Part 52

4, If the Fainting proves obstinate, that is, if it continues longer than a Quarter of an Hour, or degenerates into a Syncope, an Abolition of Feeling and Understanding, he must be bled in the Arm, which quickly revives him.

5, After the Bleeding, the Injection of a Glyster will be highly proper; and then the Patient should be kept still and calm, only letting him drink, every half Hour, some Cups of Elder Flower Tea, with the Addition of a little Sugar and Vinegar.

When Swoonings which result from this Cause occur frequently in the same Person, he should, in Order to escape them, pursue the Directions I shall hereafter mention, Sec. 544, when treating of Persons who superabound with Blood.

The very same Cause, or Causes, which occasion these Swoonings, also frequently produce violent Palpitations, under the same Circumstances; the Palpitation often preceding or following the Deliquium, or Swooning.

Of Swoonings occasioned by Weakness.

Sec. 496. If too great a Quantity of Blood, which may be considered as some Excess of Health, is sometimes the Cause of Swooning, this last is oftener the Effect of a very contrary Cause, that is, of a Want of Blood, or an Exhaustion of too much.

This Sort of Swooning happens after great Haemorrhages, or Discharges of Blood; after sudden or excessive Evacuations, such as one of some Hours Continuance in a Cholera Morbus (Sec. 321) or such as are more slow, but of longer Duration, as for Instance, after an inveterate Diarrhoea, or Purging; excessive Sweats; a Flood of Urine; such Excesses as tend to exhaust Nature; obstinate Wakefulness; a long Inappetency, which, by depriving the Body of its necessary Sustenance, is attended with the same Consequence as profuse Evacuations.

These different Causes of Swooning should be opposed by the Means and Remedies adapted to each of them. A Detail of all these would be improper here; but the Assistances that are necessary at the Time of Swooning, are nearly the same for all Cases of this Class; excepting for that attending a great Loss of Blood, of which I shall treat hereafter: first of all, the Patients should be laid down on a Bed, and being covered, should have their Legs and Thighs, their Arms, and their whole Bodies rubbed pretty strongly with hot Flanels; and no Ligature should remain on any Part of them.

2, They should have very spirituous Things to smell or snuff up, such as the Carmelite Water, Hungary Water, the English Salt, Spirit of Sal Ammoniac, strong smelling Herbs, such as Rue, Sage, Rosemary, Mint, Wormwood, and the like.

Dr. Tissot informs me, that in Swisserland, they call a volatile Salt of Vipers, or the volatile Salt of raw Silk, Sel. d'Angleterre, of which one Goddard made a Secret, and which he brought into Vogue the latter End of the last Century. But he justly observes at the same Time, that on the present Occasion every other volatile Alkali will equally answer the Purpose; and indeed the Smell of some of them, as the Spirit of Sal Ammoniac with Quicklime, Eau de Luce, &c. seem more penetrating. K.

3, These should be conveyed into their Mouths; and they should be forced, if possible, to swallow some Drops of Carmelite Water, or of Brandy, or of some other potable Liquor, mixed with a little Water; while some hot Wine mixed with Sugar and Cinnamon, which makes one of the best Cordials, is getting ready.

4, A Compress of Flanel, or of some other woollen Stuff, dipt in hot Wine, in which some aromatic Herb has been steeped, must be applied to the Pit of the Stomach.

5, If the Swooning seems likely to continue, the Patient must be put into a well heated Bed, which has before been perfumed with burning Sugar and Cinnamon; the Frictions of the whole Body with hot Flanels being still continued.

6, As soon as the Patient can swallow, he should take some Soup or Broth, with the Yolk of an Egg; or a little Bread or Biscuit; soaked in the hot spiced Wine.

7, Lastly, during the whole Time that all other Precautions are taken to oppose the Cause of the Swooning, Care must be had for some Days to prevent any Deliquium or Fainting, by giving them often, and but little at a time, some light yet strengthening Nourishment, such as Panada made with Soup instead of Water, new laid Eggs very lightly poached, light roast Meats with sweet Sauce, Chocolate, Soups of the most nourishing Meats, Jellies, Milk, &c.

Sec. 497. Those Swoonings, which are the Effect of Bleeding, or of the violent Operation of some Purge, are to be ranged in this Class.

Such as happen after artificial Bleeding, are generally very moderate, commonly terminating as soon as the Patient is laid upon the Bed: and Persons subject to this Kind, should be bled lying down, in Order to prevent it. But should the Fainting continue longer than usual, some Vinegar smelt to, and a little swallowed with some Water, is a very good Remedy.

The Treatment of such Faintings or Swoonings, as are the Consequences of too violent Vomits or Purges, may be seen hereafter Sec. 552.

Of Faintings occasioned by a Load, or Uneasiness, at Stomach.

Sec. 498. It has been already observed, Sec. 308, that Indigestions were sometimes attended with Swoonings, and indeed such vehement ones, as required speedy and very active Succour too, such as that of a Vomit. The Indigestion is sometimes less the Effect of the Quantity, than of the Quality, or the Corruption of the Food, contained in the Stomach. Thus we see there are some Persons, who are disordered by eating Eggs, Fish, Craw Fish, or any fat Meat; being thrown by them into inexpressible Anguish attended with Swooning too. It may be supposed to depend on this Cause, when these very Aliments have been lately eaten; and when it evidently neither depends on the other Causes I have mentioned; nor on such as I shall soon proceed to enumerate.

We should in Cases of this Sort, excite and revive the Patients as in the former, by making them receive some very strong Smell, of whatever Kind is at hand; but the most essential Point is to make them swallow down a large Quantity of light warm Fluid; which may serve to drown, as it were, the indigested Matter; which may soften its Acrimony; and either effect the Discharge of it by vomiting, or force it down into the Chanel of the Intestines.

A light Infusion of Chamomile Flowers, of Tea, of Sage, of Elder Flowers, or of Carduus Benedictus, operate with much the same Efficacy; though the Chamomile and Carduus promote the Operation of vomiting rather more powerfully; which warm Water alone will sometimes sufficiently do.

The Swooning ceases, or at least, considerably abates in these Cases, as soon as ever the Vomiting commences. It frequently happens too, that, during the Swooning, Nature herself brings on certain Nausea, a Wambling and sickish Commotion of the Stomach, that revives or rouses the Patient for a Moment; but yet not being sufficient to excite an actual Vomiting, lets him soon sink down again into this temporary Dissolution, which often continues a pretty considerable Time; leaving behind it a Sickness at Stomach, Vertigos, and a Depression and Anxiety, which do not occur in the former Species of this Malady.

Whenever these Swoonings from this Cause are entirely terminated, the Patient must be kept for some Days to a very light Diet, and take, at the same Time, every Morning fasting, a Dose of the Powder, No. 38, which relieves and exonerates the Stomach of whatever noxious Contents might remain in it; and then restores its natural Strength and Functions.

Sec. 499. There is another Kind of Swooning, which also results from a Cause in the Stomach; but which is, nevertheless, very different from this we have just been treating of; and which requires a very different Kind of Assistance. It arises from an extraordinary Sensibility of this important Organ, and from a general Weakness of the Patient.

Those subject to this Malady are valetudinary weakly Persons, who are disordered from many slight Causes, and whose Stomachs are at once very feeble and extremely sensible. They have almost continually a little Uneasiness after a Meal, though they should indulge but a little more than usual; or if they eat of any Food not quite so easy of Digestion, they have some Qualm or Commotion after it: Nay, should the Weather only be unfavourable, and sometimes without any perceivable assignable Cause, their Uneasiness terminates in a Swoon.

Patients swooning, from these Causes, have a greater Necessity for great Tranquillity and Repose, than for any other Remedy; and it might be sufficient to lay them down on the Bed: But as the Bystanders in such Cases find it difficult to remain inactive Spectators of Persons in a Swoon, some spirituous Liquid may be held to their Nose, while their Temples and Wrists are rubbed with it; and at the same Time a little Wine should be given them. Frictions are also useful in these Cases.

This Species of Swooning is oftener attended with a little Feverishness than the others.