One morning about ten I was desired to visit a poor man in a fever.
Two days before, in the evening, he had been seized with a shivering
fit, which was then supposed to be the ague; he soon grew extremely
hot, with pain in his head, back, and loins, which continued till I saw
him, the 24th of October: he had kept his bed, had scarce any sleep,
his heat great, pulse strong and quick, and the pain in his loins very
severe. This man had applied to me to be inoculated a little before
he was taken ill, on account of the small-pox being very much in his
neighbourhood; but he had not as yet taken any preparatory steps. I
made no doubt but he was now attacked with this disease, and from the
severity of the symptoms expected it would prove of the confluent kind.
As he lived near me, and I could easily attend to every circumstance,
I determined to try how far the cooling method might be beneficial in
treating the natural small-pox.
I found it very difficult to persuade him to rise out of bed, as he
thought himself utterly unable to support himself, notwithstanding
he was on other occasions a resolute man. Assuring him however that
I would not attend him, unless he would comply, he promised to use
his utmost endeavours. I left him to put this advice in practice, and
ordered him to a carpenter’s yard about one hundred yards distance,
where I promised to meet him.
In about a quarter of an hour I found he had reached the place of
appointment, by the assistance of a neighbour, and was sitting on a
bench, complaining of great weakness, and pain in his loins; which he
described, by saying he felt as if he was cutting in two; but allowed
that his head was easier since he had been in the air. Finding that he
had had a stool the preceding day, but none since, I gave him a pill,
containing about six grains of calom. and 1/8 gr. of emet. tartar,
immediately; and as he complained of great thirst, I permitted him to
drink half a pint of cold water after it. I advised him not to sit,
but to endeavour to walk about a little, though ever so slowly; this
he attempted, but went almost double. At this time the weather was not
very cold, but there was a pretty brisk wind, with small rain.
About a quarter of an hour after, I saw him again. He had resolutely
persisted in following my directions, and said his head was greatly
relieved, but the pain in his back and loins was much the same. His
pulse was now much altered; instead of being full and strong as before,
it was low, but quick, and the heat on the skin greatly abated. As he
seemed much fatigued, I did not insist on his keeping abroad longer,
but permitted him to go home, desiring him to refresh himself, but not
to pull off his cloaths, or go into bed.
At two o’clock I saw him again; his pill had then worked twice;
he seemed fatigued and faint, but was abroad, for he said the air
refreshed him, and his head was easier in the air than within, so that
as soon as he was a little rested he came out by choice. The pain in
his loins still remained very grievous, but his head was much easier;
and his back and loins became less painful towards evening. I allowed
him to go to bed about seven; but being desirous of observing the full
effect of this kind of treatment, I ordered no medicine.
25th. Had but little rest, and his complaints nearly the same as when
he went to bed. His pulse was now raised, and more full than in the
evening, and the degree of heat greater than over night. A few small
pustules were now beginning to shew themselves on his face; I directed
a purging draught of infusion of sena and manna, quickened with jalap;
advised him to get out of bed, and venture again into the air. This
he did: by two o’clock the purge had worked thrice, and he was freer
from the pain in his back and loins: more pustules now appeared in the
face, but scarce any on the limbs. He had hitherto taken nothing since
his first seizure, but tea with milk, sage and balm tea, loathing all
other nourishment. He persisted in keeping out the greatest part of the
afternoon; and at seven went to bed, when I found the pulse more calm
and regular, and as his complaints were less violent, he began to think
of nourishment.
26th. I saw him at seven in the morning; he had slept but little, had
one purging stool in the night, and felt himself low and languid; his
pulse was now even, full, and regular, and his heat moderate. Many more
pustules were out in the face, though but few on the limbs, and his
complaints of pain in the head and back went off. He took milk pottage
with some appetite, and spent the greatest part of the day abroad.
At three in the afternoon I saw him, and was told, that lying down in
the bed he had fallen asleep, and waked almost choked with blood; that
he had vomited up a considerable quantity, which doubtless had been
swallowed, as he was found bleeding at the nose. From what I could
learn, the whole scarcely exceeded six or eight ounces. He complained
of faintness, and said his pains were removed. I ordered him to drink
the pectoral decoction, acidulated with a mixture of equal quantities
of sweet and weak spirit of vitriol. The number of pustules continued
increasing slowly on the face and other parts.
Late in the evening I saw him again; two more purging stools had
followed; he complained of being very faint and low, and feared he
should have no rest.
I now thought it proper to give him an anodyne cordial, and therefore
ordered mithrid. [ounce]ss. which he took immediately. By the help
of this he passed a very refreshing comfortable night, and thought
himself quite well. The eruption was now completed; the small-pox might
be properly called distinct: though full in the face, he had only a
moderate number of a large sort on all the other parts; and he went
through the succeeding stages without any difficulty.