Part 5

As long as the State of the Pulse is promising; Respiration or Breathing is free; the Brain does not seem to be greatly affected; while the Patient takes his Medicines, and they are attended with the Consequence that was expected; and he both preserves his Strength pretty well, and continues sensible of his Situation, we may reasonably hope for his Cure. As often as all, or the greater Number of these characterizing Circumstances are wanting, he is in very considerable Danger.

The Stoppage of Perspiration is often mentioned in the Course of this Work. We call the Discharge of that Fluid which continually passes off through the Pores of the Skin, Transpiration; and which, though invisible, is very considerable. For if a Person in Health eats and drinks to the Weight of eight Pounds daily, he does not discharge four of them by Stool and Urine together, the Remainder passing off by insensible Transpiration. It may easily be conceived, that if so considerable a Discharge is stopt, or considerably lessened; and if this Fluid, which ought to transpire through the Skin, should be transfered to any inward Part, it must occasion some dangerous Complaint. In fact this is one of the most frequent Causes of Diseases.

To conclude very briefly--All the Directions in the following Treatise are solely designed for such Patients, as cannot have the Attendance of a Physician. I am far from supporting, they ought to do instead of one, even in those Diseases, of which I have treated in the fullest Manner; and the Moment a Physician arrives, they ought to be laid aside. The Confidence reposed in him should be entire, or there should be none. The Success of the Event is founded in that. It is his Province to judge of the Disease, to select Medicines against it; and it is easy to foresee the Inconveniences that may follow, from proposing to him to consult with any others, preferably to those he may chuse to consult with; only because they have succeeded in the Treatment of another Patient, whose Case they suppose to have been nearly the same with the present Case. This were much the same, as to order a Shoemaker to make a Shoe for one Foot by the Pattern of another Shoe, rather than by the Measure he has just taken.

N. B. Though a great Part of this judicious Introduction is less applicable to the political Circumstances of the British Empire, than to those of the Government for which it was calculated; we think the good Sense and the unaffected Patriotism which animate it, will supersede any Apology for our translating it. The serious Truth is this, that a thorough Attention to Population seems never to have been more expedient for ourselves, than after so bloody and expensive, though such a glorious and successful War: while our enterprizing Neighbours, who will never be our Friends, are so earnest to recruit their Numbers; to increase their Agriculture; and to force a Vent for their Manufactures, which cannot be considerably effected, without a sensible Detriment to our own. Besides which, the unavoidable Drain from the People here, towards an effectual Cultivation, Improvement, and Security of our Conquests, demands a further Consideration. K.

ADVICE TO THE PEOPLE,

With Respect to their HEALTH.

*_Chapter I._*

Of the most usual Causes of popular Maladies.

_Sect._ 1.

The most frequent Causes of Diseases commonly incident to Country People are, 1. Excessive Labour, continued for a very considerable Time. Sometimes they sink down at once in a State of Exhaustion and Faintness, from which they seldom recover: but they are oftener attacked with some inflammatory Disease; as a Quinsey, a Pleurisy, or an Inflammation of the Breast.

There are two Methods of preventing these Evils: one is, to avoid the Cause which produces them; but this is frequently impossible. Another is, when such excessive Labour has been unavoidable, to allay their Fatigue, by a free Use of some temperate refreshing Drink; especially by sweet Whey, by Butter-milk, or by Water, to a Quart of which a Wine-glass of Vinegar may be added; or, instead of that, the expressed Juice of Grapes not fully ripe, or even of Goosberries or Cherries: which wholesome and agreeable Liquors are refreshing and cordial. I shall treat, a little lower, of inflammatory Disorders. The Inanition or Emptiness, though accompanied with Symptoms different from the former, have yet some Affinity to them with Respect to their Cause, which is a kind of general Exsiccation or Dryness. I have known some cured from this Cause by Whey, succeeded by tepid Baths, and afterwards by Cow's Milk: for in such Cases hot Medicines and high Nourishment are fatal.

This supposes they are not greatly heated, as well as fatigued, by their Labour or Exercise, in which Circumstance free and sudden Draughts of cooling Liquors might be very pernicious: and it evidently also supposes these Drinks to be thus given, rather in Summer, than in very cold Weather, as the Juice of the unripe Grapes, and the other fresh Fruits sufficiently ascertain the Season of the Year. We think the Addition of Vinegar to their Water will scarcely ever be necessary in this or the adjoining Island, on such Occasions. The Caution recommended in this Note is abundantly enforced by Dr. Tissot, Sec. 4: but considering the Persons, to whom this Work is more particularly addressed, we were willing to prevent every Possibility of a Mistake, in so necessary, and sometimes so vital a Point. K.

Sec. 2. There is another Kind of Exhaustion or Emptiness, which may be termed real Emptiness, and is the Consequence of great Poverty, the Want of sufficient Nourishment, bad Food, unwholesome Drink, and excessive Labour. In Cases thus circumstanced, good Soups and a little Wine are very proper. Such happen however very seldom in this Country: I believe they are frequent in some others, especially in many Provinces of France.

Sec. 3. A second and very common Source of Disorders arises, from Peoples' lying down and reposing, when very hot, in a cold Place. This at once stops Perspiration, the Matter of which being thrown upon some internal Part, proves the Cause of many violent Diseases, particularly of Quinseys, Inflammations of the Breast, Pleurisies, and inflammatory Cholics. These Evils, from this Cause, may always be avoided by avoiding the Cause, which is one of those that destroy a great Number of People. However, when it has occurred, as soon as the first Symptoms of the Malady are perceiveable, which sometimes does not happen till several Days after, the Patient should immediately be bled; his Legs should be put into Water moderately hot, and he should drink plentifully of the tepid Infusion marked No. 1. Such Assistances frequently prevent the Increase of these Disorders; which, on the contrary, are greatly aggravated, if hot Medicines are given to sweat the Patient.

Sec. 4. A third Cause is drinking cold Water, when a Person is extremely hot. This acts in the same Manner with the second; but its Consequences are commonly more sudden and violent. I have seen most terrible Examples of it, in Quinseys, Inflammations of the Breast, Cholics, Inflammations of the Liver, and all the Parts of the Belly, with prodigious Swellings, Vomitings, Suppressions of Urine, and inexpressible Anguish. The most available Remedies in such Cases, from this Cause, are, a plentiful Bleeding at the Onset, a very copious Drinking of warm Water, to which one fifth Part of Whey should be added; or of the Ptisan No. 2, or of an Emulsion of Almonds, all taken warm. Fomentations of warm Water should also be applied to the Throat, the Breast and Belly, with Glysters of the same, and a little Milk. In this Case, as well as in the preceding one, (Sec. 3.) a Semicupium, or Half-bath of warm Water has sometimes been attended with immediate Relief. It seems really astonishing, that labouring People should so often habituate themselves to this pernicious Custom, which they know to be so very dangerous to their very Beasts. There are none of them, who will not prevent their Horses from drinking while they are hot, especially if they are just going to put them up. Each of them knows, that if he lets them drink in that State, they might possibly burst with it; nevertheless he is not afraid of incurring the like Danger himself. However, this is not the only Case, in which the Peasant seems to have more Attention to the Health of his Cattle, than to his own.

Sec. 5. The fourth Cause, which indeed affects every Body, but more particularly the Labourer, is, the Inconstancy of the Weather. We shift all at once, many times a Day, from Hot to Cold, and from Cold to Hot, in a more remarkable Manner, and more suddenly, than in most other Countries. This makes Distempers from Defluxion and Cold so common with us: and it should make us careful to go rather a little more warmly cloathed, than the Season may seem to require; to have Recourse to our Winter-cloathing early in Autumn, and not to part with it too early in the Spring. Prudent Labourers, who strip while they are at Work, take care to put on their Cloaths in the Evening when they return home. Those, who from Negligence, are satisfied with hanging them upon their Country Tools, frequently experience, on their Return, the very unhappy Effects of it. There are some, tho' not many Places, where the Air itself is unwholsome, more from its particular Quality, than from its Changes of Temperature, as at Villeneuve, and still more at Noville, and in some other Villages situated among the Marshes which border on the Rhone. These Countries are particularly subject to intermitting Fevers; of which I shall treat briefly hereafter.

This good Advice is enforced in a Note, by the Editor of Lyons, who observes, it should be still more closely attended to, in Places, where Rivers, Woods or Mountains retain, as it were, a considerable Humidity; and where the Evenings are, in every Season, cold and moist.--It is a very proper Caution too in our own variable Climate, and in many of our Colonies in North America. K.

Sec. 6. Such sudden Changes are often attended with great Showers of Rain, and even cold Rain, in the Middle of a very hot Day; when the Labourer who was bathed, as it were, in a hot Sweat, is at once moistened in cold Water; which occasions the same Distempers, as the sudden Transition from Heat to Cold, and requires the same Remedies. If the Sun or a hot Air succeed immediately to such a Shower, the Evil is considerably lighter: but if the Cold continues, many are often greatly incommoded by it.

A Traveller is sometimes thoroughly and unavoidably wet with Mud; the ill Consequence of which is often inconsiderable, provided he changes his Cloaths immediately, when he sets up. I have known fatal Pleurisies ensue from omitting this Caution. Whenever the Body or the Limbs are wet, nothing can be more useful than bathing them in warm Water. If the Legs only have been wet, it may be sufficient to bath them. I have radically, thoroughly, cured Persons subject to violent Cholics, as often as their Feet were wet, by persuading them to pursue this Advice. The Bath proves still more effectual, if a little Soap be dissolved in it.

Sec. 7. A fifth Cause, which is seldom attended to, probably indeed because it produces less violent Consequences, and yet is certainly hurtful, is the common Custom in all Villages, of having their Ditches or Dunghills directly under their Windows. Corrupted Vapours are continually exhaling from them, which in Time cannot fail of being prejudicial, and must contribute to produce putrid diseases. Those who are accustomed to the Smell, become insensible of it: but the Cause, nevertheless, does not cease to be unwholesomly active; and such as are unused to it perceive the Impression in all its Force.

Sec. 8. There are some Villages, in which, after the Curtain Lines are erased, watery marshy Places remain in the Room of them. The Effect of this is still more dangerous, because that putrify'd Water, which stagnates during the hot Season, suffers its Vapours to exhale more easily, and more abundantly, than that in the Curtain Lines did. Having set out for Pully le Grand, in 1759, on Account of an epidemical putrid Fever which raged there, I was sensible, on traversing the Village, of the Infection from those Marshes; nor could I doubt of their being the Cause of this Disease, as well as of another like it, which had prevailed there five Years before. In other Respects the Village is wholesomly situated. It were to be wished such Accidents were obviated by avoiding these stagnated Places; or, at least, by removing them and the Dunghils, as far as possible from the Spot, where we live and lodge.

Sec. 9. To this Cause may also be added the Neglect of the Peasants to air their Lodgings. It is well known that too close an Air occasions the most perplexing malignant Fevers; and the poor Country People respire no other in their own Houses. Their Lodgings, which are very small, and which notwithstanding inclose, (both Day and Night) the Father, Mother, and seven or eight Children, besides some Animals, are never kept open during six Months in the Year, and very seldom during the other six. I have found the Air so bad in many of these Houses, that I am persuaded, if their Inhabitants did not often go out into the free open Air, they must all perish in a little Time. It is easy, however, to prevent all the Evils arising from this Source, by opening the Windows daily: so very practicable a Precaution must be followed with the happiest Consequences.

Sec. 10. I consider Drunkenness as a sixth Cause, not indeed as producing epidemical Diseases, but which destroys, as it were, by Retail, at all times, and every where. The poor Wretches, who abandon themselves to it, are subject to frequent Inflammations of the Breast, and to Pleurisies, which often carry them off in the Flower of their Age. If they sometimes escape through these violent Maladies, they sink, a long Time before the ordinary Approach of old Age, into all its Infirmities, and especially into an Asthma, which terminates in a Dropsy of the Breast. Their Bodies, worn out by Excess, do not comply and concur, as they ought, with the Force or Operation of Remedies; and Diseases of Weakness, resulting from this Cause, are almost always incurable. It seems happy enough, that Society loses nothing in parting with these Subjects, who are a Dishonour to it; and whose brutal Souls are, in some Measure, dead, long before their Carcases.

Sec. 11. The Provisions of the common People are also frequently one Cause of popular Maladies. This happens 1st, whenever the Corn, not well ripened, or not well got in, in bad Harvests, has contracted an unwholesome Quality. Fortunately however this is seldom the Case; and the Danger attending the Use of it, may be lessened by some Precautions, such as those of washing and drying the Grain completely; of mixing a little Wine with the Dough, in kneading it; by allowing it a little more Time to swell or rise, and by baking it a little more. 2dly, The fairer and better saved Part of the Wheat is sometimes damaged in the Farmers House; either because he does not take due Care of it, or because he has no convenient Place to preserve it, only from one Summer to the next. It has often happened to me, on entering one of these bad Houses, to be struck with the Smell of Wheat that has been spoiled. Nevertheless, there are known and easy Methods to provide against this by a little Care; though I shall not enter into a Detail of them. It is sufficient to make the People sensible, that since their chief Sustenance consists of Corn, their Health must necessarily be impaired by what is bad. 3dly, That Wheat, which is good, is often made into bad Bread, by not letting it rise sufficiently; by baking it too little, and by keeping it too long. All these Errors have their troublesome Consequences on those who eat it; but in a greater Degree on Children and Valetudinarians, or weakly People.

Thus I have ventured to translate Etes (Summers) to apply it to this and the neighbouring Islands. Their Harvests in Swisserland perhaps are earlier, and may occur in August, and that of some particular Grain, probably still earlier. K.

Tarts or Cakes may be considered as an Abuse of Bread, and this in some Villages is increased to a very pernicious Height. The Dough is almost constantly bad, and often unleavened, ill baked, greasy, and stuffed with either fat or sour Ingredients, which compound one of the most indigestible Aliments imaginable. Women and Children consume the most of this Food, and are the very Subjects for whom it is the most improper: little Children especially, who live sometimes for many successive Days on these Tarts, are, for the greater Part, unable to digest them perfectly. Hence they receive a Source of Obstructions in the Bowels of the Belly, and of a slimy Viscidity or Thickishness, throughout the Mass of Humours, which throws them into various Diseases from Weakness; slow Fevers, a Hectic, the Rickets, the King's Evil, and Feebleness; for the miserable Remainder of their Days. Probably indeed there is nothing more unwholesome than Dough not sufficiently leavened, ill-baked, greasy, and soured by the Addition of Fruits. Besides, if we consider these Tarts in an oeconomical View, they must be found inconvenient also for the Peasant on that Account.

The Abuse just mentioned can scarcely be intended to forbid the moderate Use of good Pastry, the Dough of which is well raised and well baked, the Flower and other Ingredients sound, and the Paste not overcharged with Butter, even though it were sweet and fresh. But the Abuse of Alum and other pernicious Materials introduced by our Bakers, may too justly be considered as one horrible Source of those Diseases of Children, &c. which our humane and judicious Author mentions here. What he adds, concerning the Pastries being rendered still more unwholesome by the sour Fruits sometimes baked in it, is true with Respect to those Children and others, who are liable to Complaints from Acidities abounding in the Bowels; and for all those who are ricketty or scrophulous, from a cold and viscid State of their Humours. But as to healthy sanguine Children, who are advanced and lively, and others of a sanguine or bilious Temperament, we are not to suppose a moderate Variety of this Food injurious to them; when we consider, that the Sharpness and Crudity of the Fruit is considerably corrected by the long Application of Fire; and that they are the Produce of Summer, when bilious Diseases are most frequent. This suggests however no bad Hint against making them immoderately sweet. K.

Some other Causes of Maladies may also be referred to the Article of Food, tho' less grievous and less frequent, into a full Detail of which it is very difficult to enter: I shall therefore conclude that Article with this general Remark; that it is the Care which Peasants usually take in eating slowly, and in chewing very well, that very greatly lessens the Dangers from a bad Regimen: and I am convinced they constitute one of the greatest Causes of that Health they enjoy. We may further add indeed the Exercise which the Peasant uses, his long abiding in the open Air, where he passes three fourths of his Life; besides (which are also considerable Advantages) his happy Custom of going soon to Bed, and of rising very early. It were to be wished, that in these Respects, and perhaps on many other Accounts, the Inhabitants of the Country were effectually proposed as Models for reforming the Citizens.