As soon as we observed a Patient to be troubled with Worms, if his present Situation did not prevent it, we gave twenty-five or thirty Grains of Rhubarb, with five or six Grains of Calomel; and if there was much Sickness, we likewise gave an Emetic; which, in more than one Case, brought up two or three Worms of the round Kind, and gave great Relief. But where the Fever was violent, we were obliged to neglect this Symptom of Worms for the present; and when the Fever was over, if there still remained any Symptoms of Worms, we gave the purgative Medicine once or oftener, and in the Intervals gave the pulvis stanni, or an Infusion of Camomile Flowers; and in some Cases, oily Medicines. By these Means most of the Patients got well and recovered their Health, and seemed to be freed, at least for the present, from these troublesome Insects; though a few continued to complain of Sickness, and other Symptoms of Worms, for some Time afterwards.
What was the Cause of the Army’s being so much troubled with Worms of the round Kind, is not easy to ascertain; unless it was owing to the great Quantity of crude Vegetables, and Fruits, which the Soldiers eat in the Course of the Summer and Autumn, and to the bad Water they were often obliged to drink.
In the Malignant Fever at Paderborn, many complained of a Dysuria, and some of a Suppression of Urine, especially towards the Decline of the Fever; and others, of a Scalding and Pain in making Water, though they had no venereal Complaint. These Symptoms appeared in other Places, but not near so frequently as at Paderborn. Decoctions of Gum Arabic, with some of the spiritus nitri dulcis, and oily Mixtures, and Opiates, commonly gave immediate Relief, and soon removed this Complaint.
One of the first salutary Symptoms which most generally appeared in those who recovered, was a Dullness of Hearing, or Deafness[17]; which came on about the Height of the Fever, and continued a longer or shorter Time, generally till the Fever was entirely gone; and sometimes for a considerable Time afterwards. For the most Part we did nothing for this Complaint, and it went off as the Patient recovered his Strength. When it continued long, Blisters applied behind the Ears, or on the Neck, and washing the meatus auditorius with the emollient Decoction, in which a small Quantity of Soap was dissolved, proved of Service.
Swellings of the parotid Glands appeared in many Subjects, towards the Decline of the Fever, which came to Suppuration, and proved critical. In two only, out of those I attended while in Germany, they came on early in the Fever, but did not suppurate. Both Patients died; all the rest recovered, except one old Man, an Invalid at Bremen; who, after having one Swelling appear on the right Side, which came to Suppuration, and seemed critical, relapsed into the Fever; and another formed on the other Side, which came likewise to Suppuration, and the Fever ceased, after having reduced him very low; but the great Discharge from the Sores wasted him gradually, and he died hectic in about a Month after the Fever had left him[18].
As soon as these Swellings of the parotid Glands appeared, we endeavoured to bring them forward to Suppuration, by the Application of emollient Cataplasms, or of gummous Plaisters; and had them opened as soon as a Fluctuation of Matter was to be felt, and afterwards treated them as common Abscesses. Riverius[19] very justly observes, that when such Tumours encrease in such a Manner as to endanger Suffocation, they ought to be opened before they come to Maturation; and Dr. Pringle[20] desires us not to wait for a Fluctuation of Matter, but to open the Abscess as soon as it can be supposed to have formed.
In February 1761, three Patients in the Decline of this Fever had Buboes formed in the Groin, which proved critical. At first, on observing them, I suspected them to be venereal; but on examining the Patients, they obstinately denied their having any Reason to suspect any such Cause; and the favourable Manner in which they healed without the Appearance of any other venereal Symptom, made me believe what they asserted to be true; especially as such People are not shy in owning Complaints of that Kind. The first Patient I saw who had a Bubo in the Decline of one of these Malignant Fevers, was a Woman, Wife to a Soldier of the thirty-seventh Regiment of Foot; she had a Child at her Breast, and her Husband was living with her at the Time she was taken ill of the Fever, and neither of them had the least venereal Complaint. In a few Days afterwards, two Soldiers in other Hospitals, towards the Decline of very bad Petechial Fevers, had likewise Buboes formed in the Groin, without any Suspicion of a venereal Taint. Except in these three, I did not see any critical Buboes appear in this Fever while I was with the Troops in Germany; tho’ Mr. Lovet, who served as a Mate to the Hospitals, and who was at Hoxter, where we had another Hospital established, while I was at Paderborn, told me, that, in the Beginning of the Year 1761, they had several Men in the Hospital ill of this Fever, who had critical Buboes formed in the Groins and Armpits[21].
About the same Time that these Buboes appeared, severals towards the Decline of this Fever complained of a Pain all along the Spermatic Chord; and soon after a Swelling of the Testicle appeared[22]. However, this Complaint was not peculiar to those who had the Fever; for others recovering from Fluxes, and other Disorders, were likewise affected with such Swellings. I did not observe any Symptom of this Kind in Fevers while I was with the Troops in Germany, except in January, February, March, and April 1761. By Bleeding, and applying emollient Fomentations and Cataplasms, and bathing the Parts with spiritus mindereri on the first Attack of the Pain, the Swelling of the Testicle was prevented; but where no Mention was made of this Pain till the Swelling had already begun, it commonly ended in a Suppuration of the Scrotum or Testicle, which healed very kindly. We had no Reason to suspect any venereal Taint in any of them.