THEIR METHOD OF CURE. Having in the foregoing said what I thought most material to be observed in fevers, as the universal disorder that attends almost every ailment in the human body, I shall for regularity sake, treat on the most material diseases, as they may seem to follow in order in the various divisions of the human body; and be as concise in their description and cure, as their nature will admit of.
SECT. I.
Of Diseases of the Head,
Of the Apoplexy.
The apoplexy is a disease, wherein the patient falls down motionless, void of sense and sensation, and is, in fact, a temporary death. It will scarce however admit of a strict definition; for there are not only various degrees of this disorder, but even different disorders under the same denomination, that have quite distinct different causes for their effect. Many indeed may be accounted for, but many more cannot.
The brain is the root of the nerves, and consequently the fountain of all sensation, and life itself. That part of the human fabric is extremely delicate, and blood vessels plentifully distributed. When therefore these vessels become either so distended with blood, so as to press the substance of the brain, that it is hindered from its motion, confusion to the animal oeconomy must naturally ensue; thence an apoplexy in its various gradations is liable to be the consequence; but as the vessels in such a distention are liable to break, and the extravasated blood pressing the brain more forcibly without a chance of dispersing, we plainly see one reason, why such a malady is apt to turn out fatal, as we find it sometimes does.
Such causes may either proceed from external, or internal injuries; thence we see that a heavy fall, or contusion on the head, may occasion an apoplexy, or at other times, a congestion of blood to the head may produce the same malady.
Sometimes the patient is motionless; and to all appearance dead, and nothing but a faint pulsation remains; at other times there is indeed more signs of life, but more terrible in appearance,—namely a convulsive breathing and foaming at the mouth, without the least signs of sensation or perception; in which case there is much to be feared, that vessels in the brain are burst.
However in all these extremities, nothing can contradict the indication of bleeding, except extreme weakness, and debility of the system; which here is very rarely the case.—After bleeding, a large blister between the shoulders should immediately be applied, and treated as directed in the second lecture, page 75.—A draught like No. XXX. will also be of singular service, till the patient comes to; after which he will require such treatment as is directed under fevers; for that disorder will always attend the shock that the apoplexy gives to the animal system.
Of the Frenzy and Delirium.
When the root of the nerves are stimulated by acrimony, so as to heighten their sensibility, or set their regulated perception in confusion, the ideas become bewildered, and the sensations act at random. This is generally the case with patients in acute and malignant fevers; and this conception differs from dreaming in this respect, that the phantoms of the confused imagination may be somewhat guided by the objects around them; as they may be said to dream with their eyes open and full awake.
When the frenzy attends acute fevers, the blood is generally in a great confusion, and the pulse high and fluctuating. Yet bleeding should by all means be avoided, unless indeed the disorder has come on remarkably sudden. Blisters here are requisite; and in order to take off the stimulus of the nerves, give the patient the following draught.
No. XXXI
Take Fever Powder (L) one Scruple; Liquid Laudanum, (T) ten Drops; Spirit of Wine and Camphor (A) twenty Drops; Essential Oil of Peppermint (U), four Drops upon a lump of Sugar; Water half a Tea Cup full.
This draught may be taken every fourth or sixth hour; and now and then a grain of calomel may with great success be added to it. Cooling clysters in this case are also of singular service; for example:
No. XXXII
Take cold water, eight ounces; Nitre, or instead of this[16] Fever Powder (L) two drachms; spirits of Camphor (A) thirty drops, mix them.
If the patient is very costive, a little honey and soap may be added, previously dissolved; which will both open the body, and promote urine.
For the rest, every method must be taken as is already observed in fevers.
Of a Stupor, and Lethargy.
This is a symptomatic affliction, that attends acute and malignant fevers, in its nature quite opposite to the former; in which the nervous system is benumbed, and have lost their sensation; this is very apt to succeed, but seldom precede the Frenzy. When a patient lays in that kind of stupefaction in a continual dosing, there is in general little hopes of recovery; nevertheless remedies must be applied.
Blisters here are very proper, and these should be pretty large. Horse radish should be frequently held to the nose, which has a reviving quality, and is very innocent with respect of adding acrimony to the system.
A vomit has often in this extremity proved very beneficial; which the patient’s weakness should not retard, unless very weak and near the end indeed. The following draught may also prove highly beneficial.
No. XXXIII
Take Sweet Spirit of Nitre (D) one drachm; Essential Oil of Peppermint (U) ten drops upon a lump of sugar; water one ounce, mix them.
Let the patient take this every four or six hours, till he comes to himself again:
But care should be taken that a good sound sleep, is not mistaken for a stupor; for it frequently happens that a patient upon a favourable crisis will fall into a long sound deep, that terminates all his danger; if therefore the patient breathes freely, and has a moistness all over the body, together with a tolerable regular pulse, disturb him not; but let nature finish her gracious work.—This kind of sleep is materially different from the stupor, wherein the patient neither sleeps nor wakes, but is equally insensible when the eyes are open, as when they are shut.
Of a Violent Head-Ach.
A Violent head-ach often attends fevers, or comes spontaneously without; it generally precedes a delirium, as the irritation of the nerves is the principal cause thereof.
The first intention must be to draw the humours from the head. A compress with vinegar, in which is dropt a little spirits of wine and camphor, is of great service, and will often have the defined effect to carry it off. Warm foot-baths also is of great use; a blister may be applied, and the draught No. XXXIV. will also prove of great service.
The head-ach may proceed from many other different causes, and in the general is only a symptomatic affection; therefore particular attention should be had to the primitive seat of the disorder.—Frequently a foul stomach will occasion the head-ach, and a vomit most times prove the best application.
SECT. II.
Of Diseases of the Neck
The diseases in that part, are indeed very numerous; but as they have so strict a connexion amongst themselves, the classes may be considered but very few; of which some have been already taken notice of.
Of the malignant Sore Throat.
Every body who is liable to catch cold, is frequently apt to have a hoarseness and consequently in some degree, more or less, a sore throat. If a fever attends it, methods should be used accordingly, as is mentioned under the head of colds: with respect to the throat, use the gargle, No. XVIII. pretty frequently, and the disorder will soon go off again.
But when an ulcerated sore throat is attended with a malignant fever and inflammation, it is called a quincey; this case is alarming, and requires very careful treatment; for first we must observe, that the larynx is of a very complicate and curious structure; and secondly, it is composed of various, and delicate materials; namely, cartilages, membranes, muscles, and glands.
The glands are very numerous in the various parts of the composition, whence the inflammation becomes not only painful, but is apt to swell up and obstruct respiration; wherefore an inflammation in such parts becomes highly dangerous to the life of the patient.
When the patient perceives a burning pain in the throat, and the parts all round swell up, respiration becoming difficult, add to this a hoarseness, great difficulty in swallowing, there is no time to lose, for immediate assistance is wanting.
Bleeding is indispensably necessary, particularly if the inflammation is sudden; warm foot-bathing also is highly requisite; to remove the humours downwards; a gargle should also immediately be applied like the foregoing No. XVIII. with the addition of a little camphor spirits. Externally apply the poultice, No. II. and give the following draught.
No. XXXIV
Take fever powder (L), one scruple; calomel (N), two grains; liquid laudanum (T), twelve drops; water two spoonfuls; mix it into a draught.
This may be given every six hours, for two days successively; and this generally will break the disorder. The patient should be made to drink as freely as he possibly can; and perspiration should ever be promoted. A blister as the case requires, may also be used with much advantage. If the body is bound, clysters may tend to incline the humours to be drawn down from the part.
No. XXXV
Take Glauber’s salts (19), one ounce and a half; honey (E), one spoonful; hot water, a pint and a half.
Sometimes the inflammation is so very great, as to choak up both the passage of respiration, as well as that of deglutition; so that the poor afflicted patient can neither breathe, nor swallow; and is not only liable to be suffocated, but even starved to death, besides the danger from the malignant inflammation.
In this exigency, have recourse to the following simple but excellent remedy.
No. XXXVI
Take a pipkin, or a tin sauce-pan, with a quart of water, a pint of vinegar, and two spoonfuls of honey; then take a funnel that will pretty well cover the vessel; then take a piece of iron, or some old nails, or a little stone, or what you have handy; heat it red hot, and put it into the pipkin, and put on the funnel so that steam may ascend through it. Over this let the patient hold his mouth, so that he breathes nothing but the steam; and to secure it the better, put something over his head, that he may reap the more the benefit of it. When the steam ceases, heat it again as before. Instead of heating it with the iron, it may be shifted with boiling, but the former is generally more handy.
In the mean time, if the patient should by the inflammation, be deprived of all nutriment, recourse must be had to nourishing clysters: milk in this respect is the best; but in want of that, fowl broth may be used; and if that is wanting, take water gruel. Milk however is superior to all: I shall give a receipt of each kind.
No. XXXVII
Take milk and water, of each a pint; cinamon (16), one drachm; boil them and strain the liquor; then dissolve one ounce and an half of good loaf sugar; add six drops, of the essential oil of peppermint (U), upon a little lump of sugar.
No. XXXVIII
Take half a fowl, bruise the bones, and cut the flesh small; this boil in three pints of fresh water, with about one drachm of cinamon; strain it clear, and add as before, an ounce of sugar, with a few drops of the oil of peppermint.—A tea cupful of good white wine may be added, if the patient is very weak, and not feverish.
No. XXXIX
Take oatmeal, two spoonfuls; malt, one spoonful; cinamon, two drachmes. Boil it in two quarts of water for some time, till when it is strained, it becomes one quart; put to it fine sugar, six ounces; a few drops of essential oil of peppermint, and a tea cupful of good wine.
These clysters are perfectly safe, and very nourishing. Some have added salt to the animal broth, perhaps through a notion to make it the more palatable, and so of course more nourishing; but probably they forget that the part they are now about to feed, differs widely from the depraved taste of the palate.
Salt is stimulating; besides, it indurates the aliment, that it never yields so much nourishment, because it always opposes assimulation; and it is universally known, that salt victuals is by far, less nourishing than fresh.
The quincey is sometimes so desperate, as to strangle the afflicted patient, particularly if assistance is given too late; in so much that bronchotomy, or opening the wind-pipe, has been the last resource in this deplorable dilemma. I have mentioned this operation, in the third lecture, and have only to observe, that in this case little hope is left after that operation, on account of the great inflammation of the parts; though we have instances of its success. If however the method which I have here laid down, together with strict observance of managing fevers is duly observed, there can scarce be a failure of success; for if I may be allowed to judge from my own experience and success, it is merely neglect, in the first setting out of these diseases, that for the most part, renders them so very desperate and mortal.
SECT. III.
Of Diseases in the Breast
Under this head, I mean principally to treat of diseases of the wind-pipe, the lungs, and the pleura, or membrane that lines the cavity of the breast, and encompasses the lungs.
Of the Cough.
A Cough is generally occasioned by a cold; unless it is symptomatic with other inflammatory diseases, or the relict of a heavy sickness; in which case, it is either near a-kin to, or else the consumption itself.
If from a cold, it seldom is deep founded, and generally has its seat in the larynx, or in the wind-pipe; though indeed sometimes in the lungs.
It generally begins first with a tickling in the throat, and occasions a short dry cough; which gradually becomes strong, and is attended with a discharge.
It is surprizing what absurd remedies are sometimes given for the cough; as if they supposed that every thing taken should immediately march at the word of command into the wind-pipe, and there set to work accordingly. Amongst the many celebrated nostrums, spermaceti, or whales fat is remarkably celebrated; it softens the phlegm say they; but in fact, a little fat pork, or hog’s lard will do equally as much good.——The truth of the matter is, the cough proceeds from an obstructed perspiration. When a person gets cold, he generally first feels a snuffling, and obstruction in the nose, then a sore throat or hoarseness, and lastly a cough; all which is a gradual defluxion from the pituitous membrane, which reaches from the cavity of the nose, all down the lungs. Whatever medicines therefore, are capable of yielding benefit, must be calculated to open and remove the obstruction, and promote universal perspiration; whence therefore we find it is impossible to cure one, without the other.—Medicines neither do, nor is it fit they should come immediately farther, than the top of the larynx; for if they happen to come into the wind-pipe, the most innocent medicine would certainly act the part of a poison.
The first indication therefore in a cough, is to promote perspiration; for then nature will repair the respirative organs with the rest.
Let the patient take a draught or two of good sage punch, No. V. and thereby promote perspiration; and in order to continue this principal intention, and to assuage the slight inflammation in the throat, which the heavy cough occasions; make the following electuary.
No. XL
Take honey, or sugar dissolved to syrup, two ounces; lemon juice, half an ounce; or elixir of vitriol, two drachmes; sweet oil, one ounce; mix them into a linctus.
Take of this, every half hour, but half a tea spoonful; and swallow it gradually, so that it may as it slides by, do some service to the larynx; and keeping the body all the time in a gentle perspiration. This method is superior to all your nonsensical pectorals, which have nothing but quackery for their foundation; for whatever you may take for the cough, it cannot possibly have any other effect on the part, till the real cause is removed, than barely to touch the larynx; for all goes to the stomach, and undergoes the same chance as your victuals. Therefore strike at the root of the evil; namely, to promote perspiration; and all the rest of the complaints will vanish, in consequence of this principal intention.
Of the Pleurisy, and Peripneumony.
The pleurisy is an inflammation of the lining of the inside of the pectoral cavity and lungs; and the peripneumony an inflammation of the lungs themselves.
These two principal kinds of inflammation have given birth to the names of many other inflammations contiguous to those parts, which I hope to be excused from entering into, as it is of very little signification to the proper treatment of those disorders; for I have often known the most skilful practitioner, to be mistaken of these disorders in his diagnostics, and yet been successful in his cure. The signs of this inflammatory disease, is an acute fixt pain in the breast; on whatever side the disorder is in, with a difficulty of breathing, and frequently attended with a small short dry cough, which however stings the patient like so many daggers. A constant fever attends with all its symptoms; which adds greatly to the patient’s misery.
On the immediate signs of these symptoms, bleeding must be had recourse to; and if the inflammation is great, and the pain pungent, it must be repeated; though with skilful management. Bleeding may be repeated after the first twenty-four hours; yet in general it is needless, and sometimes dangerous; for my own part, I never approved of it; nor have I seen any necessity for it. Perspiration however should be promoted.
If the pain is violent, let the patient use the following medicine.
No. XLI
Take sweet Spirit of Nitre (D) twenty drops; Spirit of Wine and Camphor (A) ten drops; Fever Powder (L) one scruple; mix it up with sugar and water into a draught.
Let the patient take this every six hours; if there is a great nausea at the stomach, a small vomit of twelve grains of Ipecacuanha, (S) may be given first, notwithstanding it is great pain to the patient; and I have often known it productive of great good, and laid the first foundation to a successful cure.
If the pain still continues, twelve drops of liquid laudanum (T) may be added to the above draught; No. XLI. If the spirits of the patient is low, give the essential oil of Peppermint (U) to the quantity of three or four, or six drops upon a lump of sugar, either put, into the draught above-mentioned, or give it by itself occasionally.
To the inflamed side, warm cloths may be put wrapt up with a hot made trencher, brick, a bag of sand, or whatever will retain heat; as that will greatly facilitate the internal resolution.
Perspiration is the principal object to be considered in this acute disease, and should therefore be promoted; but every thing forcing that produces profuse sweats should be avoided, as that only encreases the fever.
If the patient is very restless, the fever depressed, and greatly oppressed in respiration, blisters may be applied; but if the patient can do without them, it is much better; as they very often are apt to encrease the inflammation.
Cooling clysters, No. XXXII. which at the same time promote urine, is of singular service; and in every respect methods must be taken, as have been directed in fevers, and the ulcerated sore throat; as all these inflammatory diseases are of one nature, and require almost one method of treatment. For farther particulars on this head, see my treatise on diseases of the lungs.
SECT. IV.
Of Diseases of the Bowels, and the Alimentary Canal
Diseases of mankind under this head are very numerous indeed; which are for the most part owing to their deviating too much from the common path of nature. But besides all this, seamen are particularly liable; not so much indeed on account of luxury as the confined diet, and the different climates they visit.
I shall in this be as concise as the subject will admit of, and confine myself to such diseases as occur most commonly; and by which others that are here omitted, may be understood.
Of a Depraved Appetite.
There is nothing that people in general are more apt to fly to, when appetite fails them, than bitters; but if we consider what bitters really are, and by what means they act in the alimentary canal, we shall find them, either only to stimulate the coat of the stomach, or else add to the strength of the bile.
But generally the default of a bad appetite is a pituitous slime in the stomach, that prevents this viscera from performing its part towards assimilation; and therefore we generally find that such stimulants only spur it on for a little while longer, till at length it loses its tone, so as to be wholly unable to prepare the food for a good nutrition; or else the stomach becomes so used to these forcing stimulants, as not to be able to do without them.
But this is not all; for in bilious complaints, when the stomach is most disordered, bitters never fail of making evil worse. The stomach is a delicate viscera, and should ever be the most cautiously dealt with. Whatever part of the human body is in exquisite pain, the stomach from the nervous consent always partakes, and is apt to be depraved in its functions; whence a nausea is liable to ensue; and in such a case any stimulants, particularly where bitters are concerned, is ever of evil tendency.
In general however, a vomit is what nature points out; and which gives not only relief to the stomach, but assists in giving a general effort to the whole animal fabric. In short, there are so very few cases where bitters are of any benefit at all, except where the stomach has injuriously been used to those stimulants, that I have entirely exploded them from my catalogue; being persuaded that every body will do better without them.
When the stomach loaths victuals, the mouth is slimy, has a bitterish taste, and attended with sour belching, and the victuals siting heavy on the stomach, nothing is preferable to a vomit.
This I know has also been carried into abuse, as well as many other good medicines.——Yet that should be no rule; for if a vomit is properly and timely given, it will ever be attended with success. Take here the following direction for a foul stomach.
First take a vomit, and work it well off with bare luke warm water; then take every night, or when going to rest, a dose of stomach powder (M). If the stomach seems very weak, add a few drops of the essential oil of peppermint (U), which will soon convince you of the good effects.
If you require a stimulant in the morning, take Turlington’s balsam (W), about a tea spoonful in a glass of wine, previously put on a lump of sugar, that it may the better incorporate: which is a good stomachic, and ever preferable to the customary bitters.
Dram drinking is another pernicious custom, whereby many have been sent to eternity long before the period of life prescribed by nature; and of which I would advise every man, who has the least regard for his health, to beware, as of a deadly poison.
On the whole, the want of appetite is what many complain of without reason. Some fancy themselves very bad, because they cannot eat their breakfast; those I would advise to stay till dinner time; others again have no appetite for their dinner, unless they wet their stomach with a glass of Stoughton, or some other bitters: Those should eat nothing in the morning, or else stay till supper time.——In short, nature should be consulted, both in the state of health, as well as in diseases, and her salutary dictates should be followed.
The custom of seasoning victuals with strong stimulating condiments is often prejudicial, and nothing should be used with more moderation; for though it may warm and stimulate the stomach, yet, it frequently gives cause to great weaknesses, and generally are the primitive causes of chronic distempers; as it hurries on the chylefaction, and thence is apt to feed the blood with many acrimonious humours.
This little dissertation on depraved appetite I hope will suffice, and doubt not if attended to, that health and longevity will become the intimate acquaintances of the man who wishes to enjoy their blessings.
Of the Colic.
If we consider the length of the ailmentary canal from the mouth to the anus, namely six times the length of the subject they belong to; and if we consider the delicacy of its substance, as also, the office for which it is ordained; we shall not at all wonder, that so many disorders are incident to mankind in that part.
The colic however is the general term for various painful sensations in the intestines; though the causes as well as the seat, and the manner of its affecting the system, is materially different.
The general cause however, is a stimulant, which irritating the inner coat of the intestines to constriction; and whence a spasmodic contraction, and a perverted peristaltic motion is produced.
If the stomach is affected with the pain of the colic, so that a nausea and reaching attends, or has been previously felt, a vomit is the first, and most expedient method to be had recourse to; for by this, not only the crudities in the stomach gets disburdened, but from the joint action on the internal canal, a stool or two is generally produced, by which frequently the offending acrimony is carried off.
When however this avails not sufficiently, and the pain rather increases, particularly if the body at the same time is costive, recourse should be had to clysters; for purges in this case, do not operate speedily enough, and in cases of costiveness, is not always safe. The clyster No. XXIII. may be of great benefit, and if necessity requires it, occasionally repeated.
But more frequently, it is from a nervous affection, and then carminatives prove the most effectual; in such cases give the following,
No. XLII
Take essential oil of peppermint (U), six drops on a lump of sugar; elixir proprietatis (H), five large tea spoonfuls; wine or water, half a tea cupful.
Let the patient take this immediately; a little Turlington’s balsam (W) about a tea spoonful, also is very beneficial. If the pain still continues violent; let ten or twelve drops of liquid laudanum (T), be added. Clysters should not be neglected, but plentifully administered; the same medicines as is given to the patient, may also be added to the clyster.
The dry belly-ach, is a spasmodic contraction of the intestines, and throws the patient into the greatest misery imaginable; clysters is the only recourse and anodynes, together with gentle mercurials will likewise prove beneficial; warm clothes and something that can retain the warmth should constantly be put to the bowels; and in great extremities, cold foot baths have often given immediate relief.
The bilious cholic is of a dangerous tendency, and always attended with the bilious belching and vomiting of bile. In this case vomits is the only method to be used with safety; and if properly continued, as long as the bile is brought up, will never fail of success. But bleeding in bilious complaints is ever pernicious. If a fever attends, method must be used accordingly.
Of Looseness, and the Bloody Flux.
A Cholic is often the forerunner of a looseness, and if the looseness is not too violent very often is salutary, and carries off many kind of disorders in the body. But if a looseness continues after twenty-four hours, it is time something should be done, in order to prevent a bloody flux.
If the flux is attended with a nausea at the stomach, and an inclination to vomit, give without delay the following draught:
No. XLIII
Take rhubarb (O) one scruple; ipecacuanha, ten grains; stomach powder (M) fifteen grains; calomel (N) three grains; mix them and make it into a draught or bolus, with sugar and water.
This probably will vomit a few times, and then occasion a few stools; but as the rhubarb has an astringency as well as cathartic quality, it will in general, after the purging has gently carried off the acrimony, act as an astringent; particularly if after the above draught, the following paragoric is taken.
No. XLIV
Take oil of peppermint (U) four drops upon a lump of sugar; liquid laudanum (T) eight drops; sweet spirits of nitre (D) twenty drops; mixt in a glass of wine.
But if the patient still continues after these medicines, with great griping, a succession of stools, together with a tenesmus, (that is a perpetual inclination to go to stool) then give the following:
No. XLV
Take rhubarb (O) ten grains; stomachic powder (M) fifteen grains; essential oil of peppermint (U) three drops; calomel (N) one grain; and make it into a bolus or draught.
Let the patient take this every six hours, for the first two days. If the stools are bloody, slimy, and attended with great pain; recourse must immediately be had to clysters, such as No. XXXVII, XXXVIII, XXXIX. mentioned in the quincey; for the more nourishing they can be made the better; as thereby they will lubricate the bowels, and strengthen them. In the mean time the white decoction should be used as a constant drink, which make as follows:
No. XLVI
Take chalk (18) pounded small, three ounces; cinamon (16) bruised, two drachms; boil them in two quarts of water for one hour, and strain off the decoction.
Of this let the patient drink for his constant drink; a few drops of oil of peppermint may be dropped upon a lump of sugar, and dissolved in it.
The same decoction may also be given as a clyster when the flux is very violent. After the two first days the rhubarb should be given but sparingly; for if the flux is bloody, we may justly suppose the intestines are in a state of inflammation, and even ulceration. In such extremity, a little calomel mixed with the clyster, as also liquid laudanum, will not only correct the acrimony, but give ease to the emaciated stamina of the intestines.
By this treatment the most inveterate bloody flux may be subdued, especially with the help of patience, cautious diet, and cleanliness.
SECT. V.
Of the Scurvy
If I was to write as much on that subject, as I have already written in this treatise, the whole would only amount to this, that the scurvy is a state of putrifying corruption in the living human body.
The causes of this disorder is a defective diet, contaminated air, and want of proper exercise.
In regard to the diet, salt provisions and foul water are the accessory means, which not only impoverishes the blood, but gives it a tendency to a putrescency, whereby it loses its spirit, the lymph its gelatinousness, and the crasamentous part its resinous consistency. Thence the serum becomes sharp and acrimonious; the lymphatic part in the blood unable to nourish the stamina of the solids; and the red crasamentous part becomes crumous, and void of its vivacity: and as the solids must in consequence suffer in proportion to the state of the blood, from whence they have their existence, and become maintained, it must follow also, that they degenerate into the same state of corruption: thence we find not only a universal lassitude and debility in the limbs, but gradually the smaller vessels become unable to circulate the corrupt humours, break, bleed, and even mortify of their own accord, without any other cause than the putrescent nature of their containing fluids.
Though the symptoms are in general too well known, not to be easily mistaken; yet I shall here describe this destructive disease in its various gradations.
When a patient first begins to be tainted with the scurvy, he feels a lassitude all over his body, and a peculiar proneness to indulgence and idleness; work becomes irksome; and neither has he strength, nor inclination, to do his work with the same chearfulness as before. He sleeps more in general, but his rest is for ever disturbed with heavy and melancholy dreams; and particularly of that nature, as for ever to be engaged in escaping from some sad danger, but unfortunately that his limbs are so remarkably heavy, that he cannot move them. With these and the like labour in vain phantoms his sleep is disturbed, till at length he awakes, and finds himself more fatigued than when he first went to rest. The mouth is always foul and slimy, and frequently attended with a disagreeable taint. The appetite is depraved, and the victuals sits very heavy on the stomach.
This is the first stage of the scurvy; and when a patient is sure of those symptoms, it is time some remedy should be used, in order to prevent the approaching evils; which gradually come on thus.
The gums begin to swell, though not very sore; and frequently bleed either on their own accord, or at the least touch of any thing that comes near them. The breath becomes very disagreeable, even to the patient himself. The teeth grow dark, brown or black, become loose, and the very jaw bone, together with the roots of the teeth are exposed and seem uncovered from the decayed gum.
Sometimes a scurfy itch ensues, and sometimes little spots appear. The body becomes remarkably weak, and sensibly falls away, and the colour of the skin gets a disagreeable tawny hew; which is most remarkable, together with other emaciated features in the patient’s countenance.
This is the second state, and now dissolution actually begins to take place.
The patient loses his strength sensibly, so as not to be able to be supported by his own limbs. Over his body variously appear red, scarlet, yellow, green, livid and black spots, of various magnitude; some of which will bleed on their own accord; others will break into malignant ulcers, and others again will mortify. The appetite fails; a flux frequently ensues; the urine will be thick and stinking; and the poor wretch gradually dies merely by putrefaction.
The scurvy has had many definitions, and has been divided into various classes. All the difference of the disorder is, that sometimes it is attended with a fever, only in some degrees, more in one habit, than in another; which may be owing either to the nature of the constitution itself, but principally depends on the climate the patient is in: to which I must not forget to add, that frequently the scurvy is complicated with other disorders. I could make many observations on this head, but, this perhaps would serve more to indulge myself than to benefit my reader.
I shall therefore suppose that I have said enough, to proceed to the cure; which I do with the more chearfulness, as I am happy in knowing it by experience to be not only easy, but efficacious.
The first time I ever experienced, and had it in my power to examine into the nature of the true scurvy, I was fortunate enough to discover so much of its corruptive quality, as to hit upon the true antidote; namely, the sacharine quality and acidity of vegetables; and upon this foundation I established my method of cure with success.
I shall not here enumerate the many experiments that I made in the course of these inquiries, but proceed to the result thereof, and the method to be observed.
In the first place, sugar is an article of more virtue, than what is in general known; and of so great a value to seamen, that he ought to esteem it as one of the greatest preservatives of his health. Next to this is vinegar, which is not only a resister of putrefaction, but has a coagulating, and condensing quality to the animal juices; whereby it not only consolidates the fluids without adding acrimony, but on the contrary, absorbs animal acrimony, and braces up the solids.
On the same principle, I have found dried malt, to be of great advantage in scorbutic cases; in which, both the saccharine and acidity of vegetables is contained even in a heightened degree,——This being premised, I proceed in the following manner:
When a man is found to have evident signs of the scurvy, let his drink be acidulated with one fourth, or third, &c. of good vinegar, or what is yet better, lemon juice, and well sweetened with sugar.
If there is malt on board, let a malt decoction, or temporary beer be made in the following manner:
No. XLVII
Take malt bruised, a pound, or three handfuls; sassafrass chips, a small handful; boil it in a gallon of water for an hour, and strain it off for use.
Let this be the constant drink, which in a short time will revive the already tainted habit. Onions, horse-raddish, and mustard, &c. such as will keep on board, should plentifully be made use of, and the pills No. X. should be taken every twenty-four hours, at a time when going to rest.
This method will soon bring the patient to health again, particularly if in the first stage; but when it is come to the second degree, or in a state of rapid decay, more effectual and immediate means must be taken.
Here then I shall present the method, which by experience I know to be efficacious.
No. XLIX
Take a large tub, (a butt sawed in two) in which place a stool, or something to sit on; Then let the patient be stript naked and seated in the tub; pour into the bottom of the vessel about one gallon of good vinegar; put a blanket all over the patient, and the tub, so that the whole is covered like a hut. Then heat a large poker; which put into the vinegar in order to rise a steam; which continue for about a quarter, or half an hour, or longer, according to the circumstances.
If the patient is very scorbutic, it should be repeated three times a day, or even oftener, for the effect of this steam-bath is so powerful, that I have with pleasure seen the patient when not able to crawl to the tub; he has been so revived by the operation, as to come out of his own accord quite refreshed.
In the mean time the elixir of iron as is described No. XXVIII. should be taken; the mouth often washed with vinegar, lemon juice, or rather with the elixir of the iron, and sugar, should be both plentifully used in the drink, and with the victuals.
Salt provisions should be avoided as much as possible, or else previously well deprived of its salt.
By this method the scurvy may not only be prevented at sea, but even cured in the most inveterate degree.
If however there is an opportunity for the patient to come on shore, it will greatly facilitate his cure; though he should reap no other benefit than the exhalations of the earth in the warmth of the day: and I have with astonishment seen patients devour vegetables in large quantities, and mended surprizingly, even in a few hours; so powerful an antidote is the vegetable effluvia to an animal putrescency.
To conclude, I have only this to observe, that the scurvy is principally owing to defaults with respect to provisions, and the customary way of living in ships in general; and such as might be much amended, both with respect to conveniency, wholesomeness, and expence.
I speak this from long experience, from the many observations I have made, and the good success that have attended my improvements, when it has been in my power to put them in execution. I have many things to offer with respect to provisions at sea; but as that is too extensive to be inserted in this volume, I shall treat of it distinctly. In the mean time give me leave to close these lectures: and being conscious that truth and utility has guided my endeavours through the whole, I lay down my pen for this time, with the pleasing reflection, that I have advanced one step farther in the performance of my duty, and in answering the end of my existence.
