Nitrous cooling Medicines frequently produce the like Effects; they increase that Faintness which accompanies this Disease, and either dispose the Patient to copious sinking Sweats, or to Stools.
Upon the whole, it appears, that all Evacuations which tend to lessen the natural Strength of the Constitution, are in this Disease injurious; and that those Persons in common are in the greatest Danger, if attacked with it, who have been previously indisposed or have had their Strength impair'd by Grief, or any other Accident. Of which it may not perhaps be improper to relate an Instance or two in this Place, as it will also tend to explain the usual Progress of the Symptoms in the worst Cases we meet with.
A young Gentlewoman about 26 Years of Age, of a pale lax Habit, but of an active chearful Disposition, had enjoy'd a pretty good Share of Health in common, till a Year or two before her last Illness; about that time she unhappily made use of some external and empirical Application to remove a Redness attended with Pimples, which now-and-then broke out in her Face. She was soon relieved from this Complaint by the Medicine she used; but was quickly after seized with Sickness, Vomiting, Loss of Appetite, and either obstinate Costiveness, or a troublesome Diarrhœa; the Menses were pale, and in small Quantities, and her Health in general greatly impaired.
She had scarce recover'd from this weak State, when the Loss of a near Relation brought her almost into the same Circumstances; from which she was slowly recruiting, when she married. Her Sickness, Vomiting, and Loss of Appetite, soon return'd; which she conceal'd as much as possible.
Under these Disadvantages, she was seized with this Distemper, a Day or two after she had visited an Acquaintance labouring under the same Disorder: It came on with a Coldness and Trembling like that of an Ague-Fit, great Faintness, and an acute Pain in her Head, with a Vomiting more violent than she was usually affected with, and a Purging. Towards Evening she grew very hot and restless, complained of a Soreness in her Throat, and the Discharges abated. Her Face, Neck, and Hands were intensely red; she frequently sigh'd, and from her Aspect and Gestures there was Reason to suspect a Delirium approaching. She slept little that Night; and next Morning her Pulse, which before was very quick and small, seemed to be somewhat more full, but not sensibly slower; and she complained of Faintness and Anxiety. The Parts about the Fauces were much relax'd, and very red, in some Places almost livid, with a kind of glossy Dryness upon them. She continued in this Manner without any remarkable Increase of Symptoms till Night, when the Looseness return'd, and in a very short time exhausted her Strength to a great Degree: The Redness upon the Skin disappeared, the Extremities grew cold, her Eyes became dim, her Pulse scarce perceptible, she breath'd with Difficulty, and expired in the Morning, on the third Day of the Disease.
Another young Woman, who frequently visited, and sometimes assisted a Relation, who had this Disease, was attack'd with it in the usual manner. She was about 17, of a pale and somewhat bloated lax Habit, naturally inactive, averse to Exercise, and was thought to have indulged some painful Solicitude, to the Prejudice of her Health, and making way for an obstinate Chlorosis.
Under these Circumstances she was seized with the usual Complaints, but in a violent manner. The Purging continued till the Day following; when it yielded for the present to Opiates, but constantly return'd when their Effects were over. The other Symptoms, such as Heat, Restlessness, Anxiety, and Faintness, increased with the Purging; the Pulse was small, quick, and hard; a Difficulty of breathing came on, the small Remains of Lustre in the Eye perish'd, and she died early on the fourth Day of the Distemper.
No Marks of any Sloughs in the Throat appeared in either of these Cases; but the Redness became daily more intense, and approached nearer to Lividness, whilst the Fauces could be inspected; which, from the great Difficulty they had in breathing, was impracticable several Hours before the Patients expired.
Warm aromatic Cordials, and anodyne Astringents, were administred assiduously, with suitable Nourishment, and Vesicatories applied successively to the Neck on each Side, the Shoulders and Arms, but without Effect.
If the Purging therefore continues long after the first Exacerbation of the Disease, it may be look'd upon as a dangerous Symptom; for though it be sometimes restrain'd for the present by Opiates or Astringents, yet it commonly returns with more Vehemence, when their Efficacy ceases, and in a short time exhausts the small Degree of Strength remaining.