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

by S. A. D. Tissot

he Causes already enumerated in the first Chapter occasion Diseases; and the bad Regimen, or Conduct of the People, on the Invasion of them, render them still more perplexing, and very often mortal.

There is a prevailing Prejudice among them, which is every Year attended with the Death of some Hundreds in this Country, and it is this—That all Distempers are cured by Sweat; and that to procure Sweat, they must take Abundance of hot and heating things, and keep themselves very hot. This is a Mistake in both Respects, very fatal to the Population of the State; and it cannot be too much inculcated into Country People; that by thus endeavouring to force Sweating, at the very Beginning of a Disease, they are with great Probability, taking Pains to kill themselves. I have seen some Cases, in which the continual Care to provoke this Sweating, has as manifestly killed the Patient, as if a Ball had been shot through his Brains; as such a precipitate and untimely Discharge carries off the thinner Part of the Blood, leaving the Mass more dry, more viscid and inflamed. Now as in all acute Diseases (if we except a very few, and those too much less frequent) the Blood is already too thick; such a Discharge must evidently increase the Disorder, by co-operating with its Cause. Instead of forcing out the watery, the thinner Part of the Blood, we should rather endeavour to increase it. There is not a single Peasant perhaps, who does not say, when he has a Pleurisy, or an Inflammation of his Breast, that his Blood is too thick, and that it cannot circulate. On seeing it in the Bason after Bleeding, he finds it black, dry, burnt; these are his very Words. How strange is it then, that common Sense should not assure him, that, far from forcing out the Serum, the watery Part, of such a Blood by sweating, there is a Necessity to increase it?

§ 15. But supposing it were as certain, as it is erroneous, that Sweating was beneficial at the Beginning of Diseases, the Means which they use to excite it would not prove the less fatal. The first Endeavour is, to stifle the Patient with the Heat of a close Apartment, and a Load of Covering. Extraordinary Care is taken to prevent a Breath of fresh Air's squeezing into the Room; from which Circumstance, the Air already in it is speedily and extremely corrupted: and such a Degree of Heat is procured by the Weight of the Patient's Bed-cloaths, that these two Causes alone are sufficient to excite a most ardent Fever, and an Inflammation of the Breast, even in a healthy Man. More than once have I found myself seized with a Difficulty of breathing, on entering such Chambers, from which I have been immediately relieved, on obliging them to open all the Windows. Persons of Education must find a Pleasure, I conceive, in making People understand, on these Occasions, which are so frequent, that the Air being more indispensably necessary to us, if possible, than Water is to a Fish, our Health must immediately suffer, whenever that ceases to be pure; in assuring them also, that nothing corrupts it sooner than those Vapours, which continually steam from the Bodies of many Persons inclosed within a little Chamber, from which the Air is excluded. The Absurdity of such Conduct is a self-evident Certainty. Let in a little fresh Air on these miserable Patients, and lessen the oppressing Burthen of their Coverings, and you generally see upon the Spot, their Fever and Oppression, their Anguish and Raving, to abate.

§ 16. The second Method taken to raise a Sweat in these Patients is, to give them nothing but hot things, especially Venice Treacle, Wine, or some [¹⁵] Faltranc, the greater Part of the Ingredients of which are dangerous, whenever there is an evident Fever; besides Saffron, which is still more pernicious. In all feverish Disorders we should gently cool, and keep the Belly moderately open; while the Medicines just mentioned both heat and bind; and hence we may easily judge of their inevitable ill Consequences. A healthy Person would certainly be seized with an inflammatory Fever, on taking the same Quantity of Wine, of Venice Treacle, or of Faltranc, which the Peasant takes now and then, when he is attacked by one of these Disorders. How then should a sick Person escape dying by them? Die indeed he generally does, and sometimes with astonishing Speed. I have published some dreadful Instances of such Fatality some Years since, in another Treatise. In fact they still daily occur, and unhappily every Person may observe some of them in his own Neighbourhood.

§ 17. But I shall be told perhaps, that Diseases are often carried off by Sweat, and that we ought to be guided by Experience. To this I answer, it is very true, that Sweating cures some particular Disorders, as it were, at their very Onset, for Instance, those Stitches that are called spurious or false Pleurisies, some rheumatic Pains, and some Colds or Defluxions. But this only happens when the Disorders depend solely and simply on stopt or abated Perspiration, to which such Pain instantly succeeds; where immediately, before the Fever has thickened the Blood, and inflamed the Humours; and where before any internal Infarction, any Load, is formed, some warm Drinks are given, such as Faltranc and Honey; which, by restoring Transpiration, remove the very Cause of the Disorder. Nevertheless, even in such a Case, great Care should be had not to raise too violent a Commotion in the Blood, which would rather restrain, than promote, Sweat, to effect which Elder-flowers are in my Opinion preferable to Faltranc. Sweating is also of Service in Diseases, when their Causes are extinguished, as it were, by plentiful Dilution: then indeed it relieves, by drawing off, with itself, some Part of the distempered Humours; after which their grosser Parts have passed off by Stool and by Urine: besides which, the Sweat has also served to carry off that extraordinary Quantity of Water, we were obliged to convey into the Blood, and which was become superfluous there. Under such Circumstances, and at such a Juncture, it is of the utmost Importance indeed, not to check the Sweat, whether by Choice, or for Want of Care. There might often be as much Danger in doing this, as there would have been in endeavouring to force a Sweat, immediately upon the Invasion of the Disorder; since the arresting of this Discharge, under the preceding Circumstances, might frequently occasion a more dangerous Distemper, by repelling the Humour on some inward vital Part. As much Care therefore should be taken not to check, imprudently, that Evacuation by the Skin, which naturally occurs towards the Conclusion of Diseases, as not to force it at their Beginning; the former being almost constantly beneficial, the latter as constantly pernicious. Besides, were it even necessary, it might be very dangerous to force it violently; since by heating the Patients greatly, a vehement Fever is excited; they become scorched up in a Manner, and the Skin proves extremely dry. Warm Water, in short, is the best of Sudorifics.

If the Sick are sweated very plentifully for a Day or two, which may make them easier for some Hours; these Sweats soon terminate, and cannot be excited again by the same Medicines. The Dose thence is doubled, the Inflammation is increased, and the Patient expires in terrible Anguish, with all the Marks of a general Inflammation. His Death is ascribed to his Want of Sweating; when it really was the Consequence of his Sweating too much at first; and of his taking Wine and hot Sudorifics. An able Swiss Physician had long since assured his Countrymen, that Wine was fatal to them in Fevers; I take leave to repeat it again and again, and wish it may not be with as little Success.

Our Country Folks, who in Health, naturally dislike red Wine, prefer it when Sick; which is wrong, as it binds them up more than white Wine. It does not promote Urine as well; but increases the Force of the circulating Arteries, and the Thickness of the Blood, which were already too considerable.

§ 18. Their Diseases are also further aggravated by the Food that is generally given them. They must undoubtedly prove weak, in Consequence of their being sick; and the ridiculous Fear of the Patients' dying of Weakness, disposes their Friends to force them to eat; which, increasing their Disorder, renders the Fever mortal. This Fear is absolutely chimerical; never yet did a Person in a Fever die merely from Weakness. They may be supported, even for some Weeks, by Water only; and are stronger at the End of that Time, than if they had taken more solid Nourishment; since, far from strengthening them, their Food increases their Disease, and thence increases their Weakness.

§ 19. From the first Invasion of a Fever, Digestion ceases. Whatever solid Food is taken corrupts, and proves a Source of Putridity, which adds nothing to the Strength of the Sick, but greatly to that of the Distemper. There are in fact a thousand Examples to prove, that it becomes a real Poison: and we may sensibly perceive these poor Creatures, who are thus compelled to eat, lose their Strength, and fall into Anxiety and Ravings, in Proportion as they swallow.