The food must be light, as panado or groat-gruel, to which a little wine may be added, if the patient be weak and low; and they ought all to be sharpened with the juice of orange, the jelly of currants, or the like. The patient ought likewise to eat freely of ripe fruits, as roasted apples, currant or gooseberry tarts, preserved cherries, or plums, &c.
Taking a little food or drink frequently, not only supports the spirits, but counteracts the putrid tendency of the humours; for which reason the patient ought frequently to be sipping small quantities of some of the acid liquors mentioned above, or any that may be more agreeable to his palate, or more readily obtained.
If he is delirious, his feet and hands ought to be frequently fomented with a strong infusion of camomile flowers. This, or an infusion of the bark, to such as can afford it, cannot fail to have a good effect. Fomentations of this kind not only relieve the head, by relaxing the vessels in the extremities, but as their contents are absorbed, and taken into the system, they may assist in preventing the putrescency of the humours.
MEDICINE.——If a vomit be given at the beginning of this fever, it will hardly fail to have a good effect; but if the fever has gone on for some days, and the symptoms are violent, vomits are not quite so safe. The body however is always to be kept gently open by clysters, or mild laxative medicines.
Bleeding is seldom necessary in putrid fevers. If there be signs of an inflammation, it may sometimes be permitted at the first onset; but the repetition of it generally proves hurtful.
Blistering plasters are never to be used unless in the greatest extremities. If the petechiæ or spots should suddenly disappear, the patient’s pulse sink remarkably, and a delirium, with other bad symptoms, come on, blistering may be permitted. In this case the blistering plasters are to be applied to the head, and inside of the legs or thighs. But as they are sometimes apt to occasion a gangrene, we would rather recommend warm cataplasms or poultices of mustard and vinegar to be applied to the feet, having recourse to blisters only in the utmost extremities.
It is common in the beginning of this fever to give the emetic tartar in small doses, repeated every second or third hour, till it shall either vomit, purge, or throw the patient into a sweat. This practice is very proper, provided it be not pushed so far as to weaken the patient.
A very ridiculous notion has long prevailed, of expelling the poisonous matter of malignant diseases by trifling doses of cordial or alexipharmic medicines. In consequence of this notion, the contrayerva-root, the cordial confection, the mithridate, &c. have been extolled as infallible remedies. There is reason however to believe, that these seldom do much good. Where cordials are necessary, we know none that is superior to good wine; and therefore again recommend it both as the safest and best. Wine, with acids and antiseptics, are the only things to be relied on in the cure of malignant fevers.
In the most dangerous species of this disease, when it is attended with purple, livid, or black spots, the Peruvian bark must be administered. I have seen it, when joined with acids, prove successful, even in cases where the petechiæ had the most threatening aspect. But, to answer this purpose, it must not only be given in large doses, but duly persisted in.
The best method of administering the bark is certainly in substance. An ounce of it in powder may be mixed with half an English pint of water, and the same quantity of red wine, and sharpened with the elixir or the spirit of vitriol, which will both make it sit easier on the stomach, and render it more beneficial. Two or three ounces of the syrup of lemon may be added, and two table-spoonfuls of the mixture taken every two hours, or oftener, if the stomach is able to bear it.