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

by S. A. D. Tissot

§ 330. The Dysentery is often epidemical; beginning sometimes at the End of July, though oftner in August, and going off when the Frosts set in. The great preceding Heats render the Blood and the Bile acrid or sharp; and though, during the Continuance of the Heat, Perspiration is kept up (See Introduct. P. 28) yet as soon as the Heat abates, especially in the Mornings and Evenings, that Discharge is diminished; and by how much the more Viscidity or Thickness the Humours have acquired, in Consequence of the violent Heats, the Discharge of the sharp Humour by Perspiration being now checked, it is thrown upon the Bowels which it irritates, producing Pains in, and Evacuations from them.

This Kind of Dysentery may happen at all Times, and in all Countries; but if other Causes, capable of producing a Putridity of the Humours, be complicated with it; such as the crouding up a great Number of People into very little Room, and very close Quarters, as in Hospitals, Camps, or Prisons, this introduces a malignant Principle into the Humours, which, co-operating with the simpler Cause of the Dysentery, renders it the more difficult and dangerous.

§ 331. This Disease begins with a general Coldness rather than a Shivering, which lasts some Hours; the Patient's Strength soon abates, and he feels sharp Pains in his Belly, which sometimes continue for several Hours, before the Flux begins. He is affected with Vertigos, or Swimmings in the Head, with Reachings to vomit, and grows pale; his Pulse at the same Time being very little, if at all, feverish, but commonly small, and at length the Purging begins. The first Stools are often thin, and yellowish; but in a little Time they are mixt with a viscid ropy Matter, which is often tinged with Blood. Their Colour and Consistence are various too, being either brown, greenish or black, thinner or thicker, and fœtid: The Pains increase before each of the Discharges, which grow very frequent, to the Number of eight, ten, twelve or fifteen in an Hour: then the Fundament becomes considerably irritated, and the Tenesmus (which is a great Urgency to go to Stool, though without any Effect) is joined to the Dysentery or Flux, and often brings on a Protrusion or falling down of the Fundament, the Patient being now most severely afflicted. Worms are sometimes voided, and glairy hairy Humours, resembling Pieces or Peelings of Guts, and sometimes Clots of Blood.

If the Distemper rises to a violent Height, the Guts become inflamed, which terminates either in Suppuration or in Mortification; the miserable Patient discharges Pus, or black and fœtid watery Stools: the Hiccup supervenes; he grows delirious; his Pulse sinks; and he falls into cold Sweats and Faintings which terminate in Death.

A kind of Phrenzy, or raging Delirium, sometimes comes on before the Minute of Expiration. I have seen a very unusual Symptom accompany this Disease in two Persons, which was an Impossibility of swallowing, for three Days before Death.

But in general this Distemper is not so extremely violent; the Discharges are less frequent, being from twenty-five to forty within a Day and Night. Their Contents are less various and uncommon, and mixed with very little Blood; the Patient retains more Strength; the Number of Stools gradually decrease; the Blood disappears; the Consistence of the Discharges improves; Sleep and Appetite return, and the Sick recovers.

Many of the Sick have not the least Degree of Fever, nor of Thirst, which perhaps is less common in this Disease, than in a simple Purging or Looseness.

Their Urine sometimes is but in a small Quantity; and many Patients have ineffectual Endeavours to pass it, to their no small Affliction and Restlessness.

§ 332. The most efficacious Remedy for this Disease is a Vomit. That of [Nº. 34], (when there is no present Circumstance that forbids the giving a Vomit) if taken immediately on the first Invasion of it, often removes it at once; and always shortens its Duration. That of [Nº. 35] is not less effectual; it has been considered for a long Time, even as a certain Specific, which it is not, though a very useful Medicine. If the Stools prove less frequent after the Operation of either of them, it is a good Sign; if they are no Ways diminished, we may apprehend the Disease is like to be tedious and obstinate.

The Patient is to be ordered to a Regimen, abstaining from all Flesh-meat with the strictest Attention, until the perfect Cure of the Disease. The Ptisan [Nº. 3] is the best Drink for him.