On the second or third Day, we repeated the Purge; or, if the Patient was weak, ordered a Clyster to be administered in its Place; in order to prevent the putrid Fluids and Excrements from being accumulated in the Bowels:—In other respects we treated it as when the Disorder was not complicated with the malignant Fever.
This Method, though it did not succeed with all, yet it answered better than any other I tried;—and it ought to be remarked, that although it had such a good Effect in Cases attended with the malignant Fever, or where the Fever inclined to the intermittent Kind, it did not answer so well in other recent Cases, but often made the Patient sick.
In military Hospitals, Fluxes are liable to be complicated with other Disorders, as well as with the malignant Fever; especially with Coughs, and pleuritic and peripneumonic Symptoms, when the Weather begins to be cold, in October and November.—In such Cases, when the Patients were strong, we were often obliged to bleed freely, to apply Blisters, and in the Beginning treat the Disorder as inflammatory; having at the same Time an Eye towards the Flux, in the other Medicines we prescribed.
Patients, who have had the Flux long, are apt to have their Legs swell at Nights; or to swell all over as soon as the Flux has stopped. Such oedematous or anasarcous Swellings, we treated nearly in the same Manner as those which followed the petechial Fever; only that we durst not at first be so free with the Use of Purgatives; for as the Bowels remained weak and easily irritated, such Medicines were apt to bring back the Flux; and therefore, in the Beginning, we were for the most part obliged to attempt the Cure by Diuretics and Diaphoretics; and to be sparing of the Use of Purgatives, especially of those of the hydragogue Kind; though if the Swellings continued for some Time after the Flux was gone off, and the Patients were strong, we then ventured to give Purges at proper Intervals:—And Blisters and Scarifications removed them in several Instances both at Paderborn and Osnabruck.
In December, 1761, we had a Case of this Kind where the oxymel scilliticum was of remarkable Service. A Soldier, belonging to the Guards, after a Flux, swelled all over, and made but a very small Quantity of Water. He took Medicines of different Sorts for some Weeks, but received no Benefit till we gave him the Oxymel Mixture; after taking a few Doses he made Water very freely, and in large Quantities, and the Swellings of his Body and Scrotum began immediately to subside; and by continuing its Use for a Fortnight, the Swellings entirely disappeared, and he recovered his Health and Strength.—The Oxymel, at the same Time that it promoted a Flow of Urine, kept his Body gently open, but did not occasion any Return of the Flux.
At the Beginning of January, 1762, one Carter, a Soldier of the Eleventh Regiment of Foot, laboured under an universal Anasarca; which about two Months before had succeeded a Flux. He made but very little Water, and that of a high red Colour. He took Variety of Medicines, as Purges, Vomits, Dover’s Powder, lixivial and neutral Salts with Opiates, Infusions of Horse-Radish, all without Effect; till he was ordered small Doses of Calomel, three Grains Morning and Evening. After the third Dose he began to make Water freely; and by the 24th of January the Swellings were all gone, and he was shipped off for England the 8th of February; having been discharged from his Regiment. The Ship, he went aboard of, was detained in the River Weser for above six Weeks, and the malignant Fever broke out aboard the Transport: He took the Distemper, and got well of it; but towards the Decline was seized with a Return of the Flux, which carried him off.
When these oedematous Swellings came after the Purging was stopt, if the Patient’s Strength was not much exhausted, and he laboured under no other Disorder, he commonly got the better of it:—But when the Strength was gone before the Swellings appeared, the Disorder often ended in a confirmed Dropsy, and at last in Death; and when the Swellings were universal over the Body, while the Flux yet continued, it was a Sign of great Weakness, and they did not survive it long[45].
FOOTNOTES:
[29] The Dysentery has been long alledged to arise from a putrescent Cause in Camps; from the Smell of corrupted dead Animals, and of Excrements, during the Heat of Summer. Ramazini, in his Chapter on Camp-Diseases, informs us, that Dr. G. Erric Barnstorff, Physician to the Duke of Brunswick, who served five Campaigns with the Brunswick and Lunenburg Troops in Hungary, told him, that the Camp Diseases, particularly the Malignant Fever and Dysentery, took their Rise from the Troops remaining long encamped on the same Ground, and being exposed to the corrupted Steams of the Bodies of dead Men, Horses, and other Animals, which lay unburied; and of Excrements, which were not covered with Earth. And these Causes have since been particularly taken notice of by Dr. Pringle, in his Observation on the Diseases of the Army.
Many have imputed the Cause of this Disorder to the eating of Fruit in excess, because it generally appears about the Middle of Summer, the Time the Fruit begins to be in Season, and continues through the Autumn. But from later Observations this should seem to be a vulgar Error. Dr. Pringle (part i. ch. iii. p. 20.) tells us, that, in the Year 1743, this Sickness began and raged before any Fruit was in Season, except Strawberries, (which from their high Price the Men never tasted) and ended about the Time the Grapes were ripe; which growing in open Vineyards were freely eat by every body. And Dr. Tissot, in a Treatise which he published, called Avis au Peuple sur la Santé, in his Chapter on the Dysentery, § 320, says, that ripe Fruit, especially the Summer-Fruits, are so far from being the Cause of the Disorder, that they are the great Preservatives against it: he says, that, in the Years which the Fruit is most plentiful, the Dysentery is least frequent; and he relates several Instances where the Use of ripe Grapes proved a Cure for the Disorder. Eleven People were attacked by the Dysentery, nine eat Fruit, and all recovered; the other two, a Grandmother and Child, from Prejudice, eat none, and both died. A Regiment of Swiss Soldiers, in Garrison in the South of France, had the Dysentery very frequent among them. The Captains purchased some Acres of a Vineyard, and carried the sick Soldiers to the Field, and gave them the Grapes to eat; and ordered the Men in Health to live upon them chiefly. After this not one Person died, nor was any one seized with the Distemper.—In an Account of a Treatise on the Dysentery, published at Hamburg in 1753, which was epidemical the Year before, in August and September, we are told, that it did not proceed, as is commonly believed, from the eating of Fruit; for it was observed, that those who eat Fruit freely escaped better than those who abstained from it altogether. Vide Comment. de Rebus in Hist. Nat. & Medecin. Gestis, vol. II. par. iv. sect. v.