Part 31

Sec. 300. Ten Days after I had recovered a Woman out of a severe Cholic, the Pains returned violently in the Night. She, supposing them to arise only from Wind, hoped to appease them by drinking a deal of distilled Walnut Water; which, far from producing any such Effect, rendered them more outrageous. They soon were heightened to a surprising Degree, which might reasonably be expected. Being sent for very early in the Morning, I found her Pulse hard, quick, short; her Belly was tense and hard; she complained greatly of her Loins: her Urine was almost entirely stopt. She past but a few Drops, which felt as it were scalding hot, and these with excessive Pain. She went very frequently to the Close-stool, with scarcely any Effect; her Anguish, Heat, Thirst, and the Dryness of her Tongue were even terrifying: and her wretched State, the Effect of the strong hot Liquor she had taken, made me very apprehensive for her. One Bleeding, to the Quantity of fourteen Ounces, somewhat abated all the Pains; she took several Glysters, and drank off a few Pots of Orgeat in a few Hours. By these Means the Disease was a little mitigated; by continuing the same Drink and the Glysters the Looseness abated; the Pain of the Loins went off, and she passed a considerable Quantity of Urine, which proved turbid, and then let fall a Sediment, and the Patient recovered. Nevertheless I verily believe, if the Bleeding had been delayed two Hours longer, this spirituous Walnut Water would have been the Death of her. During the Progress of this violent Disease, no Food is to be allowed; and we should never be too inattentive to such Degrees of Pain, as sometimes remain after their Severity is over; lest a Scirrhus, an inward hard Tumour, should be generated, which may occasion the most inveterate and tedious Maladies.

Sec. 301. An Inflammation of the Intestines, and one of the Stomach, may also terminate in an Abscess, like an Inflammation of any other Part; and it may be apprehended that one is forming, when, though the Violence of the Pains abates, there still remains a slow, obtuse, heavy Pain, with general Inquietude, little Appetite, frequent Shiverings; the Patient at the same Time not recovering any Strength. In such Cases the Patient should be allowed no other Drinks, but what are already directed in this Chapter, and some Soops made of Pulse, or other farinaceous Food.

The Breaking of the Abscess may sometimes be discovered by a slight Swoon or fainting Fit; attended with a perceivable Cessation of a Weight or Heaviness in the Part, where it was lately felt: and when the Pus, or ripe Matter, is effused into the Gut, the Patient sometimes has Reachings to vomit, a Vertigo, or Swimming in the Head, and the Matter appears in the next Stools. In this Case there remains an Ulcer within the Gut, which, if either neglected, or improperly treated, may pave the Way to a slow wasting Fever, and even to Death. Yet this I have cured by making the Patient live solely upon skimmed Milk, diluted with one third Part Water, and by giving every other Day a Glyster, consisting of equal Parts of Milk and Water, with the Addition of a little Honey.

When the Abscess breaks on the Outside of the Gut, and discharges its Contents into the Cavity of the Belly, it becomes a very miserable Case, and demands such further Assistance as cannot be particularized here.

Of the bilious Cholic.

Sec. 302. The bilious Cholic discovers itself by very acute Pains, but is seldom accompanied with a Fever; at least not until it has lasted a Day or two. And even if there should be some Degree of a Fever, yet the Pulse, though quick, is neither strong nor hard: the Belly is neither tense or stretched as it were, nor burning hot, as in the former Cholic: the Urine comes away with more Ease, and is less high-coloured: Nevertheless the inward Heat and Thirst are considerable; the Mouth is bitter; the Vomiting or Purging, when either of them attend it, discharge a yellowish Humour or Excrement; and the Patient's Head is often vertiginous or dizzy.

Sec. 303. The Method of curing this is,

1, By injecting Glysters of Whey and Honey; or, if Whey is not readily procurable, by repeating the Glyster, No. 5.

2, By making the Sick drink considerably of the same Whey, or of a Ptisan made of the Root of Dog's-Grass (the common Grass) and a little Juice of Lemon, for want of which, a little Vinegar and Honey may be substituted instead of it.

Pullet, or rather Chicken Water, but very weak, may often do instead of Ptisan, or serve for a little Variety of Drink to some Patients. E. L.--K.

3, By giving every Hour one Cup of the Medicine No. 32; or where this is not to be had, half a Drachm of Cream of Tartar at the same short Intervals.

4, Fomentations of warm Water and Half-baths are also very proper.

5, If the Pains are sharp and violent, in a robust strong Person, and the Pulse is strong and tense, Bleeding should be used to prevent an Inflammation.

6, No other Nourishment should be given, except some maigre Soops, made from Vegetables, and particularly of Sorrel.

7, After plentiful Dilution with the proper Drink, if no Fever supervenes; if the Pains still continue, and the Patient discharges but little by Stool, he should take a moderate Purge. That directed No. 47 is a very proper one.

Sec. 304. This bilious Cholic is habitual to many Persons; and may be prevented or greatly mitigated by an habitual Use of the Powder No. 24; by submitting to a moderate Retrenchment in the Article of Flesh-meat; and by avoiding heating and greasy Food, and the Use of Milk.

Of Cholics from Indigestions, and of Indigestion.

Sec. 305. Under this Appellation I comprehend all those Cholics, which are either owing to any overloading Quantity of Food taken at once; or to a Mass or Accumulation of Aliments formed by Degrees in such Stomachs, as digest but very imperfectly; or which result from noxious Mixtures of Aliment in the Stomach, such as that of Milk and Acids; or from Food either not wholesome in its self, or degenerated into an unwholesome Condition.

This kind of Cholic may be known from any of these Causes having preceded it; by its Pains, which are accompanied with great Restlessness, and come on by Degrees, being less fixed than in the Cholics before treated of. These Cholics are also without any Fever, Heat or Thirst, but accompanied with a Giddiness of the Head, and Efforts to vomit, and rather with a pale, than a high-coloured Visage.

Sec. 306. These Disorders, from these last Causes, are scarcely ever dangerous in themselves; but may be made such by injudicious Management, and doing more than is necessary or proper: as the only Thing to be done is to promote the Discharges by warm Drinks. There are a considerable Variety of them, which seem equally good, such as warm Water, or even cold Water with a Toast, with the Addition either of a little Sugar, or a little Salt: a light Infusion of Chamomile, or of Elder-flowers, common Tea, or Baum, it imports little which, provided the Patient drink plentifully of them: in Consequence of which the offending Matter is discharged, either by vomiting, or a considerable purging; and the speedier and more in Quantity these Discharges are, the sooner the Patient is relieved.

If the Belly is remarkably full and costive, Glysters of warm Water and Salt should be injected.

The Expulsion of the obstructing Matter is also facilitated, by rubbing the Belly heartily with hot Cloths.

Sometimes the Humours, or other retained Contents of the Belly, are more pernicious from their Quality, than their Quantity; and then the Malady may be dissipated without the former Discharges, by the irritating sharp Humour being diluted, or even drowned, as it were, in the Abundance of small watery Drinks. When the Pains invade first in the Stomach, they become less sharp, and the Patient feels less Inquietude, as soon as the Cause of the Pain has descended out of the Stomach into the Intestines, whose Sensations are something less acute than, or somewhat different from, those of the Stomach.

It is often found that after these plentiful Discharges, and when the Pains are over, there remains a very disagreeable Taste in the Mouth, resembling the Savour of rotten Eggs. This may be removed by giving some Doses of the Powder No. 24, and drinking largely of good Water:

It is an essential Point in these Cases, to take no Food before a perfect Recovery.

Sec. 307. Some have been absurd enough in them, to fly at once to some heating Cordial Confection, to Venice Treacle, Aniseed Water, Geneva, or red Wine to stop these Evacuations; but there cannot be a more fatal Practice: since these Evacuations are the only Thing which can cure the Complaint, and to stop them is to deprive the Person, who was in Danger of drowning, of the Plank which might save him. Nay should this Endeavour of stopping them unhappily succeed, the Patient is either thrown into a putrid Fever, or some chronical tedious Malady; unless Nature, much wiser than such a miserable Assistant, should prevail over the Obstacles opposed to her Recovery, and restore the obstructed Evacuations by her own Oeconomy, in the Space of a few Days.

Sec. 308. Sometimes an Indigestion happens, with very little Pain or Cholic, but with violent Reachings to vomit, inexpressible Anguish, Faintings, and cold Sweats: and not seldom also the Malady begins, only with a very sudden and unexpected Fainting: the Patient immediately loses all his Senses, his Face is pale and wan: he has some Hickups rather than Reachings to vomit, which joined to the Smallness of his Pulse, to the Easiness of his respiring, or breathing, and to the Circumstance of his being attacked immediately, or very soon, after a Meal, makes this Disorder distinguishable from a real Apoplexy. Nevertheless, when it rises to this Height, with these terrible Symptoms, it sometimes kills in a few Hours. The first thing to be done is to throw up a sharp Glyster, in which Salt and Soap are to be dissolved; next to get down as much Salt and Water as he can swallow; and if that is ineffectual, the Powder No. 34 is to be dissolved in three Cups of Water; one half of which is to be given directly; and, if it does not operate in a Quarter of an Hour, the other half. Generally speaking the Patient's Sense begins to return, as soon as he begins to vomit.

Of the flatulent or windy Cholic.