When agues are not properly cured, they often degenerate into obstinate chronical diseases, as the dropsy, jaundice, &c. For this reason all possible care should be taken to have them radically cured, before the constitution has been too much weakened.
Though nothing is more rational than the method of treating intermitting fevers, yet, by some strange infatuation, more charms and whimsical remedies are daily used for removing this than any other disease. There is hardly an old woman who is not in possession of a nostrum for stopping an ague; and it is amazing with what readiness their pretensions are believed. Those in distress eagerly grasp at any thing that promises sudden relief; but the shortest way is not always the best in the treatment of diseases. The only method to obtain a safe and lasting cure, is gradually to assist Nature in removing the cause of the disorder.
Some indeed try bold, or rather fool-hardy experiments to cure agues, as drinking great quantities of strong liquors, jumping into a river, &c. These may sometimes have the desired effect, but must always be attended with danger[[63]]. When there is any degree of inflammation, or the least tendency to it, such experiments may prove fatal. The only patient whom I remember to have lost in an intermittent fever, evidently killed himself by drinking strong liquor, which some person had persuaded him would prove an infallible remedy.
Many dirty things are extolled for the cure of intermitting fevers, as spiders, cobwebs, snuffings of candles, &c. Though these may sometimes succeed, yet their very nastiness is sufficient to set them aside, especially when cleanly medicines will answer the purpose better. The only medicine that can be depended upon, for thoroughly curing an intermittent fever, is the Peruvian bark. It may always be used with safety: and I can honestly declare, that in all my practice I never knew it fail, when combined with the medicines mentioned above, and duly persisted in.
Where agues are endemical, even children are often afflicted with that disease. Such patients are very difficult to cure, as they can seldom be prevailed upon to take the bark, or any other disagreeable medicine. One method of rendering this medicine more palatable, is to make it into a mixture with distilled waters and syrup, and afterwards to give it an agreeable sharpness with the elixir or spirit of vitriol. This both improves the medicine, and takes off the nauseous taste. In cases where the bark cannot be administered, the saline mixture may be given with advantage to children[[64]].
Wine-whey is a very proper drink for a child in an ague; to half an English pint of which may be put a tea-spoonful of the spirit of hartshorn. Exercise is likewise of considerable service; and when the disease proves obstinate, the child ought, if possible, to be removed to a warm dry air. The food ought to be nourishing, and sometimes a little generous wine should be allowed.
To children, and such as cannot swallow the bark, or when the stomach will not bear it, it may be given by clyster. Half an ounce of the extract of bark, dissolved in four ounces of warm water, with the addition of half an ounce of sweet oil, and six or eight drops of laudanum, in the form recommended by Dr. Lind for an adult, and this to be repeated every fourth hour, or oftener, as the occasion shall require. For children the quantity of extract and laudanum must be proportionally lessened. Children have been cured of agues by making them wear a waistcoat with powdered bark quilted between the folds of it; by bathing them frequently in a strong decoction of the bark, and by rubbing the spine with strong spirits, or with a mixture of equal parts of laudanum and the saponaceous liniment.
We have been the more full upon this disease, because it is very common, and because few patients in an ague apply to physicians unless in extremities. There are, however, many cases in which the disease is very irregular, being complicated with other diseases, or attended with symptoms which are both very dangerous and very difficult to understand. All these we have purposely passed over, as they would only bewilder the generality of readers. When the disease is very irregular, or the symptoms dangerous, the patient ought immediately to apply to a physician, and strictly to follow his advice.
To prevent agues, people must endeavour to avoid their causes. These have been already pointed out in the beginning of this section; we shall therefore only add one preventive medicine, which may be of use to such as are obliged to live in low marshy countries, or who are liable to frequent attacks of this disease.
Take an ounce of the best Peruvian bark; Virginian snake-root, and orange-peel, of each half an ounce; bruise them all together, and infuse for five or six days in a bottle of brandy, Holland gin, or any good spirit; afterwards pour off the clear liquor; and take a wine glass of it twice or thrice a day. This indeed is recommending a dram; but the bitter ingredients in a great measure take off the ill effects of the spirit. Those who do not chuse it in brandy, may infuse it in wine; and such as can bring themselves to chew the bark, will find that method succeed very well. Gentian root, or calamus aromaticus, may also be chewed by turns for the same purpose. All bitters seem to be antidotes to agues, especially those that are warm and astringent.