If the stitch continues after repeated bleedings, fomentations, &c. a blistering-plaster must be applied over the part affected, and suffered to remain for two days. This not only procures a discharge from the side, but takes off the spasm, and by that means assists in removing the cause of the disease. To prevent a strangury when the blistering-plaster is on, the patient may drink freely of the Arabic emulsion[[68]].
If the patient is costive, a clyster of thin water-gruel, or of barley-water, in which a handful of mallows, or any other emollient vegetable has been boiled, may be daily administered. This will not only empty the bowels, but have the effect of a warm fomentation applied to the inferior viscera, which will help to make a derivation from the breast.
The expectoration of spitting may be promoted by sharp, oily, and mucilaginous medicines. For this purpose an ounce of the oxymel, or the vinegar of squills, may be added to six ounces of the pectoral decoction, and two table-spoonfuls of it taken every two hours.
Should the squill disagree with the stomach, the oily emulsion may be administered[[69]]; or, in place of it, two ounces of the oil of sweet almonds, or oil of olives, and two ounces of the syrup of violets, may be mixed with as much sugar-candy powdered, as will make an electuary of the consistence of honey. The patient may take a tea-spoonful of this frequently, when the cough is troublesome. Should oily medicines prove nauseous, which is sometimes the case, two table-spoonfuls of the solution of gum ammoniac in barley-water may be given three or four times a-day[[70]].
If the patient does not perspire, but has a burning heat upon his skin, and passes very little water, some small doses of purified nitre and camphire will be of use. Two drams of the former may be rubbed with five or six grains of the latter in a mortar, and the whole divided into six doses, one of which may be taken every five or six hours, in a little of the patient’s ordinary drink.
We shall only mention one medicine more, which some reckon almost a specific in the pleurisy, viz. the decoction of the seneka rattle-snake root[[71]]. After bleeding and other evacuations have been premised, the patient may take two, three, or four table-spoonfuls of this decoction, according as his stomach will bear it, three or four times a-day. If it should occasion vomiting, two or three ounces of simple cinnamon-water may be mixed with the quantity of decoction here directed, or it may be taken in smaller doses. As this medicine promotes perspiration and urine, and likewise keeps the body easy, it may be of some service in a pleurisy, or any other inflammation of the breast.
No one will imagine that these medicines are all to be used at the same time. We have mentioned different things, on purpose that people may have it in their power to chuse; and likewise, that when one cannot be obtained, they may make use of another. Different medicines are no doubt necessary in the different periods of a disorder; and where one fails of success, or disagrees with the patient, it will be proper to try another.
What is called the crisis, or height of the fever, is sometimes attended with very alarming symptoms, as difficulty of breathing, an irregular pulse, convulsive motions, &c. These are apt to frighten the attendants, and induce them to do improper things, as bleeding the patient, giving him strong stimulating medicines, or the like. But they are only the struggles of Nature to overcome the disease, in which she ought to be assisted by plenty of diluting drink, which is then peculiarly necessary. If the patient’s strength however be much exhausted by the disease, it will be necessary at this time to support him with frequent small draughts of wine-whey, negus, or the like.
When the pain and fever are gone, it will be proper, after the patient has recovered sufficient strength, to give him some gentle purges, as those directed towards the end of the acute continual fever. He ought likewise to use a light diet, of easy digestion, and his drink should be butter-milk, whey, and other things of a cleansing nature.
Of the BASTARD PLEURISY.