Part 20

6, Every three Hours a Dose of the Powder No. 30, should be taken in a Cup of the Infusion of Lime-tree and Elder Flowers.

7, The Prescription No. 31, 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 No. 35, 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.

Sec. 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 No. 14, thrice a Day.

Sec. 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 Opium were dissolved; with the Addition of repeated Frictions of the Ointment No. 28, 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.

Sec. 199. Dogs may be cured by rubbing in a triple Quantity of the same Ointment directed for Men, and by giving them the Bolus No. 33. 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.

Sec. 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.

Sec. 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.

The 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.

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' Parallele 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.

Sec. 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.

Sec. 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.

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.

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.

Sec. 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.