Part 6

Sec. 12. We should not omit, in enumerating the Causes of Maladies among Country People, the Construction of their Houses, a great many of which either lean, as it were, close to a higher Ground, or are sunk a little in the Earth. Each of these Situations subjects them to considerable Humidity; which is certain greatly to incommode the Inhabitants, and to spoil their Provisions, if they have any Quantity in Store; which, as we have observed, is another, and not the least important, Source of their Diseases. A hardy Labourer is not immediately sensible of the bad Influence of this moist and marshy Habitation; but they operate at the long Run, and I have abundantly observed their most evident bad Effects, especially on Women in Child-bed, on Children, and in Persons recovering of a preceding Disease. It would be easy to prevent this Inconvenience, by raising the Ground on which the House stood, some, or several, Inches above the Level of the adjacent Soil, by a Bed of Gravel, of small Flints, pounded Bricks, Coals, or such other Materials; and by avoiding to build immediately close to, or, as it were, under a much higher Soil. This Object, perhaps, may well deserve the Attention of the Publick; and I earnestly advise as many as do build, to observe the necessary Precautions on this Head. Another, which would cost still less Trouble, is to give the Front of their Houses an Exposure to the South-East. This Exposure, supposing all other Circumstances of the Building and its Situation to be alike, is both the most wholesome and advantageous. I have seen it, notwithstanding, very often neglected, without the least Reason being assigned for not preferring it.

These Admonitions may possibly be thought of little Consequence by three fourths of the People. I take the Liberty of reminding them, however, that they are more important than they may be supposed; and so many Causes concur to the Destruction of Men, that none of the Means should be neglected, which may contribute to their Preservation.

Sec. 13. The Country People in Swisserland drink, either 1, pure Water, 2, some Wine, 3, Perry, made from wild Pears, or sometimes Cyder from Apples, and, 4, a small Liquor which they call Piquette, that is Water, which has fermented with the Cake or Husks of the Grapes, after their Juice has been expressed. Water however is their most general Drink; Wine rarely falling in their Way, but when they are employed by rich Folks; or when they can spare Money enough for a Debauch. Fruit Wines and the Piquettes are not used in all Parts of the Country; they are not made in all Years; and keep but for some Months.

This Word's occurring in the plural Number will probably imply, the Swiss make more than one Species of this small Drink, by pouring Water on the Cake or Remainder of their other Fruits, after they have been expressed; as our People in the Cyder, and perhaps in the Perry, Counties, make what they call Cyderkin, Perkin, &c. It should seem too from this Section, that the laborious Countrymen in Swisserland drink no Malt Liquor, though the Ingredients may be supposed to grow in their Climate. Now Beer, of different Strength, making the greater Part of our most common Drink, it may be proper to observe here, that when it is not strong and heady, but a middling well-brewed Small-beer, neither too new, nor hard or sour, it is full as wholesome a Drink for laborious People in Health as any other, and perhaps generally preferable to Water for such; which may be too thin and light for those who are unaccustomed to it; and more dangerous too, when the labouring Man is very hot, as well as thirsty. The holding a Mouthful of any weak cold Liquor in the Mouth without swallowing 'till it becomes warm, there, and spurting it out before a Draught is taken down would be prudent; and in Case of great Heat, to take the requisite Quantity rather at two Draughts, with a little Interval between them, than to swallow the Whole precipitately at one, would be more safe, and equally refreshing, though perhaps less grateful. K.

Our Waters in general, are pretty good; so that we have little Occasion to trouble ourselves about purifying them; and they are well known in those Provinces where they are chiefly and necessarily used. The pernicious Methods taken to improve or meliorate, as it is falsely called, bad Wines, are not as yet sufficiently practiced among us, for me to treat of them here: and as our Wines are not hurtful, of themselves, they become hurtful only from their Quantity. The Consumption of made Wines and Piquettes is but inconsiderable, and I have not hitherto known of any ill Effects from them, so that our Liquors cannot be considered as Causes of Distempers in our Country; but in Proportion to our Abuse of them by Excess. The Case is differently circumstanced in some other Countries; and it is the Province of Physicians who reside in them, to point out to their Country-Men the Methods of preserving their Health; as well as the proper and necessary Remedies in their Sickness.

The bad Quality of Water is another common Cause of Country Diseases; either where the Waters are unwholesome, from the Soils in which they are found, as when they flow through, or settle, on Banks of Shells; or where they become such, from the Neighbourhood of, or Drainings from Dunghills and Marshes.

When Water is unclear and turbid, it is generally sufficient to let it settle in order to clear itself, by dropping its Sediment. But if that is not effected, or if it be slimy or muddy, it need only be poured into a large Vessel, half filled with fine Sand, or, for want of that, with Chalk; and then to shake and stir it about heartily for some Minutes. When this Agitation is over, the Sand, in falling to the Bottom of the Vessel, will attract some of the Foulness suspended in the Water. Or, which is still better, and very easy to do, two large Vessels may be set near together, one of which should be placed considerably higher than the other. The highest should be half filled with Sand. Into this the turbid, or slimy muddy Water is to be poured; whence it will filter itself through the Body of Sand, and pass off clear by an Opening or Orifice made at the Bottom of the Vessel; and fall from thence into the lower one, which serves as a Reservoir. When the Water is impregnated with Particles from the Beds of Selenites, or of any Spar (which Water we call hard, because Soap will not easily dissolve in it, and Puls and other farinaceous Substances grow hard instead of soft, after boiling in it) such Water should be exposed to the Sun, or boiled with the Addition of some Puls, or leguminous Vegetables, or Bread toasted, or untoasted. When Water is in its putrid State, it may be kept till it recovers its natural sweet one: but if this cannot be waited for, a little Sea Salt should be dissolved in it, or some Vinegar may be added, in which some grateful aromatic Plant has been infused. It frequently happens, that the publick Wells are corrupted by foul Mud at the Bottom, and by different Animals which tumble in and putrify there. Drinking Snow-water should be avoided, when the Snow is but lately fallen, as it seems to be the Cause of those swelling wenny Throats in the Inhabitants of some Mountains; and of endemic Cholics in many Persons. As Water is so continually used, great Care should be taken to have what is good. Bad Water, like bad Air, is one of the most general Causes of Diseases; that which produces the greater Number of them, the most grieveous ones; and often introduces such as are epidemical. E. L. i.e. the Editor of Lyons.

Many Persons, With a Design to preserve their Wines, add Shot to them, or Preparations of Lead, Alum, &c. The Government should forbid, under the most severe Penalties, all such Adulterations, as tend to introduce the most painful Cholics, Obstruction, and a long Train of Evils, which it sometimes proves difficult to trace to this peculiar Cause; while they shorten the lives of, or cruelly torment, such over credulous Purchasers, as lay in a Stock of bad Wines, or drink of them, without distinction, from every Wine Merchant or Tavern. E. L.

This Note, from the Editor at Lyons, we have sufficient Reason for retaining here. K.

_Chapter II._

Of the Causes which aggravate the Diseases of the People. General Considerations.

_Sect._ 14.

The Causes already enumerated in the first Chapter occasion Diseases; and the bad Regimen, or Conduct of the People, on the Invasion of them, render them still more perplexing, and very often mortal.

There is a prevailing Prejudice among them, which is every Year attended with the Death of some Hundreds in this Country, and it is this--That all Distempers are cured by Sweat; and that to procure Sweat, they must take Abundance of hot and heating things, and keep themselves very hot. This is a Mistake in both Respects, very fatal to the Population of the State; and it cannot be too much inculcated into Country People; that by thus endeavouring to force Sweating, at the very Beginning of a Disease, they are with great Probability, taking Pains to kill themselves. I have seen some Cases, in which the continual Care to provoke this Sweating, has as manifestly killed the Patient, as if a Ball had been shot through his Brains; as such a precipitate and untimely Discharge carries off the thinner Part of the Blood, leaving the Mass more dry, more viscid and inflamed. Now as in all acute Diseases (if we except a very few, and those too much less frequent) the Blood is already too thick; such a Discharge must evidently increase the Disorder, by co-operating with its Cause. Instead of forcing out the watery, the thinner Part of the Blood, we should rather endeavour to increase it. There is not a single Peasant perhaps, who does not say, when he has a Pleurisy, or an Inflammation of his Breast, that his Blood is too thick, and that it cannot circulate. On seeing it in the Bason after Bleeding, he finds it black, dry, burnt; these are his very Words. How strange is it then, that common Sense should not assure him, that, far from forcing out the Serum, the watery Part, of such a Blood by sweating, there is a Necessity to increase it?

Sec. 15. But supposing it were as certain, as it is erroneous, that Sweating was beneficial at the Beginning of Diseases, the Means which they use to excite it would not prove the less fatal. The first Endeavour is, to stifle the Patient with the Heat of a close Apartment, and a Load of Covering. Extraordinary Care is taken to prevent a Breath of fresh Air's squeezing into the Room; from which Circumstance, the Air already in it is speedily and extremely corrupted: and such a Degree of Heat is procured by the Weight of the Patient's Bed-cloaths, that these two Causes alone are sufficient to excite a most ardent Fever, and an Inflammation of the Breast, even in a healthy Man. More than once have I found myself seized with a Difficulty of breathing, on entering such Chambers, from which I have been immediately relieved, on obliging them to open all the Windows. Persons of Education must find a Pleasure, I conceive, in making People understand, on these Occasions, which are so frequent, that the Air being more indispensably necessary to us, if possible, than Water is to a Fish, our Health must immediately suffer, whenever that ceases to be pure; in assuring them also, that nothing corrupts it sooner than those Vapours, which continually steam from the Bodies of many Persons inclosed within a little Chamber, from which the Air is excluded. The Absurdity of such Conduct is a self-evident Certainty. Let in a little fresh Air on these miserable Patients, and lessen the oppressing Burthen of their Coverings, and you generally see upon the Spot, their Fever and Oppression, their Anguish and Raving, to abate.

Sec. 16. The second Method taken to raise a Sweat in these Patients is, to give them nothing but hot things, especially Venice Treacle, Wine, or some Faltranc, the greater Part of the Ingredients of which are dangerous, whenever there is an evident Fever; besides Saffron, which is still more pernicious. In all feverish Disorders we should gently cool, and keep the Belly moderately open; while the Medicines just mentioned both heat and bind; and hence we may easily judge of their inevitable ill Consequences. A healthy Person would certainly be seized with an inflammatory Fever, on taking the same Quantity of Wine, of Venice Treacle, or of Faltranc, which the Peasant takes now and then, when he is attacked by one of these Disorders. How then should a sick Person escape dying by them? Die indeed he generally does, and sometimes with astonishing Speed. I have published some dreadful Instances of such Fatality some Years since, in another Treatise. In fact they still daily occur, and unhappily every Person may observe some of them in his own Neighbourhood.

This Word, which must be of German, not of French Extraction, strictly signifies, Drink for a Fall, as we say Pulvis ad Casum, &c. Powder for a Fall, or a supposed inward Bruise. Dr. Tissot informs me, it is otherwise called the vulnerary Herbs, or the Swiss Tea; and that it is an injudicious Farrago or Medley of Herbs and Flowers, blended with Bitters, with stimulating, harsh and astringent Ingredients, being employed indiscriminately in all their Distempers by the Country People in Swisserland. K.

Sec. 17. But I shall be told perhaps, that Diseases are often carried off by Sweat, and that we ought to be guided by Experience. To this I answer, it is very true, that Sweating cures some particular Disorders, as it were, at their very Onset, for Instance, those Stitches that are called spurious or false Pleurisies, some rheumatic Pains, and some Colds or Defluxions. But this only happens when the Disorders depend solely and simply on stopt or abated Perspiration, to which such Pain instantly succeeds; where immediately, before the Fever has thickened the Blood, and inflamed the Humours; and where before any internal Infarction, any Load, is formed, some warm Drinks are given, such as Faltranc and Honey; which, by restoring Transpiration, remove the very Cause of the Disorder. Nevertheless, even in such a Case, great Care should be had not to raise too violent a Commotion in the Blood, which would rather restrain, than promote, Sweat, to effect which Elder-flowers are in my Opinion preferable to Faltranc. Sweating is also of Service in Diseases, when their Causes are extinguished, as it were, by plentiful Dilution: then indeed it relieves, by drawing off, with itself, some Part of the distempered Humours; after which their grosser Parts have passed off by Stool and by Urine: besides which, the Sweat has also served to carry off that extraordinary Quantity of Water, we were obliged to convey into the Blood, and which was become superfluous there. Under such Circumstances, and at such a Juncture, it is of the utmost Importance indeed, not to check the Sweat, whether by Choice, or for Want of Care. There might often be as much Danger in doing this, as there would have been in endeavouring to force a Sweat, immediately upon the Invasion of the Disorder; since the arresting of this Discharge, under the preceding Circumstances, might frequently occasion a more dangerous Distemper, by repelling the Humour on some inward vital Part. As much Care therefore should be taken not to check, imprudently, that Evacuation by the Skin, which naturally occurs towards the Conclusion of Diseases, as not to force it at their Beginning; the former being almost constantly beneficial, the latter as constantly pernicious. Besides, were it even necessary, it might be very dangerous to force it violently; since by heating the Patients greatly, a vehement Fever is excited; they become scorched up in a Manner, and the Skin proves extremely dry. Warm Water, in short, is the best of Sudorifics.

If the Sick are sweated very plentifully for a Day or two, which may make them easier for some Hours; these Sweats soon terminate, and cannot be excited again by the same Medicines. The Dose thence is doubled, the Inflammation is increased, and the Patient expires in terrible Anguish, with all the Marks of a general Inflammation. His Death is ascribed to his Want of Sweating; when it really was the Consequence of his Sweating too much at first; and of his taking Wine and hot Sudorifics. An able Swiss Physician had long since assured his Countrymen, that Wine was fatal to them in Fevers; I take leave to repeat it again and again, and wish it may not be with as little Success.

Our Country Folks, who in Health, naturally dislike red Wine, prefer it when Sick; which is wrong, as it binds them up more than white Wine. It does not promote Urine as well; but increases the Force of the circulating Arteries, and the Thickness of the Blood, which were already too considerable.

Sec. 18. Their Diseases are also further aggravated by the Food that is generally given them. They must undoubtedly prove weak, in Consequence of their being sick; and the ridiculous Fear of the Patients' dying of Weakness, disposes their Friends to force them to eat; which, increasing their Disorder, renders the Fever mortal. This Fear is absolutely chimerical; never yet did a Person in a Fever die merely from Weakness. They may be supported, even for some Weeks, by Water only; and are stronger at the End of that Time, than if they had taken more solid Nourishment; since, far from strengthening them, their Food increases their Disease, and thence increases their Weakness.

Sec. 19. From the first Invasion of a Fever, Digestion ceases. Whatever solid Food is taken corrupts, and proves a Source of Putridity, which adds nothing to the Strength of the Sick, but greatly to that of the Distemper. There are in fact a thousand Examples to prove, that it becomes a real Poison: and we may sensibly perceive these poor Creatures, who are thus compelled to eat, lose their Strength, and fall into Anxiety and Ravings, in Proportion as they swallow.

Sec. 20. They are also further injured by the Quality, as well as the Quantity, of their Food. They are forced to sup strong Gravey Soups, Eggs, Biscuits, and even Flesh, if they have but just Strength and Resolution to chew it. It seems absolutely impossible for them to survive all this Trash. Should a Man in perfect Health be compelled to eat stinking Meat, rotten Eggs, stale sour Broth, he is attacked with as violent Symptoms, as if he had taken real Poison, which, in Effect, he has. He is seized with Vomiting, Anguish, a violent Purging, and a Fever, with Raving, and eruptive Spots, which we call the Purple Fever. Now when the very same Articles of Food, in their soundest State, are given to a Person in a Fever, the Heat, and the morbid Matter already in his Stomach, quickly putrify them; and after a few Hours produce all the abovementioned Effects. Let any Man judge then, if the least Service can be expected from them.

Sec. 21. It is a Truth established by the first of Physicians, above two thousand Years past, and still further ratified by his Successors, that as long as a sick Person has a bad Humour or Ferment in his Stomach, his Weakness increases, in Proportion to the Food he receives. For this being corrupted by the infected Matter it meets there, proves incapable of nourishing, and becomes a conjunct or additional Cause of the Distemper.

The most observing Persons constantly remark, that whenever a feverish Patient sups, what is commonly called some good Broth, the Fever gathers Strength and the Patient Weakness. The giving such a Soup or Broth, though of the freshest soundest Meat, to a Man who has a high Fever, or putrid Humours in his Stomach, is to do him exactly the same service, as if you had given him, two or three Hours later, stale putrid Soup.

Sec. 22. I must also affirm, that this fatal Prejudice, of keeping up the Patients' Strength by Food, is still too much propagated, even among those very Persons, whose Talents and whose Education might be expected to exempt them from any such gross Error. It were happy for Mankind, and the Duration of their Lives would generally be more extended, if they could be thoroughly persuaded of this medical, and so very demonstrable, Truth;--That the only things which can strengthen sick Persons are those, which are able to weaken their Disease; but their Obstinacy in this Respect is inconceivable: it is another Evil superadded to that of the Disease, and sometimes the more grievous one. Out of twenty sick Persons, who are lost in the Country, more than two Thirds might often have been cured, if being only lodged in a Place defended from the Injuries of the Air, they were supplied with Abundance of good Water. But that most mistaken Care and Regimen I have been treating of, scarcely suffers one of the twenty to survive them.

Sec. 23. What further increases our Horror at this enormous Propensity to heat, dry up, and cram the sick is, that it is totally opposite to what Nature herself indicates in such Circumstances. The burning Heat of which they complain; the Dryness of the Lips, Tongue and Throat; the flaming high Colour of their Urine; the great Longing they have for cooling things; the Pleasure and sensible Benefit they enjoy from fresh Air, are so many Signs, or rather Proofs, which cry out with a loud Voice, that we ought to attemperate and cool them moderately, by all means. Their foul Tongues, which shew the Stomach to be in the like Condition; their Loathing, their Propensity to vomit, their utter Aversion to all solid Food, and especially to Flesh; the disagreeable Stench of their Breath; their Discharge of fetid Wind upwards and downwards, and frequently the extraordinary Offensiveness of their Excrements, demonstrate, that their Bowels are full of putrid Contents, which must corrupt all the Aliments superadded to them; and that the only thing, which can prudently be done, is to dilute and attemper them by plentiful Draughts of refreshing cooling Drinks, which may promote an easy Discharge of them. I affirm it again, and I heartily wish it may be thoroughly attended to, that as long as there is any Taste of Bitterness, or of Putrescence; as long as there is a Nausea or Loathing, a bad Breath, Heat and Feverishness with fetid Stools, and little and high-coloured Urine; so long all flesh, and Flesh-Soup, Eggs, and all kind of Food composed of them, or of any of them, and all Venice Treacle, Wine, and all heating things are so many absolute Poisons.

Sec. 24. I may possibly be censured as extravagant and excessive on these Heads by the Publick, and even by some Physicians: but the true and enlightened Physicians, those who attend to the Effects of every Particular, will find on the contrary, that far from exceeding in this Respect, I have rather feebly expressed their own Judgment, in which they agree with that of all the good ones, who have existed within more than two thousand Years; that very Judgment which Reason approves, and continual Experience confirms. The Prejudices I have been contending against have cost Europe some Millions of Lives.