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

by S. A. D. Tissot

§ 166. If the Disease continues fixed, for a considerable Time, in one Joint, the Motion of it is impaired for Life. I have seen a Person, who has now a wry Neck, of twenty Years standing, in Consequence of a Rheumatism in the Nape of the Neck; and I also saw a poor young Man from Jurat, who was Bed-ridden, and who had lost the Motion of one Hip and both Knees. He could neither stand nor sit, and there were but a few Postures in which he could even lie in Bed.

§ 167. An obstructed Perspiration, an inflammatory Thickness of the Blood, constitute the most general Cause of the Rheumatism. This last concurring Cause is that we must immediately encounter; since, as long as that subsists, Perspiration cannot be perfectly re-established, which follows of Course, when the Inflammation is cured. For which Reason this Distemper must be conducted like the other inflammatory ones, of which I have already treated.

§ 168. As soon as it is sufficiently manifest, the Glyster [Nº. 5], should be injected; and twelve Ounces of Blood be taken from the Arm an Hour after. The Patient is to enter upon a Regimen, and drink plentifully of the Ptisan [Nº. 2], and of Almond Milk or Emulsion [Nº. 4]. As this last Medicine may be too costly in Country Places for the poor Peasantry; they may drink, in Lieu of it, very clear Whey, sweetened with a little Honey. I have known a very severe Rheumatism cured, after twice bleeding, without any other Food or Medicine, for the Space of thirteen Days. The Whey also may be happily used by Way of Glyster.

§ 169. If the Distemper is not considerably asswaged by the first Bleeding, it should be repeated some Hours after. I have ordered it four Times within the first two Days; and some Days after I have even directed a fifth Bleeding. But in general the Hardness of the Pulse becomes less after the second: and notwithstanding the Pains may continue as severe as before, yet the Patient is sensible of less Inquietude. The Glyster must be repeated every Day, and even twice a Day, if each of them is attended only with a small Discharge; and particularly if there be a violent Head-ach. In such Cases as are excessively painful, the Patient can scarcely dispose himself into a proper Attitude or Posture to receive Glysters: and in such Circumstances his Drinks should be made as opening as possible; and a Dose of the Cream of Tartar [Nº. 24] should be given Night and Morning. This very Medicine, with the Assistance of Whey, cured two Persons I advised it to, of rheumatic Pains, of which they had been infested with frequent Returns for many Years, and which were attended with a small Fever.

Apples coddled, Prunes stewed, and well ripened Summer Fruits are the properest Nourishment in this Disease.

We may save the Sick a good deal of Pain, by putting one strong Towel always under their Back, and another under their Thighs, in order to move them the more easily. When their Hands are without Pain, a third Towel hung upon a Cord, which is fastened across the Bed, must considerably assist them in moving themselves.

§ 170. When the Fever entirely disappears, and the Hardness of the Pulse is removed, I have ordered the Purge [Nº. 23] with a very good Effect; and if it is attended with five or six Motions, the Patient is very sensibly relieved. The Day but one after it may be repeated successfully, and a third Time, after an Interval of a greater Number of Days.

§ 171. When the Pains are extremely violent, they admit of no Application: Vapour-Baths however may be employed, and provided they are often used, and for a considerable Time, they prove very efficacious. The Purpose of these Baths is only to convey the Steam of boiling Water to the Parts affected; which may always easily be effected, by a Variety of simple and easy Contrivances; the Choice of which must depend on the different Circumstances and Situation of the Sick.

Whenever it is possible, some of the emollient Applications [Nº. 9], should be continually employed. A half Bath, or an entire Bath of warm Water, in which the Patient should remain an Hour, after sufficient Bleedings and many Glysters, affords the greatest Relief. I have seen a Patient, under the most acute Pains of the Loins, of the Hips, and of one Knee, put into one. He continued still under extreme Torment in the Bath, and on being taken out of it: but an Hour after he had been put to Bed, he sweated, to an incredible Quantity, for thirty six Hours, and was cured. The Bath should never be made use of, until after repeated Bleedings, or at least other equivalent Evacuations: for otherwise timed, it would aggravate the Disease.

§ 172. The Pains are generally most severe in the Night; whence it has been usual to give composing soporific Medicines. This however has been very erroneous, as Opiates really augment the Cause of the Disease, and destroy the Efficacy of the proper Remedies: and, even not seldom, far from asswaging the Pains, they increase them. Indeed they agree so little in this Disease, that even the Patient's natural Sleep at the Invasion of this Complaint, is rather to his Detriment. They feel, the very Moment they are dropping asleep, such violent Jirks as awaken them with great Pain: or if they do sleep a few Minutes, the Pains are stronger when they awake.