Chapter III: Part 3

[14] 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._

__Chapter II.__

_Of the Causes which aggravate the Diseases of the People. General
Considerations._

__Sect.__ 14.

The 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?

Sec. 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.

Sec. 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 [15] _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.

[15] 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._

Sec. 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.

Sec. 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.

Sec. 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.

Sec. 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.

Sec. 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.

Sec. 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.

Sec. 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.

Sec. 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.

Sec. 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.

Sec. 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.

Sec. 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.

Sec. 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.

Sec. 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 [16] 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.

[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._

Sec. 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.

I 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.

Sec. 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 No. 1 and 2, 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 [17] 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.

[17] 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._

4. Let the Person, affected with such previous Complaints, receive Glysters of warm Water, or the Glyster No. 5. 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.

Sec. 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.

Sec. 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, No. 1 or 2, warm; or, if that is not at Hand, of some one of those Liquids I have recommended Sec. 32.

Sec. 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.

Sec. 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.

Sec. 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.

Sec. 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.

Sec. 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.

Sec. 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.

Sec. 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 No. 5 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.

Sec. 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.

Sec. 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.

Sec. 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 [18] 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.

[18] 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._

Sec. 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, [19] 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.

[19] 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._

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 No. 14. 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.

The 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.

Sec. 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.

Sec. 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.

Sec. 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 No. 2, the Almond Emulsion No. 4, or that of No. 7. 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 No. 5 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.

Sec. 50. When the Disease is circumstanced as described (Sec. 46) 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. [20]