9. The Urine appeared to be less inflamed, than in other Diseases of the
Throat.
10. Bleeding and other Medicines did not relieve them, as soon as in the
other kind; and the Disease itself continued a longer Time.
11. It did not terminate in a Suppuration like other Quinsies, but
sometimes the Tonsils were ulcerated.
12. [30] Almost every Child, and indeed a great many of the grown
Persons assaulted with this Disease, threw out, either on the first Day,
or on some succeeding one, within the first six Days, a certain
Efflorescence, or Eruptions, resembling the Measles considerably in
some, but of a less lively Colour, and without any Elevation, or rising
above the Skin. It appeared first in the Face, next in the Arms, and
descended to the Legs, Thighs and Trunk; disappearing gradually at the
End of two or three Days, in the same Order it had observed in breaking
out. A few others (I have seen but five Instances of it) suffered the
most grievous Symptoms before the Eruption; and threw out the genuine
_purpura_, or white miliary Eruption.
[30] This seems to have been the same kind of Quinsey, of which Drs.
_Huxham_, _Fothergil_, _Cotton_ and others wrote, though under
different Appellations. _K._
13. As soon as these Efflorescences or Eruptions appeared, the Sick
generally found themselves better. That, last mentioned, continued four,
five, or six Days, and frequently went off by Sweats. Such as had not
these Ebullitions, which was the Case of many Adults, were not cured
without very plentiful Sweats towards the Termination of the Disease:
those which occurred at the Invasion of it being certainly unprofitable,
and always hurtful.
14. I have seen some Patients, in whom the Complaint of the Throat
disappeared entirely, without either Eruptions or Sweats: but such still
remained in very great Inquietude and Anguish, with a quick and small
Pulse. I ordered them a sudorific Drink, which being succeeded by the
Eruption, or by Sweating, they found themselves sensibly relieved.
15. But whether the Sick had, or had not, these external Rednesses or
Eruptions, every one of them parted with their Cuticle or Scarf Skin,
which fell off, in large Scales, from the whole Surface of the Body: so
great was the Acrimony or Sharpness of that Matter, which was to be
discharged through the Skin.
16. A great Number suffered a singular Alteration in their Voice,
different from that which occurs in common Quinsies, the Inside of their
Nostrils being extremely dry.
17. The Sick recovered with more Difficulty after this, than after the
common Quinsies: and if they were negligent or irregular, during their
Recovery; particularly, if they exposed themselves too soon to the Cold,
a Relapse ensued, or some different Symptoms; such as a Stuffing with
Oppression, a Swelling of the Belly, windy Swellings in different Parts;
Weakness, Loathings, Ulcerations behind the Ears, and something of a
Cough and Hoarseness.
18. I have been sent for to Children, and also to some young Folks, who,
at the End of several Weeks, had been taken with a general Inflammation
of the whole Body, attended with great Oppression, and a considerable
Abatement of their Urine, which was also high-coloured and turbid, or
without Separation. They seemed also in a very singular State of
Indifference, or Disregard, with Respect to any Object, or Circumstance.
I recovered every one of them entirely by Blisters, and the Powder No.
25. The first Operation of this Medicine was to vomit them: to this
succeeded a Discharge by Urine, and at last very plentiful Sweating,
which compleated the Cure. Two Patients only, of a bad Constitution, who
were a little ricketty, and disposed to glandular Scirrhosity or
Knottiness, relapsed and died, after being recovered of the Disease
itself for some Days.
Sec. 118. I have bled some adult Persons, and made Use of the cooling
Regimen, as long as there was an evident Inflammation: it was necessary
after this to unload the first Passages; and at last to excite moderate
Sweats. The same Powders No. 25 have often effected both these
Discharges, and with entire Success. In other Cases I have made Use of
Ipecacuanha, as directed No. 35.
In some Subjects there did not appear any inflammatory Symptom; and the
Distemper resulted solely from a Load of putrid Matter in the first
Passages. Some Patients also discharged Worms. In such Cases I never
bled; but the Vomit had an excellent Effect, at the very Onset of the
Disease; it produced a perceivable Abatement of all the Symptoms;
Sweating ensued very kindly and naturally, and the Patient recovered
entirely a few Hours after.
Sec. 119. There were some Places, in which no Symptom or Character of
Inflammation appeared; and in which it was necessary to omit Bleeding,
which was attended with bad Consequences.
I never directed Infants to be bled. After opening the first Passages,
Blisters and diluting Drinks proved their only Remedies. A simple
Infusion of Elder Flowers, and those of the Lime Tree, has done great
Service to those who drank plentifully of it.
Sec. 120. I am sensible that in many Villages a great Number of Persons
have died, with a prodigious Inflation or Swelling of the Neck. Some
have also died in the City, and among others a young Woman of twenty
Years of Age, who had taken nothing but hot sweating Medicines and red
Wine, and died the fourth Day, with violent Suffocations, and a large
Discharge of Blood from the Nose. Of the great Number I have seen in
Person, only two died. One was a little Girl of ten Months old. She had
an Efflorescence which very suddenly disappeared: at this Time I was
called in; but the Humour had retreated to the Breast, and rendered her
Death inevitable. The other was a strong Youth from sixteen to seventeen
Years old, whose sudden Attack from the Disease manifested, from the
very Beginning, a violent Degree of it. Nevertheless, the Symptoms
subsiding, and the Fever nearly terminating, the Sweats which approached
would probably have saved him. But he would not suffer them to have
their Course, continually stripping himself quite naked. The
Inflammation was immediately repelled upon the Lungs, and destroyed him
within the Space of thirty Hours. I never saw a Person die with so very
dry a Skin. The Vomit affected him very little upwards, and brought on a
purging. His own bad Conduct seems to have been the Occasion of his
Death; and may this serve as one Example of it.
Sec. 121. I chose to expatiate on this Disease, as it may happen to reach
other Places, where it may be useful to have been apprized of its Marks,
and of its Treatment, which agrees as much with that of putrid Fevers,
of which I shall speak hereafter, as with that of the inflammatory
Diseases I have already considered: since in some Subjects the Complaint
of the Throat has evidently been a Symptom of a putrid Fever, rather
than of the chiefly apparent Disease, a Quinsey. [31]
Sec. 122. Disorders of the Throat are, with Respect to particular Persons,
an habitual Disease returning every Year, and sometimes oftner than once
a Year. They may be prevented by the same Means, which I have directed
for the Preservation from habitual Pleurisies Sec. 100; and by defending
the Head and the Neck from the Cold; especially after being heated by
Hunting, or any violent Exercise, or even by singing long and loud,
which may be considered as an extraordinary Exercise of some of the
Parts affected in this Disease.
[31] I reserve some other interesting Reflections on this Disease, for
the second Edition of my Treatise on Fevers; and the Editor at
_Paris_ has very well observed, that it has some Relation to the
gangrenous sore Throat, which has been epidemical these twenty
Years past, in many Parts of _Europe_.----This Note is from Dr.
_Tissot_ himself.
__Chapter VII.__
_Of Colds._
__Sect.__ 123.
There are many erroneous Prejudices, with Regard to Colds, all of which
may be attended with pernicious Consequences. The first is, that a Cold
is never dangerous; an Error which daily destroys the Lives of many. I
have already complained of it for many Years past; and I have since
beheld a Multitude of such Examples of it, as have but too sufficiently
warranted my Complaints.
No Person however, it is certain, dies merely of a Cold, as long as it
is nothing but a Cold simply; but when, from Inattention and Neglect, it
is thrown upon, and occasions Distempers of the Breast, it may, and
often does, prove mortal. _Colds destroy more than Plagues_, was the
Answer of a very sagacious and experienced Physician to one of his
Friends, who, being asked, how he was in Health, replied, Very well, I
have nothing but a Cold.
A second erroneous Prejudice is, that Colds require no Means, no
Medicines, and that they last the longer for being nursed, or tampered
with. The last Article may be true indeed, with Respect to the Method,
in which the Person affected with them treats them; but the Principle
itself is false. Colds, like other Disorders, have their proper
Remedies; and are removed with more or less Facility, as they are
conducted better or worse.
Sec. 124. A third Mistake is, that they are not only considered as not
dangerous, but are even supposed wholesome too. Doubtless a Man had
better have a Cold than a more grievous Disease; though it must be still
better to have neither of them. The most that can reasonably be said and
admitted on this Point, is, that when a checked, or an obstructed
Perspiration becomes the Cause of a Distemper, it is fortunate that it
produces rather a Cold, than any very dreadful Disease, which it
frequently does: though it were to be wished, that neither the Cause,
nor its Effect existed. A Cold constantly produces some Disorder or
Defect in the Functions of some Part or Parts of the Body, and thus
becomes the Cause of a Disease. It is indeed a real Disorder itself, and
which, when in a violent Degree, makes a very perceivable Assault upon
our whole Machine. Colds, with their Defluxions, considerably weaken the
Breast, and sooner or later considerably impair the Health. Persons
subject to frequent Colds are never robust or strong; they often sink
into languid Disorders; and a frequent Aptitude to take Cold is a Proof,
that their Perspiration may be easily checked and restrained; whence the
Lungs become oppressed and obstructed, which must always be attended
with considerable Danger.
Sec. 125. We may be convinced of the Weakness and Fallacy of these
Prejudices, by considering attentively the Nature of Colds; which are
nothing else than the very Diseases already described in the three
preceding Chapters, though in their greatest Degree only.
A Cold in Truth is almost constantly an inflammatory Disease; a light
Inflammation of the Lungs, or of the Throat; of the Membrane or very
thin Skin, which lines the Nostrills, and the Inside of certain Cavities
in the Bones of the Cheeks and Forehead. These Cavities communicate with
the Nose, in such a Manner, that when one Part of this Membrane is
affected with an Inflammation, it is easily communicated to the other
Parts.
Sec. 126. It is scarcely necessary to describe the Symptoms of a Cold, and
it may be sufficient to remark, 1. That their chief Cause is the same
with that, which most commonly produces the Diseases already treated of,
that is, an obstructed Perspiration, and a Blood somewhat inflamed. 2.
That whenever these Diseases affect great Numbers, many Colds prevail at
the same Time. 3. That the Symptoms which manifest a violent Cold,
greatly resemble those which precede or usher in these Diseases. People
are rarely attacked by great Colds, without a shivering and Fever; which
last sometimes continues for many Days. There is a Cough, a dry Cough,
for some Time; after which some Expectoration ensues; which allays the
Cough, and lightens the Oppression; at which Time the Cold may be said
to be maturated, or ripe. There are pretty often slight Stitches, but
unfixed or flying about, with a little Complaint of the Throat. When the
Nostrills happen to be the Seat of the Disorder, which is then very
improperly termed a Cold of the Brain, it is often attended with a
vehement Head-ach; which sometimes depends on an Irritation of the
Membrane, that lines the Cavities in the Bone of the Forehead, or the
maxillary Sinusses, that is, the Cavities in the Jaws: At first the
Running from the Nose is very clear; thin and sharp; afterwards, in
Proportion to the Abatement of the Inflammation, it becomes thicker; and
the Consistence and Colour of it resemble those of what others cough up.
The Smell, the Taste and the Appetite are commonly impaired by it.
Sec. 127. Colds seem to be of no certain Duration or Continuance. Those of
the Head or Brain generally last but a few Days; of the Breast longer.
Some Colds nevertheless terminate in four or five Days. If they extend
beyond this Term they prove really hurtful. 1. Because the Violence of
the Cough disorders the whole Machine; and particularly, by forcing up
the Blood to the Head. 2. By depriving the Person afflicted of his usual
Sleep, which is almost constantly diminished by it. 3. By impairing the
Appetite, and confusing the Digestion, which is unavoidably lessened by
it. 4. By weakening the very Lungs, by the continual Agitations from
Coughing; whence all the Humours being gradually determined towards
them, as the weakest Part, a continual Cough subsists. Hence also they
become overcharged with Humours, which grow viscid there; the
Respiration is overloaded and oppressed; a slow Fever appears; Nutrition
almost ceases; the Patient becomes very weak; sinks into a Wasting; an
obstinate Wakefulness and Anguish, and often dies in a short Time. 5. By
Reason that the Fever, which almost constantly accompanies great Cold,
concurs to wear the body down.
Sec. 128. Wherefore, since a Cold is a Disease of the same kind with
Quinsies, Peripneumonies and Inflammations of the Breast, it ought to be
treated in the same Manner. If it is a violent one, Blood should be
taken from the Arm, which may considerably shorten its Duration: and
this becomes most essentially necessary, whenever the Patient is of a
sanguineous ruddy Complexion, abounds with Blood, and has a strong
Cough, and great Head-ach. The Drinks No. 1, 2, 3, 4, should be very
plentifully used. It is advantagious to bathe the Feet in warm Water
every Night at going to Bed. [32] In a Word, if the Patient is put into
a Regimen, the Cure is very speedily effected.
[32] It frequently happens, that the Bathings alone remove the Head-ach,
and the Cough too, by relaxing the lower Parts, and the entire
Surface of the Body. If the Patient is costive, he should receive
Glysters of warm Water, in which some Bran has been boiled, with
the Addition of a little common Soap or Butter. _E. L._
Sec. 129. The Disorder indeed, however, is often so very slight, that it
may be thought to require very little, if any, medical Treatment, and
may be easily cured without Physick, by abstaining from Flesh, Eggs,
Broth, and Wine; from all Food that is sharp, fat and heavy; and by
dieting upon Bread, Pulse, Fruit, and Water; particularly by eating
little or no Supper; and drinking, if thirsty, a simple Ptisan of
Barley, or an Infusion of Elder Flowers, with the Addition of a third or
fourth Part of Milk. Bathing the Feet, and the Powder No. 20 contribute
to dispose the Patient to sleep. Five Tea-Cups of an Infusion of the
Red, or wild Poppy Leaves may also be ventured on safely.
Sec. 130. When the Fever, Heat and Inflammation wholly disappear; when the
Patient has kept to his Regimen for some Days, and his Blood is well
diluted, if the Cough and Want of Sleep still continues, he may take in
the Evening a Dose of Storax [33] Pill, or of Venice Treacle with Elder
Flower Tea, after bathing his Feet. These Remedies by stilling the
Cough, and restoring Perspiration, frequently cure the Cold in the Space
of one Night. I confess at the same Time, I have seen bad Consequences
from such Opiates, when given too early in the Complaint. It is also
necessary, when they are given, that the Patient should have supt but
very moderately, and that his Supper should be digested.
[33] Under these Circumstances of a tickling Cough from a Cold, without
a Fever, and with very little Inflammation, I have known great and
very frequent Success, from a Dose of _Elixir paregoricum_, taken
at Bed-time, after a very light thin Supper. If the Patient be
sanguine, strong and costive, Bleeding in a suitable Quantity, and
a gently opening Potion, or purging Glyster, may be prudently
premised to it. Grown Persons may take from 30 to 80, or even 100
Drops of it, in Barley Water, or any other pectoral Drink; and
Children in the Chincough from five to twenty Drops; half an Ounce
of it by Measure containing about one Grain of Opium, which is the
Quantity contained in less than quite six Grains of the Storax
Pill; this last being a very available pectoral Opiate too in
Coughs from a Distillation, in more adult Bodies, who may also
prefer a Medicine in that small Size, and Form. _K._
Sec. 131. An immense Number of Remedies are cried up for the Cure of Colds;
such as Ptisans of Apples or Pippins, of Liquorice, of dry Raisins, of
Figs, of Borage, of Ground-Ivy, of _Veronica_ or Speedwell, of Hysop, of
Nettles, _&c. &c._ I have no Design to depreciate them; as all of them
may possibly be useful: But unfortunately, those who have seen any
particular one of them succeed in one Case, readily conclude it to be
the most excellent of them all; which is a dangerous Error, because no
one Case is a sufficient Foundation to decide upon: which besides none
are qualified to do, who have not often seen a great Number of such
Cases; and who do not so attentively observe the Effects of different
Medicines, as to determine on those which most frequently agree with the
Disorder; and which, in my Judgment, are those I have just enumerated. I
have known a Tea or Infusion of Cherry Stalks, which is not a
disagreeable Drink, to cure a very inveterate Cold.
Sec. 132. In Colds of the Head or Brain, the Steam of warm Water alone, or
that in which Elder Flowers, or some other mild aromatic Herbs, have
been boiled, commonly afford a pretty speedy Relief. These are also
serviceable in Colds fallen on the Breast. See Sec. 55.
It has been a Practice, though of no very long standing, to give the Fat
of a Whale in these Cases; but this is a very crude indigestible kind of
Fat, and greasy oily Medicines seldom agree with Colds. Besides, this
Whales' Fat is very disagreeable and rancid, that is rank; so that it
were better to forbear using it: I have sometimes seen ill Effects from
it, and rarely any good ones. [34]
[34] This seems but too applicable to the very popular Use of
_Spermaceti_, &c. in such Cases, which can only grease the Passage
to the Stomach; must impair its digestive Faculty, and cannot
operate against the Cause of a Cold; though that Cure of it, which
is effected by the Oeconomy of Nature in due Time, is often
ascribed to such Medicines, as may rather have retarded it. _K._
Sec. 133. Such Persons as abate nothing of the usual Quantity of their
Food, when seized with a Cold, and who swallow down large Quantities of
hot Water, ruin their Health. Their Digestion ceases; the Cough begins
to affect the Stomach, without ceasing to afflict the Breast; and they
incur a Chance of sinking into the Condition described Sec. 127, No. 4.
Burnt Brandy and spiced Wine are very pernicious in the Beginning of
Colds, and the Omission of them must be a very prudent Omission. If any
good Effects have ever been known to attend the Use of them, it has been
towards the going off of the Cold; when the Disorder maintained its
Ground, solely from the Weakness of the Patient. Whenever this is the
Case, there is not the least Room for farther Relaxation; but the
Powders No. 14, should be taken every Day in a little Wine; and should
the Humours seem likely to be thrown upon the Lungs, Blisters ought to
be applied to the fleshy Part of the Legs.
Sec. 134. Drams, or _Liqueurs_, as they are called in _French_, agree so
very little in this last State, that frequently a very small Quantity of
them revives a Cold that was just expiring. There really are some
Persons who never drink them without taking Cold, which is not to be
wondered at, as they occasion a light Inflammation in the Breast, which
is equivalent to a Cold or Distillation.
Nevertheless, People in this Disorder should not expose themselves to
violent cold Weather, if there is a Possibility of avoiding it: though
they should equally guard too against excessive Heat. Those, who inclose
themselves in very hot Rooms, never get quite cured; and how is it
possible they should be cured in such a Situation? Such Rooms,
abstracted from the Danger of coming out of them, produce Colds in the
same Manner that Drams do, by producing a light inflammation in the
Breast.
Sec. 135. Persons subject to frequent Colds, which Habits are sometimes
termed _fluxionary_, or liable to Distillations, imagine, they ought to
keep themselves very hot. This is an Error which thoroughly destroys
their Health. Such a Disposition to take Cold arises from two Causes;
either because their Perspiration is easily impaired; or sometimes from
the Weakness of the Stomach or the Lungs, which require particular
Remedies. When the Complaint arises from the Perspiration's being easily
disturbed and lessened, the hotter they keep themselves, the more they
sweat, and increase their Complaint the more. This incessantly warm Air
lets down and weakens the whole Machine, and more particularly the
Lungs; where the Humours finding less Resistance, are continually
derived, and are accumulated there. The Skin, being constantly bathed in
a small Sweat, becomes relaxed, soft, and incapable of compleating its
Functions: from which Failure the slightest Cause produces a total
Obstruction of Perspiration; and a Multitude of languid Disorders ensue.
These Patients thus circumstanced, redouble their Precautions against
the Cold, or even the Coolness of the Air, while their utmost Cautions
are but so many effectual Means to lower their Health; and this the more
certainly, as their Dread of the free Air necessarily subjects them to a
sedentary Life, which increases all their Symptoms; while the hot Drinks
they indulge in, compleat their Severity. There is but one Method to
cure People thus situated; that is, by accustoming them gradually to the
Air; to keep them out of hot Chambers; to lessen their Cloathing by
Degrees; to make them sleep cool; and to let them eat or drink nothing
but what is cold, Ice itself being wholesome in their Drink: to make
them use much Exercise; and finally, if the Disorder be inveterate, to
give them for a considerable Time the Powder No. 14, and make them use
the cold Bath. This Method succeeds equally too with those, in whom the
Disease originally depended on a Weakness of the Stomach, or of the
Lungs: and in fact, at the End of a certain Period, these three Causes
are always combined. Some Persons who have been subject, for many Years,
to catch Colds throughout the Winter; and who, during that Season, never
went out, and drank every thing warm, have been evidently the better,
during the Winter of 1761, and 1762, for the Direction I have given
here. They now walk out every Day; drink their Liquids cold; and by this
Means entirely escape Colds, and enjoy perfect Health.
Sec. 136. It is more customary indeed in Town, than in the Country, to have
different Troches, and Compositions in the Mouth. I am not for excluding
this Habit; though I think nothing is so efficacious as Juice of
Liquorice; and provided a sufficient Dose be taken, it affords certain
Relief. I have taken an Ounce and a half in one Day, and have felt the
good Consequences of it very remarkably.
__Chapter VIII.__
_Of Diseases of the Teeth._
__Sect.__ 137.
The Diseases of the Teeth, which are sometimes so tedious and so
violent, as to cause obstinate Wakefulness, a considerable Degree of
Fever, Raving, Inflammations, Abscesses, Rottenness of the Bones,
Convulsions and Faintings, depend on three principal Causes. 1. On a
_Caries_ or Rottenness of the Teeth. 2. On an Inflammation of the Nerves
of the Teeth, or of the Membrane which invests and covers them; and
which affects the Membrane of the Gums. 3. A cold Humour or Defluxion
that is determined to the Teeth, and to their Nerves and Membrane.
Sec. 138. In the first of these Cases, the _Caries_ having eat down to, and
exposed the naked Nerve, the Air, Food and Drink irritate, or, as it
were sting it; and this irritation is attended with Pain more or less
violent. Every thing that increases the Motion or Action of the affected
Part, as Exercise, Heat or Food, will be attended with the same
Consequence.
When the Tooth is greatly decayed, there is no other Cure besides that
by extracting it, without which the Pain continues; the Breath becomes
very offensive; the Gum is eat down; the other Teeth, and sometimes even
the Jaw-bone, are infected with the Rottenness: besides, that it
prevents the Use of the other Teeth, which are infected with a kind of
tartarous Matter, and decay.
But when the Disorder is less considerable, the Progress of it may
sometimes be restrained, by burning the Tooth with a hot Iron, or by
filling it with Lead, if it is fitted to receive and to retain it.
Different corroding Liquids are sometimes used on these Occasions, _Aqua
fortis_ itself, and Spirit of Vitriol: but such Applications are highly
dangerous, and ought to be excluded. When the Patients, from Dread,
reject the Operations just mentioned, a little Oyl of Cloves may be
applied, by introducing a small Pellet of Cotton, dipt in it, to the
rotten hollow Tooth; which often affords considerable Ease, and Respite.
Some make use of a Tincture of Opium, or Laudanum, after the same
Manner; and indeed these two Medicines may be used together in equal
Quantities. I have often succeeded with _Hoffman's_ mineral anodyne
Liquor; which seemed indeed, for a few Moments, to increase the Pain;
but Ease generally ensues after spitting a little Time. A Gargarism made
of the Herb _Argentina_; that is Silver-weed or wild Tansey, in Water,
frequently appeases the Pain that results from a _Caries_ of the Teeth:
and in such Cases many People have found themselves at Ease, under a
constant Use of it. It certainly is an Application that cannot hurt, and
is even beneficial to the Gums. Others have been relieved by rubbing
their Faces over with Honey.
Sec. 139. The second Cause is the Inflammation of the Nerve within the
Substance, or of the Membrane on the Outside, of the Tooth. This is
discovered by the Patient's Temperament, Age and Manner of living. They
who are young, sanguine, who heat themselves much, whether by Labour, by
their Food, their Drink, by sitting up late, or by any other Excess:
they who have been accustomed to any Discharges or Eruptions of Blood,
whether natural or artificial, and who cease to have them as usual, are
much exposed to the Tooth-ach, from this Cause.
This Pain, or rather Torment, if in an acute Degree, commonly happens
very suddenly, and often after some heating Cause. The Pulse is strong
and full; the Countenance considerably red; the Mouth extremely hot:
there is often a pretty high Fever, and a violent Head-ach. The Gums, or
some Part of them, become inflamed, swelled, and sometimes an Abscess
appears. At other times the Humours throw themselves upon the more
external Parts; the Cheek swells, and the Pain abates. When the Cheek
swells, but without any Diminution of the Pain, it then becomes an
Augmentation, but no essential Change, of the Disorder.
Sec. 140. In this Species of the Disease, we must have Recourse to the
general Method of treating inflammatory Disorders, and direct Bleeding,
which often produces immediate Ease, if performed early. After Bleeding,
the Patient should gargle with Barley Water, or Milk and Water; and
apply an emollient Cataplasm to the Cheek. If an Abscess or little
Imposthume appears, the Suppuration or ripening of it is to be promoted,
by holding continually in the Mouth some hot Milk, or Figs boiled in
some Milk: and as soon as ever it seems ripe, it should be opened, which
may be done easily, and without any Pain. The Disorder, when depending
on this Cause, is sometimes not so violent, but of a longer Duration,
and returns whenever the Patient heats himself; when he goes to Bed;
when he eats any heating Food, or Drink, Wine or Coffee. In this Case he
should be bled, without which his other Medicines will have little
Effect; and he should bathe his Feet in warm Water for some Evenings
successively, taking one Dose of the Powder No. 20. Entire Abstinence
from Wine and Meat, especially at Night, has cured several Persons of
inveterate and obstinate Maladies of the Teeth.
In this Species of Tooth-ach, all hot Remedies are pernicious; and it
often happens that Opium, Venice Treacle, and Storax Pills, are so far
from producing the Relief expected from them, that they have aggravated
the Pain.
Sec. 141. When the Disease arises from a cold Distillation, or Humour,
tending to these Parts, it is commonly (though equally painful) attended
with less violent Symptoms. The Pulse is neither strong, full nor quick;
the Mouth is less heated, and less swelled. In such Cases, the afflicted
should be purged with the Powder No. 21, which has sometimes perfectly
cured very obstinate Complaints of this Sort. After purging they should
make Use of the Diet Drink of the Woods No. 22. This has cured
Tooth-achs, which have baffled other Attempts for many Years; but it
must be added, this Drink would be hurtful in the Disease from a
different Cause. Blisters to the Nape of the Neck, or [35] elsewhere, it
matters not greatly where, have often extraordinary good Effects, by
diverting the Humour, and restoring a compleat Perspiration. In short in
this Species, we may employ, not only with Safety, but with Success
(especially after due purging) Pills of Storax, Opium and Venice
Treacle. Acrid sharp Remedies, such as hard spun [35] Tobacco, Root of
Pellitory of _Spain_, &c. by exciting much Spitting, discharge part of
the Humour which causes the Disease, and hence diminish the Pain. The
Smoke of Tobacco also succeeds now and then in this Disorder, whether
this happens from the Discharge of the Rheum or Spittle it occasions; or
whether it is owing to any anodyne Efficacy of this Plant, in which it
resembles Opium.
[35] A small Blister behind the Ear of the affected Side, or both Ears,
has very often removed the Pain, when from a Defluxion. It is
pretty common for the Subjects of this Disease to be very costive,
during the Exacerbations of it, which I have sometimes experienced
to be pretty regularly and severely quotidian, for a Week or two.
The Custom of smoking Tobacco very often, which the Violence of
this Pain has sometimes introduced, often disposes to a Blackened
and premature Decay of the Teeth, to which the Chewers of it are
less obnoxious: and this Difference may result from some particles
of its chemical Oil rising by Fumigation, and being retained in the
Teeth, which Particles are not extracted by Mastication. But with
Regard to the habitual Use of this very acrid and internally
violent Herb, for, but chiefly after, this Disease, it should be
considered well, whether in some Constitutions it may not pave the
Way to a more dangerous one, than it was introduced to remove. _K._
Sec. 142. As this last Cause is often the Consequence of a Weakness in the
Stomach, it daily happens that we see some People, whose Disorder from
this Cause is augmented, in Proportion as they indulge in a cooling,
refreshing Way of living. The Increase of the Disorder disposes them to
increase the Dose of what they mistake for its Remedy, in Proportion to
which their Pain only increases. There is a Necessity that such Persons
should alter this Method; and make use of such Medicines as are proper
to strengthen the Stomach, and to restore Perspiration. The Powder No.
14. has often produced the best Consequences, when I have ordered it in
these Cases; and it never fails to dissipate the Tooth-ach very
speedily, which returns periodically at stated Days and Hours. I have
also cured some Persons who never drank Wine, by advising them to the
Use of it.
Sec. 143. But besides the Diseases of the Teeth, that are owing to these
three principal Causes, which are the most common ones; there are some
very tedious and most tormenting Disorders of them, that are occasioned
by a general Acrimony, or great Sharpness, of the Mass of Blood, and
which are never cured by any other Medicines but such, as are proper to
correct that Acrimony. When it is of a scorbutic Nature, the wild
Horse-radish (Pepperwort) Water Cresses, Brooklime, Sorrel, and
Wood-sorrell correct and cure it. If it is of a different Nature, it
requires different Remedies. But very particular Details do not come
within the Plan of this Work. As the Malady is of the chronical or
tedious kind, it allows Time to consider and consult more particularly
about it.
The Gout and the Rheumatism are sometimes transferred to the Teeth, and
give Rise to the most excruciating Pains; which must be treated like the
Diseases from which they arise.
Sec. 144. From what has been said on this Disorder, the Reader will
discern, in what that imaginary Oddness may consist, which has been
ascribed to it, from the same Application's relieving one Person in it,
and not affording the least Relief to another. Now the plain Reason of
this is, that these Applications are always directed, without an exact
Knowledge of the particular Cause of the Disease, in different Subjects
and Circumstances; whence the Pain from a rotten Tooth, is treated like
that from an Inflammation; that from an Inflammation, like the Pain from
a cold Humour or Fluxion; and this last like a Pain caused by a
scorbutic Acrimony: so that the Disappointment is not in the least
surprizing. Perhaps Physicians themselves do not always attend
distinctly enough to the Nature of each particular Disorder: and even
when they do, they content themselves with directing some of the less
potent Medicines, which may be inadequate to accomplish the necessary
Effect. If the Distemper truly be of an inflammatory Disposition,
Bleeding is indispensible to the Cure.
It happens in Fact, with Regard to the Diseases of the Teeth, as well as
to all other Diseases, that they arise from different Causes; and if
these Causes are not opposed by Medicines suited to them, the Disease,
far from being cured, is aggravated.
I have cured violent Tooth-achs, of the lower Jaw, by applying a
Plaister of Meal, the White of an Egg, Brandy and Mastich, at the Corner
of that Jaw, over the Spot where the Pulsation of the Artery may be
perceived: and I have also mitigated the most excruciating Pains of the
Head, by applying the same Plaister upon the temporal Artery.
__Chapter IX.__
_Of the Apoplexy._
__Sect.__ 145.
Every Person has some Idea of the Disease termed an Apoplexy, which is a
sudden Privation or Loss of all Sense, and of all voluntary Motion; the
Pulse at the same Time being kept up, but Respiration or Breathing,
being oppressed. I shall treat of this Disease only in a brief Manner,
as it is not common in our Country Villages; and as I have expatiated on
it in a different Manner in a Letter to Dr. _Haller_, published in 1761.
Sec. 146. This Disease is generally distinguished into two Kinds, the
sanguineous and serous Apoplexy. Each of them results from an
Overfulness of the Blood Vessels of the Brain, which presses upon, and
prevents or impairs the Functions of the Nerves. The whole Difference
between these two Species consists in this, that the sanguineous
Apoplexy prevails among strong robust Persons, who have a rich, heavy,
thick and inflammable Blood, and that in a large Quantity; in which
Circumstance it becomes a genuine inflammatory Distemper. The serous, or
humoral Apoplexy invades Persons of a less robust Constitution; whose
Blood is more dilute or watery; and rather viscid, or lightly
gelatinous, than heavy or rich; whole Vessels are in a more relaxed
State; and who abound more in other Humours than in red Blood.
Sec. 147. When the first kind of this Disease exists in its most violent
Degree, it is then sometimes termed, an apoplectic Stroke, or thundering
Apoplexy, which kills in a Moment or instantaneously, and admits of no
Remedies. When the Assault is less violent, and we find the Patient with
a strong, full and raised Pulse, his Visage red and bloated, and his
Neck swelled up; with an oppressed and loud hoarse Respiration; being
sensible of nothing, and capable of no other Motions, except some
Efforts to vomit, the Case is not always equally desperate. We must
therefore immediately,
1. Entirely uncover the Patient's Head, covering the rest of his Body
but very lightly; procure him instantly very fresh free Air, and leave
his Neck quite unbound and open.
2. His Head should be placed as high as may be, with his Feet hanging
down.
3. He must lose from twelve to fifteen Ounces of Blood, from a free open
Orifice in the Arm: the Strength or Violence with which the Blood
sallies out, should determine the Surgeon to take a few Ounces more or
less. It should be repeated to the third or fourth Time, within the
Space of three or four Hours; if the Symptoms seem to require it, either
in the Arm, or in the Foot.
4. A Glyster should be given of a Decoction of the first emollient
opening Herbs that can be got, with four Spoonfuls of Oil, one Spoonful
of Salt: and this should be repeated every three Hours.
5. If it is possible, he should be made to swallow Water plentifully, in
each Pot of which three Drams of Nitre are to be dissolved.
6. As soon as the Height and Violence of the Pulse abates; when his
Breathing becomes less oppressed and difficult, and his Countenance less
inflamed, he should take the Decoction No. 23; or, if it cannot be got
ready in Time, he should take three Quarters of an Ounce of Cream of
Tartar, and drink Whey plentifully after it. This Medicine succeeded
extremely well with me in a Case, where I could not readily procure any
other.
7. He should avoid all strong Liquor, Wine, distilled Spirit, whether
inwardly or by outward Application, and should even be prevented
from [36] smelling them.
[36] I have been very authentically assured of the Death of a hale Man,
which happened in the very Act of pouring out a large Quantity of
distilled Spirits, by Gallons or Bucketfulls, from one Vessel into
another. _K._
8. The Patient should be stirred, moved, or even touched, as little as
it is possible: in a Word every Thing must be avoided that can give him
the least Agitation. This Advice, I am sensible, is directly contrary to
the common Practice; notwithstanding which it is founded in Reason,
approved by Experience, and absolutely necessary. In Fact, the whole
Evil results from the Blood being forced up with too much Force, and in
too great a Quantity, to the Brain; which being thence in a State of
Compression, prevents every Movement and every Influence of the Nerves.
In Order, therefore, to re-establish these Movements, the Brain must be
unloaded, by diminishing the Force of the Blood. But strong Liquors,
Wines, Spirits, volatile Salts, all Agitation and Frictions augment it,
and by that very Means increase the Load, the Embarrassment of the
Brain, and thus heighten the Disease itself. On the contrary, every
Thing that calms the Circulation, contributes to recall Sensation and
voluntary Motion the sooner.
9. Strong Ligatures should be made about the Thighs under the Ham: By
this Means the Blood is prevented in its Ascent from the Legs, and less
is carried up to the Head.
If the Patient seems gradually, and in Proportion as he takes proper
Medicines, to advance into a less violent State, there may be some
Hopes. But if he rather grows worse after his earliest Evacuations, the
Case is desperate.
Sec. 148. When Nature and Art effect his Recovery, his Senses return:
though there frequently remains a little _Delirium_ or Wandering for
some Time; and almost always a paralytic Defect, more or less, of the
Tongue, the Arm, the Leg, and the Muscles of the same Side of the Face.
This Palsy sometimes goes off gradually, by the Help of cooling Purges
from Time to Time, and a Diet that is but very moderately and lightly
nourishing. All hot Medicines are extremely hurtful in this Case, and
may pave the Way to a repeated Attack. A Vomit might be even fatal, and
has been more than once so. It should be absolutely forbidden; nor
should we even promote, by Draughts of warm Water, the Efforts of the
Patient to vomit. They do not any ways depend on any Humour or Mass in
the Stomach; but on the Oppression and Embarrassment of the Brain: and
the more considerable such Efforts are, the more such Oppression is
increased: by Reason that as long as they continue, the Blood cannot
return from the Head, by which Means the Brain remains overcharged.
Sec. 149. The other Species of Apoplexy is attended with the like Symptoms,
excepting the Pulse not being so high nor strong; the Countenance being
also less red, sometimes even pale; the Breathing seems less oppressed;
and sometimes the Sick have a greater Facility to vomit, and discharge
more upwards.
As this Kind of the Disease attacks Persons who abound less in Blood;
who are less strong, and less heated or inflamed, Bleeding is not often
at all necessary: at least the Repetition of it is scarcely ever so: and
should the Pulse have but a small Fulness, and not the least unnatural
Hardness, Bleeding might even be pernicious.
1. The Patient however should be placed as was directed in the former
Mode of this Disease; though it seems not equally necessary here.
2. He should receive a Glyster, but without Oil, with double the
Quantity of Salt, and a Bit of Soap of the Size of a small Egg; or with
four or five Sprigs of Hedge Hyssop. It may be repeated twice a Day.