Part 30

4, A Cup of the Mixture No. 8 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.

Sec. 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.

Sec. 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.

Sec. 294. It must be treated exactly like a Rheumatism. See Sec. 168 and 169.

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.

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. 118, 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.

Sec. 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 Sec. 96, 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.

The 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.

Sec. 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 Diarrhoea, 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 foetid 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.

Sec. 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 No. 4; 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.

Glauber or Epsom Salt may be substituted, where the other is not to be readily procured. K.

Sec. 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 Sec. 164.