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

by S. A. D. Tissot

Sect. 236.

aving treated of such feverish Distempers, as arise from an Inflammation of the Blood, I shall here treat of those produced by corrupt Humours, which stagnate in the Stomach, the Guts, or other Bowels of the lower Cavity, the Belly; or which have already passed from them into the Blood. These are called putrid Fevers, or sometimes bilious Fevers, when a certain Degeneracy or Corruption of the Bile seems chiefly to prevail in the Disease.

§ 237. This Distemper frequently gives Notice of its Approach, several Days before its manifest Attack; by a great Dejection, a Heaviness of the Head; Pains of the Loins and Knees; a Foulness of the Mouth in the Morning; little Appetite; broken Slumber; and sometimes by an excessive Head-ach for many Days, without any other Symptom. After this, or these Disorders, a Shivering comes on, followed by a sharp and dry Heat: the Pulse, which was small and quick during the Shivering, is raised during the Heat, and is often very strong, though it is not attended with the same Hardness, as in the preceding Fever; except the putrid Fever be combined with an inflammatory one, which it sometimes is. During this Time, that is the Duration of the Heat, the Head-ach is commonly extremely violent; the Patient is almost constantly affected with Loathings, and sometimes even with Vomiting; with Thirst, disagreeable Risings, a Bitterness in the Mouth; and very little Urine. This Heat continues for many Hours, frequently the whole Night; it abates a little in the Morning, and the Pulse, though always feverish, is then something less so, while the Patient suffers less, though still greatly dejected.

The Tongue is white and furred, the Teeth are foul, and the Breath smells very disagreeably. The Colour, Quantity and Consistence of the Urine, are very various and changeable. Some Patients are costive, others frequently have small Stools, without the least Relief accruing from them. The Skin is sometimes dry, and at other Times there is some sensible Perspiration, but without any Benefit attending it. The Fever augments every Day, and frequently at unexpected irregular Periods. Besides that great Paroxysm or Increase, which is perceivable in all the Subjects of this Fever, some have also other less intervening ones.

§ 238. When the Disease is left to itself, or injudiciously treated; or when it proves more powerful than the Remedies against it, which is by no Means seldom the Case, the Aggravations of it become longer, more frequent and irregular. There is scarcely an Interval of Ease. The Patient's Belly is swell'd out like a Foot-ball; a Delirium or Raving comes on; he proves insensible of his own Evacuations, which come away involuntarily; he rejects Assistance, and keeps muttering continually, with a quick, small, irregular Pulse. Sometimes little Spots of a brown, or of a livid Colour appear on the Surface, but particularly about the Neck, Back and Breast. All the Discharges from his Body have a most fœtid Smell: convulsive Motions also supervene, especially in the Face; he lies down only on his Back, sinks down insensibly towards the Foot of the Bed, and picks about, as if catching Flies; his Pulse becomes so quick and so small, that it cannot be perceived without Difficulty, and cannot be counted. His Anguish seems inexpressible: his Sweats stream down from Agony: his Breast swells out as if distended by Fullness, and he dies miserably.

§ 239. When this Distemper is less violent, or more judiciously treated, and the Medicines succeed well, it continues for some Days in the State described [§ 237], without growing worse, though without abating. None of these Symptoms however appear, described [§ 238]; but, on the contrary, all the Symptoms become milder, the Paroxysms, or Aggravations, are shorter and less violent, the Head-ach more supportable; the Discharges by Stool are less frequent, but more at once, and attended with Relief to the Patient. The Quantity of Urine is very considerable, though it varies at different Times in Colour and Consistence, as before. The Patient soon begins to get a little Sleep, and grows more composed and easy. The Tongue disengages itself from its Filth and Furriness, and Health gradually, yet daily, advances.

§ 240. This Fever seems to have no critical Time, either for its Termination in Recovery, or in Death. When it is very violent, or very badly conducted, it proves sometimes fatal on the ninth Day. Persons often die of it from the eighteenth to the twentieth; sometimes only about the fortieth; after having been alternately better and worse.

When it happens but in a light Degree, it is sometimes cured within a few Days, after the earliest Evacuations. When it is of a very different Character, some Patients are not out of Danger before the End of six Weeks, and even still later. Nevertheless it is certain, that these Fevers, extended to this Length of Duration, often depend in a great Measure on the Manner of treating them; and that in general their Course must be determined, some time from the fourteenth to the thirtieth Day.

§ 241. The Treatment of this Species of Fevers is comprized in the following Method and Medicines.