Chapter IV.
Of an Inflammation of the Breast.
Sect. 46.
he Inflammation of the Breast, or Peripneumony, or a Fluxion upon the Breast, is an Inflammation of the Lungs, and most commonly of one only, and consequently on one Side. The Signs by which it is evident, are a Shivering, of more or less Duration, during which the Person affected is sometimes very restless and in great Anguish, an essential and inseparable symptom; and which has helped me more than once to distinguish this Disease certainly, at the very Instant of its Invasion. Besides this, a considerable Degree of Heat succeeds the Shivering, which Heat, for a few ensuing Hours, is often blended as it were, with some Returns of Chilliness. The Pulse is quick, pretty strong, moderately full, hard and regular, when the Distemper is not very violent; but small, soft and irregular, when it is very dangerous. There is also a Sensation of Pain, but rather light and tolerable, in one Side of the Breast; sometimes a kind of straitning or Pressure on the Heart; at other times Pains through the whole Body, especially along the Reins; and some Degree of Oppression, at least very often; for sometimes it is but very inconsiderable. The Patient finds a Necessity of lying almost continually upon his Back, being able to lie but very rarely upon either of his Sides. Sometimes his Cough is dry, and then attended with the most Pain; at other times it is accompanied with a Spitting or Hawking up, blended with more or less Blood, and sometimes with pure sheer Blood. There is also some Pain, or at least a Sensation of Weight and Heaviness in the Head: and frequently a Propensity to rave. The Face is almost continually flushed and red: though sometimes there is a Degree of Paleness and an Air of Astonishment, at the Beginning of the Disease, which portend no little Danger. The Lips, the Tongue, the Palate, the Skin are all dry; the Breath hot; the Urine little and high coloured in the first Stage: but more plentiful, less flaming, and letting fall much Sediment afterwards. There is a frequent Thirst, and sometimes an Inclination to vomit; which imposing on the ignorant Assistants, have often inclined them to give the Patient a Vomit, which is mortal, especially at this Juncture. The Heat becomes universal. The Symptoms are heightened almost every Night, during which the Cough is more exasperated, and the Spitting or Expectoration in less Quantity. The best Expectoration is of a middling Consistence, neither too thin, nor too hard and tough, like those which are brought up at the Termination of a Cold; but rather more yellow, and mixed with a little Blood, which gradually becomes still less, and commonly disappears entirely, before the seventh Day. Sometimes the Inflammation ascends along the Wind-pipe, and in some Measure suffocates the Patient, paining him considerably in Swallowing, which makes him think he has a sore Throat.
§ 47. Whenever the Disease is very violent at first, or increases to be such, the Patient cannot draw his Breath, but when he sits up. The Pulse becomes very small and very quick; the Countenance livid, the Tongue black; the Eyes stare wildly; and he suffers inexpressible Anguish, attended with incessant Restlessness and Agitation in his Bed. One of his Arms is sometimes affected with a sort of Palsy; he raves without Intermission; can neither thoroughly wake nor sleep. The Skin of his Breast and of his Neck is covered (especially in close sultry Weather, and when the Distemper is extremely violent) with livid Spots, more or less remarkable, which should be called petechial ones, but are improperly termed the pourpre, or purple. The natural Strength becomes exhausted; the Difficulty of breathing increases every Moment; he sinks into a Lethargy, and soon dies a terrible Death in Country Places, by the very Effects of the inflaming Medicines they employ on such Occasions. It has been known in Fact, that the Use of them has raised the Distemper to such a Height, that the very Heart has been rent open, which the Dissection of the Body has demonstrated.
§ 48. If the Disease rushes on at once, with a sudden and violent Attack; if the Horror, the Cold and Shivering last many Hours, and are followed with a nearly scorching Degree of Heat; if the Brain is affected from the very Onset; if the Patient has a small Purging, attended with a Tenesinus, or straining to Stool, often termed a Needy; if he abhors the Bed; if he either sweat excessively, or if his Skin be extremely dry; if his natural Manner and Look are considerably changed; and if he spits up with much Difficulty, the Disease is extremely dangerous.
§ 49. He must directly, from the first Seizure in this State, be put upon a Regimen, and his Drink must never be given cold. It should either be the Barley Water [Nº. 2], the Almond Emulsion [Nº. 4], or that of [Nº. 7]. The Juices of the Plants, which enter into the last of these Drinks, are excellent Remedies in this Case; as they powerfully attenuate, or melt down, the viscid thick Blood, which causes the Inflammation.
The Advantage of Bleeding: