Part 32

Sec. 309. Every Particular which constitutes our Food, whether solid or liquid, contains much Air, but some of them more than others. If they do not digest soon enough, or but badly, which occasions a sensible Escape of such Air; if they are such as contain an extraordinary Quantity of Air; or if the Guts being straitened or compressed any where in the Course of their Extent, prevent that Air from being equally diffused (which must occasion a greater Proportion of it in some Places) then the Stomach and the Guts are distended by this Wind; and this Distention occasions these Pains, which are called flatulent, or windy.

This Sort of Cholic rarely appears alone and simple; but is often complicated with, or added, as it were, to the other Sorts, of which it is a Consequence; and is more especially joined with the Cholic from Indigestions, whose Symptoms it multiplies and heightens. It may be known, like that, by the Causes which have preceded it, by its not being accompanied either with Fever, Heat, or Thirst; the Belly's being large and full, though without Hardness, being unequal in its Largeness, which prevails more in one Part of it than in another, forming something like Pockets of Wind, sometimes in one Part, sometimes in another; and by the Patient's feeling some Ease merely from the rubbing of his Belly, as it moves the Wind about; which escaping either upwards or downwards affords him still a greater Relief.

Sec. 310. When it is combined with any different Species of the Cholic, it requires no distinct Treatment from that Species; and it is removed or dissipated by the Medicines which cure the principal Disease.

Sometimes however it does happen to exist alone, and then it depends on the Windiness of the solid and liquid Food of the Person affected with it, such as the Must or new Wine, Beer, especially very new Beer, certain Fruits and Garden-stuff. It may be cured by a Glyster; by chaffing the Belly with hot Cloths; by the Use of Drink moderately spiced; and especially by Camomile Tea, to which a little cordial Confection, or even Venice Treacle, may be added. When the Pains are almost entirely vanished, and there is no Fever, nor any unhealthy Degree of Heat; and if the Patient is sensible of a Weakness at Stomach, he may take a little aromatic, or spiced Wine, or even a small cordial stomachic Dram. It should be observed, that these are not to be allowed in any other Kind of Cholic.

Sec. 311. When any Person is frequently subject to cholic-like Pains, it is a Proof that the digestive Faculty is impaired; the restoring of which should be carefully attended to; without which the Health of the Patient must suffer considerably, and he must be very likely to contract many tedious and troublesome Disorders.

Of Cholics from Cold.

Sec. 312. When any Person has been very cold, and especially in his Feet, it is not uncommon for him to be attacked, within a few Hours after it, with violent Cholic Pains, in which heating and spirituous Medicines are very pernicious: but which are easily cured by rubbing the Legs well with hot Cloths; and keeping them afterwards for a considerable Time in warm Water; advising them at the same Time to drink freely of a light Infusion of Chamomile or Elder-flowers.

The Cure will be effected the sooner, if the Patient is put to Bed and sweats a little, especially in the Legs and Feet.

A Woman who had put her Legs into a pretty cool Spring, after travelling in the Height of Summer, was very quickly after attacked with a most violent Cholic. She took different hot Medicines; she became still worse; she was purged, but the Distemper was still further aggravated. I was called in on the third Day, a few Hours before her Decease.

In such Cases, if the Pain be excessive, it may be necessary to bleed; to give a Glyster of warm Water; to keep the Legs several Hours over the Steam of hot Water, and afterwards in the Water; to drink plentifully of an Infusion of the Flowers of the Lime-tree, with a little Milk; and if the Distemper is not subdued by these Means, Blisters should be applied to the Legs, which I have known to be highly efficacious.

Bleeding should not be determined on too hastily in this Sort of Cholic, but rather be omitted, or deferred at least, till there be an evident Tendency to an Inflammation. E. L.

The Propriety or Impropriety of Bleeding in a Cholic from this Cause should be determined, I think, from the State of the Person it happens to: So that Bleeding a strong Person with a firm Fibre, and a hard Pulse, may be very prudent and precautionary: But if it be a weakly lax Subject with a soft and low Pulse, there may be Room either for omitting, or for suspending it. K.

Sec. 313. It appears, through the Course of this Chapter, that it is necessary to be extremely on our Guard, against permitting the Use of heating and spirituous Medicines in Cholics, as they may not only aggravate, but even render them mortal. In short they should never be given, and when it is difficult to discover the real Cause of the Cholic, I advise Country People to confine themselves to the three following Remedies, which cannot be hurtful in any Sort of Cholic, and may remove as many as are not of a violent Nature. First then, let Glysters be frequently repeated. 2, Let the Patient drink warm Water plentifully, or Elder Tea. 3, Let the Belly be often fomented in pretty warm Water, which is the most preferable Fomentation of any.

Sec. 314 I have said nothing here of the Use of any Oils in this Disease, as they agree but in very few Species of Cholics, and not at all in those of which I have been treating. For this Reason I advise a total Disuse of them, since they may be of bad Consequence in many Respects.

Sec. 315. Chronical Diseases not coming within the Plan of this Work, I purposely forbear treating of any Kind of those tedious Cholics, which afflict some People for many Years: but I think it my Duty to admonish such, that their Torments being very generally occasioned by Obstructions in the Viscera, or different Bowels of the Belly, or by some other Fault, and more particularly in those Organs, which are intended to prepare the Bile, they should, 1, avoid with the greatest Care, the Use of sharp, hot, violent Medicines, Vomits, strong Purges, Elixirs, &c. 2, They should be thoroughly on their Guard against all those, who promise them a very speedy Cure, by the Assistance of some specific Remedy; and ought to look upon them as Mountebanks, into whose Hands it is highly dangerous to trust themselves. 3, They should be persuaded, or rather convinced, that they can entertain no reasonable Hope of being cured, without an exact Conformity to a proper and judicious Regimen, and a long Perseverance in a Course of mild and safe Remedies. 4, They should continually reflect with themselves, that there is little Difficulty in doing them great Mischief; and that their Complaints are of that Sort, which require the greatest Knowledge and Prudence in those Persons, to whom the Treatment and Cure of them are confided.

_Chapter XXII._

Of the Iliac Passion, and of the Cholera-morbus.

_Sect._ 316.

These violent Diseases are fatal to many Country People, while their Neighbours are frequently so ignorant of the Cause of their Death, that Superstition has ascribed it to Poison, or to Witchcraft.

Sec. 317. The first of these, the Miserere, or Iliac Passion, is one of the most excruciating Distempers. If any Part of the Intestines, the Cavity of the Guts is closed up, whatever may have occasioned it, the Course or Descent of the Food they contain is necessarily stopped; in which Case it frequently happens, that that continual Motion observed in the Guts of a living Animal dissected, and which was intended to detrude, or force their Contents downwards, is propagated in a directly contrary Manner, from the Guts towards the Mouth.

This Disease sometimes begins after a Constipation, or Costiveness, of some Days; at other Times without that Costiveness having been preceded by Pains in any Part of the Belly, especially around the Navel; but which Pains, gradually increasing after their Commencement, at length become extremely violent, and throw the Patient into excessive Anguish. In some of these Cases a hard Tumour may be felt, which surrounds the Belly like a Cord. The Flatulences within become very audible, some of them are discharged upwards; in a little Time after, Vomitings come on, which increase till the Patient has thrown up all he had taken in, with a still further Augmentation of the excessive Pain. With the first of his Vomitings he only brings up the last Food he had taken, with his Drink and some yellowish Humour: but what comes up afterwards proves stinking; and when the Disease is greatly heightened, they have what is called the Smell of Excrement or Dung; but which rather resembles that of a putrid dead Body. It happens too sometimes, that if the Sick have taken Glysters composed of Materials of a strong Smell, the same Smell is discernible in the Matter they vomit up. I confess however I never saw either real Excrements, or the Substance of their Glysters, brought up, much less the Suppositories that were introduced into the Fundament: and were it credible that Instances of this Kind had occurred, they must be allowed very difficult to account for. Throughout this whole Term of the Disease, the Patient has not a single Discharge by Stool; the Belly is greatly distended; the Urine not seldom suppressed, and at other Times thick and foetid. The Pulse, which at first was pretty hard, becomes quick and small; the Strength entirely vanishes; a Raving comes on; a Hiccup almost constantly supervenes, and sometimes general Convulsions; the Extremities grow cold, the Pulse scarcely perceivable; the Pain and the Vomiting cease, and the Patient dies very quickly after.

Sec. 318. As this Disease is highly dangerous, the Moment it is strongly apprehended, it is necessary to oppose it by proper Means and Remedies: the smallest Error may be of fatal Consequence, and hot inflaming Liquids have been known to kill the Patient in a few Hours. I was called in the second Day of the Disease to a young Person, who had taken a good deal of Venice Treacle: Nothing could afford her any Relief, and she died early on the third Day.

This Disease should be treated precisely in the same Manner as an inflammatory Cholic; the principal Difference being, that in the former there are no Stools, but continual Vomitings.

1, First of all then the Patient should be plentifully bled, if the Physician has been called in early enough, and before the Sick has lost his Strength.

2, He should receive opening Glysters made of a Decoction of Barley Water, with five or six Ounces of Oil in each.

3, We should endeavour to allay the violent Efforts to vomit, by giving every two Hours a Spoonful of the Mixture No. 48.

4, The Sick should drink plentifully, in very small Quantities, very often repeated, of an appeasing, diluting, refreshing Drink, which tends at the same Time to promote both Stools and Urine. Nothing is preferable to the Whey No. 49, if it can be had immediately: if not, give simple clear Whey sweetened with Honey, and the Drinks prescribed Sec. 298, Art. 3.

5, The Patient is to be put into a warm Bath, and kept as long as he can bear it, repeating it as often daily too, as his Strength will permit.