[84]. The late Sir John Pringle expressed a concern lest these cautions should prevent people from attending their friends or relations when afflicted with putrid fevers. I told him I meant only to discourage unnecessary attendance, and mentioned a number of instances where putrid fevers had proved fatal to persons, who were rather hurtful than beneficial to the sick. This sagacious physician agreed with me, in thinking that a good doctor and a careful nurse were the only necessary attendants; and that all others not only endangered themselves, but generally, by their solicitude and ill-directed care, hurt the sick.
[85]. Take two ounces of the shavings of hartshorn, and the same quantity of sarsaparilla, boil them in two English quarts of water. To the strained decoction add a little white sugar, and let the patient take it for his ordinary drink.
[86]. In the commercium literarium for the year 1735, we have the history of an epidemical miliary fever, which raged at Strasburgh in the months of November, December, and January; from which we learn the necessity of a temperate regimen in this malady, and likewise that physicians are not always the first who discover the proper treatment of diseases. “This fever made terrible havock even among men of robust constitutions, and all medicine proved in vain. They were seized in an instant with shivering, yawning, stretching, and pains in the back, succeeded by a most intense heat; at the same time there was a great loss of strength and appetite. On the seventh or ninth day the miliary eruptions appeared, or spots like flea-bites, with great anxiety, a delirium, restlessness, and tossing in bed. Bleeding was fatal. While matters were in this unhappy situation, a midwife, of her own accord, gave to a patient, in the height of the disease, a clyster of rain-water and butter without salt, and for his ordinary drink a quart of spring water, half a pint of generous wine, the juice of a lemon, and six ounces of the whitest sugar, gently boiled till a scum arose, and this with great success; for the belly was soon loosened, the grievous symptoms vanished, and the patient was restored to his senses, and snatched from the jaws of death.” This practice was imitated by others with the like happy effects.
[87]. The ingenious Dr. Lind, of Edinburgh, in his inaugural dissertation concerning the putrid remitting fever of Bengal, has the following observation: “Indusia, lodices, ac stragula, sæpius sunt mutanda, ac aëri exponenda; fœces sordesque quam primum removendæ; oportet etiam ut loca quibus ægri decumbunt sint salubria, et aceto conspersa; denique ut ægris cura quanta maxima prospiciatur. Compertum ego habeo, medicum hæc fedulo observantem, quique ea exequi potest, multo magis ægris profuturum, quam medicum peritiorem hisce commodis destitutum.”
“The patient’s shirt, bed-clothes, and bedding, ought frequently to be changed, and exposed to the air, and all his excrements immediately removed; the bed-chamber should be well ventilated, and frequently sprinkled with vinegar; in short, every attention should be paid to the patient. I can affirm, that a physician who puts these in practice will much oftener succeed than one who is even more skilful, but has not opportunity of using these means.”
[88]. Convulsion-fits are no doubt very alarming, but their effects are often salutary. They seem to be one of the means made use of by Nature for breaking the force of a fever. I have always observed the fever abated, and sometimes quite removed, after one or more convulsion-fits. This readily accounts for convulsions being a favourable symptom in the fever which precedes the eruption of the small-pox, as every thing that mitigates this fever lessens the eruption.
[89]. I have known a nurse, who had the small-pox before, so infected by lying constantly a-bed with a child in a bad kind of small-pox, that she had not only a great number of pustules which broke out all over her body, but afterwards a malignant fever, which terminated in a number of imposthumes or boils, and from which she narrowly escaped with her life. We mention this to put others upon their guard against the danger of this virulent infection.
[90]. This observation is likewise applicable to hospitals, workhouses, &c. where numbers of children happen to have the small-pox at the same time. I have seen above forty children cooped up in one apartment all the while they had this disease, without any of them being admitted to breathe the fresh air. No one can be at a loss to see the impropriety of such conduct. It ought to be a rule, not only in hospitals for the small-pox, but likewise for other diseases, that no patient should be within sight or hearing of another. This is a matter to which too little regard is paid. In most hospitals and infirmaries, the sick, the dying, and the dead, are often to be seen in the same apartment.
[91]. Though this operation can never do harm, yet it is only necessary when the patient has a great load of small-pox, or when the matter which they contain is of so thin and acrid a nature, that there is reason to apprehend bad consequences from its being too quickly resorbed, or taken up again into the mass of circulating humours.
[92]. I have of late been accustomed, after the small-pox, to give one, two, three, four, or five grains of calomel, according to the age of the patient, over night, and to work it off next morning with a suitable dose of jalap.