1. Uncertain in their operation; and from the same cause. Many ounces of salts and castor oil, and whole drachms of calomel and jalap, have often been given, without effect, to remove the costiveness which is connected with the malignant state of fever.
2. They are not subject to the direction of a physician, with respect to the time of their operation, or the quantity or quality of matter they are intended to discharge from the bowels.
3. They are unsafe in the advanced stage of fevers. Dr. Physick informed me, that three patients died in the water-closet, under the operation of purges, in St. George's hospital, during his attendance upon it. I have seen death, in several instances, succeed a plentiful spontaneous stool in debilitated habits.
III. Sweating was introduced into practice at a time when morbific matter was supposed to be the proximate cause of fever. It acts, not by expelling any thing exclusively morbid from the blood, but by abstracting a portion of its fluid parts, and thus reducing the action of the blood-vessels. This mode of curing fever is still fashionable in genteel life. It excites no fear, and offends no sense. The sweating remedies have been numerous, and fashion has reigned as much among them, as in other things. Alexipharmic waters, and powders, and all the train of sudorific medicines, have lately yielded to the different preparations of antimony, particularly to James's powder. I object to them all,
1. Because they are uncertain; large and repeated doses of them being often given to no purpose.
2. Because they are slow, and disagreeable, where they succeed in curing fever.
3. Because, like vomits and purges, they are not under the direction of a physician, with respect to the quantity of fluid discharged by them.
4. Because they are sometimes, even when most profuse, ineffectual in the cure of fever.
5. The preparations of antimony, lately employed for the purpose of exciting sweats, are by no means safe. They sometimes convulse the system by a violent puking. Even the boasted James's powder has done great mischief. Dr. Goldsmith and Mr. Howard, it is said, were destroyed by it.
None of these objections to sweating remedies are intended to dissuade from their use, when nature shows a disposition to throw off a fever by the pores of the skin; but, even then, they often require the aid of bleeding to render them effectual for that purpose.