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

by S. A. D. Tissot

§ 92. Spring is commonly the Season most productive of Pleurisies: in general there are few in Summer: notwithstanding that in the Year 1762, there were a great many during the hottest Season, which then was excessively so. The Disease usually begins with a violent Shivering, succeeded by considerable Heat, with a Cough, an Oppression, and sometimes with a sensible Straitning, or Contraction, as it were, all over the Breast; and also with a Head-ach, a Redness of the Cheeks, and with Reachings to vomit. The Stitch does not always happen at the very first Onset; often not 'till after several Hours from the first Complaint; sometimes not before the second, or even the third Day. Sometimes the Patient feels two Stitches, in different Parts of the Side; though it seldom happens that they are equally sharp, and the lightest soon ceases. Sometimes also the Stitch shifts its Place, which promises well, if the Part first attacked by it continues perfectly free from Pain: but it has a bad Appearance, if, while the first is present, another also supervenes, and both continue. The Pulse is usually very hard in this Distemper; but in the dreadful Cases described [§ 47] and [90], it becomes soft and small. There often occur at, or very quickly after, the Invasion, such an Expectoration, or hawking up, as happens in an Inflammation of the Breast; at other Times there is not the least Appearance of it, whence such are named dry Pleurisies, which happen pretty often. Sometimes the Sick cough but little, or not at all. They often lie more at Ease upon the Side affected, than on the sound one. The Progress of this Disease advances exactly like that described in the preceding Chapter: for how can they differ considerably? and the Treatment of both is the same. Large Hæmorrhages, or Bleedings from the Nose, frequently happen, to the great Relief of the Patient; but sometimes such Discharges consist of a kind of corrupted Blood, when the Patient is very ill, and these portend Death.

§ 93. This Distemper is often produced by drinking cold Water, while a Person is hot; from which Cause it is sometimes so violent, as to kill the Patient in three Hours. A young Man was found dead at the Side of the Spring, from which he had quenched his Thirst: neither indeed is it uncommon for Pleurisies to prove mortal within three Days.

Sometimes the Stitch disappears, whence the Patient complains less; but at the same Time his Countenance changes; he grows pale and sad; his Eyes look dull and heavy, and his Pulse grows feeble. This signifies a Translation of the Disease to the Brain, a Case which is almost constantly fatal.

There is no Disease in which the critical Symptoms are more violent, and more strongly marked, than in this. It is proper this should be known, as it may prevent or lessen our excessive Terror. A perfect Cure supervenes sometimes, at the very Moment when Death was expected.

§ 94. This Malady is one of the most common and the most destroying kind, as well from its own violent Nature, as through the pernicious Treatment of it in Country Places. That Prejudice, which insists on curing all Diseases by Sweating, entirely regulates their Conduct in treating a Pleurisy; and as soon as a Person is afflicted with a Stitch, all the hot Medicines are immediately set to Work. This mortal Error destroys more People than Gunpowder; and it is by so much the more hurtful, as the Distemper is of the most violent kind; and because, as there is commonly not a Moment to be lost, the whole depends on the Method immediately recurred to.

§ 95. The proper Manner of treating this Disease, is exactly the same in all Respects, with that of the Peripneumony; because, I again affirm, it is the very same Disease. Hence the Bleedings, the softening and diluting Drinks, the Steams, the Glysters, the Potion [Nº. 8], and the emollient Poultices are the real Remedies. These last perhaps are still more effectual in the Pleurisy; and therefore they should be continually applied over the very Stitch.

The first Bleeding, especially if there has been a considerable Discharge, almost constantly abates the Stitch, and often entirely removes it: though it more commonly returns, after an Intermission of some Hours, either in the same Spot, or sometimes in another. This shifting of it is rather favourable, especially if the Pain, that was first felt under the Breast, shifts into the Shoulders, to the Back, the Shoulder-blade, or the Nape of the Neck.

When the Stitch is not at all abated, or only a little; or if, after having abated, it returns as violently as at first, and especially if it returns in the same Spot, and the Height of the other Symptoms continue, Bleeding must be repeated. But if a sensible Abatement of the Stitch continues; and if, though it returns, it should be in a smaller Degree, and by Intervals, or in these Places I have mentioned above; if the Quickness, or the Hardness of the Pulse, and all the other Symptoms are sensibly diminished, this repeated Bleeding may sometimes be omitted. Nevertheless, in a very strong Subject, it seems rather prudent not to omit it, since in such Circumstances it can do no Mischief; and a considerable Hazard may sometimes be incurred by the Omission. In very high and dangerous Pleurisies a frequent Repetition of bleeding is necessary; except some Impediment to it should arise from the particular Constitution of the Patient, or from his Age, or some other Circumstances.

If, from the Beginning of the Disease, the Pulse is but a little quicker and harder than in a healthy State; if it is not manifestly strong; if the Head-ach and the Stitch are so moderate as to prove supportable; if the Cough is not too violent; if there is no sensible Oppression or Straitness, and the Patient expectorate, or cough up, Bleeding may be omitted.

With Respect to the administering of other Remedies, the same Directions are to be exactly followed, which have been already given in the preceding Chapter, to which the Reader is referred from [§ 53] to [66].