Part 55

Of suffocating, or strangling Fits.

Sec. 518. These Fits (by whatever other Name they may be called) whenever they very suddenly attack a Person, whose Breathing was easy and natural just before, depend almost constantly on a Spasm or Contraction of the Nerves, in the Vesicles of the Lungs; or upon an Infarction, a Stuffing of the same Parts, produced by viscid clammy Humours.

That Suffocation which arises from a Spasm is not dangerous, it goes off of itself, or it may be treated like Swoonings owing to the same Cause. See Sec. 502.

Sec. 519. That Suffocation, which is the Effect of a sanguineous Fulness and Obstruction, may be distinguished by its attacking strong, vigorous, sanguine Persons, who are great Eaters, using much juicy nutritious Food, and strong Wine and Liquors, and who frequently eat and inflame themselves; and when the Fit has come on after any inflaming Cause; when the Pulse is full and strong, and the Countenance red.

Such are cured, 1, by a very plentiful Discharge of Blood from the Arm, which is to be repeated, if necessary.

2, By the Use of Glysters.

3, By drinking plentifully of the Ptisan No. 1; to each Pot of which, a Drachm of Nitre is to be added; and,

4, By the Vapour of hot Vinegar, continually received by Respiration or Breathing. See Sec. 55.

Sec. 520. There is Reason to think that one of these Fits is owing to a Quantity of tough viscid Humours in the Lungs, when it attacks Persons, whose Temperament, and whose Manner of living are opposite to those I have just described; such as valetudinary, weakly, phlegmatic, pituitous, inactive, and squeamish Persons, who feed badly, or on fat, viscid, and insipid Diet, and who drink much hot Water, either alone, or in Tea-like Infusions. And these Signs of Suffocation, resulting from such Causes, are still more probable, if the Fit came on in rainy Weather, and during a southerly Wind; and when the Pulse is soft and small, the Visage pale and hollow.

The most efficacious Treatment we can advise, is, 1, To give every half Hour half a Cup of the Potion, No. 8, if it can be readily had. 2, To make the Patient drink very plentifully of the Drink No. 12; and, 3, to apply two strong Blisters to the fleshy Parts of his Legs.

If he was strong and hearty before the Fit, and the Pulse still continues vigorous, and feels somewhat full withall, the Loss of seven or eight Ounces of Blood is sometimes indispensably necessary. A Glyster has also frequently been attended with extraordinary good Effects.

Those afflicted with this oppressing Malady are commonly relieved, as soon as they expectorate, and sometimes even by vomiting a little.

The Medicine No. 25, a Dose of which may be taken every two Hours, with a Cup of the Ptisan No. 12, often succeeds very well.

But if neither this Medicine, nor the Prescription of No. 8 are at Hand, which may be the Case in Country Places; an Onion of a moderate Size should be pounded in an Iron or Marble Mortar; upon this, a Glass of Vinegar is to be poured, and then strongly squeezed out again through a Piece of Linen. An equal Quantity of Honey is then to be added to it. A Spoonful of this Mixture, whose remarkable Efficacy I have been a Witness of, is to be given every half Hour.

Of the violent Effects of Fear.

Sec. 521. Here I shall insert some Directions to prevent the ill Consequences of great Fear or Terror, which are very prejudicial at every Term of Life, but chiefly during Infancy.

The general Effects of Terror, are a great Straitening or Contraction of all the small Vessels, and a Repulsion of the Blood into the large and internal ones. Hence follows the Suppression of Perspiration, the general Seizure or Oppression, the Trembling, the Palpitations and Anguish, from the Heart and the Lungs being overcharged with Blood; and sometimes attended with Swoonings, irremediable Disorders of the Heart, and Death itself. A heavy Drowsiness, Raving, and a Kind of furious or raging Delirium happen in other Cases, which I have frequently observed in Children, when the Blood-vessels of the Neck were swelled and stuffed up; and Convulsions, and even the Epilepsy have come on, all which have proved the horrible Consequence of a most senseless and wicked Foolery or Sporting. One half of those Epilepsies which do not depend on such Causes, as might exist before the Child's Birth, are owing to this detestable Custom; and it cannot be too much inculcated into Children, never to frighten one another; a Point which Persons intrusted with their Education, ought to have the strictest Regard to.

When the Humours that should have passed off by Perspiration, are repelled to the Intestines, a tedious and very obstinate Looseness is the frequent Consequence.

Sec. 522. Our Endeavours should be directed, to re-establish the disordered Circulation; to restore the obstructed Perspiration; and to allay the Agitation of the Nerves.

The popular Custom in these Cases has been to give the terrified Patient some cold Water directly; but when the Fright has been considerable, this is a very pernicious custom, and I have seen some terrible Consequences from it.

They should, on the contrary, be conveyed into some very quiet Situation, leaving there but very few Persons, and such only as they are thoroughly familiar with. They should take a few Cups of pretty warm Drink, particularly of an Infusion of Lime-tree Flowers and Bawm. Their Legs should be put into warm Water, and remain there an Hour, if they will patiently permit it, rubbing them gently now and then, and giving them every half-quarter of an Hour, a small Cup of the said Drink. When their Composure and Tranquillity are returned a little, and their Skin seems to have recovered its wonted and general Warmth, Care should be taken to dispose them to sleep, and to perspire plentifully. For this Purpose they may be allowed a few Spoonfuls of Wine, on putting them into Bed, with one Cup of the former Infusion; or, which is more certain and effectual, a few Drops of Sydenham's Liquid Laudanum, No. 44; but should that not be near at Hand, a small Dose of Venice Treacle.

Sec. 523. It sometimes happens that Children do not seem at first extremely terrified; but the Fright is renewed while they sleep, and with no small Violence. The Directions I have just given must then be observed, for some successive Evenings, before they are put to Bed.

Their Fright frequently returns about the latter End of the Night, and agitates them violently every Day. The same Treatment should be continued in such Cases; and we should endeavour to dispose them to be a-sleep at the usual Hour of its Return.

By this very Method, I have dissipated the dismal Consequences of Fear of Women in Child-bed, which is so commonly, and often speedily, mortal.

If a Suffocation from this Cause is violent, there is sometimes a Necessity for opening a Vein in the Arm.

These Patients should gradually be inured to an almost continual, but gentle, Kind of Exercise.

All violent Medicines render those Diseases, which are the Consequences of great Fear, incurable. A pretty common one is that of an Obstruction of the Liver, which has been productive of a Jaundice.

I have seen this actually verified by great and disagreeable Surprize, attended indeed with much Concern, in a Person of exquisite Sensations. K.