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times dangerous practice, of purging or vomiting, at the very beginning of a distemper.
Chap. III. contains some very useful and plain directions concerning the management and diet, in acute diseases. Acute diseases may be considerably mitigated, if on their first invasion the following regulations be carefully observed. To omit ali violent labour: to abstain almost entirely from folid food : to drink plentifully of soft, diluting liquors; and to avoid coltiveness. When the disease is farther advanced, and the weariness, loss of appetite, numbness, and other lefser complaints, which had hung about the patient for a few days or even weeks, are succeeded by coldness and shivering, with an universal opprefa fion and pains over the whole body, he should then be put tobed, and drink frequently of some saitable liquor, barley-water, or a light infusion of elder-flowers, sweetened with honey, to a quart of which may be added one ounce and an half of vinegar; clear sweet whey, or an infusion of the flowers of the limes tree. During the cold fit, the patient naturally calls out for a load of covering; the additional weight however is to be reo moved as soon as the heat comes on, and sometimes it may be proper to have even less than the usual covering. As the fever proceeds, care should be taken that there be as litele noise as porfible ; that the room be not too hot, and that the air be kept fresh, by removing every offensive matter, and sprinkling vinegar upon the floor. With respect to nourishment, the fimpleft and the best is panada, or bread boiled in water, which is to be allowed in proportion to the mildness or vehemence of the fever. Grits, barley, oatmeal, or rice, may be prepared in the same manner with the addition of a little falt. In summer, Dr. Tissot recommends found, ripe fruits ; and in winter, apples roasted or boiled. The body to be kept easily open ; and the drink such as is suited to allay the thirst, and abate the fever. The patient should daily fit up one hour, or as long as his strength will permit; at this time the bed should be inade, and his linen frequently changed. Dr. Tistot finishes this chapter with proper directions for those who have palled the crisis; the more effc&tually to secure their recovery and to prevent a relapse. The directions with regard to bleeding and medicines, are fully laid down by Dr. Titiot, when he treats of particular diseases.
We have thus given an abstract of the preliminary parts of this work. Dr. Tissot next proceeds to the history and method of treating particular diseases. His histories are in general full, plain, and diftinét; his observations are just and penetrating; and his practice is simple and efficacious: for the table of mejicines which he has formed, and to which he always refers, con fits only of seventy-one different articles, which articles, arro, are as little compounded as poliible. If there is any thing
doubıful, either as to the observations or practice of our Author, the reader is sufficiently advertised of it by the learned and judicious Translator.
We cannot, however, pretend to convey a proper idea of this work, without giving a specimen or iwo of Dr. Tillöt's manner of delcribing and treating dileases. Chap. IV. begins with a description:
of an Inflammation of the Breas. • The inflammation of the breast, or peripneumony, or a Auxion upon the breast, is an inflammation of the lungs, and most commonly of one only, and consequently on one side. The signs by which it is evident, are a shivering, of more or less duration, during which the person affected is sometimes very restless and in great anguish, an essential and inseparable lymptom ; and which has helped me more than once to distinguish this disease certainly, at the very instant of its invasion. Be. sides this, a considerable degree of heat succeeds the shivering, which heat, for a few ensuing hours, is often blended as it were, with some returns of chillness. The pulse is quick, pretty strong, moderately full, hard and regular, when the distemper is not very violent; but small, soft and irregular, when it is very dangerous. There is also a sensation of pain, but rather light and tolerable, in one side of the breast; sometimes a kind of straitning or pressure on the heart; at other times pains thro' the whole body, especially along the reins, and some degree of oppression, at least very often; for sometimes it is but very inconsiderable. The patient finds a necessity of lying almost continually on his back, being able to lic but very rarely upon either of his sides. Sometimes his cough is dry, and then attended with the most pain; at other tinies it is accompanied with a spitting or hawking up, blended with more or less blood, and fometimes with pure sheer blood. There is also some pain, or at least a sensation of weight and heaviness in the head; and frequently a propensity to rave. The face is almost continually flushed and red; though sometimes there is a degree of paleneis and an air of astonishment, at the beginning of the disease, which portend no little danger. The lips, the tongue, the palate, the skin, are all dry; the breath hot, the urine little and high coloured in the first stage ; but more plentiful, less flaming, and letting fall much sediment afterwards. There is a frequent thirst, and sometimes an inclination to vomit, which imposing on the ignorant assistants, have often inclined them to give the patient a vomit, which is mortal, especially at this juncture: The heat becomes universal. The symptoms are heightened almost every night, during which the cough is more exasperated, and the expectoration less in quantity. Sometimes the inflammation ascends along the wind-pipe, and in some measure suffo
cates the patient, paining him considerably in swallowing, which makes him think he has a sore throat.'
If the disease rushes on at once, with a sudden and violent attack; if the horror, the cold and shivering last many hours, ard are followed with a nearly scorching degree of heat; if the brain is affected from the very onset; if the patient has a small purging, attended with a tenemus, or straining to stool, often termed a needy; if he cannot draw his breath, but when he fits up; if the pulse be small and very quick, the countenance livid, and he abhors the bed ; if he either sweat excesively, or his skin be extremely dry; and if he spits up with much difficulty, the disease is extremely dangerous.' Dr. Tiflot next proceeds to the method of cure, during this the inflammatory state ; he then points out the different terminations of the disease, and the manner in which each is to be treated.
Chap. XU. Of the Bite of a Mad Dog. . Dr.Tissot thus describes the symptoms of the diseale in the animal. "If a dog which used to be lively and active, becomes all at once mopish and morose; if he has an aversion to eat; a par:icular and unusual look about his eyes, a restlessness, which appears from his continually running to and fro, we may be apprehenfive he is likely to prove mad. Whenever the malady is certain, the symptoms heighten pretty foon. His aversion to food, but especially to drink, grows stronger. He no longer seems to know his master; the sound of his voice changes; he suffers no person to handle or approach him, and bites those who attempt it. He quits his ordinary habitation, marching on with his head and his tail hanging downwards; his tongue lolling half out, and covered with foam or slaver, which indeed not leldom happens indifferently to all dogs. Other dogs scent him, not seldom at a considerable distance, and fly from him with an air of horror, which is a certain indication of this disease. Sometimes he contents himself with biting only those who happen to be near him; while at other times becoming more enraged, he springs to the right and left on all men and animals about him. He hurries away with manifest dread from whatever waters occur to him : at length he falls down as spent and exhausted, sometimes he rises up again, and drags himself on for a little time; commonly dying on the third, or at the latest, on the fourth day after the manifest appearance of the disease, and sometimes even sooner.'
The disease in a person bit by such a dog, appears in the following manner: "The wound commonly heals up as readily, as if it was not in the lenít poisonous ; but after the expiration of a longer or shorter term, from three weeks to three months, most commonly in about six weeks, the person bitten begins to perceive, in the spot that was bit, a certain dul cbtuc paio. E 3
Cor unealid it is caitot goe
The scar of it swells, inflames; bursts open, and weeps out & Sharp, færid, and sanious, or somewhat bloody, humour. At the same time the patient becomes sad and melancholy : he feels a kind of indifference, insensibility, and general numbness; an almost incessant coldness; a difficulty of breathing, a continual anguish, and pains in his bowels. His pulle is weak and irregular, his sleep restless, turbid, and confused with ravings ; with Itarting up in surprize, and with terrible frights. His discharges by fool are often much altered and irregular, and small cold sweats appear at very short intervals. Sometimes there is also a slight pain or uneasiness in the throat ; such is the first degree of this disease, and it is called by some physicians the dumb rage, or madness. Dr. Tissot goes on to describe the more violent and dreadful symptoms of this disease in its second degree, the confirmed or downright madness. He next observes that, " a great number of remedies have been highly cried up, as famous in the cure of this disease; it is incontestable however that to the year 1730, not a single patient escaped, in whom the disease was indisputably manifeft; and that every medicine then employed against it, was useless. Since that time, we have had the happiness to be informed of a certain remedy, which is mercury joined to a few others.'
The following are our Author's practical directions. As soon as possible after receiving the bite, all the part affected should be cut away, if it can be done with safety: the ancients directed it. to be burnt with a red hot iron; this practice, however, requires more resolution, than every patient is endued with. The wound should be well washed with warm water, in which a little seafalt has been dissolved. After this, into the edges of the wound, and into the surface all about it, thould be rubbed a quarter of an ounce of mercurial ointment; the ointment directed is of the same strength with our unguentum cæruleum fortius: the wound Thould be drefled twice daily, with fome soft easy digestive, but the mercurial ointment is to be used only once a day; and even in this quantity will soon produce a salivation, which we apprehend not always to be necessary. The quantity of nourishment should be less than usual ; spirituous liquors, hot spices, and every thing inflammatory should be avoided; costiveness is to be guarded against, and the legs bathed once a day in warm water. Every third day a dose of cinnabar and musk is to be taken: this medicine is to counteract the poison, and to prevent the spasms : Dr. Tissot however confesses, that he has less dependance on mercury given in this form, and thinks it less efficacious than rubbing in the ointment.
If the disease has made a considerable progress, and the raging symptom, the dread of water, has already appeared, our Author gives the following direộtions; to bleed once, twice, or oftener,
according as the symptoms, strength, and constitution of the paticnt may require :-to put the patient if pollible into a warm bath twice a day :- to administer every day two or three emollient glyfters:---to rub in the mercurial ointment we have already mentioned, twice a day :--the whole limb on which the wound was made, to be rubbed with oil, and wrapped up in an oily flannel :-to give every three hours, a dose of cinnabar with fixteen grains of musk; and every night an antispasmodic bolus, consisting of Virginia snake-root, camphor, affa-fætida, and one grain of opium; this is to be repeated in the morning provided the patient be violent:-if there be a great nausea or fickness, with bitterness in the mouth, an emetic o: ipecacuanha is to be given. - By this method the symptoms will abate, and the disease disappear by degrees; but if the patient should long continue weak, and subject to terrors, he must take half a drachm of the Jesuits bark thrice a day.
A boy, in whom ihe raging symptom of this disease had just appeared, was perfectly cured, by bathing all about the wounded part with sallad-oil, in which some camphor and opium were dissolved ; with the addition of rep. ated frictions of the mercurial ointment, and making him take some Eau de Luce with a little wine; this medicine, a coffee-cup of which may be given e:ery four hours, allayed the great inquictude and agitation of the patient, and brought on a very plentiful sweat, on which all the symptoms vanished.'
Dogs are cured by rubbing in thrice the quantity of the mere curial ointment directed for men, and by giving them seven grains of turbith mineral, made into a bolus with the crumb of bread three days successively, and afterwards twice a week for fifteen days: this medicine makes the dogs vomit and slaver abundantly,
Mercury is considered by Dr. Tifot as the proper antidote for this poison.-Julius Palmarius who wrote on contagious discases near two hundred years ago, ordered the wound caused by the bite of a mad dog to be dressed with sublimate or red præcis pitate; his intention was, by this corrosive mercurial application to enlarge the wound, to excite a flux of humours to the part affected, and thus to wash away the infection. It does not appear however that Palmarius either gave any of the preparations of mercury internally, or administered it externally in the form of ointment.- In the Paris Transactions for the year 1699, mercury is proposed in a dubious manner, as a medicine, whose powers might overcome this dreadful disease. - About thirty years ago, Default introduced the practice with the mercurial ointment, and with great success: he supposed this infection as well as that of the itch, lues venerea, &c. consisted of little worms, which were communicated to the person infected ; however er. roneous this supposition may be, as mercury was known to be