FOOTNOTES:
[60] Sydenham, in treating of this Disease, orders Bleeding, and that to be repeated next Day; and afterwards every other Day, two, three, or four Times, or more, as the Patients Strength can bear it; and on the intermediate Days to give a purgative Clyster. But in young People, and those who have lived regularly, he says, that a very low Diet will cure as effectually as Bleeding and Medicines; That the Patients must live four Days on Whey alone, but after this may eat Bread for Dinner; and on the last Days for Supper also; and when the Symptoms begin to abate, he allows them to eat boiled Chicken, or other light Food; but says they must live every third Day on Whey, till their Strength returns. Precess. Integr. de Rheumatismo.
[61] A Remark of Dr. Huxham’s deserves to be taken Notice of here: He tells us, that there are some Kinds of Rheumatisms, viz. those which come from a sharp serous Rheum, which do not bear the free Use of the Lancet; that plentiful Bleeding does more Hurt than Good; and that, in such Cases, the Medicines which bring out breathing Sweats, and at the same Time correct the Acrimony of the Blood, joined with gentle Opiates, have a much better Effect. De Aere, Vol. II. p. 185.
[62] Dr. Brocklesby, in his Observations on military Diseases, recommends the Use of large Quantities of Nitre dissolved in Water Gruel, or Sage Tea, (in the Proportion of two Drachms of the Nitre to a Quart of the Liquor) in acute Rheumatisms. He says, “I am assured from numberless Instances, that in stout young Men, by taking six hundred Grains (ten Drachms) daily, for four or five Days successively, and diluting plentifully, as before recommended, plain Nitre proves the most powerful and best Sudorific, in such Complaints, that I have ever tried; and this Quantity, and even more, may be retained in the Stomach, and pass through the Course of the Circulation, by only diluting properly with those thin attenuating Beverages as before recommended. Such Quantities, in three or four Days, seldom failed wonderfully to relieve the Patient, and very often to cure him entirely, by the most plentiful and profuse Sweats.” See from p. 116, to p. 124.
I have never hitherto given Nitre in such large Quantities as here recommended by Dr. Brocklesby.
[63] I have frequently ordered the warm Bath with Advantage in Rheumatic Cases in St. George’s Hospital; but we had no Convenience of this Kind with the flying Hospital in Germany.
[64] This I have seen many Instances of, particularly in the Case of Ann Walker, a Woman of twenty three Years of Age, who was under my Care in St. George’s Hospital, in May, 1759. Before she came to the Hospital, she had been blooded, and had gone into the cold Bath four Times, which, she told me, had increased her Pains to a violent Degree; in which State she had continued for some Weeks before she came to the Hospital; but by being blooded, and taking the cooling saline Medicines, with gentle Purges, and mild Diaphoretics, she got well in a Month’s Time.
[65] Warm Water, pumped upon the Part, often removes such rheumatic Pains as have resisted the Force of internal and other Remedies. On the 29th of August, 1759, Mary Ward was admitted into St. George’s Hospital for rheumatic Pains of the Arms, Legs, and Knees, attended with Fever, which all yielded to Evacuations, and the Use of cooling Medicines, mild Diaphoretics, and of the warm Bath, except the Pain of the Knee; which, after it had resisted the Course above-mentioned, was at last removed by pumping warm Water on the Part, three Times a Week; joined to the Use of Fomentations and volatile Liniments.
[66] Ann Ragen, a Woman about thirty-three Years of Age, was admitted into St. George’s Hospital the 17th of January, 1759, for rheumatic Pains of her Legs and Arms, and a Swelling of her right Knee. Free Evacuations, and the Use of cooling Medicines, and mild Diaphoretics, removed all her other Complaints, except the Swelling of the Knee, by the Middle of February, when I ordered a Blister to be applied to it; after which the Swelling gradually decreased, and she was discharged, cured, the 20th of March.—Rachael Hyde, a Woman twenty-four Years of Age, was admitted into St. George’s Hospital the 9th of May, 1759, for similar Complaints, which were removed by the same Means, all except the Swelling of the Knee. A Blister was applied, and most of the Swelling went away, but returned soon after: It was at last removed by the Use of the warm Pump three Times a Week, and drinking a Pint of the Guaiac Decoction daily.
[67] I have sometimes ordered Leetches to be applied to such Swellings (as recommended by Dr. Pringle), and found them to be of Service; and, at other Times, I have applied emollient Fomentations and Poultices, which have given great Ease to the Patient.—I have seen Setons or Issues, made near the Part affected, afford considerable Relief.