Advice to the people in general, with regard to their health

by S. A. D. Tissot

1. It is often useful, and even necessary, to take a considerable Quantity of Blood from the Arm; but especially if the Patient's Respiration, or Breathing, is extremely oppressed; or when we cannot speedily succeed in our Efforts to remove the obstructing Substance; as the Bleeding is adapted to prevent the Inflammation, which the frequent Irritations from such Substances occasion; and as by its disposing the whole Body into a State of Relaxation, it might possibly procure an immediate Discharge of the offending Substance.

2. Whenever it is manifest that all Endeavours, either to extract, or to push down the Substance stopt in the Passage, are ineffectual, they should be discontinued; because the Inflammation occasioned by persisting in them, would be as dangerous as the Obstruction itself; as there have been Instances of People's dying in Consequence of the Inflammation; notwithstanding the Body, which caused the Obstruction, had been entirely removed.

3. While the Means already advised are making Use of, the Patient should often swallow, or if he cannot, he should frequently receive by Injection through a crooked Tube or Pipe, that may reach lower down than the Glottis, some very emollient Liquor, as warm Water, either alone or mixed with Milk, or a Decoction of Barley, of Mallows, or of Bran. A two-fold Advantage may arise from this; the first is, that these softening Liquors smooth and sooth the irritated Parts; and secondly, an Injection, strongly thrown in, has often been more successful in loosening the obstructing Body, than all Attempts with Instruments.

4. When after all we are obliged to leave this in the Part, the Patient must be treated as if he had an inflammatory Disease; he must be bled, ordered to a Regimen, and have his whole Neck surrounded with emollient Pultices. The like Treatment must also be used, though the obstructing Substance be removed; if there is Room to suppose any Inflammation left in the Passage.

5. A proper Degree of Agitation has sometimes loosened the inhering Body, more effectually than Instruments. It has been experienced that a Blow with the Fist on the Spine, the Middle of the Back, has often disengaged such obstructed and obstructing Bodies; and I have known two Instances of Patients who had Pins stopt in the Passage; and who getting on Horseback to ride out in Search of Relief at a neighbouring Village, found each of them the Pin disengaged after an Hour's riding: One spat it out, and the other swallowed it, without any ill Consequence.

6. When there is an immediate Apprehension of the Patient's being suffocated; when bleeding him has been of no Service; when all Hope of freeing the Passage in time is vanished, and Death seems at Hand, if Respiration be not restored; the Operation of Bronchotomy, or opening of the Wind-pipe, must be directly performed; an Operation neither difficult to a tolerably knowing and expert Surgeon, nor very painful to the Patient.

7. When the Substance that was stopt passes into the Stomach, the Patient must immediately be put into a very mild and smooth Regimen. He should avoid all sharp, irritating, inflaming Food; Wine, spirituous Liquors, all strong Drink, and Coffee; taking but little Nourishment at once, and no Solids, without their having been thoroughly well chewed. The best Diet would be that of farinaceous mealy Soups, made of various leguminous Grains, and of Milk and Water, which is much better than the usual Custom of swallowing different Oils.

§ 429. The Author of Nature has provided, that in eating, nothing should pass by the Glottis into the Wind-pipe. This Misfortune nevertheless does sometimes happen; at which very Instant there ensues an incessant and violent Cough, an acute Pain, with Suffocation; all the Blood being forced up into the Head, the Patient is in extreme Anguish, being agitated with violent and involuntary Motions, and sometimes dying on the Spot. A Hungarian Grenadier, by Trade a Shoemaker, was eating and working at the same time. He tumbled at once from his Seat, without uttering a single Word. His Comrades called out for Assistance; some Surgeons speedily arrived, but after all their Endeavours he discovered no Token of Life. On opening the Body, they found a Lump, or large Morsel, of Beef, weighing two Ounces, forced into the Windpipe, which it plugged up so exactly, that not the least Air could pass through it into the Lungs.

§ 430. In a Case so circumstanced, the Patient should be struck often on the Middle of the Back; some Efforts to vomit should be excited; he should be prompted to sneeze with Powder of Lilly of the Valley, Sage, or any cephalic Snuffs, which should be blown strongly up his Nose.

A Pea, pitched into the Mouth in playing, entered into the Wind-pipe, and sprung out again by vomiting the Patient with Oil. A little Bone was brought up by making another sneeze, with powdered Lilly of the Valley.