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

by S. A. D. Tissot

Involuntary Discharges of Blood from the Nose often occur, in the first Stage of this Distemper, which are extremely serviceable, and commonly lessen, or carry off, the Head-ach. Meer Infants are less subject to this Discharge; though they have sometimes a little of it: and I have known a considerable Stupor or Drowsiness, vanish immediately after this Bleeding.

§ 209. The Small-Pocks is commonly distinguished into two Kinds, the confluent and the distinct, such a Distinction really existing in Nature: but as the Treatment of each of them is the same; and as the Quantity or Dose of the Medicines is only to be varied, in Proportion to the Danger of the Patient (not to enter here into very tedious Details, and such as might exceed the Comprehension of many of our Readers; as well as whatever might relate particularly to the malignant Small-Pocks) I shall limit myself within the Description I have premised, which includes all the Symptoms common to both these Kinds of the Small-Pocks. I content myself with adding here, that we may expect a very confluent and dangerous Pock, is, at the very Time of seizure, the Patient is immediately attacked with many violent Symptoms; more especially if his Eyes are extremely quick, lively, and even glistening, as it were; if he vomits almost continually; if the Pain of his Loins be violent; and if he suffers at the same Time great Anguish and Inquietude: If in Infants there is great Stupor or Heaviness; if Eruption appears on the third Day, and sometimes even on the second: as the hastier Eruptions in this Disease signify the most dangerous Kind and Degree of it; and on the contrary, the slower Eruption is, it is the safer too; supposing this Slowness of the Eruption not to have been the Consequence of great Weakness, or of some violent inward Pain.

§ 210. The Disorder is sometimes so very mild and slight, that Eruption appears with scarcely any Suspicion of the Child's having the least Ailment, and the Event is as favourable as the Invasion. The Pustules appear, grow large, suppurate and attain their Maturity, without confining the Patient to his Bed, or lessening either his Sleep, or Appetite.

It is very common to see Children in the Country (and they are seldom more than Children who have it so very gently) run about in the open Air, through the whole Course of this Disease, and feeding just as they do in Health. Even those who take it in a somewhat higher Degree, commonly go out when Eruption is finished, and give themselves up, without Reserve, to the Voracity of their Hunger. Notwithstanding all this Neglect, many get perfectly cured; though such a Conduct should never be proposed for Imitation, since Numbers have experienced its pernicious Consequences, and several of these Children have been brought to me, especially from Jurat, who after such Neglect, in the Course of the mild and kindly Sort of this Distemper, have contracted Complaints and Infirmities of different Kinds, which have been found very difficult to subdue.

§ 211. This still continues to be one of these Distempers, whose Danger has long been increased by its improper Treatment, and especially by forcing the Patients into Sweats; and it still continues to be increased, particularly among Country People. They have seen Eruption appear, where the Patient sweats, and observed he found himself better after its Appearance: and hence they conclude that, by quickening and forcing out this Eruption, they contribute to his Relief; and suppose, that by increasing the Quantity of his Sweats, and the Number of his Eruptions, the Blood is the better cleared and purified from the Poison. These are mortal Errors, which daily Experience has demonstrated, by their tragical Consequences.

When the Contagion or Poison, which generates this Disease, has been admitted into the Blood, it requires a certain Term to produce its usual Effects: at which Time the Blood being tainted by the Venom it has received, and by that which such Venom has formed or assimilated from it, Nature makes an Effort to free herself of it, and to expell it by the Skin, precisely at the Time when every Thing is predisposed for that Purpose. This Effort pretty generally succeeds, being very often rather too rapid and violent, and very seldom too weak. Hence it is evident, that whenever this Effort is deficient, it ought not to be heightened by hot Medicines or Means, which make it too violent and dangerous: for when it already exceeds in this Respect, a further Increase of such Violence must render it mortal. There are but few Cases in which the Efforts of Nature, on this Occasion, are too languid and feeble, especially in the Country; and whenever such rare Cases do occur, it is very difficult to form a just and proper Estimation of them: for which Reason we should be very reserved and cautious in the Use of heating Medicines, which are so mortally pernicious in this Disease.

Wine, Venice Treacle, cordial Confections, hot Air, and Loads of Bed-cloths, annually sweep off Thousands of Children, who might have recovered, if they had taken nothing but warm Water: and every Person who is interested in the Recovery of Patients in this Distemper, ought carefully to prevent the smallest Use of such Drugs; which, if they should not immediately aggravate it to a fatal Degree, yet will certainly increase the Severity and Torment of it, and annex the most unhappy and tragical Consequences to it.

The Prejudice in this Point is so strongly rooted, that a total Eradication of it must be very difficult: but I only desire People would be convinced by their own Eyes, of the different Success of the hot Regimen, and of that I shall propose. And here indeed I must confess, I found more Attention and Docility, on this Point, among the Inhabitants of the City, and especially in the last epidemical spreading of the Small-Pocks, than I presumed to hope for. Not only as many as consulted me on the Invasion of it, complied exactly with the cooling Regimen I advised them; but their Neighbours also had Recourse to it, when their Children sickened: and being often called in when it had been many Days advanced, I observed with great Pleasure, that in many Houses, not one heating Medicine had been given; and great Care had been taken to keep the Air of the Patient's Chamber refreshingly cool and temperate. This encourages me to expect, that this Method hereafter will become general here. What certainly ought most essentially to conduce to this is, that notwithstanding the Diffusion or spreading of this Disease was as numerous and extensive as any of the former, the Mortality, in Consequence of it, was evidently less.

§ 212. At the very Beginning of the Small-Pocks (which may be reasonably suspected, from the Presence of the Symptoms I have already described; supposing the Person complaining never to have had it, and the Disease to prevail near his Residence) the Patient is immediately to be put on a strict Regimen, and to have his Legs bathed Night and Morning in warm Water. This is the most proper and promising Method to lessen the Quantity of Eruption in the Face and Head, and to facilitate it every where else on the Surface. Glysters also greatly contribute to abate the Head-ach, and to diminish the Reachings to vomit, and the actual Vomitings, which greatly distress the Patient; but which however it is highly absurd and pernicious to stop by any stomachic cordial Confection, or by Venice Treacle; and still more dangerous to attempt removing the Cause of them, by a Vomit or Purge, which are hurtful in the beginning of the Small-Pocks.

If the Fever be moderate, the Bathings of the Legs on the first Day of sickening, and one Glyster may suffice then. The Patient must be restrained to his Regimen; and instead of the Ptisan [Nº. 1], [2], [4], a very young Child should drink nothing but Milk diluted with two thirds of Elder Flower or Lime-tree Tea, or with Balm Tea, if there be no perceivable Fever; and in short, if they have an Aversion to the Taste of them all, with only the same Quantity of good clear [⁵³] Water. An Apple coddled or baked may be added to it; and if they complain of Hunger, a little Bread may be allowed; but they must be denied any Meat, or Meat Broth, Eggs and strong Drink; since it has appeared from Observations frequently repeated, that Children who had been indulged with such Diet proved the worse for it, and recovered more slowly than others. In this early Stage too, clear Whey alone may serve them instead of every other Drink, the good Effects of which I have frequently been a Witness to; or some Buttermilk may be allowed. When the Distemper is of a mild Species, a perfect Cure ensues, without any other Assistance or Medicine: but we should not neglect to purge the Patient as soon as the Pustules are perfectly scabbed on the greater Part of his Face, with the Prescription [Nº. 11], which must be repeated six Days after. He should not be allowed Flesh 'till after this second Purge; though after the first he may he allowed some well-boiled Pulse, or Garden-stuff and Bread, and in such a Quantity, as not to be pinched with Hunger, while he recovers from the Disease.