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

by S. A. D. Tissot

Of Phlegmons or Boils.

§ 480. Every Person knows what Boils are at Sight, which are considerably painful when large, highly inflamed, or so situated as to incommode the Motions, or different Positions of the Body. Whenever their Inflammation is very considerable; when there are a great many of them at once, and they prevent the Patients from sleeping, it becomes necessary to enter them into a cooling Regimen; to throw up some opening Glysters; and to make them drink plentifully of the Ptisan, [Nº. 2]. Sometimes it is also necessary to bleed the Patient.

Should the Inflammation be very high indeed, a Pultice of Bread and Milk, or of Sorrel a little boiled and bruised, must be applied to it. But if the Inflammation is only moderate, a Mucilage Plaister, or one of the simple Diachylon, may be sufficient. Diachylon with the Gums is more active and efficacious; but it so greatly augments the Pain of some Persons afflicted with Boils, that they cannot bear it.

Boils, which often return, signify some Fault in the Temperament, and frequently one so considerable, that might dispose a Physician to be so far apprehensive of its Consequences, as to enquire into the Cause, and to attempt the Extinction of it. But the Detail of this is no Part nor Purpose of the present Work.

§ 481. The Phlegmon, or Boil, commonly terminates in Suppuration, but a Suppuration of a singular Kind. It breaks open at first on its Top, or the most pointed Part, when some Drops of a Pus like that of an Abscess comes out, after which the Germ, or what is called the Core of it may be discerned. This is a purulent Matter or Substance, but so thick and tenacious, that it appears like a solid Body; which may be drawn out entirely in the Shape of a small Cylinder, like the Pith of Elder, to the Length of some Lines of an Inch; sometimes to the Length of a full Inch, and even more. The Emission of this Core is commonly followed by the Discharge of a certain Quantity, according to the Size of the Tumour, of liquid Matter, spread throughout the Bottom of it. As soon as ever this Discharge is made, the Pain goes entirely off; and the Swelling disappears at the End of a few Days, by continuing to apply the simple Diachylon, or the Ointment [Nº. 66].

Of Fellons or Whitlows.

§ 482. The Danger of these small Tumours is much greater than is generally supposed. It is an Inflammation at the Extremity or End of a Finger, which is often the Effect of a small Quantity of Humour extravasated, or stagnant, in that Part; whether this has happened in Consequence of a Bruise, a Sting, or a Bite. At other times it is evident that it has resulted from no external Cause, but is the Effect of some inward one.

It is distinguished into many Kinds, according to the Place in which the Inflammation begins; but the essential Nature of the Malady is always the same, and requires the same Sort of Remedies. Hence such as are neither Physicians nor Surgeons, may spare themselves the Trouble of enquiring into the Divisions of this Distemper; which, though they vary the Danger of it, and diversify the Manner of the Surgeons Operation, yet have no Relation to the general Treatment of it; the Power and Activity of which must be regulated by the Violence of the Symptoms.

§ 483. This Disorder begins with a slow heavy Pain, attended by a slight Pulsation, without Swelling, without Redness, and without Heat; but in a little Time the Pain, Heat, and Pulsation or Throbbing becomes intolerable. The Part grows very large and red; the adjoining Fingers and the whole Hand swelling up. In some Cases a Kind of red and inflated Fuse or Streak may be observed, which, beginning at the affected Part, is continued almost to the Elbow; neither is it unusual for the Patients to complain of a very sharp Pain under the Shoulder; and sometimes the whole Arm is excessively inflamed and swelled. The Sick have not a Wink of Sleep, the Fever and other Symptoms quickly increasing. If the Distemper rises to a violent Degree indeed, a Delirium and Convulsions supervene.

This Inflammation of the Finger determines, either in Suppuration, or in a Gangrene. When the last of these occurs, the Patient is in very great Danger, if he is not very speedily relieved; and it has proved necessary more than once to cut off the Arm, for the Preservation of his Life. When Suppuration is effected, if the Matter lies very deep and sharp, or if the Assistance of a Surgeon has arrived too late, the Bone of the last Phalanx, or Row of Bones of the Finger, is generally carious and lost. But how gentle soever the Complaint has been, the Nail is very generally separated and falls off.