CASE XXVI.
A young woman was seized with a fever, and the usual symptoms. The next day an eruption appeared, which gave some suspicion of the small-pox: on the third day more spots were discovered, but she was not relieved. The disorder was now supposed to be an inflammatory fever, attended with a rash; and as she was extremely delirious, a blister had been applied about two hours before I first saw her. The face was extremely full of very small pustules, which indeed were the small-pox, and there was a considerable number on the neck and limbs; but notwithstanding this eruption, the fever was very high, and the degree of heat so excessive, that I scarce ever felt a person hotter; she was so far sensible as to complain of great pain in her head, stomach, and loins, though very delirious and extremely restless. She was at an inn much used by carriers, and it was highly improper she should remain there. In her present situation I was sensible it might appear very hazardous to move her; but it was evident that the small-pox would be confluent. I judged from the violence of the symptoms the disease would be dangerous, and the event doubtful, and was therefore desirous of trying how far the same method and remedies, which were used so successfully in the inoculated small-pox, as well as in some cases of the natural disease, would avail in this. The necessity of removing the patient afforded me a good opportunity, without any imputation of rashness. I therefore proposed her being taken down stairs into a parlour under the room where she then lay, while I was present, and ready to assist, if the fatigue should be too much for her; this was consented to; the women assisted in getting her cloaths on, which she seemed much pleased with, being then delirious. She was altogether unable to stand, and was therefore brought down by three persons in the same manner as if she had been dead. She was then placed in a chair, but had not even strength to hold herself upright, but was supported in that posture by the women about her.
The fatigue of moving, and change of posture, occasioned a faintness, in which she lost all colour, and the pustules for a time disappeared; upon this, the chair was leaned quite back, the bed was brought down, and laid on the floor, she was placed on it with her cloaths on, and eagerly drank a glass of cold water. Her colour soon returned; the pustules appeared as before; but she was considerably cooled, and her pulse, though it retained the quickness, was not near so strong. I stayed with her about half an hour, during which time she was more sensible, and not so restless, but seemed languid and tired. I ordered the window to be opened, the room to be kept cool, and gave her three grains of calomel, tart. emet. gr. 1⁄8, in a pill, and directed a purging draught to be taken as soon as it could be procured, and as there seemed no occasion for the blister, it was taken off.
I saw her next morning at a house to which she had been removed at a small distance, and found her almost free from complaints; she had rested moderately well, and was perfectly sensible. Those about her dated her amendment from the time when the purge (which had procured three stools) began to operate.
She was however extremely full all over of a very small confluent kind; yet these inflamed and maturated in a very favourable manner. From the minutest observation I could make, it seemed to me that by this management the number in the face was less than when I first saw her, consequently that some pustules were repressed after they had appeared.