A miliary eruption sometimes breaks out about the ninth or tenth day. As eruptions are often critical, great care should be taken not to retard Nature’s operation in this particular. The eruption ought neither to be checked by bleeding nor other evacuations, nor pushed out by a hot regimen; but the patient should be supported by gentle cordials, as wine-whey, small negus, sago-gruel with a little wine in it, and such like. He ought not to be kept too warm; yet a kindly breathing sweat should by no means be checked.
Though blistering and the use of cordial liquors are the chief things to be depended on in this kind of fever; yet, for those who may chuse to use them, we shall mention one or two of the forms of medicine which are commonly prescribed in it[[81]].
In desperate cases, where the hiccup and starting of the tendons have already come on, we have sometimes seen extraordinary effects from large doses of musk frequently repeated. Musk is doubtless an antispasmodic, and may be given to the quantity of a scruple three or four times a-day, or oftener if necessary. Sometimes it may be proper to add to the musk a few grains of camphire, and salt of hartshorn, as these tend to promote perspiration and the discharge of urine. Thus fifteen grains of musk, with three grains of camphire, and six grains of salt of hartshorn, may be made into a bolus with a little syrup, and given as above.
If the fever should happen to intermit, which it frequently does towards the decline, or if the patient’s strength should be wasted with colliquative sweats, &c. it will be necessary to give him the Peruvian bark. Half a drachm, or a whole drachm, if the stomach will bear it, of the bark in fine powder, may be given four or five times a-day in a glass of red port or claret. Should the bark in substance not sit easy on the stomach, an ounce of it in powder may be infused in a bottle of Lisbon or Rhenish wine for two or three days, afterwards it may be strained, and a glass of it taken frequently[[82]].
Some give the bark in this and other fevers, where there are no symptoms of inflammation, without any regard to the remission or intermission of the fever. How far future observations may tend to establish this practice, we will not pretend to say; but we have reason to believe that the bark is a very universal febrifuge, and that it may be administered with advantage in most fevers where bleeding is not necessary, or where there are no symptoms of topical inflammation.
CHAP. XX.
OF THE MALIGNANT, PUTRID, OR SPOTTED FEVER.
This may be called the pestilential fever of Europe, as in many of its symptoms it bears a great resemblance to that dreadful disease the plague. Persons of a lax habit, a melancholy disposition, and those whose vigour has been wasted by long fasting, watching, hard labour, excessive venery, frequent salivations, &c. are most liable to it.
CAUSES.——This fever is occasioned by foul air, from a number of people being confined in a narrow place, not properly ventilated; from putrid animal and vegetable effluvia, &c. Hence it prevails in camps, jails, hospitals and infirmaries, especially where such places are too much crowded, and cleanliness is neglected.
A close constitution of the air, with long rainy or foggy weather, likewise occasions putrid fevers. They often succeed great inundations in low and marshy countries, especially when these are preceded or followed by a hot and sultry season.
Living too much upon animal food, without a proper mixture of vegetables, or eating fish or flesh that has been kept too long, are likewise apt to occasion this kind of fever. Hence sailors on long voyages, and the inhabitants of besieged cities, are very often visited with putrid fevers.