Part 12

The catarrhal fever, and all the other symptoms of cold, viz. cold in the head, cough, hoarseness, &c. generally keep one another company, leave the patient generally at one time; and in fact, one method of cure, namely, promoting a perspiration, serves for all; for thereby the obstructions become removed, and nature is restored to its primitive tranquillity again.

SECT. IV.

_Of Intermitting fevers, and Agues_.

There is scarce a disease that makes a patient more wretched, and unhappy, than the fever and ague. The causes of these kind of fevers is principally from a pituitous, or slimy blood, together with its being loaded with acrimony; and a flacidity of the moving fibres.

They are divided into various classes; though in fact all of one nature. When the ague with its succeeding fever comes on regularly every day, it is called _quotidian_, or every day’s ague; when every second day, _tertian_, or third day’s ague, and when every third day; a _quartan_, or fourth day’s ague. There are many other classes as subdivisions of these, but they are the mere speculations of physical pedants, who are ever sworn enemies to plain understanding, and delight in perplexities; which therefore, we shall neither spend paper nor time upon to recount.

Suffice it, let their paroxysms return at what stated period of time they will, either regularly or irregularly, they differ in nothing but this, that the farther the fits are distanced, the severer they generally are, when they come on; and the more regular, the more obstinate in their cure; though in this even there are exceptions.

It is surprizing to imagine, how many different opinions have been sent into the world concerning the returns of the periodical fits of the ague; and equally astonishing, how few with any probability of truth or reason.

I shall not here enter into an enquiry of this nature; certain it is, that at the stated times of these returning fits of the ague, there is an obstruction in some particular part of the system, that corresponds with the dated time of the circulation of fluids in such parts—which when disturbed, effects by the nervous consent, the whole animal structure.

The principal intention in all intermitting fevers, should be to correct the petuity and acrimony of the blood; to remove the obstructions; and to strengthen the solids.

With respect to the blood, it is an inevitable consequence, that when it is loaded with a vicidity and lentor, that it will ever occasion a depraved nutrition; and hence we see, that people labouring under agues, and intermittent fevers of any kind, have a depraved appetite, and many disagreeablenesses in the first passages.

The intermittent fever and ague approach with the following symptoms, viz. a heavy dull head-ach, a shivering chill all over the body, with a yawning, &c. pain in all the limbs attended with weariness, a nausea at the stomach, a depressed pulse; which after it has lasted for half an hour, changes into a burning heat, a throbbing head-ach, pain in the loins, and in every limb, a great draught, a _full hard pulse_, and which at last terminates in a profuse sweat; this seems to give the patient ease, for one, two, or three days; and then attacks the patient with the same symptom, increasing every time, and reduces the patient both in body and spirit.

The first thing to be done is to give a vomit, like No. XV. and XXVI. This is best taken at the approach of the cold fit, and worked well off with plenty of luke warm water. After the operation of the vomit is over, let the patient take the following draught.

No. XXVII

_Take fever powder_ (L), _thirty grains; calomel_ (N), _one grain; elixir of vitriol_ (G), _sixty, or seventy drops; essential oil of peppermint_ (U), _four drops upon a little lump of sugar; to which add water, half a tea cup full._

This draught will not only promote perspiration, but help to dissolve the siziness in the blood; and may therefore be repeated every six hours, for a few days. But the patient should always be kept moderately warm upon it, that it may work by perspiration.—This simple method I have known put the patient to rights again, after a severe onset.

But sometimes this wretched disorder will require more powerful medicines to keep it in subjection. When the fibres are debilitated, and the blood still retains its viscid corruptive quality, the ague is apt to hang on the patient a long time, the succeeding fever apt to melt the patient down to a mere skeleton, and even destroy him. In this it is requisite to brace up the solids, and to infuse an astringency into the blood.

To this intent, the Peruvian bark is now frequently prescribed, and if judiciously administered it is an excellent medicine; but as it is liable however, to be improperly given, and then productive of irreparable mischief, I have purposely omitted it in this catalogue; nevertheless, I shall give in its stead a medicine, superior both in virtue, and by far more safe in the application; not only in this kind of complaint, but in scorbutic cases, as I shall hereafter take notice of. The medicine is this,

No. XXVIII

_Elixir of Iron._

_Take a quantity of rusty iron, the smaller the pieces are, the better, for the less quantity will do_; pour on it good strong vinegar, sufficient to cover it; _let them steep till the vinegar becomes of a deep brown colour, which it soon will, and at length acquire a consistence of a black elixir. The vessel should be either stone or glass; but what is yet better is an iron pot, which of itself will contribute to the medicine._

If the patient therefore, after the vomit, and the above draught, is attacked again with the fit of the ague, and succeeding fever, have immediate recourse to your elixir of iron.——Let him take after the fever is off, every three hours, a table spoonful of the elixir, and should it seem to come up again at first (which it sometimes will, particularly if the stomach is yet foul) give immediately another spoonful, and repeat this at least three times of the day.

A little gentle exercise upon taking the elixir is highly beneficial; and if it throws a gentle warmth over the body, and brings it into a gentle perspiration, you are sure of success.

The quantity of it should be adapted to the condition of the patient, and the strength of the stomach; if it sits easy, a larger quantity may be taken, and seldomer; and if it is more nauseous, a smaller dose and oftener.—Should the fits seem obstinate, the following electuary may be used; and is a powerful specific.

No. XXIX

_Take stomach powder_ (M), _two drachmes; nutmeg powdered, one drachm; powdered alum_ (17), _half a drachm; essential oil of peppermint_ (U), _twenty drops; calomel_ (N), _ten grains; honey_ (E), _one ounce: the whole well mixed._

Of this let the patient take every eight, or twelve hours, the bigness of a nutmeg, taking his elixir as before observed; and this will ever prove successful in the most obstinate case.

As patients of that kind at sea, have ever a taint of the scurvy in their composition, or at least have a tendency towards it, exercise and freshness of food, will prove one of the restorative means. The malt decoction should also be their drink, as well as in the scurvy.

To conclude, I shall only observe, that bleeding in agues must at all events be omitted, as being absolutely pernicious, as it cannot fail of impoverishing the blood; which is the principle source of the disorder. Also, in the intermitting time, exercise should be observed, and the diet should, when the stomach craves, be good. Sometimes indeed, the stomach is too ravenous and greedy; but that is a default which proceeds from the same cause as that which makes it loath its victuals; a vomit in either case is the most effectual medicine, and may be repeated as often as it is requisite, without the least fear of injury, particularly in this disease.

SECT. V.

_Of Putrid and Malignant Fevers._

I Shall on this head restrain myself from saying more than what is absolutely requisite to the cure. It seldom happens to infect a ship’s crew at sea, unless the ship has carried it from some place where the disease was contagious.

Though notwithstanding, great sickness on board may give rise to it, if care is not taken to prevent it. I would therefore ever advise, in case of sickness, to steam the birth with vinegar; namely, taking a vessel with vinegar, in which put a hot iron, and thereby raise a steam, which is a powerful preservative.

A putrid fever may be generated from the contaminated atmosphere of a sick person, though it rarely is the case; yet prudence demands every precaution that is in our power.

The fever that I now speak of is of the malignant kind, and peculiar to the hotter climates.

The patient is seized first with a shivering chilliness, which is soon succeeded with a weak unequal fluttering pulse; the body is seized with a universal pain, together with a great debility; the mouth is hot and dry; the respiration depressed; and the mind labours under a heavy anxiety.—The fever continues, though not very high; and the pulse not very full;—a delirium or else a stupor ensues; the urine becomes deep coloured, and has an oily skim at top; and the patient is in so imminent a state of danger, that, unless a favourable crisis happens soon, twenty-four hours rapid progress is liable to put him beyond all help. The first and immediate remedy should be a vomit, No. XXVI, which is the grand step to be taken in all fevers; not so much for the sake of cleansing the stomach, as for the universal ease it gives to nature.

The next step is to correct the putrescent acrimony in the system; for which purpose make the following draught.

No. XXX

_Take fever powder_ (L) _one scruple; elixir of vitriol_ (G) _thirty drops; sweet spirit of nitre_ (D) _thirty drops; calomel_ (N) _two grains; essential oil of peppermint_ (U) _four drops; upon a lump of sugar; and half a tea cup full of water._

Let the patient take this draught every six hours; and after four have been taken, the calomel should be omitted. If the nerves seem to be affected, the essential oil of peppermint may be increased. If a delirium should come on, the _liquid laudanum_ (T) from ten to twelve drops and upwards may be given in the draught.

I know many will think it odd, that I should give calomel in a fever; but all this is merely the effect of blind prejudice; a better medicine than calomel is not in all Nature, if judiciously applied; and so fortunate have I been in my success with this exalted medicine in contagious fevers, that I have preserved myself and my patients in the midst of Death’s spreading horror around us. But to proceed; if the patient continues to be dry on the surface of the skin, and perspiration seems backward, a blister betwixt the shoulders, the bigness of the palm of the hand[15], will greatly facilitate the crisis or turn of the fever; but let it not be erroneously supposed, that a blister will draw off the bad humour, or that it does good by such an operation; for this notion has proved destructive to many patients. All the good a blister does is to spur on the animal function; by which sometimes the acrimony is thrown off from the system; but if thus irritating the system be overdone, or wrong applied, it is productive of many additional evils to the disease; causes spasms, strictures, and other acute disorders, that of themselves may become mortal. Therefore blisters should never be used but when the body is defective of perspiration, or when the debilitated system is defective in its excretory functions.

Footnote 15:

The method how to apply a blister is described under the article of Blister Plaister, in the second section, p. 75.

When the patient is rid of the fever, a general weakness will be left behind; this is best assisted with the _elixir of iron_; and now and then as a stomachic, a tea spoonful of _Turlington’s balsam_ (W), or some few drops of _oil of peppermint_ (U), as also the malt decoction, and fresh diet.

Malignant fevers are generally attended with eruptions on the skin, which is sometimes in favour of the patient, and therefore by no means to be hindered; but if there appears purple spots on the skin, and that they incline to turn black, it is rather a dangerous symptom, and indicates very little hope of the patient’s recovery.

The same method as above must be observed; which if medicine can avail, will afford benefit.

On the whole, I have this to observe, that all acute fevers are liable to become malignant and putrid; and in my practice I never found, that there was any real distinction to be made in the method of cure, whether the acrimony was generated in the habit by disease, or introduced by contagion; and if I may be allowed to judge by comparison, it must appear that my method is superior to the more general doctrine; because I have ever found it to be attended with much more success.

LECTURE VI.

OF THE

VARIOUS INTERNAL DISEASES,

AND

THEIR METHOD OF CURE.

Having in the foregoing said what I thought most material to be observed in fevers, as the universal disorder that attends almost every ailment in the human body, I shall for regularity sake, treat on the most material diseases, as they may seem to follow in order in the various divisions of the human body; and be as concise in their description and cure, as their nature will admit of.

SECT. I.

_Of Diseases of the Head,_ _Of the Apoplexy._

The apoplexy is a disease, wherein the patient falls down motionless, void of sense and sensation, and is, in fact, a temporary death. It will scarce however admit of a strict definition; for there are not only various degrees of this disorder, but even different disorders under the same denomination, that have quite distinct different causes for their effect. Many indeed may be accounted for, but many more cannot.

The brain is the root of the nerves, and consequently the fountain of all sensation, and life itself. That part of the human fabric is extremely delicate, and blood vessels plentifully distributed. When therefore these vessels become either so distended with blood, so as to press the substance of the brain, that it is hindered from its motion, confusion to the animal œconomy must naturally ensue; thence an apoplexy in its various gradations is liable to be the consequence; but as the vessels in such a distention are liable to break, and the extravasated blood pressing the brain more forcibly without a chance of dispersing, we plainly see one reason, why such a malady is apt to turn out fatal, as we find it sometimes does.

Such causes may either proceed from external, or internal injuries; thence we see that a heavy fall, or contusion on the head, may occasion an apoplexy, or at other times, a congestion of blood to the head may produce the same malady.

Sometimes the patient is motionless; and to all appearance dead, and nothing but a faint pulsation remains; at other times there is indeed more signs of life, but more terrible in appearance,—namely a convulsive breathing and foaming at the mouth, without the least signs of sensation or perception; in which case there is much to be feared, that vessels in the brain are burst.

However in all these extremities, nothing can contradict the indication of bleeding, except extreme weakness, and debility of the system; which here is very rarely the case.—After bleeding, a large blister between the shoulders should immediately be applied, and treated as directed in the second lecture, page 75.—A draught like No. XXX. will also be of singular service, till the patient comes to; after which he will require such treatment as is directed under fevers; for that disorder will always attend the shock that the apoplexy gives to the animal system.

_Of the Frenzy and Delirium._

When the root of the nerves are stimulated by acrimony, so as to heighten their sensibility, or set their regulated perception in confusion, the ideas become bewildered, and the sensations act at random. This is generally the case with patients in acute and malignant fevers; and this conception differs from dreaming in this respect, that the phantoms of the confused imagination may be somewhat guided by the objects around them; as they may be said to dream with their eyes open and full awake.

When the frenzy attends acute fevers, the blood is generally in a great confusion, and the pulse high and fluctuating. Yet bleeding should by all means be avoided, unless indeed the disorder has come on remarkably sudden. Blisters here are requisite; and in order to take off the stimulus of the nerves, give the patient the following draught.

No. XXXI

_Take Fever Powder_ (L) _one Scruple; Liquid Laudanum_, (T) _ten Drops; Spirit of Wine and Camphor_ (A) _twenty Drops; Essential Oil of Peppermint_ (U), _four Drops upon a lump of Sugar; Water half a Tea Cup full._

This draught may be taken every fourth or sixth hour; and now and then a grain of calomel may with great success be added to it. Cooling clysters in this case are also of singular service; for example:

No. XXXII

_Take cold water, eight ounces; Nitre, or instead of this[16] Fever Powder_ (L) _two drachms; spirits of Camphor_ (A) _thirty drops, mix them_.

Footnote 16:

The fever powder may be steept in a little water before hand, and the clear poured off, because nothing but the nitre here is useful.

If the patient is very costive, a little honey and soap may be added, previously dissolved; which will both open the body, and promote urine.

For the rest, every method must be taken as is already observed in fevers.

_Of a Stupor, and Lethargy._

This is a symptomatic affliction, that attends acute and malignant fevers, in its nature quite opposite to the former; in which the nervous system is benumbed, and have lost their sensation; this is very apt to succeed, but seldom precede the Frenzy. When a patient lays in that kind of stupefaction in a continual dosing, there is in general little hopes of recovery; nevertheless remedies must be applied.

Blisters here are very proper, and these should be pretty large. Horse radish should be frequently held to the nose, which has a reviving quality, and is very innocent with respect of adding acrimony to the system.

A vomit has often in this extremity proved very beneficial; which the patient’s weakness should not retard, unless very weak and near the end indeed. The following draught may also prove highly beneficial.

No. XXXIII

_Take Sweet Spirit of Nitre_ (D) _one drachm; Essential Oil of Peppermint_ (U) _ten drops upon a lump of sugar; water one ounce, mix them._

Let the patient take this every four or six hours, till he comes to himself again:

But care should be taken that a good sound sleep, is not mistaken for a stupor; for it frequently happens that a patient upon a favourable crisis will fall into a long sound deep, that terminates all his danger; if therefore the patient breathes freely, and has a moistness all over the body, together with a tolerable regular pulse, disturb him not; but let nature finish her gracious work.—This kind of sleep is materially different from the stupor, wherein the patient neither sleeps nor wakes, but is equally insensible when the eyes are open, as when they are shut.

_Of a Violent Head-Ach._

A Violent head-ach often attends fevers, or comes spontaneously without; it generally precedes a delirium, as the irritation of the nerves is the principal cause thereof.

The first intention must be to draw the humours from the head. A compress with vinegar, in which is dropt a little spirits of wine and camphor, is of great service, and will often have the defined effect to carry it off. Warm foot-baths also is of great use; a blister may be applied, and the draught No. XXXIV. will also prove of great service.

The head-ach may proceed from many other different causes, and in the general is only a symptomatic affection; therefore particular attention should be had to the primitive seat of the disorder.—Frequently a foul stomach will occasion the head-ach, and a vomit most times prove the best application.

SECT. II.

_Of Diseases of the Neck_

The diseases in that part, are indeed very numerous; but as they have so strict a connexion amongst themselves, the classes may be considered but very few; of which some have been already taken notice of.

_Of the malignant Sore Throat._

Every body who is liable to catch cold, is frequently apt to have a hoarseness and consequently in some degree, more or less, a sore throat. If a fever attends it, methods should be used accordingly, as is mentioned under the head of colds: with respect to the throat, use the gargle, No. XVIII. pretty frequently, and the disorder will soon go off again.

But when an ulcerated sore throat is attended with a malignant fever and inflammation, it is called a quincey; this case is alarming, and requires very careful treatment; for first we must observe, that the larynx is of a very complicate and curious structure; and secondly, it is composed of various, and delicate materials; namely, cartilages, membranes, muscles, and glands.

The glands are very numerous in the various parts of the composition, whence the inflammation becomes not only painful, but is apt to swell up and obstruct respiration; wherefore an inflammation in such parts becomes highly dangerous to the life of the patient.

When the patient perceives a burning pain in the throat, and the parts all round swell up, respiration becoming difficult, add to this a hoarseness, great difficulty in swallowing, there is no time to lose, for immediate assistance is wanting.

Bleeding is indispensably necessary, particularly if the inflammation is sudden; warm foot-bathing also is highly requisite; to remove the humours downwards; a gargle should also immediately be applied like the foregoing No. XVIII. with the addition of a little _camphor spirits_. Externally apply the poultice, No. II. and give the following draught.

No. XXXIV

_Take fever powder_ (L), _one scruple; calomel_ (N), _two grains; liquid laudanum_ (T), _twelve drops; water two spoonfuls; mix it into a draught._

This may be given every six hours, for two days successively; and this generally will break the disorder. The patient should be made to drink as freely as he possibly can; and perspiration should ever be promoted. A blister as the case requires, may also be used with much advantage. If the body is bound, clysters may tend to incline the humours to be drawn down from the part.

No. XXXV

_Take Glauber’s salts_ (19), _one ounce and a half; honey_ (E), _one spoonful; hot water, a pint and a half._

Sometimes the inflammation is so very great, as to choak up both the passage of respiration, as well as that of deglutition; so that the poor afflicted patient can neither breathe, nor swallow; and is not only liable to be suffocated, but even starved to death, besides the danger from the malignant inflammation.

In this exigency, have recourse to the following simple but excellent remedy.

No. XXXVI