SECT. IV.
Of Intermitting fevers, and Agues.
There is scarce a disease that makes a patient more wretched, and unhappy, than the fever and ague. The causes of these kind of fevers is principally from a pituitous, or slimy blood, together with its being loaded with acrimony; and a flacidity of the moving fibres.
They are divided into various classes; though in fact all of one nature. When the ague with its succeeding fever comes on regularly every day, it is called quotidian, or every day’s ague; when every second day, tertian, or third day’s ague, and when every third day; a quartan, or fourth day’s ague. There are many other classes as subdivisions of these, but they are the mere speculations of physical pedants, who are ever sworn enemies to plain understanding, and delight in perplexities; which therefore, we shall neither spend paper nor time upon to recount.
Suffice it, let their paroxysms return at what stated period of time they will, either regularly or irregularly, they differ in nothing but this, that the farther the fits are distanced, the severer they generally are, when they come on; and the more regular, the more obstinate in their cure; though in this even there are exceptions.
It is surprizing to imagine, how many different opinions have been sent into the world concerning the returns of the periodical fits of the ague; and equally astonishing, how few with any probability of truth or reason.
I shall not here enter into an enquiry of this nature; certain it is, that at the stated times of these returning fits of the ague, there is an obstruction in some particular part of the system, that corresponds with the dated time of the circulation of fluids in such parts—which when disturbed, effects by the nervous consent, the whole animal structure.
The principal intention in all intermitting fevers, should be to correct the petuity and acrimony of the blood; to remove the obstructions; and to strengthen the solids.
With respect to the blood, it is an inevitable consequence, that when it is loaded with a vicidity and lentor, that it will ever occasion a depraved nutrition; and hence we see, that people labouring under agues, and intermittent fevers of any kind, have a depraved appetite, and many disagreeablenesses in the first passages.
The intermittent fever and ague approach with the following symptoms, viz. a heavy dull head-ach, a shivering chill all over the body, with a yawning, &c. pain in all the limbs attended with weariness, a nausea at the stomach, a depressed pulse; which after it has lasted for half an hour, changes into a burning heat, a throbbing head-ach, pain in the loins, and in every limb, a great draught, a full hard pulse, and which at last terminates in a profuse sweat; this seems to give the patient ease, for one, two, or three days; and then attacks the patient with the same symptom, increasing every time, and reduces the patient both in body and spirit.
The first thing to be done is to give a vomit, like No. [XV]. and XXVI. This is best taken at the approach of the cold fit, and worked well off with plenty of luke warm water. After the operation of the vomit is over, let the patient take the following draught.
No. XXVII
Take fever powder (L), thirty grains; calomel (N), one grain; elixir of vitriol (G), sixty, or seventy drops; essential oil of peppermint (U), four drops upon a little lump of sugar; to which add water, half a tea cup full.
This draught will not only promote perspiration, but help to dissolve the siziness in the blood; and may therefore be repeated every six hours, for a few days. But the patient should always be kept moderately warm upon it, that it may work by perspiration.—This simple method I have known put the patient to rights again, after a severe onset.
But sometimes this wretched disorder will require more powerful medicines to keep it in subjection. When the fibres are debilitated, and the blood still retains its viscid corruptive quality, the ague is apt to hang on the patient a long time, the succeeding fever apt to melt the patient down to a mere skeleton, and even destroy him. In this it is requisite to brace up the solids, and to infuse an astringency into the blood.
To this intent, the Peruvian bark is now frequently prescribed, and if judiciously administered it is an excellent medicine; but as it is liable however, to be improperly given, and then productive of irreparable mischief, I have purposely omitted it in this catalogue; nevertheless, I shall give in its stead a medicine, superior both in virtue, and by far more safe in the application; not only in this kind of complaint, but in scorbutic cases, as I shall hereafter take notice of. The medicine is this,
No. XXVIII
Elixir of Iron.
Take a quantity of rusty iron, the smaller the pieces are, the better, for the less quantity will do; pour on it good strong vinegar, sufficient to cover it; let them steep till the vinegar becomes of a deep brown colour, which it soon will, and at length acquire a consistence of a black elixir. The vessel should be either stone or glass; but what is yet better is an iron pot, which of itself will contribute to the medicine.
If the patient therefore, after the vomit, and the above draught, is attacked again with the fit of the ague, and succeeding fever, have immediate recourse to your elixir of iron.——Let him take after the fever is off, every three hours, a table spoonful of the elixir, and should it seem to come up again at first (which it sometimes will, particularly if the stomach is yet foul) give immediately another spoonful, and repeat this at least three times of the day.
A little gentle exercise upon taking the elixir is highly beneficial; and if it throws a gentle warmth over the body, and brings it into a gentle perspiration, you are sure of success.
The quantity of it should be adapted to the condition of the patient, and the strength of the stomach; if it sits easy, a larger quantity may be taken, and seldomer; and if it is more nauseous, a smaller dose and oftener.—Should the fits seem obstinate, the following electuary may be used; and is a powerful specific.
No. XXIX
Take stomach powder (M), two drachmes; nutmeg powdered, one drachm; powdered alum (17), half a drachm; essential oil of peppermint (U), twenty drops; calomel (N), ten grains; honey (E), one ounce: the whole well mixed.
Of this let the patient take every eight, or twelve hours, the bigness of a nutmeg, taking his elixir as before observed; and this will ever prove successful in the most obstinate case.
As patients of that kind at sea, have ever a taint of the scurvy in their composition, or at least have a tendency towards it, exercise and freshness of food, will prove one of the restorative means. The malt decoction should also be their drink, as well as in the scurvy.
To conclude, I shall only observe, that bleeding in agues must at all events be omitted, as being absolutely pernicious, as it cannot fail of impoverishing the blood; which is the principle source of the disorder. Also, in the intermitting time, exercise should be observed, and the diet should, when the stomach craves, be good. Sometimes indeed, the stomach is too ravenous and greedy; but that is a default which proceeds from the same cause as that which makes it loath its victuals; a vomit in either case is the most effectual medicine, and may be repeated as often as it is requisite, without the least fear of injury, particularly in this disease.