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

by S. A. D. Tissot

§ 465. Since they manifestly depend on the Sensibility of the Skin, the Nature of the Humours, and the Changes of the Weather from Heat to Cold, in Order to prevent them, in the first Place, the Skin must be rendered firmer or less tender. 2, That vicious Quality of the Temperament, which contributes to their Existence, must be corrected; and, 3, the Persons so liable must guard themselves as well as possible, against these Changes of the Weather.

Now the Skin of the Hands, as well as that of the whole Body, may be strengthened by that Habit of washing or bathing in cold Water, which I have described at large, [§ 384]; and in Fact I have never seen Children, who had been early accustomed and inured to this Habit, as much afflicted with Chilblains as others. But still a more particular Regard should be had to fortify the Skin of the Hands, which are more obnoxious to this Disorder than the Feet, by making Children dip them in cold Water, and keep them for some Moments together in it every Morning, and every Evening too before Supper, from the very Beginning of the Fall. It will give the Children no Sort of Pain, during that Season, to contract this Habit; and when it is once contracted, it will give them no Trouble to continue it throughout the Winter, even when the Water is ready to freeze every where. They may also be habituated to plunge their Feet into cold Water twice or thrice a Week: and this Method, which might be less adapted for grown Persons, who had not been accustomed to it, must be without Objection with Respect to such Children, as have been accustomed to it; to whom all its Consequences must be useful and salutary.

At the same Time Care must be taken not to defeat or lessen the Effect of the cold bathing, by suffering the Bather or Washer, to grow too warm between two Baths or Dippings; which is also avoiding the too speedy Successions of Heat and Cold. For this Purpose, 1, the Children must be taught never to warm their Hands before the Fire at such Times, and still less before the Stoves, which very probably are one of the principal Causes of Chilblains, that are less usual in Countries which use no such Stoves, and among those Individuals who make the least Use of them, where they are. Above all, the Use of Cavettes (that is, of Seats or little Stairs, as it were, contrived between the Stove and the Wall) is prejudicial to Children, and even to grown People, upon several Accounts. 2, They should never accustom themselves to wear Muffs. 3, It would be also proper they should never use Gloves, unless some particular Circumstances require it; and I recommend this Abstinence from Gloves, especially to young Boys: but if any should be allowed them, let the Gloves be thin and smooth.

§ 466. When Chilblains seem to be nourished by some Fault in the Temperament or Humours, the Consideration of a Physician becomes necessary, to direct a proper Method of removing or altering it. I have seen Children from the Age of three, to that of twelve or thirteen Years, in whom their Chilblains, raw and flead, as it were, for eight Months of the Year, seemed to be a particular Kind of Issue, by which Nature freed herself of an inconvenient Superfluity of Humours, when the Perspiration was diminished by the Abatement of the violent Heats. In such Cases I have been obliged to carry them through a pretty long Course of Regimen and Remedies; which, however, being necessarily various from a Variety of Circumstances, cannot be detailed here. The milder Preparations of Antimony are often necessary in such Cases; and some Purges conduce in particular ones to allay and to abridge the Disorder.

§ 467. The first Degree of this Complaint goes off, as I have already said, without the Aid of Medicine; or should it prove somewhat more obstinate, it may easily be dissipated by some of the following Remedies. But when they rise to the second Degree, they must be treated like other Complaints from Congelation, or Frost-biting (of which they are the first Degree) with cold Water, Ice-water and Snow.

No other Method or Medicine is nearly as efficacious as very cold Water, so as to be ready to freeze, in which the Hands are to be dipt and retained for some Minutes together, and several Times daily. In short it is the only Remedy which ought to be applied, when the Hands are the Parts affected; when the Patient has the Courage to bear this Degree of Cold; and when he is under no Circumstance which may render it prejudicial. It is the only Application I have used for myself, after having been attacked with Chilblains for some Years past, from having accustomed myself to too warm a Muff.

There ensues a slight Degree of Pain for some Moments after plunging the Hand into Water, but it diminishes gradually. On taking the Hand out, the Fingers are numbed with the Cold, but they presently grow warm again; and within a Quarter of an Hour, it is entirely over.

The Hands, on being taken out of the Water, are to be well dried, and put into Skin Gloves; after bathing three or four Times, their Swelling subsides, so that the Skin wrinkles: but by continuing the cold Bathing, it grows tight and smooth again; the Cure is compleated after using it three or four Days; and, in general, the Disorder never returns again the same Winter.

The most troublesome raging Itching is certainly assuaged by plunging the Hands into cold Water.

The Effect of Snow is, perhaps, still more speedy: the Hands are to be gently and often rubbed with it for a considerable Time; they grow hot, and are of a very high Red for some Moments, but entire Ease very quickly succeeds.