The Symptoms accompanying a Pestilential Fever are Yawning, Stretching,
Coldness, frequently to the greatest Extremity, Shuddering, suddain
Pains in the Head, Giddiness, Loathing, Vomiting, a low unequal Pulse,
Trembling, great inward Heat, especially about the _Præcordia_, Coldness
of the Extremities, uncertain Sweats, Inquietude, Stupor, Delirium,
Watching, Convulsions, Carbuncles, Buboes, Livid Vesications, Purple
Spots, _Hæmorrhages_, which three last are the certain Forerunners of
Death.
But here it is to be observed, that all the preceeding Symptoms do not
constantly happen to every individual Person who is affected with a
Pestilential Fever, but differ both in Number and Degree according to
the Degree of Infection, Virulence of the Contagious Particles, and
Constitutions of particular Persons; Thus the more the Blood is stock'd
with Acrid and Pungent Salts, and other Parts render'd Glutinous,
Coagulated, or Inspissated, the hotter the Season of the Year, the more
violent the Symptoms will be, where the Degree of Infection is equal,
and _vice versa_.
[Sidenote: _Yawning, Stretching
Lassitude._]
These are the first Signs of the Seisure of the fatal Enemy, and take
their Rise from the Slowness of the Motion of the Circulating Fluids.
For the Viscosity of the moving Fluids being increased, and the
_Liquidum Nervorum_ degenerating in Proportion thereto, the Weight to be
moved will bear a greater Proportion to the moving Force than in a
Natural State, and consequently the Animal must be affected with
Weariness, as we find it is in all Cases where the Spirits are exhausted
and weakned, in Proportion to the Circulating Juices. The other two are
the necessary Consequence of this, for the Viscosity of the Fluids
rendring them unfit to pass the small Capillary Vessels, the Pressure on
the _Fibres_ and Vessels will be increased, excite an uneasy Sensation,
and stimulate them to more frequent Vibrations, in order to dislodge the
Enemy: Whence follows a Contraction of the Muscles, and especially those
which serve for Voluntary Motion, and into which the Spirits are most
frequently determin'd: Hence then appears the Necessity of such a Method
and Medicines as may dilute and dissolve the Cohering Fluids, and
especially of such as are taken actually hot, and with large Quantities
of Diluters, the great Activity of the Fiery Particles contain'd in
them, rendring them much more capable of penetrating into the smallest
Recesses of the Body, and disjoining the Coagulated Fluids.
[Sidenote: _Coldness, Shuddering._]
These likewise depend on the too great Cohesion of the sanguineous
Particles, on which account the Circulatory as well as the Motion of the
intestine Particles of the Blood being diminish'd, and many of the
Igneous Particles intangled in the viscous Cohesions, a Sensation of
Cold must necessarily ensue, and especially in those Parts where the
Motion of the Blood is most slow, and its Cohesion increased as happens
in the Extremities. The nervous Juice being likewise for the same reason
determin'd Irregularly, and in less Quantity into the Muscles, sometimes
one, sometimes another of them will be weakly contracted, or a
Shuddering will ensue.
[Sidenote: _A Low, quick, unequal
Pulse._]
These arise from the Secretion of a smaller Quantity of Animal Spirits,
and those too unfit to actuate the Heart and other Muscles, whence their
Contractions will be more weak, and being stimulated by the Acrimony of
the Juices more frequent than in a Natural State. The Derivation
likewise of the Nervous Fluid into the _Fibres_ of the Heart being
irregular, for the Reasons afore-given, the Motion of the Heart, and
consequently of the Pulse, must be weak, quick, and unequal.
[Sidenote: _Loathing, Vomiting._]
These are occasion'd partly by the Contagious Particles being drawn in
with the Breath, and in their Passage tainting the _Saliva_, which when
swallowed Irritates the Nervous Filaments of the Stomach, and partly by
the Secretion of a more Pungent and Acrid Matter by its Glandulous Coat;
as appears from their spontaneous Ceasing as soon as a Sweat can be
procured, and the Discharge of these Acrid Particles promoted by the
Perspirable Glands[u], and seldom otherwise.
[u] _Sydenham_ de Peste.
[Sidenote: _Diarrhoea._]
A _Diarrhoea_ is likewise oftentimes a Concomitant of these Fevers, and
ever of most dangerous Consequence in the Beginning of the Disease,
inasmuch as it exhausts the Strength of the Patient, and prevents the
regular Expulsion of the Perspirable Matter, by which Experience assures
us that these Contagious Particles are most effectually discharg'd.
These then indicate such Medicines as cleanse the _Primæ Viæ_ from the
Contagious Particles, and other Crudities lodged in them, blunt the
Acrimony of the Saline Particles, and promote the Regular Expulsion of
the Perspirable Matter.
[Sidenote: _Coldness of the
Extremities._]
This is occasion'd by the weak Contraction of the Heart, and greater
Viscosity of the Blood in the Extream Parts of the Body, for the
Circulating Fluids being prest on every Side by the containing Vessels,
the more thin and liquid Part will pass into such Vessels as arise
nearest the Heart, and leave the rest more Viscous and unfit for Motion.
The Force of the Heart in the extream Parts being also much diminish'd,
thro' the numerous Ramifications of the Vessels, the Motion of the Blood
will be more slow, the Cohesion of the Particles of the Blood greater,
and the Obstructions in the Capillaries more fixt than in other Parts of
the Body. Now the Heat of the Body depending in a great Measure on the
Attrition of the Particles against each other, this being diminish'd in
the Extream Parts of the Body, the other must be lessen'd in Proportion.
[Sidenote: _Great inward Heat
especially about the Præcordia._]
This is occasion'd by the greater Intestine Motion and Colluctation of
the Particles of the Blood, and the Expansive Particles of Heat being in
greater Proportion in these than other Parts of the Body, from the more
numerous Ramifications and Obstructions of the Vessels, and their
Proximity to the Heart, as appears by _Prop. 2_.
[Sidenote: _Inquietude Watching._]
These arise from the same Cause as the Preceeding, the great inward Heat
being a constant _Stimulus_ to the nervous Parts, and obliging the Sick
to seek continual Change of Place and Posture, in order to abate this
uneasy Sensation. These therefore indicate the use of such Medicines as
specifically correct the Acrid and Stimulating Particles, restrain the
inordinate Effervescence of the Circulating Fluids, and attenuate the
Viscous Cohesions, of which kind are diluting and attenuating Acids,
temperate Cordials and Anodynes, in such Doses and Proportions as are
agreeable to the Age, Strength, and other Circumstances of the Patient.
[Sidenote: _Delirium._]
This arises from the Inordinate Influx of the _Liquidum Nervorum_,
occasioned from its Acrimony, Viscosity, and Quantity, different from
those in a healthful State. Whence the Reflux of the Spirits to the
Brain will be altogether irregular, and the Representations brought by
them Irrational and Inconsistent. As this Symptom may arise as well from
the increased as lessen'd Quantity, and different Texture of the Fluids,
and Springyness of the Solids; so Regard must be had to the particular
State of the Solids and Fluids in every Individual, for the abating of
this Symptom.
[Sidenote: _Stupor._]
This Symptom necessarily supposes the Flux of the Spirits thro' the
Brain and Nerves in some Measure intercepted or diminished, and
consequently as the preceeding may arise from different and even
contrary Causes, but generally in these Cases shews a greater Degree of
Coagulation in the Juices than the former, and consequently of greater
Danger from the more numerous Obstructions in the Capillary and Nervous
Vessels. Agreeable to which is that Observation of Dr. _Hodges_, That
they who were attended with this Symptom rarely recover'd.
[Sidenote: _Trembling, Faultering in
the Speech._]
These depend on the same Cause as the former, _viz._ On the Diminution
or Obstruction of the _Liquidum Nervorum_, whereby the Muscles are
involuntarily and weakly contracted. As these suppose a more torpid
Motion and greater Viscosity of the Fluids, and less Degree of
Elasticity in the solid Parts, so the Method taken herein ought to be
more active and stimulating than in any of the foregoing Symptoms.
Whence Epispasticks, and the most Volatil Attenuating Medicines are more
necessarily required, and ought to be oftner repeated, than in
preceeding Symptoms.
[Sidenote: _Pain in the Head._]
This is Occasioned by the Obstruction of some of the Capillary Vessels
of the Brain by the Coagulated Part of the Blood, and the wounding of
the Nervous Filaments by the Poisonous Saline _Spiculæ_. Whence the
Blood being resisted in its Motion, must press more strongly against the
Sides of the Vessels, and distend them beyond their Natural Diameters,
and produce a shooting and throbbing Pain; and if the Obstruction
continue or increase, a Phrensy, Inflammation, Suppuration, and Gangreen
of the Part affected. Why this Symptom should be one of the first, as
well as a constant Attendant thro' the whole Course of the Disease,
appears from _Prop. 2_.
[Sidenote: _Carbuncles, Buboes_, &c.]
Hence likewise appears the Reason of Carbuncles, Boboes, Vesications,
and the like, which take their Rise from the same Cause, and are
different only in Proportion to the Viscosity or Acrimony of the
obstructing Matter, and the Situation and Structure of the Part
affected.
[Sidenote: _Purple spots, Hemorrhages_]
These show the greatest Corrosion and Acrimony imaginable in the
Circulating Fluids, so as to be able to break and destroy the very
Vessels themselves, and consequently certain Signs of a speedy
Dissolution of the whole Animal Oeconomy.
[Sidenote: _Dissections of such as
have died of Malignant and
Pestilential diseases._]
The Dissections of such as have died of these Diseases are a farther
Confirmation of the foregoing Theory, inasmuch as they demonstrate a
greater Acrimony and Coagulation in the Juices than other Diseases, by
the numerous Obstructions Inflammations, and Mortifications of different
Parts of the Body. Thus the Stomach and Intestines are commonly highly
Inflamed, and frequently Gangreen'd. The Lungs, Diaphragm, and several
of the _Viscera_ inflamed, obstructed, and beset with Carbuncles and
Purple Spots. The Arteries of the _Dura_ and _Pia Mater_ obstructed, and
stuff'd with Grumous Blood, and often mortified. The Arteries of the
whole Body in general fuller than ordinary, the Veins more empty. The
Vessels about _Præcordia_ much obstructed, highly inflamed, and often
Gangreen'd. The membranous Parts of the Body in general more dry and
rigid than in most other Diseases.
[Decoration]