Dr. Coe says, “I have more Reason to be satisfied of the Effect of Vomits in dislodging these Calculi, than of any other, or indeed of all other Medicines.” Treatise on biliary Concretions, chap. ii. p. 253. Besides viscid Humours, which Vomits bring away from the biliary Passages, how often are Gall Stones likewise found in the Stools after the Operation of a Vomit? Ibid. p. 256.
[94] Sometimes the warm Bath has a good Effect after other Remedies have afforded no Relief. In the Year 1743, a young Gentleman, a Student of Physic at Edinburgh, had a Jaundice for which he had taken Variety of Medicines, and rode daily on Horseback for some Weeks, without receiving any Benefit: At last, by my Father’s Advice, he took a brisk Dose of Physic, and before it began to operate had a large Quantity of warm Whey thrown up by way of a Clyster, and went immediately into the warm Bath. In the Bath he was taken with a violent Inclination to go to Stool; and after coming out, had a great Number of bilious Stools that Day, and next Morning was still inclined to be loose; and in a few Days all the icteric Symptoms vanished. On the 20th of July 1763, a middle aged Woman, Elizabeth Hosier, was admitted into St. George’s Hospital for a Jaundice, which came about a Fortnight before. She had been blooded, and had taken some Medicines, before I saw her. I ordered her a Vomit and Purge, and to take too Scruples of the Soap Pills and Rhubarb daily; and four Days afterwards the Vomit and Purge were repeated, but without making any Change in her Disorder. On the 29th she went into the warm Bath, and took a Vomit immediately on coming out. After the Vomit she had some loose Stools, and the icteric Symptoms went all off in a few Days. She continued well for some Months; but I have been told, that she has since relapsed.
When the Jaundice continues obstinate, there is hardly any Thing has often a better Effect than the continued Use of Decoctions of the Juices of succulent Plants, of Whey in the Spring, Soap, and such like Medicines. The Baron Van Swieten tells us, that he has cured many obstinate Jaundices by making the Patients drink daily a Pint or two Pints of a Decoction of Grass, Dandelion, Fumaria, Succory, and such like, prepared in Whey; to each Pint of which he added Half an Ounce of sal polychrest, and an Ounce or two of Syrup of the five aperient Roots; and by ordering them to drink the Spa Water in Summer, and take freely of Soap, along with a Decoction of the aperient Roots, in Winter. In those who were cured by these Remedies, he says, Stones, or a kind of a grumous calculous Matter, were always found in the Stools, as the Jaundice was going off. He relates one very particular Case of a Lady of sixty Years of Age, who had had a black Jaundice for twelve Years, and was cured by continuing the Use of these Medicines for eighteen Months; during the last six Months of which she had a Looseness, and constantly discharged by Stool a fetid granulated Matter of the Colour of Clay;—and another singular Case of a Man who was cured by living mostly upon Grass, and a Decoction of it, for two Years together. The Man came at last to devour such Quantities of it, and could distinguish the good Sort from the bad so well, that the Farmers often used to drive him out of their Fields. Vol. III. §. 950.
Glisson tells us, that Cattle are subject to bilious Concretions in Winter, which are dissolved and evacuated in the Spring, when they begin to move much about, and to eat the new Grass, which purges them. Oper. vol. II. Anat. Hepat. chap. vii. p. 104.
Dr. Russel greatly recommends the Use of Sea Water along with the saponaceous Medicines. See his Treatise on the Use of Sea Water.
OF
Tumours of the Breast.
In May 1761, a great many of the Patients, who had been in Hospitals the preceding Winter, had Tumours formed on the external Part of the Breast, which they shewed me at Osnabruck. They began in the Form of indolent Tumours, and came slowly to Suppuration. For the most part, the Suppuration was only partial, and the Tumour, on being opened, discharged a very small Quantity of Matter. Some of them, though they felt soft, and seemed to contain Matter, yet, upon being opened, discharged only a small Quantity of black Blood. None of them melted down entirely into Pus, or came fully to Suppuration, and healed kindly as Abscesses which succeed acute Inflammations. But after a small Quantity of Matter was discharged, for the most part, there still remained a hard Tumour, which felt as if it was a Swelling of the Bone, or Cartilage below; and in some the Surface of the Bone was found rough at the Bottom of the Abscess.
These Tumours seldom rose high, and were most of them situated at the lower Part of the Sternum, or a little to one Side of it, commonly on the left Side, above the cartilago ensiformis. Some Patients had only one, others two, and some three such Tumours. The first of them I saw was on the left Side, which, on being felt, gave exactly the same Sensation as when the Cartilages of the Sternum are begun to be raised by an Aneurism of the Aorta; only no Pulsation was to be perceived; and most of them had the same Appearance.
The Patients, who had such Tumours, commonly complained of Pains of their Breast. One or two, after these Tumours came to Suppuration, seemed to recover their Health, and to feel no Uneasiness, tho’ some of the Swelling remained: But many of them were inclined to be hectic, and seemed likely to grow consumptive.
Being ordered up to the flying Hospital in June, and the Sick going down to Bremen, I had no Opportunity of seeing the Event of these Tumours, or of examining the Bodies of those who died with them. One I accidentally met with the following Winter at Bremen, who died of a Consumption and Diarrhœa. He had a large Abscess, which penetrated into the Cavity of the Chest, and discharged a great Quantity of very fetid Matter, at the Part where one of these Tumours had been seated, and the Sternum and Ribs were carious all round the Abscess.