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

by S. A. D. Tissot

§ 244. The Causes of this Disease are a long Use of animal Food or Flesh alone, without Pulse, Fruits or Acids; the continued Use of other bad Provisions, such as Bread made of damaged Corn or Grain, or very stale Meat. Eight Persons, who dined together on corrupt Fish, were all seized with a malignant Fever, which killed five of them, notwithstanding the Endeavours of the most able Physicians. These Fevers are also frequently the Consequence of a great Dearth or Famine; of too hot and moist an Air, or an Air, which highly partakes of these two Qualities; so that they happen to spread most in hot Years, in Places abounding with Marshes and standing Waters. They are also the Effect of a very close and stagnant Air, especially if many Persons are crouded together in it, this being a Cause that particularly tends to corrupt the Air. Tedious Grief and Vexation also contribute to generate these Fevers.

§ 245. The Symptoms of malignant Fevers are, as I have already observed, a total and sudden Loss of Strength, without any evident preceding Cause, sufficient to produce such a Privation of Strength: at the same Time there is also an utter Dejection of the Mind, which becomes almost insensible and inattentive to every Thing, and even to the Disease itself; a sudden Alteration in the Countenance, especially in the Eyes: some small Shiverings, which are varied throughout the Space of twenty-four Hours, with little Paroxysms or Vicissitudes of Heat; sometimes there is a great Head-ach and a Pain in the Loins; at other Times there is no perceivable Pain in any Part; a kind of Sinkings or Faintings, immediately from the Invasion of the Disease, which is always very unpromising; not the least refreshing Sleep; frequently a kind of half Sleep, or Drowsiness; a light and silent or inward Raving, which discovers itself in the unusual and astonished Look of the Patient, who seems profoundly employed in meditating on something, but really thinks of nothing, or not at all: Some Patients have, however, violent Ravings; most have a Sensation of Weight or Oppression, and at other Times of a Binding or Tightness about, or around, the Pit of the Stomach.

The sick Person seems to labour under great Anguish: he has sometimes slight convulsive Motions and Twitchings in his Face and his Hands, as well as in his Arms and Legs. His Senses seem torpid, or as it were benumbed. I have seen many who had lost, to all Appearance, the whole five, and yet some of them recover. It is not uncommon to meet with some, who neither see, understand, nor speak. Their Voices change, become weak, and are sometimes quite lost. Some of them have a fixed Pain in some Part of the Belly: this arises from a Stuffing or Obstruction, and often ends in a Gangrene, whence this Symptom is highly dangerous and perplexing.

The Tongue is sometimes very little altered from its Appearance in Health; at other Times covered over with a yellowish brown Humour; but it is more rarely dry in this Fever than in the others; and yet it sometimes does resemble a Tongue that has been long smoaked.

The Belly is sometimes very soft, and at other Times tense and hard. The Pulse is weak, sometimes pretty regular, but always more quick than in a natural State, and at some Times even very quick; and such I have always found it, when the Belly has been distended.

The Skin is often neither hot, dry, nor moist: it is frequently overspread with petechial or eruptive Spots (which are little Spots of a reddish livid Colour) especially on the Neck, about the Shoulders, and upon the Back. At other Times the Spots are larger and brown, like the Colour of Wheals from the Strokes of a Stick.

The Urine of the Sick is almost constantly crude, that is of a lighter Colour than ordinary. I have seen some, which could not be distinguished, merely by the Eye, from Milk. A black and stinking Purging sometimes attends this Fever, which is mortal, except the Sick be evidently relieved by the Discharge.

Some of the Patients are infested with livid Ulcers on the Inside of the Mouth, and on the Palate. At other Times Abscesses are formed in the Glands of the Groin, of the Arm-pit, in those between the Ears and the Jaw; or a Gangrene may appear in some Part, as on the Feet, the Hands, or the Back. The Strength proves entirely spent, the Brain is wholly confused: the miserable Patient stretched out on his Back, frequently expires under Convulsions, an enormous Sweat, and an oppressed Breast and Respiration. Hæmorrhages also happen sometimes and are mortal, being almost unexceptionably such in this Fever. There is also in this, as in all other Fevers, an Aggravation of the Fever in the Evening.

§ 246. The Duration and Crisis of these malignant, as well as those of putrid Fevers, are very irregular. Sometimes the Sick die on the seventh or eighth Day, more commonly between the twelfth and the fifteenth, and not infrequently at the End of five or six Weeks. These different Durations result from the different Degree and Strength of the Disease. Some of these Fevers at their first Invasion are very slow; and during a few of the first Days, the Patient, though very weak, and with a very different Look and Manner, scarcely thinks himself sick.

The Term or Period of the Cure or the Recovery, is as uncertain as that of Death in this Distemper. Some are out of Danger at the End of fifteen Days, and even sooner; others not before the Expiration of several Weeks.