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

by S. A. D. Tissot

§ 162. It is past Doubt, that if a Person stands still in the violent Heat of the Sun, he is more liable to be struck with it, than if he walks about; and the Use of white Hats, or of some Folds of clean white Paper under a black one, may sensibly contribute to prevent any Injury from the considerable Heat of the Sun; though it is a very incompetent Defence against a violent Degree of it.

The natural Constitution, or even that Constitution, which has been formed from long Custom and Habit, make a very great Difference between the Effects of solar Heat on different Persons. People insensibly accustom themselves to the Impressions of it, as they do to those of all the other Bodies and Elements, which are continually acting upon us; and by Degrees we arrive at a Power of sustaining his violent Heat with Impunity: just as others arrive at the Hardiness of bearing the most rigid Colds, with very little Complaint or Inconvenience. The human Body is capable of supporting many more Violences and Extremes, than it commonly does. Its natural Force is scarcely ever ascertained among civilized Nations; because their Education generally tends to impair and lessen it, and always succeeds in this Respect. If we were inclined to consider a purely natural, a simply physical Man, we must look for him among savage Nations; where only we can discover what we are able to be, and to bear. We certainly could not fail of being Gainers, by adopting their corporal Education; neither does it seem as yet to have been infallibly demonstrated, that we should be great Losers in commuting our moral Education for theirs. [³⁹]

Chapter XI.

Of the Rheumatism.

Sect. 163.

he Rheumatism may exist either with or without a Fever. The first of these may be classed among the Diseases, of which I have already treated; being an Inflammation which is manifested by a violent Fever, preceded by Shivering, a subsequent Heat, hard Pulse, and a Head-ach. Sometimes indeed an extraordinary Coldness, with general Uneasiness and Inquietude, exists several Days before the Fever is perceived. On the second or third Day, and sometimes even on the first, the Patient is seized with a violent Pain in some Part of his Body, but especially about the Joints, which entirely prevents their Motion, and which is often accompanied with Heat, Redness and a Swelling of the Part. The Knee is often the first Part attacked, and sometimes both the Knees at once. When the Pain is fixed, an Abatement of the Fever frequently happens; though in some other Persons it continues for several Days, and increases every Evening. The Pain diminishes in one Part after a Duration of some Days, and then invades some other. From the Knee it descends to the Foot, or mounts to the Hip, to the Loins, the Shoulder-blades, Elbow, Wrist, the Nape of the Neck, and frequently is felt in the intermediate Parts. Sometimes one Part is quite free from Pain, when another is attacked; at other Times many Parts are seized nearly at the same Instant; and I have sometimes seen every Joint afflicted at once. In this Case the Patient is in a very terrible Situation, being incapable of any Motion, and even dreading the Assistance of his Attendants, as he can scarcely admit of touching, without a sensible Aggravation of his Pains. He is unable to bear even the Weight of the Bed-clothes, which must be, as it were, arched over his Limbs by a proper Contrivance, to prevent their Pressure: and the very walking across the Chamber increases his Torments. The Parts in which they are the most excruciating, and obstinate, are the Region of the Loins, the Hips, and the Nape or hinder Part of the Neck.

§ 164. This Disease is also often extended over the Scalp and the Surface of the Head; and there the Pains are excessive. I have seen them affect the Eyelids and the Teeth with inexpressible Torment. As long as the Distemper is situated in the more external Parts, the Patient, however painful his Situation may prove, is in no great Danger, if he be properly treated: but if by some Accident, some Error, or by any latent Cause, the Disease be repelled upon an internal Part or Organ, his Case is extremely dangerous. If the Brain is attacked, a frantic raging Delirium is the Consequence; if it falls upon the Lungs, the Patient is suffocated: and if it attacks the Stomach or the Bowels, it is attended with the most astonishing Pains, which are caused by the Inflammation of those Parts, and which Inflammation, if violent, is [⁴⁰] speedily fatal. About two Years since I was called to a robust Man, whose Guts were already in a gangrenous State, which was the Consequence of a Rheumatism, that first attacked one Arm and one Knee; the Cure of which had been attempted by sweating the Patient with some hot Remedies. These indeed brought on a plentiful Sweat; but the inflammatory Humour seized the Intestines, whose Inflammation degenerated into a Gangrene, after a Duration of the most acute Pain for thirty-six Hours; his Torments terminating in Death two Hours after I saw him.

§ 165. This Malady however is often in a less violent Degree; the Fever is but moderate, and ceases entirely when the Pain begins; which is also confined to one, or not more than two Parts.