CHAP. V.
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.
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.
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.
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.
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 [], and seldom otherwise.
[ ] Sydenham de Peste.
Diarrhœa.
A Diarrhœa 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
