fome blood, if the heat be too great, and the patient have ftrength enough left to bear it.

Whofoever thoroughly confiders all the circumftances of this fubject, which I have hitherto explained, muft justly wonder how the learned Dr Boerhaave could be induced to hope, that fome time or other a fpecific antidote may be found against this contagious poifon *; that is, by which it may be fo thoroughly deftroyed, that though it had been received into the body, it may not produce the difeafe. But the principles and elements of things are fo certain, and fo well established by the permanent laws of nature, that whofoever would endeavour to change them, would act like those philofophers by fire, (as they style themfelves), who labour hard to tranfmute the bafer metals into gold; and when continual difappointments have convinced them of the vanity of their hopes, actually extract gold out of the purfes of the ignorant and credulous, by the fumes of their charcoal,

This one obfervation I must add, that there is no fpecies of fever, which requires the body to be thoroughly cleared of the remains of the difeafe, more than this. Wherefore, upon the patient's recovery, blood is to be drawn, if his ftrength will bear it; and cathartics are to be given feveral times at proper intervals. After which, the body is to be restored to its former state by a course of milk, especially that of affes, with fuitable food, and the air and amusements of the country.

I fhall close this long chapter with the account of a very malignant small-pox in a youth of fifteen years * Aphor, de cognofcendis et curandis morbis, 1390. 1391, & 92.

of age, communicated to me by my fon-in-law, the learned and ingenious Dr Wilmot; who, from the fifth day of the difeafe, attended the patient jointly with Dr Connel.

In the beginning of the fever preceding the eruption, the patient was directed to be let blood, and to take a vomit, and the next morning a gentle purge: the day following, the fmall-pox flushed out. The puftules were very numerous and fmall all over the body, looking more like a rank measles than the finall-pox. As his fever ran very high, he was ordered draughts of Gafcoign's powder with nitre, to be taken every fix hours; and to drink plentifully of barley-water acidulated with spirit of vitriol.

On the fourth day of the eruption, as he was very delirious, in order to procure fleep, a paregoric of fix drachms of diacodion was given him, which did not produce the effect.

The fifth day there was not the least fwelling of the face; his pulfe was quick and full, his heat intenfe, and the delirium not abated. Wherefore he was ordered another bleeding; the nitrofe draughts were continued, with the addition of five grains of myrrh to each; as likewife barley-water with fpirit of vitriol, and the paregoric as before.

The feventh, the appearance of the disease was still the fame, with the addition of an oppreffion of his breath, and a very troublesome dry cough. Diascordium was added to his nitrofe draughts, and he was ordered a folution of gum ammoniac, to be taken, a spoonful at a time, as occafion required; and the paregoric continued.

The eighth, he complained much of a most acute

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pain in his head; his fhortness of breath and cough were increased, his pulfe low, and there were no figns of fuppuration; nor the leaft fwelling in the face or hands but the fkin of his face looked like a piecé of parchment. Blifters were ordered to be laid on his arms and legs, and plafters made of equal parts of the cephalic and blistering plafters, to be wrapt round his feet: likewife draughts containing of mithridate half a drachm, and of volatile falt of amber half a fcruple, to be taken every fixth hour; and a gargle of pectoral decoction, and oxymel of fquills.

The tenth, as every thing was grown worfe, befides continuing the fame medicines, blifters were ordered below the elbows.

The eleventh, his pulfe being much lower, and the patient much weaker, a mixture with Raleigh's confection was ordered to be taken often by spoonfuls, and the other cardiacs continued.

On the twelfth, the pulfe being fcarcely perceptible, and his breath oppreffed to the laft degree; when all hopes of fuccefs were given up, a fit of coughing, in which he was almoft fuffocated, brought on a spitting of a limpid, fœtid humour, equal in quantity to a falivation raised by mercury. And this' flux continued twelve days without any apparent abatement from thence it gradually diminished for four days, when it ftopped entirely.

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By the fixteenth day, the difeafe, together with that discharge, had fo far exhaufted him, that he was fcarce able to turn in his bed and yet his fpirits were fo much better, that he could take plentifully of liquid nourishment. Whereby gathering ftrength, his fever had now the appearance of a hectic only;

for

for which he was ordered to lose five ounces of blood, to take draughts of lemon-juice, and falt of wormwood, with a little fperma ceti diffolved in them, every four hours, and to drink asses milk every morning.

By this method, with the repetition of bleeding to five ounces two or three times, and now and then purging him gently with rhubarb; together with elixir of vitriol in Bristol water, and the country-air, he in time happily recovered.

In this cafe we have a most remarkable instance of what I have already faid more than once, that is, how folicitous nature always is, at any rate to expel the poisonous matter of this difeafe out of the body.

MA

С Н А Р. IV.

Of accidents in the fmall-pox.

Any fymptoms and circumstances attend the small-pox, which, as they neither commonly occur, nor feem to depend on the nature of the dif ease, either affright, or perplex the physician. Wherefore it may not be improper to make some remarks concerning them.

Sometimes the patient is feized with convulfions, just before the eruption. But this fymptom is more terrifying than dangerous; and in children particularly, thofe convulfions which frequently come on before the diftemper appears, are generally rather a good, than a bad fign. Now, in this cafe, though it may feem ftrange, blood-letting is to be carefully a

voided;

voided; but a blifter is to be applied to the neck, and to the foles of the feet plafters made of equal parts of the cephalic and blistering plafters: not forgetting at the fame time to give thofe medicines inwardly, which experience has fhewn to be antifpafmodic. Of these the chief are, wild valerian root, Ruffian caftor, and the fpirits and volatile falts, chemically extracted from animals. For it has been frequently obferved, that, upon drawing blood in this cafe, the difeafe ended fatally. I can affign no other reason for this event, but that thofe involuntary motions are occafioned by the patient's weakness ; which is fo increased by that evacuation, that nature becomes incapable of throwing out the morbid matter upon the skin. But the thing is otherwise in adults, who, if not too weak, ought to lose a moderate quantity of blood, and then be put into the foregoing method.

The disease begins fometimes in a different, and almost contrary manner. For the eruption appears without much fever or pain; for which reafon there feems to be no danger. But that fond fecurity is very frequently ill-grounded. For at the time when the puftules ought to tend to maturity, as if nature were lazy, and not attending to her duty, there is no fuppuration made hence the fever increafes, with inquietude of body, anxiety of mind, difficulty of breathing, and a delirium; which carry off the patient in a few days. In this ftate, the fever ought rather to be railed than checked; and therefore warm medicines are to be directed, which promote fuppuration, by increafing the motion of the blood, and thinning the humours: fuch are the Virginian

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fnake