A cautious employment of wine was apparently of great use[498], and what may excite surprise, physicians gave detailed and frivolous precepts on the choice and enjoyment of food. If the irritable stomach rejected this repeatedly, they even went so far, according to the Roman method, as to make the patient vomit both before and after his meals, in order that the organ might thus bear the repeated use of nourishment. It was also asserted that the stomach retained food and wine better if the body were previously rubbed all over with bruised onions[499]. All this affords us an insight into the nature of this remarkable disease, which has now so completely vanished from the world. Finally, when astringent decoctions proved fruitless, particular confidence was placed in the application of various powders[500] to the surface of the body, conjointly with the use of light bed-clothes and the avoidance of feather-beds, which the effeminacy of the ancients had already introduced[501]. As astringents they selected pomegranate bark, the leaves of roses, blackberries, and myrtles, as also fullers’ earth, gypsum, alum, litharge, slaked lime[502], and, when nothing else was at hand, even common road dust[503]! The efficacy of some of these extraordinary remedies cannot be denied. At least it has been proved in modern times with respect to alkalies, which are of a somewhat similar nature, that they are of great service where there is an abundant determination of acid towards the skin, and it is very probable that the perspiration of these diaphoretic patients contained much acid.
Sect. 2.—The Picardy Sweat.
(Suette des Picards—Suette Miliaire.)
The Picardy Sweat is a decided miliary fever, which has often prevailed, not only in Picardy, but also in other provinces of France, for more than a hundred years, and even at the present time exists in some places as an endemic disease[504]. We have pointed out the affinity between the English Sweating Sickness and miliary fever. Both are rheumatic fevers—the former of twenty-four hours’ duration, the latter running a course of at least seven days. In the former there was no eruption, or if in isolated cases an eruption made its appearance, it was doubtless subordinate, not essential. In the miliary fever, on the contrary, the eruption is so essential, that this disease may be considered as a completely exanthematous form of rheumatic fever.
The history of miliary fever is full of important facts, and the sweating fever of Picardy forms but a variety of it. The eruption in itself is of very ancient occurrence, and was most probably, as at present, observed time immemorial in conjunction with petechiæ, occurring as a critical metastasis in the oriental glandular plague, perhaps even in the ancient plague recorded by Thucydides. It also occasionally accompanied petechial fever, as unquestionably it did small-pox and many other diseases, in the same manner as we now see; for the miliary eruption is a very common symptom, which is easily induced, and increases the danger of various other accidental complications. This is different, however, from the idiopathic miliary fever, which did not exist either before, or even at the period of the English Sweating Sickness, but occurred as an epidemic, frequently mentioned in Saxony, a hundred years later[505], (1652.)
We cannot, therefore, consider this eruptive disease as having proceeded from the English Sweating Sickness, in the same manner as the petechial fever had its probable origin in the glandular plague, even supposing a more decided inclination of the Sweating Sickness to the eruptive character could be proved than is possible from the facts afforded. A whole century intervened, and what vast national revolutions!
This same separation of so long a period makes also against the supposition, that the English Sweating Sickness was an interrupted miliary fever, which exhausted its power by a too luxuriant activity of the skin on the first day, before the eruption made its appearance. Moreover, the similarity and isolation of all the five epidemic sweating fevers, as regards the brevity of the course of the disease, and the absence of all transition forms of any duration, which certainly would have existed had nature intended gradually to form a miliary fever out of the English Sweating Sickness, lead to the same conclusion.
But to return to the miliary fever. Some forms of this disease have been observed, in which a profuse perspiration, in combination with nervous symptoms, has endangered life on the first day of the attack; equally often, too, the eruption has appeared fully formed on the very first day; and if we duly consider, as we ought, the regular course of miliary fever whenever it has assumed an epidemic character, we shall always find, even in that case, a development of symptoms differing fundamentally from those of the English Sweating Sickness. If, occasionally, instances of miliary fever occurred, in which no eruption came out, as was the case recently (in 1821), they were to be considered in the same light as other acute eruptive diseases, as, for example, scarlet fever, in which nature indulges in a like irregularity, without, however, altering the essence of those diseases. And since, finally, it has been observed in many cases[506], that the miliary eruption could be prevented by the application of cold at the commencement, a distinguished modern physician has attached great consequence to this circumstance, as showing that miliary fever and the English Sweating Sickness were the same disease[507]; but a check of this kind is, at all events, impossible in those miliary fevers where the eruption breaks forth on the first or second day; and moreover, experience tells us, that many other diseases also, such as inflammations, rheumatisms, gastric fevers, and even abdominal typhus, may be arrested in their course, and confined within narrower bounds, so as not to manifest all their symptoms.
We are, therefore, completely entitled to consider the appearance of the miliary sweating fevers as altogether a novelty, originating in the middle of the 17th century, and having no discoverable connexion with the English Sweating Sickness. There have been in Germany, since the year 1652, many visitations of miliary fever; but this disease did not increase much in extent until about the year 1715, when it spread into France and the neighbouring countries, particularly Piedmont[508], whilst England remained almost entirely free from it. The French epidemics were, upon the whole, much more severe than the German; and on this account we select one of the most ancient, and also the most recent of them, in order to give a general view of miliary fever, as compared with the English Sweating Sickness.
The miliary fever first appeared in Picardy, in the year 1718, in le Vimeux (Vinnemacus pagus), a district on the north of the Somme and on the south of the Bresle and the department of the Lower Seine. It increased annually in extent; most places in Picardy were visited by it, and it was not long before it was seen in Flanders[509].