, may be given them to
chew.
It frequently happens, that during Dentition,
or the Time of their toothing, Children prove
subject to Knots or Kernels.
Of Worms.
§ 388. The Meconium, the Acidity of the
Milk, and Cutting of the Teeth are the three
great Causes of the Diseases of Children. There
is also a fourth, Worms, which is likewise very
often pernicious to them; but which, nevertheless,
is not, at least not near so much, a general
Cause of their Disorders, as it is generally supposed,
when a Child exceeding two Years of Age
proves sick. There are a great Variety of Symptoms,
which dispose People to think a Child has
Worms; though there is but one that demonstrates
it, which is discharging them upwards or
downwards. There is great Difference among
Children too in this Respect, some remaining
healthy, though having several Worms, and others
being really sick with a few.
They prove hurtful, 1, by obstructing the
Guts, and compressing the neighbouring Bowels
by their Size. 2, By sucking up the Chyle intended
to nourish the Patient, and thus depriving
him of his very Substance as well as Subsistence:
and, 3, by irritating the Guts and even gnawing
them.
§ 389. The Symptoms which make it probable
they are infested with Worms, are slight,
frequent and irregular Cholics; a great Quantity
of Spittle running off while they are fasting; a
disagreeable Smell of their Breath, of a particular
Kind, especially in the Morning; a frequent
Itchiness of their Noses which makes them
scratch or rub them often; a very irregular Appetite,
being sometimes voracious, and at other
Times having none at all: Pains at Stomach and
Vomitings: sometimes a costive Belly; but more
frequently loose Stools of indigested Matter; the
Belly rather larger than ordinary, the rest of the
Body meagre; a Thirst which no Drink allays;
often great Weakness, and some Degree of Melancholy.
The Countenance has generally an
odd unhealthy Look, and varies every Quarter of
an Hour; the Eyes often look dull, and are surrounded
with a Kind of livid Circle: the White
of the Eye is sometimes visible while they sleep,
their Sleep being often attended with terrifying
Dreams or Deliriums, and with continual Startings,
and Grindings of their Teeth. Some Children
find it impossible to be at Rest for a single
Moment. Their Urine is often whitish, I have
seen it from some as white as Milk. They are
afflicted with Palpitations, Swoonings, Convulsions,
long and profound Drowsiness; cold
Sweats which come on suddenly; Fevers which
have the Appearances of Malignity; Obscurities
and even Loss of Sight and of Speech, which continue
for a considerable Time; Palsies either of
their Hands, their Arms, or their Legs, and
Numbnesses. Their Gums are in a bad State,
and as though they had been gnawed or corroded:
they have often the Hickup, a small
and irregular Pulse, Ravings, and, what is one
of the least doubtful Symptoms, frequently a
small dry Cough; and not seldom a Mucosity or
Sliminess in their Stools: sometimes very long
and violent Cholics, which terminate in an Abscess
on the Outside of the Belly, from whence
Worms issue. (See Note p. .)
§ 390. There are a great Multitude of Medicines
against Worms. The Grenette or Worm-seed,
which is one of the commonest, is a very
good one. The Prescription , is also a
very successful one; and the Powder is
one of the best. Flower of Brimstone, the Juice
of Nasturtium, or Cresses, Acids and Honey Water
have often been very serviceable; but the first
three I have mentioned, succeeded by a Purge,
are the best. is a purging Medicine, that
the most averse and difficult Children may easily
take. But when, notwithstanding these Medicines,
the Worms are not expelled, it is necessary to
take Advice of some Person qualified to prescribe
more efficacious ones. This is of considerable
Importance, because, notwithstanding a great
Proportion of Children may probably have
Worms, and yet many of them continue in
good Health, there are, nevertheless, some who
are really killed by Worms, after having been
cruelly tormented by them for several Years.
A Disposition to breed Worms always shews
the Digestions are weak and imperfect; for
which Reason Children liable to Worms should
not be nourished with Food difficult to digest.
We should be particularly careful not to stuff
them with Oils, which, admitting such Oils
should immediately kill some of their Worms,
do yet increase that Cause, which disposes them to
generate others. A long continued Use of Filings
of Iron is the Remedy, that most effectually
destroys this Disposition to generate Worms.
Of Convulsions.
§ 391. I have already said, , that the
Convulsions of Children are almost constantly the
Effect of some other Disease, and especially of
some of the four I have mentioned. Some
other, though less frequent Causes, sometimes
occasion them, and these may be reduced to the
following.
The first of them is the corrupted Humours,
that often abound in their Stomachs and Intestines;
and which, by their Irritation, produce
irregular Motions throughout the whole System
of the Nerves, or at least through some Parts of
them; whence those Convulsions arise, which
are merely involuntary Motions of the Muscles.
These putrid Humours are the Consequence of
too great a Load of Aliments, of unsound ones,
or of such, as the Stomachs of Children are incapable
of digesting. These Humours are also
sometimes the Effect of a Mixture and Confusion
of different Aliments, and of a bad Distribution
of their Nourishment.
It may be known that the Convulsions of a
Child are owing to this Cause, by the Circumstances
that have preceded them, by a disgusted
loathing Stomach; by a certain Heaviness and
Load at it; by a foul Tongue; a great Belly;
by its bad Complexion, and its disturbed unrefreshing
Sleep.
The Child's proper Diet, that is, a certain
Diminution of the Quantity of its Food; some
Glysters of warm Water, and one Purge of ,
very generally remove such Convulsions.
§ 392. The second Cause is the bad Quality
of their Milk. Whether it be that the Nurse has
fallen into a violent Passion, some considerable
Disgust, great Fright or frequent Fear: whether
she has eat unwholesome Food, drank too much
Wine, spirituous Liquors, or any strong Drink:
whether she is seized with a Descent of her
monthly Discharges, and that has greatly disordered
her Health; or finally whether she prove
really sick: In all these Cases the Milk is vitiated,
and exposes the Infant to violent Symptoms,
which sometimes speedily destroy it.
The Remedies for Convulsions, from this
Cause, consist, 1, In letting the Child abstain
from this corrupted Milk, until the Nurse shall
have recovered her State of Health and Tranquillity,
the speedy Attainment of which may be forwarded
by a few Glysters; by gentle pacific Medicines;
by an entire Absence of whatever caused
or conduced to her bad Health; and by drawing
off all the Milk that had been so vitiated.
2, In giving the Child itself some Glysters:
in making it drink plentifully of a light Infusion
of the Lime-tree Flowers, in giving it no other
Nourishment for a Day or two, except Panada
and other light Spoon-meat, without Milk.
3, In purging the Child (supposing what has
been just directed to have been unavailable)
with an Ounce, or an Ounce and a Half, of compound
Syrup of Succory, or as much Manna.
These lenient gentle Purges carry off the Remainder
of the corrupted Milk, and remove the
Disorders occasioned by it.
§ 393. A third Cause which also produces
Convulsions, is the feverish Distempers which
attack Children, especially the Small-pocks and
the Measles; but in general such Convulsions require
no other Treatment, but that proper for
the Disease, which has introduced them.
§ 394. It is evident from what has been said
in the Course of this Chapter, and it deserves to
be attended to, that Convulsions are commonly a
Symptom attending some other Disease, rather
than an original Disease themselves: that they
depend on many different Causes; that from this
Consideration there can be no general Remedy
for removing or checking them; and that the
only Means and Medicines which are suitable in
each Case, are those, which are proper to oppose
the particular Cause producing them, and which I
have already pointed out in treating of each
Cause.
The greater Part of the pretended Specifics,
which are indiscriminately and ignorantly employed
in all Sorts of Convulsions, are often
useless, and still oftner prejudicial. Of this last Sort
and Character are,
1, All sharp and hot Medicines, spirituous
Liquors, Oil of Amber,—other hot Oils and
Essences, volatile Salts, and such other Medicines,
as, by the Violence of their Action on
the irritable Organs of Children, are likelier to
produce Convulsions, than to allay them.
2, Astringent Medicines, which are highly
pernicious, whenever the Convulsions are caused
by any sharp Humour, that ought to be discharged
from the Body by Stool; or when such Convulsions
are the Consequences of an Effort of
Nature, in Order to effect a Crisis: And as they
almost ever depend on one or the other of these
Causes, it follows that Astringents can very rarely,
if ever, be beneficial. Besides that there is always
some Danger in giving them to Children
without a mature, a thorough Consideration of
their particular Case and Situation, as they often
dispose them to Obstructions.
3, The over early, and too considerable Use
of Opiates, either not properly indicated, or continued
too long, such as Venice Treacle, Mithridate,
Syrup of Poppies (and it is very easy to
run upon some of these Sholes) are also attended
with the most embarrassing Events, in Regard to
Convulsions; and it may be affirmed they are
improper, for nine Tenths of those they are advised
to. It is true they often produce an apparent
Ease and Tranquillity for some Minutes, and
sometimes for some Hours too; but the Disorder
returns even with greater Violence for this
Suspension, by Reason they have augmented all
the Causes producing it; they impair the Stomach;
they bind up the Belly; they lessen the
usual Quantity of Urine; and besides, by their
abating the Sensibility of the Nerves, which
ought to be considered as one of the chief Centinels
appointed by Nature, for the Discovery of any
approaching Danger, they dispose the Patient
insensibly to such Infarctions and Obstructions,
as tend speedily to produce some violent and mortal
Event, or which generate a Disposition to languid
and tedious Diseases: and I do again repeat
it, that notwithstanding there are some Cases, in
which they are absolutely necessary, they ought
in general to be employed with great Precaution
and and Prudence. To mention the principal Indications
for them in convulsive Cases, they are
proper,
1, When the Convulsions still continue, after
the original Cause of them is removed.
2, When they are so extremely violent, as to
threaten a great and very speedy Danger of Life;
and when they prove an Obstacle to the taking
Remedies calculated to extinguish their Cause;
and,
3, When the Cause producing them is of such
a Nature, as is apt to yield to the Force of
Anodynes; as when, for Instance, they have been
the immediate Consequence of a Fright.
§ 395. There is a very great Difference in
different Children, in Respect to their being
more or less liable to Convulsions. There are
some, in whom very strong and irritating Causes
cannot excite them; not even excruciating Gripes
and Cholics; the most painful Cutting of their
Teeth; violent Fevers; the Small Pocks; Measles;
and though they are, as it were, continually
corroded by Worms, they have not the
slightest Tendency to be convulsed. On the
other Hand, some are so very obnoxious to Convulsions,
or so easily convulsible, if that Expression
may be allowed, that they are very often
seized with them from such very slight Causes,
that the most attentive Consideration cannot investigate
them. This Sort of Constitution, which
is extremely dangerous, and exposes the unhappy
Subject of it, either to a very speedy Death,
or to a very low and languid State of Life, requires
some peculiar Considerations; the Detail
of which would be the more foreign to the Design
of this Treatise, as they are pretty common
in Cities, but much less so in Country Places.
In general cold Bathing and the Powder
are serviceable in such Circumstances.
General Directions, with Respect to Children.
§ 396. I shall conclude this Chapter by such
farther Advice, as may contribute to give
Children a more vigorous Constitution and Temperament,
and to preserve them from many Disorders.
First then, we should be careful not to cram
them too much, and to regulate both the Quantity
and the set Time of their Meals, which is a
very practicable Thing, even in the very earliest
Days of their Life; when the Woman who
nurses them, will be careful to do it regularly.
Perhaps indeed this is the very Age, when such a
Regulation may be the most easily attempted and
effected; because it is that Stage, when the constant
Uniformity of their Way of living should
incline us to suppose, that what they have Occasion
for is most constantly very much the same.
A Child who has already attained to a few
Years, and who is surrendered up more to his
own Exercise and Vivacity, feels other Calls; his
Way of Life is become a little more various and
irregular, whence his Appetite must prove so too.
Hence it would be inconvenient to subject him
over exactly to one certain Rule, in the Quantity
of his Nourishment, or the Distance of his
Meals. The Dissipation or passing off of his
Nutrition being unequal, the Occasions he has
for repairing it cannot be precisely dated and regular.
But with Respect to very little Children
in Arms, or on the Lap, a Uniformity in the
first of these Respects, the Quantity of their Food,
very consistently conduces to a useful Regularity
with Respect to the second, the Times of feeding
them. Sickness is probably the only Circumstance,
that can warrant any Alteration in the
Order and Intervals of their Meals; and then
this Change should consist in a Diminution of
their usual Quantity, notwithstanding a general
and fatal Conduct seems to establish the very Reverse;
and this pernicious Fashion authorizes the
Nurses to cram these poor little Creatures the
more, in Proportion as they have real Need of
less feeding. They conclude of Course, that all
their Cries are the Effects of Hunger, and the
Moment an Infant begins, then they immediately
stop his Mouth with his Food; without once
suspecting, that these Wailings may be occasioned
by the Uneasiness an over-loaded Stomach may
have introduced; or by Pains whose Cause is neither
removed nor mitigated, by making the
Children eat; though the meer Action of eating
may render them insensible to slight Pains, for a
very few Minutes; in the first Place, by calling off
their Attention; and secondly, by hushing them
to sleep, a common Effect of feeding in Children,
being in fact, a very general and constant one,
and depending on the same Causes, which dispose
so many grown Persons to sleep after Meals.
A Detail of the many Evils Children are exposed
to, by thus forcing too much Food upon them,
at the very Time when their Complaints are owing
to Causes, very different from Hunger, might
appear incredible. They are however so numerous
and certain, that I seriously wish sensible
Mothers would open their Eyes to the Consideration
of this Abuse, and agree to put an End
to it.
Those who overload them with Victuals, in
Hopes of strengthening them, are extremely deceived;
there being no one Prejudice equally fatal
to such a Number of them. Whatever unnecessary
Aliment a Child receives, weakens, instead of
strengthening him. The Stomach, when over-distended,
suffers in its Force and Functions, and
becomes less able to digest thoroughly. The
Excess of the Food last received impairs the Concoction
of the Quantity, that was really necessary:
which, being badly digested, is so far from yielding
any Nourishment to the Infant, that it
weakens it, and proves a Source of Diseases, and
concurs to produce Obstructions, Rickets, the
Evil, slow Fevers, a Consumption and Death.
Another unhappy Custom prevails, with Regard
to the Diet of Children, when they begin
to receive any other Food besides their Nurse's
Milk, and that is, to give them such as exceeds
the digestive Power of their Stomachs; and to
indulge them in a Mixture of such Things in
their Meals, as are hurtful in themselves, and
more particularly so, with Regard to their feeble
and delicate Organs.
To justify this pernicious Indulgence, they affirm
it is necessary to accustom their Stomachs to
every Kind of Food; but this Notion is highly
absurd, since their Stomachs should first be
strengthened, in Order to make them capable of
digesting every Food; and crouding indigestible,
or very difficultly digestible Materials into it, is not
the Way to strengthen it. To make a Foal sufficiently
strong for future Labour, he is exempted
from any, till he is four Years old; which enables
him to submit to considerable Work, without
being the worse for it. But if, to inure him to
Fatigue, he should be accustomed, immediately
from his Birth, to submit to Burthens above his
Strength, he could never prove any Thing but
an utter Jade, incapable of real Service. The
Application of this to the Stomach of a Child is
very obvious.
I shall add another very important Remark,
and it is this, that the too early Work to which
the Children of Peasants are forced, becomes of
real Prejudice to the Publick. Hence Families
themselves are less numerous, and the more Children
that are removed from their Parents, while
they are very young, those who are left are the
more obliged to Work, and very often even at
hard Labour, at an Age when they should exercise
themselves in the usual Diversions and
Sports of Children. Hence they wear out in a
Manner, before they attain the ordinary Term of
Manhood; they never arrive at their utmost
Strength, nor reach their full Stature; and it is
too common to see a Countenance with the Look
of twenty Years, joined to a Stature of twelve or
thirteen. In fact, they often sink under the
Weight of such hard involuntary Labour, and
fall into a mortal Degree of Wasting and Exhaustion.
§ 397. Secondly, which indeed is but a Repetition
of the Advice I have already given, and
upon which I cannot insist too much, they must
be frequently washed or bathed in cold Water.
§ 398. Thirdly, they should be moved about
and exercised as much as they can bear, after
they are some Weeks old: the earlier Days of
their tender Life seeming consecrated, by Nature
herself, to a nearly total Repose, and to sleeping,
which seems not to determine, until they have
Need of Nourishment: so that, during this very
tender Term of Life, too much Agitation or Exercise
might be attended with mortal Consequences.
But as soon as their Organs have attained
a little more Solidity and Firmness, the
more they are danced about (provided it is not
done about their usual Time of Repose, which
ought still to be very considerable) they are so
much the better for it; and by increasing it gradually,
they may be accustomed to a very quick
Movement, and at length very safely to such, as
may be called hard and hearty Exercise. That
Sort of Motion they receive in Go-Carts, or other
Vehicles, particularly contrived for their Use, is
more beneficial to them, than what they have
from their Nurses Arms, because they are in a
better Attitude in the former; and it heats them
less in Summer, which is a Circumstance of no
small Importance to them; considerable Heat
and Sweat disposing them to be ricketty.
§ 399. Fourthly, they should be accustomed
to breathe in the free open Air as much as possible.
If Children have unhappily been less attended
to than they ought, whence they are evidently
feeble, thin, languid, obstructed, and liable to
Scirrhosities (which constitute what is termed a
ricketty or consumptive State) these four Directions
duly observed retrieve them from that unhappy
State; provided the Execution of them
has not been too long delayed.
§ 400. Fifthly, If they have any natural Discharge
of a Humour by the Skin, which is very
common with them, or any Eruption, such as
Tetters, white Scurf, a Rashe, or the like, Care
must be taken not to check or repel them, by
any greasy or restringent Applications. Not a
Year passes without Numbers of Children having
been destroyed by Imprudence in this Respect;
while others have been reduced to a deplorable
and weakly Habit.
I have been a Witness to the most unhappy
Consequences of external Medicines applied for
the Rashe and white Scurf; which, however
frightful they may appear, are never dangerous;
provided nothing at all is applied to them, without
the Advice and Consideration of a truly skilful
Person.
When such external Disorders prove very obstinate,
it is reasonable to suspect some Fault or
Disagreement in the Milk the Child sucks; in
which Case it should immediately be discontinued,
corrected, or changed. But I cannot enter
here into a particular Detail of all the Treatment
necessary in such Cases.
Chapter XXVIII.
Directions with Respect to drowned Persons.
Sect. 401.
henever a Person who has been
drowned, has remained a Quarter of
an Hour under Water, there can be
no considerable Hopes of his Recovery:
the Space of two or three Minutes in such a Situation
being often sufficient to kill a Man irrecoverably.
Nevertheless, as several Circumstances
may happen to have continued Life, in such an
unfortunate Situation, beyond the ordinary Term,
we should always endeavour to afford them the
most effectual Relief, and not give them up as
irrecoverable too soon: since it has often been
known, that until the Expiration of two, and
sometimes even of three Hours, such Bodies have
exhibited some apparent Tokens of Life.
Water has sometimes been found in the Stomach
of drowned Persons; at other times none
at all. Besides, the greatest Quantity which has
ever been found in it has not exceeded that,
which may be drank without any Inconvenience;
whence we may conclude, the meer Quantity
was not mortal; neither is it very easy to conceive
how drowned Persons can swallow Water.
What really kills them is meer Suffocation, or
the Interception of Air, of the Action of breathing;
and the Water which descends into the
Lungs, and which is determined there, by the Efforts
they necessarily, though involuntarily make,
to draw Breath, after they are under Water: for
there absolutely does not any Water descend, either
into the Stomach or the Lungs of Bodies plunged
into Water, after they are dead; a Circumstance,
which serves to establish a legal Sentence and
Judgment in some criminal Cases, and Trials:
This Water intimately blending itself with the
Air in the Lungs, forms a viscid inactive Kind
of Froth, which entirely destroys the Functions
of the Lungs; whence the miserable Sufferer is
not only suffocated, but the Return of the Blood
from the Head being also intercepted, the Blood
Vessels of the Brain are overcharged, and an
Apoplexy is combined with the Suffocation.
This second Cause, that is, the Descent of the
Water into the Lungs, is far from being general,
it having been evident from the Dissection of several
drowned Bodies, that it really never had
existed in them.
§ 402. The Intention that should be pursued,
is that of unloading the Lungs and the Brain, and
of reviving the extinguished Circulation. For
which Purpose we should, 1, immediately strip
the Sufferer of all his wet Cloaths; rub him
strongly with dry coarse Linnen; put him, as
soon as possible, into a well heated Bed, and continue
to rub him well a very considerable Time
together.
2, A strong and healthy Person should force
his own warm Breath into the Patient's Lungs;
and the Smoke of Tobacco, if some was at
Hand, by Means of some Pipe, Chanel, Funnel
or the like, that may be introduced into the
Mouth. This Air or Fume, being forcibly
blown in, by stopping the Sufferer's Nostrils close
at the same Time, penetrates into the Lungs,
and there rarifies by its Heat that Air, which
blended with the Water, composed the viscid
Spume or Froth. Hence that Air becomes disengaged
from the Water, recovers its Spring, dilates
the Lungs; and, if there still remains within
any Principle of Life, the Circulation is renewed
again that Instant.
3, If a moderately expert Surgeon is at Hand,
he must open the jugular Vein, or any large
Vein in the Neck, and let out ten or twelve
Ounces of Blood. Such a Bleeding is serviceable
on many Accounts. First, merely as Bleeding,
it renews the Circulation, which is the constant
Effect of Bleeding in such Swoonings, as arise
from an intercepted or suffocated Circulation.
Secondly, it is that particular Bleeding, which
most suddenly removes, in such Cases, the Infarction
or Obstruction of the Head and Lungs;
and, thirdly, it is sometimes the only Vessel,
whence Blood will issue under such Circumstances.
The Veins of the Feet then afford none;
and those of the Arms seldom; but the Jugulars
almost constantly furnish it.
Fourthly, the Fume of Tobacco should be
thrown up, as speedily and plentifully as possible,
into the Intestines by the Fundament. There
are very commodious Contrivances devised for
this Purpose; but as they are not common, it
may be effected by many speedy Means. One,
by which a Woman's Life was preserved, consisted
only in introducing the small Tube of a Tobacco
Pipe well lighted up: the Head or Bowl
of it was wrapped up in a Paper, in which several
Holes were pricked, and through these the
Breath was strongly forced. At the fifth Blast a
considerable Rumbling was heard in the Woman's
Belly; she threw up a little Water, and a
Moment afterwards came to her Senses. Two
Pipes may be thus lighted and applied, with their
Bowls covered over; the Extremity of one is to
be introduced into the Fundament; and the other
may be blown through into the Lungs.
Any other Vapour may also be conveyed up,
by introducing a Canula, or any other Pipe, with
a Bladder firmly fixed to it. This Bladder is
fastened at its other End to a large Tin Funnel,
under which Tobacco is to be lighted. This
Contrivance has succeeded with me upon other
Occasions, in which Necessity compelled me to
invent and apply it.
Fifthly, the strongest Volatiles should be applied
to the Patient's Nostrils. The Powder of
some strong dry Herb should be blown up his
Nose, such as Sage, Rosemary, Rue, Mint, and
especially Marjoram, or very well dried Tobacco;
or even the Fume, the Smoke of these Herbs.
But all these Means are most properly employed
after Bleeding, when they are most efficacious
and certain.
Sixthly, as long as the Patient shews no Signs
of Life, he will be unable to swallow, and it is
then useless, and even dangerous, to pour much
Liquid of any kind into his Mouth, which could
do nothing but keep up, or increase Suffocation.
It is sufficient, in such Circumstances, to instil a
few Drops of some irritating Liquor, which
might also be cordial and reviving. But as soon
as ever he discovers any Motion, he should take,
within the Space of one Hour, five or six common
Spoonfuls of Oxymel of Squills diluted with
warm Water: or if that Medicine was not to be
had very speedily, a strong Infusion of the blessed
Thistle, or Carduus benedictus, of Sage, or of Chamomile
Flowers sweetened with Honey, might do
instead of it: and supposing nothing else to be had,
some warm Water, with the Addition of a little
common Salt, should be given. Some Persons
are bold enough to recommend Vomits in such
Cases; but they are not without their Inconvenience;
and it is not as a Vomit that I recommend
the Oxymel of Squills in them.
Seventhly, Notwithstanding the Sick discover
some Tokens of Life, we should not cease to
continue our Assistance; since they sometimes
irrecoverably expire, after these first Appearances
of recovering.
And lastly, though they should be manifestly
re-animated, there sometimes remains an Oppression,
a Coughing and Feverishness, which
effectually constitute a Disease: and then it becomes
necessary sometimes to bleed them in the
Arms; to give them Barley Water plentifully,
or Elder-flower Tea.
§ 403. Having thus pointed out such Means
as are necessary, and truly effectual, in such unfortunate
Accidents, I shall very briefly mention
some others, which it is the general Custom to
use and apply in the first Hurry.
1, These unhappy People are sometimes
wrapped up in a Sheep's, or a Calf's, or a Dog's
Skin, immediately flead from the Animal: these
Applications have sometimes indeed revived the
Heat of the Drowned; but their Operations are
more slow, and less efficacious, than the Heat of
a well-warmed Bed; with the additional Vapour
of burnt Sugar, and long continued Frictions with
hot Flanels.
2, The Method of rolling them in an empty
Hogshead is dangerous, and mispends a deal of
important Time.
3, That also of hanging them up by the Feet
is attended with Danger, and ought to be wholly
discontinued. The Froth or Foam, which is
one of the Causes of their Death, is too thick and
tough to discharge itself, in Consequence of its
own Weight. Nevertheless, this is the only
Effect that can be expected, from this Custom
of suspending them by the Feet; which must also
be hurtful, by its tending to increase the Overfulness
of the Head and of the Lungs.
§ 404. It is some Years since a Girl of eighteen
Years old was recovered [though it is unknown
whether she remained under Water only a little
Time or some Hours] who was motionless, frozen
as it were, insensible, with her Eyes closed,
her Mouth wide open, a livid Colour, a swoln Visage,
a Tumour or bloating of the whole Body,
which was overladen as it were, or Water-soaked.
This miserable Object was extended on a Kind
of Bed, of hot or very warm Ashes, quickly
heated in great Kettles; and by laying her quite
naked on these Ashes; by covering her with
others equally hot; by putting a Bonnet round
her Head, with a Stocking round her Neck
stuffed with the same, and heaping Coverings
over all this, at the End of half an Hour her
Pulse returned, she recovered her Speech, and
cried out, I freeze, I freeze: A little Cherry-Brandy
was given her, and then she remained
buried, as it were, eight Hours under the Ashes;
being taken out of them afterwards without any
other Complaint, except that of great Lassitude
or Weariness, which went entirely off the third
Day. This Method was undoubtedly so effectual,
that it well deserves Imitation; but it should not
make us inattentive to the others. Heated Gravel
or Sand mixed with Salt, or hot Salt alone,
would have been equally efficacious, and they
have been found so.
At the very Time of writing this, two young
Ducks, who were drowned, have been revived
by a dry Bath of hot Ashes. The Heat of a
Dung-heap may also be beneficial; and I have
just been informed, by a very creditable and sensible
Spectator of it, that it effectually contributed
to restore Life to a Man, who had certainly remained
six Hours under Water.
§ 405. I shall conclude these Directions with
an Article printed in a little Work at Paris, about
twenty Years since, by Order of the King, to
which there is not the least Doubt, but that any
other Sovereign will readily accede.
“Notwithstanding the common People are
very generally disposed to be compassionate,
and may wish to give all Assistance to drowned
Persons, it frequently happens they do not,
only because they dare not; imagining they
expose themselves by it to Prosecutions. It
is therefore necessary, that they should know,
and it cannot be too often repeated, in order
to eradicate such a pernicious Prejudice, that
the Magistrates have never interposed to prevent
People from trying every possible Means
to recover such unfortunate Persons, as shall
be drowned and taken out of the Water. It is
only in those Cases, when the Persons are
known to be absolutely and irrecoverably dead,
that Justice renders it necessary to seize their
Bodies.”
Chapter XXIX.
Of Substances stopt between the Mouth and the Stomach.
Sect. 406.
he Food we take in descends from the
Mouth through a very strait Passage
or Chanel, called the Oesophagus, the
Gullet, which, going parallel with the
Spine or Backbone, joins to, or terminates at, the
Stomach.
It happens sometimes that different Bodies are
stopt in this Chanel, without being able either to
descend or to return up again; whether this Difficulty
arises from their being too large; or whether
it be owing to their having such Angles or
Points, as by penetrating into, and adhering to
the Sides of this membranous Canal, absolutely
prevent the usual Action and Motion of it.
§ 407. Very dangerous Symptoms arise from
this Stoppage, which are frequently attended with
a most acute Pain in the Part; and at other
Times, with a very incommodious, rather than
painful, Sensation; sometimes a very ineffectual
Commotion at, or rising of, the Stomach, attended
with great Anguish; and if the Stoppage
be so circumstanced, that the Glottis is closed,
or the Wind-pipe compressed, a dreadful Suffocation
is the Consequence: the Patient cannot
breathe, the Lungs are quite distended; and the
Blood being unable to return from the Head,
the Countenance becomes red, then livid; the
Neck swells; the Oppression increases, and the
poor Sufferer speedily dies.
When the Patient's Breathing is not stopt, nor
greatly oppressed; if the Passage is not entirely
blocked up, and he can swallow something, he
lives very easily for a few Days, and then his
Case becomes a particular Disorder of the Oesophagus,
or Gullet. But if the Passage is absolutely
closed, and the Obstruction cannot be removed
for many Days, a terrible Death is the
Consequence.
§ 408. The Danger of such Cases does not
depend so much on the Nature of the obstructing
Substance, as on its Size, with Regard to that of
the Passage of the Part where it stops, and of the
Manner in which it forms the Obstruction; and
frequently the very Food may occasion Death;
while Substances less adapted to be swallowed are
not attended with any violent Consequences,
though swallowed.
A Child of six Days old swallowed a Comfit
or Sugar Plumb, which stuck in the Passage,
and instantly killed it.
A grown Person perceived that a Bit of Mutton
had stopt in the Passage; not to alarm any
Body he arose from Table; a Moment afterwards,
on looking where he might be gone, he
was found dead. Another was choaked by a Bit
of Cake; a third by a Piece of the Skin of a Ham;
and a fourth by an Egg, which he swallowed
whole in a Bravo.
A Child was killed by a Chesnut swallowed
whole. Another died suddenly, choaked (which
is always the Circumstance, when they die instantly
after such Accidents) by a Pear which he
had tossed up, and catched in his Mouth. A
Woman was choaked with another Pear. A
Piece of a Sinew continued eight Days in the
Passage, so that it prevented the Patient from
getting down any Thing else; at the Expiration
of that Time it fell into the Stomach, being
loosened by its Putridity: The Patient notwithstanding
died soon after, being killed by the Inflammation,
Gangrene and Weakness it had occasioned.
Unhappily there occur but too many
Instances of this Sort, of which it is unnecessary
to cite more.
§ 409. Whenever any Substance is thus detained
in the Gullet, there are two Ways of removing
it; that is either by extracting it, or
pushing it down. The safest and most certain
Way is always to extract or draw it out, but this
is not always the easiest: and as the Efforts made
for this Purpose greatly fatigue the Patient, and
are sometimes attended with grievous Consequences;
and yet if the Occasion is extremely urging,
it may be eligible to thrust it down, if that is
easier; and if there is no Danger from the obstructing
Bodies Reception into the Stomach.
The Substances which may be pushed down
without Danger, are all common nourishing ones,
as Bread, Meat, Cakes, Fruits, Pulse, Morsels
of Tripe, and even Skin of Bacon. It is only
very large Morsels of particular Aliments, that
prove very difficult to digest; yet even such are
rarely attended with any Fatality.
§ 410. The Substances we should endeavour
to extract or draw out, though it be more painful
and less easy than to push them down, are
all those, whose Consequences might be highly
dangerous, or even mortal, if swallowed. Such
are all totally indigestible Bodies, as Cork, Linen-Rags,
large Fruit Stones, Bones, Wood, Glass,
Stones, Metals; and more especially if any further
Danger may be superadded to that of its Indigestibility,
from the Shape, whether rough, sharp,
pointed, or angular, of the Substance swallowed.
Wherefore we should chiefly endeavour to extract
Pins, Needles, Fish-bones, other pointed Fragments
of Bones, Bits of Glass, Scissars, Rings,
or Buckles.
Nevertheless it has happened, that every one
of these Substances have at one Time or another
been swallowed, and the most usual
Consequences of them are violent Pains of the Stomach,
and in the Guts; Inflammations, Suppurations,
Abscesses, a slow Fever, Gangrene, the Miserere
or Iliac Passion; external Abscesses, through
which the Bodies swallowed down have been
discharged; and frequently, after a long Train
of Maladies, a dreadful Death.
§ 411. When such Substances have not passed
in too deep, we should endeavour to extract them
with our Fingers, which often succeeds. If they
are lower, we should make use of Nippers or a
small Forceps; of which Surgeons are provided
with different Sorts. Those which some Smoakers
carry about them might be very convenient
for such Purposes; and in Case of Necessity they
might be made very readily out of two Bits of
Wood. But this Attempt to extract rarely succeeds,
if the Substance has descended far into the
Oesophagus, and if the Substance be of a flexible
Nature, which exactly applies itself to, and fills
up the Cavity or Chanel of it.
§ 412. If the Fingers and the Nippers fail,
or cannot be duly applied, Crotchets, a Kind of
Hooks, must be employed.
These may be made at once with a pretty
strong iron Wire, crooked at the End. It must
be introduced in the flat Way, and for the better
conducting of it, there should be another
Curve or Hook at the End it is held by, to serve
as a Kind of Handle to it, which has this further
Use, that it may be secured by a String tied to
it; a Circumstance not to be omitted in any
Instrument employed on such Occasions, to avoid
such ill Accidents as have sometimes ensued, from
these Instruments slipping out of the Operators
Hold. After the Crotchet has passed beyond and
below the Substance, that obstructs the Passage,
it is drawn up again, and hooks up with it and
extracts that Impediment to swallowing.
This Crotchet is also very convenient, whenever
a Substance somewhat flexible, as a Pin or
a Fishbone stick, as it were, across the Gullet:
the Crotchet in such Cases seizing them about
their middle Part, crooks and thus disengages
them. If they are very brittle Substances, it
serves to break them; and if any Fragments still
stick within, some other Means must be used to
extract them.
§ 413. When the obstructing Bodies are small,
and only stop up Part of the Passage; and which
may either easily elude the Hook, or straiten
it by their Resistance, a Kind of Rings may be
used, and made either solid or flexible.
The solid ones are made of iron Wire, or of
a String of very fine brass Wire. For this Purpose
the Wire is bent into a Circle about the
middle Part of its Length, the Sides of which
Circle do not touch each other, but leave a Ring,
or hollow Cavity, of about an Inch Diameter.
Then the long unbent Sides of the Wire are
brought near each other; the circular Part or
Ring is introduced into the Gullet, in order to be
conducted about the obstructing Body, and so
to extract it. Very flexible Rings may be made
of Wool, Thread, Silk, or small Packthread,
which may be waxed, for their greater Strength
and Consistence. Then they are to be tied fast
to a Handle of Iron-Wire, of Whale-bone, or of
any flexible Wood; after which the Ring is to
be introduced to surround the obstructing Substance,
and to draw it out.
Several of these Rings passed through one another
are often made use of, the more certainly to
lay hold of the obstructing Body, which may be
involved by one, if another should miss it. This
Sort of Rings has one Advantage, which is, that
when the Substance to be extracted is once laid
hold of, it may then, by turning the Handle, be
retained so strongly in the Ring thus twisted, as
to be moved every Way; which must be a
considerable Advantage in many such Cases.
§ 414. A fourth Material employed on these
unhappy Occasions is the Sponge. Its Property
of swelling considerably, on being wet, is the
Foundation of its Usefulness here.
If any Substance is stopt in the Gullet, but
without filling up the whole Passage, a Bit of
Sponge is introduced, into that Part that is unstopt,
and beyond the Substance. The Sponge
soon dilates, and grows larger in this moist Situation,
and indeed the Enlargement of it may be
forwarded, by making the Patient swallow a few
Drops of Water; and then drawing back the
Sponge by the Handle it is fastened to, as it is
now too large to return through the small Cavity,
by which it was conveyed in, it draws out the
obstructing Body with it, and thus unplugs, as
it were, and opens the Gullet.
As dry Sponge may shrink or be contracted,
this Circumstance has proved the Means of
squeezing a pretty large Piece of it into a very
small Space. It becomes greatly compressed by
winding a String or Tape very closely about it,
which Tape may be easily unwound and withdrawn,
after the Sponge has been introduced. It
may also be inclosed in a Piece of Whalebone,
split into four Sticks at one End, and which, being
endued with a considerable Spring, contracts
upon the Sponge. The Whalebone is so smoothed
and accommodated, as not to wound; and
the Sponge is also to be safely tied to a strong
Thread; that after having disengaged the Whalebone
from it, the Surgeon may also draw out
the Sponge at Pleasure.
Sponge is also applied on these Occasions in
another Manner. When there is no Room to
convey it into the Gullet, because the obstructing
Substance ingrosses its whole Cavity; and supposing
it not hooked into the Part, but solely detained
by the Straitness of the Passage, a pretty
large Bit of Sponge is to be introduced towards
the Gullet, and close to the obstructing Subtance:
Thus applied, the Sponge swells, and
thence dilates that Part of the Passage that is
above this Substance. The Sponge is then withdrawn
a little, and but a very little, and this
Substance being less pressed upon above than below,
it sometimes happens, that the greater
Staitness and Contraction of the lower Part of
the Passage, than of its upper Part, causes that
Substance to ascend; and as soon as this first
Loosening or Disengagement of it has happened,
the total Disengagement of it easily follows.
§ 415. Finally, when all these Methods prove
unavailable, there remains one more, which is
to make the Patient vomit; but this can scarcely
be of any Service, but when such obstructing Bodies
are simply engaged in, and not hooked or
stuck into the Sides of the Oesophagus; since under
this latter Circumstance vomiting might occasion
further Mischief.
If the Patient can swallow, a Vomiting may
be excited with the Prescription , or with
, or . By this Operation a Bone was
thrown out, which had stopt in the Passage four
and twenty Hours.
When the Patient cannot swallow, an Attempt
should be made to excite him to vomit by
introducing into, and twirling about the feathery
End of a Quill in, the Bottom of the Throat,
which the Feather however will not effect, if
the obstructing Body strongly compresses the
whole Circumference of the Gullet; and then no
other Resource is left, but giving a Glyster of
Tobacco. A certain Person swallowed a large Morsel
of Calf's Lights, which stopt in the Middle
of the Gullet, and exactly filled up the Passage.
A Surgeon unsuccessfully attempted various Methods
to extract it; but another seeing how unavailable
all of them were; and the Patient's
Visage becoming black and swelled; his Eyes
ready to start, as it were, out of his Head; and
falling into frequent Swoonings, attended with
Convulsions too, he caused a Glyster of an
Ounce of Tobacco boiled to be thrown up; the
Consequence of which was a violent Vomiting,
which threw up the Substance that was so very
near killing him.
§ 416. A sixth Method, which I believe has
never hitherto been attempted, but which may
prove very useful in many Cases, when the Substances
in the Passage are not too hard, and
are very large, would be to fix a Worm (used
for withdrawing the Charge of Guns that have
been loaded) fast to a flexible Handle, with a
waxed Thread fastened to the Handle, in Order
to withdraw it, if the Handle slipt from the
Worm; and by this Contrivance it might be very
practicable, if the obstructing Substance was
not too deep in the Passage of the Gullet, to extract
it—It has been known that a Thorn fastened
in the Throat, has been thrown out by
laughing.
§ 417. In the Circumstances mentioned ,
when it is more easy and convenient to push the
obstructing Body downwards, it has been usual
to make Use of Leeks, which may generally be
had any where (but which indeed are very subject
to break) or of a Wax-candle oiled, and but a
very little heated, so as to make it flexible; or
of a Piece of Whale-bone; or of Iron-Wire;
one Extremity of which may be thickened and
blunted in a Minute with a little melted Lead.
Small Sticks of some flexible Wood may be as
convenient for the same Use, such as the Birch-tree,
the Hazel, the Ash, the Willow, a flexible
Plummet, or a leaden Ring. All these Substances
should be very smooth, that they may not
give the least Irritation; for which Reason they
are sometimes covered over with a thin Bit of
Sheep's Gut. Sometimes a Sponge is fastened
to one End of them, which, completely filling
up the whole Passage, pushes down whatever
Obstacle it meets with.
In such Cases too, the Patient may be prompted
to attempt swallowing down large Morsels of
some unhurtful Substance, such as a Crust of
Bread, a small Turnep, a Lettuce Stalk, or a
Bullet, in Hopes of their carrying down the obstructing
Cause with them. It must be acknowledged,
however, that these afford but a feeble
Assistance; and if they are swallowed without
being well secured to a Thread, it may be apprehended
they may even increase the Obstruction,
by their own Stoppage.
It has sometimes very happily, though rarely,
occurred, that those Substances attempted to be
detruded or thrust downwards, have stuck in the
Wax-Candle, or the Leek, and sprung up and
out with them: but this can never happen except
in the Case of pointed Substances.
§ 418. Should it be impossible to extract the
Bodies mentioned , and all such as it must
be dangerous to admit into the Stomach, we must
then prefer the least of two Evils, and rather run
the Hazard of pushing them down, than suffer
the Patient to perish dreadfully in a few Moments.
And we ought to scruple this Resolution the less,
as a great many Instances have demonstrated,
that notwithstanding several bad Consequences, and
even a tormenting Death, have often followed
the swallowing of such hurtful or indigestible
Substances; yet at other times they have been
attended with little or no Disorder.
§ 419. One of these four Events is always the
Case, after swallowing such Things. They
either, 1, go off by Stool; or, 2, they are not
discharged and kill the Patient. Or else, 3,
they are discharged by Urine; or, 4, are visibly
extruded to the Skin. I shall give some Instances
of each of these Events.
§ 420. When they are voided by Stool, they
are either voided soon after they have been swallowed,
and that without having occasional scarce
any troublesome Symptom; or the voiding of
them has not happened till a long Time after
swallowing, and is preceded with very considerable
Pain. It has been seen that a Bone of the
Leg of a Fowl, a Peach-stone, the Cover of a
small Box of Venice Treacle, Pins, Needles,
and Coins of different Sorts, have been voided
within a few Days after they had slipt down into
the Stomach; and that with little or no Complaint.
A small Flute, or Pipe also, four Inches
long, which occasioned acute Pains for three
Days, has been voided happily afterwards,
besides, Knives, Razors, and one Shoe-buckle. I have
seen but a few Days since a Child between two
and three Years old, who swallowed a Nail
above an Inch long, the Head of which was
more than three Tenths of an Inch broad: it
stopt a few Moments about the Neck, but descended
while its Friends were looking for me;
and was voided with a Stool that Night, without
any bad Consequence. And still more lately I
have known the entire Bone of a Chicken's
Wing thus swallowed, which only occasioned a
slight Pain in the Stomach for three or four
Days.
Sometimes such Substances are retained within
for a long Time, not being voided till after several
Months, and even Years, without the least
ill Effect: and some of them have never either
appeared, nor been complained of.
§ 421. But the Event is not always so happy;
and sometimes though they are discharged through
the natural Passages, the Discharges have been
preceded by very acute Pains in the Stomach,
and in the Bowels. A Girl swallowed down
some Pins, which afflicted her with violent Pains
for the Space of six Years; at the Expiration of
which Term she voided them and recovered.
Three Needles being swallowed brought on Cholics,
Swoonings and Convulsions for a Year after:
and then being voided by Stool, the Patient recovered.
Another Person who swallowed two,
was much happier in suffering but six Hours
from them; when they were voided by Stool,
and he did well.
It sometimes happens that such indigestible
Substances, after having past all the Meanders,
the whole Course of the Intestines, have been
stopt in the Fundament, and brought on very
troublesome Symptoms; but such however, as
an expert Surgeon may very generally remove.
If it is practicable to cut them, as it is when they
happen to be thin Bones, the Jaw-bones of Fish,
or Pins, they are then very easily extracted.
§ 422. The second Event is, when these fatal
Substances are never voided, but cause very embarrassing
Symptoms which finally kill the Patient;
and of these Cases there have been but too
many Examples.
A young Girl having swallowed some Pins,
which she held in her Mouth, some of them were
voided by Stool; but others of them pricked and
pierced into her Guts, and even into the Muscles
of her Belly, with the severest Pain; and killed
her at the End of three Weeks.
A Man swallowed a Needle, which pierced
through his Stomach, and into his Liver, and
ended in a mortal Consumption.
A Plummet which slipt down, while the
Throat of a Patient was searching, killed him at
the End of two Years.
It is very common for different Coins, and of
different Metals, to be swallowed without any
fatal or troublesome Effects. Even a hundred
Luidores have been swallowed, and all voided.
Nevertheless these fortunate Escapes ought not
to make People too secure and incautious on
such Occasions, since such melancholy Consequences
have happened, as may very justly alarm
them. One single Piece of Money that was
swallowed, entirely obstructed the Communication
between the Stomach and the Intestines,
and killed the Patient. Whole Nuts have often
been inadvertently swallowed; but there have
been some Instances of Persons in whom a
Heap of them has been formed, which proved
the Cause of Death, after producing much Pain
and Inquietude.
§ 423. The third Issue or Event is, when
these Substances, thus swallowed down, have
been discharged by Urine: but these Cases are
very rare.
A Pin of a middling Size has been discharged
by Urine, three Days after it slipt down; and a
little Bone has been expelled the same Way, besides
Cherry-stones, Plumb-stones, and even one
Peach-stone.
§ 424. Finally, the fourth Consequence or
Event is, when the indigestible Substances thus
swallowed, have pierced through the Stomach
or Intestines, and even to the Skin itself; and occasioning
an Abscess, have made an Outlet for
themselves, or have been taken out of the Abscess.
A long Time is often required to effect this extraordinary
Trajection and Appearance of them;
sometimes the Pains they occasion are continual;
in other Cases the Patient complains for a Time,
after which the Pain ceases, and then returns
again. The Imposthume, or Gathering, is formed
in the Stomach, or in some other Part of the
Belly: and sometimes these very Substances, after
having pierced through the Guts, make very singular
Routs, and are discharged very remotely
from the Belly. One Needle that had been
swallowed found its Way out, at the End of
four Years, through the Leg; another at the
Shoulder.
§ 425. All these Examples, and many others
of cruel Deaths, from swallowing noxious Substances,
demonstrate the great Necessity of an
habitual Caution in this Respect; and give in
their Testimony against the horrid, I had almost
said, the criminal Imprudence, of People's amusing
themselves with such Tricks as may lead to
such terrible Accidents; or even holding any
such Substance in their Mouths, as by slipping
down through Imprudence or Accident, may
prove the Occasion of their Death. Is it possible
that any one, without shuddering, can hold
Pins or Needles in their Mouths, after reflecting
on the dreadful Accidents, and cruel Deaths, that
have thus been caused by them.
§ 426. It has been shewn already, that Substances
obstructing the Passage of the Gullet
sometimes suffocate the Patient; that at other
Times they can neither be extracted nor thrust
down; but that they stop in the Passage, without
killing the Patient, at least not immediately and
at once. This is the Case when they are so
circumstanced, as not to compress the Trachæa,
the Wind-pipe, and not totally to prevent the
swallowing of Food; which last Circumstance
can scarcely happen, except the Obstruction has
been formed by angular or pointed Bodies. The
Stoppage of such Bodies is sometimes attended,
and that without much Violence, with a small
Suppuration, which loosens them; and then they
are either returned upwards through the Mouth,
or descend into the Stomach. But at other
Times an extraordinary Inflammation is produced,
which kills the Patient. Or if the Contents
of the Abscess attending the Inflammation
tend outwardly, a Tumour is formed on the external
Part of the Neck, which is to be opened,
and through whose Orifice the obstructing Body
is discharged. In other Instances again they take
a different Course, attended with little or no Pain,
and are at length discharged by a Gathering behind
the Neck, on the Breast, the Shoulder, or
various other Parts.
§ 427. Some Persons, astonished at the extraordinary
Course and Progression of such Substances,
which, from their Size, and especially
from their Shape, seem to them incapable of being
introduced into, and in some Sort, circulating
through the human Body, without destroying it,
are very desirous of having the Rout and Progression
of such intruding Substances explained
to them. To gratify such Inquirers, I may be
indulged in a short Digression, which perhaps is
the less foreign to my Plan; as in dissipating
what seems marvelous, and has been thought
supernatural in such Cases, I may demolish that
superstitious Prejudice, which has often ascribed
Effects of this Sort to Witchcraft; but which
admit of an easy Explanation. This very Reason
is the Motive that has determined me to give a
further Extent to this Chapter.
Wherever an Incision is made through the
Skin, a certain Membrane appears, which consists
of two Coats or Laminæ, separated from
each other by small Cells or Cavities, which all
communicate together; and which are furnished,
more or less, with Fat. There is not any Fat
throughout the human Body, which is not inclosed
in, or enveloped with, this Coat, which is
called the adipose, fatty, or cellular Membrane.
This Membrane is not only found under the
Skin, but further plying and insinuating itself in
various Manners, it is extended throughout the
whole Body. It distinguishes and separates all
the Muscles; it constitutes a Part of the Stomach,
of the Guts, of the Bladder, and of all the Viscera
or Bowels. It is this which forms what is
called the Cawl, and which also furnishes a
Sheath or Envelopement to the Veins, Arteries,
and Nerves. In some Parts it is very thick, and
is abundantly replenished with Fat; in others it is
very thin and unprovided with any; but wherever
it extends, it is wholly insensible, or void of all
Sensation, all Feeling.
It may be compared to a quilted Coverlet, the
Cotton, or other Stuffing of which, is unequally
distributed; greatly abounding in some Places,
with none at all in others, so that in these the Stuff
above and below touch each other. Within this
Membrane, or Coverlet, as it were, such extraneous
or foreign Substances are moved about;
and as there is a general Communication throughout
the whole Extent of the Membrane, it is no
ways surprizing, that they are moved from one
Part to another very distant, in a long Course and
Duration of Movement. Officers and Soldiers
very often experience, that Bullets which do not
pass through the Parts where they have entered,
are transferred to very different and remote ones.
The general Communication throughout this
Membrane is daily demonstrated by Facts, which
the Law prohibits; this is the Butchers inflating,
or blowing up, the cellular Membrane throughout
the whole Carcase of a Calf, by a small Incision
in the Skin, into which they introduce a Pipe
or the Nozzle of a small Bellows; and then,
blowing forcibly, the Air evidently puffs up the
whole Body of the Calf into this artificial Tumour
or Swelling.
Some very criminal Impostors have availed
themselves of this wicked Contrivance, thus to
bloat up Children into a Kind of Monsters, which
they afterwards expose to View for Money.
In this cellular Membrane the extravasated
Waters of hydropic Patients are commonly diffused;
and here they give Way to that Motion, to
which their own Weight disposes them. But
here I may be asked—As this Membrane is
crossed and intersected in different Parts of it, by
Nerves, Veins, Arteries, &c. the wounding of
which unavoidably occasions grievous Symptoms,
how comes it, that such do not ensue upon the
Intrusion of such noxious Substances? To this I
answer, 1, that such Symptoms do sometimes
really ensue; and 2, that nevertheless they must
happen but seldom, by Reason that all the aforesaid
Parts, which traverse and intersect this Membrane,
being harder than the Fat it contains;
such foreign Substances must almost necessarily,
whenever they rencounter those Parts, be turned
aside towards the Fat which surrounds them,
whose Resistance is very considerably less; and
this the more certainly so, as these Nerves, &c.
are always of a cylindrical Form.——But to
return from this necessary Digression.
§ 428. To all these Methods and Expedients
I have already recommended on the important
Subject of this Chapter, I shall further add some
general Directions.
1. It is often useful, and even necessary, to
take a considerable Quantity of Blood from the
Arm; but especially if the Patient's Respiration,
or Breathing, is extremely oppressed; or when
we cannot speedily succeed in our Efforts to remove
the obstructing Substance; as the Bleeding
is adapted to prevent the Inflammation, which
the frequent Irritations from such Substances occasion;
and as by its disposing the whole Body
into a State of Relaxation, it might possibly procure
an immediate Discharge of the offending
Substance.
2. Whenever it is manifest that all Endeavours,
either to extract, or to push down the Substance
stopt in the Passage, are ineffectual, they should
be discontinued; because the Inflammation occasioned
by persisting in them, would be as dangerous
as the Obstruction itself; as there have
been Instances of People's dying in Consequence
of the Inflammation; notwithstanding the Body,
which caused the Obstruction, had been entirely
removed.
3. While the Means already advised are making
Use of, the Patient should often swallow, or
if he cannot, he should frequently receive by Injection
through a crooked Tube or Pipe, that
may reach lower down than the Glottis, some
very emollient Liquor, as warm Water, either
alone or mixed with Milk, or a Decoction of
Barley, of Mallows, or of Bran. A two-fold
Advantage may arise from this; the first is, that
these softening Liquors smooth and sooth the irritated
Parts; and secondly, an Injection, strongly
thrown in, has often been more successful in
loosening the obstructing Body, than all Attempts
with Instruments.
4. When after all we are obliged to leave this
in the Part, the Patient must be treated as if he
had an inflammatory Disease; he must be bled,
ordered to a Regimen, and have his whole Neck
surrounded with emollient Pultices. The like
Treatment must also be used, though the obstructing
Substance be removed; if there is Room
to suppose any Inflammation left in the Passage.
5. A proper Degree of Agitation has sometimes
loosened the inhering Body, more effectually than
Instruments. It has been experienced that a
Blow with the Fist on the Spine, the Middle of
the Back, has often disengaged such obstructed
and obstructing Bodies; and I have known two Instances
of Patients who had Pins stopt in the Passage;
and who getting on Horseback to ride out in
Search of Relief at a neighbouring Village, found
each of them the Pin disengaged after an Hour's
riding: One spat it out, and the other swallowed
it, without any ill Consequence.
6. When there is an immediate Apprehension
of the Patient's being suffocated; when bleeding
him has been of no Service; when all Hope of
freeing the Passage in time is vanished, and Death
seems at Hand, if Respiration be not restored;
the Operation of Bronchotomy, or opening of the
Wind-pipe, must be directly performed; an
Operation neither difficult to a tolerably knowing
and expert Surgeon, nor very painful to the Patient.
7. When the Substance that was stopt passes
into the Stomach, the Patient must immediately
be put into a very mild and smooth Regimen.
He should avoid all sharp, irritating, inflaming
Food; Wine, spirituous Liquors, all strong
Drink, and Coffee; taking but little Nourishment
at once, and no Solids, without their having
been thoroughly well chewed. The best
Diet would be that of farinaceous mealy Soups,
made of various leguminous Grains, and of Milk
and Water, which is much better than the usual
Custom of swallowing different Oils.
§ 429. The Author of Nature has provided,
that in eating, nothing should pass by the Glottis
into the Wind-pipe. This Misfortune nevertheless
does sometimes happen; at which very Instant
there ensues an incessant and violent Cough,
an acute Pain, with Suffocation; all the Blood
being forced up into the Head, the Patient is in
extreme Anguish, being agitated with violent
and involuntary Motions, and sometimes dying
on the Spot. A Hungarian Grenadier, by Trade
a Shoemaker, was eating and working at the
same time. He tumbled at once from his Seat,
without uttering a single Word. His Comrades
called out for Assistance; some Surgeons speedily
arrived, but after all their Endeavours he discovered
no Token of Life. On opening the Body,
they found a Lump, or large Morsel, of Beef,
weighing two Ounces, forced into the Windpipe,
which it plugged up so exactly, that not
the least Air could pass through it into the Lungs.
§ 430. In a Case so circumstanced, the Patient
should be struck often on the Middle of the
Back; some Efforts to vomit should be excited;
he should be prompted to sneeze with Powder of
Lilly of the Valley, Sage, or any cephalic Snuffs,
which should be blown strongly up his Nose.
A Pea, pitched into the Mouth in playing, entered
into the Wind-pipe, and sprung out again
by vomiting the Patient with Oil. A little Bone
was brought up by making another sneeze, with
powdered Lilly of the Valley.
In short, if all these Means of assisting, or saving
the Patient are evidently ineffectual, Bronchotomy
must be speedily performed (See .) By this Operation, some
Bones, a Bean, and a Fish-bone have been extracted,
and the Patient has been delivered from
approaching Death.
§ 431. Nothing should be left untried, when
the Preservation of human Life is the Object. In
those Cases, when an obstructing Body can neither
be disengaged from the Throat, the Passage
to the Stomach, nor be suffered to remain there
without speedily killing the Patient, it has been
proposed to make an Incision into this Passage,
the Oesophagus, through which such a Body is to
be extracted; and to employ the like Means,
when a Substance which had slipt even into the
Stomach itself, was of a Nature to excite such
Symptoms, as must speedily destroy the Patient.
When the Oesophagus is so fully and strongly
closed, that the Patient can receive no Food by
the Mouth, he is to be nourished by Glysters of
Soup, Gelly, and the like.
Chapter ***.
Of external Disorders, and such as require chirurgical
Application. Of Burns, Wounds, Contusions
or Bruises: Of Sprains, Ulcers, frostbitten
Limbs, Chilblains, Ruptures, Boils.
Of Fellons, Thorns or Splinters in the Fingers or
Flesh; of Warts, and of Corns.
Sect. 432.
abouring Countrymen are exposed in
the Course of their daily Work, to many
outward Accidents, such as Cuts,
Contusions, &c. which, however considerable
in themselves, very generally end happily;
and that chiefly in Consequence of the pure
and simple Nature of their Blood, which is generally
much less acrimonious, or sharp, in the
Country, than in great Towns or Cities. Nevertheless,
the very improper Treatment of such
Accidents, in the Country, frequently renders
them, however light in themselves, very troublesome;
and indeed, I have seen so many Instances
of this, that I have thought it necessary to mark
out here the proper Treatment of such Accidents,
as may not necessarily require the Hand or Attendance
of a Surgeon. I shall also add something
very briefly, concerning some external Disorders,
which at the same Time result from an
inward Cause.
Of Burns.
§ 433. When a Burn is very trifling and superficial,
and occasions no Vesication or Blister,
it is sufficient to clap a Compress of several Folds
of soft Linen upon it, dipt in cold Water, and to
renew it every Quarter of an Hour, till the Pain
is entirely removed. But when the Burn has
blistered, a Compress of very fine Linen, spread
over with the Pomatum, , should be applied
over it, and changed twice a Day.
If the true Skin is burnt, and even the Muscles,
the Flesh under it, be injured, the same Pomatum
may be applied; but instead of a Compress, it
should be spread upon a Pledget of soft Lint, to
be applied very exactly over it, and over the
Pledget again, a Slip of the simple Plaister ,
which every Body may easily prepare; or, if they
should prefer it, the Plaister .
But, independently of these external Applications,
which are the most effectual ones, when
they are directly to be had; whenever the Burn
has been very violent, is highly inflamed, and we
are apprehensive of the Progress and the Consequences
of the Inflammation, the same Means
and Remedies must be recurred to, which are
used in violent Inflammations: the Patient should
be bled, and, if it is necessary, it should be repeated
more than once, and he should be put into a
Regimen; drink nothing but the Ptisans
and , and receive daily two simple Glysters.
If the Ingredients for the Ointment, called
Nutritum, are not at Hand to make the Pomatum
; one Part of Wax should be melted
in eight such Parts of Oil, to two Ounces of
which Mixture the Yolk of an Egg should be
added. A still more simple and sooner prepared
Application, is that of one Egg, both the Yolk
and the White, beat up with two common
Spoonfuls of the sweetest Oil, without any Rankness.
When the Pain of the Burn, and all its
other Symptoms have very nearly disappeared, it
is sufficient to apply the Sparadrap, or Oil-cloth
.
Of Wounds.
§ 434. If a Wound has penetrated into any of
the Cavities, and has wounded any Part contained
in the Breast, or in the Belly: Or if, without
having entered into one of the Cavities, it has
opened some great Blood-vessel; or if it has
wounded a considerable Nerve, which occasions
Symptoms much more violent, than would otherwise
have happened; if it has penetrated even to
and injured the Bone: in short, if any great and
severe Symptom supervenes, there is an absolute
Necessity for calling in a Surgeon. But whenever
the Wound is not attended with any of these
Circumstances; when it affects only the Skin,
the fat Membrane beneath it, the fleshy Parts and
the small Vessels, it may be easily and simply
dressed without such Assistance; since, in general,
all that is truly necessary in such Cases is, to defend
the Wound from the Impressions of the Air;
and yet not so, as to give any material Obstruction
to the Discharge of the Matter, that is to issue
from the Wound.
§ 435. If the Blood does not particularly flow
out of any considerable Vessel, but trickles almost
equally from every Spot of the Wound, it may
very safely be permitted to bleed, while some
Lint is speedily preparing. As soon as the Lint
is ready, so much of it may be introduced into
the Wound as will nearly fill it, without being
forced in; which is highly improper, and would
be attended with the same Inconveniences as
Tents and Dossils. It should be covered over
with a Compress dipt in sweet Oil, or with the
Cerecloth ; though I prefer the Compress
for the earliest Dressings: and the whole
Dressing should be kept on, with a Bandage of
two Fingers Breadth, and of a Length proportioned
to the Size of the Part it is to surround:
This should be rolled on tight enough to secure
the Dressings, and yet so moderately, as to bring
on no Inflammation.
This Bandage with these Dressings are to remain
on twenty-four or forty-eight Hours;
Wounds being healed the sooner, for being less
frequently drest. At the second Dressing all the
Lint must be removed, which can be done with
Ease, and with reasonable Speed, to the Wounded;
and if any of it should stick close, in Consequence
of the clogged and dried Blood, it should
be left behind, adding a little fresh Lint to it;
this Dressing in other Respects exactly resembling
the first.
When, from the Continuance of this simple
Dressing, the Wound is become very superficial,
it is sufficient to apply the Cerecloth, or Plaister,
without any Lint.
Such as have conceived an extraordinary Opinion
of any medical Oils, impregnated with the
Virtues of particular Plants, may, if that will increase
their Satisfaction, make use of the common
Oil of Yarrow, of Trefoil, of Lilies, of Chamomile,
of Balsamines, or of red Roses; only being
very careful, that such Oils are not become stale
and rank.
§ 436. When the Wound is considerable, it
must be expected to inflame before Suppuration
(which, in such a Case, advances more slowly)
can ensue; which Inflammation will necessarily
be attended with Pain, with a Fever, and sometimes
with a Raving, or Wandering, too. In
such a Situation, a Pultice of Bread and Milk,
with the Addition of a little Oil, that it may not
stick too close, must be applied instead of the
Compress or the Plaister: which Pultice is to be
changed, but without uncovering the Wound,
thrice and even four times every Day.
§ 437. Should some pretty considerable Blood-vessel
be opened by the Wound, there must be
applied over it, a Piece of Agaric of the Oak,
, with which no Country place ought to
be unprovided. It is to be kept on, by applying
a good deal of Lint over it; covering the whole
with a thick Compress, and then with a Bandage
a little tighter than usual. If this should not be
sufficient to prevent the Bleeding from the large
Vessel, and the Wound be in the Leg or Arm, a
strong Ligature must be made above the Wound
with a Turniquet, which is made in a Moment
with a Skain of Thread, or of Hemp, that is
passed round the Arm circularly, into the Middle
of which is inserted a Piece of Wood or Stick
of an Inch Thickness, and four or five Inches
long; so that by turning round this Piece of
Wood, any Tightness or Compression may be
effected at Pleasure; exactly as a Country-man
secures a Hogshead, or a Piece of Timber on his
Cart, with a Chain and Ring. But Care must
be taken, 1, to dispose the Skain in such a Manner,
that it must always be two Inches wider
than the Part it surrounds: and, 2, not to strain
it so tight as to bring on an Inflammation, which
might terminate in a Gangrene.
§ 438. All the boasted Virtues of a Multitude
of Ointments are downright Nonsense or Quackery.
Art, strictly considered, does not in the least
contribute to the healing of Wounds; the utmost
we can do amounting only to our removing
those Accidents, which are so many Obstacles to
their Re-union. On this Account, if there is
any extraneous Body in the Wound, such as
Iron, Lead, Wood, Glass, Bits of Cloth or
Linen, they must be extracted, if that can be
very easily done; but if not, Application must
be made to a good Surgeon, who considers what
Measures are to be taken, and then dresses the
Wound, as I have already advised.
Very far from being useful, there are many
Ointments that are pernicious on these Occasions;
and the only Cases in which they should be used,
are those in which the Wounds are distinguished
with some particular Appearances, which ought
to be removed by particular Applications: But a
simple recent Wound, in a healthy Man, requires
no other Treatment but what I have already
directed, besides that of the general Regimen.
Spirituous Applications are commonly hurtful,
and can be suitable and proper but in a few Cases,
which Physicians and Surgeons only can distinguish.
When Wounds occur in the Head, instead of
the Compress dipt in Oil, or of the Cerecloth,
the Wound should be covered with a Betony
Plaister; or, when none is to be had in time,
with a Compress squeezed out of hot Wine.
§ 439. As the following Symptoms, of which
we should be most apprehensive, are such as attend
on Inflammations, the Means we ought to
have Recourse to are those which are most likely
to prevent them; such as Bleeding, the usual
Regimen, moderate Coolers and Glysters.
Should the Wound be very inconsiderable in
its Degree, and in its Situation, it may be sufficient
to avoid taking any Thing heating; and
above all Things to retrench the Use of any strong
Drink, and of Flesh-meat.
But when it is considerable, and an Inflammation
must be expected, there is a Necessity for
Bleeding; the Patient should be kept in the most
quiet and easy Situation; he should be ordered
immediately to a Regimen; and sometimes the
Bleeding also must be repeated. Now all these
Means are the more indispensably necessary, when
the Wound has penetrated to some internal Part;
in which Situation, no Remedy is more certain
than that of an extremely light Diet. Such
wounded Persons as have been supposed incapable
of living many Hours, after Wounds in the
Breast, in the Belly, or in the Kidnies, have
been completely recovered, by living for the
Course of several Weeks, on nothing but a Barley,
or other farinaceous mealy, Ptisans, without
Salt, without Soup, without any Medicine;
and especially without the Use of any Ointments.
§ 440. In the same Proportion that Bleeding,
moderately and judiciously employed, is serviceable,
in that very same an Excess of it becomes
pernicious. Great Wounds are generally attended
with a considerable Loss of Blood, which has
already exhausted the wounded Person; and the
Fever is often a Consequence of this copious Loss
of Blood. Now if under such a Circumstance,
Bleeding should be ordered and performed, the
Patient's Strength is totally sunk; the Humours
stagnate and corrupt; a Gangrene supervenes,
and he dies miserably, at the End of two or three
Days, of a Series of repeated Bleedings, but not
of the Wound. Notwithstanding the Certainty
of this, the Surgeon frequently boasts of his ten,
twelve, or even his fifteen Bleedings; assuring
his Hearers of the insuperable Mortality of the
Wound, since the letting out such a Quantity of
Blood could not recover the Patient; when it
really was that excessive artificial Profusion of it,
that downright dispatched him.———The
Pleasures of Love are very mortal ones to the
Wounded.
§ 441. The Balsams and vulnerary Plants,
which have often been so highly celebrated for the
Cure of Wounds, are very noxious, when taken
inwardly; because the Introduction of them gives
or heightens the Fever, which ought to have been
abated.
Of Contusions, or Bruises.
§ 442. A Contusion, which is commonly
called a Bruise, is the Effect of the forcible Impression
or Stroke of a Substance not sharp or
cutting, on the Body of a Man, or any Animal;
whether such an Impression be violently made
on the Man, as when he is struck by a Stick, or
by a Stone thrown at him; or whether the Man
be involuntarily forced against a Post, a Stone,
or any hard Substance by a Fall; or whether, in
short, he is squeezed and oppressed betwixt two
hard Bodies, as when his Finger is squeezed betwixt
the Door and the Door-Post, or the whole
Body jammed in betwixt any Carriage and the
Wall. These Bruises, however, are still more
frequent in the Country than Wounds, and commonly
more dangerous too; and indeed the more
so, as we cannot judge so exactly, and so soon,
of the whole Injury that has been incurred; and
because all that is immediately visible of it is often
but a small Part of the real Damage attending it:
since it frequently happens that no Hurt appears
for a few successive Days; nor does it become
manifest, until it is too late to admit of an effectual
Cure.
§ 443. It is but a few Weeks since a Cooper
came to ask my Advice. His Manner of breathing,
his Aspect, the Quickness, Smallness, and
Irregularity of his Pulse, made me apprehensive at
once, that some Matter was formed within his Breast.
Nevertheless he still kept up, and went about,
working also at some Part of his Trade. He
had fallen in removing some Casks or Hogsheads;
and the whole Weight of his Body had been
violently impressed upon the right Side of his
Breast. Notwithstanding this, he was sensible
of no Hurt at first; but some Days afterwards he
began to feel a dull heavy Pain in that Part,
which continued and brought on a Difficulty of
Breathing, Weakness, broken Sleep and Loss of
Appetite. I ordered him immediately to Stillness
and Repose, and I advised him to drink a Ptisan
of Barley sweetened with Honey, in a plentiful
Quantity. He regularly obeyed only the latter
Part of my Directions: yet on meeting him a
few Days after, he told me he was better. The
very same Week, however, I was informed he
had been found dead in his Bed. The Imposthume
had undoubtedly broke, and suffocated
him.
§ 444. A young Man, run away with by his
Horse, was forced with Violence against a Stable-Door,
without being sensible of any Damage
at the Time. But at the Expiration of twelve
Days, he found himself attacked by some such
Complaints, as generally occur at the Beginning
of a Fever. This Fever was mistaken for a putrid
one, and he was very improperly treated, for
the Fever it really was, above a Month. In
short, it was agreed at a Consultation, that Matter
was collected in the Breast. In Consequence
of this, he was more properly attended, and at
length happily cured by the Operation for an
Empyema, after languishing a whole Year. I
have published these two Instances, to demonstrate
the great Danger of neglecting violent
Strokes or Bruises; since the first of these Patients
might have escaped Death; and the second
a tedious and afflicting Disorder, if they had
taken, immediately after each Accident, the necessary
Precautions against its Consequences.
§ 445. Whenever any Part is bruised, one of
two Things always ensues, and commonly both
happen together; especially if the Contusion is
pretty considerable: Either the small Blood-vessels
of the contused Part are broken, and the
Blood they contained is spread about in the adjoining
Parts; or else, without such an Effusion
of it, these Vessels have lost their Tone, their
active Force, and no longer contributing to the
Circulation, their Contents stagnate. In each of
these Cases, if Nature, either without or with
the Assistance of Art, does not remove the Impediment,
an Inflammation comes on, attended
with an imperfect, unkindly Suppuration, with
Putrefaction and a Gangrene; without mentioning
the Symptoms that arise from the Contusion
of some particular Substance, as a Nerve, a large
Vessel, a Bone, &c. Hence we may also conceive
the Danger of a Contusion, happening to
any inward Part, from which the Blood is either
internally effused, or the Circulation wholly obstructed
in some vital Organ. This is the Cause
of the sudden Death of Persons after a violent
Fall; or of those who have received the violent
Force of heavy descending Bodies on their Heads;
or of some violent Strokes, without any evident
external Hurt or Mark.
There have been many Instances of sudden
Deaths after one Blow on the Pit of the Stomach,
which has occasioned a Rupture of the Spleen.
It is in Consequence of Falls occasioning a general
slight Contusion, as well internal as external,
that they are sometimes attended with such
grievous Consequences, especially in old Men,
where Nature, already enfeebled, is less able to
redress such Disorders. And thus in Fact has it
been, that many such, who had before enjoyed
a firm State of Health, have immediately lost it
after a Fall (which seemed at first to have affected
them little or not at all) and languished soon
after to the Moment of their Death, which such
Accidents very generally accelerate.
§ 446. Different external and internal Remedies
are applicable in Contusions. When the
Accident has occurred in a slight Degree, and
there has been no great nor general Shock, which
might produce an internal Soreness or Contusion,
external Applications may be sufficient. They
should consist of such Things as are adapted,
first, to attenuate and resolve the effused and
stagnant Blood, which shews itself so apparently;
and which, from its manifest Blackness very
soon after the Contusion, becomes successively
brown, yellow, and greyish, in Proportions as the
Magnitude of the Suffusion or Sealing decreases,
till at last it disappears entirely, and the Skin recovers
its Colour, without the Blood's having been
discharged through the external Surface, as it
has been insensibly and gradually dissolved, and
been taken in again by the Vessels: And secondly,
the Medicines should be such as are qualified to
restore the Tone, and to recover the Strength of
the affected Vessels.
The best Application is Vinegar, diluted, if
very sharp, with twice as much warm Water;
in which Mixture Folds of Linnen are to be
dipt, within which the contused Parts are to be
involved; and these Folds are to be remoistened
and re-applied every two Hours on the first
Day.
Parsley, Chervil, and Houseleek Leaves, lightly
pounded, have also been successfully employed;
and these Applications are preferable to
Vinegar, when a Wound is joined to the Bruise.
The Pultices, , may also be used with
Advantage.
§ 447. It has been a common Practice immediately
to apply spirituous Liquors, such as Brandy,
Arquebussade and Alibour Water, and the
like; but a long Abuse ought not to be established
by Prescription. These Liquids which coagulate
the Blood, instead of resolving it, are truly pernicious;
notwithstanding they are sometimes
employed without any visible Disadvantage on very
slight Occasions. Frequently by determining
the settled Blood towards the Insterstices of the
Muscles, the fleshy Parts; or sometimes even by
preventing the Effusion, or visible Settling of
the Blood, and fixing it, as it were, within the
bruised Vessels, they seem to be well; though
this only arises from their concentring and concealing
the Evil, which, at the End of a few
Months, breaks forth again in a very troublesome
Shape. Of this I have seen some miserable Examples,
whence it has been abundantly evinced,
that Applications of this Sort should never be admitted;
and that Vinegar should be used instead
of them. At the utmost it should only be allowed,
(after there is Reason to suppose all the stagnant
Blood resolved and resorbed into the Circulation)
to add a third Part of Arquebusade Water
to the Vinegar; with an Intention to restore some
Strength to the relaxed and weakened Parts.
§ 448. It is still a more pernicious Practice to
apply, in Bruises, Plaisters composed of greasy
Substances, Rosins, Gums, Earths, &c. The
most boasted of these is always hurtful, and there
have been many Instances of very slight Contusions
being aggravated into Gangrenes by such
Plaisters ignorantly applied; which Bruises would
have been entirely subdued by the Oeconomy of
Nature, if left to herself, in the Space of four
Days.
Those Sacs or Suffusions of coagulated Blood,
which are visible under the Skin, should never
be opened, except for some urgent Reason; since
however large they may be, they insensibly disappear
and dissipate; instead of which Termination,
by opening them, they sometimes terminate
in a dangerous Ulceration.
§ 449. The internal Treatment of Contusions
is exactly the same with that of Wounds; only
that in these Cases the best Drink is the Prescription,
, to each Pot of which a Drachm of
Nitre must be added.
When any Person has got a violent Fall; has
lost his Senses, or is become very stupid; when
the Blood starts out of his Nostrils, or his Ears;
when he is greatly oppressed, or his Belly feels
very tight and tense, which import an Effusion
of Blood either into the Head, the Breast or the
Belly, he must, first of all, be bled upon the
Spot, and all the Means must be recurred to,
which have been mentioned , giving the
wretched Patient the least possible Disturbance
or Motion; and by all means avoiding to jog or
shake him, with a Design to bring him to his
Senses; which would be directly and effectually
killing him, by causing a further Effusion of
Blood. Instead of this the whole Body should
be fomented, with some one of the Decoctions
already mentioned: and when the Violence
has been chiefly impressed on the Head, Wine
and Water should be prefered to Vinegar.
Falls attended with Wounds, and even a
Fracture of the Skull, and with the most alarming
Symptoms, have been cured by these internal
Remedies, and without any other external Assistance,
except the Use of the aromatic Fomentation,
.
A Man from Pully-petit came to consult me
some Months ago, concerning his Father, who
had a high Fall out of a Tree. He had been
twenty-four Hours without Feeling or Sense, and
without any other Motion than frequent Efforts
to vomit; and Blood had issued both from his
Nose and Ears. He had no visible outward Hurt
neither on his Head, nor any other Part; and,
very fortunately for him, they had not as yet exerted
the least Effort to relieve him. I immediately
directed a plentiful Bleeding in the Arm;
and a large Quantity of Whey sweetened with
Honey to be drank, and to be also injected by
Way of Glyster. This Advice was very punctually
observed; and fifteen Days after the Father
came to Lausanne, which is four Leagues from
Pully-petit, and told me he was very well. It is
proper, in all considerable Bruises, to open the
Patient's Belly with a mild cooling Purge, such
as , , , . The Prescription
, and the honyed Whey are excellent Remedies,
from the same Reason.
§ 450. In these Circumstances, Wine, distiled
Spirits, and whatever has been supposed to revive
and to rouse, is mortal. For this Reason
People should not be too impatient, because the
Patients remain some Time without Sense or
Feeling. The giving of Turpentine is more
likely to do Mischief than Good; and if it has
been sometimes serviceable, it must have been in
Consequence of its purging the Patient, who probably
then needed to be purged. The Fat of a
Whale, (Sperma cæti) Dragons Blood, Crabs-Eyes,
and Ointments of whatsoever Sort are at
least useless and dangerous Medicine, if the Case
be very hazardous; either by the Mischief they
do, or the Good they prevent from being done.
The proper Indication is to dilute the Blood, to
render it more fluid and disposed to circulate;
and the Medicines just mentioned produce a very
contrary Effect.
§ 451. When an aged Person gets a Fall,
which is the more dangerous in Proportion to his
Age and Grossness; notwithstanding he should
not seem in the least incommoded by it, if he is
sanguine and still somewhat vigorous, he should
part with three or four Ounces of Blood. He
should take immediately a few successive Cups of
a lightly aromatic Drink, which should be given
him hot; such, for Instance, as an Infusion of
Tea sweetened with Honey, and he should be
advised to move gently about. He must retrench
a little from the usual Quantity of his Food, and
accustom himself to very gentle, but very frequent,
Exercise.
§ 452. Sprains or Wrenches, which very often
happen, produce a Kind of Contusion, in the
Parts adjoining to the sprained Joint. This Contusion
is caused by the violent Friction of the
Bone against the neighbouring Parts; and as soon
as the Bones are immediately returned into their
proper Situation, the Disorder should be treated
as a Contusion. Indeed if the Bones should not
of themselves return into their proper natural
Position, Recourse must be had to the Hand of
a Surgeon.
The best Remedy in this Case is absolute Rest
and Repose, after applying a Compress moistened
in Vinegar and Water, which is to be renewed
and continued, till the Marks of the Contusion
entirely disappear; and there remains not the
smallest Apprehension of an Inflammation. Then
indeed, and not before, a little Brandy or Arquebusade
Water may be added to the Vinegar;
and the Part (which is almost constantly the
Foot) should be strengthened and secured for a
considerable Time with a Bandage; as it might
otherwise be liable to fresh Sprains, which would
daily more and more enfeeble it: and if this Evil
is overlooked too much in its Infancy, the Part
never recovers its full Strength; and a small
Swelling often remains to the End of the Patient's
Life.
If the Sprain is very slight and moderate, a
Plunging of the Part into cold Water is excellent;
but if this is not done at once immediately
after the Sprain, or if the Contusion is violent,
it is even hurtful.
The Custom of rolling the naked Foot upon
some round Body is insufficient, when the Bones
are not perfectly replaced; and hurtful, when
the Sprain is accompanied with a Contusion.
It happens continually almost that Country
People, who encounter such Accidents, apply
themselves either to ignorant or knavish Imposters,
who find, or are determined to find, a Disorder
or Dislocation of the Bones, where there is
none; and who, by their violent Manner of
handling the Parts, or by the Plaisters they surround
them with, bring on a dangerous Inflammation,
and change the Patient's Dread of a small
Disorder, into a very grievous Malady.
These are the very Persons who have created,
or indeed rather imagined, some impossible Diseases,
such as the Opening, the Splitting of the
Stomach, and of the Kidnies. But these big
Words terrify the poor Country People, and
dispose them to be more easily and effectually
duped.
Of Ulcers.
§ 453. Whenever Ulcers arise from a general
Fault of the Blood, it is impossible to cure them,
without destroying the Cause and Fuel of them.
It is in Fact imprudent to attempt to heal them
up by outward Remedies; and a real Misfortune
to the Patient, if his Assistant effectually heals
and closes them.
But, for the greater Part, Ulcers in the Country
are the Consequence of some Wound, Bruise,
or Tumour improperly treated; and especially
of such as have been dressed with too sharp, or
too spirituous Applications. Rancid Oils are also
one of the Causes, which change the most simple
Wounds into obstinate Ulcers, for which
Reason they should be avoided; and Apothecaries
should be careful, when they compound greasy
Ointments, to make but little at a Time, and
the oftner, as a very considerable Quantity of
any of them becomes rank before it is all sold;
notwithstanding sweet fresh Oil may have been
employed in preparing them.
§ 454. What serves to distinguish Ulcers from
Wounds, is the Dryness and Hardness of the
Sides or Borders of Ulcers, and the Quality of
the Humour discharged from them; which, instead
of being ripe consistent Matter, is a Liquid
more thin, less white, sometimes yielding a disagreable
Scent, and so very sharp, that if it touch
the adjoining Skin, it produces Redness, Inflammation,
or Pustules there; sometimes a serpiginous,
or Ring-worm like Eruption, and even
a further Ulceration.
§ 455. Such Ulcers as are of a long Duration,
which spread wide, and discharge much, prey
upon the Patient, and throw him into a slow
Fever, which melts and consumes him. Besides,
when an Ulcer is of a long Standing, it is
dangerous to dry it up; and indeed this never
should be done, but by substituting in the Place
of one Discharge that is become almost natural,
some other Evacuation, such as Purging from
Time to Time.
We may daily see sudden Deaths, or very tormenting
Diseases, ensue the sudden drying up
such Humours and Drains as have been of a long
Continuance: and whenever any Quack (and as
many as promise the speedy Cure of such, deserve
that Title) assures the Patient of his curing
an inveterate Ulcer in a few Days, he demonstrates
himself to be a very dangerous and ignorant
Intermeddler, who must kill the Patient, if
he keeps his Word. Some of these impudent
Impostors make use of the most corrosive Applications,
and even arsenical ones; notwithstanding
the most violent Death is generally the Consequence
of them.
§ 456. The utmost that Art can effect, with
Regard to Ulcers, which do not arise from any
Fault in the Humours, is to change them into
Wounds. To this End, the Hardness and Dryness
of the Edges of the Ulcer, and indeed of
the whole Ulcer, must be diminished, and its
Inflammation removed. But sometimes the
Hardness is so obstinate, that this cannot be
mollified any other Way, than by scarifying the
Edges with a Lancet. But when it may be
effected by other Means, let a Pledget spread
with the Ointment, , be applied all over
the Ulcer; and this Pledget be covered again
with a Compress of several Folds, moistened in
the Liquid, , which should be renewed
three times daily; though it is sufficient to apply
a fresh Pledget only twice.
As I have already affirmed that Ulcers were often
the Consequence of sharp and spirituous Dressings,
it is evident such should be abstained from,
without which Abstinence they will prove incurable.
To forward the Cure, salted Food, Spices, and
strong Drink should be avoided; the Quantity of
Flesh-meat should be lessened; and the Body be
kept open by a Regimen of Pulse, of Vegetables,
and by the habitual Use of Whey sweetened
with Honey.
If the Ulcers are in the Legs, a very common
Situation of them, it is of great Importance, as
well as in Wounds of the same Parts, that the
Patient should walk about but little; and yet
never stand up without walking. This indeed is
one of these Cases, in which those, who have
some Credit and Influence in the Estimation of
the People, should omit nothing to make them
thoroughly comprehend the Necessity of confining
themselves, some Days, to undisturbed Tranquillity
and Rest; and they should also convince
them, that this Term of Rest is so far from being
lost Time, that it is likely to prove their most
profitable Time of Life. Negligence, in this material
Point, changes the slightest Wounds into
Ulcers, and the most trifling Ulcers into obstinate
and incurable ones: insomuch that there is
scarcely any Man, who may not observe some
Family in his Neighbourhood, reduced to the
Hospital, from their having been too inattentive
to the due Care of some Complaint of this
Sort.
I conclude this Article on Ulcers with repeating,
that those which are owing to some internal
Cause; or even such as happen from an
external one, in Persons of a bad Habit of Body,
frequently require a more particular Treatment.
Of Frozen Limbs.
§ 457. It is but too common, in very rigorous
Winters, for some Persons to be pierced with so
violent a Degree of Cold, that their Hands or
Feet, or sometimes both together are frozen at
once, just like a Piece of Flesh-meat exposed to
the Air.
If a Person thus pierced with the Cold, dispose
himself to walk about, which seems so natural
and obvious a Means to get warm; and especially,
if he attempts to warm the Parts that have
been frozen, his Case proves irrecoverable. Intolerable
Pains are the Consequence, which
Pains are speedily attended with an incurable
Gangrene; and there is no Means left to save
the Patient's Life, but by cutting off the gangrened
Limbs.
There was a very late and terrible Example of
this, in the Case of an Inhabitant at Cossonay,
who had both his Hands frozen. Some greasy
Ointments were applied hot to them, the Consequence
of which was, the Necessity of cutting
off six of his Fingers.
§ 458. In short, there is but one certain Remedy
in such Cases, and this is to convey the
Person affected into some Place where it does not
freeze, but where, however, it is but very moderately
hot, and there continually to apply, to
the frozen Parts, Snow, if it be at hand; and if
not, to keep washing them incessantly, but very
gently (since all Friction would at this Juncture
prove dangerous) in Ice-water, as the Ice thaws
in the Chamber. By this Application the Patients
will be sensible of their Feeling's returning
very gradually to the Part, and that they begin to
recover their Motion. In this State they may
Safely be moved into a Place a little warmer, and
drink some Cups of the Potion , or of
another of the like Quality.
§ 459. Every Person may be a competent
judge of the manifest Danger of attempting to
relieve such Parts by heating them, and of the
Use of Ice-water, by a common, a daily Experience.
Frozen Pears, Apples, and Radishes,
being put into Water just about to freeze, recover
their former State, and prove quickly eatable.
But if they are put into warm Water, or into a
hot Place, Rottenness, which is one Sort of
Gangrene, is the immediate Effect. The following
Case will make this right Method of
treating them still more intelligible, and demonstrate
its Efficacy.
A Man was travelling to the Distance of six
Leagues in very cold Weather; the Road being
covered with Snow and Ice. His Shoes, not
being very good, failed him on his March, so
that he walked the three last Leagues bare-footed;
and felt, immediately after the first Half
League, sharp Pains in his Legs and Feet, which
increased as he proceeded. He arrived at his
Journey's End in a Manner nearly deprived of
his lower Extremities. They set him before a
great Fire, heated a Bed well, and put him into
it. His Pains immediately became intolerable:
he was incessantly in the most violent Agitations,
and cried out in the most piercing and affecting
Manner. A Physician, being sent for in the
Night, found his Toes of a blackish Colour, and
beginning to lose their Feeling. His Legs and
the upper Part of his Feet, which were excessively
swelled, of a purplish Red, and varied with
Spots of a violet Colour, were still sensible of
the most excruciating Pains. The Physician ordered
in a Pail of Water from the adjoining River,
adding more to it, and some Ice withal. In
this he obliged the Patient to plunge his Legs;
they were kept in near an Hour, and within
that Time, the Pains became less violent. After
another Hour he ordered a second cold Bath,
from which the Patient perceiving still further
Relief, prolonged it to the Extent of two Hours.
During that Time, some Water was taken out
of the Pail, and some Ice and Snow were put
into it. Now his Toes, which had been black,
grew red; the violet Spots in his Legs disappeared;
the Swelling abated; the Pains became
moderate, and intermitted. The Bath was nevertheless
repeated six times; after which there remained
no other Complaint, but that of a great
Tenderness or extraordinary Sensibility in the
Soles of his Feet, which hindered him from
walking. The Parts were afterwards bathed
with some aromatic Fomentations; and he drank
a Ptisan of Sarsaparilla [one of Elder Flowers
would have answered the same Purpose, and have
been less expensive.] On the eighth Day from
his Seizure he was perfectly recovered, and
returned home on Foot on the fifteenth.
§ 460. When cold Weather is extremely severe,
and a Person is exposed to it for a long
Time at once, it proves mortal, in Consequence
of its congealing the Blood, and because it forces
too great a Proportion of Blood up to the Brain;
so that the Patient dies of a Kind of Apoplexy,
which is preceded by a Sleepiness. In this Circumstance
the Traveller, who finds himself
drowsy, should redouble his Efforts to extricate
himself from the eminent Danger he is exposed
to. This Sleep, which he might consider as
some Alleviation of his Sufferings, if indulged,
would prove his last.
§ 461. The Remedies in such Cases are the
same with those directed in frozen Limbs. The
Patient must be conducted to an Apartment
rather cold than hot, and be rubbed with Snow
or with Ice-water. There have been many well
attested Instances of this Method; and as such
Cases are still more frequent in more northern
Climates, a Bath of the very coldest Water has
been found the surest Remedy.
Since it is known that many People have been
revived, who had remained in the Snow, or
had been exposed to the freezing Air during five,
or even six successive Days, and who had discovered
no one Mark of Life for several Hours,
the utmost Endeavours should be used for the Recovery
of Persons in the like Circumstances and
Situation.
Of Kibes, or Chilblains.
§ 462. These troublesome and smarting Complaints
attack the Hands, Feet, Heels, Ears, Nose
and Lips, those of Children especially, and mostly
in Winter; when these Extremities are exposed to
the sudden Changes from hot to cold, and from
cold to hot Weather. They begin with an Inflation
or kind of Swelling, which, at first, occasions
but little Heat, Pain or Itching. Sometimes
they do not exceed this first State, and go
off spontaneously without any Application: But
at other Times (which may be termed the second
Degree of the Disorder, whether it happens from
their being neglected, or improperly treated)
their Heat, Redness, Itching and Pain increase
considerably; so that the Patient is often deprived
of the free Use of his Fingers by the Pain,
Swelling and Numbness: in which Case the
Malady is still aggravated, if effectual Means are
not used.
Whenever the Inflammation mounts to a still
higher Degree, small Vesications or Blisters are
formed, which are not long without bursting;
when they leave a slight Excoriation, or Rawness,
as it were, which speedily ulcerates, and
frequently proves a very deep and obstinate
Ulcer, discharging a sharp and ill-conditioned
Matter.
The last and most virulent Degree of Chilblains,
which is not infrequent in the very coldest
Countries, though very rare in the temperate
ones, is, when the Inflammation degenerates
into a Gangrene.
§ 463. These Tumours are owing to a Fulness
and Obstruction of the Vessels of the Skin,
which occurs from this Circumstance, that the
Veins, which are more superficial than the Arteries,
being proportionably more affected and
straitened by the Cold, do not carry off all the
Blood communicated to them by the Arteries;
and perhaps also the Particles or Atoms of Cold,
which are admitted through the Pores of the
Skin, may act upon our Fluids, as it does upon
Water, and occasion a Congelation of them, or
a considerable Approach towards it.
If these Complaints are chiefly felt, which in
Fact is the Case, rather on the extreme Parts
than on others, it arises from two Causes, the
principal one being, that the Circulation's being
weaker at the Extremities than elsewhere, the
Effect of those Causes, that may impair it, must be
more considerably felt there. The second Reason
is, because these Parts are more exposed to
the Impressions from without than the others.
They occur most frequently to Children, from
their Weakness and the greater Tenderness and
Sensibility of their Organs, which necessarily increases
the Effect of external Impressions. It
is the frequent and strong Alteration from Heat
to Cold, that seems to contribute the most
powerfully to the Production of Chilblains; and
this Effect of it is most considerable, when the
Heat of the Air is at the same Time blended with
Moisture; whence the extreme and superficial
Parts pass suddenly as it were, out of a hot, into
a cold, Bath. A Man sixty Years of Age, who
never before was troubled with Kibes, having
worn, for some Hours on a Journey, a Pair of
furred Gloves, in which his Hands sweated, felt
them very tender, and found them swelled up
with Blood: as the common Effect of the warm
Bath is to soften and relax, and to draw Blood
abundantly to the bathed Parts, whence it renders
them more sensible.
This Man, I say, thus circumstanced, was at
that Age first attacked with Chilblains, which
proved extremely troublesome; and he was every
succeeding Winter as certainly infested with
them, within Half an Hour after he left off his
Gloves, and was exposed to a very cold Air.
It is for this Reason, that several Persons are
never infested with Chilblains, but when they
use themselves to Muffs, which are scarcely
known in hot Countries; nor are they very common
among the more northern ones, in which
the extraordinary Changes from Cold to Heat are
very rare and unusual.
Some People are subject to this troublesome
Complaint in the Fall; while others have
it only in the Spring. The Child of a labouring
Peasant, who has a hard Skin, and one inured
to all the Impressions of the Seasons and of the
Elements, is, and indeed necessarily must be,
less liable to Kibes, than the Child of a rich Citizen,
whose Skin is often cherished, at the Expence
of his Constitution. But even among
Children of the same Rank in Life and Circumstances,
who seem pretty much of the same
Complexion, and live much in the same Manner;
whence they might of Course be supposed equally
liable to the same Impressions, and to the like
Effects of them, there is, nevertheless, a very
great Difference with Respect to their constitutional
Propensity to contract Chilblains. Some
are very cruelly tormented with them, from the
setting in of Autumn, to the very End of the
Spring: others have either none at all, or have
them but very slightly, and for a very short
Time. This Difference undoubtedly arises from
the different Quality of their Humours, and the
Texture of their whole Surface, but particularly
from that of the Skin of their Hands; though
we readily confess it is by no Means easy to determine,
with Certainty and Precision, in what this
Difference essentially consists.
Children of a sanguine Complexion and delicate
Skin are pretty generally subject to this Disorder,
which is often regarded much too slightly,
though it is really severe enough to engage our
Attention more; since, even abstracted from the
sharp Pains which smart these unhappy Children
for several Months; it sometimes gives them a
Fever, hinders them from sleeping, and yet confines
them to their Bed, which is very prejudicial
to their Constitutions. It also breaks in upon the
Order of their different Duties and Employments;
it interrupts their innocent salutary Pleasures;
and sometimes, when they are obliged to earn
their daily Bread by doing some Work or other,
it sinks them down to Misery. I knew a young
Man, who from being rendered incapable by
Chilblains, of serving out his Apprenticeship to a
Watch-maker, is become a lazy Beggar.
Chilblains which attack the Nose, often leave
a Mark that alters the Physiognomy, the Aspect
of the Patient, for the Remainder of his Life: and
the Hands of such as have suffered from very obstinate
ones, are commonly ever sensible of their
Consequences.
§ 464. With Respect, therefore, to these afflicting
Tumours and Ulcerations, we should,
in the first Place, do our utmost to prevent
them; and next exert our best Endeavours to
cure such as we could not prevent.
§ 465. Since they manifestly depend on the
Sensibility of the Skin, the Nature of the Humours,
and the Changes of the Weather from
Heat to Cold, in Order to prevent them, in the
first Place, the Skin must be rendered firmer or
less tender. 2, That vicious Quality of the
Temperament, which contributes to their Existence,
must be corrected; and, 3, the Persons
so liable must guard themselves as well as possible,
against these Changes of the Weather.
Now the Skin of the Hands, as well as that
of the whole Body, may be strengthened by that
Habit of washing or bathing in cold Water,
which I have described at large, ; and in
Fact I have never seen Children, who had been
early accustomed and inured to this Habit, as
much afflicted with Chilblains as others. But
still a more particular Regard should be had to
fortify the Skin of the Hands, which are more
obnoxious to this Disorder than the Feet, by
making Children dip them in cold Water, and
keep them for some Moments together in it
every Morning, and every Evening too before Supper,
from the very Beginning of the Fall. It
will give the Children no Sort of Pain, during
that Season, to contract this Habit; and when
it is once contracted, it will give them no Trouble
to continue it throughout the Winter, even
when the Water is ready to freeze every where.
They may also be habituated to plunge their
Feet into cold Water twice or thrice a Week:
and this Method, which might be less adapted for
grown Persons, who had not been accustomed to
it, must be without Objection with Respect to
such Children, as have been accustomed to it;
to whom all its Consequences must be useful and
salutary.
At the same Time Care must be taken not to
defeat or lessen the Effect of the cold bathing,
by suffering the Bather or Washer, to grow too
warm between two Baths or Dippings; which
is also avoiding the too speedy Successions of Heat
and Cold. For this Purpose, 1, the Children
must be taught never to warm their Hands before
the Fire at such Times, and still less before
the Stoves, which very probably are one of the
principal Causes of Chilblains, that are less usual
in Countries which use no such Stoves, and among
those Individuals who make the least Use of them,
where they are. Above all, the Use of Cavettes
(that is, of Seats or little Stairs, as it were, contrived
between the Stove and the Wall) is prejudicial
to Children, and even to grown People,
upon several Accounts. 2, They should never accustom
themselves to wear Muffs. 3, It would
be also proper they should never use Gloves, unless
some particular Circumstances require it; and I
recommend this Abstinence from Gloves, especially
to young Boys: but if any should be allowed
them, let the Gloves be thin and smooth.
§ 466. When Chilblains seem to be nourished
by some Fault in the Temperament or Humours,
the Consideration of a Physician becomes necessary,
to direct a proper Method of removing or
altering it. I have seen Children from the Age
of three, to that of twelve or thirteen Years, in
whom their Chilblains, raw and flead, as it
were, for eight Months of the Year, seemed to
be a particular Kind of Issue, by which Nature
freed herself of an inconvenient Superfluity of
Humours, when the Perspiration was diminished
by the Abatement of the violent Heats. In such
Cases I have been obliged to carry them through
a pretty long Course of Regimen and Remedies;
which, however, being necessarily various from
a Variety of Circumstances, cannot be detailed
here. The milder Preparations of Antimony are
often necessary in such Cases; and some Purges
conduce in particular ones to allay and to abridge
the Disorder.
§ 467. The first Degree of this Complaint
goes off, as I have already said, without the Aid
of Medicine; or should it prove somewhat more
obstinate, it may easily be dissipated by some
of the following Remedies. But when they rise
to the second Degree, they must be treated like
other Complaints from Congelation, or Frost-biting
(of which they are the first Degree) with
cold Water, Ice-water and Snow.
No other Method or Medicine is nearly as
efficacious as very cold Water, so as to be ready
to freeze, in which the Hands are to be dipt and
retained for some Minutes together, and several
Times daily. In short it is the only Remedy
which ought to be applied, when the Hands are
the Parts affected; when the Patient has the Courage
to bear this Degree of Cold; and when he is
under no Circumstance which may render it prejudicial.
It is the only Application I have used
for myself, after having been attacked with Chilblains
for some Years past, from having accustomed
myself to too warm a ***.
There ensues a slight Degree of Pain for some
Moments after plunging the Hand into Water,
but it diminishes gradually. On taking the Hand
out, the Fingers are numbed with the Cold, but
they presently grow warm again; and within a
Quarter of an Hour, it is entirely over.
The Hands, on being taken out of the Water,
are to be well dried, and put into Skin Gloves;
after bathing three or four Times, their Swelling
subsides, so that the Skin wrinkles: but by continuing
the cold Bathing, it grows tight and
smooth again; the Cure is compleated after using
it three or four Days; and, in general, the Disorder
never returns again the same Winter.
The most troublesome raging Itching is certainly
assuaged by plunging the Hands into cold
Water.
The Effect of Snow is, perhaps, still more
speedy: the Hands are to be gently and often
rubbed with it for a considerable Time; they
grow hot, and are of a very high Red for
some Moments, but entire Ease very quickly
succeeds.
Nevertheless, a very small Number of Persons,
who must have extremely delicate and sensible
Skins, do not experience the Efficacy of this
Application. It seems too active for them; it
affects the Skin much like a common blistering
Plaister; and by bringing on a large flow of Humours
there, it increases, instead of lessening
the Complaint.
§ 468. When this last Reason indeed, or some
other Circumstance exists; such as the Child's Want
of Courage, or its Affliction; the monthly Discharges
in a Woman; a violent Cough; habitual
Colics; and some other Maladies, which have
been observed to be renewed or aggravated by the
Influence of Cold at the Extremities, do really
forbid this very cold Application, some others
must be substituted.
One of the best is to wear Day and Night,
without ever putting it off, a Glove made of
some smooth Skin, such as that of a Dog;
which seldom fails to extinguish the Disorder in
some Days time.
When the Feet are affected with Chilblains,
Socks of the same Skin should be worn; and
the Patient keep close to his Bed for some Days.
§ 469. When the Disorder is violent, the Use
of cold Water prohibited, and the Gloves just recommended
have but a slow Effect, the diseased
Parts should be gently fomented or moistened
several times a Day, with some Decoction,
rather more than warm; which at the same time
should be dissolving and emollient. Such is that
celebrated Decoction of the Scrapings, the Peel
of Radishes, whose Efficacy is still further increased,
by adding one sixth Part of Vinegar to
the Decoction.
Another Decoction, of whose great Efficacy I
have been a Witness, but which dies the Hands
yellow for a few Days, is the Prescription .
Many others may be made, of nearly the same
Virtues, with all the vulnerary Herbs, and even
with the Faltranc.
Urine, which some boast of in these Cases,
from their having used it with Success; and the
Mixture of Urine and Lime-water have the like
Virtues with the former Decoctions.
As soon as the Hands affected are taken out
of these Decoctions, they must be defended from
the Air by Gloves.
§ 470. Vapours or Steams are often more efficacious
than Decoctions; whence instead of dipping
the Hands into these already mentioned, we
may expose them to their Vapours, with still
more Success. That of hot Vinegar is one of
the most powerful Remedies; those of Asphalt,
or of Turpentine have frequently succeeded too.
It may be needless to add that the affected Parts
must be defended from the Air, as well after the
Steams as the Decoctions; since it is from this
Cause of keeping off the Air, that the Cerecloths
are of Service; and hence also the Application of
Suet has sometimes answered.
When the Distemper is subdued by the Use of
Bathings or Steams, which make the Skin supple
and soft, then it should be strengthened by
washing the Parts with a little camphorated Brandy,
diluted with an equal Quantity of Water.
§ 471. When the Nose is affected with a
Chilblain, the Steam of Vinegar, and an artificial
Nose, or Covering for it, made of Dog-skin, are
the most effectual Applications. The same Treatment
is equally proper for the Ears and the Chin,
when infested with them. Frequently washing
these Parts in cold Water is a good Preservative
from their being attacked.
§ 472. Whenever the Inflammation rises very
high, and brings on some Degree of a Fever, the Patient's
usual Quantity of strong Drink and of Flesh-meat
must be lessened; his Body should be kept
open by a few Glysters; he should take every
Evening a Dose of Nitre as prescribed, ;
and if the Fever proved strong, he should lose
some Blood too.
As many as are troubled with obstinate Chilblains,
should always be denied the Use of strong
Liquor and Flesh.
§ 473. When this Distemper prevails in its
third Degree, and the Parts are ulcerated; besides
keeping the Patients strictly to the Regimen
of Persons in a Way of Recovery, and giving
them a Purge of Manna, the swelled Parts should
be exposed to the Steams of Vinegar; the Ulcerations
should be covered with a Diapalma Plaister;
and the whole Part should be enveloped in
a smooth soft Skin, or in thin Cerecloths.
§ 474. The fourth Degree of this Disease, in
which the Parts become gangrenous, must be
prevented by the Method and Medicines which
remove an Inflammation; but if unhappily a
Gangrene has already appeared, the Assistance
of a Surgeon proves indispensably necessary.
Of Ruptures.
§ 475. Hernias or Ruptures, which Country-People
term being bursten, are a Disorder which
sometimes occurs at the very Birth; though more
frequently they are the Effects of violent crying,
of a strong forcing Cough, or of repeated Efforts
to vomit, in the first Months of Infancy.
They may happen afterwards indiscriminately
at every Age, either as Consequences of particular
Maladies, or Accidents, or from Peoples' violent
Exertions of their Strength. They happen
much oftner to Men than Women; and the most
common Sort, indeed the only one of which I
propose to treat, and that but briefly, is that
which consists in the Descent of a Part of
the Guts, or of the Cawl, into the Bag or
Cod-piece.
It is not difficult to distinguish this Rupture.
When it occurs in little Children, it is almost
ever cured by making them constantly wear a
Bandage which should be made only of Fustian,
with a little Pillow or Pincushion, stuffed with
Linen Rags, Hair or Bran. There should be at
least two of these Bandages, to change them alternately;
nor should it ever be applied, but
when the Child is laid down on its Back, and after
being well assured that the Gut or Cawl,
which had fallen down, has been safely returned
into the Cavity of the Belly; since without this
Precaution it might occasion the worst Consequences.
The good Effect of the Bandage may be still
further promoted, by applying upon the Skin,
and within the Plait or Fold of the Groin (under
which Place the Rings, or Passage out of the
Belly into the Bag lie) some pretty astringent or
strengthening Plaister, such as that commonly
used for Fractures, or that I have already mentioned,
. Here we may observe by the
Way, that ruptured Children should never be set
on a Horse, nor be carried by any Person on
Horseback, before the Rupture is perfectly
cured.
§ 476. In a more advanced Age, a Bandage
only of Fustian is not sufficient; one must be
procured with a Plate of Steel, even so as to
constrain and incommode the Wearer a little at
first: nevertheless it soon becomes habitual, and
is then no longer inconvenient to them.
§ 477. Ruptures sometimes attain a monstrous
Size; and a great Part of the Guts fall down in
to the *** or Bag, without any Symptom
of an actual Disease. This Circumstance, nevertheless,
is accompanied with very great Inconvenience,
which disables Persons affected with
it to work; and whenever the Malady is so considerable,
and of a long Standing too, there are
commonly some Obstacles that prevent a compleat
Return of the Guts into the Belly. In this
State indeed, the Application of the Bandage or
Truss is impracticable, and the miserable Patients
are condemned to carry their grievous Burthen
for the Remainder of their Lives; which may
however, be palliated a little by the Use of a
Suspensory and Bag, adapted to the Size of the
Rupture. This Dread of its increasing Magnitude
is a strong Motive for checking the Progress
of it, when it first appears. But there is another
still stronger, which is, that Ruptures expose the
Patient to a Symptom frequently mortal. This
occurs when that Part of the Intestines fallen into
the *** inflames; when still increasing in
its Bulk, and being extremely compressed,
acute Pains come on: for now from the Increase
of the Rupture's Extent, the Passage which gave
Way to its Descent, cannot admit of its Return
or Ascent; the Blood-vessels themselves being
oppressed, the Inflammation increases every Moment;
the Communication between the Stomach
and the Fundament is often entirely cut off; so
that nothing passes through, but incessant Vomitings
come on [this being the Kind of Miserere,
or Iliac Passion I have mentioned, ] which
are succeeded by the Hickup, Raving, Swooning,
cold Sweats, and Death.
§ 478. This Symptom supervenes in Ruptures,
when the Excrements become hard in that
Part of the Guts fallen into the ***; when
the Patient is overheated with Wine, Drams,
an inflammatory Diet, &c. or when he has received
a Stroke on the ailing Part, or had a
Fall.
§ 479. The best Means and Remedies are, 1,
as soon as ever this Symptom or Accident is manifest,
to bleed the Patient very plentifully, as
he lies down in his Bed and upon his Back,
with his Head a little raised, and his Legs somewhat
bent, so that his Knees may be erect.
This is the Attitude or Posture they should always
preserve as much as possible. When the
Malady is not too far advanced, the first Bleeding
often makes a compleat Cure; and the Guts
return up as soon as it is over. At other Times
this Bleeding is less successful, and leaves a Necessity
for its Repetition.
2, A Glyster must be thrown up consisting of
a strong Decoction of the large white Beet Leaves,
with a small Spoonful or Pinch of common Salt,
and a Bit of fresh Butter of the Size of an Egg.
3, Folds of Linen dipt in Ice-water must be
applied all over the Tumour, and constantly
renewed every Quarter of an Hour. This
Remedy, when immediately applied, has produced
the most happy Effects; but if the Symptom
has endured violently more than ten or
twelve Hours, it is often too late to apply it; and
then it is better to make Use of Flanels dipt in a
warm Decoction of Mallow and Elder Flowers,
shifting them frequently. It has been known
however, that Ice-water, or Ice itself has succeeded
as late as the third Day.
4, When these Endeavours are insufficient,
Glysters of Tobacco Smoke must be tried, which
has often redressed and returned Ruptures, when
every Thing else had failed.
5, And lastly, if all these Attempts are fruitless,
the Operation must be resolved on, without
losing a Moment's Time; as this local Disease
proves sometimes mortal in the Space of two
Days; but for this Operation an excellent Surgeon
is indispensably necessary. The happy Consequence
with which I have ordered it, in a most
desperate Case since the first Edition of this Work,
on the sixth Day after a Labour, has convinced
me, still more than any former Observation I
had made, that the Trial of it ought never to be
omitted, when other Attempts have been unavailing.
It cannot even hasten the Patient's
Death, which must be inevitable without it, but
it rather renders that more gentle, where it might
fail to prevent it. When it is performed as Mr.
Levade effected it, in the Case I have just referred
to, the Pain attending it is very tolerable
and soon over.
I shall not attempt to describe the Operation,
as I could not explain myself sufficiently to instruct
an ignorant Surgeon in it; and an excellent
and experienced one must be sufficiently apprized
of all I could say concerning it.
A certain Woman in this Place, but now
dead, had the great and impudent Temerity to
attempt this Operation, and killed her Patients
after the most excruciating Torments, and an
Extirpation, or cutting away of the ***;
which Quacks and ignorant Surgeons always do,
but which a good Surgeon never does in this
Operation. This is often the Custom too (in
Country Places) of those Caitiffs, who perform
this Operation without the least Necessity; and
mercilessly emasculate a Multitude of Infants;
whom Nature, if left to her own Conduct, or
assisted only by a simple Bandage, would have
perfectly cured; instead of which, they absolutely
kill a great many, and deprive those of their Virility,
who survive their Robbery and Violence.
It were religiously to be wished such Caitiffs were
to be duly, that is, severely punished; and it
cannot be too much inculcated into the People,
that this Operation (termed the Bubonocele) in the
Manner it is performed by the best Surgeons, is
not necessary; except in the Symptoms and Circumstances
I have mentioned, and that the cutting
off the *** never is so.
Of Phlegmons or Boils.
§ 480. Every Person knows what Boils are
at Sight, which are considerably painful when
large, highly inflamed, or so situated as to incommode
the Motions, or different Positions of
the Body. Whenever their Inflammation is very
considerable; when there are a great many of
them at once, and they prevent the Patients
from sleeping, it becomes necessary to enter them
into a cooling Regimen; to throw up some
opening Glysters; and to make them drink plentifully
of the Ptisan, . Sometimes it is also
necessary to bleed the Patient.
Should the Inflammation be very high indeed,
a Pultice of Bread and Milk, or of Sorrel a little
boiled and bruised, must be applied to it. But
if the Inflammation is only moderate, a Mucilage
Plaister, or one of the simple Diachylon,
may be sufficient. Diachylon with the Gums is
more active and efficacious; but it so greatly
augments the Pain of some Persons afflicted with
Boils, that they cannot bear it.
Boils, which often return, signify some Fault
in the Temperament, and frequently one so
considerable, that might dispose a Physician to be so
far apprehensive of its Consequences, as to enquire
into the Cause, and to attempt the Extinction
of it. But the Detail of this is no Part nor
Purpose of the present Work.
§ 481. The Phlegmon, or Boil, commonly
terminates in Suppuration, but a Suppuration of
a singular Kind. It breaks open at first on its
Top, or the most pointed Part, when some
Drops of a Pus like that of an Abscess comes out,
after which the Germ, or what is called the Core
of it may be discerned. This is a purulent Matter
or Substance, but so thick and tenacious, that
it appears like a solid Body; which may be drawn
out entirely in the Shape of a small Cylinder,
like the Pith of Elder, to the Length of some
Lines of an Inch; sometimes to the Length of a
full Inch, and even more. The Emission of this
Core is commonly followed by the Discharge of
a certain Quantity, according to the Size of the
Tumour, of liquid Matter, spread throughout
the Bottom of it. As soon as ever this Discharge
is made, the Pain goes entirely off; and the
Swelling disappears at the End of a few Days,
by continuing to apply the simple Diachylon, or
the Ointment .
Of Fellons or Whitlows.
§ 482. The Danger of these small Tumours
is much greater than is generally supposed. It
is an Inflammation at the Extremity or End of a
Finger, which is often the Effect of a small
Quantity of Humour extravasated, or stagnant,
in that Part; whether this has happened in Consequence
of a Bruise, a Sting, or a Bite. At
other times it is evident that it has resulted from
no external Cause, but is the Effect of some inward
one.
It is distinguished into many Kinds, according
to the Place in which the Inflammation begins;
but the essential Nature of the Malady is always
the same, and requires the same Sort of Remedies.
Hence such as are neither Physicians nor
Surgeons, may spare themselves the Trouble of
enquiring into the Divisions of this Distemper;
which, though they vary the Danger of it, and
diversify the Manner of the Surgeons Operation,
yet have no Relation to the general Treatment
of it; the Power and Activity of which must be
regulated by the Violence of the Symptoms.
§ 483. This Disorder begins with a slow heavy
Pain, attended by a slight Pulsation, without
Swelling, without Redness, and without Heat;
but in a little Time the Pain, Heat, and Pulsation
or Throbbing becomes intolerable. The Part
grows very large and red; the adjoining Fingers
and the whole Hand swelling up. In some Cases
a Kind of red and inflated Fuse or Streak may be
observed, which, beginning at the affected Part,
is continued almost to the Elbow; neither is it
unusual for the Patients to complain of a very
sharp Pain under the Shoulder; and sometimes
the whole Arm is excessively inflamed and swelled.
The Sick have not a Wink of Sleep, the
Fever and other Symptoms quickly increasing.
If the Distemper rises to a violent Degree indeed,
a Delirium and Convulsions supervene.
This Inflammation of the Finger determines,
either in Suppuration, or in a Gangrene. When
the last of these occurs, the Patient is in very
great Danger, if he is not very speedily relieved;
and it has proved necessary more than once to
cut off the Arm, for the Preservation of his Life.
When Suppuration is effected, if the Matter lies
very deep and sharp, or if the Assistance of a Surgeon
has arrived too late, the Bone of the last
Phalanx, or Row of Bones of the Finger, is generally
carious and lost. But how gentle soever
the Complaint has been, the Nail is very generally
separated and falls off.
§ 484. The internal Treatment in Whitlows,
is the same with that in other inflammatory Distempers.
The Patient must enter upon a Regimen
more or less strict, in Proportion to the Degree
of the Fever; and if this runs very high, and
the Inflammation be very considerable, there
may be a Necessity for several Bleedings.
The external Treatment consists in allaying
the Inflammation; in softening the Skin; and in
procuring a Discharge of the Matter, as soon as
it is formed. For this Purpose,
1, The Finger affected is to be plunged, as
soon as the Disorder is manifest, in Water a little
more than warm: the Steam of boiling Water
may also by admitted into it; and by doing these
Things almost constantly for the first Day, a
total Dissipation of the Malady has often been
obtained. But unhappily it has been generally
supposed, that such slight Attacks could have but
very slight Consequences, whence they have been
neglected until the Disorder has greatly advanced;
in which State Suppuration becomes absolutely
necessary.
2, This Suppuration therefore may be forwarded,
by continually involving the Finger, as
it were, in a Decoction of Mallow Flowers boiled
in Milk, or with a Cataplasm of Bread and
Milk. This may be rendered still more active
and ripening, by adding a few white Lilly Roots,
or a little Honey. But this last must not be applied
before the Inflammation is somewhat abated,
and Suppuration begins; before which Term, all
sharp Applications are very dangerous. At this
Time, Yeast or Leaven may be advantagiously
used, which powerfully promotes Suppuration.
The Sorrel Pultice, mentioned , is also a
very efficacious one.
§ 485. A speedy Discharge of the ripe Matter
is of considerable Importance, but this particularly
requires the Attention of the Surgeon; as
it is not proper to wait till the Tumour breaks
and discharges of itself; and this the rather, as
from the Skin's proving sometimes extremely
hard, the Matter might be inwardly effused between
the Muscles, and upon their Membranes,
before it could penetrate through the Skin. For
this Reason, as soon as Matter is suspected to be
formed, a Surgeon should be called in, to determine
exactly on the Time, when an Opening
should be made; which had better be performed
a little too soon than too late; and a little too
deep, than not deep enough.
When the Orifice has been made, and the
Discharge is effected, it is to be dressed up with
the Plaister , spread upon Linen, or with
the Cerecloth; and these Dressings are to be repeated
daily.
§ 486. When the Whitlow is caused by a
Humour extravasated very near the Nail, an expert
Surgeon speedily checks its Progress, and
cures it effectually by an Incision which lets out
the Humour. Yet, notwithstanding this Operation
is in no wise difficult, all Surgeons are not
qualified to perform it, and but too many have
no Idea at all of it.
§ 487. Fungous, or, as it is commonly called,
proud Flesh sometimes appears during the incarning
or healing of the Incision. Such may be kept
down with sprinkling a little Minium (red Lead)
or burnt Alum over it.
§ 488. If a Caries, a Rottenness of the Bone,
should be a Consequence, there is a Necessity
for a Surgeon's Attendance, as much as if there
was a Gangrene; for which Reason, I shall add
nothing with Respect to either of these Symptoms;
only observing, there are three very
essential Remedies against the last; viz. the
Bark, , a Drachm of which must be
taken every two Hours; Scarifications throughout
the whole gangrened Part; and Fomentations
with a Decoction of the Bark, and the Addition
of Spirit of Sulphur. This Medicine is
certainly no cheap one; but a Decoction of other
bitter Plants, with the Addition of Spirit of Salt,
may sometimes do instead of it. And here I
take leave to insist again upon it, that in most
Cases of gangrened Limbs, it is judicious not to
proceed to an Amputation of the mortified Part,
till the Gangrene stops, which may be known by
a very perceivable Circle, (and easily distinguished
by the most ignorant Persons) that marks
the Bounds of the Gangrene, and separates the
living from the mortified Parts.
Of Thorns, Splinters, or other pointed Substances piercing into the Skin, or Flesh.
§ 489. It is very common for the Hands,
Feet or Legs, to be pierced by the forcible Intrusion
of small pointed Substances, such as Thorns
or Prickles, whether of Roses, Thistles or Chestnuts,
or little Splinters of Wood, Bone, &c.
If such Substances are immediately and entirely
extracted, the Accident is generally attended
with no bad Consequences; though more certainly
to obviate any such, Compresses of Linen dipt
in warm Water may be applied to the Part, or
it may be kept a little while in a warm Bath.
But if any such pointed penetrating Body cannot
be directly extracted, or if a Part of it be left
within, it causes an Inflammation, which, in its
Progress, soon produces the same Symptoms as a
Whitlow: or if it happens in the Leg, it inflames
and forms a considerable Abscess there.
§ 490. To prevent such Consequences, if the
penetrating Substance is still near the Surface,
and an expert Surgeon is at Hand, he must immediately
make a small Incision, and thence extract
it. But if the Inflammation were already
formed, this would be useless, and even dangerous.
When the Incision, therefore, is improper;
there should be applied to the affected Part, (after
conveying the Steam of some hot Water into
it) either some very emollient Pultices of the
Crumb of Bread, Milk and Oil, or some very
emollient unctuous Matter alone, the Fat of a Hare being generally employed in such Cases,
and being indeed very effectual to relax and supple
the Skin; and, by thus diminishing its Resistance,
to afford the offensive penetrating Body
an Opportunity of springing forth. Nothing
however, but the grossest Prejudice, could make
any one imagine, that this Fat attracted the
Splinter, Thorn, or any other intruded Substance
by any sympathetic Virtue; no other Sympathy
in Nature being clearly demonstrated, except
that very common one between wrong Heads,
and absurd extravagant Opinions.
It is absolutely necessary that the injured Part
should be kept in the easiest Posture, and as immoveable
as possible.
If Suppuration has not been prevented by an
immediate Extraction of the offending Substance,
the Abscess should be opened as soon as ever
Matter is formed. I have known very troublesome
Events from its being too long delayed.
§ 491. Sometimes the Thorn, after having
very painfully penetrated through the Teguments,
the Skin, enters directly into the Fat;
upon which the Pain ceases, and the Patient begins
to conclude no sharp prickling Substance had
ever been introduced into the Part; and of
Course supposes none can remain there. Nevertheless
some Days after, or, in other Instances,
some Weeks, fresh Pains are excited, to which
an Inflammation and Abscess succeed, which are
to be treated as usual, with Emollients, and seasonably
opened.
A Patient has been reduced to lose his Hand,
in Consequence of a sharp Thorn's piercing into
his Finger; from its having been neglected at
first, and improperly treated afterwards.
Of Warts.
§ 492. Warts are sometimes the Effects of a
particular Fault in the Blood, which feeds and
extrudes a surprizing Quantity of them. This
happens to some Children, from four to ten Years
old, and especially to those who feed most plentifully
on Milk or Milk-meats. They may be
removed by a moderate Change of their Diet,
and the Pills prescribed .
But they are more frequently an accidental
Disorder of the Skin, arising from some external
Cause.
In this last Case, if they are very troublesome
in Consequence of their great Size, their Situation
or their long Standing, they may be destroyed,
1, by tying them closely with a Silk Thread,
or with a strong flaxen one waxed. 2, By cutting
them off with a sharp Scissars or a Bistory,
and applying a Plaister of Diachylon, with the
Gums, over the cut Wart, which brings on a
small Suppuration that may destroy or dissolve the
Root of the Wart: and, 3, By drying, or, as it
were, withering them up by some moderately corroding
Application, such as that of the milky Juice
of Purslain, of Fig-leaves, of Chelidonium
(Swallow-wort) or of Spurge. But besides these
corroding vegetable Milks being procurable only
in Summer, People who have very delicate thin
Skins should not make Use of them, as they may
occasion a considerable and painful Swelling.
Strong Vinegar, charged with as much common
Salt as it will dissolve, is a very proper Application
to them. A Plaister may also be composed
from Sal Ammoniac and some Galbanum, which
being kneaded up well together and applied, seldom
fails of destroying them.
The most powerful Corrosives should never be
used, without the Direction of a Surgeon; and
even then it is full as prudent not to meddle with
them, any more than with actual Cauteries. I
have lately seen some very tedious and troublesome
Disorders and Ulcerations of the Kidnies,
ensue the Application of a corrosive Water, by
the Advice of a Quack. Cutting them away is a
more certain, a less painful, and a less dangerous
Way of removing them.
Wens, if of a pretty considerable Size, and
Duration, are incurable by any other Remedy,
except Amputation.
Of Corns.
§ 493. The very general or only Causes of
Corns, are Shoes either too hard and stiff, or too
small.
The whole Cure consists in softening the Corns
by repeated Washings and Soakings of the Feet
in pretty hot Water; then in cutting them, when
softened, with a Penknife or Scissars, without
wounding the sound Parts (which are the more
sensible, in Proportion as they are more extended
than usual) and next in applying a Leaf of
House-leek, of Ground-ivy, or of Purslain dipt
in Vinegar, upon the Part. Instead of these
Leaves, if any Person will give himself the little
Trouble of dressing them every Day, he may
apply a Plaister of simple Diachylon, or of Gum
Ammoniacum softened in Vinegar.
The Increase or Return of Corns can only be
prevented, by avoiding the Causes that produce
them.
Chapter XXXI.
Of some Cases which require immediate Assistance;
such as Swoonings; Hæmorrhages, or involuntary
Loss of Blood; Convulsion Fitts, and Suffocations;
the sudden Effects of great Fear; of
Disorders caused by noxious Vapours; of Poisons,
and of acute Pains.
Of Swoonings.
Sect. 494.
here are many Degrees of Swooning,
or fainting away: the slightest is
that in which the Patient constantly
perceives and understands, yet without
the Power of speaking. This is called a Fainting,
which happens very often to vapourish
Persons, and without any remarkable Alteration of
the Pulse.
If the Patient entirely loses Sensation, or Feeling,
and Understanding, with a very considerable
Sinking of the Pulse, this is called a Syncopè,
and is the second Degree of Swooning.
But if this Syncopè is so violent, that the Pulse
seems totally extinguished; without any discernible
Breathing; with a manifest Coldness of the
whole Body; and a wanly livid Countenance, it
constitutes a third and last Degree, which is the
true Image of Death, that in Effect sometimes
attends it, and it is called an Asphixy, which
may signify a total Resolution.
Swoonings result from many different Causes,
of which I shall only enumerate the principal;
and these are, 1, Too large a Quantity of Blood.
2, A Defect or insufficient Proportion of it, and
a general Weakness. 3, A Load at and violent
Disorders of the Stomach. 4, Nervous Maladies.
5, The Passions; and, 6, some Kinds of
Diseases.
Of Swoonings occasioned by Excess of Blood.
§ 495. An excessive Quantity of Blood is frequently
a Cause of Swooning; and it may be inferred
that it is owing to this Cause, when it attacks
sanguine, hearty and robust Persons; and
more especially when it attacks them, after being
combined with any additional or supervening
Cause, that suddenly increased the Motion of the
Blood; such as heating Meats or Drinks, Wine,
spirituous Liquors: smaller Drinks, if taken very
hot and plentifully, such as Coffee, Indian Tea,
Bawm Tea and the like; a long Exposure to the
hot Sun, or being detained in a very hot Place;
much and violent Exercise; an over intense and
assiduous Study or Application, or some excessive
Passion.
In such Cases, first of all the Patient should
be made to smell to, or even to snuff up, some
Vinegar; and his Forehead, his Temples and his
Wrists should be bathed with it; adding an equal
Quantity of warm Water, if at Hand. Bathing
them with distilled or spirituous Liquids would
be prejudicial in this Kind of Swooning.
2, The Patient should be made, if possible,
to swallow two or three Spoonfuls of Vinegar,
with four or five Times as much Water.
3, The Patient's Garters should be tied very
tightly above his Knees; as by this Means a
greater Quantity of Blood is retained in the Legs,
whence the Heart may be less overladen with
it.
4, If the Fainting proves obstinate, that is, if
it continues longer than a Quarter of an Hour, or
degenerates into a Syncopè, an Abolition of Feeling
and Understanding, he must be bled in the
Arm, which quickly revives him.
5, After the Bleeding, the Injection of a
Glyster will be highly proper; and then the Patient
should be kept still and calm, only letting
him drink, every half Hour, some Cups of Elder
Flower Tea, with the Addition of a little Sugar
and Vinegar.
When Swoonings which result from this Cause
occur frequently in the same Person, he should,
in Order to escape them, pursue the Directions
I shall hereafter mention, , when treating
of Persons who superabound with Blood.
The very same Cause, or Causes, which occasion
these Swoonings, also frequently produce
violent Palpitations, under the same Circumstances;
the Palpitation often preceding or following
the Deliquium, or Swooning.
Of Swoonings occasioned by Weakness.
§ 496. If too great a Quantity of Blood,
which may be considered as some Excess of
Health, is sometimes the Cause of Swooning,
this last is oftener the Effect of a very contrary
Cause, that is, of a Want of Blood, or an Exhaustion
of too much.
This Sort of Swooning happens after great
Hæmorrhages, or Discharges of Blood; after
sudden or excessive Evacuations, such as one of
some Hours Continuance in a Cholera Morbus
() or such as are more slow, but of longer
Duration, as for Instance, after an inveterate
Diarrhœa, or Purging; excessive Sweats; a
Flood of Urine; such Excesses as tend to exhaust
Nature; obstinate Wakefulness; a long Inappetency,
which, by depriving the Body of its
necessary Sustenance, is attended with the same
Consequence as profuse Evacuations.
These different Causes of Swooning should be
opposed by the Means and Remedies adapted to
each of them. A Detail of all these would be
improper here; but the Assistances that are necessary
at the Time of Swooning, are nearly the
same for all Cases of this Class; excepting for that
attending a great Loss of Blood, of which I shall
treat hereafter: first of all, the Patients should be
laid down on a Bed, and being covered, should
have their Legs and Thighs, their Arms, and
their whole Bodies rubbed pretty strongly with
hot Flanels; and no Ligature should remain on
any Part of them.
2, They should have very spirituous Things to
smell or snuff up, such as the Carmelite Water,
Hungary Water, the English Salt, Spirit of Sal
Ammoniac, strong smelling Herbs, such as Rue,
Sage, Rosemary, Mint, Wormwood, and the
like.
3, These should be conveyed into their
Mouths; and they should be forced, if possible,
to swallow some Drops of Carmelite Water, or
of Brandy, or of some other potable Liquor,
mixed with a little Water; while some hot Wine
mixed with Sugar and Cinnamon, which makes
one of the best Cordials, is getting ready.
4, A Compress of Flanel, or of some other
woollen Stuff, dipt in hot Wine, in which some
aromatic Herb has been steeped, must be applied
to the Pit of the Stomach.
5, If the Swooning seems likely to continue,
the Patient must be put into a well heated Bed,
which has before been perfumed with burning
Sugar and Cinnamon; the Frictions of the whole
Body with hot Flanels being still continued.
6, As soon as the Patient can swallow, he
should take some Soup or Broth, with the Yolk
of an Egg; or a little Bread or Biscuit; soaked in
the hot spiced Wine.
7, Lastly, during the whole Time that all
other Precautions are taken to oppose the Cause
of the Swooning, Care must be had for some
Days to prevent any Deliquium or Fainting, by
giving them often, and but little at a time, some
light yet strengthening Nourishment, such as
Panada made with Soup instead of Water, new
laid Eggs very lightly poached, light roast Meats
with sweet Sauce, Chocolate, Soups of the most
nourishing Meats, Jellies, Milk, &c.
§ 497. Those Swoonings, which are the Effect
of Bleeding, or of the violent Operation of some
Purge, are to be ranged in this Class.
Such as happen after artificial Bleeding, are
generally very moderate, commonly terminating
as soon as the Patient is laid upon the Bed: and
Persons subject to this Kind, should be bled lying
down, in Order to prevent it. But should the
Fainting continue longer than usual, some Vinegar
smelt to, and a little swallowed with some
Water, is a very good Remedy.
The Treatment of such Faintings or Swoonings,
as are the Consequences of too violent Vomits
or Purges, may be seen hereafter .
Of Faintings occasioned by a Load, or Uneasiness, at Stomach.
§ 498. It has been already observed, ,
that Indigestions were sometimes attended with
Swoonings, and indeed such vehement ones, as
required speedy and very active Succour too,
such as that of a Vomit. The Indigestion is
sometimes less the Effect of the Quantity, than
of the Quality, or the Corruption of the Food,
contained in the Stomach. Thus we see there
are some Persons, who are disordered by eating
Eggs, Fish, Craw Fish, or any fat Meat; being
thrown by them into inexpressible Anguish attended
with Swooning too. It may be supposed to
depend on this Cause, when these very Aliments
have been lately eaten; and when it evidently
neither depends on the other Causes I have mentioned;
nor on such as I shall soon proceed to
enumerate.
We should in Cases of this Sort, excite and
revive the Patients as in the former, by making
them receive some very strong Smell, of whatever
Kind is at hand; but the most essential Point is to
make them swallow down a large Quantity of
light warm Fluid; which may serve to drown,
as it were, the indigested Matter; which may
soften its Acrimony; and either effect the Discharge
of it by vomiting, or force it down into
the Chanel of the Intestines.
A light Infusion of Chamomile Flowers, of
Tea, of Sage, of Elder Flowers, or of Carduus
Benedictus, operate with much the same Efficacy;
though the Chamomile and Carduus promote
the Operation of vomiting rather more
powerfully; which warm Water alone will
sometimes sufficiently do.
The Swooning ceases, or at least, considerably
abates in these Cases, as soon as ever the
Vomiting commences. It frequently happens
too, that, during the Swooning, Nature herself
brings on certain Nausea, a Wambling and
sickish Commotion of the Stomach, that revives
or rouses the Patient for a Moment; but yet not
being sufficient to excite an actual Vomiting,
lets him soon sink down again into this temporary
Dissolution, which often continues a pretty
considerable Time; leaving behind it a Sickness
at Stomach, Vertigos, and a Depression and
Anxiety, which do not occur in the former Species
of this Malady.
Whenever these Swoonings from this Cause are
entirely terminated, the Patient must be kept for
some Days to a very light Diet, and take, at
the same Time, every Morning fasting, a Dose
of the Powder, , which relieves and exonerates
the Stomach of whatever noxious Contents
might remain in it; and then restores its
natural Strength and Functions.
§ 499. There is another Kind of Swooning,
which also results from a Cause in the Stomach;
but which is, nevertheless, very different from
this we have just been treating of; and which requires
a very different Kind of Assistance. It
arises from an extraordinary Sensibility of this
important Organ, and from a general Weakness
of the Patient.
Those subject to this Malady are valetudinary
weakly Persons, who are disordered from many
slight Causes, and whose Stomachs are at once very
feeble and extremely sensible. They have almost
continually a little Uneasiness after a Meal,
though they should indulge but a little more than
usual; or if they eat of any Food not quite so
easy of Digestion, they have some Qualm or
Commotion after it: Nay, should the Weather
only be unfavourable, and sometimes without any
perceivable assignable Cause, their Uneasiness
terminates in a Swoon.
Patients swooning, from these Causes, have a
greater Necessity for great Tranquillity and Repose,
than for any other Remedy; and it might
be sufficient to lay them down on the Bed: But
as the Bystanders in such Cases find it difficult to
remain inactive Spectators of Persons in a Swoon,
some spirituous Liquid may be held to their Nose,
while their Temples and Wrists are rubbed with
it; and at the same Time a little Wine should
be given them. Frictions are also useful in these
Cases.
This Species of Swooning is oftener attended
with a little Feverishness than the others.
Of those Swoonings, which arise from nervous Disorders.
§ 500. This Species of Swooning is almost
wholely unknown to those Persons, for whom
this Treatise is chiefly intended. Yet as there
are some Citizens who pass a Part of their Lives
in the Country; and some Country People who
are unhappily afflicted with the Ailments of the
Inhabitants of large Towns and Cities, it seemed
necessary to treat briefly of them.
By Disorders of the Nerves, I understand in
this Place, only that Fault or Defect in them,
which is the Cause of their exciting in the Body,
either irregular Motions, that is, Motions without
any external Cause, at least any perceivable
one; and without our Will's consenting to the
Production of them: or such Motions, as are
greatly more considerable than they should be,
if they had been proportioned to the Force of the
Impression from without. This is very exactly
that State, or Affection termed the Vapours; and
by the common People, the Mother: And as
there is no Organ unprovided with Nerves; and
none, or hardly any Function, in which the
Nerves have not their Influence; it may be easily
comprehended, that the Vapours being a
State or Condition, which arises from the Nerves
exerting irregular involuntary Motions, without
any evident Cause, and all the Functions of the
Body depending partly on the Nerves; there is
no one Symptom of other Diseases which the Vapours
may not produce or imitate; and that these
Symptoms, for the same Reason, must vary infinitely,
according to those Branches of the
Nerves which are disordered. It may also hence
be conceived, why the Vapours of one Person
have frequently no Resemblance to those of another:
and why the Vapours of the very same
Person, in one Day, are so very different from
those in the next. It is also very conceivable
that the Vapours are a certain, a real Malady;
and that Oddity of the Symptoms, which cannot
be accounted for, by People unacquainted with
the animal Oeconomy, has been the Cause of
their being considered rather as the Effect of a
depraved Imagination, than as a real Disease. It is
very conceiveable, I say, that this surprizing Oddity
of the Symptoms is a necessary Effect of the
Cause of the Vapours; and that no Person can
any more prevent his being invaded by the Vapours,
than he can prevent the Attack of a Fever,
or of the Tooth-ach.
§ 501. A few plain Instances will furnish out
a more compleat Notion of the Mechanism, or
Nature, of Vapours. An Emetic, a vomiting
Medicine, excites the Act, or rather the Passion,
the Convulsion of Vomiting, chiefly by the
Irritation it gives to the Nerves of the Stomach; which
Irritation produces a Spasm, a Contraction of this
Organ. Now if in Consequence of this morbid
or defective Texture of the Nerves, which constitutes
the Vapours, those of the Stomach are
excited to act with the same Violence, as in
Consequence of taking a Vomit, the Patient will
be agitated and worked by violent Efforts to
vomit, as much as if he had really taken one.
If an involuntary unusual Motion in the Nerves,
that are distributed through the Lungs, should
constrain and straiten the very little Vesicles, or
Bladders, as it were, which admit the fresh Air
at every Respiration, the Patient will feel a Degree
of Suffocation; just as if that Straitening or
Contraction of the Vesicles were occasioned by
some noxious Steam or Vapour.
Should the Nerves which are distributed
throughout the whole Skin, by a Succession of
these irregular morbid Motions, contract themselves,
as they may from external Cold, or by
some stimulating Application, Perspiration by the
Pores will be prevented or checked; whence the
Humours, which should be evacuated through
the Pores of the Skin, will be thrown upon the
Kidnies, and the Patient will make a great
Quantity of thin clear Urine, a Symptom very
common to vapourish People; or it may be diverted
to the Glands of the Intestines, the Guts,
and terminate in a watery Diarrhœa, or Looseness,
which frequently proves a very obstinate
one.
§ 502. Neither are Swoonings the least usual
Symptoms attending the Vapours: and we may
be certain they spring from this Source, when
they happen to a Person subject to the Vapours;
and none of the other Causes producing them
are evident, or have lately preceded them.
Such Swoonings, however, are indeed very
rarely dangerous, and scarcely require any medical
Assistance. The Patient should be laid upon
a Bed; the fresh Air should be very freely admitted
to him; and he should be made to smell
rather to some disagreeable and fetid, than to any
fragrant, Substance. It is in such Faintings as
these that the Smell of burnt Leather, of Feathers,
or of Paper, have often proved of great
Service.
§ 503. Patients also frequently faint away, in
Consequence of fasting too long; or from having
eat a little too much; from being confined in too
hot a Chamber; from having seen too much
Company; from smelling too over-powering a
Scent; from being too costive; from being too
forcibly affected with some Discourse or Sentiments;
and, in a Word, from a great Variety
of Causes, which might not make the least Impression
on Persons in perfect Health; but which
violently operate upon those vapourish People, because,
as I have said, the Fault of their Nerves
consists in their being too vividly, too acutely affected;
the Force of their Sensation being nowise
proportioned to the external Cause of it.
As soon as that particular Cause is distinguished
from all the rest, which has occasioned the present
Swooning; it is manifest that this Swooning is to
be remedied by removing that particular Cause
of it.
Of Swoonings occasioned by the Passions.
§ 504. There have been some Instances of
Persons dying within a Moment, through excessive
Joy. But such Instances are so very rare and
sudden, that Assistance has seldom been sought
for on this Occasion. The Case is otherwise
with Respect to those produced from Rage,
Vexation, and Dread or Horror. I shall treat in
a separate Article of those resulting from great
Fear; and shall briefly consider here such as ensue
from Rage, and vehement Grief or Disappointment.
§ 505. Excessive Rage and violent Affliction
are sometimes fatal in the Twinkling of an Eye;
though they oftener terminate in fainting only.
Excessive Grief or Chagrine is especially accompanied
with this Consequence; and it is very
common to see Persons thus affected, sink into
successive Faintings for several Hours. It is
plainly obvious that very little Assistance can be
given in such Cases: it is proper, however, they
should smell to strong Vinegar; and frequently
take a few Cups of some hot and temperately
cordial Drink, such as Bawm Tea, or Lemonade
with a little Orange or Lemon-peel.
The calming asswaging Cordial, that has seemed
the most efficacious to me, is one small Coffee
Spoonful of a Mixture of three Parts of the Mineral
Anodyne Liquor of Hoffman, and one
Part of the spirituous Tincture of Amber, which
should be swallowed in a Spoonful of Water;
taking after it a few Cups of such Drinks as I
shall presently direct.
It is not to be supposed that Swoonings or
Faintings, from excessive Passions, can be cured
by Nourishment. The physical State or Condition,
into which vehement Grief throws the Body,
is that, of all others, in which Nourishment
would be most injurious to it: and as long as
the Vehemence of the Affliction endures, the
Sufferer should take nothing but some Spoonfuls
of Soup or Broth, or a few Morsels of some
light Meat roasted.
§ 506. When Wrath or Rage has risen to so
high a Pitch, that the human Machine, the
Body, entirely exhausted, as it were, by that
violent Effort, sinks down at once into excessive
Relaxation, a Fainting sometimes succeeds, and
even the most perilous Degree of it, a Syncopè.
It is sufficient, or rather the most that can be
done here, to let the Patient be perfectly still a
while in this State; only making him smell to some
Vinegar. But when he is come to himself, he
should drink plentifully of hot Lemonade, and
take one or more of the Glysters .
Sometimes there remain in these Cases Sicknesses
at Stomach, Reachings to vomit, a Bitterness
in the Mouth, and some vertiginous Symptoms
which seem to require a Vomit. But such
a Medicine must be very carefully avoided, since
it may be attended with the most fatal Consequence;
and Lemonade with Glysters generally
and gradually remove these Swoonings. If the
Nausea and Sickness at Stomach continue, the
utmost Medicine we should allow besides, would
be that of , or a few Doses of .
Of symptomatical Swoonings, or such, as happen in the Progress of other Diseases.
§ 507. Swoonings, which supervene in the
Course of other Diseases, never afford a favourable
Prognostic; as they denote Weakness, and
Weakness is an Obstacle to Recovery.
In the Beginning of putrid Diseases, they also
denote an Oppression at Stomach, or a Mass of
corrupt Humours; and they cease as soon as
an Evacuation supervenes, whether by Vomit or
Stool.
When they occur at the Beginning of malignant
Fevers, they declare the high Degree of
their Malignancy, and the great Diminution of
the Patient's natural Strength.
In each of these Cases Vinegar, used externally
and internally, is the best Remedy during the
Exacerbation or Height of the Paroxysm; and
Plenty of Lemon Juice and Water after it.
§ 508. Swoonings which supervene in Diseases,
accompanied with great Evacuations, are
cured like those which are owing to Weakness;
and Endeavours should be used to restrain or moderate
the Evacuations.
§ 509. Those who have any inward Abscess
or Imposthume are apt to swoon frequently.
They may sometimes be revived a little by Vinegar,
but they prove too frequently mortal.
§ 510. Many Persons have a slighter or a
deeper Swooning, at the End of a violent Fit of
an intermitting Fever, or at that of each Exacerbation
of a continual Fever; this constantly shews the
Fever has run very high, the Swooning having
been the Consequence of that great Relaxation,
which has succeeded to a very high Tension. A
Spoonful or two of light white Wine, with an
equal Quantity of Water, affords all the Succour
proper in such a Case.
§ 511. Persons subject to frequent Swoonings,
should neglect nothing that may enable them to remove
them when known; since the Consequences
of them are always detrimental, except in some
Fevers, in which they seem to mark the Crisis.
Every swooning Fit leaves the Patient in Dejection
and Weakness; the Secretions from the
Blood are suspended; the Humours disposed to
Stagnation; Grumosities, or Coagulations, and
Obstructions are formed; and if the Motion of
the Blood is totally intercepted, or considerably
checked, Polypus's, and these often incurable,
are formed in the Heart, or in the larger Vessels;
the Consequences of which are dreadful, and
sometimes give Rise to internal Aneurisms,
which always prove mortal, after long Anxiety
and Oppression.
Swoonings which attack old People, without
any manifest Cause, always afford an unfavourable
Prognostic.
Of Hæmorrhages, or an involuntary Loss of Blood.
§ 512. Hæmorrhages of the Nose, supervening
in inflammatory Fevers, commonly prove a
favourable Crisis; which Bleeding we should
carefully avoid stopping; except it becomes excessive,
and seems to threaten the Patient's Life.
As they scarcely ever happen in very healthy
Subjects, but from a superfluous Abundance of
Blood, it is very improper to check them too
soon; lest some internal Stuffings and Obstructions
should prove the Consequence.
A Swooning sometimes ensues after the Loss
of only a moderate Quantity of Blood. This
Swooning stops the Hæmorrhage, and goes off
without any further Assistance, except the smelling
to Vinegar. But in other Cases there is a
Succession of fainting Fits, without the Blood's
stopping; while at the same time slight convulsive
Motions and Twitchings ensue, attended
with a Raving, when it becomes really necessary
to stop the Bleeding: and indeed, without waiting
till these violent Symptoms appear, the following
Signs will sufficiently direct us, when it
is right to stop the Flux of Blood, or to permit
its Continuance—As long as the Pulse is still
pretty full; while the Heat of the Body is equally
extended to the very Extremities; and the
Countenance and Lips preserve their natural
Redness, no ill Consequence is to be apprehended
from the Hæmorrhage, though it has been
very copious, and even somewhat profuse.
But whenever the Pulse begins to faulter and
tremble; when the Countenance and the Lips
grow pale, and the Patient complains of a Sickness
at Stomach, it is absolutely necessary to stop
the Discharge of Blood. And considering that
the Operation of Remedies does not immediately
follow the Exhibition or Application of them, it
is safer to begin a little too early with them,
than to delay them, though ever so little too
long.
§ 513. First of all then, tight Bandages, or
Ligatures, should be applied round both Arms,
on the Part they are applied over in order to
Bleeding; and round the lower Part of both
Thighs, on the gartering Place; and all these
are to be drawn very tight, with an Intention to
detain and accumulate the Blood in the Extremities.
2, In Order to increase this Effect, the Legs
are to be plunged in warm Water up to the
Knees; for by relaxing the Blood-vessels of the
Legs and Feet, they are dilated at the same time,
and thence receive, and, in Consequence of the
Ligatures above the Knees, retain the more
Blood. If the Water were cold, it would repel
the Blood to the Head; if hot, it would increase
the Motion of it; and, by giving a greater
Quickness to the Pulse, would even contribute to
increase the Hæmorrhage.
As soon however, as the Hæmorrhage is
stopt, these Ligatures [on the Thighs] may be
relaxed a little, or one of them be entirely removed;
allowing the others to continue on an
Hour or two longer without touching them: but
great Precaution should be taken not to slacken
them entirely, nor all at once.
3, Seven or eight Grains of Nitre, and a
Spoonful of Vinegar, in half a Glass of cool Water,
should be given the Patient every half
Hour.
4, One Drachm of white Vitriol must be dissolved
in two common Spoonfuls of Spring Water;
and a Tent of Lint, or Bits of soft fine
Linen dipt in this Solution, are to be introduced
into the Nostrils, horizontally at first, but afterwards
to be intruded upwards, and as high as
may be, by the Assistance of a flexible Bit of
Wood or Whale-bone. But should this Application
be ineffectual, the Mineral Anodyne Liquor
of Hoffman is certain to succeed: and in
the Country, where it often happens that neither
of these Applications are to be had speedily,
Brandy, and even Spirit of Wine, mixt with a
third Part Vinegar, have answered entirely well,
of which I have been a Witness.
The Prescription , which I have already
referred to, on the Article of Wounds, may
also be serviceable on this Occasion. It must be
reduced to Powder, and conveyed up the Nostrils
as high as may be, on the Point or Extremity
of a Tent of Lint, which may easily be
covered with it. Or a Quill, well charged with
the Powder, may be introduced high into the
Nostrils, and its Countents be strongly blown up
from its other Extremity: though after all the
former Method is preferable.
5, When the Flux of Blood is totally stopt,
the Patient is to be kept as still and quiet as possible;
taking great Care not to extract the Tent
which remains in the Nose; nor to remove the
Clots of coagulated Blood which fill up the Passage.
The loosening and removing of these
should be effected very gradually and cautiously;
and frequently the Tent does not spring out spontaneously,
till after many Days.
§ 514. I have not, hitherto, said any thing
of artificial Bleeding in these Cases, as I think it
at best unserviceable; since, though it may sometimes
have stopt the morbid Loss of Blood, it has
at other times increased it. Neither have I mentioned
Anodynes here, whose constant Effect is
to determine a larger Quantity of Blood to the
Head.
Applications of cold Water to the Nape of the
Neck ought to be wholly disused, having sometimes
been attended with the most embarrassing
Consequences.
In all Hæmorrhages, all Fluxes of Blood,
great Tranquillity, Ligatures, and the Use of the
Drinks or , are very useful.
§ 515. People who are very liable to frequent
Hæmorrhages, ought to manage themselves conformably
to the Directions contained in the next
Chapter, . They should take very little
Supper; avoid all sharp and spirituous Liquors;
Apartments that are over hot, and cover their
Heads but very lightly.
When a Patient has for a long time been subject
to Hæmorrhages, if they cease, he should
retrench from his usual Quantity of Food; accustom
himself to artificial Bleedings at proper
Intervals; and take some gentle opening Purges,
especially that of , and frequently a little
Nitre in an Evening.
Of Convulsion Fits.
§ 516. Convulsions are, in general, more terrifying
than dangerous; they result from many
and various Causes; and on the Removal or
Extirpation of these, their Cure depends.
In the very Fit itself very little is to be done or
attempted.
As nothing does shorten the Duration, nor
even lessen the Violence, of an epileptic Fit, so
nothing at all should be attempted in it; and the
rather, because Means and Medicines often aggravate
the Disease. We should confine our Endeavours
solely to the Security of the Patient, by
preventing him from giving himself any violent
Strokes; by getting something, if possible, between
his Teeth, such as a small Roller of Linen to
prevent his Tongue from being hurt, or very
dangerously squeezed and bruised, in a strong
Convulsion.
The only Case which requires immediate Assistance
in the Fit, is, when it is so extremely
violent, the Neck so swelled, and the Face so
very red, that there is Room to be apprehensive
of an Apoplexy, which we should endeavour to
obviate, by drawing eight or ten Ounces of Blood
from the Arm.
As this terrible Disease is common in the
Country, it is doing a real Service to the unfortunate
Victims of it, to inform them how very
dangerous it is to give themselves blindly up to
take all the Medicines, which are cried up to
them in such Cases. If there be any one Disease,
which requires a more attentive, delicate,
and exquisite Kind of Treatment, it is this very
Disease. Some Species of it are wholly incurable:
and such as may be susceptible of a Cure, require
the utmost Care and Consideration of the most
enlightned and most experienced Physicians: while
those who pretend to cure all epileptic Patients,
with one invariable Medicine, are either Ignorants,
or Impostors, and sometimes both in one.
§ 517. Simple Convulsion Fits, which are not
epileptic, are frequently of a long Continuance,
persevering, with very few and short Intervals,
for Days and even for Weeks.
The true genuine Cause should be investigated
as strictly as possible, though nothing should be
attempted in the Fit. The Nerves are, during
that Term, in so high a Degree of Tension
and Sensibility, that the very Medicines, supposed
to be strongly indicated, often redouble the
Storm they were intended to appease.
Thin watery Liquors, moderately imbued
with Aromatics, are the least hurtful, the most
innocent Things that can be given; such as
Bawm, Lime-tree, and Elder Flower Tea. A
Ptisan of Liquorice Root only has sometimes answered
better than any other.
Of suffocating, or strangling Fits.
§ 518. These Fits (by whatever other Name
they may be called) whenever they very suddenly
attack a Person, whose Breathing was easy and
natural just before, depend almost constantly on
a Spasm or Contraction of the Nerves, in the
Vesicles of the Lungs; or upon an Infarction, a
Stuffing of the same Parts, produced by viscid
clammy Humours.
That Suffocation which arises from a Spasm is
not dangerous, it goes off of itself, or it may
be treated like Swoonings owing to the same
Cause. See .
§ 519. That Suffocation, which is the Effect
of a sanguineous Fulness and Obstruction, may
be distinguished by its attacking strong, vigorous,
sanguine Persons, who are great Eaters, using
much juicy nutritious Food, and strong Wine
and Liquors, and who frequently eat and inflame
themselves; and when the Fit has come on
after any inflaming Cause; when the Pulse is full
and strong, and the Countenance red.
Such are cured, 1, by a very plentiful Discharge
of Blood from the Arm, which is to be
repeated, if necessary.
2, By the Use of Glysters.
3, By drinking plentifully of the Ptisan ;
to each Pot of which, a Drachm of Nitre is to be
added; and,
4, By the Vapour of hot Vinegar, continually
received by Respiration or Breathing. See
.
§ 520. There is Reason to think that one of
these Fits is owing to a Quantity of tough viscid
Humours in the Lungs, when it attacks Persons,
whose Temperament, and whose Manner of
living are opposite to those I have just described;
such as valetudinary, weakly, phlegmatic, pituitous,
inactive, and squeamish Persons, who feed
badly, or on fat, viscid, and insipid Diet, and
who drink much hot Water, either alone, or in
Tea-like Infusions. And these Signs of Suffocation,
resulting from such Causes, are still more
probable, if the Fit came on in rainy Weather,
and during a southerly Wind; and when the
Pulse is soft and small, the Visage pale and
hollow.
The most efficacious Treatment we can advise,
is, 1, To give every half Hour half a Cup of
the Potion, , if it can be readily had. 2,
To make the Patient drink very plentifully of the
Drink ; and, 3, to apply two strong
Blisters to the fleshy Parts of his Legs.
If he was strong and hearty before the Fit,
and the Pulse still continues vigorous, and feels
somewhat full withall, the Loss of seven or eight
Ounces of Blood is sometimes indispensably necessary.
A Glyster has also frequently been attended
with extraordinary good Effects.
Those afflicted with this oppressing Malady
are commonly relieved, as soon as they expectorate,
and sometimes even by vomiting a little.
The Medicine , a Dose of which may
be taken every two Hours, with a Cup of the
Ptisan , often succeeds very well.
But if neither this Medicine, nor the Prescription
of are at Hand, which may be the
Case in Country Places; an Onion of a moderate
Size should be pounded in an Iron or Marble
Mortar; upon this, a Glass of Vinegar is to be
poured, and then strongly squeezed out again
through a Piece of Linen. An equal Quantity
of Honey is then to be added to it. A Spoonful
of this Mixture, whose remarkable Efficacy I
have been a Witness of, is to be given every half
Hour.
Of the violent Effects of Fear.
§ 521. Here I shall insert some Directions to
prevent the ill Consequences of great Fear or Terror,
which are very prejudicial at every Term of
Life, but chiefly during Infancy.
The general Effects of Terror, are a great
Straitening or Contraction of all the small Vessels,
and a Repulsion of the Blood into the large and
internal ones. Hence follows the Suppression of
Perspiration, the general Seizure or Oppression,
the Trembling, the Palpitations and Anguish,
from the Heart and the Lungs being overcharged
with Blood; and sometimes attended with
Swoonings, irremediable Disorders of the Heart,
and Death itself. A heavy Drowsiness, Raving,
and a Kind of furious or raging Delirium happen
in other Cases, which I have frequently observed
in Children, when the Blood-vessels of the Neck
were swelled and stuffed up; and Convulsions,
and even the Epilepsy have come on, all which
have proved the horrible Consequence of a most
senseless and wicked Foolery or Sporting. One
half of those Epilepsies which do not depend on
such Causes, as might exist before the Child's
Birth, are owing to this detestable Custom;
and it cannot be too much inculcated into Children,
never to frighten one another; a Point
which Persons intrusted with their Education,
ought to have the strictest Regard to.
When the Humours that should have passed off
by Perspiration, are repelled to the Intestines, a
tedious and very obstinate Looseness is the frequent
Consequence.
§ 522. Our Endeavours should be directed,
to re-establish the disordered Circulation; to restore
the obstructed Perspiration; and to allay
the Agitation of the Nerves.
The popular Custom in these Cases has been
to give the terrified Patient some cold Water
directly; but when the Fright has been considerable,
this is a very pernicious custom, and I
have seen some terrible Consequences from it.
They should, on the contrary, be conveyed
into some very quiet Situation, leaving there but
very few Persons, and such only as they are
thoroughly familiar with. They should take a
few Cups of pretty warm Drink, particularly of
an Infusion of Lime-tree Flowers and Bawm.
Their Legs should be put into warm Water, and
remain there an Hour, if they will patiently permit
it, rubbing them gently now and then, and
giving them every half-quarter of an Hour, a
small Cup of the said Drink. When their Composure
and Tranquillity are returned a little, and
their Skin seems to have recovered its wonted
and general Warmth, Care should be taken to
dispose them to sleep, and to perspire plentifully.
For this Purpose they may be allowed a few
Spoonfuls of Wine, on putting them into Bed,
with one Cup of the former Infusion; or, which
is more certain and effectual, a few Drops of
Sydenham's Liquid Laudanum, ; but
should that not be near at Hand, a small Dose
of Venice Treacle.
§ 523. It sometimes happens that Children do
not seem at first extremely terrified; but the
Fright is renewed while they sleep, and with no
small Violence. The Directions I have just
given must then be observed, for some successive
Evenings, before they are put to Bed.
Their Fright frequently returns about the latter
End of the Night, and agitates them violently
every Day. The same Treatment should be
continued in such Cases; and we should endeavour
to dispose them to be a-sleep at the usual
Hour of its Return.
By this very Method, I have dissipated the
dismal Consequences of Fear of Women in
Child-bed, which is so commonly, and often
speedily, mortal.
If a Suffocation from this Cause is violent,
there is sometimes a Necessity for opening a Vein
in the Arm.
These Patients should gradually be inured
to an almost continual, but gentle, Kind of
Exercise.
All violent Medicines render those Diseases,
which are the Consequences of great Fear, incurable.
A pretty common one is that of an
Obstruction of the Liver, which has been productive
of a Jaundice.
Of Accidents or Symptoms produced by the Vapours of Coal, and of Wine.
§ 524. Not a single Year passes over here,
without the Destruction of many People by the
Vapour of Charcoal, or of small Coal, and by
the Steam or Vapour of Wine.
The Symptoms by Coal occur, when small
Coal, and especially when Charcoal is burnt in
a Chamber close shut, which is direct Poison to
a Person shut up in it. The sulphureous Oil,
which is set at Liberty and diffused by the Action
of Fire, expands itself through the Chamber;
while those who are in it perceive a Disorder and
Confusion in their Heads; contract Vertigos,
Sickness at Stomach, a Weakness, and very unusual
Kind of Numbness; become raving, convulsed
and trembling; and if they fail of Presence
of Mind, or of Strength, to get out of the Chamber,
they die within a short Time.
I have seen a Woman who had vertiginous
Commotions in her Head for two Days, and almost
continual Vomitings, from her having been
confined less than six Minutes in a Chamber
(and that notwithstanding, both one Window
and one Door were open) in which there was a
Chafing-dish with some burning Coals. Had
the Room been quite close, she must have
perished by it.
This Vapour is narcotic or stupefying, and
proves mortal in Consequence of its producing a
sleepy or apoplectic Disorder, though blended,
at the same time, with something convulsive;
which sufficiently appears from the Closure of
the Mouth, and the strict Contraction or Locking
of the Jaws.
The Condition of the Brain, in the dissected
Bodies of Persons thus destroyed, proves that
they die of an Apoplexy: notwithstanding it is
very probable that Suffocation is also partly the
Cause of their Deaths; as the Lungs have been
found stuffed up with Blood and livid.
It has also been observed in some other such
Bodies, that Patients killed by the Vapour of
burning Coals, have commonly their whole Body
swelled out to one third more than their Magnitude,
when living. The Face, Neck, and
Arms are swelled out, as if they had been blown
up; and the whole human Machine appears in
such a State, as the dead Body of a Person would,
who had been violently strangled; and who had
made all possible Resistance for a long time, before
he was overpowered.
§ 525. Such as are sensible of the great Danger
they are in, and retreat seasonably from it, are generally
relieved as soon as they get into the open Air;
or if they have any remaining Uneasiness, a little
Water and Vinegar, or Lemonade, drank hot,
affords them speedy Relief. But when they are
so far poisoned, as to have lost their Feeling and
Understanding, if there be any Means of reviving
them, such Means consist,
1, In exposing them to a very pure, fresh and
open Air.
2, In making them smell to some very penetrating
Odour, which is somewhat stimulating
and reviving, such as the volatile Spirit of Sal
Ammoniac, the English Salt; and afterwards to
surround them, as it were, with the Steam of
Vinegar.
3, In taking some Blood from their Arm.
4, In putting their Legs into warm or hot
Water, and chafing them well.
5, In making them swallow, if practicable,
much Lemonade, or Water and Vinegar, with
the Addition of Nitre: and,
6, In throwing up some sharp Glysters.
As it is manifest there is something spasmodic
in these Cases, it were proper to be provided
with some antispasmodic Remedies, such as the
Mineral Anodyne Liquid of Hoffman. Even
*** has sometimes been successfully given
here, but it should be allowed to Physicians only
to direct it in such Cases.
A Vomit would be hurtful; and the Reachings
to vomit arise only from the Oppression on
the Brain.
It is a common but erroneous Opinion, that
if the Coal be suffered to burn for a Minute or so
in the open Air, or in a Chimney, it is sufficient
to prevent any Danger from the Vapour of it.
Hence it amounts even to a criminal Degree
of Imprudence, to sleep in a Chamber while
Charcoal or small Coal is burning in it; and the
Number of such imprudent Persons, as have
never awaked after it, is so considerable, and so
generally known too, that the Continuance of
this unhappy Custom is astonishing.
§ 526. The Bakers, who make Use of much
small Coal, often keep great Quantities of it in
their Cellars, which frequently abound so much
with the Vapour of it, that it seizes them violently
the Moment they enter into the Cellar. They
sink down at once deprived of all Sensation, and
die if they are not drawn out of it soon enough
to be assisted, according to the Directions I have
just given.
One certain Means of preventing such fatal
Accidents is, upon going into the Cellar to throw
some flaming Paper or Straw into it, and if
these continue to flame out and consume, there
is no Reason for dreading the Vapour: but if
they should be extinguished, no Person should
venture in. But after opening the Vent-hole, a
Bundle of flaming Straw must be set at the Door,
which serves to attract the external Air strongly.
Soon after the Experiment of the flaming Paper
must be repeated, and if it goes out, more Straw
is to be set on Fire before the Cellar Door.
§ 527. Small Coal, burnt in an open Fire, is not
near so dangerous as Charcoal, properly so called,
the Danger of which arises from this, that in
extinguishing it by the usual Methods, all those
sulphureous Particles of it, in which its Danger
consists, are concentred. Nevertheless, small
Coal is not entirely deprived of all its noxious
Quality, without some of which it could not
strictly be Coal.
The common Method of throwing some Salt
on live Coals, before they are conveyed into
a Chamber; or of casting a Piece of Iron among
them to imbibe some Part of their deadly narcotic
Sulphur, is not without its Utility; though by no
means sufficient to prevent all Danger from
them.
§ 528. When the most dangerous Symptoms
from this Cause disappear, and there remains
only some Degree of Weakness, of Numbness,
and a little Inappetency, or Loathing at Stomach,
nothing is better than Lemonade with one fourth
Part Wine, half a Cup of which should frequently
be taken, with a small Crust of Bread.
§ 529. The Vapour which exhales from
Wine, and in general from all fermenting Liquors,
such as Beer, Cyder, &c. contains something
poisonous, which kills in the like Manner
with the Vapour of Coal; and there is always
some Danger in going into a Cellar, where there
is much Wine in the State of Fermentation; if it
has been shut up close for several Hours. There
have been many Examples of Persons struck
dead on entering one, and of others who have
escaped out of it with Difficulty.
When such unhappy Accidents occur, Men
should not be successively exposed, one after
another, to perish, by endeavouring to fetch out
the first who sunk down upon his Entrance; but
the Air should immediately be purified by the
Method already directed, or by discharging some
Guns into the Cellar; after which People may
venture in with Precaution. And when the
Persons unfortunately affected are brought out,
they are to be treated like those, who were
affected with the Coal-Vapour.
I saw a Man, about eight Years since, who was
not sensible of the Application of Spirit of Sal Ammoniac,
till about an Hour after he was struck
down, and who was entirely freed at last by a
plentiful Bleeding; though he had been so insensible,
that it was several Hours before he discovered
a very great Wound he had, which extended
from the Middle of his Arm to his Armpit,
and which was made by a Hook intended
to be used, in Case of a House catching Fire,
to assist Persons in escaping from the Flames.
§ 530. When subterraneous Caves that have
been very long shut are opened; or when deep
Wells are cleaned, that have not been emptied
for several Years, the Vapours arising from them
produce the same Symptoms I have mentioned,
and require the same Assistance. They are to be
cleansed and purified by burning Sulphur and
Salt Petre in them, or Gunpowder, as compounded
of both.
§ 531. The offensive Stink of Lamps and of
Candles, especially when their Flames are extinguished,
operate like other Vapours, though
with less Violence, and less suddenly. Nevertheless
there have been Instances of People
killed by the Fumes of Lamps fed with Nut
Oil, which had been extinguished in a close
Room. These last Smells or Fumes prove noxious
also, in Consequence of their Greasiness,
which being conveyed, together with the Air,
into the Lungs, prevent their Respiration: And
hence we may observe, that Persons of weak delicate
*** find themselves quickly oppressed in
Chambers or Apartments, illuminated with many
Candles.
The proper Remedies have been already directed,
. The Steam of Vinegar is very
serviceable in such Cases.
Of Poisons.
§ 532. There are a great Number of Poisons,
whose Manner of acting is not alike; and whose
ill Effects are to be opposed by different Remedies:
But Arsenic, or Ratsbane, and some particular
Plants are the Poisons which are the most
frequently productive of Mischief, in Country
Places.
§ 533. It is in Consequence of its excessive
Acrimony, or violent Heat and Sharpness, which
corrodes or gnaws, that Arsenic destroys by an
excessive Inflammation, with a burning Fire as
it were, most torturing Pains in the Mouth,
Throat, Stomach, Guts; with rending and often
bloody Vomitings, and Stools, Convulsions,
Faintings, &c.
The best Remedy of all is pouring down
whole Torrents of Milk, or, where there is not
Milk, of warm Water. Nothing but a prodigious
Quantity of such weak Liquids can avail such
a miserable Patient. If the Cause of the Disorder
is immediately known, after having very speedily
taken down a large Quantity of warm Water,
Vomiting may be excited with Oil, or with
melted Butter, and by tickling the Inside of the
Throat with a Feather. But when the Poison
has already inflamed the Stomach and the Guts,
we must not expect to discharge it by vomiting.
Whatever is healing or emollient, Decoctions of
mealy Pulse, of Barley, of Oatmeal, of Marsh-mallows,
and Butter and Oil are the most suitable.
As soon as ever the tormenting Pains are felt
in the Belly, and the Intestines seem attacked,
Glysters of Milk must be very frequently thrown
up.
If at the very Beginning of the Attack, the Patient
has a strong Pulse, a very large Bleeding may
be considerably serviceable by its delaying the Progress,
and diminishing the Degree of Inflammation.
And even though it should happen that a Patient
overcomes the first Violence of this dreadful
Accident, it is too common for him to continue
in a languid State for a long Time, and sometimes
for all the Remainder of his Life. The
most certain Method of preventing this Misery,
is to live for some Months solely upon Milk,
and some very new laid Eggs, just received from
the Hen, and dissolved or blended in the Milk,
without boiling them.
§ 534. The Plants which chiefly produce
these unhappy Accidents are some Kinds of Hemlock,
whether it be the Leaf or the Root, the
Berries of the Bella Donna, or deadly Nightshade,
which Children eat by mistake for Cherries;
some Kind of Mushrooms, the Seed of the
Datura, or the stinking Thorn-Apple.
All the Poisons of this Class prove mortal
rather from a narcotic, or stupefying, than from
an acrid, or very sharp Quality. Vertigos,
Faintings, Reachings to vomit, and actual Vomitings
are the first Symptoms produced by them.
The Patient should immediately swallow down
a large Quantity of Water, moderately seasoned
with Salt or with Sugar; and then a Vomiting
should be excited as soon as possible by the Prescription
or : or, if neither of these is
very readily procurable, with Radish-seed pounded,
to the Quantity of a Coffee Spoonful, swallowed
in warm Water, soon after forcing a Feather
or a Finger into the Patient's Throat, to expedite
the Vomiting.
After the Operation of the Vomit, he must continue
to take a large Quantity of Water, sweetened
with Honey or Sugar, together with a considerable
Quantity of Vinegar, which is the true
Specific, or Antidote, as it were, against those
Poisons: the Intestines must also be emptied by a
few Glysters.
Thirty-seven Soldiers having unhappily eaten,
instead of Carrots, of the Roots of the Oenanthè;
or Water-hemlock, became all extremely sick;
when the Emetic, , with the Assistance
of Glysters, and very plentiful drinking of warm
Water, saved all but one of them, who died before
he could be assisted.
§ 535. If a Person has taken too much ***;
or any Medicine into which it enters, as
Venice Treacle, Mithridate, Diascordium, &c.
whether by Imprudence, Mistake, Ignorance,
or through any bad Design, he must be bled
upon the Spot, and treated as if he had a sanguine
Apoplexy, (See ) by Reason that
*** in Effect produces such a one. He should
snuff up and inhale the Vapour of Vinegar plentifully,
adding it also liberally to the Water he
is to drink.
Of acute Pains.
§ 536. It is not my Intention to treat here of
those Pains, that accompany any evident known
Disease, and which should be conducted as relating
to such Diseases; nor of such Pains as infirm
valetudinary Persons are habitually subject to;
since Experience has informed such of the most
effectual Relief for them: But when a Person
sound and hale, finds himself suddenly attacked
with some excessive Pain, in whatever Part it
occurs, without knowing either the Nature, or
the Cause of it, they may, till proper Advice can
be procured,
1, Part with some Blood, which, by abating
the Fulness and Tension, almost constantly
asswages the Pains, at least for some Time: and
it may even be repeated, if, without weakening
the Patient much, it has lessened the Violence of
the Pain.
2, The Patient should drink abundantly of
some very mild temperate Drink, such as the
Ptisan , the Almond Emulsion , or
warm Water with a fourth or fifth Part Milk.
3, Several emollient Glysters should be given.
4, The whole Part that is affected, and the
adjoining Parts should be covered with Cataplasms,
or soothed with the emollient Fomentation,
.
5, The warm Bath may also be advantagiously
used.
6, If notwithstanding all these Assistances, the
Pain should still continue violent, and the Pulse
is neither full nor hard, the grown Patient may
take an Ounce of Syrup of Diacodium, or sixteen
Drops of liquid Laudanum; and when neither
of these are to be had, an English Pint of boiling
Water must be poured upon three or four
Poppy-heads with their Seeds, but without the
Leaves, and this Decoction is to be drank like
Tea.
§ 537. Persons very subject to frequent Pains,
and especially to violent Head-achs, should abstain
from all strong Drink; such Abstinence being often
the only Means of curing them: And People are
very often mistaken in supposing Wine necessary
for as many as seem to have a weak Stomach.
Chapter XXXII.
Of Medicines taken by Way of Precaution, or Prevention.
Sect. 538.
Have pointed out, in some Parts of
this Work, the Means of preventing
the bad Effects of several Causes of Diseases;
and of prohibiting the Return of
some habitual Disorders. In the present Chapter
I shall adjoin some Observations, on the Use of
the principal Remedies, which are employed as
general Preservatives; pretty regularly too at certain
stated Times, and almost always from meer
Custom only, without knowing, and often with
very little Consideration, whether they are right
or wrong.
Nevertheless, the Use, the Habit of taking
Medicines, is certainly no indifferent Matter: it
is ridiculous, dangerous, and even criminal to
omit them, when they are necessary, but not less
so to take them when they are not wanted. A
good Medicine taken seasonably, when there is
some Disorder, some Disarrangement in the Body,
which would in a short time occasion a Distemper,
has often prevented it. But yet the very
same Medicine, if given to a Person in perfect
Health, if it does not directly make him sick,
leaves him at the best in a greater Propensity to
the Impressions of Diseases: and there are but
too many Examples of People, who having very
unhappily contracted a Habit, a Disposition to
take Physick, have really injured their Health,
and impaired their Constitution, however naturally
strong, by an Abuse of those Materials
which Providence has given for the Recovery
and Re-establishment of it; an Abuse which,
though it should not injure the Health of the
Person, would occasion those Remedies, when
he should be really sick, to be less efficacious and
serviceable to him, from their having been familiar
to his Constitution; and thus he becomes
deprived of the Assistance he would have received
from them, if taken only in those Times
and Circumstances, in which they were necessary
for him.
Of Bleeding.
§ 539. Bleeding is necessary only in these
four Cases. 1, When there is too great a Quantity
of Blood in the Body. 2, When there is
any Inflammation, or an inflammatory Disease.
3, When some Cause supervenes, or is about to
supervene, in the Constitution, which would
speedily produce an Inflammation, or some other
dangerous Symptom, if the Vessels were not relaxed
by Bleeding. It is upon this Principle
that Patients are bled after Wounds, and after
Bruises; that Bleeding is directed for a pregnant
Woman, if she has a violent Cough; and that
Bleeding is performed, by Way of Precaution,
in several other Cases. 4, We also advise Bleeding
sometimes to asswage an excessive Pain,
though such Pain is not owing to Excess of
Blood, nor arises from an inflamed Blood; but
in Order to appease and moderate the Pain by
Bleeding; and thereby to obtain Time for destroying
the Cause of it by other Remedies.
But as these two last Reasons are in Effect involved
or implied in the two first; it may be very
generally concluded, that an Excess of Blood,
and an inflamed State of it, are the only two
necessary Motives for Bleeding.
§ 540. An Inflammation of the Blood is
known by the Symptoms accompanying those
Diseases, which that Cause produces. Of these
I have already spoken, and I have at the same
time regulated the Practice of Bleeding in such
Cases. Here I shall point out those Symptoms
and Circumstances, which manifest an Excess of
Blood.
The first, then, is the general Course and
Manner of the Patient's living, while in Health.
If he is a great Eater, and indulges in juicy nutritious
Food, and especially on much Flesh-meat;
if he drinks rich and nourishing Wine, or
other strong Drink, and at the same time enjoys
a good Digestion; if he takes but little Exercise,
sleeps much, and has not been subject to any
very considerable Evacuation, he may well be
supposed to abound in Blood. It is very obvious
that all these Causes rarely occur in Country
People; if we except only the Abatement of their
Exercise, during some Weeks in Winter, which
indeed may contribute to their generating more
Blood than they commonly do.
The labouring Country-man, for much the
greater part of his Time, lives only on Bread,
Water and Vegetables; Materials but very moderately
nourishing, as one Pound of Bread probably
does not make, in the same Body, more Blood
than one Ounce of Flesh; though a general Prejudice
seems to have established a contrary Opinion.
2, The total Stopping or long Interruption of
some involuntary Bleeding or Hæmorrhage, to
which he had been accustomed. 3, A full and
strong Pulse, and Veins visibly filled with Blood,
in a Body that is not lean and thin, and when he
is not heated. 4, A florid lively Ruddiness.
5, A considerable and unusual Numbness; Sleep
more profound, of more Duration, and yet less
tranquil and calm, than at other times; a greater
Propensity than ordinary to be fatigued after moderate
Exercise or Work; and a little Oppression
and Heaviness from walking. 6, Palpitations,
accompanied sometimes with very great Dejection,
and even with a slight fainting Fit; especially on
being in any hot Place, or after moving about
considerably. 7, Vertigos, or Swimmings of the
Head, especially on bowing down and raising it
up at once, and after sleeping. 8, Frequent
Pains of the Head, to which the Person was not
formerly subject; and which seem not to arise
from any Defect in the Digestions. 9, An evident
Sensation of Heat, pretty generally diffused
over the whole Body. 10, A smarting Sort of
Itching all over, from a very little more Heat
than usual. And lastly, frequent Hæmorrhages,
and these attended with manifest Relief, and
more Vivacity.
People should, notwithstanding, be cautious
of supposing an unhealthy Excess of Blood, from
any one of these Symptoms only. Many of
them must concur; and they should endeavour
to be certain that even such a Concurrence of
them does not result from a very different Cause,
and wholly opposite in Effect to that of an Excess
of Blood.
But when it is certain, from the whole Appearance,
that such an Excess doth really exist,
then a single, or even a second Bleeding is attended
with very good Effects. Nor is it material,
in such Cases, from what Part the Blood is
taken.
§ 541. On the other Hand, when these Circumstances
do not exist, Bleeding is in no wise
necessary: nor should it ever be practised in these
following Conditions and Circumstances; except
for some particular and very strong Reasons; of
the due Force of which none but Physicians can
judge.
First, when the Person is in a very advanced
Age, or in very early Infancy. 2, When he is
either naturally of a weakly Constitution, or it
has been rendered such by Sickness, or by some
other Accident. 3, When the Pulse is small,
soft, feeble, and intermits, and the Skin is manifestly
pale. 4, When the Limbs, the Extremities
of the Body, are often cold, puffed up
and soft. 5, When their Appetite has been very
small for a long time; their Food but little nourishing,
and their Perspiration too plentiful, from
great Exercise. 6, When the Stomach has long
been disordered, and the Digestion bad, whence
very little Blood could be generated. 7, When
the Patient has been considerably emptied, whether
by Hæmorrhages, a Looseness, profuse
Urine or Sweat: or when the Crisis of some Distemper
has been effected by any one of these
Evacuations. 8, When the Patient has long
been afflicted with some depressing Disease; and
troubled with many such Obstructions as prevent
the Formation of Blood. 9, Whenever a Person
is exhausted, from whatever Cause. 10, When
the Blood is in a thin, pale, and dissolved State.
§ 542, In all these Cases, and in some others
less frequent, a single Bleeding often precipitates
the Patient into an absolutely incurable State, an
irreparable Train of Evils. Many dismal Examples
of it are but too obvious.
Whatever, therefore, be the Situation of the
Patient, and however naturally robust, that
Bleeding, which is unnecessary, is noxious. Repeated,
re-iterated Bleedings, weaken and enervate,
hasten old Age, diminish the Force of the
Circulation, thence fatten and puff up the Body;
and next by weakening, and lastly by destroying,
the Digestions, they lead to a fatal
Dropsy. They disorder the Perspiration by the
Skin, and leave the Patient liable to Colds and
Defluxions: They weaken the nervous System,
and render them subject to Vapours, to the
hypochondriac Disorders, and to all nervous
Maladies.
The ill Consequence of a single, though erroneous
Bleeding is not immediately discernible:
on the contrary, when it was not performed in
such a Quantity, as to weaken the Patient perceivably,
it appears to have been rather beneficial.
Yet I still here insist upon it, that it is not the
less true that, when unnecessary, it is prejudicial;
and that People should never bleed, as sometimes
has been done, for meer Whim, or, as
it were, for Diversion. It avails nothing to affirm,
that within a few Days after it, they have
got more Blood than they had before it, that is,
that they weigh more than at first, whence they
infer the Loss of Blood very speedily repaired.
The Fact of their augmented Weight is admitted;
but this very Fact testifies against the real
Benefit of that Bleeding; hence it is a Proof,
that the natural Evacuations of the Body are less
compleatly made; and that Humours, which
ought to be expelled, are retained in it. There
remains the same Quantity of Blood, and perhaps
a little more; but it is not a Blood so well
made, so perfectly elaborated; and this is so
very true, that if the thing were otherwise; if
some Days after the Bleeding they had a greater
Quantity of the same Kind of Blood, it would
amount to a Demonstration, that more re-iterated
Bleedings must necessarily have brought
on an inflammatory Disease, in a Man of a robust
Habit of Body.
§ 543. The Quantity of Blood, which a
grown Man may Part with, by Way of Precaution,
is about ten Ounces.
§ 544. Persons so constituted as to breed much
Blood, should carefully avoid all those Causes
which tend to augment it, (See , Nº. 1)
and when they are sensible of the Quantity augmented,
they should confine themselves to a
light frugal Diet, on Pulse, Fruits, Bread and
Water; they should often bathe their Feet in
warm Water, taking Night and Morning the
Powder ; drink of the Ptisan ; sleep
but very moderately, and take much Exercise.
By using these Precautions they may either prevent
any Occasion for Bleeding, or should they
really be obliged to admit of it, they would increase
and prolong its good Effects. These are
also the very Means, which may remove all the
Danger that might ensue from a Person's omitting
to bleed, at the usual Season or Interval,
when the Habit, the Fashion of Bleeding had
been inveterately established in him.
§ 545. We learn with Horror and Astonishment,
that some have been bled eighteen, twenty
and even twenty-four times in two Days; and
some others, some hundred times, in the
Course of some Months. Such Instances irrefragably
demonstrate the continual Ignorance of
their Physician or Surgeon; and should the Patient
escape, we ought to admire the inexhaustible
Resources of Nature, that survived so many
murderous Incisions.
§ 546. The People entertain a common Notion,
which is, that the first Time of bleeding
certainly saves the Life of the Patient; but to
convince them of the Falsity of this silly Notion,
they need only open their Eyes, and see the very
contrary Fact to this occur but too unhappily
every Day; many People dying soon after their
first Bleeding. Were their Opinion right, it
would be impossible that any Person should die
of the first Disease that seized him, which yet
daily happens. Now the Extirpation of this absurd
Opinion is really become important, as the
Continuance of it is attended with some unhappy
Consequences: their Faith in, their great Dependance
on, the extraordinary Virtue of this
first Bleeding makes them willing to omit it,
that is, to treasure it up against a Distemper,
from which they shall be in the greatest Danger;
and thus it is deferred as long as the Patient is
not extremely bad, in Hopes that if they can do
without it then, they shall keep it for another
and more pressing Occasion. Their present Disease
in the mean time rises to a violent Height;
and then they bleed, but when it is too late, and
I have seen Instances of many Patients, who
were permitted to die, that the first Bleeding
might be reserved for a more important Occasion.
The only Difference between the first
Bleeding, and any subsequent one is, that the
first commonly gives the Patient an Emotion,
that is rather hurtful than salutary.
Of Purges.
§ 547. The Stomach and Bowels are emptied
either by Vomiting, or by Stools, the latter Discharge
being much more natural than the first,
which is not effected without a violent Motion,
and one indeed to which Nature is repugnant.
Nevertheless, there are some Cases, which really
require this artificial Vomiting; but these excepted
(some of which I have already pointed out)
we should rather prefer those Remedies, which
empty the Belly by Stool.
§ 548. The Signs, which indicate a Necessity
for Purging, are, 1, a disagreeable Tast or Savour
of the Mouth in a Morning, and especially
a bitter Tast; a foul, furred Tongue and
Teeth, disagreable Eructations or Belchings,
Windiness and Distension.
2, A Want of Appetite which increases very
gradually, without any Fever, which degenerates
into a Disgust or total Aversion to Food; and
sometimes communicates a bad Tast to the very
little such Persons do eat.
3, Reachings to vomit in a Morning fasting,
and sometimes throughout the Day; supposing
such not to depend on a Woman's Pregnancy, or
some other Disorder, in which Purges would
be either useless or hurtful.
4, A vomiting up of bitter, or corrupted,
Humours.
5, A manifest Sensation of a Weight, or
Heaviness in the Stomach, the Loins, or the
Knees.
6, A Want of Strength sometimes attended
with Restlessness, ill Humour, or Peevishness,
and Melancholy.
7, Pains of the Stomach, frequent Pains of
the Head, or Vertigos; sometimes a Drowsiness,
which increases after Meals.
8, Some Species of Cholics; irregular Stools
which are sometimes very great in Quantity, and
too liquid for many Days together; after which
an obstinate Costiveness ensues.
9, A Pulse less regular, and less strong, than
what is natural to the Patient, and which sometimes
intermits.
§ 549. When these Symptoms, or some of
them, ascertain the Necessity of purging a Person,
not then attacked by any manifest Disease
(for I am not speaking here of Purges in such
Cases) a proper purging Medicine may be given
him. The bad Tast in his Mouth; the continual
Belchings; the frequent Reachings to vomit;
the actual Vomitings and Melancholy discover,
that the Cause of his Disorder resides in
the Stomach, and shew that a Vomit will be of
Service to him. But when such Signs or Symptoms
are not evident, the Patient should take
such purging or opening Remedies, as are particularly
indicated by the Pains, whether of the
Loins; from the Cholic; or by a Sensation of
Weight or Heaviness in the Knees.
§ 550. But we should abstain from either
vomiting or purging, 1, Whenever the Complaints
of the Patients are founded in their Weakness,
and their being already exhausted, 2,
When there is a general Dryness of the Habit, a
very considerable Degree of Heat, some Inflammation,
or a strong Fever. 3, Whenever Nature
is exerting herself in some other salutary Evacuation;
whence purging must never be attempted
in critical Sweats, during the monthly Discharges,
nor during a Fit of the Gout. 4, Nor
in such inveterate Obstructions as Purges cannot
remove, and really do augment. 5, Neither
when the nervous System is considerably weakened.
§ 551. There are other Cases again, in which
it may be proper to purge, but not to give a Vomit.
These Cases are, 1, When the Patient
abounds too much with Blood, (See ) since
the Efforts which attend vomiting, greatly augment
the Force of the Circulation; whence the
Blood-vessels of the Head and of the Breast, being
extremely distended with Blood, might burst,
which must prove fatal on the Spot, and has
repeatedly proved so. 2, For the same Reason
they should not be given to Persons, who are
subject to frequent Bleeding from the Nose, or
to coughing up or vomiting of Blood; to Women
who are subject to excessive or unseasonable
Discharges of Blood, &c. from the ***, the
Neck of the Womb; nor to those who are with
Child. 3, Vomits are improper for ruptured
Persons.
§ 552. When any Person has taken too acrid,
too sharp, a Vomit, or a Purge, which operates
with excessive Violence; whether this consists in
the most vehement Efforts and Agitations, the
Pains, Convulsions, or Swoonings, which are
their frequent Consequences; or whether that
prodigious Evacuation and Emptiness their Operation
causes, (which is commonly termed a Super-purgation)
and which may hurry the Patient
off; Instances of which are but too common
among the lower Class of the People, who much
too frequently confide themselves to the Conduct
of ignorant Men-slayers: In all such unhappy
Accidents, I say, we should treat these unfortunate
Persons, as if they had been actually poisoned,
by violent corroding Poisons, (See )
that is, we should fill them, as it were, with
Draughts of warm Water, Milk, Oil, Barley-water,
Almond Milk, emollient Glysters with
Milk, and the Yolks of Eggs; and also bleed
them plentifully, if their Pains are excessive, and
their Pulses strong and feverish.
The Super-purgation, the excessive Discharge,
is to be stopt, after having plied the Patient
plentifully with diluting Drinks, by giving the
calming Anodyne Medicines directed in the Removal
of acute Pains, .
Flanels dipt in hot Water, in which some Venice
Treacle is dissolved, are very serviceable:
and should the Evacuations by Stool be excessive,
and the Patient has not a high Fever, and a
parching Kind of Heat, a Morsel of the same
Treacle, as large as a Nutmeg, may be dissolved
in his Glyster.
But should the Vomiting solely be excessive,
without any Purging, the Number of the emollient
Glysters with Oil and the Yolk of an Egg
must be increased; and the Patient should be
placed in a warm Bath.
§ 553. Purges frequently repeated, without
just and necessary Indications, are attended with
much the same ill Effects as frequent Bleedings.
They destroy the Digestions; the Stomach no
longer, or very languidly, exerts its Functions;
the Intestines prove inactive; the Patient becomes
liable to very severe Cholics; the Plight of the
Body, deprived of its salutary Nutrition, falls off;
Perspiration is disordered; Defluxions ensue;
nervous Maladies come on, with a general Languor;
and the Patient proves old, long before
the Number of his Years have made him so.
Much irreparable Mischief has been done to
the Health of Children, by Purges injudiciously
given and repeated. They prevent them from
attaining their utmost natural Strength, and frequently
contract their due Growth. They ruin
their Teeth; dispose young Girls to future Obstructions;
and when they have been already
affected by them, they render them still more
obstinate.
It is a Prejudice too generally received, that
Persons who have little or no Appetite need
purging; since this is often very false, and most
of those Causes, which lessen or destroy the Appetite,
cannot be removed by purging; though
many of them may be increased by it.
Persons whose Stomachs contain much glairy
viscid Matter suppose, they may be cured by
Purges, which seem indeed at first to relieve
them: but this proves a very slight and deceitful
Relief. These Humours are owing to that
Weakness and Laxity of the Stomach, which
Purges augment; since notwithstanding they carry
off Part of these viscid Humours generated in
it, at the Expiration of a few Days there is a
greater Accumulation of them than before; and
thus, by a Re-iteration of purging Medicines,
the Malady soon becomes incurable, and Health
irrecoverably lost. The real Cure of such Cases
is effected by directly opposite Medicines. Those
referred to, or mentioned, , are highly
conducive to it.
§ 554. The Custom of taking stomachic Medicines
infused in Brandy, Spirit of Wine, Cherry
Water, &c. is always dangerous; for notwithstanding
the present immediate Relief such
Infusions afford in some Disorders of the Stomach,
they really by slow Degrees impair and
ruin that Organ; and it may be observed, that
as many as accustom themselves to Drams, go
off, just like excessive Drinkers, in Consequence
of their having no Digestion; whence they sink
into a State of Depression and Languor, and die
dropsical.
§ 555. Either Vomits or Purges may be often
beneficially omitted, even when they have
some Appearance of seeming necessary, by abating
one Meal a Day for some time; by abstaining
from the most nourishing Sorts of Food; and
especially from those which are fat; by drinking
freely of cool Water, and taking extraordinary
Exercise. The same Regimen also serves to
subdue, without the Use of Purges, the various
Complaints which often invade those, who omit
taking purging Medicines, at those Seasons and
Intervals, in which they have made it a Custom
to take them.
§ 556. The Medicines, and , are
the most certain Vomits. The Powder, ,
is a good Purge, when the Patient is in no wise
feverish.
The Doses recommended in the Table of Remedies
are those, which are proper for a grown
Man, of a vigorous Constitution. Nevertheless
there are some few, for whom they may be too
weak: in such Circumstances they may be increased
by the Addition of a third or fourth Part
of the Dose prescribed. But should they not
operate in that Quantity, we must be careful
not to double the Dose, much less to give a
three-fold Quantity, which has sometimes been
done, and that even without its Operation, and at
the Risque of killing the Patient, which has not
seldom been the Consequence. In Case of such
purging not ensuing, we should rather give large
Draughts of Whey sweetened with Honey, or of
warm Water, in a Pot of which an Ounce, or
an Ounce and a half of common Salt must be
dissolved; and this Quantity is to be taken from
time to time in small Cups, moving about with
it.
The Fibres of Country People who inhabit
the Mountains, and live almost solely on Milk,
are so little susceptible of Sensation, that they
must take such large Doses to purge them, as
would kill all the Peasantry in the Vallies. In
the Mountains of Valais there are Men who take
twenty, and even twenty-four Grains of Glass of
Antimony for a single Dose; a Grain or two of
which were sufficient to poison ordinary Men.
§ 557. Notwithstanding our Cautions on this
important Head, whenever an urgent Necessity
commands it, Purging must be recurred to at all
Times and Seasons: but when the Season may
be safely selected, it were right to decline Purging
in the Extremities of either Heat or Cold;
and to take the Purge early in the Morning, that
the Medicines may find less Obstruction or Embarrassment
from the Contents of the Stomach.
Every other Consideration, with Relation to the
Stars and the Moon, is ridiculous, and void of
any Foundation. The People are particularly
averse to purging in the Dog-days; and if this
were only on Account of the great Heat, it would
be very pardonable: but it is from an astrological
Prejudice, which is so much the more absurd, as
the real Dog-days are at thirty-six Days Distance
from those commonly reckoned such; and it is a
melancholy Reflection, that the Ignorance of the
People should be so gross, in this Respect, in our
enlightened Age; and that they should still imagine
the Virtue and Efficacy of Medicines to depend on
what Sign of the Zodiac the Sun is in, or in any
particular Quarter of the Moon. Yet it is certain
in this Point, they are so inveterately attached
to this Prejudice, that it is but too common
to see Country-People die, in waiting for
the Sign or Quarter most favourable to the Operation
and Effect of a Medicine, which was truly
necessary five or six Days before either of them.
Sometimes too that particular Medicine is given,
to which a certain Day is supposed to be auspicious
and favourable, in Preference to that which
is most prevalent against the Disease. And thus
it is, than an ignorant Almanack Maker determines
on the Lives of the human Race; and
contracts the Duration of them with Impunity.
§ 558. When a Vomit or a Purge is to be
taken, the Patient's Body should be prepared for
the Reception of it twenty-four Hours beforehand;
by taking very little Food, and drinking
some Glasses of warm Water, or of a light Tea
of some Herbs.
He should not drink after a Vomit, until it
begins to work; but then he should drink very
plentifully of warm Water, or a light Infusion
of Chamomile Flowers, which is preferable.
It is usual, after Purges, to take some thin
Broth or Soup during their Operation; but warm
Water sweetened with Sugar or Honey, or an
Infusion of Succory Flowers, would sometimes be
more suitable.
§ 559. As the Stomach suffers, in some Degree,
as often as either a Vomit, or a Purge, is
taken, the Patient should be careful how he lives
and orders himself for some Days after taking
them, as well in Regard to the Quantity as Quality
of his Food.
§ 560. I shall say nothing of other Articles
taken by Way of Precaution, such as Soups,
Whey, Waters, &c. which are but little used
among the People; but confine myself to this
general Remark, that when they take any of
these precautionary Things, they should enter on
a Regimen or Way of living, that may co-operate
with them, and contribute to the same Purpose.
Whey is commonly taken to refresh and
cool the Body; and while they drink it, they
deny themselves Pulse, Fruits, and Sallads.
They eat nothing then, but the best and heartiest
Flesh-meats they can come at; such Vegetables
as are used in good Soups, Eggs, and good
Wine; notwithstanding this is to destroy, by
high and heating Aliments, all the attemperating
cooling Effects expected from the Whey.
Some Persons propose to cool and attemperate
their Blood by Soups and a thin Diet, into which
they cram Craw-fish, that heat considerably, or
Nasturtium, Cresses which also heat, and thus
defeat their own Purpose. Happily, in such a
Case, the Error in one Respect often cures that
in the other; and these Kinds of Soup, which
are in no wise cooling, prove very serviceable, in
Consequence of the Cause of the Symptoms,
which they were intended to remove, not requiring
any Coolers at all.
The general physical Practice of the Community,
which unhappily is but too much in Fashion,
abounds with similar Errors. I will just
cite one, because I have seen its dismal Effects.
Many People suppose Pepper cooling, though
their Smell, Taste, and common Sense concur
to inform them of the contrary. It is the very
hottest of Spices.
§ 561. The most certain Preservative, and
the most attainable too by every Man, is to
avoid all Excess, and especially Excess in eating
and in drinking. People generally eat more than
thoroughly consists with Health, or permits them
to attain the utmost Vigour, of which their natural
Constitutions are capable. The Custom is
established, and it is difficult to eradicate it:
notwithstanding we should at least resolve not
to eat, but through Hunger, and always under
a Subjection to Reason; because, except in a
very few Cases, Reason constantly suggests to us
not to eat, when the Stomach has an Aversion
to Food. A sober moderate Person is capable of
Labour, I may say, even of excessive Labour of
some Kinds; of which greater Eaters are absolutely
incapable. Sobriety of itself cures such
Maladies as are otherwise incurable, and may
recover the most shattered and unhealthy Persons.
Chapter XXXIII.
Of Mountebanks, Quacks, and Conjurers.
Sect. 562.
ne dreadful Scourge still remains to be
treated of, which occasions a greater
Mortality, than all the Distempers I
have hitherto described; and which, as
long as it continues, will defeat our utmost
Precautions to preserve the Healths and Lives of the
common People. This, or rather, these Scourges,
for they are very numerous, are Quacks; of which
there are two Species: The Mountebanks or
travelling Quacks, and those pretended Physicians
in Villages and Country-Places, both male
and female, known in Swisserland by the Name
of Conjurers, and who very effectually unpeople
it.
The first of these, the Mountebanks, without
visiting the Sick, or thinking of their Distempers,
sell different Medicines, some of which
are for external Use, and these often do little
or no Mischief; but their internal ones are
much oftener pernicious. I have been a Witness
of their dreadful Effects, and we are not visited
by one of these wandering Caitiffs, whose Admission
into our Country is not mortally fatal to
some of its Inhabitants. They are injurious also
in another Respect, as they carry off great Sums
of Money with them, and levy annually some
thousands of Livres, amongst that Order of the
People, who have the least to spare. I have seen,
and with a very painful Concern, the poor Labourer
and the Artisan, who have scarcely possessed
the common Necessaries of Life, borrow
wherewithal to purchase, and at a dear Price,
the Poison that was to compleat their Misery, by
increasing their Maladies; and which, where
they escaped with their Lives, has left them in
such a languid and inactive State, as has reduced
their whole Family to Beggary.
§ 563. An ignorant, knavish, lying and impudent
Fellow will always seduce the gross and
credulous Mass of People, incapable to judge of
and estimate any thing rightly; and adapted to
be the eternal Dupes of such, as are base enough
to endeavour to dazzle their weak Understandings;
by which Method these vile Quacks will certainly
defraud them, as long as they are tolerated. But
ought not the Magistrates, the Guardians, the
Protectors, the political Fathers of the People interpose,
and defend them from this Danger, by
severely prohibiting the Entrance of such pernicious
Fellows into a Country, where Mens'
Lives are very estimable, and where Money is
scarce; since they extinguish the first, and carry
off the last, without the least Possibility of their
being in anywise useful to it. Can such forcible
Motives as these suffer our Magistrates to delay
their Expulsion any longer, whom there never
was the least Reason for admitting?
§ 564. It is acknowledged the Conjurers, the
residing Conjurers, do not carry out the current
Money of the Country, like the itinerant Quacks;
but the Havock they make among their Fellow
Subjects is without Intermission, whence it must
be very great, as every Day in the Year is marked
with many of their Victims. Without the
least Knowledge or Experience, and offensively
armed with three or four Medicines, whose Nature
they are as thoroughly ignorant of, as of
their unhappy Patients Diseases; and which Medicines,
being almost all violent ones, are very
certainly so many Swords in the Hands of raging
Madmen. Thus armed and qualified, I say,
they aggravate the slightest Disorders, and make
those that are a little more considerable, mortal;
but from which the Patients would have recovered,
if left solely to the Conduct of Nature;
and, for a still stronger Reason, if they had confided
to the Guidance of her experienced Observers
and Assistants.
§ 565. The Robber who assassinates on the
High-way, leaves the Traveller the Resource of
defending himself, and the Chance of being aided
by the Arrival of other Travellers: But the
Poisoner, who forces himself into the Confidence
of a sick Person, is a hundred times more dangerous,
and as just an Object of Punishment.
The Bands of Highwaymen, and their Individuals,
that enter into any Country or District,
are described as particularly as possible to the
Publick. It were equally to be wished, we had
also a List of these physical Impostors and Ignorants
male and female; and that a most exact
Description of them, with the Number, and a
brief Summary of their murderous Exploits,
were faithfully published. By this Means the
Populace might probably be inspired with such a
wholesome Dread of them, that they would no
longer expose their Lives to the Mercy of such
Executioners.
§ 566. But their Blindness, with Respect to
these two Sorts of maleficent Beings, is inconceivable.
That indeed in Favour of the Mountebank
is somewhat less gross, because as they are
not personally acquainted with him, they may
the more easily credit him with some Part of
the Talents and the Knowledge he arrogates. I
shall therefore inform them, and it cannot be repeated
too often, that whatever ostentatious Dress
and Figure some of these Impostors make, they
are constantly vile Wretches, who, incapable of
earning a Livelyhood in any honest Way, have
laid the Foundation of their Subsistence on their
own amazing Stock of Impudence, and that of
the weak Credulity of the People; that they have
no scientific Knowledge; that their Titles and
Patents are so many Impositions, and inauthentic;
since by a shameful Abuse, such Patents and
Titles are become Articles of Commerce, which
are to be obtained at very low Prices; just like the
second-hand laced Cloaks which they purchase
at the Brokers. That their Certificates of Cures
are so many Chimeras or Forgeries; and that in
short, if among the prodigious Multitudes of
People who take their Medicines, some of them
should recover, which it is almost physically impossible
must not sometimes be the Case, yet it
would not be the less certain, that they are a pernicious
destructive Set of Men. A Thrust of a
Rapier into the Breast has saved a Man's Life by
seasonably opening an Imposthume in it, which
might otherwise have killed him: and yet internal
penetrating Wounds, with a small Sword,
are not the less mortal for one such extraordinary
Consequence. Nor is it even surprizing that
these Mountebanks, which is equally applicable
to Conjurers, who kill thousands of People,
whom Nature alone, or assisted by a Physician,
would have saved, should now and then cure a
Patient, who had been treated before by the
ablest Physicians. Frequently Patients of that
Class, who apply to these Mountebanks and
Conjurers (whether it has been, that they would
not submit to the Treatment proper for their
Distempers; or whether the real Physician tired
of the intractable Creatures has discontinued his
Advice and Attendance) look out for such Doctors,
as assure them of a speedy Cure, and venture
to give them such Medicines as kill many, and
cure one (who has had Constitution enough to
overcome them) a little sooner than a justly reputable
Physician would have done. It is but
too easy to procure, in every Parish, such Lists
of their Patients, and of their Feats, as would
clearly evince the Truth of whatever has been
said here relating to them.
§ 567. The Credit of this Market, this Fair-hunting
Doctor, surrounded by five or six hundred
Peasants, staring and gaping at him, and
counting themselves happy in his condescending
to cheat them of their very scarce and necessary
Cash, by selling them, for twenty times more
than its real Worth, a Medicine whose best Quality
were to be only a useless one; the Credit,
I say, of this vile yet tolerated Cheat, would
quickly vanish, could each of his Auditors be
persuaded, of what is strictly true, that except a
little more Tenderness and Agility of Hand, he
knows full as much as his Doctor; and that if
he could assume as much Impudence, he would
immediately have as much Ability, would equally
deserve the same Reputation, and to have the
same Confidence reposed in him.
§ 568. Were the Populace capable of reasoning,
it were easy to disabuse them in these Respects;
but as it is, their Guardians and Conductors
should reason for them. I have already proved
the Absurdity of reposing any Confidence in
Mountebanks, properly so called; and that Reliance
some have on the Conjurers is still more
stupid and ridiculous.
The very meanest Trade requires some Instruction:
A Man does not commence even a
Cobler, a Botcher of old Leather, without serving
an Apprenticeship to it; and yet no Time
has been served, no Instruction has been attended
to, by these Pretenders to the most necessary,
useful and elegant Profession. We do not confide
the mending, the cleaning of a Watch to
any, who have not spent several Years in considering
how a Watch is made; what are the
Requisites and Causes of its going right; and the
Defects or Impediments that make it go wrong:
and yet the preserving and rectifying the Movements
of the most complex, the most delicate
and exquisite, and the most estimable Machine
upon Earth, is entrusted to People who have not
the least Notion of its Structure; of the Causes
of its Motions; nor of the Instruments proper to
rectify their Deviations.
Let a Soldier discarded from his Regiment for
his roguish Tricks, or who is a Deserter from it,
a Bankrupt, a disreputable Ecclesiastic, a drunken
Barber, or a Multitude of such other worthless
People, advertize that they mount, set and fit
up all Kinds of Jewels and Trinkets in Perfection;
if any of these are not known; if no Person in
the Place has ever seen any of their Work; or if
they cannot produce authentic Testimonials of
their Honesty, and their Ability in their Business,
not a single Individual will trust them with two
Pennyworth of false Stones to work upon; in
short they must be famished. But if instead of
professing themselves Jewellers, they post themselves
up as Physicians, the Croud purchase, at a
high Rate, the Pleasure of trusting them with
the Care of their Lives, the remaining Part of
which they rarely fail to empoison.
§ 569. The most genuine and excellent Physicians,
these extraordinary Men, who, born
with the happiest Talents, have began to inform
their Understandings from their earliest Youth;
who have afterwards carefully qualified themselves
by cultivating every Branch of Physic;
who have sacrificed the best and most pleasurable
Days of their Lives, to a regular and assiduous
Investigation of the human Body; of its various
Functions; of the Causes that may impair
or embarrass them, and informed themselves of
the Qualities and Virtues of every simple and
compound Medicine; who have surmounted
the Difficulty and Loathsomness of living in
Hospitals among thousands of Patients; and who
have added the medical Observations of all Ages
and Places to their own; these few and extraordinary
Men, I say, still consider themselves as
short of that perfect Ability and consummate
Knowledge, which they contemplate and wish
for, as necessary to guarding the precious Depositum
of human Life and Health, confided to
their Charge. Nevertheless we see the same inestimable
Treasures, intrusted to gross and stupid
Men, born without Talents; brought up without
Education or Culture; who frequently can
scarcely read; who are as profoundly ignorant of
every Subject that has any Relation to Physic, as
the Savages of Asia; who awake only to drink
away; who often exercise their horrid Trade merely
to find themselves in strong Liquor, and execute
it chiefly when they are drunk: who, in short,
became Physicians, only from their Incapacity to
arrive at any Trade or Attainment! Certainly
such a Conduct in Creatures of the human Species
must appear very astonishing, and even melancholy,
to every sensible thinking Man; and
constitute the highest Degree of Absurdity and
Extravagance.
Should any Person duly qualified enter into
an Examination of the Medicines they use, and
compare them with the Situation and Symptoms
of the Patients to whom they give them, he must
be struck with Horror; and heartily deplore the
Fate of that unfortunate Part of the human Race,
whose Lives, so important to the Community,
are committed to the Charge of the most murderous
Set of Beings.
§ 570. Some of these Caitiffs however, apprehending
the Force and Danger of that Objection,
founded on their Want of Study and
Education, have endeavoured to elude it, by infusing
and spreading a false, and indeed, an impudent
impious Prejudice among the People,
which prevails too much at present; and this is,
that their Talents for Physic are a supernatural
Gift, and, of Course, greatly superior to all
human Knowledge. It were going out of my
Province to expatiate on the Indecency, the Sin,
and the Irreligion of such Knavery, and incroaching
upon the Rights and perhaps the Duty
of the Clergy; but I intreat the Liberty of
observing to this respectable Order of Men, that
this Superstition, which is attended with dreadful
Consequences, seems to call for their utmost
Attention: and in general the Expulsion of Superstition
is the more to be wished, as a Mind,
imbued with false Prejudices, is less adapted to
imbibe a true and valuable Doctrine. There are
some very callous hardened Villains among this
murdering Band, who, with a View to establish
their Influence and Revenue as well upon Fear
as upon Hope, have horridly ventured so far as
to incline the Populace to doubt, whether they
received their boasted Gift and Power from Heaven
or from Hell! And yet these are the Men
who are trusted with the Health and the Lives
of many others.
§ 571. One Fact which I have already mentioned,
and which it seems impossible to account
for is, that great Earnestness of the Peasant
to procure the best Assistance he can for his
sick Cattle. At whatever Distance the Farrier
lives, or some Person who is supposed qualified
to be one (for unfortunately there is not one in
Swisserland) if he has considerable Reputation in
this Way, the Country-man goes to consult him,
or purchases his Visit at any Price. However expensive
the Medicines are, which the Horse-doctor
directs, if they are accounted the best, he
procures them for his poor Beast. But if himself,
his Wife or Children fall sick, he either
calls in no Assistance nor Medicines; or contents
himself with such as are next at Hand, however
pernicious they may be, though nothing the
cheaper on that account: for certainly the Money,
extorted by some of these physical Conjurers
from their Patients, but oftner from their
Heirs, is a very shameful Injustice, and calls
loudly for Reformation.
§ 572. In an excellent Memoir or Tract,
which will shortly be published, on the Population
of Swisserland, we shall find an important
and very affecting Remark, which strictly demonstrates
the Havock made by these immedical
Magicians or Conjurers; and which is this: That
in the common Course of Years, the Proportion
between the Numbers and Deaths of the Inhabitants
of any one Place, is not extremely different
in City and Country: but when the very same
epidemical Disease attacks the City and the Villages,
the Difference is enormous; and the
Number of Deaths of the former compared with
that of the Inhabitants of the Villages, where
the Conjurer exercises his bloody Dominion, is
infinitely more than the Deaths in the City.
I find in the second Volume of the Memoirs
of the oeconomical Society of Berne, for the
Year 1762, another Fact equally interesting,
which is related by one of the most intelligent
and sagacious Observers, concerned in that Work.
“Pleurisies and Peripneumonies (he says) prevailed
at Cottens a la Côte; and some Peasants
died under them, who had consulted the Conjurers
and taken their heating Medicines; while
of those, who pursued a directly opposite Method,
almost every one recovered.”
§ 573. But I shall employ myself no longer
on this Topic, on which the Love of my Species
alone has prompted me to say thus much;
though it deserves to be considered more in Detail,
and is, in Reality, of the greatest Consequence.
None methinks could make themselves
easy with Respect to it so much as Physicians,
if they were conducted only by lucrative Views;
since these Conjurers diminish the Number of
those poor People, who sometimes consult the
real Physicians, and with some Care and Trouble,
but without the least Profit, to those Gentlemen.
But what good Physician is mean and
vile enough to purchase a few Hours of Ease and
Tranquillity at so high, so very odious a Price?
§ 574. Having thus clearly shewn the Evils
attending this crying Nusance, I wish I were
able to prescribe an effectual Remedy against it,
which I acknowledge is far from being easy to
do.
The first necessary Point probably was to have
demonstrated the great and public Danger, and
to dispose the State to employ their Attention on
this fatal, this mortal Abuse; which, joined to
the other Causes of Depopulation, has a manifest
Tendency to render Swisserland a Desert.
§ 575. The second, and doubtless the most
effectual Means, which I had already mentioned
is, not to admit any travelling Mountebank to
enter this Country; and to set a Mark on all the
Conjurers: It may probably also be found convenient,
to inflict corporal Punishment on them;
as it has been already adjudged in different Countries
by sovereign Edicts. At the very least they
should be marked with public Infamy, according
to the following Custom practised in a great
City in France. “When any Mountebanks
appeared in Montpellier, the Magistrates had a
Power to mount each of them upon a meagre
miserable ***, with his Head to the ***'s Tail.
In this Condition they were led throughout the
whole City, attended with the Shouts and Hooting
of the Children and the Mob, beating them,
throwing Filth and Ordure at them, reviling
them, and dragging them all about.”
§ 576. A third conducive Means would be
the Instructions and Admonition of the Clergy
on this Subject, to the Peasants in their several
Parishes. For this Conduct of the common
People amounting, in Effect, to Suicide, to
Self-***, it must be important to convince
them of it. But the little Efficacy of the strongest
and repeated Exhortations on so many other Articles,
may cause us to entertain a very reasonable
Doubt of their Success on this. Custom seems
to have determined, that there is nothing in our
Day, which excludes a Person from the Title
and Appellation of an honest or honourable Man,
except it be meer and convicted Theft; and
that for this simple and obvious Reason, that we
attach ourselves more strongly to our Property,
than to any Thing else. Even Homicide is
esteemed and reputed honourable in many Cases.
Can we reasonably then expect to convince the
Multitude, that it is criminal to confide the Care
of their Health to these Poisoners, in Hopes of a
Cure of their Disorders? A much likelier Method
of succeding on this Point would certainly
be, to convince the deluded People, that it will
cost them less to be honestly and judiciously
treated, than to suffer under the Hands of these
Executioners. The Expectation of a good and
cheap Health-market will be apt to influence
them more, than their Dread of a Crime would.
§ 577. A fourth Means of removing or restraining
this Nusance would be to expunge,
from the Almanacs, all the astrological Rules
relating to Physick; as they continually conduce
to preserve and increase some dangerous Prejudices
and Notions in a Science, the smallest Errors
in which are sometimes fatal. I had already
reflected on the Multitude of Peasants that
have been lost, from postponing, or mistiming a
Bleeding, only because the sovereign Decision of
an Almanac had directed it at some other Time.
May it not also be dreaded, to mention it by the
Way, that the same Cause, the Almanacs, may
prove injurious to their rural Oeconomy and Management;
and that by advising with the Moon,
who has no Influence, and is of no Consequence
in Vegetation or other Country Business, they
may be wanting in a due Attention to such other
Circumstances and Regulations, as are of real
Importance in them?
§ 578. A fifth concurring Remedy against
this popular Evil would be the Establishment of
Hospitals, for the Reception of poor Patients, in
the different Cities and Towns of Swisserland.
There may be a great many easy and concurring
Means of erecting and endowing such, with
very little new Expence; and immense Advantages
might result from them: besides, however
considerable the Expenses might prove, is not
the Object of them of the most interesting, the
most important Nature? It is incontestably our
serious Duty; and it would soon be manifest,
that the Performance of it would be attended
with more essential intrinsic Benefit to the
Community, than any other Application of Money
could produce. We must either admit, that
the Multitude, the Body of the People is useless
to the State, or agree, that Care should be taken
to preserve and continue them. A very respectable
English Man, who, after a previous and
thorough Consideration of this Subject, had applied
himself very assiduously and usefully on the
Means of increasing the Riches and the Happiness
of his Country-men, complains that in England,
the very Country in which there are the
most Hospitals, the Poor who are sick are not
sufficiently assisted. What a deplorable Deficience
of the necessary Assistance for such must
then be in a Country, that is not provided with
a single Hospital? That Aid from Surgery and
Physic, which abounds in Cities, is not sufficiently
diffused into Country-places: and the Peasants
are liable to some simple and moderate
Diseases, which, for Want of proper Care, degenerate
into a State of Infirmity, that sinks
them into premature Death.
§ 579. In fine, if it be found impossible to
extinguish these Abuses (for those arising from
Quacks are not the only ones, nor is that Title
applied to as many as really deserve it) beyond all
Doubt it would be for the Benefit and Safety of
the Public, upon the whole, entirely to prohibit
the Art, the Practice of Physic itself. When
real and good Physicians cannot effect as much
Good, as ignorant ones and Impostors can do
Mischief, some real Advantage must accrue to
the State, and to the whole Species, from
employing none of either. I affirm it, after much
Reflection, and from thorough Conviction, that
Anarchy in Medicine is the most dangerous
Anarchy. For this Profession, when loosed
from every Restraint, and subjected to no Regulations,
no Laws, is the more cruel Scourge and
Affliction, from the incessant Exercise of it; and
should its Anarchy, its Disorders prove irremediable,
the Practice of an Art, become so very noxious,
should be prohibited under the severest Penalties:
Or, if the Constitution of any Government was
inconsistent with the Application of so violent a
Remedy, they should order public Prayers against
the Mortality of it, to be offered up in all the
Churches; as the Custom has been in other great
and general Calamities.
§ 580. Another Abuse, less fatal indeed than
those already mentioned (but which, however,
has real ill Consequences, and at the best, carries
out a great deal of Money from us, though
less at the Expense of the common People, than
of those of easy Circumstances) is that Blindness
and Facility, with which many suffer themselves
to be imposed upon, by the pompous Advertisements
of some Catholicon, some universal Remedy,
which they purchase at a high Rate, from
some foreign Pretender to a mighty Secret or
Nostrum. Persons of a Class or two above the
Populace do not care to run after a Mountebank,
from supposing they should depretiate themselves
by mixing with the Herd. Yet if that very
Quack, instead of coming among us, were to
reside in some foreign City; if, instead of posting
up his lying Puffs and Pretentions at the Corners
of the Streets, he would get them inserted
in the Gazettes, and News-papers; if, instead of
selling his boasted Remedies in Person, he should
establish Shops or Offices for that Purpose in every
City; and finally, if instead of selling them
twenty times above their real Value, he would
still double that Price; instead of having the
common People for his Customers, he would
take in the wealthy Citizen, Persons of all
Ranks, and from almost every Country. For
strange as it seems, it is certain, that a Person of
such a Condition, who is sensible in every other
Respect; and who will scruple to confide his
Health to the Conduct of such Physicians as
would be the justest Subjects of his Confidence,
will venture to take, through a very unaccountable
Infatuation, the most dangerous Medicine,
upon the Credit of an imposing Advertisement,
published by as worthless and ignorant a Fellow
as the Mountebank whom he despises, because
the latter blows a Horn under his Window; and
yet who differs from the former in no other Respects
except those I have just pointed out.
§ 581. Scarcely a Year passes, without one
or another such advertized and vaunted Medicine's
getting into high Credit; the Ravages of which
are more or less, in Proportion to its being more
or less in Vogue. Fortunately, for the human
Species, but few of these Nostrums have attained
an equal Reputation with Ailbaud's Powders, an
Inhabitant of Aix in Provence, and unworthy the
Name of a Physician; who has over-run Europe
for some Years, with a violent Purge, the Remembrance
of which will not be effaced before
the Extinction of all its Victims. I attend now,
and for a long time past, several Patients, whose
Disorders I palliate without Hopes of ever curing
them; and who owe their present melancholy
State of Body to nothing but the manifest Consequences
of these Powders; and I have actually
seen, very lately, two Persons who have been
cruelly poisoned by this boasted Remedy of his.
A French Physician, as eminent for his Talents
and his Science, as estimable from his personal
Character in other Respects, has published some
of the unhappy and tragical Consequences which
the Use of them has occasioned; and were a
Collection published of the same Events from
them, in every Place where they have been introduced,
the Size and the Contents of the Volume
would make a very terrible one.
§ 582. It is some Comfort however, that all
the other Medicines thus puffed and vended have
not been altogether so fashionable, nor yet quite
so dangerous: but all posted and advertized
Medicines should be judged of upon this Principle
(and I do not know a more infallible one in
Physics, nor in the Practice of Physic), that
whoever advertises any Medicine, as a universal
Remedy for all Diseases, is an absolute Impostor,
such a Remedy being impossible and contradictory.
I shall not here offer to detail such Proofs
as may be given of the Verity of this Proposition:
but I freely appeal for it to every sensible Man,
who will reflect a little on the different Causes of
Diseases; on the Opposition of these Causes;
and on the Absurdity of attempting to oppose
such various Diseases, and their Causes, by one
and the same Remedy.
As many as shall settle their Judgments properly
on this Principle, will never be imposed
upon by the superficial Gloss of these Sophisms
contrived to prove, that all Diseases proceed
from one Cause; and that this Cause is so very
tractable, as to yield to one boasted Remedy.
They will perceive at once, that such an Assertion
must be founded in the utmost Knavery or Ignorance;
and they will readily discover where the
Fallacy lies. Can any one expect to cure a
Dropsy, which arises from too great a Laxity of
the Fibres, and too great an Attenuation or
Thinness of the Blood, by the same Medicines
that are used to cure an inflammatory Disease, in
which the Fibres are too stiff and tense, and the
Blood too thick and dense? Yet consult the
News-papers and the Posts, and you will see
published in and on all of them, Virtues just as
contradictory; and certainly the Authors of such
poisonous Contradictions ought to be legally
punished for them.
§ 583. I heartily wish the Publick would attend
here to a very natural and obvious Reflection.
I have treated in this Book, but of a small
Number of Diseases, most of them acute ones;
and I am positive that no competent well qualified
Physician has ever employed fewer Medicines,
in the Treatment of the Diseases themselves.
Nevertheless I have prescribed seventy-one, and
I do not see which of them I could retrench, or
dispense with the Want of, if I were obliged to
use one less. Can it be supposed then, that any
one single Medicine, compound or simple, shall
cure thirty times as many Diseases as those I have
treated of?
§ 584. I shall add another very important Observation,
which doubtless may have occurred to
many of my Readers; and it is this, that the different
Causes of Diseases, their different Characters;
the Differences which arise from the necessary
Alterations that happen throughout their Progress
and Duration; the Complications of which they
are susceptible; the Varieties which result from
the State of different Epidemics, of Seasons, of
Sexes, and of many other Circumstances; that
these Diversities, I say, oblige us very often to
vary and change the Medicines; which proves
how very ticklish and dangerous it is to have
them directed by Persons, who have such an imperfect
Knowledge of them, as those who are
not Physicians must be supposed to have. And
the Circumspection to be used in such Cases
ought to be proportioned to the Interest the
Assistant takes in the Preservation of the Patient;
and that Love of his Neighbour with which he
is animated.
§ 585. Must not the same Arguments and
Reflections unavoidably suggest the Necessity of
an entire Tractability on the Part of the Patient,
and his Friends and Assistants? The History of
Diseases which have their stated Times of Beginning,
of manifesting and displaying themselves;
of arriving at, and continuing in their Height,
and of decreasing; do not all these demonstrate
the Necessity of continuing the same Medicines,
as long as the Character of the Distemper is the
same; and the Danger of changing them often,
only because what has been given has not afforded
immediate Relief? Nothing can injure the
Patient more than this Instability and Caprice.
After the Indication which his Distemper suggests,
appears to be well deduced, the Medicine
must be chosen that is likeliest to resist the
Cause of it; and it must be continued as long as
no new Symptom or Circumstance supervenes,
which requires an Alteration of it; except it
should be evident, that an Error had been incurred
in giving it. But to conclude that a Medicine
is useless or insignificant, because it does not remove
or abate the Distemper as speedily, as the
Impatience of the Sick would naturally desire it;
and to change it for another, is as unreasonable,
as it would be for a Man to break his Watch,
because the Hand takes twelve Hours, to make
a Revolution round the Dial-plate.
§ 586. Physicians have some Regard to the
State of the Urine of sick Persons, especially in
inflammatory Fevers; as the Alterations occurring
in it help them to judge of the Changes that
may have been made in the Character and Consistence
of the Humours in the Mass of Blood;
and thence may conduce to determine the Time,
in which it will be proper to dispose them to
some Evacuation. But it is gross Ignorance to
imagine, and utter Knavery and Imposture to
persuade the Sick, that the meer Inspection of
their Urine solely, sufficiently enables others to
judge of the Symptoms and Cause of the Disease,
and to direct the best Remedies for it.
This Inspection of the Urine can only be of Use
when it is duly inspected; when we consider at
the same time the exact State and the very
Looks of the Patient; when these are compared
with the Degree of the Symptoms of the Malady;
with the other Evacuations; and when the Physician
is strictly informed of all external Circumstances,
which may be considered as foreign to
the Malady; which may alter or affect the Evacuations,
such as particular Articles of Food,
particular Drinks, different Medicines, or the
very Quantity of Drink. Where a Person is not
furnished with an exact Account of these Circumstances,
the meer Inspection of the Urine is
of no Service, it suggests no Indication, nor any
Expedient; and meer common Sense sufficiently
proves, and it may be boldly affirmed, that whoever
orders any Medicine, without any other
Knowledge of the Disease, than what an Inspection
of the Urine affords, is a rank Knave,
and the Patient who takes them is a Dupe.
§ 587. And here now any Reader may very
naturally ask, whence can such a ridiculous Credulity
proceed, upon a Subject so essentially interesting
to us as our own Health?
In Answer to this it should be observed, that
some Sources, some Causes of it seem appropriated
merely to the People, the Multitude. The
first of these is, the mechanical Impression of
Parade and Shew upon the Senses. 2, The
Prejudice they have conceived, as I said before,
of the Conjurers curing by a supernatural Gift.
3, The Notion the Country People entertain,
that their Distemper and Disorders are of a Character
and Species peculiar to themselves, and
that the Physicians, attending the Rich, know
nothing concerning them. 4, The general Mistake
that their employing the Conjurer is much
cheaper. 5, Perhaps a sheepish shame-faced
Timidity may be one Motive, at least with some
of them. 6, A Kind of Fear too, that Physicians
will consider their Cases with less Care and
Concern, and be likely to treat them more cavalierly;
a Fear which increases that Confidence
which the Peasant, and which indeed every
Man has in his Equal, being sounded in Equality
itself. And 7, the Discourse and Conversation
of such illiterate Empirics being more to
their Tast, and more adapted to their Apprehension.
But it is less easy to account for this blind
Confidence, which Persons of a superior Class
(whole Education being considered as much better
are regarded as better Reasoners) repose in
these boasted Remedies; and even for some Conjurer
in Vogue. Nevertheless even some of their
Motives may be probably assigned.
The first is that great Principle of Seïty, or
Selfness, as it may be called, innate to Man,
which attaching him to the Prolongation of his
own Existence more than to any other thing in
the Universe, keeps his Eyes, his utmost Attention,
continually fixed upon this Object; and
compels him to make it the very Point, the Purpose
of all his Advances and Proceedings; notwithstanding
it does not permit him to distinguish
the safest Paths to it from the dangerous ones.
This is the surest and shortest Way says some
Collector at the Turnpike, he pays, passes, and
perishes from the Precipices that occur in his
Route.
This very Principle is the Source of another
Error, which consists in reposing, involuntarily,
a greater Degree of Confidence in those, who flatter
and fall in the most with us in our favourite
Opinions. The well apprised Physician, who
foresees the Length and the Danger of a Disease;
and who is a Man of too much Integrity to
affirm what he does not think, must, from a
necessary Construction of the human Frame and
Mind, be listened to less favourably, than he who
flatters us by saying what we wish. We endeavour
to elongate, to absent ourselves, from the
Sentiments, the Judgment of the first; we smile,
from Self-complacency, at those of the last,
which in a very little time are sure of obtaining
our Preference.
A third Cause, which results from the same
Principle is, that we give ourselves up the most
readily to his Conduct, whose Method seems the
least disagreeable, and flatters our Inclinations
the most. The Physician who enjoins a strict
Regimen; who insists upon some Restraints and
Self-denials; who intimates the Necessity of
Time and Patience for the Accomplishment of
the Cure, and who expects a thorough Regularity
through the Course of it, disgusts a Patient
who has been accustomed to indulge his own
Tast and Humour; the Quack, who never hesitates
at complying with it, charms him. The
Idea of a long and somewhat distant Cure, to be
obtained at the End of an unpleasant and unrelaxing
Regimen, supposes a very perilous Disease;
this Idea disposes the Patient to Disgust and Melancholy,
he cannot submit to it without Pain;
and he embraces, almost unconsciously, merely
to avoid this, an opposite System which presents
him only with the Idea of such a Distemper, as
will give Way to a few Doses of Simples.
That Propensity to the New and Marvellous,
which tyrannizes over so large a Proportion of
our Species, and which has advanced so many
absurd Persons and Things into Reputation, is a
fourth and a very powerful Motive. An irksome
Satiety, and a Tiresomeness, as it were,
from the same Objects, is what our Nature is
apt to be very apprehensive of; though we are
incessantly conducted towards it, by a Perception
of some Void, some Emptiness in ourselves, and
even in Society too: But new and extraordinary
Sensations rousing us from this disagreeable State,
more effectually than any Thing else, we unthinkingly
abandon ourselves to them, without
foreseeing their Consequences.
A fifth Cause arises from seven Eighths of
Mankind being managed by, or following, the
other Eighth; and, generally speaking, the
Eighth that is so very forward to manage them,
are the least fit and worthy to do it; whence all
must go amiss, and absurd and embarrassing
Consequences ensue from the Condition of Society.
A Man of excellent Sense frequently sees
only through the Eyes of a Fool, of an intriguing
Fellow, or of a Cheat; in this he judges wrong,
and his Conduct must be so too. A man of real
Merit cannot connect himself with those who are
addicted to caballing; and yet such are the Persons,
who frequently conduct others.
Some other Causes might be annexed to these,
but I shall mention only one of them, which I
have already hinted, and the Truth of which I
am confirmed in from several Years Experience;
which is, that we generally love those who reason
more absurdly than ourselves, better than
those who convince us of our own weak Reasoning.
I hope the Reflexions every Reader will make
on these Causes of our ill Conduct on this important
Head, may contribute to correct or diminish
it; and to destroy those Prejudices whose fatal
Effects we may continually observe.
[N. B. The Multitude of all the Objects of this
excellent Chapter in this Metropolis, and doubtless
throughout England, were strong Inducements to
have taken a little wholesome Notice of the Impostures
of a few of the most pernicious. But on a
second Perusal of this Part of the Original and its
Translation, I thought it impossible (without descending
to personal, nominal Anecdotes about the Vermin)
to add any Thing material upon a Subject, which the
Author has with such Energy exhausted. He even
seems, by some of his Descriptions, to have taken
Cognizance of a few of our most self-dignified itinerant
Empirics; as these Genius's find it necessary
sometimes to treat themselves with a little
Transportation. In reality Dr. Tissot has, in a very
masterly Way, thoroughly dissected and displayed the
whole Genus, every Species of Quacks. And when
he comes to account for that Facility, with which
Persons of very different Principles from them, and
of better Intellects, first listen to, and finally countenance
such Caitiffs, he penetrates into some of the
most latent Weaknesses of the human Mind; even
such as are often Secrets to their Owners. It is difficult,
throughout this Disquisition, not to admire the
Writer; but impossible not to love the Man, the
ardent Philanthropist. His Sentiment that—“A
Man of real Merit cannot connect himself with
those who are addicted to caballing,”—is exquisitely
just, and so liberal, that it never entered into the
Mind of any disingenuous Man, however dignified,
in any Profession. Persons of the simplest Hearts
and purest Reflections must shrink at every Consciousness
of Artifice; and secretly reproach themselves
for each Success, that has redounded to them at the
Expence of Truth.] K.
Chapter XXXIV.
Containing Questions absolutely necessary to be answered
exactly by the Patient, who consults a
Physician.
Sect. 588.
reat Consideration and Experience
are necessary to form a right Judgment
of the State of a Patient, whom
the Physician has not personally seen;
even though he should receive the best Information
it is possible to give him, at a Distance
from the Patient. But this Difficulty is greatly
augmented, or rather changed into an Impossibility,
when his Information is not exact and
sufficient. It has frequently happened to myself,
that after having examined Peasants who came
to get Advice for others, I did not venture to
prescribe, because they were not able to give me
a sufficient Information, in order to my being
certain of the Distemper. To prevent this great
Inconvenience, I subjoin a List of such Questions,
as indispensably require clear and direct Answers.
General Questions.
What is the Patient's Age?
Is he generally a healthy Person?
What is his general Course of Life?
How long has he been sick?
In what Manner did his present Sickness begin,
or appear?
Has he any Fever?
Is his Pulse hard or soft?
Has he still tolerable Strength, or is he weak?
Does he keep his Bed in the Day Time, or
quit it?
Is he in the same Condition throughout the
whole Day?
Is he still, or restless?
Is he hot, or cold?
Has he Pains in the Head, the Throat, the
Breast, the Stomach, the Belly, the Loins, or in
the Limbs, the Extremities of the Body?
Is his Tongue dry? does he complain of
Thirst? of an ill Tast in his Mouth? of Reachings
to vomit, or of an Aversion to Food?
Does he go to stool often or seldom?
What Appearance have his Stools, and what
is their usual quantity?
Does he make much Urine? What Appearance
has his Urine, as to Colour and Contents?
Are they generally much alike, or do they
change often?
Does he sweat?
Does he expectorate, or cough up?
Does he get Sleep?
Does he draw his Breath easily?
What Regimen does he observe in his Sickness?
What Medicines has he taken?
What Effects have they produced?
Has he never had the same Distemper before?
§ 589. The Diseases of Women and Children
are attended with peculiar Circumstances; so
that when Advice is asked for them, Answers
must be given, not only to the preceding Questions,
which relate to sick Persons in general;
but also to the following, which regard these
particularly.
Questions with Respect to Women.
Have they arrived at their monthly Discharges,
and are these regular?
Are they pregnant? Is so, how long since?
Are they in Child-bed?
Has their Delivery been happily accomplished?
Has the Mother cleansed sufficiently?
Has her Milk come in due Time and Quantity?
Does she suckle the Infant herself?
Is she subject to the Whites?
Questions relating to Children.
What is the Child's exact Age?
How many Teeth has he cut?
Does he cut them painfully?
Is he any-wise ricketty, or subject to Knots or
Kernels?
Has he had the Small Pocks?
Does the Child void Worms, upwards or
downwards?
Is his Belly large, swelled, or hard?
Is his Sleep quiet, or otherwise?
§ 590. Besides these general Questions, common
in all the Diseases of the different Sexes and
Ages, the Person consulting must also answer to
those, which have a close and direct Relation to
the Disease, at that very Time affecting the
Sick.
For Example, in the Quinsey, the Condition
of the Throat must be exactly inquired into. In
Diseases of the Breast, an Account must be given
of the Patient's Pains; of his Cough; of the Oppression,
and of his Breathing, and Expectoration.
I shall not enter upon a more particular
Detail; common Sense will sufficiently extend
this Plan or Specimen to other Diseases; and
though these Questions may seem numerous, it
will always be easy to write down their Answers
in as little Room, as the Questions take up here.
It were even to be wished that Persons of every
Rank, who occasionally write for medical Advice
and Directions, would observe such a Plan
or Succession, in the Body of their Letters. By
this Means they would frequently procure the
most satisfactory Answers; and save themselves
the Trouble of writing second Letters, to give a
necessary Explanation of the first.
The Success of Remedies depends, in a very
great Measure, on a very exact Knowledge of
the Disease; and that Knowledge on the precise
Information of it, which is laid before the
Physician.
FINIS.
TABLE
Of the Prescriptions and Medicines, referred to in
the foregoing Treatise: Which, with the Notes
beneath them, are to be read before the taking,
or Application, of any of the said Medicines.
s in Order to ascertain the Doses of
Medicines, I have generally done it by
Pounds, Ounces, Half-Ounces, &c.
&c. and as this Method, especially to
the common People, might prove a little too obscure
and embarrassing, I have specified here the
exact Weight of Water, contained in such Vessels
or liquid Measures, as are most commonly
used in the Country.
The Pound which I mean, throughout all
these Prescriptions, is that consisting of sixteen
Ounces. These Ounces contain eight Drachms,
each Drachm consisting of three Scruples, and
each Scruple of twenty Grains; the medical
Scruple of Paris solely containing twenty-four
Grains.
The liquid Measure, the Pot used at Berne,
being that I always speak of, may be estimated,
without any material Error, to contain three
Pounds and a Quarter, which is equal to three
Pints, and eight common Spoonfuls English
Measure. But the exact Weight of the Water,
contained in the Pot of Berne, being fifty-one
Ounces and a Quarter only, it is strictly equal
but to three Pints and six common Spoonfuls
English. This however is a Difference of no
Importance, in the usual Drinks or Aliments of
the Sick.
The small drinking Glass we talk of, filled so
as not to run over, contains three Ounces and
three Quarters. But filled, as we propose it
should for the Sick, it is to be estimated only at
three Ounces.
The common middle sized Cup, though rather
large than little, contains three Ounces and
a Quarter. But as dealt out to the Sick, it
should not be estimated, at the utmost, above
three Ounces.
The small Glass contains seven common
Spoonfuls; so that a Spoonful is supposed to
contain half an Ounce.
The small Spoon, or Coffee Spoon, when of
its usual Size and Cavity, may contain thirty
Drops, or a few more; but, in the Exhibition
of Medicines, it may be reckoned at thirty Drops.
Five or six of these are deemed equal in Measure,
to a common Soup-Spoon.
The Bason or Porrenger, mentioned in the
present Treatise, holds, without running over,
the Quantity of five Glasses, which is equivalent
to eighteen Ounces and three Quarters. It may
be estimated however, without a Fraction, at
eighteen Ounces: and a sick Person should
never be allowed to take more than a third Part
of this Quantity of Nourishment, at any one
Time.
The Doses in all the following Prescriptions
are adjusted to the Age of an Adult or grown
Man, from the Age of eighteen to that of sixty
Years. From the Age of twelve to eighteen,
two thirds of that Dose will generally be sufficient:
and from twelve down to seven Years one
half, diminishing this still lower, in Proportion
to the greater Youth of the Patient: so that not
more than one eighth of the Dose prescribed
should be given to an infant of some Months old,
or under one Year. But it must also be considered,
that their different Constitutions will make
a considerable Difference in adjusting their different
Doses. It were to be wished, on this Account,
that every Person would carefully observe
whether a strong Dose is necessary to purge him,
or if a small one is sufficient; as Exactness is
most important in adjusting the Doses of such
Medicines, as are intended to purge, or to evacuate
in any other Manner.
Nº. 1.
Take a Pugil or large Pinch between the
Thumb and Fingers of Elder Flowers; put
them into an earthen-ware Mug or Porrenger,
with two Ounces of Honey, and an Ounce and
a half of good Vinegar. Pour upon them three
Pints and one Quarter of boiling Water. Stir it
about a little with a Spoon to mix and dissolve the
Honey; then cover up the Mug; and, when
the Liquor is cold, strain it through a Linen
Cloth.
Nº. 2.
Take two Ounces of whole Barley, cleanse
and wash it well in hot Water, throwing away
this Water afterwards. Then boil it in five
Chopins or English Pints of Water, till the Barley
bursts and opens. Towards the End of the
boiling, throw in one Drachm and a half of
Nitre [Salt Petre] strain it through a Linen
Cloth, and then add to it one Ounce and a half
of Honey, and one Ounce of Vinegar.
Nº. 3.
Take the same Quantity of Barley as before,
and instead of Nitre, boil in it, as soon as the
Barley is put in to boil, a Quarter of an Ounce
of Cream of Tartar. Strain it, and add nothing
else to it.
Nº. 4.
Take three Ounces of the freshest sweet Almonds,
and one Ounce of Gourd or Melon
Seed; bruise them in a Mortar, adding to them
by a little at a time, one Pint of Water, then
strain it through Linen. Bruise what remains
again, adding gradually to it another Pint of
Water, then straining; and adding Water to the
Residue, till full three Pints at least of Water
are thus used: after which it may again be
poured upon the bruised Mass, stirred well
about, and then be finally strained off. Half an
Ounce of Sugar may safely be bruised with the
Almonds and Seeds at first, though some weakly
imagine it too heating; and delicate Persons
may be allowed a little Orange Flower Water
with it.
Nº. 5.
Take two Pugils of Mallow Leaves and
Flowers, cut them small, and pour a Pint of
boiling Water upon them. After standing some
time strain it, adding one Ounce of Honey to it.
For Want of Mallows, which is preferable, a
similar Glyster may be made of the Leaves of
Mercury, Pellitory of the Wall, the Marsh-Mallows,
the greater Mallows, from Lettuce,
or from Spinage. A few very particular Consititutions
are not to be purged by any Glyster but
warm Water alone; such should receive no other,
and the Water should not be very hot.
Nº. 6.
Boil a Pugil of Mallow Flowers, in a Pint of
Barley Water for a Glyster.
Nº. 7.
Take three Pints of simple Barley Water, add
to it three Ounces of the Juice of Sow-thistle, or
of Groundsel, or of the greater Houseleek, or of
Borage.
Nº. 8.
To one Ounce of Oxymel of Squills, add
five Ounces of a strong Infusion of Elder
Flowers.
Nº. 9.
There are many different emollient Applications,
which have very nearly the same Virtues.
The following are the most efficacious.
1, Flanels wrung out of a hot Decoction of
Mallow Flowers.
2, Small Bags filled with Mallow Flowers, or
with those of Mullein, of Elder, of Camomile,
of wild Corn Poppy, and boiled either in Milk
or Water.
3, Pultices of the same Flowers boiled in Milk
and Water.
4, Bladders half filled with hot Milk and
Water, or with some emollient Decoction.
5, A Pultice of boiled Bread and Milk, or of
Barley or Rice boiled till thoroughly soft and
tender.
6, In the Pleurisy (See ) the affected Part
may be rubbed sometimes with Ointment of
Marsh-mallows.
Nº. 10.
To one Ounce of Spirit of Sulphur, add six
Ounces of Syrup of Violets, or for want of
the latter, as much Barley Water, of a thicker
Consistence than ordinary.
Nº. 11.
Take two Ounces of Manna, and half an
Ounce of Sedlitz Salt, or for want of it, as
much Epsom Salt; dissolving them in four
Ounces of hot Water, and straining them.
Nº. 12.
Take of Elder Flowers one Pugil, of Hyssop
Leaves half as much. Pour three Pints of boiling
Water upon them. After infusing some
time, strain, and dissolve three Ounces of Honey
in the Infusion.
Nº. 13.
Is only the same Kind of Drink made by
omitting the Hyssop, and adding instead of it as
much more Elder Flowers.
Nº. 14.
Let one Ounce of the best Jesuits Bark in fine
Powder be divided into sixteen equal Portions.
Nº. 15.
Take of the Flowers of St. John's Wort, of
Elder, and of Melilot, of each a few Pinches;
put them into the Bottom of an Ewer or Vessel
containing five or six English Pints, with half an
Ounce of Oil of Turpentine, and fill it up with
boiling Water.
Nº. 16.
Is only the Syrup of the Flowers of the wild
red Corn Poppy.
Nº. 17.
Is only very clear sweet Whey, in every Pint
of which one Ounce of Honey is to be dissolved.
Nº. 18.
Take of Castile or hard white Soap six
Drachms; of Extract of Dandelion one Drachm
and a half; of Gum Ammoniacum half a Drachm,
and with Syrup of Maidenhair make a Mass of
Pills, to be formed into Pills, weighing three
Grains each.
Nº. 19.
Gargarisms may be prepared from a Decoction,
or rather an Infusion, of the Leaves of Periwinkle,
or of Red Rose-Leaves, or of Mallows. Two
Ounces of Vinegar and as much Honey must be
added to every Pint of it, and the Patient should
gargle with it pretty hot. The deterging, cleansing
Gargarisin referred to , is a light Infusion
of the Tops of Sage, adding two Ounces of
Honey to each Pint of it.
Nº. 20.
Is only one Ounce of powdered Nitre, divided
into sixteen equal Doses.
Nº. 21.
Take of Jalap, of Senna, and of Cream of
Tartar of each thirty Grains finely powdered;
and let them be very well mixed.
Nº. 22.
Take of China Root, and of Sarsaparilla of
each one Ounce and a half, of Sassafras Root,
and of the Shavings of Guiacum, otherwise
called Lignum vitæ, of each one Ounce. Let the
whole be cut very fine. Then put them into a
glazed earthen Vessel; pouring upon them about
five pints of boiling Water. Let them boil gently
for an Hour; then take it from the Fire, and
strain it off through Linen. This is called the
Decoction of the Woods, and is often of different
Proportions of these Ingredients, or with the Addition
of a few others. More Water may, after
the first boiling, be poured on the same Ingredients,
and be boiled up into a small Decoction for
common Drink.
Nº. 23.
Take one Ounce of the Pulp of Tamarinds,
half a Drachm of Nitre, and four Ounces of
Water; let them boil not more than one Minute,
then add two Ounces of Manna, and
when dissolved strain the Mixture off.
Nº. 24.
Is only an Ounce of Cream of Tartar, divided
into eight equal Parts.
Nº. 25.
This Prescription is only the Preparation of
Kermes mineral, otherwise called the Chartreusian
Powder. Dr. Tissot orders but one Grain
for a Dose. It has been directed from one to three.
Nº. 26.
Take three Ounces of the common Burdock
Root; boil it for half an Hour, with half a
Drachm of Nitre, in three full Pints of Water.
Nº. 27.
Take half a Pinch of the Herbs prescribed , and half an Ounce of hard white
Soap shaved thin. Pour on these one Pint and a
half of boiling Water, and one Glass of Wine.
Strain the Liquor and squeeze it strongly out.
Nº. 28.
Take of the purest Quicksilver one Ounce;
of Venice Turpentine half a Drachm, of the
freshest Hog's Lard two Ounces, and let the
whole be very well rubbed together into an
Ointment.
Nº. 29.
This Prescription is nothing but the yellow
Basilicon.
Nº. 30.
Take of natural and factitious, or artificial
Cinnabar, twenty-four Grains each; of Musk
sixteen Grains, and let the whole be reduced
into fine Powder, and very well mixed.
Nº. 31.
Take one Drachm of Virginia Snake Root in
Powder; of Camphor and of Assa-foetida ten
Grains each; of *** one Grain, and with a
sufficient Quantity of Conserve, or Rob of Elder,
make a Bolus.
Nº. 32.
Take three Ounces of Tamarinds. Pour on
them one Pint of boiling Water, and after letting
them boil a Minute or two, strain the Liquor
through a Linen Cloth.
Nº. 33.
Take seven Grains of Turbith Mineral; and
make it into a Pill or Bolus with a little Crumb
of Bread.
Nº. 34.
This is nothing but a Prescription of six Grains
of Tartar emetic.
Nº. 35.
Take thirty-five Grains of Ipecacuanna, which,
in the very strongest Constitutions, may be augmented
to forty-five, or even to fifty Grains.
Nº. 36.
Prescribes only the common blistering Plaister;
and the Note observes that very young Infants
who have delicate Skins may have Sinapisms applied
instead of Blisters; and made of a little old
Leaven, kneaded up with a few Drops of sharp
Vinegar.
Nº. 37.
Take of the Tops of Chamaedrys or Ground
Oak, of the lesser Centaury, of Wormwood and
of Camomile, of each one Pugil. Pour on them
three Pints of boiling Water; and suffering them
to infuse until it is cold, strain the Liquor
through a Linen Cloth, pressing it out strongly.
Nº. 38.
Take forty Grains of Rhubarb, and as much
Cream of Tartar in Powder, mixing them well
together.
Nº. 39.
Take three Drachms of Cream of Tartar, and
one Drachm of Ipecacuanna finely powdered.
Rub them well together, and divide them into
six equal Parts.
Nº. 40.
Take of the simple Mixture one Ounce, of
Spirit of Vitriol half an Ounce, and mix them.
The Dose is one or two Tea Spoonfuls in a Cup
of the Patient's common Drink. The simple
Mixture is composed of five Ounces of Treacle
Water camphorated, of three Ounces of Spirit of
Tartar rectified, and one Ounce of Spirit of Vitriol.
If the Patient has an insuperable Aversion
to the Camphor, it must be omitted, though
the Medicine is less efficacious without it. And
if his Thirst is not very considerable, the simple
Mixture may be given alone, without any further
Addition of Spirit of Vitriol.
Nº. 41.
Take half a Drachm of Virginia Snake-root,
ten Grains of Camphor, and make them into a
Bolus with Rob of Elder-Berries. If the Patient's
Stomach cannot bear so large a Dose of Camphor,
he may take it in smaller Doses and oftner,
viz. three Grains, every two Hours. If there
is a violent Looseness, Diascordium must be
substituted instead of the Rob of Elder-berries.
Nº. 42.
Prescribes only the Theriaca pauperum, or poor
Man's Treacle, in the Dose of a Quarter of an
Ounce. The following Composition of it is that
chiefly preferred by our Author. Take equal
Parts of round Birthwort Roots, of Elecampane,
of Myrrh, and of Rob or Conserve of Juniper-berries,
and make them into an Electuary of a
rather thin, than very stiff Consistence, with
Syrup of Orange-peel.
Nº. 43.
The first of the three Medicines referred to in
this Number, is that already directed, .
The second is as follows.
Take equal Parts of the lesser Centaury, of
Wormwood, of Myrrh, all powdered, and of
Conserve of Juniper-berries, making them up
into a pretty thick Consistence with Syrup of
Wormwood. The Dose is a Quarter of an
Ounce; to be taken at the same Intervals as the
Bark.
For the third Composition—Take of the Roots
of Calamus Aromaticus and Elecampane well
bruised, two Ounces; of the Tops of the lesser
Centaury cut small, a Pugil; of Filings of
unrusted Iron two Ounces, of old white Wine,
three Pints. Put them all into a wide necked
Bottle, and set it upon Embers, or on a Stove,
or by the Chimney, that it may be always kept
hot. Let them infuse twenty-four Hours,
shaking them well five or six Times; then let the
Infusion settle, and strain it. The Dose is a
common Cup every four Hours, four Times
daily, and timing it one Hour before Dinner.
Nº. 44.
Take a Quarter of an Ounce of Cream of
Tartar, a Pugil of common Camomile; boil
them in twelve Ounces of Water for half an
Hour, and strain it off.
Nº. 45.
Directs only the common Sal Ammoniac,
from two Scruples to one Drachm for a Dose.
The Note to it adds, that it may be made into a
Bolus with Rob of Elder; and observes, that
those feverish Patients, who have a weak delicate
Stomach, do not well admit of this Salt; no more
than of several others, which affect them with
great Disorder and Anxiety.
Nº. 46.
The Powder. Take one Pugil of Camomile
Flowers, and as much Elder Flowers, bruising
them well; of fine Flour or Starch three Ounces;
of Ceruss and of blue Smalt each half an Ounce.
Rub the whole, and mix them well. This
Powder may be applied immediately to the Part.
The Plaister. Take of the Ointment called
Nutritum, made with the newest sweet Oil, two
Ounces; of white Wax three Quarters of an
Ounce, and one Quarter of an Ounce of blue
Smalt. Melt the Wax, then add the Nutritum
to it, after the Smalt finely powdered has been
exactly incorporated with it; stirring it about
with an Iron Spatula or Rod, till the whole is
well mixed and cold. This is to be smoothly
spread on Linen Cloth.
A Quarter of an Ounce of Smalt may also
be mixed exactly with two Ounces of Butter or
Ointment of Lead, to be used occasionally instead
of the Plaister.
Nº. 47.
Take one Ounce of Sedlitz, or for want of
that, as much Epsom Salt, and two Ounces of
Tamarinds: pour upon them eight Ounces of
boiling Water, stirring them about to dissolve
the Tamarinds. Strain it off; and divide it into
two equal Draughts, to be given at the Interval
of Half an Hour between the first and last.
Nº. 48.
Take of Sydenham's Liquid Laudanum eighty
Drops; of Bawm Water two Ounces and a half.
If the first, or the second, Dose stops or considerably
lessens the Vomiting, this Medicine
should not be further repeated.
Nº. 49.
Dissolve three Ounces of Manna and twenty
Grains of Nitre in twenty Ounces, or six Glasses,
of sweet Whey.
Nº. 50.
To two Ounces of Syrup of Diacodium, or
white Poppy Heads, add an equal Weight of
Elder Flower Water, or, for want of it, of
Spring Water.
Nº. 51.
Directs nothing but a Drachm of Rhubarb in
Powder.
Nº. 52.
Take of Sulphur vivum, or of Flower of
Brimstone, one Ounce; of Sal Ammoniac, one
Drachm; of fresh Hogs Lard, two Ounces;
and mix the whole very well in a Mortar.
Nº. 53.
Take two Drachms of crude Antimony and
as much Nitre, both finely powdered and very
well mixed; dividing the whole into eight equal
Doses.
Nº. 54.
Take of Filings of Iron, not the least rusty,
and of Sugar, each one Ounce; of Aniseeds
Powdered, half an Ounce. After rubbing then
very well together, divide the Powder into twenty-four
equal Portions; one of which is to be
taken three times a Day an Hour before eating.
Nº. 55.
Take of Filings of sound Iron two Ounces; of
Leaves of Rue, and of white ***-hound one
Pugil each; of black Hellebore Root, one
Quarter of an Ounce, and infuse the whole in
three Pints of Wine in the Manner already directed,
. The Dose of this is one small
Cup three times a Day, an Hour before eating.
Nº. 56.
Take two Ounces of Filings of Iron; of Rue
Leaves and Aniseed powdered, each half an
Ounce. Add to them a sufficient Quantity of
Honey to make an Electuary of a good Consistence.
The Dose is a Quarter of an Ounce
three times daily.
Nº. 57.
Take of the Extract of the stinking Hemlock,
with the purple spotted Stalk, one Ounce.
Form it into Pills weighing two Grains each;
adding as much of the Powder of dry Hemlock
Leaves, as the Pills will easily take up. Begin the
Use of this Medicine by giving one Pill Night
and Morning. Some Patients have been so familiarized
to it, as to take at length Half an
Ounce daily.
Nº. 58.
Take of the Roots of Grass and of Succory
well washed, each one Ounce. Boil them a
Quarter of an Hour in a Pint of Water. Then
dissolve in it Half an Ounce of Sedlitz, or of
Epsom Salt, and two Ounces of Manna; and
strain it off to drink one Glass of it from Half
Hour, to Half Hour, till its Effects are sufficient.
It is to be repeated at the Interval of two
or three Days.
Nº. 59.
Is a Cataplasm or Pultice made of Crumb of
Bread, with Camomile Flowers boiled in Milk,
with the Addition of some Soap, so that each
Pultice may contain half a Quarter of an Ounce
of this last Ingredient. And when the Circumstances
of female Patients have not afforded them
that regular Attendance, which the Repetition
of the Pultice requires, as it should be renewed
every three Hours, I have successfully directed
the Hemlock Plaister of the Shops.
Nº. 60.
Take a sufficient Quantity of dry Hemlock
Leaves. Secure them properly between two
Pieces of thin Linen Cloth, so as to make a very
flexible Sort of small Matrass, letting it boil a
few Moments in Water, then squeeze it out and
apply it to the affected Part. It must thus be
moistened and heated afresh, and re-applied every
two Hours.
Nº. 61.
Take of the Eyes of the Craw-fish, or of the
true white Magnesia, two Drachms; of Cinnamon
powdered four Grains. Rub them very
well together, and divide the whole into eight
Doses. One of these is to be given in a Spoonful
of Milk, or of Water, before the Infant
sucks.
Nº. 62.
Take of an Extract of Walnuts, made in Water,
two Drachms; and dissolve it in half an
Ounce of Cinnamon Water. Fifty Drops a
Day of this Solution is to be given to a Child
of two Years old; and after the whole has been
taken, the Child should be purged. This Extract
is to be made of the unripe Nuts, when
they are of a proper Growth and Consistence for
pickling.
Nº. 63.
Take of Rezin of Jalap two Grains. Rub it
a considerable time with twelve or fifteen Grains
of Sugar, and afterwards with three or four sweet
Almonds; adding, very gradually, two common
Spoonfuls of Water. Then strain it through
clear thin Linen, as the Emulsion of Almonds
was ordered to be. Lastly, add a Tea Spoonful
of Syrup of Capillaire to it. This is no disagreable
Draught, and may be given to a Child of two
Years old: and if they are older, a Grain or two
more of the Rezin may be allowed. But under
two Years old, it is prudent to purge Children
rather with Syrup of Succory, or with Manna.
Nº. 64.
Take of the Ointment called Nutritum one
Ounce; the entire Yolk of one small Egg, or
the Half of a large one, and mix them well
together. This Nutritum may be readily made
by rubbing very well together, and for some
time, two Drachms of Ceruss [white Lead]
half an Ounce of Vinegar, and three Ounces of
common Oil.
Nº. 65.
Melt four Ounces of white Wax; add to it,
if made in Winter two Spoonfuls of Oil; if in
Summer none at all, or at most, not above a
Spoonful. Dip in this Slips of Linen Cloth not
worn too thin, and let them dry: or spread it
thin and evenly over them.
Nº. 66.
Take of Oil of Roses one Pound; of red Lead
half a Pound; of Vinegar four Ounces. Boil them
together nearly to the Consistence of a Plaister;
then dissolve in the liquid Mass an Ounce and a
Half of yellow Wax, and two Drachms of Camphor,
stirring the whole about well. Remove it
then from the Fire, and spread it on Sheets or
Slips of Paper, of what Size you think most
convenient. The Ointment of Chambauderie, so
famous in many Families on the Continent, is
made of a Quarter of a Pound of yellow Wax,
of the Plaister of three Ingredients (very nearly
the same with ) of compound Diachylon
and of common Oil, of each the same Quantity,
all melted together, and then stirred about well,
after it is removed from the Fire, till it grows
cold. To make a Sparadrap, or Oil Cloth,
which is Linen, covered with, or dipt in an
emplastic Substance or Ointment, it must be
melted over again with the Addition of a little
Oil, and applied to the Linen as directed at
Nº. 67.
Gather in Autumn, while the fine Weather
lasts, the Agaric of the Oak, which is a Kind of
Fungus or Excrescence, issuing from the Wood
of that Tree.
It consists at first of four Parts, which present
themselves successively, 1, The outward Rind or
Skin, which may be thrown away. 2, That Part
immediately under this Rind, which is the best
of all. This is to be beat well with a Hammer,
till it becomes soft and very pliable. This is
the only Preparation it requires, and a Slice of
it of a proper Size is to be applied directly over
the bursting, open Blood-vessels. It constringes
and brings them close together; stops the Bleedings;
and generally falls off at the End of two
Days. 3, The third Part, adhering to the second
may serve to stop the Bleeding from the
smaller Vessels; and the fourth and last Part may
be reduced to Powder, as conducing to the same
Purpose.
Nº. 68.
Take four Ounces of Crumbs of Bread, a
Pugil of Elder Flowers, and the same Quantity
of those of Camomile, and of St. John's Wort.
Boil them into a Pultice in equal Quantities of
Vinegar and Water.
If Fomentations should be thought preferable,
take the same Herbs, or some Pugils of the Ingredients
for Faltrank: throw them into a Pint
and a Half of boiling Water: and let them infuse
some Minutes. Then a Pint of Vinegar is
to be added, and Flanels or other woollen Cloths
dipt in the Fomentation, and wrung out, are to
be applied to the Part affected.
For the aromatic Fomentations recommended
, take Leaves of Betony and of Rue,
Flowers of Rosemary or Lavender, and red Roses,
of each a Pugil and a Half. Boil them for a
Quarter of an Hour in a Pot with a Cover, with
three Pints of old white Wine. Then strain off,
squeezing the Liquor strongly from the Herbs,
and apply it as already directed.
Nº. 69.
Directs only the Plaister of Diapalma.
Nº. 70.
Directs only a Mixture of two Parts Water,
and one Part of Vinegar of Litharge.
Nº. 71.
Take of the Leaves of Sow-bread, and of Camomile
Tops, of each one Pugil. Put them into
an earthen Vessel with half an Ounce of Soap,
and as much Sal Ammoniac, and pour upon
them three Pints of boiling Water.
N. B. I conceive all the Notes to this Table, in which I have
not mentioned the Editor at Lyons, nor subscribed with my initial
Letter K, to come from the Author, having omitted nothing
of them, but the Prices.
ERRATA.
Page 4, Line 6, for os read . p. 16, l. 16, for be read . p. 29, l. 12,
after add . p. 49, l. 12, dele at the End of it. p. 51, in the running
Title, for Causss read Causes. ib. l. 2, dele . ib. l. 7, dele . p. 57,
last line, for hurtsul read . p. 67, l. 17, after Water, add, . p. 74, line last but two, after , dele , p. 96, l. 11,
for Aiiment read . p. 106, l. 23, for the second is read . p. 126,
l. 21, for breath read . p. 137, l. 13, for Efflorescene read ,
p. 145, l. 1, for Water read . p. 148, l. 19, for beomes read .
p. 163, l. 30. in the Note, for occured read ; p. 171, l. 20, dele .
p. 189, l. 28, dele . p. 199, l. 6, for Paulmier read , being the
Latinized Name of that Physician; as we say for Fernel Fernelius, Holler Hollerius,
&c. N. B. His Powder for the Bite of a mad Dog consisted of equal Parts of
Rue, Vervain, Plantain, Polypody, common Wormwood, Mugwort, ***
Baum, Betony, St. John's Wort, and lesser Centaury Tops, to which Default
adds Coraline.——p. 237, l. 2, for Streakes read . p. 256, first line
of the Note * dele the first . p. 261, l. 15, for happens read .
p. 270, l. 12, dele t in . p. 282, l. 23, for enters read .
p. 283, l. 23, for Stomach read . p. 284, l. 12, for it read .
p. 287, Note * l. 25, for here read . p. 303, l. 14, for doubtsul read .
p. 311, l. 18, for abate read . p. 337, l. 7, for glary read .
N. B. In the first Page that is folio'd 445 read 345. p. 346, l. 19, for two read
. p. 351, l. 25, after Waters add, p. 375, l. 7,
for two read . p. 392, last line, for Leaves read . p. 393, l. 26,
after them, insert . p. 397, l. 1 and 2, for Temparrament read .
p. 422, l. 6, between several and Consequences insert . p. 454, l. 5, for
Diflocation read . p. 459, l. 17, in dele - p. 466, l. 16,
to add s. p. 486, l. 29, after or add . p. 487, l. 12, for Parts
read . p. 511, l. 12, for not read . p. 533, l. 12, for arrives read
. p. 542, l. 22, for Patient read . p. 562, l. 14, for fays read
. p. 573, l. 10, after , dele Comma.
Table of the several Chapters, and their principal Contents.
——————————————
———————— &————————————
—— —— &———— —— ——
—————————— ,
———— &——————————————————————
———— to———— ,
——————————
———— &————
——
———— &———— & seq.
——
———————— ,
——
————
— ——
— ——
— ——
— ——
— ——
— ——————
——
, to ——
——
——
————
——
— ————————————————
——————
——
— ——
— ——
————
— ——
— ——
— ——
— ——
———— &——
——
——————————
——
————————————
————
— ——
— ——
— ——
&
— ——
— —————— & seq.
——
——
——————————————————————————
————————
——————————————————
—————————— , &c.
——
————
Notes
Of all these the Schoolmasters, with us, may seem the
most reasonably exempted from this Duty.
See the Author's Preface, immediately following this
Dedication.
Le Socrate rustique, a Work, which every Person should
read.
This Preface is indeed premised to this French Edition,
but a Translation of it was omitted, to avoid extending the Bulk
and Price of the Work. Dr. Tissot must then have been ignorant
of this Addition, when first published at Lyons.
The Reasons for omitting the Prices here, may be seen Page
of this Translation.
The Marquis of Mirabeau.
This oeconomical Information was doubtless very proper,
where our judicious and humane Author published it; but notwithstanding
his excellent Motives for giving it, we think it
less necessary here, where many Country Gentlemen furnish
themselves with larger or smaller Medicine Chests, for the Benefit
of their poor sick Neighbours; and in a Country, where
the settled parochial Poor are provided with Medicines, as well
as other Necessaries, at a parochial Expence. Besides, tho' we
would not suppose our Country Apothecaries less considerate or
kind than others, we acknowledge our Apprehension, that in such
Valuation of their Drugs (some of which often vary in their
Price) might dispose a few of them, rather to discountenance
the Extension of a Work, so well intended and executed as
Dr. Tissot's; a Work, which may not be wholly unuseful to
some of the most judicious among them, and will be really necessary
for the rest. K.
This supposes they are not greatly heated, as well as fatigued,
by their Labour or Exercise, in which Circumstance
free and sudden Draughts of cooling Liquors might be very
pernicious: and it evidently also supposes these Drinks to be
thus given, rather in Summer, than in very cold Weather, as
the Juice of the unripe Grapes, and the other fresh Fruits sufficiently
ascertain the Season of the Year. We think the Addition
of Vinegar to their Water will scarcely ever be necessary
in this or the adjoining Island, on such Occasions. The Caution
recommended in this Note is abundantly enforced by Dr.
Tissot, : but considering the Persons, to whom this Work
is more particularly addressed, we were willing to prevent
every Possibility of a Mistake, in so necessary, and sometimes
so vital a Point. K.
This good Advice is enforced in a Note, by the Editor of
Lyons, who observes, it should be still more closely attended to,
in Places, where Rivers, Woods or Mountains retain, as it
were, a considerable Humidity; and where the Evenings are,
in every Season, cold and moist.—It is a very proper Caution
too in our own variable Climate, and in many of our Colonies
in North America. K.
Thus I have ventured to translate Etés (Summers) to apply
it to this and the neighbouring Islands. Their Harvests
in Swisserland perhaps are earlier, and may occur in August, and
that of some particular Grain, probably still earlier. K.
[11](, ) The Abuse just mentioned can scarcely be intended to forbid
the moderate Use of good Pastry, the Dough of which is
well raised and well baked, the Flower and other Ingredients
sound, and the Paste not overcharged with Butter, even though
it were sweet and fresh. But the Abuse of Alum and other
pernicious Materials introduced by our Bakers, may too justly
be considered as one horrible Source of those Diseases of Children,
&c. which our humane and judicious Author mentions
here. What he adds, concerning the Pastries being rendered
still more unwholesome by the sour Fruits sometimes baked in
it, is true with Respect to those Children and others, who are
liable to Complaints from Acidities abounding in the Bowels;
and for all those who are ricketty or scrophulous, from a cold
and viscid State of their Humours. But as to healthy sanguine
Children, who are advanced and lively, and others of a sanguine
or bilious Temperament, we are not to suppose a moderate Variety
of this Food injurious to them; when we consider, that
the Sharpness and Crudity of the Fruit is considerably corrected
by the long Application of Fire; and that they are the Produce
of Summer, when bilious Diseases are most frequent.
This suggests however no bad Hint against making them immoderately
sweet. K.
This Word's occurring in the plural Number will probably
imply, the Swiss make more than one Species of this small
Drink, by pouring Water on the Cake or Remainder of their
other Fruits, after they have been expressed; as our People in
the Cyder, and perhaps in the Perry, Counties, make what
they call Cyderkin, Perkin, &c. It should seem too from this
Section, that the laborious Countrymen in Swisserland drink no
Malt Liquor, though the Ingredients may be supposed to grow
in their Climate. Now Beer, of different Strength, making
the greater Part of our most common Drink, it may be proper
to observe here, that when it is not strong and heady, but a
middling well-brewed Small-beer, neither too new, nor hard
or sour, it is full as wholesome a Drink for laborious People in
Health as any other, and perhaps generally preferable to Water
for such; which may be too thin and light for those who are
unaccustomed to it; and more dangerous too, when the labouring
Man is very hot, as well as thirsty. The holding a
Mouthful of any weak cold Liquor in the Mouth without
swallowing 'till it becomes warm, there, and spurting it out
before a Draught is taken down would be prudent; and in
Case of great Heat, to take the requisite Quantity rather at
two Draughts, with a little Interval between them, than to
swallow the Whole precipitately at one, would be more safe,
and equally refreshing, though perhaps less grateful. K.
The bad Quality of Water is another common Cause of
Country Diseases; either where the Waters are unwholesome,
from the Soils in which they are found, as when they flow
through, or settle, on Banks of Shells; or where they become
such, from the Neighbourhood of, or Drainings from Dunghills
and Marshes.
When Water is unclear and turbid, it is generally sufficient
to let it settle in order to clear itself, by dropping its Sediment.
But if that is not effected, or if it be slimy or muddy,
it need only be poured into a large Vessel, half filled with fine
Sand, or, for want of that, with Chalk; and then to shake
and stir it about heartily for some Minutes. When this Agitation
is over, the Sand, in falling to the Bottom of the Vessel,
will attract some of the Foulness suspended in the Water.
Or, which is still better, and very easy to do, two large Vessels
may be set near together, one of which should be placed
considerably higher than the other. The highest should be half
filled with Sand. Into this the turbid, or slimy muddy Water
is to be poured; whence it will filter itself through the Body of
Sand, and pass off clear by an Opening or Orifice made at the
Bottom of the Vessel; and fall from thence into the lower one,
which serves as a Reservoir. When the Water is impregnated
with Particles from the Beds of Selenites, or of any Spar (which
Water we call hard, because Soap will not easily dissolve in it,
and Puls and other farinaceous Substances grow hard instead of
soft, after boiling in it) such Water should be exposed to the
Sun, or boiled with the Addition of some Puls, or leguminous
Vegetables, or Bread toasted, or untoasted. When Water is
in its putrid State, it may be kept till it recovers its natural
sweet one: but if this cannot be waited for, a little Sea Salt
should be dissolved in it, or some Vinegar may be added, in
which some grateful aromatic Plant has been infused. It frequently
happens, that the publick Wells are corrupted by foul
Mud at the Bottom, and by different Animals which tumble in
and putrify there. Drinking Snow-water should be avoided,
when the Snow is but lately fallen, as it seems to be the Cause
of those swelling wenny Throats in the Inhabitants of some
Mountains; and of endemic Cholics in many Persons. As
Water is so continually used, great Care should be taken to
have what is good. Bad Water, like bad Air, is one of the
most general Causes of Diseases; that which produces the
greater Number of them, the most grieveous ones; and often
introduces such as are epidemical. E. L. i.e. the Editor of Lyons.
Many Persons, With a Design to preserve their Wines,
add Shot to them, or Preparations of Lead, Alum, &c. The
Government should forbid, under the most severe Penalties, all
such Adulterations, as tend to introduce the most painful Cholics,
Obstruction, and a long Train of Evils, which it sometimes
proves difficult to trace to this peculiar Cause; while
they shorten the lives of, or cruelly torment, such over credulous
Purchasers, as lay in a Stock of bad Wines, or drink of
them, without distinction, from every Wine Merchant or
Tavern. E. L.
This Note, from the Editor at Lyons, we have sufficient Reason
for retaining here. K.
This Word, which must be of German, not of French Extraction,
strictly signifies, Drink for a Fall, as we say Pulvis ad
Casum, &c. Powder for a Fall, or a supposed inward Bruise.
Dr. Tissot informs me, it is otherwise called the vulnerary Herbs,
or the Swiss Tea; and that it is an injudicious Farrago or
Medley of Herbs and Flowers, blended with Bitters, with stimulating,
harsh and astringent Ingredients, being employed indiscriminately
in all their Distempers by the Country People in
Swisserland. K.
[16](, ) It is pretty common to hear of Persons recovering from
Inflammations of the Bowels, or Guts, which our Author more
justly and ingenuously considers as general Passports to Death:
for it is difficult to conceive, that a real and considerable Inflammation
of such thin, membranous, irritable Parts, lined
with such putrescent Humours and Contents, and in so hot and
close a Situation, could be restored to a sound and healthy State
so often as Rumour affirms it. This makes it so important a
Point, to avert every Tendency to an Inflammation of these
feculent Parts, as to justify a Bleeding directed, solely, from
this Precaution, and which might have been no otherwise indicated
by a Disease, attended with any Symptom, that threatened
such an Inflammation. But when a Person recovers, there can
be no anatomical Search for such Inflammations, or its Effects,
the real or imaginary Cure of which may well amaze the Patient,
and must greatly redound to the Honour of his Prescriber;
so that there may be Policy sometimes in giving a moderate
Disease a very bad Name. K.
This Direction of our Author's, which may surprize some,
probably arises from his preferring a small Quantity of the marine
Acid to no Acid at all: For though a great Proportion of
Salt, in saving and seasoning Flesh and other Food, generally
excites Thirst, yet a little of it seems to have rather a different
Effect, by gently stimulating the salivary Glands: And we
find that Nature very seldom leaves the great diluting Element
wholly void of this quickening, antiputrescent Principle. K.
The most allowable of these are Whitings, Flounders,
Plaice, Dabbs, or Gudgeons; especially such of the last as are
taken out of clear current Streams with gravelly Bottoms.
Salmon, Eels, Carp, all the Skate kind, Haddock, and the like,
should not be permitted, before the Sick return to their usual
Diet when in Health. K.
We have known many who had an Aversion to Water, and
with whom, on that very Account, it might probably agree less,
find Water very grateful, in which a thoroughly baked and hot,
not burnt, Slice of Bread had been infused, untill it attained the
Colour of fine clear Small-beer, or light Amber coloured Beer,
and we never saw any Inconvenience result from it. Doubtless
pure, untoasted elemental Water may be preferable for those who
like, and have been accustomed to it. K.
We should however, with the greater Circumspection (of
how much the longer standing the Disease has been, and by
how much the more difficult the viscous Humours are to be
melted down and dislodged) attend to the Coction of the Matter
of Expectoration; which Nature does not often easily effect,
and which she effects the more imperfectly and slowly, the
weaker he is. Her last Efforts have often been attended with
such high Paroxysms, as have imposed even upon very competent
Physicians, and have made them open a Vein a few Hours
before the Patients' Death, from their Pulses being strong, hard
and frequent. Excessive Weakness is the Sign, by which we
may discover such unavailing Efforts to be the last. E. L.
The Use of Acids, in Inflammations of the Breast, requires
no little Consideration. Whenever the sick Person has an
Aversion to them; when the Tongue is moist, the Stomach is
heavy and disordered, and the Habit and Temperament of the
Patient is mild and soft; when the Cough is very sharp without
great Thirst, we ought to abstain from them. But when
the Inflammation is joined to a dry Tongue, to great Thirst,
Heat and Fever, they are of great Service. Slices of China
Oranges sprinkled with Sugar may be given first; a light Limonade
may be allowed afterwards; and at last small Doses of
the Mixture, . if it becomes necessary. E. L.—I have
chosen to retain this Note of the Editor of Lyons, from having
frequently seen the Inefficacy, and sometimes, I have even
thought, the ill Effects of Acids in Peripneumonies and Pleurisies,
in a Country far South of Swisserland; and where these
Diseases are very frequent, acute and fatal. On the other hand I
shall add the Substance of what Dr. Tissot says on this Head in
a Note to his Table of Remedies, wherein he affirms, that he
has given in this Disease very large Doses of them, rising gradually
from small ones, and always with great Success; intreating
other Physicians to order this Acid (the Spirit of Sulphur)
in the same large Doses which he directs in this Chapter, and
assuring himself of their thanks, for its good Consequences—Now
the only ill Effect I can surmize here, from shewing this
Diversity of Opinion in these two learned Physicians, and my
own Doubts, is, that the Subjects of this Disease in Country
Places may prove somewhat confused and irresolute by it, in
their Conduct in such Cases. But as all of us certainly concur
in the great Intention of doing all possible Good, by the
extensive Publication of this Treatise, I shall take leave to observe
that in this Disease, and in Pleurisies, more solid Benefit has been
received in Carolina, Virginia, &c. from the Use of the Seneka
Rattle-snake Root, than from any other Medicine whatever.
Bleeding indeed is necessarily premised to it; but it has often
saved the Necessity of many repeated Bleedings. This Medicine,
which is termed in Latin, the Polygala Virginiana, is certainly
rather of a saponaceous attenuating Quality, and betrays not any
Marks of Acidity, being rather moderately acrid. There will
be Occasion to mention it more particularly in the subsequent
Chapter, as such a Liberty can need no Apology to any philosophical
Physician. K.
That is, into the Cavity of the Breast, rather than within
the Substance of the Lungs.
This is, undoubtedly, Baron Van Swieten, with whom he
had premised, he agreed considerably, in all the Diseases they
had both treated of. K.
This, with great Probability, means that small black Substance
often visible in a rotten Egg, which is undoubtedly of a
violent, or even poisonous Quality. Dr. Tissot terms it expressly—la
suie dans un Oeuf. K.
Dr. Lewis, who has not taken Notice of this Species of
Wormwood in his Improvement of Quincy's Dispensatory, has
mentioned it in his late Materia Medica. K.
[26](, ) This being a proper Place for directing the Seneka Rattle
Snake Root, I shall observe, that the best Way of exhibiting it is
in Decoction, by gradually simmering and boiling two Ounces of
it in gross Powder, in two Pints and a half of Water, to a Pint and
a quarter; and then giving three Spoonfuls of it to a grown Person,
every six Hours. If the Stitch should continue, or return,
after taking it, Bleeding, which should be premised to it, must be
occasionally repeated; though it seldom proves necessary, after
a few Doses of it. It greatly promotes Expectoration, keeps the
Body gently open, and sometimes operates by Urine and by
Sweat; very seldom proving at all emetic in Decoction. The
Regimen of Drinks directed here in Pleurisies are to be given as
usual. Dr. Tennant, the Introducer of this valuable Medicine,
confided solely in it, in *** Peripneumonies, without Bleeding,
Blistering, or any other Medicines. K.
The English avail themselves considerably, in this Disease,
of a Mixture of equal Parts of Sallad Oil, and Spirit of Sal Ammoniac;
or of Oil and Spirit of Hartshorn, as a Liniment and
Application round the Neck. This Remedy corresponds with
many Indications; and deserves, perhaps, the first Place amongst
local Applications against the inflammatory Quinsey. E. L.
Dr. Pringle is apprehensive of some ill Effects from Acids
in Gargarisms [which is probably from their supposed repelling Property]
and prefers a Decoction of Figs in Milk and Water, to which
he adds a small Quantity of Spirit of Sal Ammoniac. E. L.
In Diseases of the Throat, which have been preceded by
such Excesses in Food or strong Drink, as occur too often in many
Countries, when the Patient has very strong Reachings to vomit,
and the Tongue is moist at the same Time; we should not hesitate,
after appeasing the first Symptoms of the Inflammation [by
sufficient Bleedings, &c.] to assist the Efforts of Nature, and
to give a small Dose of Tartar emetic, dissolved in some Spoonfuls
of Water. This Remedy in this Case, promotes the Dispersion
of the Inflammation, beyond any other. E. L.
This seems to have been the same kind of Quinsey, of which
Drs. Huxham, Fothergil, Cotton and others wrote, though under different
Appellations. K.
I reserve some other interesting Reflections on this Disease,
for the second Edition of my Treatise on Fevers; and the Editor
at Paris has very well observed, that it has some Relation to the
gangrenous sore Throat, which has been epidemical these twenty
Years past, in many Parts of Europe.——This Note is from Dr.
Tissot himself.
It frequently happens, that the Bathings alone remove the
Head-ach, and the Cough too, by relaxing the lower Parts, and
the entire Surface of the Body. If the Patient is costive, he
should receive Glysters of warm Water, in which some Bran has
been boiled, with the Addition of a little common Soap or Butter.
E. L.
Under these Circumstances of a tickling Cough from a Cold,
without a Fever, and with very little Inflammation, I have known
great and very frequent Success, from a Dose of Elixir paregoricum,
taken at Bed-time, after a very light thin Supper. If the Patient
be sanguine, strong and costive, Bleeding in a suitable Quantity,
and a gently opening Potion, or purging Glyster, may be prudently
premised to it. Grown Persons may take from 30 to 80,
or even 100 Drops of it, in Barley Water, or any other pectoral
Drink; and Children in the Chincough from five to twenty
Drops; half an Ounce of it by Measure containing about one
Grain of ***, which is the Quantity contained in less than
quite six Grains of the Storax Pill; this last being a very available
pectoral *** too in Coughs from a Distillation, in more adult
Bodies, who may also prefer a Medicine in that small Size, and
Form. K.
This seems but too applicable to the very popular Use of
Spermaceti, &c. in such Cases, which can only grease the Passage
to the Stomach; must impair its digestive Faculty, and cannot
operate against the Cause of a Cold; though that Cure of it,
which is effected by the Oeconomy of Nature in due Time, is often
ascribed to such Medicines, as may rather have retarded it. K.
[35](, ) A small Blister behind the Ear of the affected Side, or both
Ears, has very often removed the Pain, when from a Defluxion.
It is pretty common for the Subjects of this Disease to be very
costive, during the Exacerbations of it, which I have sometimes experienced
to be pretty regularly and severely quotidian, for a Week
or two. The Custom of smoking Tobacco very often, which the
Violence of this Pain has sometimes introduced, often disposes
to a Blackened and premature Decay of the Teeth, to which the
Chewers of it are less obnoxious: and this Difference may result
from some particles of its chemical Oil rising by Fumigation,
and being retained in the Teeth, which Particles are not extracted
by Mastication. But with Regard to the habitual Use of this very
acrid and internally violent Herb, for, but chiefly after, this Disease,
it should be considered well, whether in some Constitutions it may
not pave the Way to a more dangerous one, than it was introduced
to remove. K.
I have been very authentically assured of the Death of a
hale Man, which happened in the very Act of pouring out a large
Quantity of distilled Spirits, by Gallons or Bucketfulls, from one
Vessel into another. K.
Vomits which are so pernicious in the sanguineous Apoplexy,
where the Patient's Countenance and Eyes are inflamed; and
which are also dangerous or useless, when a Person has been very
moderate in his Meals, or is weakened by Age or other Circumstances,
and whole Stomach is far from being overloaded with
Aliment, are nevertheless very proper for gross Feeders, who are
accustomed to exceed at Table, who have Indigestions, and have
a Mass of viscid glairy Humours in their Stomachs; more especially,
if such a one has a little while before indulged himself excessively,
whence he has vomited without any other evident Cause,
or at least had very Strong Nauseas, or Loathings. In brief, Vomits
are the true Specific for Apoplexies, occasioned by any narcotic
or stupifying Poisons, the pernicious Effects of which cease, the
Moment the Persons so poisoned vomit them up. An attentive
Consideration of what has occurred to the Patient before his Seizure;
his small natural Propensity to this Disease, and great and
incessant Loathings, render it manifest, whether it has been caused
by such Poisons, or such poisonous Excesses. In these two Last
Cases a double Dose of Tartar emetic should be dissolved in a
Goblet or Cup of Water, of which the Patient should immediately
take a large Spoonful; which should be repeated every Quarter
of an Hour, till it operates. E. L.
These Blisters may be preceded by Cupping with Scarification
on the Nape of the Neck. This Remedy, often used by the
ancient Physicians, but too little practiced in France, is one of
the most speedy, and not the least efficacious, Applications in both
sanguine and serous Apoplexies. E. L.
As some may think an Apology necessary for a Translation of
this Chapter on a Disease, which never, or very seldom, exists in this
or the adjacent Island, I shall observe here, that, abstracted from
the Immorality of a narrow and local Solicitude only for ourselves,
we are politically interested as a Nation always in Trade, and often
at War (and whose Subjects are extended into very distant
and different Climates) to provide against a sudden and acute Distemper,
to which our Armies, our Sailors and Colonies are certainly
often exposed. A Fatality from this Cause is not restrained
to our Islands within the Tropic, where several Instances of it
have occurred during the late War: but it has also been known to
prevail as far Northward as Pensylvania, in their Summers, and
even in their Harvests. I once received a sensible Scald on the
Back of my Thumb, from the Sun suddenly darting out through a
clear Hole, as it were, in a Cloud, after a short and impetuous
Shower in Summer; which Scald manifestly blistered within
some Minutes after. Had this concentrated Ray been darted on
my bare Head, the Consequence might have been more dangerous;
or perhaps as fatal as some of the Cases recorded by Dr.
Tissot, in this Chapter. K.
See Note to Page .
This, according to our Author's Estimation of the Pot-Measure
at Berne, which is that he always means, and which he says
contains exactly (of Water we suppose) fifty one Ounces and a
Quarter (though without a material Error it may be computed
at three Pounds and a Quarter) will amount at least to nine Pounds
and three Quarters of Matter, supposing this no heavier than Water.
By Measure it will want but little of five of our Quarts: a
very extraordinary Discharge indeed of Pus at once, and not unlikely
to be attended by the Event which soon followed. K.
Half a Pint of a pretty strong Infusion of the Leaves of
Buckbean, which grows wild here, taken once a Day rather
before Noon, has also been found very serviceable in that
Species of a chronical Rheumatism, which considerably results
from a scorbutic State of the Constitution. K.
Another very good Purge, in this Kind of Rheumatism,
may also be compounded of the best Gum Guiacum in Powder
from 30 to 40 Grains; dissolved in a little Yolk of a fresh Egg;
adding from 6 to 10 Grains of Jallap powdered, and from 3 to
5 Grains of powdered Ginger, with as much plain or sorrel
Water, as will make a purging Draught for a stronger or weaker
grown Patient. Should the Pains frequently infest the Stomach,
while the Patient continues costive, and there is no
other Fever than such a small symptomatic one, as may arise
solely from Pain, he may safely take, if grown up, from 30 to
45 Drops of the volatile Tincture of Gum Guiacum, in any
diluting Infusion, that may not coagulate or separate the Gum.
It generally disposes at first to a gentle Diaphoresis or Sweat,
and several Hours after to one, and sometimes to a second
Stool, with little or no Griping. K.
Gum Guaiacum, given from six to ten Grains Morning
and Night, is often very successful in these Cases. It may be made
into Pills or Bolusses with the Rob of Elder, or with the Extract
of Juniper. E. L.
This Advice is truly prudent and judicious; Hope, as I have
observed on a different Occasion, being a powerful, though impalpable,
Cordial: and in such perilous Situations, we should excite
the most agreeable Expectations we possibly can in the Patient;
that Nature, being undepressed by any desponding melancholy
ones, may exert her Functions the more firmly, and co-operate
effectually with the Medicines, against her internal Enemy. K.
I knew a brave worthy Gentleman abroad, who above forty
Years past thus preserved his Life, after receiving the Bite of a
large Rattle-Snake, by resolutely cutting it and the Flesh surrounding
it out, with a sharp pointed Penknife.—Perhaps those
who would not suffer the Application of the actual Cautery, that
is, of a red hot Iron (which certainly promises well for a Cure)
might be persuaded to admit of a potential Cautery, where the
Bite was inflicted on a fleshy Part. Though even this is far from
being unpainful, yet the Pain coming on more gradually, is less
terrifying and horrid. And when it had been applied quickly
after, and upon the Bite, and kept on for 3 or 4 Hours, the Discharge,
after cutting the Eschar, would sooner ensue, and in more
Abundance, than that from the actual Cautery; the only Preference
of which seems to consist in its being capable perhaps of absorbing,
or otherwise consuming, all the poisonous Saliva at once.
This Issue should be dressed afterwards according to our Author's
Direction; and in the gradual healing of the Ulcer, it may be
properly deterged by adding a little Præcipitate to the Digestive.
Neither would this interfere with the Exhibition of the Tonquin
Powder , nor the antispasmodic Bolus , if they should
be judged necessary. And these perhaps might prove the most
certain Means of preventing the mortal Effects of this singular
animal Poison, which it is so impossible to analyze, and so extremely
difficult to form any material Idea of; but which is not
the Case of some other Poisons. K.
It seems not amiss to try the Effects of a solely vegetable
Diet (and that perhaps consisting more of the acescent than alcalescent
Herbs and Roots) in this Disease, commencing immediately
from the Bite of a known mad Dog. These carnivorous
Animals, who naturally reject all vegetable Food, are the only
primary Harbingers or Breeders of it; though they are capable
of transmitting it by a Bite to graminivorous and granivorous
ones. The Virtue of Vinegar in this Disease, said to have been
accidentally discovered on the Continent, seems not to have been
hitherto experienced amongst us; yet in Case of such a morbid
Accident it may require a Tryal; tho' not so far, as to occasion
the Omission of more certainly experienced Remedies, with some
of which it might be improper. K.
The great Usefulness of mercurial Frictions, we may even
say, the certain Security which they procure for the Patients, in
these Cases, provided they are applied very soon after the Bite,
have been demonstrated by their Success in Provence, at Lyons, at
Montpellier, at Pondacherry, and in many other Places. Neither
have these happy Events been invalidated by any Observations or
Instances to the contrary. It cannot therefore be too strongly
inculcated to those who have been bitten by venomous Animals, to
comply with the Use of them. They ought to be used in such a
Quantity, and after such a Manner, as to excite a moderate Salivation,
for fifteen, twenty, or even thirty Days. E. L. Though
this Practice may justly be pursued from great Caution, when no
Cautery had been speedily applied to, and no such Discharge had
been obtained from, the bitten Part; yet wherever it had, this
long and depressing Salivation, I conceive, would be very seldom
necessary; and might be hurtful to weak Constitutions. K.
As far as the Number of inoculated Persons, who remained
entirely uninfected (some very few after a second Inoculation) has
enabled me, I have calculated the Proportion naturally exempted
from this Disease, though residing within the Influence of it, to
be full 25 in 1000. See Analysis of Inoculation, Ed. 2d. P. 157.
Note *. K.
It has sometimes been observed (and the Observation has
been such, as not to be doubted) that a very mild distinct Small-Pocks
has sometimes invaded the same Person twice: But such Instances
are so very rare, that we may very generally affirm, those
who have once had it, will never have it again. E. L.——In
Deference to a few particular Authorities, I have also supposed
such a repeated Infection. (Analysis of Inoculation, Ed.
2d. P. 43.) though I have really never seen any such myself;
nor ever heard more than two Physicians affirm it, one at
Versailles, and another in London; the last of whom declared, he
took it upon the Credit of a Country Physician, thoroughly acquainted
with this Disease, and a Witness to the Repetition of it.
Hence we imagine the Editor of this Work at Lyons might have
justly termed this Re-infection extremely rare, which would have
a Tendency to reconcile the Subjects of the Small-Pocks, more generally,
to the most salutary Practice of Inoculation. Doubtless
some other eruptive Fevers, particularly, the Chicken Pocks,
Crystals, &c. have been often mistaken for the real Small-Pocks by
incompetent Judges, and sometimes even by Persons better qualified,
yet who were less attentive to the Symptoms and Progress of
the former. But whoever will be at the Pains to read Dr. Paux'
Paralléle de la petite verole naturalle avec l'artificielle, or a practical
Abstract of Part of it in the Monthly Review. Vol. XXV.
P. 307 to 311, will find such a just, clear and useful Distinction of
them, as may prevent many future Deceptions on this frequently
interesting Subject. K.
The same Appearances very often occur in such Subjects by
Inoculation, before actual Sickening, as I have observed and instanced,
Ed. 1st. P. 62, Ed. 2. P. 75, 76. K.
As Pustules are, and not very seldom, visible on the Tongue,
and sometimes on the Roof, even to its Process called the Palate,
which I have plainly seen; it seems not very easy to assign any
insuperable Obstacle to the Existence of a few within the Throat;
though this scarcely ever occurs, in the distinct Small-Pocks.
Doubtless however, a considerable Inflammation of that Part
will be as likely to produce the great Difficulty of Swallowing,
as the Existence of Pustules there; which our learned Author does
not absolutely reject, and consequently will forgive this Supposition
of them; especially if he credits the ocular Testimony of
Dr. Violante, cited in the Analysis, Ed. 2d. p 71. K.
A *** Girl, about five or six Years old, under a coherent
Pock, stole by Night out of the Garret where she lay, into
a Kitchen out of Doors, where she drank plentifully of cold
Water. How often she repeated these nightly cooling Potions
I never could certainly learn, though they occurred in my own
House in South-Carolina in Summer. But it is certain the Child
recovered as speedily as others, whose Eruption was more distinct,
and who drank Barley-Water, very thin Rice or Indian
Corn Gruel, Balm Tea, or the like. In fact, throughout the
Course of this Visitation from the Small Pocks in Carolina in
1738, we had but too many Demonstrations of the fatal Co-operation
of violent Heat with their Contagion; and not a very
few surprizing Instances of the salutary Effects of being necessarily
and involuntarily exposed to same very cooling Accidents
after Infection, and in some Cases after Eruption too: which I
then more particularly mentioned is a small controversial Tract
printed there. K.
We must remember that Dr. Tissot is treating here of the
higher or confluent Degrees of this Disease; for in the distinct
Small-Pocks, it is common to find Persons for several Days
without a Stool, and without the least perceiveable Disorder for
Want of one (their whole Nourishment being very light and
liquid) in which Cases, while Matters proceeded well in all
other Respects, there seems little Occasion for a great Solicitude
about Stools: But if one should be judged necessary after
four or five Days Costiveness, accompanied with a Tightness
or Hardness of the Belly, doubtless the Glyster should be of
the lenient Kind (as those directed by our Author are) and not
calculated to produce more than a second Stool at the very
most. Indeed, where there is Reason to apprehend a strong
secondary Fever, from the Quantity of Eruption, and a previously
high Inflammation, it is more prudent to provide for a
Mitigation of it, by a moderately open Belly, than to suffer a
long Costiveness; yet so as to incur very little Hazard of abating
the Salivation, or retarding the Growth or Suppuration of
the Pustules, by a Superpurgation, which it may be too easy
to excite in some Habits. If the Discharge by spitting, and
the Brightness and Quantity of Suppuration, have been in Proportion
to the Number of Eruptions; though the Conflict from
the secondary Fever, where these have been numerous, is often
acute and high; and the Patient, who is in great Anguish,
is far from being out of Danger, yet Nature pretty generally
proves stronger than the Disease, in such Circumstances. As
the Elect. Catholicon, is little used, or made here, the lenitive Electuary
of our Dispensatory may be substituted for it, or that of
the Edinburgh Dispensatory, which was calculated particularly
for Glysters. K.
This Practice which I had heard of, and even suggested to
myself, but never seen actually enterprized, seems so very rational
as highly to deserve a fair Trial in the confluent Degrees of the
Small-Pocks [for in the distinct it can scarcely be necessary]
wherein every probable Assistance should be employed, and in
which the most potent Medicines are very often unsuccessful. We
have but too many Opportunities of trying it sufficiently; and it
certainly has a more promising Aspect than a Practice so highly
recommended many Years ago, of covering all the Pustules (which
is sometimes the whole Surface of the Patient) in Melilot, or suppose
any other suppurating, Plaister; which will effectually prevent
all Perspiration, and greatly increase the Soreness, Pain
and Embarrassment of the Patient, at the Height of the Disease.
I can conceive but one bad Consequence that might possibly sometimes
result from the former; but this (besides the Means that may
be used to avert it) is rather remote, and so uncertain, until the
Trial is repeatedly made, that I think it ought not to be named,
in Competition with the Benefits that may arise from it in such Cases,
as seem, otherwise, too generally irrecoverable. K.
The Use of Opiates in this Disease undoubtedly requires no
Small Consideration, the great Sydenham himself not seeming
always sufficiently guarded in the Exhibition of them; as far as
Experience since his Day has enabled Physicians to judge of this
Matter. In general our Author's Limitations of them seem very
just; though we have seen a few clear Instances, in which a light
Raving, which evidently arose from Want of Sleep (joined to some
Dread of the Event of the Disease by Inoculation) was happily removed,
with every other considerable Complaint, by a moderate ***.
In sore and fretful Children too, under a large or middling Eruption,
as the Time gained to Rest is taken from Pain, and from
wasting their Spirits in Crying and Clamour, I have seen Suppuration
very benignly promoted by Diacodium. But in the Crisis
of the secondary Fever in the confluent or coherent Pock, when
there is a morbid Fulness, and Nature is struggling to unload
herself by some other Outlets than those of the Skin, which now
are totally obstructed (and which seems the only Evacuation, that
is not restrained by Opiates) the giving and repeating them then,
as has too often been practised, seems importantly erroneous; for
I think Dr. Swan has taken a judicious Liberty of dissenting
from the great Author he translates, in forbidding an ***, if
the Spitting abates, or grows so tough and ropy, as to endanger
Suffocation. As the Difference of our Oeconomy in the Administration
of Physic from that in Swisserland, and Dr.
Tissot's just Reputation may dispose many Country Practitioners
to peruse this Treatise, I take the Liberty of referring such Readers,
for a Recollection of some of my Sentiments of Opiates,
long before the Appearance of this Work in French, to the second
Edition of the Analysis from P. 94 to 97, &c. K.
That I have long since had the Honour of agreeing
with our learned Author, in this Consideration for the Benefit of
the Body of the People, which is the Benefit of the State, will appear
from p. 288 of Analys. Ed. 1st. and from p. 371, 372 of the
Second. K.
The Substance of this Section flows from the Combination
of an excellent Understanding with great Experience, mature Reflection,
and real Probity; and fundamentally exposes both the
Absurdity of such as universally decry any Preparation of any Subject
previous to Inoculation, (which is said to be the Practice of a
present very popular Inoculator in Paris) and the opposite Absurdity
of giving one and the very same Preparation to all Subjects,
without Distinction; though this was avowed to have been successfully
fully practised in Pensylvania, some Years since; which the Reader
may see Analys. Ed. 2d, from p. 329 to 331 and the Note there.
K.
There may certainly be an inflammatory Acrimony or Thinness,
as well as Thickness of the Blood; and many medical Readers
may think a morbid Fusion of the red Globules to be a more
frequent Effect of this Contagion, than an increased Viscidity of
them. See Analys. Ed. 2d. p. 75 to 83. But this Translation,
conforming to the Spirit of its Original, admits very little Theory,
and still less Controversy, into its Plan. K.
Our Author very prudently limits this Discharge, and the
Repetition of it, in this Disease () as an erroneous Excess of
it has sometimes prevailed. I have seen a very epidemical Season
of the Measles, where Bleeding was not indicated in one
third of the infected. And yet I have known such an Abuse of
Bleeding in it, that being repeated more than once in a Case before
Eruption (the Measles probably not being suspected) the
Eruption was retarded several Days; and the Patient, a young
Lady of Condition, remained exceeding low, faint and sickish; 'till
after recruiting a very little, the Measles appeared, and she recovered.
In a Youth of a lax Fibre, where the Measles had appeared,
a seventh or eighth Bleeding was ordered on a Stitch in
the Side, supervening from their too early Disappearance, and the
Case seemed very doubtful. But Nature continued very obstinately
favourable in this Youth, who at length, but very slowly,
recovered. His Circulation remained so languid, his Strength,
with his Juices, so exhausted, that he was many Weeks before
he could sit upright in a Chair, being obliged to make Use of a
Cord depending from the Ceiling, to raise himself erectly in his
Seat. K.
Bristol Water will be no bad Substitute for any of these, in
such Cases. K.
The only Account I have read of this Practice, is in the
learned Dr. Home's Medical Facts and Experiments, published in
1759, which admits, that but nine out of fifteen of the Subjects
of this Practice took. Cotton dipt in the Blood of a Patient in the
Measles was inserted into the Arms of twelve; and three received
the Cotton into their Nostrils, after the Chinese Manner of infusing
the Small-Pocks; but of these last not one took, and one of
those who had taken, had the Measles again two Months after.
We think the sharp hot Lymph distilling from the inflamed Eyes
of Persons in this Disease, a likelier Vehicle to communicate it
than the Blood, especially the dry Blood, which was sometimes
tried; since the human Serum seems the Fluid more particularly affected
by it; and this must have been evaporated when the Blood
grew dry. A few practical Strictures on this Work, and particularly
on this Practice described in it, appeared in the Monthly
Review Vol. XXI. P. 68 to 75. K.
That is about two Ounces more than a Pint and a half of our
Measure.
About three Ounces.
As our Jail, Hospital, and Camp Fevers may often
be ranged in this Class, as of the most putrid Kind, and not
seldom occasioned by bad Food, bad Air, unclean, unwholesome
Lodging, &c. a judicious Use may certainly be made of
a small Quantity of genuine, and not ungenerous, Wine in such
of them, as are not blended with an inflammatory Cause, or
inflammable Constitution, or which do not greatly result from a
bilious Cause; though in these last, where there is manifest
Lowness and Dejection, perhaps a little Rhenish might be properly
interposed between the Lemonade and other Drinks directed
. Doubtless Dr. Tissot was perfectly apprized of this
salutary Use of it in some low Fevers; but the Necessity of its
being regulated by the Presence of a Physician has probably
disposed him rather to omit mentioning it, than to leave the Allowance
of it to the Discretion of a simple Country Patient, or
his ignorant Assistants. K.
The French Word is Griettes, which Beyer englishes, the
Agriot, the red or sour Cherry; and Chambaud, the sweeter large
black Cherry or Mazzard—But as Dr. Tissot was recommending
the Use of Acids, it is more probably the first of these: so
that our Morellas, which make a pleasant Preserve, may be a
good Substitute to them, supposing them not to be the same.
Our Berbery Jam, and Jelly of Red Currants, may be also employed
to answer the same Indication. K.
Observation and Experience have demonstrated the Advantage
of the Bark, to obviate a Gangrene, and prevent the Putrefaction
of animal Substances. We therefore conclude it may be
usefully employed in malignant Fevers, as soon as the previous
and necessary Evacuations shall have taken Place. E. L.—Provided
there be very clear and regular Remissions at least. K.
This admirable Medicine was unknown in Europe, till about
one hundred and twenty Years past; we are obliged to the Spaniards
for it, who found it in the Province of Quito in Peru;
the Countess of Chinchon being the first European who used it in
America, whence it was brought to Spain, under the Name of
the Countesses Powder. The Jesuits having soon dispensed and
distributed it abroad, it became still more publick by the Name
of the Jesuits Powder: and since it has been known by that of Kinkina
or the Peruvian Bark. It met with great Opposition at first;
some deeming it a Poison, while others considered it as a divine
Remedy: so that the Prejudices of many being heightened by
their Animosity, it was nearly a full Century, before its true Virtue
and its Use were agreed to: and about twenty Years since the
most unfavourable Prejudices against it pretty generally subsided.
The Insufficience of other Medicines in several Cases; its great Efficaciousness;
and the many and surprizing Cures which it did, and
daily does effect; the Number of Distempers; the different kinds of
Fevers, in which it proves the sovereign Remedy; its Effects in
the most difficult chirurgical Cases; the Comfort, the Strength and
Sprits it gives those who need and take it, have at length opened
every Persons Eyes; so that it has almost unanimously obtained
the first Reputation, among the most efficacious Medicines. The
World is no longer amused with Apprehensions of its injuring the
Stomach; of its fixing, or shutting up the Fever (as the Phrase has
been) without curing it; that it shuts up the Wolf in the Sheepfold;
that it throws those who take it into the Scurvy, the Asthma,
the Dropsy, the Jaundice. On the contrary they are persuaded
it prevents there very Diseases; and, that if it is ever
hurtful, it is only when it is either adulterated, as most great Remedies
have been; or has been wrongly prescribed, or improperly
taken: or lastly when it meets with some latent, some unknown
Particularities in a Constitution, which Physicians term an Idiosyncrasy,
and which prevent or pervert its very general Effects. Tissot.
It happens very seldom that intermitting Fevers require no
Purge towards their Cure, especially in Places, which are disposed
to generate Putridity. There is always some material Cause essential
to these Fevers, of which Nature disembarrasses herself
more easily by Stools, than by any other Discharge: And as
there is not the least Danger to be apprehended from a gentle
Purge, such at those of or , we think it would be prudent
always to premise a Dose or two of either to the Bark. E. L.
Yet I have known many in whom no Purge was necessary, and have seen
some rendered more obstinate and chronical by erroneous Purging. But a Vomit
is very generally necessary before the Bark is given. K.
[70](, ) I have seen several Cases in very marshy maritime Countries,
with little good drinking Water, and far South of Swisserland,
where intermitting Fevers, with Agues at different Intervals, are
annually endemic, very popular, and often so obstinate as to return
repeatedly, whenever the weekly precautionary Doses of the
Bark have been omitted (through the Patient's nauseating the frequent
Swallowing of it) so that the Disease has sometimes been
extended beyond the Term of a full Year, and even far into a second,
including the temporary Removals of it by the Bark. Nevertheless,
in some such obstinate Intermittents, and particularly
Quartans there, wherein the Bark alone has had but a short and
imperfect Effect, I have known the following Composition, after a
good Vomit, attended with speedy and final Success, viz. Take
of fresh Sassafras Bark, of Virginia Snake-root, of Roch-Allom,
of Nutmeg, of diaphoretic Antimony, and of Salt of Wormwood
of each one Drachm. To these well rubbed together into fine
Powder, add the Weight of the whole, of the best and freshest
Bark; then drop in three Drops of the chemical Oil of Mint,
and with Syrup of Cloves make it into the Consistence of an Electuary
or Bolus, for 12 Doses for a grown Person, to be taken at
the Distance of three or four Hours from each other, while the
Patient is awake, according to the longer or shorter Intermission
of the Fever.
I have also known, particularly in obstinate autumnal Agues
there, an Infusion of two Ounces of the best Bark in fine Powder,
or two Ounces and a half in gross Powder, in a Quart of the best
Brandy, for three or four Days (a small Wine Glass to be taken
by grown Persons at the Distance of from four to six Hours) effectually
and speedily terminate such intermittent Agues, as had given
but little Way to the Bark in Substance. This was certainly
more suitable for those who were not of a light delicate Habit and
Temperament, and who had not been remarkable for their Abstinence
from strong Liquors: the inebriating Force of the Brandy
being remarkably lessened, by the Addition and long Infusion of
the Bark. These Facts which I saw, are the less to be wondered
at, as in such inveterate, but perfectly clear and distinct Intermittents,
both the State of the Fluids and Solids seem very opposite
to their State in an acutely inflammatory Disease. K.
These, in some Parts of America, are called Muskito Hawks;
but we do not recollect their biting there. K.
Pounded Parsley is one of the most availing Applications in
such Accidents. E.L.
The Seneka Rattle-Snake root, already recommended in true
Pleurisies, will, with the greatest Probability, be found not less
effectual in these false ones, in which the Inflammation of the
Blood is less. The Method of giving it may be seen P. ,
N. (.)
By Dr. Tissot's having never mentioned this valuable Simple
throughout his Work, it may be presumed, that when he wrote it,
this Remedy had not been admitted into the Apothecaries Shops in
Swisserland. K.
Glauber or Epsom Salt may be substituted, where the other is
not to be readily procured. K.
Pullet, or rather Chicken Water, but very weak, may often
do instead of Ptisan, or serve for a little Variety of Drink to
some Patients. E. L.—K.
Bleeding should not be determined on too hastily in this Sort
of Cholic, but rather be omitted, or deferred at least, till there
be an evident Tendency to an Inflammation. E. L.
The Propriety or Impropriety of Bleeding in a Cholic from
this Cause should be determined, I think, from the State of the
Person it happens to: So that Bleeding a strong Person with a
firm Fibre, and a hard Pulse, may be very prudent and precautionary:
But if it be a weakly lax Subject with a soft and low Pulse,
there may be Room either for omitting, or for suspending it. K.
The Experience of all Countries and Times so strongly confirms
these important Truths, that they cannot be too often repeated,
too generally published, whenever and wherever this Disease
rages. The Succession of cold Showers to violent Heats;
too moist a Constitution of the Air; an Excess of animal Food;
Uncleanliness and Contagion, are the frequent Causes of epidemical
Fluxes. E. L.
I have retained the preceding Note, abridged from this Gentleman,
as it contains the Suffrage of another experienced Physician,
against that Prejudice of ripe Fruits occasioning Fluxes,
which is too popular among ourselves, and probably more so in
the Country than in London. I have been also very credibly assured,
that the Son of a learned Physician was perfectly cured of
a very obstinate Purging, of a Year's Continuance (in Spite of all
the usual officinal Remedies) by his devouring large Quantities of
ripe Mulberries, for which he ardently longed, and drinking very
freely of their expressed Juice. The Fact occurred after his
Father's Decease, and was affirmed to me by a Gentleman intimately
acquainted with them both. K.
Our learned Author, or his medical Editor at Lyons, observes
here, ‘that in the Edition of this Treatise at Paris, there was an
essential Mistake, by making Boerhaave recommend the Addition
of Brandy, Eau de vie, instead of stumming or sulphurizing it,’ for
which this Note, and the Text too use the Verb branter, which
Word we do not find in any Dictionary. We are told however,
it means to impregnate the Casks in which the Water is reserved,
with the Vapour of Sulphur, and then stopping them; in the
same Manner that Vessels are in some Countries, for the keeping
of Wine. He observes the Purpose of this is to oppose Corruption
by the acid Steams of the Sulphur. K.
A first or second Dose of Glauber Salt has been known to
succeed in the epidemical Summer Fluxes of the hotter Climates,
when repeated Doses of Rhubarb and Opiates had failed. Such
Instances seems a collateral Confirmation of Dr. Tissot's rational
and successful Use of cooling opening Fruits in them. K.
I have seen a pretty singular Consequence from the Abuse of
mercurial Unction for the Itch; whether it happened from the
Strength or Quantity of the Ointment, or from taking Cold after
applying it, as this Subject, a healthy Youth of about sixteen, probably
did, by riding three or four Miles through the Rain. But
without any other previous Complaint, he awoke quite blind one
Morning, wondering, as he said, when it would be Day. His
Eyes were very clear, and free from Inflammation, but the Pupil
was wholly immoveable, as in a Gutta serena. I effected the Cure
by some moderate Purges repeated a few Times; by disposing him
to sweat by lying pretty much in Bed (it being towards Winter)
and by promoting his Perspiration, chiefly with Sulphur: after
which the shaved Scalp was embrocated with a warm nervous
Mixture, in which Balsam of Peru was a considerable Ingredient.
In something less than three Weeks he could discern a glowing
Fire, or the bright Flame of a Candle. As his Sight increased,
he discerned other Objects, which appeared for some Days inverted
to him, with their Colours confused; but Red was most
distinguishable. He discovered the Aces sooner than other Cards;
and in about six or seven Weeks recovered his full Sight in all its
natural Strength, which he now enjoys. K.
Sea water, and those of Dulwich, Harrigate, Shadwell, &c.
will be full as effectual. K.
The French Word here, Opiat, is sometimes used by them for
a compound Medicine of the Consistence of an Electary; and
cannot be supposed, in this Place, to mean any Preparation, into
which *** enters. K.
Too great a Fulness of Blood is undoubtedly the Cause of all
these Complaints; but as there are different Methods of opposing
this Cause, the gentlest should always be preferred; nor should the
Constitution become habituated to such Remedies, as might either
impair the Strength of the Mother, or of her Fruit. Some Expedients
therefore should be thought of, that may compensate for the
Want of Bleeding, by enjoining proper Exercise in a clear Air,
with a less nourishing, and a less juicy Diet. E. L.
This Note might have its Use sometimes, in the Cases of such
delicate and hysterical, yet pregnant Women, as are apt to suffer
from Bleeding, or any other Evacuation, though no ways immoderate.
But it should have been considered, that Dr. Tissot was professedly
writing here to hearty active Country Wives, who are very
rarely thus constituted; and whom he might be unwilling to confuse
with such multiplied Distinctions and Directions, as would
very seldom be necessary, and might sometimes prevent them from
doing what was so. Besides which, this Editor might have seen,
our Author has hinted at such Cases very soon after. K.
The Use of Hemlock, which has been tried at Lyons, by all
who have had cancerous Patients, having been given in very large
Doses, has been attended with no Effect there, that merited the
serious Attention of Practitioners. Many were careful to obtain
the Extract from Vienna, and even to procure it from Dr. Storck
himself. But now it appears to have had so little Success, as to
become entirely neglected. E. L.
Having exactly translated in this Place, and in the Table of
Remedies, our learned Author's considerable Recommendation of
the Extract of Hemlock in Cancers, we think it but fair, on the
other Hand, to publish this Note of his Editor's against it; that
the real Efficacy or Inefficacy of this Medicine may at length be
ascertained, on the most extensive Evidence and Experience. As
far as my own Opportunities and Reflections, and the Experience
of many others, have instructed me on this Subject, it appears clear
to myself, that though the Consequences of it have not been constantly
unsuccessful with us, yet its Successes have come very short
of its Failures. Nevertheless, as in all such Cancers, every other
internal Medicine almost universally fails, we think with Dr.
Tissot it should always be tried (from the meer Possibility of its
succeeding in some particular Habit and Circumstances) at least
till longer Experience shall finally determine against it. K.
This Method (says the Editor and Annotator of Lyons) is
useful, whenever the Mother does not suckle her Child. Art is
then obliged to prove a Kind of Substitute to Nature, though always
a very imperfect one. But when a Mother, attentive to her
own true Interest, as well as her Infant's, and, listening to the
Voice of Nature and her Duty, suckles it herself, these Remedies
[he adds] seem hurtful, or at least, useless. The Mother should
give her Child the Breast as soon as she can. The first Milk, the
Colostrum, or Strippings, as it is called in Quadrupeds, which is
very serous or watery, will be serviceable as a Purgative; it will
forward the Expulsion of the Meconium, prove gradually nourishing,
and is better than Biscuits, or Panada, which (he thinks) are
dangerous in the first Days after the Birth. E. L.
This Syrup of Succory being scarcely ever prepared with us,
though sufficiently proper for the Use assigned it here, I have retained
the preceding Note, as the Author of it directs these Strippings,
for the same Purpose, with an Air of certain Experience; and
as this Effect of them seems no Ways repugnant to the physical Wisdom
and Oeconomy of Nature, on such important Points. Should
it in fact be their very general Operation, it cannot be unknown to
any Male or Female Practitioner in Midwifery, and may save
poor People a little Expence, which was one Object of our humane
Author's Plan. The Oil Of Ricinus, corruptly called Castor Oil (being
expressed from the Berries of the Palma Christi) is particularly
recommended by some late medical Writers from Jamaica, &c. for
this Purpose of expelling the Meconium, to the Quantity of a small
Spoonful. These Gentlemen also consider it as the most proper,
and almost specific Opener, in the dry Belly-ach of that torrid
Climate, which tormenting Disease has the closest Affinity to the
Miserere, or Iliac Passion, of any I have seen. The Annotator's
Objection to our Author's very thin light Panada, seems to be of
little Weight. K.
Or, for Want of it, the solutive Syrup of Roses. K.
The Magnesia is an excellent Substitute in Children, for these
Oils Dr. Tissot so justly condemns here. K.
That Part of the Head where a Pulsation may be very plainly
felt, where the Bones are less hard, and not as yet firmly joined
with those about them.
There is however a certain Degree of Weakness, which
may very reasonably deter us from this Washing; as when the
Infant manifestly wants Heat, and needs some Cordial and frequent
Frictions, to prevent its expiring from downright Feebleness;
in which Circumstances Washing must be hurtful to it. Tissot.
[90](, ) I have seen a Child about three Years old, whose Navel,
after swelling and inflaming, suppurated, and through a small Orifice
(which must have communicated with the Cavity of the Gut
or the Belly) discharged one of these Worms we call teretes, about
three Inches long. He had voided several by Stool, after taking
some vermifuge Medicines. The Fact I perfectly remember; and
to the best of my Recollection, the Ulcer healed some Time after,
and the Orifice closed: but the Child died the following Year of a
putrid Fever, which might be caused, or was aggravated, by
Worms. K.
This Word occurs in none of the common Dictionaries; but
suspecting it for the *** Santonici of the Shops, I find the learned
Dr. Bikker has rendered it so, in his very well received
Translation of this valuable Work into Low Dutch. K.
This very important Consideration, on which I have treated
pretty largely, in the Analysis, seems not to be attended to in
Practice, as frequently as it ought. K.
The Misfortune of a young Man drowned in bathing himself,
at the Beginning of the Season, occasioned the Publication
of this Chapter by itself in June, 1761. A few Days after, the
like Misfortune happened to a labouring Man; but he was happily
taken out of the water sooner than the first (who had remained
about half an Hour under it) and he was recovered by
observing Part of the Advice this Chapter contains; of which
Chapter several Bystanders had Copies.—This Note seems to be
from the Author himself.
I saw a very similar Instance and Event in a Lady's little
favourite ***, whole Body she desired to be opened, from suspecting
her to have been poisoned. But it appeared that a small
Needle with fine Thread, which she had swallowed, had passed
out of the Stomach into the Duodenum (one of the Guts) through
which the Point had pierced and pricked and corroded the concave
Part of the Liver, which was all rough and putrid. The
whole Carcase was greatly bloated and extremely offensive, very
soon after the poor Animal's Death, which happened two or three
Months after the Accident, and was preceded by a great Wheezing,
Restlessness and Loss of Appetite. The Needle was rusty,
but the Thread entire, and very little altered. K.
I knew a Man of the Name of Poole, who being taken in
the same Ship with me, 1717 or 18, by Pirates, had swallowed
four Ginueas, and a gold Ring, all which he voided some
Days after without any Injury or Complaint, and saved them.
I forget the exact Number of Days he retained them, but the
Pirates staid with us from Saturday Night to Thursday Noon. K.
Many fatal Examples of this Kind may be seen in the Philosophical
Transactions; and they should caution People against swallowing
Cherry-stones, and still more against those of Prunes, or
such as are pointed, though not very acutely. K.
This, Dr. Tissot informs me, is a Solution of white Vitriol
and some other Drugs in Spirit of Wine, and is never used in regular
Practice now. It has its Name from the Author of the
Solution. K.
This seems just the same as coming on the Parish, or being received
into an Alms house here; in Consequence of such an incurable
Disability happening to the poor working Father of a
Family. K.
The Reason of the Fatality of Heat, in these Cases, and of
the Success of an opposite Application, (See ) seems strictly and
even beautifully analogous to what Hippocrates has observed of
the Danger, and even Fatality, of all great and sudden Changes
in the human Body, whether from the Weather or otherwise.
Whence this truly great Founder of Physick, when he observes
elsewhere, that Diseases are to be cured by something contrary to
their Causes, very consistently advises, not a direct and violent
Contrariety, but a gradual and regulated one, a Sub-contrariety. K.
Chilblains may also be advantageously washed with Water
and Flower of Mustard, which will concur, in a certain and easy
Manner, both to cleanse and to cure them. E. L.
This is or should be, the same with the Bitumen Judaicum,
formerly kept in the Shops; but which is never directed, except
in that strange Medley the Venice Treacle, according to the old
Prescription. The best is found in Egypt, and on the Red Sea:
but a different Sort, from Germany, France, and Swisserland, is
now generally substituted here. K.
Pieces of Ice applied between two Pieces of Linen, directly
upon the Rupture, as soon as possible after its first Appearance, is
one of those extraordinary Remedies, which we should never hesitate
to make immediate Use of. We may be certain by this Application,
if the Rupture is simple, and not complicated from some
aggravating Cause, to remove speedily, and with very little Pain,
a Disorder, that might be attended with the most dreadful Consequences.
But the Continuance of this Application must be proportioned
to the Strength of the Person ruptured, which may be
sufficiently estimated by the Pulse. E. L.
These Creatures perhaps are fatter in Swisserland, than we
often see them here. K.
Our Garden Purslain, though a very juicy Herb, cannot strictly
be termed milky. In the hotter Climates where it is wild, and
grows very rankly, they sometimes boil the Leaves and Stalks
(besides eating them as a cooling Salad) and find the whole an
insipid mucilaginous Pot-herb. But Dr. Tissot observes to me,
that its Juice will inflame the Skin; and that some Writers on
Diet, who disapprove it internally, affirm they have known it
productive of bad Effects. Yet none such have ever happened to
myself, nor to many others, who have frequently eaten of it. Its
Seeds have sometimes been directed in cooling Emulsions. The
Wart Spurge is a very milky and common Herb, which flowers
in Summer here. K.
[105](, ) Dr. Tissot informs me, that in Swisserland, they call a
volatile Salt of Vipers, or the volatile Salt of raw Silk, Sel.
d'Angleterre, of which one Goddard made a Secret, and which he
brought into Vogue the latter End of the last Century. But he
justly observes at the same Time, that on the present Occasion
every other volatile Alkali will equally answer the Purpose; and
indeed the Smell of some of them, as the Spirit of Sal Ammoniac
with Quicklime, Eau de Luce, &c. seem more penetrating. K.
Our sweet Spirit of Vitriol is a similar, and as effectual a
Medicine. K.
I have seen this actually verified by great and disagreeable
Surprize, attended indeed with much Concern, in a Person of
exquisite Sensations. K.
La Braise.
Charbon. Dr. Tissot informs me, their Difference consists
in this, that the Charcoal is prepared from Wood burnt in a close
or stifled Fire; and that the small Coal is made of Wood (and of
smaller Wood) burnt in an open Fire, and extinguished before it
is reduced to the State of a Cinder. He says the latter is smaller,
softer, less durable in the Fire, and the Vapour of it less dangerous
than that of Charcoal.
See Note Page .
Une Quartette.
How shocking is this! and yet how true in some Countries!
I have been most certainly assured, that Bleeding has been inflicted
and repeated in the last sinking and totally relaxing Stage of
a Sea-Scurvy, whose fatal Termination it doubtless accelerated.
This did not happen in our own Fleet; yet we are not as yet
Wholly exempt on Shore, from some Abuse of Bleeding, which a
few raw unthinking Operators are apt to consider as a meer Matter
of Course. I have in some other Place stigmatized the Madness
of Bleeding in Convulsions, from manifest Exhaustion and
Emptiness, with the Abhorrence it deserves. K.
This makes an agreeable Drink; and the Notion of its
being windy is idle; since it is so only to those, with whom
Barley does not agree. It may, where Barley is not procurable,
be made from Oats.
In those Cases mentioned , , , instead of the
Barley, four Ounces of Grass Roots may be boiled in the
same Quantity of Water for half an Hour, with the Cream of
Tartar.
These Juices are to be procured from the Herbs when
fresh and very young, if possible, by beating them in a Marble
Mortar, or for Want of such [or a wooden Mortar] in an
Iron one, and then squeezing out the Juice through a Linen
Bag. It must be left to settle a little in an earthen Vessel,
after which the clear Juice must be decanted gently off, and
the Sediment be left behind.
Some Friends, says Dr. Tissot, whose judgment I
greatly respect, have thought the Doses of acid Spirit which
I direct extremely strong; and doubtless they are so, if compared
with the Doses generally prescribed, and to which I
should have limited myself, if I had not frequently seen their
Insufficience. Experience has taught me to increase them
considerably; and, augmenting the Dose gradually, I now venture
to give larger Doses of them than have ever been done before,
and always with much Success; the same Doses which I
have advised in this Work not being so large as those I frequently
prescribe. For this Reason I intreat those Physicians,
who have thought them excessive, to try the acid Spirits in
larger Doses than those commonly ordered; and I am persuaded
they will see Reason to congratulate themselves upon
the Effect.
Our Author's French Annotator has a Note against this Acid, which I
have omitted; for though I have given his Page [with the Substance of
the immediately preceding one] to which I have also added some Doubts of my
own, from Facts, concerning the Benefit of Acids in inflammatory Disorders of
the Breast; yet with Regard to the ardent, the putrid, the malignant Fever,
and Erisipelas, in which Dr. Tissot directs this, I have no Doubt of its Propriety
(supposing no insuperable Disagreement to Acids in the Constitution) and
with Respect to their Doses, I think we may safely rely on our honest Author's
Veracity. Dr. Fuller assures us, a Gentleman's Coachman was recovered
from the Bleeding Small Pocks, by large and repeated Doses of the Oil of Vitriol,
in considerable Draughts of cold Water. K.
This, our Author observes, will work a strong Country-man
very well: by which however he does not seem to mean
an Inhabitant of the Mountains in Valais. See P. .
This Ointment should be prepared at the Apothecaries; the
Receipt of it being given here, only because the Proportions of
the Quicksilver and the Lard are not always the same in different
Places.
This Medicine is known by the Name of Cob's Powder;
and as its Reputation is very considerable, I did not chuse to
omit it; though I must repeat here what I have said —That
the Cinnabar is probably of little or no Efficacy; and
there are other Medicines that have also much more than the
Musk; which besides is extremely dear for poor People, as the
requisite Doses of it, in very dangerous Cases, would cost
ten or twelve Shillings daily. The Prescription, , is
more effectual than the Musk; and instead of the useless Cinnabar,
the powerful Quicksilver may be given to the Quantity
of forty-five Grains. I have said nothing hitherto in this
Work of the red blossomed Mulberry Tree, which passes for a
real Specific, among some Persons, in this dreadful Malady.
An Account of it may be seen in the first Volume of the
Oeconomical Journal of Berne. It is my Opinion however,
that none of the Instances related there are satisfactory and decisive;
its Efficacy still appearing to me very doubtful.
When this is preferred to , of which Musk is an
Ingredient, the Grain of *** should be omitted, except
once or at most twice in the twenty-four Hours. Two Doses
of Quicksilver, of fifteen Grains each, should be given daily
in the Morning, in the Interval between the other Bolus's.
This Medicine makes the Dogs vomit and slaver abundantly.
It has effected many Cures after the Hydrophobia, the
Dread of Water, was manifest. It must be given three Days
successively, and afterwards twice a Week, for fifteen Days.
When People are ignorant of the Strength of the Tartar
emetic (which is often various) or of the Patient's being easy
or hard to vomit, a Dose and a half may be dissolved in a
Quart of warm Water, of which he may take a Glass every
Quarter of an Hour, whence the Operation may be forwarded,
or otherwise regulated, according to the Number of Vomits
or Stools. This Method, much used in Paris, seems a safe
and eligible one.
The medical Editor at Lyons justly notes here, that these
eighty Drops are a very strong Dose of liquid Laudanum;
adding that it is scarcely ever given at Lyons in a greater Dose
than thirty Drops; and recommending a Spoonful of Syrup
of Lemon-peel to be given with it—But we must observe here
in answer to this Note, that when Dr. Tissot directs this Mixture
in the Iliac Passion , to appease the Vomitings, , he orders but one spoonful of this Mixture to be taken at
once, and an Interval of two Hours to be observed between
the first and second Repetition, which reduces each Dose to
sixteen Drops, and which is not to be repeated without Necessity.
This Medicine, which often occasions Cholics in some
Persons of a weakly Stomach, is attended with no such Inconvenience
in strong Country People; and has been effectual
in some Disorders of the Skin, which have baffled other
Medicines—The Remainder of this Note observes the great
Efficacy of Antimony in promoting Perspiration, and the extraordinary
Benefit it is of to Horses in different Cases.
The Prescriptions , , , are calculated against
Distempers which arise from Obstructions, and a Stoppage of
the monthly Discharges; which is more particularly
intended to remove; those of and are most convenient,
either when the Suppression does not exist, or is not to be
much regarded, if it does. This Medicine may be rendered
less unpalatable for Persons in easy Circumstances, by adding
as much Cinamon instead of Aniseeds; and though the Quantity
of Iron be small, it may be sufficient, if given early in
the Complaint; one, or at the most, two of these Doses daily,
being sufficient for a very young Maiden.
I chuse to repeat here, the more strongly to inculcate so
important a Point, that in Women who have long been ill and
languid, our Endeavours must be directed towards the restoring
of the Patient's Health and Strength, and not to forcing down
the monthly Discharges, which is a very pernicious Practice.
These will return of Course, if the Patient is of a proper Age,
as she grows better. Their Return succeeds the Return of her
Health, and should not, very often cannot, precede it.
Our learned and candid Author has a very long Note in
this Place, strongly in Favour of Storck's Extract of Hemlock,
in which it is evident he credits the greater Part of the Cures
affirmed by Dr. Storck to have been effected by it. He says
he made some himself, but not of the right Hemlock, which
we think it very difficult to mistake, from its peculiar rank
fetid Smell, and its purple spotted Stalk. After first taking
this himself, he found it mitigated the Pain of Cancers, but
did not cure them. But then addressing himself to Dr. Storck,
and exactly following his Directions in making it, he took of
Dr. Storck's Extract, and of his own, which exactly resembled
each other, to the Quantity of a Drachm and a half daily; and
finding his Health not in the least impaired by it, he then
gave it to several Patients, curing many scrophulous and cancerous
Cases, and mitigating others, which he supposes were
incurable. So that he seems fully persuaded Dr. Storck's
Extract is always innocent [which in Fact, except in a very
few Instances, none of which were fatal, it has been] and he
thinks it a Specific in many Cases, to which nothing can be
substituted as an equivalent Remedy; that it should be
taken with entire Confidence, and that it would be absurd to
neglect its Continuance.
The Translator of this Work of Dr. Tissot's has thought
it but fair to give all the Force of this Note here, which must
be his own, as his Editor at Lyons seems to entertain a very
different Opinion of the Efficacy of this Medicine; for which
Opinion we refer back to his Note, , of this Treatise,
which the Reader may compare with this of our Author's. K.
Our Author attests his seeing the happiest Consequences
from this Application, which M. Brossard, a very eminent
French Surgeon, first published; and declared his Preference of
that Agaric which sprung from those Parts of the Tree, from
whence large Boughs had been lopped.
To spread this upon Lint as directed, , it must be
melted down again with a little Oil.
Transcription note
Old and variant spellings, like surprising / surprizing,
/ Butter-milk, Blood-vessels / Blood-Vessels,
Faltranc / Faltrank, wholesome / wholsome, fetid / fœtid,
public / publick, Physic / Physick, etc.
have been preserved in the present transcription.
In some cases of doubt, the present edition has been compared
with scans of the 1766 edition printed by Donaldson, which
differs slightly in setting, for instance having all names
not capitalized, and corrects many typographic mistakes.
Corrections listed in the at the end of the book
have been carried into this transcription (excepting those which are
not relevant for the transcription, like those in running titles).
Typographic errors, occurring at the following pages and lines
in the original, have been corrected (negative numbers indicate lines
from the bottom of the page):
p. 23, note *, l. -6 their Druggs —>
p. 29, l. 12 thorough Attentention —>
p. 39, l. 2 btutal Souls —>
p. 48, l. 12-13 thick, and and that —>
p. 55, l. -5 increases our Horrour —>
p. 61, l. 3-4 deserves a Patients Confidence —>
p. 62, l. 16 Drink and Glisters —>
p. 87, l. -8 the loosening Glyster No. 5 —>
p. 106, l. 1 Inflammamations —>
p. 148, l. 21-22 Perspiraration —>
p. 182, l. 19 Applications N. 9 —>
p. 189, l. 1 the Powder No. 29 —>
p. 223, note *, l. 4 without the least peceiveable —>
p. 226, l. 17-18 Relax-tion —>
p. 244, l. 4-5 Dis-seases —>
p. 261, l. 15 Hæmmorrhages —>
p. 283, l. 14-15 Pre-Precription —>
p. 344, note †, l. -2 missing closing quote
conjecturally inserted after
p. 353, l. 1 stance constitutes —>
p. 355, l. 18 not pregant —>
p. 383, l. 6 the back Bart of the Head —>
p. 485, l. 13 checks it Progress —>
p. 495, l. 19 strong swelling Herbs —>
p. 506, l. 15 Weakness is an Obstable —>
p. 506, l. 19 an Evacution supervenes —>
p. 525, l. -2,-1 Never-vertheless —>
p. 560, l. -7 Villians —>
p. 573, l. 6 some Evacution —>
p. 608. l. -7 Temparrament —>
p. 611, col. 2, l. 4 Of a Diarrhæa —>
So has been corrected the punctuation:
p. xxii, last line, note [missing period]
p. xxix, l. 10 [missing dot]
p. xxix, l. 13-14 Numbers 1. 2, and 4 —>
p. 63, l. 15 [missing dot]
p. 84, l. -7, note [missing dot]
p. 88, l. 21 [missing dot]
p. 89, l. 12
[missing dot]
p. 89, l. -7
[missing dot]
p. 117, l. 12-13
[dots instead of commas]
p. 118, note *, l. 3 [missing period]
p. 173, l. -8 [additional comma]
p. 198, l. 16 3. The Bites —>
p. 203, note, l. 5 [missing period]
p. 231, note, l- 1 [comma instead of period]
p. 233, l. 10 [missing period]
p. 265, l. -6
[period instead of comma]
p. 320, last line of the note
[missing dot]
p. 371, l. 7 [period instead of comma]
p. 531, l. -6 [missing period]
p. 538, l. -9 [missing dot]
p. 601, first line of the note
[missing dot after Nº and periods instead of commas]
The footnotes, marked in the text mostly by asterisks, symbols
and alphabetic letters on a page by page basis, have been
renumbered progressively throughout the book. The footnote * on
page does not appear to be referenced at any specific
point on the printed page, and has been treated as footnote to
the last word of the paragraph.
Italics markup of abbreviations like &c., K., which was not
always consistent in the original, has been retained as printed.
The Greek letters {alpha}, {beta}, {gamma} enumerating the
prescriptions of have been replaced by the Latin letters a,
b, c for better character set portability.