An Account of the Diseases which were most frequent in the British military hospitals in Germany

by Donald Monro

OF
Erisypilatous Swellings.

In January 1762, several Patients in the Hospitals I had the Care of at Bremen, had shining watery Swellings of the Face, or Extremities; which came suddenly, and were attended with a slight Degree of Inflammation, and watery Blisters rising above the Skin, and some Degree of Fever. The Blisters were not small, round, and angry, as in St. Antony’s Fire; but larger, and of an irregular Figure, resembling those raised when People are scalded by boiling Water. The Swellings did not pit on being pressed, as the oedematous Swellings commonly do: They gave Pain when pressed, but the Inflammation was not in that high Degree as it is in the common Phlegmon: The Blood was sizy, and the Water of a high Colour. The Disorder seemed to be a Species of the Erisypelas.

Between the 9th and 12th of January, three Patients were seized with such Swellings.

The first was a Dragoon, who had just recovered from a Flux, and a bad Cough. On the 9th, he was suddenly seized in the Night with a large Swelling of his Face, Hands, and Arms, which had a shining oedematous Appearance, with a small Degree of Redness, and was painful when pressed; and he had two or three watery Blisters rose on the Back of each Hand above the Division of the Fingers, attended with a quick full Pulse, a feverish Heat and Thirst, a Cough, and somewhat of a Difficulty of Breathing, and high-coloured Water; and he was inclined to be costive. He was immediately blooded, had a saline Mixture with Contrayerva and Nitre, and was ordered to take a Purge in the Morning. Next Day the Blood had thrown up an inflammatory Buff, the Fever was abated, and the Breathing easier; but the Cough and Swelling still remained. He then took a Julep made of equal Parts of the Saline and Sperma Ceti Mixtures, which eased the Cough. The fourth Day the Pulse was soft, and the Swellings still in the same Situation, and the Breathing a little affected. A large Blister was applied to his Back, which discharged plentifully, relieved the Breathing, and lessened the Swellings considerably. The Cough and some Degree of Swelling still remained; but were removed by the Use of the Sperma Ceti Mixture with Oxymel, gentle Opiates, and some Doses of Physic.

The second was a Man of the Twentieth Regiment of Foot, who had been some Months in the Hospital for a hectic Complaint; he was taken ill, the same Night as the Dragoon, with a Swelling of his whole Face, particularly the Lips, which had a shining watery Appearance, and a slight Degree of Redness, attended with a strong Fever; and was cured by Bleeding, Purging, the Use of the saline Medicines, and the Application of a Blister.

The third was an Invalid, who had been admitted for a pleuritic Complaint, which he had got the better of. He was attacked, the second Night after the other two, with a shineing, watery, reddish Swelling, of his right Hand and Arm, up as far as the Joint of the Shoulder; four large watery Bladders likewise appeared on the fore Part of his Arm, above the Joint of the Elbow. Bleeding, with the cooling Medicines, and two Doses of Salts, carried off the Fever, and lessened the Swelling, in about seven Days Time; but a little of it, with a Stiffness, still remained; which at last was removed by the Use of aromatic Fomentations, rubbing with the linimentum saponaceum, and taking two Doses of Physic.

Within less than a Fortnight, five or six more were seized with Swellings of the same Kind on some of the Extremities, and all got well by nearly the same Treatment; excepting one Man, who was in a very low State, and had a large deep Ulcer on his Hip, where there had been a Mortification from his lying on that Part in a Fever. The Swelling at first seemed to give Way; but on the third or fourth Day, having got a severe Cough, the Swelling increased, and the Inflammation began to look livid, and the Discharge from the Sore to look bad; and, notwithstanding various Means were used, a Mortification of the Part came on, and he died the seventh Day.

OF THE
SCURVY.

The true Scurvy, attended with spungy fetid Gums of a livid Colour, with livid Blotches, and Ulcers of the Legs, and other Symptoms, began to shew itself at Bremen in January 1762; tho’ we had not the least Appearance of this Disorder in the Hospitals at any other Place, while I was with the Troops in Germany.

A great Variety of Disorders have been called by the Name of Scurvy: and the Disease has been divided into hot and cold; into the Acid, the Alcaline; and the Muriatic, according to the different Fancies of Authors, and the Causes they imagined it took its Rise from; but, from later and more accurate Observations, Dr. Lind has justly remarked, that the true Scurvy has been found to be the same in all the different Parts of the Globe, and to take its Rise from similar Causes; from Cold and Moisture, and living much upon salted Provisions, joined to a Want of fresh Vegetables, and of good generous fermented Liquors; and hence it is most frequent in low marshy Places in northern Climates, where there is a Scarcity of fresh Vegetables; and where the Inhabitants live much upon salted Provisions in Winter; and aboard of Ships in long Voyages or Cruizes, especially in the northern Seas; and hence this Disorder was so frequent at Quebec the first Winter it was in our Possession; and in some of the other Forts in North America, which were taken so late in the Year, that the Troops had not sufficient Time to lay in a Stock of Vegetables, and of fresh Meat to be preserved by the Frost[106]; but were obliged to live mostly on Ship Provisions.