Note 74 — OF THE Autumnal Remitting Fever.
Reading edition
According to Dr. Hillary’s Account of the Yellow Fever in the West Indies, which is attended with bilious Vomiting, it bears bleeding once or twice, but not a third Time, before the third Day, but not at all after that Time; and after Bleeding a great Part of the Cure depends on carrying off as much of the putrid Bile as expeditiously and safely as possible, which he says is to be done by making the Patients drink freely of warm Water (sometimes mixed with a little simple Oxymel or Green Tea) so as to vomit seven or eight Times; and then to give a grain, or a Grain and a half of Opium, to procure Rest, and to settle the Stomach; to make the Patient take nothing for two Hours after; and then, if he has not had a Stool, to give a laxative Clyster; after six Hours Rest, to give a gentle Purge, to carry off as much as possible of the bilious corrupted Humours; and in the Course of the Disorder to repeat the Purge, as often as the Patient is attacked with an Anxiety, and a painful burning Heat about the Præcordia; which almost always depend on bilious corrupted Humours pent up within the Bowels; and to endeavour to support the Patient’s Strength, and stop the putrescent Diathesis of the Fluids by suitable Antiseptics, of which he found a watery Infusion of Snake Root, mixed with Madeira Wine and Syrup of Poppies, to answer the best of any Thing he tried, and to sit easiest on the Stomach; and to this he added the Use of Cordials, and of strong Wine Whey as the Patient became lower.
Dr. Hillary’s Purge was: ℞. Mannæ sescunc. vel unc. ij. Tamarind. cond. unc. i. Tartar vitriolat. gr. x. solve in seri lactis præparat. cum Vin. Maderiens. unc. vi. Colaturæ adde Tinct. Senæ unciam dimidiam. Divide in Partes quatuor, & capt. æger unam omni hora donec laxetur alvus.
His Infusion of Snake-Root was prepared in the following Manner:
℞. Rad. Serpent. Virgin. drachm. ij. Croci Angl. drachmam dimidiam, infunde per horam vase clauso in aq. bull. q. s. & dein unc. vi. Colaturæ, adde aq. Menth. simp. unc. ij. Vin. Maderiensis, unc. iv. Syrup. Croci vel Syr. e Mecon. unc. i. Elix. Vitriol. acid. q. s. ad gratum saporem M. capiat æger cochlear. ij. vel iij. omni hora vel secunda quaq; hora vel sæpius pro re nata.
The Stomach is so irritable in the Beginning of this Disorder, as to reject the saline Draughts, Nitre, and such other Medicines. Nor will the Bark, which might be judged a very proper Medicine in the second Stage of the Disorder, lie upon the Stomach, but is thrown up immediately, in whatever Form it is given. However, a Gentleman who had practised long in the West Indies told me, that although the Patient could not retain it in his Stomach, yet that he had found great Service, after the Bowels were emptied, from the Bark used freely in Clysters.
Dr. Hillary disapproves of the Use of Blisters in the advanced State of these Fevers.