[43] On the 21st of November, 1759, Hanah Meredith, a middle-aged Woman, was admitted into St. George’s Hospital for a Flux, which she had six or seven Weeks; she had no Fever, but complained much of Sickness and Gripes, and her Disorder had reduced her very low. During the two first Weeks of her being in the Hospital, she had two Vomits of Ipecacuana and four Doses of Rhubarb; and in the Intervals anodyne and astringent Medicines, which made no Alteration in her Complaints. On the 2d of December, she told me, that two Years before she had had a Flux for above three Months, which had yielded to no Remedies till she was ordered repeated Clysters, and that they had made a Cure in a short Time. I then ordered an emollient Clyster with a drachm of the electuarium diascordii, and a Scruple of the tinctura thebaica, to be given twice a Day, which gave her almost immediate Relief; and with the Assistance of some Doses of Rhubarb, and one or two Vomits and occasional Opiates, removed her Disorder by the Middle of January; though she remained long weak, and troubled at Times with Gripes; but these Complaints were at last got the better of by her taking some Doses of Rhubarb, and drinking daily a Pint of Lime Water mixed with Half a Pint of Milk.
Sarah Spencer, a middle-aged Woman, was admitted into St. George’s Hospital the 9th of November, 1763, for a Flux, which had continued for two Months, and reduced her very low. She complained much of Sickness and Gripes; her Stools were mostly composed of Mucus and Blood; her Pulse was low, and she had no Fever, but a Whiteness of the Tongue, and complained of Thirst.—The first Day she had a Vomit, and next Day a Dose of the purging saline oily Draught.—She was ordered to have an emollient Clyster, with a Drachm of Diascord, and as much tinctura thebaica, given her every Evening; and to have a Dose of the saline oily Purge twice a Week, and Opiates occasionally; by following this Course, and drinking at Times the Chalk Julep, her Disorder was removed, and she was discharged the Hospital on the 30th of the same Month.
[44] This Practice of giving the Cortex with Opiates in the Dysentery is not new; for Dr. R. Morton, in his Appendix to his second Exercise on the Fevers, which appeared from 1658 to 1691, observes, that after the Plague of 1666 had ceased, a Fever from a milder Poison, attended with Gripes and Dysentery, began to make its Appearance. As the common Methods of Cure proved unsuccessful, and Dr. Morton observed Exacerbations and Remissions, he resolved to give the Bark mixed with Laudanum; and found it answer his Expectation. The first Patient to whom he gave it, was a man in Long Lane, who laboured under a Tertian Dysentery; upon observing a Remission, he ordered a Drachm of the Bark, mixed with a Grain of Opium, to be given every four Hours for six Times; and this removed both the Fever and Dysentery.—He says, he afterwards gave it, with equal Success, in the Quotidian Dysenteries, where he observed Exacerbations or Remissions; and he adds, that he does not doubt but that it will answer as well in Epidemical Diarrhœa’s, and Camp Fevers attended with such Symptoms.
Dr. Whytt of Edinburgh has given with Success a strong Decoction of the Bark, mixed with the confectio japonica of the Edinburgh Dispensatory, in the bad State of the Dysentery, when the Mouth and alimentary Canal were threatened with Aphthæ, and even sometimes after they had appeared. And Dr. Pringle mentions his having given the Decoction of the Bark, with Snake-Root and some Drops of Laudanum, in the Dysentery complicated with the malignant Fever. See Note to Page 245 of his third Edition on the Diseases of the Army.
[45] Many other Medicines have been used for the Cure of old Dysenteries,—The Conessi Bark, recommended as a Specific in Diarrhœas, cured a Dysentery which had yielded nothing to a Variety of Medicines. Edinburgh Medical Essays, Vol. III. Art. iv.—The cortex eleutheriæ vel cascarillæ is much recommended for the Cure of Dysenteries in the Memoir. de L’Academie des Sciences a Paris 1719, and is still in great Repute among the Germans.—The Decoction of the semiruba Bark was found to have a good Effect in the Dysentery, where the Patient continued to void Blood with his Stools; and when the Stools were only liquid, without a Mixture of Blood, some of the Cascarilla added to the Decoction encreased its Efficacy. See Degnerus’s Treatise de Dysenteria, cap. iii. sect. 55. These and many other Remedies have been tried in obstinate Dysenteries.
From what I have observed myself, and from the Accounts of others, I am now convinced, that such Cases as are not already too far gone, are most likely to be cured,
1. By keeping the Patients on a low Diet, composed principally of Milk, Sago, Rice, Salop, and such other Things as are recommended by Dr. Pringle; allowing weak Broths, and a small Quantity of white Meat, as they recover their Strength. The common Drink to be Barley or Rice-Water, Toast and Water, Bristol Water, Almond Emulsion, and such like.—By making them wear some additional Cloathing, and guarding carefully against catching cold.—Errors of Diet and Exposure to Cold being the most frequent Causes of Relapses into this Disorder.
2. By giving from Time to Time a Dose of some mild Purge; such as a little Manna and Salts; a Solution of Manna in Almond Emulsion; twenty or thirty Grains of Rhubarb, in a saline Draught, or such like; and occasionally gentle Emetics.
3. By the Use of some of the mild Astringents and Corroborants.—The Bark, with Astringents and Opiates, agreeing best with some—Decoctions of the Semiruba with others—Chalk in Electuaries, or Juleps, with others—anodyne and astringent Clysters with others—while others receive more Benefit from other Remedies—and severals find themselves better when they use no Medicines of this Kind.
4. And by the occasional Use of Opiates, and a free Air: And by moderate Exercise on Horseback, or in a Machine in the convalescent State.