In February and March, seven or eight more scorbutic Patients were sent to the Hospital I attended, who were all treated in the same Manner; and all did well. About the Middle of February this Distemper began to shew itself in the other Hospital attended by Dr. Miller, who treated the Patients nearly in the same Way, and they all recovered.
On the 5th of April, a young Man, belonging to the Eighth Regiment of Foot, came to the Hospital with all the Symptoms of the true Scurvy; his Gums were spungy and fœtid; he had livid Blotches on his Legs, and Contractions of the Hams, and a Stiffness and Hardness in the Calves of both Legs[112]. By following the same Course as the others, and the Use of frequent Fomentations, and rubbing the contracted Parts with soft Liniments, he mended daily; and, after taking a Dose or two of Physic, was dismissed perfectly recovered on the 10th of May. At his first Admission into the Hospital, he was taken with a severe Cough, attended with Pain of the Breast, and a Spitting of Blood for a Day or two, for which he was blooded. His Blood threw up a little Buff; the Crassamentum was of a blackish Colour and of a loose Texture, with a good Proportion of a yellowish Serum. This Bleeding relieved the Complaints of his Breast, and he had no Return of them while he remained in the Hospital.
The first Week in May four Invalids were admitted into the Hospital for this Disorder. The first had spungy Gums, a fœtid Breath, his Legs swelled and hard, and of a deep purple Colour. The second was a Case at first of a more doubtful Kind; there were no spungy Gums, though an offensive Breath; his Ancles and Feet were swelled, attended with Pain and Uneasiness, and a great Weakness and Lassitude; but no Fever, nor any livid Blotches. The Swelling of the Feet and Ancles seemed at first Sight rather gouty or rheumatic, than of the scorbutic Kind; but from the Man’s Way of Life, and the Disorder being so frequent, we discovered it to be the Scurvy. The third had a very fœtid Breath and spungy Gums, livid Spots and fungous Ulcers[113] on his Legs, with Pains and Weakness all over. The fourth had also spungy Gums and a fœtid Breath, Pains of the Legs and Arms, livid Blotches on his Legs, great Hardness and Contraction of the right Ham, and a livid hard Swelling on the Outside of the left Thigh, immediately above the Knee.
We treated them all four in the Method above-mentioned, adding a Mess of Greens to Dinner, giving Lemonade for Drink, and the Bark, with Elixir of Vitriol, by Way of Medicine. The Parts that were hard and swelled, were fomented, and rubbed with soft Liniments, and Poultices were applied to the hard Swelling on the Outside of the left Thigh; and the Ulcers of the Legs dressed with Digestives, and occasionally washed with spirituous Tinctures, and touched with Escharotics. Before I left Bremen, the first Week in June, the first and second Patients were perfectly recovered, and the third and fourth almost well. All of them had had the Disorder some Months before they came to the Hospital.
FOOTNOTES:
[106] In Quebec, and other northern Parts of North America, as soon as the Frost sets in, they kill their Meat intended for their Winter Store, and hang it up: It soon freezes, and will keep in this Manner all through the Winter. They preserve Vegetables in the same Way; and when they intend to make Use of either, they put so much as they want into cold Water for some Time, which draws the Frost out of it; and then they boil or roast it, as they think proper.
[107] The free Use of raw Spirits is found to be very prejudicial; but a moderate Quantity of these Spirits, diluted with Water, and acidulated with Lemons or Oranges (or with Cream of Tartar, or Tamarinds, when the former cannot be got), and made into Punch, is found to be a good Antiscorbutic.
[108] Most ripe Fruits, particularly Lemons and Oranges, and esculent Herbs, and many Kinds of Roots, such as Horse-Radish, Onions, Leeks, and many others, have been found the most useful Remedies in the Cure of the Scurvy. Decoctions and Infusions of Fir-Tops, of Spruce, and of other Species of the Pine-Tree; and Beer made of these Infusions, by fermenting them with Molasses, are approved Antiscorbutics: and when such Remedies cannot be got, Infusions of the common Bitters, and weak Punch, made with Tamarinds or Cream of Tartar, have proved serviceable; and where these Acids cannot be had, the Mineral Acids may be used for acidulating the Drink. However, it ought always to be remembered, that fresh Vegetables and Fruits, and vegetable Acids, produce much better Effects in the Scurvy, than any other Sorts of Remedies; and ought always to be used, when they can be got.
[109] Most of the common Bitters have been strongly recommended in this Disorder, Gentian, Trifoil, Wormwood, &c.—as likewise aromatic Bitters and Aromatics; such as calamus aromaticus, Carvi Seeds, Winters Bark, Cinnamon, and many others.
[110] Dr. Lind, who has wrote one of the best Treatises on this Disorder, and who had a great Deal of Practice himself, says, “When first the Patient complains of an Itching and a Spunginess of the Gums, with loose Teeth, either a Tincture of the Bark in Brandy, or aluminous Medicines, will be found serviceable in putting a Stop to the Beginning Laxity of these Parts.” When the Putrefaction increases, he recommends the Use of some of the mineral Acids. See his Treatise on the Scurvy, part ii. chap. v. p. 201.—Van Swieten says, he never found any Thing answer better than a Gargle made of four Ounces of Elder or Rose Water, acidulated with a Drachm of the Spirit of Sea Salt; and where the Gums were very putrid and gangrened, he has been obliged to touch them slightly with the pure Acid Spirit, and some Hours after to have them washed with the Gargle just mentioned. Vide Comment. vol. III. p. 629, sect. 1163.