4. The stomach being settled, mild sudorifics were given in small doses, every five or six hours. In the beginning, nitre was joined with contrayerva, but where it occasioned loose stools, was left off. Spiritus mindereri and saline mixture were also given as sudorifics.
5. In case of diarrhœa, dilution was first prescribed and then the white decoction. Laxative medicines were seldom admitted by the friends of the patient. Diascordium and opiates were used in cases of obstinate diarrhœa.
6. In the advance of the distemper it was found more eligible to give the sudorifics at shorter intervals, when occasion required, than to augment the dose, which was apt to occasion disgust, and a rejection of medicine entirely; consequences which also attended an attempt to heighten the power of the medicines themselves. The general design was to make their operation coincide with the periodical determination to the skin naturally occurring in the disease.
7. The sudorifics exhibited having but small power by themselves, it was found necessary to assist them by dilution, as well as in every other method which could be attempted. If the patient was not naturally inclined to drink, he was encouraged to it by offering agreeable liquids, either hot or cold at the person’s option.
8. The diet was the same as in other acute distempers. No animal food stronger than chicken broth was allowed; the rest confided of farinacea and leguminous vegetables. “It was certainly necessary (says our author) to a certain degree, to support nature by proper food; but to force it upon a nauseating stomach seems to have been irrationally recommended; and, where attempted, which the over care of the nurses frequently did, usually excited vomiting. I sometimes wished to give wine, but a religious bar lay in the way of Mahommedans, and a prejudice against it, in all fevers, rendered it equally inadmissible among the Christians and Jews.”
9. For oppression at the præcordia, mild cordials, acidulated drinks and cool air were found useful. Throughout the disease access of cool air to the chamber was constantly allowed, and, where the chamber itself was not sufficiently airy, the bed was removed to the house top. Towards the height of the exacerbations, however, when there happened to be the least appearance of moisture on the skin, the sick were kept moderately covered up from the chin downward.
10. After the height, and through the decline of the disease, the bark in substance, or Huxham’s tincture, were given instead of the ordinary sudorifics.
In the plague which took place in the Russian army, the greatest confidence seems to have been put in vomits. The disease commonly began with a dull pain in the head, resembling that produced by the fumes of charcoal, accompanied with shivering, universal weakness, &c.[135] On the first appearance of these a vomit was given, working it off with acid drinks. “If the nausea and bitter taste in the mouth was not removed by the first, they gave a second, and sometimes a third or fourth; nay, they sometimes, if the symptoms were very urgent, gave two or three in the space of twelve hours, as there is no time to be lost in this disease; for they did not find this species of evacuation subject to the same inconvenience with purges, which a man in the plague is unable to support; nay, they are even dangerous, though he bears brisk vomits, and a repetition of them, when the nature of the case requires it.
“The stomach being thus cleansed, they gave every morning a powder composed of twenty grains of rhubarb, mixed with as much flower of brimstone, and three grains of ipecacuanha, exhibiting also, every hour, five grains of pure nitre mixed with two grains of camphor; and, if costive, a laxative clyster was given every evening, composed of decoction of camomile, wine vinegar, with or without soap, according to circumstances.
“The head, temples and buboes were frequently washed with warm vinegar, and the last urged to suppuration with emollient cataplasms; but, in case they were found to baffle all attempts to bring them forward, they were then scarified or extirpated, and the patient ordered to drink plentifully of lime-water. Bark was given after evacuation, joined to the flower of brimstone in the proportion of one ounce of the former to a drachm of the latter, divided into sixteen powders, and taken in twenty-four hours. When delirium came on, blisters were applied to the legs and arms, and camphor given largely. Vegetable and mineral acids were given indiscriminately; but they found the vegetable kind sometimes remain on the stomach when the other was thrown up; and of the latter they preferred the vitriolic. Acidulated drinks were given in quantity through the whole disease, and the food consisted of acidulated water-gruel, and fruit when they could procure any. The air of the room was kept charged with acetous vapours, as much as possible, and it was remarked, that, while the bitter taste remained, there was little hope of the disease abating.”