13. A Christian youth of 17, taken suddenly, was visited on the second day. A cataplasm was applied to the groin; he had a vomit of ipecacuan, and a diaphoretic draught with nitre and diascordium at night, but did not sweat. Next day he had acidulated drinks, a mixture with sweet spirit of nitre, and a small proportion of nitre itself. On the fourth, he had two stools, of a reddish colour like blood, after which he became much worse. In the night he had two other stools, which seemed to lower him. Throughout the day a larger portion of nitre had been added to his mixture, and three tea-cupfuls of blood were taken away, without the Doctor’s knowledge, by cupping. On the fifth the nitre was omitted; he was ordered an astringent cordial, but it was not given; however, the diaphoretic medicines were continued, and he had three loose stools, which sunk him greatly. Next day he seemed past recovery; lying motionless, insensible, his breathing quick, laborious and interrupted; the skin not cold, but the feverish heat gone, and his countenance ghastly. From this lethargic state the women attempted frequently to rouse him, by applying vinegar to his nostrils, calling him loudly by his name, and such like means, by which they sometimes succeeded; but, though he opened his eyes, and gave signs of sense, he could not be prevailed on to drink; and he remained silent. He would then, for some time, writhe his body as in mortal agony, and again relapse into lethargy. This dreadful paroxysm, however, began to wear off about noon; and at night he was less disturbed than usual. On the seventh day he was manifestly better; he had a looseness, with gripes, for which the white decoction was ordered; and he had tincture of bark thrice in twenty-four hours. On the sixteenth day the fever was entirely gone. The Doctor observes that this patient sweated much less than was usual with those who recovered.
14. A Christian boy about 17 was visited on the 4th day, having taken some absorbent powders on the 2d from another physician. The family would allow no other medicines to be given, except a few grains of bezoar, and he died next day.
15. An Italian, a man about 40, of a gross habit of body, and addicted to drinking, but who, finding himself somewhat indisposed, had for two or three days lived temperately, was visited on the second day of his illness, had a diaphoretic mixture, and a laxative medicine, without relief. In the night between the 5th and 6th he had some retchings to vomit. Next day he complained of a pain at the pit of the stomach, had a vomit of ipecacuanha, which brought off a considerable quantity of bile by vomit and stool, but without any apparent relief. He had two fœtid stools, and was ordered a cordial with volatiles. On the 7th his pulse was exceedingly sunk, and his extremities had been as cold as ice, but with very little alteration in the eyes or countenance. The patient did not know that these parts had lost their heat; and, notwithstanding this change, the sensation still remained in them. He died on the afternoon of the 8th day. This patient had no eruptions.
16. A Christian merchant about 50, of an atrabilious habit, and subject to the hæmorrhoids, on being taken ill drank immoderately of cold water. He was visited next day. In the afternoon about ten ounces of blood were taken away, and, as his pulse rose after the operation, he lost, by Dr. Russel’s order, six ounces more. Three ounces were afterwards taken away by cupping, and about as much more was accidentally lost by the loosening of the bandage of the arm; so that about 24 ounces were taken away in all. Next day he got a few drops of Carmelite water, a kind of spiritous cordial, which he vomited, had a blister and sinapisms applied, and died between 10 and 11 at night. He had no eruptions.
17. An Armenian youth was visited on the morning of the third day, was bled, and had a saline draught every four or five hours. On the fifth he was removed into a more airy chamber, and had Huxham’s tincture of the bark. He died on the ninth day.
18. A young lady of French extraction, of a thin, slender make, was visited on the morning of the second day. On the third she had diaphoretic powders, and lost a few ounces of blood by cupping, without the Doctor’s knowledge; she had a diaphoretic mixture, and died on the sixth day.
From these accounts it is easy to see, that, in violent cases of the plague, medicine can do little or nothing. Such cases generally occur in the earlier months of the season, though they may take place, and do take place in great numbers, at any time. In the beginning of the season the patients are almost all attacked in this violent manner, and very seldom recover, whether they take medicines or not. It being then an established fact, that as the epidemic season advances the disease grows milder, and many more continue to recover of themselves than did so at first, we are naturally led to suppose that a multitude of those who recovered after taking the medicines would have done the same without them. Little therefore needs be said of the immense number of prescriptions found in authors who have written upon the plague, as it may generally be supposed that at certain times these would have been ineffectual, and at others they were useless.—The following is an epitome of Dr. Patrick Russel’s practice:
1. Bleeding as early as possible, seldom repeated, except where manifestly indicated by circumstances.
2. Vomiting, if spontaneous, was encouraged by warm water. If the patient was affected by nausea, vomiting was provoked by warm water or camomile tea, assisted by a feather. If a bitter taste in the mouth was complained of, ten or fifteen grains of ipecacuanha were given. The times of remission were laid hold of for those remedies.
3. Where spontaneous vomiting continued too long, a saline mixture was given, sometimes with opiates and external applications.