We must allow critical sweats to go on until they produce the necessary
evacuation, and assist by means of moderate heat and rest, and by not
wiping away the sweat (for one brings on another), by washing the mouth
with warm liquids, by warm drinks, and by sleep. The sweats which occur
in the decline of a fever are to be treated like the critical. Sudorific
remedies are sufficiently treated of in the 48th section of the First
Book. But when the sweats exceed in quantity, they must be wiped off,
and the covering of clothes lightened, so as to cool the patient. For,
by exceeding, they occasion lassitude, and often bring on syncope. Let,
therefore, the covering be light and moistened; let the air be cooled;
and let ventilation be used during sleep. Let the black myrtle, pounded,
be sprinkled on the body, and gall, and the bark of the pine, in like
manner. Let amber and polenta, with astringent wine, be applied to the
proper parts; and let the face be sponged with oxycrate. Archigenes
uses quicklime and the burned lees of wine in these cases, and for the
rigor not succeeded by heat; for both, he says, when heated, become
dry. He also orders us to bathe the middle parts of the body with the
juice of plantain, or coriander, or purslain, or cabbage, that they may
obstruct the passages of the sweat. In sleep, pieces of cloth smeared
with Cimolian earth, dissolved in water, are to be applied to the back
and chest; and the whole body should be anointed with the oil of roses,
or of apples, or of lentisk, or of myrtle, or with the cerates from them.
But fatty substances are particularly adapted to them; for, by shutting
up the insensible pores, they prevent the passage of the fluid. It is
clear that dry food and moderately astringent wines are befitting to
them; but much drink should be avoided, and, in particular, all things
of a very liquid nature, and likewise frequent washings of the mouth.
But, if possible, gestation should be taken in a cold state of the air.
The extremities in particular are to be cooled by these means. For
those sweats which are extorted by spasms and pains, tight ligatures,
or fomentations, are to be applied to the extremities, and they may be
relieved by gently rubbing with woollen cloths.
* * * * *
COMMENTARY. Hippocrates has delivered many interesting remarks on sweats
which occur in fevers. (See Epidem., Aphor., Prognost. _passim._) Febrile
sweats, attended with miliary eruptions, are held to be unfavorable. “In
general,” he says, “sweats proceed either from resolution of the body,
or the intensity of the inflammation.” (Prog.) In general he holds that
febrile sweats, unless they occur on critical days are unfavorable.
(Aphor.)
Galen remarks that profuse sweats are occasioned by rarity (i. e.
relaxation) of the body, or redundance of the superfluity, or thinness
thereof. The perspiration is checked, on the other hand, either because
the superfluity is small in quantity, thick, and viscid; or because the
pores of the skin are constricted. Either state, he adds, may arise from
atony of the natural powers of the flesh. (De Causis Sympt. iii, 9.) He
says, in another place, that for the removal of copious sweats astringent
and refrigerant remedies are indicated, and that everything of a relaxing
nature ought to be avoided. He recommends cold wine, and forbids all
hot things, also ligatures to the extremities, emetics, and motion. He
approves of cool air medicated by sprinkling the apartment of the sick
with austere things, such as myrtles, vine shoots, and roses. (Therap. ad
Glauc. ii.)
Celsus directs us, when the febrile sweats are slight, to rub the body
with oil, and, when more profuse, with roses, quince ointment, or myrtle
oil, to which austere wine is to be added. (iii, 6.)
Constantinus Africanus and his prototype Synesius concur in directing
colliquative sweats to be checked by rubbing the body with oil of
myrtles, of roses, &c. They commend an epitheme made of a decoction of
roses, the flowers of the wild pomegranate, galls, and myrtle leaves,
to which a proper proportion of oil is to be added. They also direct us
to place beside the patient vessels filled with water, to sprinkle the
apartment with myrtles, roses, &c. to give him the syrup of roses, in
cold water, and to avoid exercise.
Actuarius takes notice of the miliary eruption which sometimes
accompanies profuse sweats. He reckons it an unfavorable symptom. (Meth.
Med. i, 58.) He also makes mention of other cutaneous eruptions, some
resembling those produced by nettles, or the bites of gnats, and others
of a red or black colour. (Ibid.)
Serapion recommends styptic and desiccative applications, such as galls,
frankincense, alum, the flowers of vine, myrtles, and the like. (De
Antidotis, vi, 20.)
Haly Abbas briefly recommends friction with styptic oils, and to remove
the patient to a cool apartment. (Pract. iii, 24.)
Alsaharavius, in like manner, recommends friction with astringent oils,
such as those prepared with roses, pomegranates, and the like. (xxxi, 2,
8.)
Avicenna and Rhases adopt the same plan of treatment as our author.
The latter directs us to rub the body with rose oil, or myrtle oil, to
sprinkle the patient with rose water in the decoction of myrtles, to
fan him, and to lay in his chamber the tops of cooling herbs and trees.
(Contin. xxxi.)
Prosper Alpinus informs us that the Methodists approved of cool air, of
sprinkling the face with cold fluids, of rubbing the body with styptic
oils, and of giving astringent wines internally. He also mentions the
application of snow over the arteries of the extremities, and pouring
cold water over those of the wrist. It is to be regretted, however, that
this author too frequently omits to quote his ancient authorities. (See
Medic. Method., vi, 18, and vii, 3.)