Part 7

Sec. 25. Neither should it be omitted, that even when a Patient has very fortunately escaped Death, notwithstanding all this Care to obtain it, the Mischief is not ended; the Consequences of the high Aliments and heating Medicines being, to leave behind the Seed, the Principle, of some low and chronical Disease; which increasing insensibly, bursts out at length, and finally procures him the Death he has even wished for, to put an End to his tedious Sufferings.

Sec. 26. I must also take Notice of another dangerous common Practice; which is that of purging, or vomiting a Patient, at the very Beginning of a Distemper. Infinite Mischiefs are occasioned by it. There are some Cases indeed, in which evacuating Medicines, at the Beginning of a Disease, are convenient and even necessary. Such Cases shall be particularly mentioned in some other Chapters: but as long as we are unacquainted with them, it should be considered as a general Rule, that they are hurtful at the Beginning; this being true very often; and always, when the Diseases are strictly inflammatory.

Sec. 27. It is hoped by their Assistance, at that Time, to remove the Load and Oppression of the Stomach, the Cause of a Disposition to vomit, of a dry Mouth, of Thirst, and of much Uneasiness; and to lessen the Leaven or Ferment of the Fever. But in this Hope they are very often deceived; since the Causes of these Symptoms are seldom of a Nature to yield to these Evacuations. By the extraordinary Viscidity or Thickness of the Humours, that foul the Tongue, we should form our Notions of those, which line the Stomach and the Bowels. It may be washed, gargled and even scraped to very little good Purpose. It does not happen, until the Patient has drank for many Days, and the Heat, the Fever and the great Siziness of the Humours are abated, that this Filth can he thoroughly removed, which by Degrees separates of itself. The State of the Stomach being conformable to that of the Tongue, no Method can effectually scour and clean it at the Beginning: but by giving refreshing and diluting Remedies plentifully, it gradually frees itself; and the Propensity to vomit, with its other Effects and Uneasinesses, go off naturally, and without Purges.

Sec. 28. Neither are these Evacuations only negatively wrong, merely from doing no Good; for considerable Evil positively ensues from the Application of those acrid irritating Medicines, which increase the Pain and Inflammation; drawing the Humours upon those Parts that were already overloaded with them; which by no means expel the Cause of the Disease, that not being at this time fitted for Expulsion, as not sufficiently concocted or ripe: and yet which, at the same Time, discharge the thinnest Part of the Blood, whence the Remainder becomes more thick; in short which carry off the useful, and leave the hurtful Humours behind.

Sec. 29. The Vomit especially, being given in an inflammatory Disease, and even without any Distinction in all acute ones, before the Humours have been diminished by Bleeding, and diluted by plentiful small Drinks, is productive of the greatest Evils; of Inflammations of the Stomach, of the Lungs and Liver, of Suffocations and Frenzies. Purges sometimes occasion a general Inflammation of the Guts, which terminates in Death. Some Instances of each of these terrible Consequences have I seen, from blundering Temerity, Imprudence and Ignorance. The Effect of such Medicines, in these Circumstances, are much the same with those we might reasonably expect, from the Application of Salt and Pepper to a dry, inflamed and foul Tongue, in Order to moisten and clean it.

It is pretty common to hear of Persons recovering from Inflammations of the Bowels, or Guts, which our Author more justly and ingenuously considers as general Passports to Death: for it is difficult to conceive, that a real and considerable Inflammation of such thin, membranous, irritable Parts, lined with such putrescent Humours and Contents, and in so hot and close a Situation, could be restored to a sound and healthy State so often as Rumour affirms it. This makes it so important a Point, to avert every Tendency to an Inflammation of these feculent Parts, as to justify a Bleeding directed, solely, from this Precaution, and which might have been no otherwise indicated by a Disease, attended with any Symptom, that threatened such an Inflammation. But when a Person recovers, there can be no anatomical Search for such Inflammations, or its Effects, the real or imaginary Cure of which may well amaze the Patient, and must greatly redound to the Honour of his Prescriber; so that there may be Policy sometimes in giving a moderate Disease a very bad Name. K.

Sec. 30. Every Person of sound plain Sense is capable of perceiving the Truth of whatever I have advanced in this Chapter: and there would be some Degree of Prudence, even in those who do not perceive the real good Tendency of my Advice, not to defy nor oppose it too hardily. The Question relates to a very important Object; and in a Matter quite foreign to themselves, they undoubtedly owe some Deference to the Judgment of Persons, who have made it the Study and Business of their whole Lives. It is not to myself that I hope for their Attention, but to the greatest Physicians, whose feeble Instrument and Eccho I am. What Interest have any of us in forbidding sick People to eat, to be stifled, or to drink such heating things as heighten their Fever? What Advantage can accrue to us from opposing the fatal Torrent, which sweeps them off? What Arguments can persuade People, that some thousand Men of Genius, of Knowledge, and of Experience, who pass their Lives among a Croud and Succession of Patients; who are entirely employed to take Care of them, and to observe all that passes, have been only amusing and deceiving themselves, on the Effects of Food, of Regimen and of Remedies? Can it enter into any sensible Head, that a Nurse, who advises Soup, an Egg, or a Biscuit, deserves a Patient's Confidence, better than a Physician who forbids them? Nothing can be more disagreeable to the latter, than his being obliged to dispute continually in Behalf of the poor Patients; and to be in constant Terror, lest this mortally officious Attendance, by giving such Food as augments all the Causes of the Disease, should defeat the Efficacy of all the Remedies he administers to remove it; and should fester and aggravate the Wound, in Proportion to the Pains he takes to dress it. The more such absurd People love a Patient, the more they urge him to eat, which, in Effect, verifies the Proverb of killing one with Kindness.

_Chapter III._

Of the Means that ought to be used, at the Beginning of Diseases; and of the Diet in acute Diseases.

_Sect._ 31.

I have clearly shewn the great Dangers of the Regimen, or Diet, and of the principal Medicines too generally made Use of by the Bulk of the People, on these Occasions. I must now point out the actual Method they may pursue, without any Risque, on the Invasion of some acute Diseases, and the general Diet which agrees with them all. As many as are desirous of reaping any Benefit from this Treatise, should attend particularly to this Chapter; since, throughout the other Parts of it, in Order to avoid Repetitions, I shall say nothing of the Diet, except the particular Distemper shall require a different one, from that of which I am now to give an exact Detail. And whenever I shall say in general, that a Patient is to be put upon a Regimen, it will signify, that he is to be treated according to the Method prescribed in this Chapter; and all such Directions are to be observed, with Regard to Air, Food, Drink and Glysters; except when I expressly order something else, as different Ptisans, Glysters, &c.

Sec. 32. The greater Part of Diseases (by which I always understand acute and feverish ones) often give some Notice of their Approach a few Weeks, and, very commonly, some Days before their actual Invasion; such as a light Lassitude, or Weariness, Stiffness or Numbness; less Activity than usual, less Appetite, a small Load or Heaviness at Stomach; some Complaint in the Head; a profounder Degree of Sleep, yet less composed, and less refreshing than usual; less Gayety and Liveliness; sometimes a light Oppression of the Breast, a less regular Pulse; a Propensity to be Cold; an Aptness to sweat; and sometimes a Suppression of a former Disposition to sweat. At such a Term it may be practicable to prevent, or at least considerably to mitigate, the most perplexing Disorders, by carefully observing the four following Points.

1. To omit all violent Work or Labour, but yet not so, as to discontinue a gentle easy Degree of Exercise.

2. To bring the Complainant to content himself without any, or with very little, solid Food; and especially to renounce all Flesh, Flesh-broth, Eggs and Wine.

3. To drink plentifully, that is to say, at least three Pints, or even four Pints daily, by small Glasses at a Time, from half hour to half hour, of the Ptisans No. 1 and 2, or even of warm Water, to each Quart of which may be added half a Glass of Vinegar. No Person can be destitute of this very attainable Assistance. But should there be a Want even of Vinegar, a few Grains of common Salt may be added to a Quart of warm Water for Drink. Those who have Honey will do well to add two or three Spoonfuls of it to the Water. A light Infusion of Elder Flowers, or of those of the Linden, the Lime-tree, may also be advantageously used, and even well settled and clear sweet Whey.

This Direction of our Author's, which may surprize some, probably arises from his preferring a small Quantity of the marine Acid to no Acid at all: For though a great Proportion of Salt, in saving and seasoning Flesh and other Food, generally excites Thirst, yet a little of it seems to have rather a different Effect, by gently stimulating the salivary Glands: And we find that Nature very seldom leaves the great diluting Element wholly void of this quickening, antiputrescent Principle. K.

4. Let the Person, affected with such previous Complaints, receive Glysters of warm Water, or the Glyster No. 5. By pursuing these Precautions some grievous Disorders have often been happily rooted out: and although they should not prove so thoroughly efficacious, as to prevent their Appearance, they may at least be rendered more gentle, and much less dangerous.

Sec. 33. Very unhappily People have taken the directly contrary Method. From the Moment these previous, these forerunning Complaints are perceived, they allow themselves to eat nothing but gross Meat, Eggs, or strong Meat-Soups. They leave off Garden-Stuff and Fruits, which would be so proper for them; and they drink heartily (under a Notion of strengthening the Stomach and expelling Wind) of Wine and other Liquors, which strengthen nothing but the Fever, and expel what Degree of Health might still remain. Hence all the Evacuations are restrained; the Humours causing and nourishing the Diseases are not at all attempered, diluted, nor rendered proper for Evacuation. Nay, on the very contrary, they become more sharp, and more difficult to be discharged: while a sufficient Quantity of diluting refreshing Liquor, asswages and separates all Matters foreign to the Blood, which it purifies; and, at the Expiration of some Days, all that was noxious in it is carried off by Stool, by Urine, or by Sweat.

Sec. 34. When the Distemper is further advanced, and the Patient is already seized with that Coldness or Shuddering, in a greater or less Degree, which ushers in all Disease; and which is commonly attended with an universal Oppression, and Pains over all the Surface of the Body; the Patient, thus circumstanced, should be put to Bed, if he cannot keep up; or should sit down as quietly as possible, with a little more Covering than usual: he should drink every Quarter of an Hour a small Glass of the Ptisan, No. 1 or 2, warm; or, if that is not at Hand, of some one of those Liquids I have recommended Sec. 32.

Sec. 35. These Patients earnestly covet a great Load of covering, during the Cold or Shivering; but we should be very careful to lighten them as soon as it abates; so that when the succeeding Heat begins, they may have no more than their usual Weight of Covering. It were to be wished perhaps, they had rather less. The Country People lie upon a Feather-bed, and under a downy Coverlet, or Quilt, that is commonly extremely heavy; and the Heat which is heightened and retained by Feathers, is particularly troublesome to Persons in a Fever. Nevertheless, as it is what they are accustomed to, this Custom may be complied with for one Season of the Year: but during our Heats, or whenever the Fever is very violent, they should lie on a Pallet (which will be infinitely better for them) and should throw away their Coverings of Down, so as to remain covered only with Sheets, or something else, less injurious than Feather-Coverings. A Person could scarcely believe, who had not been, as I have, a Witness of it, how much Comfort a Patient is sensible of, in being eased of his former Coverings. The Distemper immediately puts on a different Appearance.

Sec. 36. As soon as the Heat after the Rigor, or Coldness and Shuddering, approaches, and the Fever is manifestly advanced, we should provide for the Patient's Regimen. And

1, Care should be taken that the Air, in the Room where he lies, should not be too hot, the mildest Degree of Warmth being very sufficient; that there be as little Noise as possible, and that no Person speak to the Sick, without a Necessity for it. No external Circumstance heightens the Fever more, nor inclines the Patient more to a Delirium or Raving, than the Persons in the Chamber, and especially about the Bed. They lessen the Spring, the elastic and refreshing Power, of the Air; they prevent a Succession of fresh Air; and the Variety of Objects occupies the Brain too much. Whenever the Patient has been at Stool, or has made Urine, these Excrements should be removed immediately. The Windows should certainly be opened Night and Morning, at least for a Quarter of an Hour each Time; when also a Door should be opened, to promote an entire Renovation or Change of the Air in the Room. Nevertheless, as the Patient should not be exposed at any Time to a Stream or Current of Air, the Curtains of his Bed should be drawn on such Occasions; and, if he lay without any, Chairs, with Blankets or Cloaths hung upon them, should be substituted in the Place of Curtains, and surround the Bed; while the Windows continued open, in Order to defend the Patient from the Force of the rushing Air. If the Season, however, be rigidly cold, it will be sufficient to keep the Windows open, but for a few Minutes, each Time. In Summer, at least one Window should be set open Day and Night. The pouring a little Vinegar upon a red-hot Shovel also greatly conduces to restore the Spring, and correct the Putridity, of the Air. In our greatest Heats, when that in the Room seems nearly scorching, and the sick Person is sensibly and greatly incommoded by it, the Floor may be sprinkled now and then; and Branches of Willow or Ash-trees dipt a little in Pails of Water may be placed within the Room.

Sec. 37. 2. With Respect to the Patient's Nourishment, he must entirely abstain from all Food; but he may always be allowed, and have daily prepared, the following Sustenance, which is one of the wholesomest, and indisputably the simplest one. Take half a Pound of Bread, a Morsel of the freshest Butter about the Size only of a Hazel Nut (which may even be omitted too) three Pints and one quarter of a Pint of Water. Boil them 'till the Bread be entirely reduced to a thin Consistence. Then strain it, and give the Patient one eighth Part of it every three, or every four, Hours; but still more rarely, if the Fever be vehemently high. Those who have Groats, Barley, Oatmeal, or Rice, may boil and prepare them in the same Manner, with some Grains of Salt.

Sec. 38. The Sick may also be sometimes indulged, in lieu of these different Spoon-Meats, with raw Fruits in Summer, or in Winter with Apples baked or boiled, or Plumbs and Cherries dried and boiled. Persons of Knowledge and Experience will be very little, or rather not at all, surprized to see various Kinds of Fruit directed in acute Diseases; the Benefit of which they may here have frequently seen. Such Advice can only disgust those, who remain still obstinately attached to old Prejudices. But could they prevail on themselves to reflect a little, they must perceive, that these Fruits which allay Thirst; which cool and abate the Fever; which correct and attemper the putrid and heated Bile; which gently dispose the Belly to be rather open, and promote the Secretion and Discharge of the Urine, must prove the properest Nourishment for Persons in acute Fevers. Hence we see, as it were by a strong Admonition from Nature herself, they express an ardent Longing for them; and I have known several, who would not have recovered, but for their eating secretly large Quantities of those Fruits they so passionately desired, and were refused. As many however, as are not convinced by my Reasoning in this Respect, may at least make a Tryal of my Advice, on my Affirmation and Experience; when I have no doubt but their own will speedily convince them of the real Benefit received from this Sort of Nourishment. It will then be evident, that we may safely and boldly allow, in all continual Fevers, Cherries red and black, Strawberries, the best cured Raisins, Raspberries, and Mulberries; provided that all of them be perfectly ripe. Apples, Pears and Plumbs are less melting and diluting, less succulent, and rather less proper. Some kinds of Pears however are extremely juicy, and even watery almost, such as the Dean or Valentia Pear, different Kinds of the Buree Pear; the St. Germain, the Virgoleuse; the green sugary Pear, and the Summer Royal, which may all be allowed; as well as a little Juice of very ripe Plumbs, with the Addition of Water to it. This last I have known to asswage Thirst in a Fever, beyond any other Liquor. Care should be taken, at the same Time, that the Sick should never be indulged in a great Quantity of any of them at once, which would overload the Stomach, and be injurious to them; but if they are given a little at a Time and often, nothing can be more salutary. Those whose Circumstances will afford them China Oranges, or Lemons, may be regaled with the Pulp and Juice as successfully; but without eating any of their Peel, which is hot and inflaming.

Sec. 39. 3. Their Drink should be such as allays Thirst, and abates the Fever; such as dilutes, relaxes, and promotes the Evacuations by Stool, Urine and Perspiration. All these which I have recommended in the preceding Chapters, jointly and severally possess these Qualities. A Glass or a Glass and a half of the Juice of such Fruits as I have just mentioned, may also be added to three full Pints of Water.

Sec. 40. The Sick should drink at least twice or thrice that Quantity daily, often, and a little at once, between three or four Ounces, every Quarter of an Hour. The Coldness of the Drink should just be taken off.

Sec. 41. 4. If the Patient has not two Motions in the 24 Hours; if the Urine be in small Quantity and high coloured; if he rave, the Fever rage, the Pain of the Head and of the Loins be considerable, with a Pain in the Belly, and a Propensity to vomit, the Glyster No. 5 should be given at least once a Day. The People have generally an Aversion to this kind of Remedy; notwithstanding there is not any more useful in feverish Disorders, especially in those I have just recounted; and one Glyster commonly gives more Relief, than if the Patient had drank four or five Times the Quantity of his Drinks. The Use of Glysters, in different Diseases, will be properly ascertained in the different Chapters, which treat of them. But it may be observed in this Place, that they are never to be given at the very Time the Patient is in a Sweat, which seems to relieve him.

Sec. 42. 5. As long as the Patient has sufficient Strength for it, he should sit up out of Bed one Hour daily, and longer if he can bear it; but at least half an Hour. It has a Tendency to lessen the Fever, the Head-ach, and a Light-headiness, or Raving. But he should not be raised, while he has a hopeful Sweating; though such Sweats hardly ever occur, but at the Conclusion of Diseases, and after the Sick has had several other Evacuations.