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

by Donald Monro

The Powder of the Root of White Helebore, made up into an Ointment with Hogs Lard, or a strong Decoction of it in Water, rubbed on the Parts, will often cure the Itch; but it is a sharp Medicine, and generally smarts, and sometimes inflames the Parts on which it is rubbed; and therefore it is not so commonly used, as we know a much surer and milder Remedy. Though I have cured some People with the Helebore Lotion without any Inconvenience, who would not use the Sulphur on Account of its Smell.

Sulphur is the most certain and easy Cure for the Itch of any we know, and perhaps is more certain in the Cure of this Disorder than almost any other Medicine in any other Disorder whatever. We used it in Form of the Sulphur Ointment of the London Dispensatory, of which one, two, or more Drachms were rubbed in every Night, in Proportion to the Extent of the Parts affected. These Unctions were continued from four or five to ten or twelve Nights, according to the Violence and Continuance of the Disorder. Most were cured in a few Days; others required a longer Time. As the sulphureous Unctions tend to obstruct the Perspiration, we generally ordered a Purge to be given before rubbing the Sulphur Ointment, and in full Habits sometimes ordered a little Blood to be taken away; and put them all under a low Diet. After the Disorder seemed to be removed, they took another Dose or two of Physic to carry off any Impurities that might have been thrown upon the Bowels, during the Use of the Sulphur Ointment. In inveterate Cases, the Sulphur was given internally at the same Time that the Patient rubbed with the Ointment.

It is generally believed (though denied by some) that Sulphur, taken internally, enters the Blood; and its Steams are thrown off by the perspiratory Vessels, and assists more effectually to destroy the Insects and their Ovula, which give Rise to the Itch; but whether this Effect be true or not, I found it to answer another very good Purpose; which was to keep the Belly rather loose, while the Patient used the Unction; and by this Way it carried off those Humours, which ought to have passed off by the Skin; and for that Reason, when it had not that Effect, we joined some Lenitive Electuary to it.

There is one Thing to be observed with regard to sulphureous Unctions, which is, that we ought not to use them too soon with People recovering out of Fevers, or other Disorders which bring them low; otherwise there will be Danger of bringing on a Relapse, which I have often observed to happen in military Hospitals, where the Itch has appeared as the Patients were recovering from Fevers and other Disorders, and the Unctions were used too soon: But whether these Relapses were owing to the sulphureous Unction’s stopping up the Pores of the Skin, and obstructing a free Perspiration, or to the Patient’s being more apt to take Cold while they used the Sulphur Ointment, than at any other Time, is what I cannot determine; but to me it seems most probable, that these Unctions rather obstruct the Perspiration; and that when they are used too soon with People recovering from Fevers, especially those of the putrid Kind, they prevent those Particles from passing off by the Skin, which it was necessary should be evacuated, in order to free the Body from the Seeds of the Fever, or other Disorders the Patients laboured under. But however this be, Experience has shewn, that we ought not to attempt the Cure of the Itch, in Patients so circumstanced, till their Strength be in a great Measure re-established, otherwise there will be Danger of a Relapse; and likewise, that Patients using Sulphur externally, ought to be particularly on their Guard against Cold.

This Observation of Peoples being so apt to relapse after Fevers by the too early Use of sulphureous Unction, is a strong Proof of the Usefulness of keeping the Body open during the Time of Rubbing and of Purging the Patient afterwards; as by these Means we may carry off by the Bowels those Particles which could not pass by the Skin; and I think, so far as I have been able to observe, those People have been less subject to relapse into Fevers where this Caution has been used, than where it has been neglected.

That Species of the Itch where it forms small Ulcers or Pustules in the Skin, is the worst Kind, and most contagious, and seems to take its Rise from the common Itch continuing long, and making its Way deeper into the Skin. The Cure is the same, only this requires more frequent Unctions, and those to be continued longer, than before the Disorder has taken such deep Root.

It is no uncommon Thing to see the Itch appear again, some Weeks after it has seemingly been cured by the Use of sulphureous Unctions; which most commonly happened to those who were in too great a Hurry to get well, and left off the Use of the Unctions too soon. Such Returns of the Itch were generally cured by the Repetition of the same Treatment as before.

TABLE of DIET.

The following is a Copy of the Table of Diet which was used in the Hospital all the Time I was with the Troops in Germany:

	Breakfast.	Dinner.	Supper.
Full Diet,	One Pint of Rice Gruel;made with two Ounces ofRice, one Spoonful of fineFlower, a little commonSalt, and fine Sugar.	One Pound of Meat.	As Breakfast.
Middle Diet,	As above.	One Pint of Broth, Half a Pound of Meat.	As above.
Low Diet,	As above, or according to the Patient’s Stomach or Indisposition.	One Pint of Broth; or Half a Pint of Panado, with two Spoonfuls of Wine, and aQuarter of an Ounce of fine Sugar.	As Breakfast.