AS for what concerns the next Means of Remedy, an Emetick may be given in the Infancy of the Disease, where the Stomach is loaded either by over-eating, or by a Crowd of bad Humours, or when there is a Loathing, or a Bitterness in the Mouth; so that any particular Conformation of the Breast and Neck doth not contra-indicate; and amongst these Remedies they are preferrable which plentifully excite Vomiting, without working also downwards.
OF this kind are the Syr. Diasari Fernelij, Syr. Scabios. compos. Oxymel. Scillit. and chiefly the Sal Vitrioli; but the Antimonial Preparations are not so advisable. The Dose of the Emetick ought to be large enough to Empty the Stomach soon; and the Posset-drink used in the Operation, in order to rince off its Coats all Filthiness, is to be impregnated with Carduus, Scordium, Meadow-sweet, Butterbur, &c. boiled in it. In my own Practice, I have always found good Service from large Draughts of the Posset-drink above-mentioned, sweetned with
simple Oxymel, without any other previous Emetick given.
AFTER Vomiting is over, in order to enable the Stomach the better to keep any Alexipharmick Medicines, its Force may be greatly strengthned by adding Stomachicks to the Alexipharmicks: But if a Reaching to vomit prove Symptomatical, Emeticks are by all Means to be avoided; least the Physician (like old Nurses, who are altogether ignorant of the Rules of Practice) should promote that Symptom, which by fruitless Strains waste the Spirits, and sollicit the pestilential Venom into the Stomach from distant Parts; which when fixed there, still irritates into more violent Reachings, that cannot be asswaged by any Remedies.
ALTHOUGH in other Cases a Vomiting may be removed by Emeticks, yet in a Pestilence it is dangerous to follow such Practice; because the Malignity, or rather Nitro-saline Effluvia, vellicate the Mouth of the Stomach, and so invert its nervous Coats, although empty, as to bring on Convulsions: And some Persons seem to have their Stomachs full, as overloaded
with Food, who crave to be freed by Vomiting, which it is by no Means safe to indulge them in, because such a Sensation of Fulness proceeds only from the pestilential Poyson vellicating the Membranes, while the Stomach is it self free from Food, or bad Humours; but what further concerns this Matter, will come to be further considered under the Cure of Symptoms.
MOREOVER, Purges are justly reckoned amongst Medicines of great Efficacy; but whether or no they are to be used in the Case before us, is a Difficulty, and full of Controversy amongst Physicians; and indeed the Varieties in pestilential Diseases, the Differences of Constitutions, the various Complication of Circumstances, the Uncertainty of Seasons, &c. do make it impossible to give any general Rules hereupon; wherefore I shall go no further than what my own Practice hath enabled me to judge concerning it.
A Turgescency or Distemperature of Humours do certainly call for an Evacuation this Way; that is, when the Humours are troublesome more by their
Quantity than any stimulating Quality; when therefore the Constitution is not able to conquer such a Burthen, neither by Digestion nor Expulsion, Catharticks are certainly necessary to help away the Load, and especially if a Person hath been before eating to Excess.
BUT if this Evacuation be delayed till the Juices have received the pestilential Taint, the Humours are then rather to be depurated, then purged away by Catharticks; and it is certainly better to trust to the Strength of Nature, when Things are gone so far, to do the Work her own Way: And whether or no the Blood is too much fused, or (according to some) coagulated, purging Medicines are certainly to be avoided; for in the first Case they further agitate and fuse the Blood, besides the Hazard of breaking open such Vessels as may not without great Difficulty be again closed; the same Medicines are also hurtful in the Blood’s Coagulation, because they evacuate only the serous Parts, and leave the Remainder more viscid and tenacious, whereby Obstructions are rendred more perverse and unconquerable, and the stagnant Matter without a Possibility of Dilution,