« PreviousContinue »
some blood, if the heat be too great, and the patient have strength enough left to bear it.
Whosoever thoroughly considers all the circumstances of this subject, which I have hitherto explained, must justly wonder how the learned Dr Boerhaave could be induced to hope, that some time or other a specific antidote may be found against this contagious poifon *; that is, by which it may be fo thoroughly destroyed, that though it had been received into the body, it may not produce the disease. But the principles and elements of things are so certain, and to well established by the permanent laws of nature, that whosoever would endeavour to change them, would act like those philosophers by fire, (as they style themselves), who labour hard to transmute the baser metals into gold ; and when continual disappointments have convinced them of the vanity of their hopes, actually extract gold out of the purses of the ignorant and credulous, by the fumes of their charcoal
This one observation I must add, thar there is no species of fever, which requires the body to be thoroughly cleared of the remains of the disease, more than this. Wherefore, upon the patient's recovery, blood is to be drawn, if his strength will bear it; and cathartics are to be given several times at proper intervals. After which, the body is to be restored to its former state by a course of milk, cspecially that of alles, with suitable food, and the air and amusements of the country.
I shall close this long chapter with the account of 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 son-in-law, the learned and ingenious Dr Wilmot ; who, from the fifth day of the disease, 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 tuke a voinit, and the next morning a gentle purge : the day following, the small.pox fushed out. The puftules were very numerous and small all over the body, looking more like a rank measles than the small-pox. As his fever ran very high, he was ordered draughts of Gascoign'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 sleep, a paregoric of fix drachms of diacodion was given him, which did not produce the effect.
The fifth day there was not the least swelling of the face ; his pulse was quick and full, his heat intense, 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 likewise barley-water with spirit of vitriol, and the paregoric as before.
The seventh, the appearance of the disease was still the fame, with the addition of an oppression of his breath, and a very troublesome dry cough. Diafcordium was added to his nitrofe draughts, and he was ordered a solution of gum ammoniac, to be taken, a spoonful at a time, as occasion required; and the paregoric continued. The eighth, he complained much of a most acute
pain in his head ; his shortness of breath and cough were increafed, his pulse low, and there were no signs of fuppuration ; 'nor the least swelling in the face or hands : but the skin of his face looked like a piece of parchment. Blifters were ordered to be laid on his arms and legs, and plasters made of equal parts of the cephalic and blistering plasters, to be wrapi 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 thiog was grown worfe, befides continuing the fame medicines, blisters 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 searcely perceptible, and his breath oppressed to the last degree ; when all hopes of success were given up, a fit of coughing, in which he was almost fuffocated, brought on a spitting of a limpid, fætid humour, equal in quantity to a salivation raised by mercury. · And this flux continued twelve days without any apparent abatement: from thence it gradually diminished for four days, when it stopped entirely.
By the sixteenth day, the disease, together with that discharge, had so far exhausted him, that he was fcarce able to turn in his bed': and yet his spirits were so much better, that he could take plentifully of liquid nourishment. Whereby gathering strength, his fever had now the appearance of a hectic only ;
for which he was ordered to lose five ounces of blood, to take draughts of lemon-juice, and salt of wormwood, with a little fperma ceti diffolved in them, e. very four hours, and to drink alles 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 case we have a most remarkable instance of what I have already said more than once, that is, how solicitous nature always is, at any rate to expel the poisonous matter of this disease out of the body.
Any symptoms and circumstances attend the
small-pox, which, as they neither commonly occur, nor seem to depend on the nature of the diseafe, either affright, or perplex the physician. Wherefore it may not be improper to make some remarks concerning them.
Sometimes the patient is feized with convulsions, just before the eruption. But this fymptom is more terrifying than dangerous ; and in children particular-, ly, thofe convulsions which frequently come on before the distemper appears, are generally rather a good, than a bad fign. Now, in this case, though it *may seem strange, blood-letting is to be carefully a
voided ; but a blister is to be applied to the neck, and to the foles of the feet plasters made of equal parts of the cephalic and blistering plasters : not forgetting at the same time to give those medicines inwardly, which experience has sewn to be antifpalmodic. Of these the chief are, wild valerian root, Ruffian caftor, and the spirits and volatile falts, chemically extracted from animals. For it has been frequently observed, that, upon drawing blood in this case, the disease ended fatally. I can aflign no other reason for this event, but that those involuntary motions are occasioned by the patient's weakness; which is so increased by that cvacuation, 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 sometimes in a different, and almost contrary manner.
For the eruption appears without much fever or pain ; for which reason there seems to be no danger. But that fond security is very frequently ill-grounded. For at the time when the pustules ought to tend to maturity, as if nature were lazy, and not attending to her duty, there is no suppuration made : bence 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 state, the fever ought rather to be raised than checked ; and therefore warm' medicines are to be directed, which promote suppuration, by increasing the motion of the blood, and thinning the humours : such are the Virginian