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London, England, 1804-11-17 00:00:00

observable. In some cues the progress of the
di-
tease is so rapid as to destroy the patient before the
fourth day.
.• Having pointed out what i conceive to be the
true nature of the disorder, and noticed the appear-
ances most frequently to be met with, I proceed to
recommend a mode of treatment which I have pur-
sued, in all fecrrs sf a muliellant nature, with the most
happy success ; for I never lose a patient, where my
advice is applied for at an early period.
If the person is incommoded by `nausea or vqmit-
ing, on his seizure with this fever, I would recom-
mend the contents of the stomach to he evacuated,
by dire&ing him to drink a few cups of a strong•in-
fusion of camomile flowers, in preference to his tak-
ing an emetic, either of ipecacuanha or tartarised
antimony ; which medicines seem inadvisable, from
the great irritability of this organ, which is apt
spontaneously to ensue. If nausea does not prevail,
then the first step to he adopted should he to clear
the bowels of all feculent matter, by a sufficient dose
of calomel, the operation of which may be rendered
more certain and quick, by an addition of a few
grains of the extra& of coloquintida.
The bowels being•cleansed, I advise an immedi-
, ate use i.' the munatic acid. To adults we may
give ten or twelve (hops at first, which dose should
be repeated every four hours, guarded with four or
five drops of the tinlure of opium, to prevent the
acid from being unpleasant on the stomach and
intestines. By degrees, we may increase the quan-
tity of the acid in each dose to eighteen or twenty
drops. employing, as a vehicle, about an ounce and
a half of a strong infusion of columbo : the effect
of mineral acids, but more partienlarly the muriatic,
in all fevers of a malignant nature, is truly great,
and, from employing it in all cases, my practice has
been marked with the most decided success.
To increase the antiseptic effet of this medieine,
,as well as to obviate debility, always recommend
a quantity Of wine, proportionable to the age of the
patient, and the exigency of'the case, to be admi-
nistered at the same time. Bleeding is a remedy
which ought never tobe resorted to; for the Spanish
physicians at Malaga, by having recourse to it, sa-
crificed most of their patients.
At a very early period of the disease, when the
rigors have ceased, and the skin is become dry and
hot, I strongly advise a general effusion of the
whole body with cold water, as first recommended
by Dr. Currie, of Liverpool, and since praftised
hr myself, and many other physicians, in innumer-
able instances, with the happiest etre& This re-
medy may be repeated twice er thrice in the course
of the twenty-four hours ; but it should be at those
periods "men there is no great sense of chilliness
present, when the heat of the body is steadily
above what is natural, and 'when there is no 'gene-
ral or profuse perspiration: Where either the deli-
cacy of the system, the apprehensions of the patient,
or the prejudices of the bye-standers, prevent the
employment of cold effusion, we must be content
to substitute tepid effusion for the more powerful
remedy. The earlier in the disease that cold allu-
sion is employed, the more likely will it be to bring
it to a favourable termination, should it fail in ar-
resting its progress wholly.
Throughout the whole course of this malignant
disorder, the bowels ought to be kept open, by ad-
ministering, as occasion may require, the laxative
of calomel before recommended ; b ,t I do not think
that mercury should be given in sufficient doses to
excite any degree of salivation, as has been prac-
tised in the yellow fever. Should further experi-
ence, however, seneien this mode of proceeding, the '
process will not interfere with the employment of
tepid effusion at the same time, although it might
with that of the more powerful remedy.
As T am indueed to suppose, that a high degree
-of delirium does not often attend on the fever in
question, and that the'Patientlitather incommoded
`by mutterin .s And slight WanderingS, I do not hesi-
late to advise the
.giving a dote of opium, propor-
tioned to the ige of the person, every evening at an
elittly hour ; which pralliee I generally adopt,in all fe-
.llven of the typhoid cla4s, and with a very good effort.
Howl% pointed out tfmmeans which I think most
gaily to procure a tatrourable termination of the
'disease, I beg leave to add a few monitory cautions
Ter suppressing its farther propagation., and de-
letroying its contagion. To answer the first of these
intentions, it will be necessary to beep the mind
cheerful,' and 'as free from all apprehensions ant
!anxiety as possible, and carefully avoid intemperance,-
! sensuality, great fatigue, proftille evacottions, a poor
rapid diet, or whatever else" may tend to produce
debility. By strengthening the bodies of men, it is
supposed they'lvill thereby be enabled to resist con-
*tagion the better : I would therefore recommend '
cold bathing every morning, with two or three
doses daily of some tonic medicine, such as the Pe-
ruvien bark. If wine be sued- at ell, it should be
sparingly ; the less, perhaps, the better.
Nurses and medical attendants, who arc Imme-
diately exposed to the contagion, should be careful
to come into immediate crested wish the diseased as
' seldom as possible ; and they might never to inhale
the breath of the sick, nor place themselves in such a
direCtion as that a streatn of air can waft the miasma
or efluv:a towards them. Possibly it might be ad-
vareagenufto anoint t!ie hands with sweet oil, as has
been praCtised, it is said, in the plague with much
advataage.
Fer the purpose of destroying the contagion, the
sick should be removed to lazarettet, and these most
be guarded, so as to cut off all unnecessary coorimu-
nleetions with those in health. The atmosphere
surrounding the Waled ought to be purified as
much as possible, by a stria attention to cleanliness,
a free ventilation, and frequent fumigations with the
nitrous or martatic acid, in the form of gas. All
suhstances capable of being' impregnated-with the
efluein, and of vitiating the atmosphere, should be
speedily removed from the apartments of the sick
to situations n trete the healthy cannot suffer by
them, and where they will be made to undergo pro-
purificatiocs.
It doeserot.s;gnify tv' ;eh of the acids we employ,
as they are boat equally efficacious in destroyiug
every species of contagion. If a preference be given
to the mur:atic, place a saucer, or any other earthen
vessel, containing about half a p ,und of common
salt, in the apartment of the sick, and pour over it
from time to time a sufficien: quantity of vitriolic
acid, to moisten. the whole of the salt: If the nitrous
is preferred, put haft an ounce orvltriont and into
a cup, saucer, or glass, and add from time to time