AN ESSAY On the present Epidemic Fever.

AN ESSAY Pointing out the Cause, Effects and Method of treating the present Epidemic Fever.


Si quid novisti rectius istis,
Candidus imperti: si non, his utere mecum.

SHERBORNE: Printed for the AUTHOR in the Year 1741.


THE following attempt to ac­count for the Cause of the pre­sent Epidemic Fever which has rag'd in the western parts of this king­dom this summer, was drawn up at the instance of some friends; and not with any direct intention to be publish'd; but the frequent alarms from all quarters, and the terrors some had, on account of the supposed danger of receiving infection, determined me to lay my thoughts on this important affair before the Public.

As I really thought peoples fears on this account were groundless and with­out the least Foundation, so I endea­voured to account for things in regard [Page 6]to the present Epidemic, in a way fa­miliar and obvious to almost ev'ry ones capacity, and to common observation.

I know 'tis commonly objected, how easy a matter it is to lay down an Hy­pothesis, and deduce and spin out Conse­quences, to make every Phaenomenon, every Symptom of a disease to be account­ed for by that Hypothesis. But the fol­lowing Remarks at least as I imagine are founded upon matters of fact, every ones experience, the known laws and properties of matter and motion in re­gard to the solids and fluids of our bodies.

If there be any thing in them mate­rially wrong, whereby it shall appear to any candid Person, that I have been mistaken, I shall think myself oblig'd to him, if he'll take the trouble to give me better information, and set me right. But as for any little conceited nibler and dealer in small wares, who will be [Page 7]snarling and finding fault when he has neither will nor capacity to instruct us better, who pretends to have wit, when he has scarce common sense; or any one who will hint his dislike without offer­ing to give us a better account, or who will sententiously condemn, because he would be look'd upon as shrewd; as for those or such like I heartily despise.

As for the Gentlemen of the Profes­sion who are of any standing, and such as really deserve that name, these Re­marks are not intended to offer them any thing that is new or uncommon; these things must have fallen under their re­flection: and if there be any thing that may be deem'd too presumptive or inde­cent in regard to the Censure past upon the recommendation of the use of vinegar by the College of Physicians to our Sail­ors in the West Indies, I hope it will give them an opportunity of reconsider­ing that affair since a recommendation of the general use of it cannot but be of ill [Page 8]consequence in a state of the fluids already too much coagulated and stagnant, as I think I have proved in the following Sheets.

In jugularem Canis injeci aceti uncias duas. Cordis contractio paulo frequen­tior; quoad caetera nulla in Cane muta­tio. Deinde iteratâ injectione ad uncias, itidem duas, Respiratio difficilis & la­boriosa; quae tamen, sectâ arteriâ iliacâ (unde exiit plurimum sanguinis nonnihil grumosi) ad consuetam normam redacta est. Injectis tandem ulterius unciis dua­bus, expiravit Animal. Apertâ venâ Iliacâ, erupit sanguis craffissimus, & in massam densatus: in venis caeteris, uti & arteriis, leviter concretus; in corde, praesertim in sinistro ventriculo, aliquâ ex parte fortiter coagulatur.

Thus far the late ingenious and learn­ed Dr. Friend *.

‘"I injected, says he, into the jugular vein of a Dog two ounces of Vine­gar, whereupon the heart was con­tracted a little more frequently, other­wise there was but little alteration in the Dog; then I injected two ounces more, upon which respiration became difficult and troublesome, but upon opening the Iliac Artery, from whence was taken, a good deal of grumous blood, he breathed pretty well again. Then I injected two ounces more, whereupon the Animal expired. Open­ing the Iliac Vein, the blood was very thick, and congeal'd into a solid Mass: in the rest of the veins and arteries 'twas somewhat concreted, in the heart, especially in the left Ventricle the blood was strongly coagulated."’

Here seems to be a pregnant in­stance of the coagulating nature of vine­gar when mixed with blood in the body, and notwithstanding any other proper­ties [Page 10]may lavishly have been bestowed upon it, and ascribed to it, and that by the greatest Names; such as that of at­tenuating, stimulating, abstersive, anti­pestilential, preventing, and resisting corruption and putrefaction and such like, yet as facts and experiments are stubborn, and irresistable, and will not give way to the greatest authorities; and that we have no reason to distrust or call in question the veracity or the skill of the late Dr. Friend in his rela­tion and his making the above experi­ment, so I think we may safely conclude, that vinegar is not discriminately on all occasions and in any quantities to be thrown into the body.

AN ESSAY On the present Epidemic Fever.


SINCE you were pleas'd to signi­fy your desire of knowing what my sentiments were concerning the present Epidemic Fever, and what my method of treating it, to your Candour I submit the following obser­vations.

I would remark to you in the first place, that notwithstanding the many outcries we have had from all parts of the Country of the malignancy and con­tagious nature of the reigning Fever, there is nothing very particular or un­common in it, any more than that a par­ticular constitution of Air may be pro­ductive of a particular disorder, and may induce what we call an Epidemic Dis­ease.

But properly speaking we know of but three contagious or infectious Dis­eases, viz. the Plague, Small-Pox, and the Measles, all which, as far as we know, have Africa for their original, if at least we except some few which are communicated by contact.

If we consider the violent heats of the present summer after an excessive cold spring, we need not, I think, be at a loss in accounting for the present [Page 13]reigning Fever, since every one knows, who is ever so little vers'd or engag'd in observations of this kind, what an ef­fect an Eastern or Northern Air has in bracing up our fibres, and rendering them rigid and elastic, and how on the con­trary a Southern or South-western Air, with excessive hot weather, relaxes them. The very great change from excessive cold to excessive hot weather, and by so suddena transition, could not but make a very great alteration in the temper of our bodies. Hypocrates, who liv'd two thousand Years ago, and who was the most diligent observer of the causes and effects of diseases either before or after him that liv'd in the World, told us, that the change of the seasons was the principal Parent of diseases; and no wonder, since we observe at different times and seasons of the year, the dif­ference of the spring, weight, heat, cold, and moisture of the Air. The blood and humours which were before by the ela­stic [Page 14]force of the solids comminuted and render'd fit for their several secretions, are now by their sunk and relax'd state, become heavy and too abounding, and want that spur which is necessary to car­ry off the recrements, and prevent a tendency to a stagnation and putrefaction. The blood's viscidity continually increa­sing by the heat's exhaling the finer and more fluid parts of it, and the vis a tergo growing less and less by the re­laxation of the fibres, obstructions must necessarily arise, and consequently there must be brought on an inactive putrid state of the fluids; from hence I think may be accounted for, the variety of symptoms, and the frequency of the pre­sent Epidemic Fever, without having recourse to any particular taint or in­fection communicated and brought to us from the West Indies, as has been idly suggested.

From the same way of reasoning we may account for the sickness and mor­tality of our men in the West Indies, having pass'd from a Northern to a Southern Climate, from a cold to a hot air, and great moisture, occasion'd by their heavy rains at particular seasons, which contribute exceedingly to the re­laxation of the fibres, and to the in­ducing that putrid and accumulated state of the fluids which has been described: and if our Sailors were to bleed, and af­terwards bath in the sea water, which they have such good opportunities for, at their arrival in the West Indies, it would contribute very much to the rai­sing the elastic force of the solids, and preventing that viscid, stagnating and putrid state of the fluids.

Here I cannot but take notice, that if this way of reasoning be just, how injurious the use of vinegar must be in [Page 16]this state of the blood, from the known properties of acids coagulating the mass.

With humble deference to the Judg­ment of so learned a Body as that of the College of Physicians I would submit it to them whether they were not a little too hasty in recommending the general use of vinegar to our men in the West Indies, for tho' a tendency of bracing the fibres may be urged in its favour, yet its coagulating stagnating property must be injurious to a blood already too coagulated and stagnant, according to the foregoing Theory. And now I am upon the story of vinegar, I cannot help taking notice of the use has been made of it since its recommendation from the College. Some are not contented with the great benefit they imagine they re­ceive from its internal use, but look up­on it as having something of a charm with it to keep off and prevent infection, and the unfriendly taint of this Epide­mic fever; and for this reason they sprinkle with vinegar walls, floors and [Page 17]bed-posts, which have contracted this taint; and which they have been told was a practice during the raging of the Plague in England.

Whether there be any thing in vine­gar opposite to the principles, nature, or effects of that direful and contagious disease, 'tis not my business at present to enquire into, but that it has any good effect either in promoting, or especially in curing the present Epidemic Fever, I think is far from being demonstrable.

Our Jayl, Bridewell and Work-house Fevers, of late so mortal, have not only the peculiar constitution of air already described for their cause, but to that we may add confinement, want of exercise, numbers and nastiness, and a want of proper and sufficient nourishment and support thro' the excessive dearth and scarcity of provisions, all which have a prodigious tendency of sinking the so­lids beneath their natural standard, of producing a depauperated, viscid, stag­nating [Page 18]and corrupted state of the blood and juices of the body.

If a great Man's definition of a Fever would in all cases hold good, viz. aucta circulatio sanguinis, perhaps acids and vinegar might be of some service; but in the present Epidemic Fever is most commonly found, a depress'd pulse, oc­casioned, as I imagine, by too great a quantity of fluids in proportion to the strength and elasticity of the solids, from whence obstructions arise, and from whence may be deduced and accounted for that variety of threatning and often­times fatal symptoms we meet with in this disease; and tho' no Epidemic does or ever did appear exactly in the same shape (very far from it) on account of different constitutions, different forma­tion of parts, mens different passions and different ways of living, &c. yet the same constitution of the air, the same properties of the air they in common breathe in, and the same properties of the food they in common feed on, will [Page 19]produce in some measure the same sort of disease, tho' differing in some, per­haps in several circumstances, and this is what we call Epidemic, from [...] among the people.

I shall not undertake to give a very particular account, and enumerate all the several symptoms attending this Fever, since they appear different in different constitutions, ages, sexes, &c. give me leave to point out a few, and which seem to be the principal ones. Most com­monly we find a low depress'd pulse from a plenitude of fluids and want of proper force in the solids. No very great thirst, or very foul tongue, an heavy pain of the head, an oppression on the breast, the Urine pretty high colour'd, tho' sometimes pale and without a sedi­ment. No very great complaint of heat, a faintness, prostration of strength, sweats, which give very little relief, because not critical, a Diarrhoea, or a Delirium, I say, or a Delirium, because if a Diarrhoea comes on towards the beginning of the [Page 20]Fever, it prevents most commonly a De­lirium.

These are the principal circumstances which I have observed attending this Fever; and tho' a variety of appellati­ons have been given to it, but chiefly that of a malignant pestilential, which I apprehend those who give it that name, have scarce any fix'd and determinate meaning and Ideas of; yet the principal thing to be regarded is, what the dis­ease itself is, and how it is to be treat­ed; and since we have laid it down as a great and prime Cause of this Fever, viz. the immoderate heats of the summer setting in after an unseasonable winter, and very cold spring, so affecting the so­lids of our bodies, whereby they were sunk beneath their natural Standard, by which means there became an accumula­tion or too great a load of humours; hence the obstructions, viscosities, stag­nations, putrefactions, and the direful train of symptoms observable in the pre­sent [Page 21]reigning disease we need not I think have recourse to (tho' that can't be demonstrably disproved) a particular deleterious quality in the Air to account for them, since we know very little or nothing about this deleterious quality, or can find out any thing specific or a­lexiterial to oppose and counteract it.

The method of cure then must in a great measure depend upon Evacuations of some kind or other, to remove the accumulation and load which oppress and overbalance the solids, to bring down and diminish the quantity of fluids that they may bear a proportion to the relaxed and sunk state of the solids; and then by proper gently stimulating and attenuating medicines to raise the force and elasticity of the fibres to such a pitch as shall be sufficient to remove the remaining obstructions, temper the viscidity, put in action the stagnating and putrid Mass, and dispose the hu­mours [Page 22]for their several excretions, and prevent the like state arising.

It frequently happens in this Fever that nature sets up a method of cure herself; so we should take care how we counteract her, for instance, if we find a Diarrhoea coming on in the beginning, which we very often find, the Patient will need scarce any other evacuation, bleeding will be then unnecessary, and 'twould be preposterous to endeavour by astringents to put a stop to it, it is an effort of nature to relieve herself, the blood throws off its enemy in plentiful streams through the intestinal glands; and it has been observed, that when it has been stopt by a too officious hand administring astringents, or by any other accident, fatal have been the consequen­ces; the patient has fallen into a Deliri­um thereupon, or into some other cir­cumstances by which he has been carried off.

During this struggle, this plentiful discharge, 'tis needless to remark, that Nature must be supported from time to time with some generous cardiacs.

Since this is a method that nature fre­quently takes to relieve herself, we may without absurdity ask, why the Physi­cian neglects this Method; and though purging in Fevers has been look'd upon by some as preposterous, and going a­gainst the rules both of nature and of art, as raising too great a commotion where there was but too great a struggle before, yet I think that affair is not car­ried so far now as it has been formerly, and that in most kinds of Fevers some or other of them we see it necessary to use this evacuation, but nature in this, as in all other cases, must be attended to, her motions narrowly watch'd, and carefully observ'd, that the Physician who is her servant, does not look one way whilst she points out another.

Bleeding is another method Nature takes to relieve herself, as we frequent­ly find by the plentiful Haemorages at the nose in this disease. Opening a vein in that case is advisable, because relief will be the sooner obtained, and in most of the cases in this fever we find a ne­cessity of this discharge, to take off the Plethora, and bring the blood to an E­quilibrium with the Fibres: But it is not the least part of the skill of the Physician to determine upon the quantity of blood which is to be taken off; and here I apprehend are many mistakes made, here is the rock which many Pre­tenders to the art medical split upon, and shipwreck the poor patient, though they themselves, the more is the pity, escape; here if they draw blood with an undistinguishing hand, not discerning what proportion the strength of the Fi­bre bears to the quantity of fluid in the vessels, irretrievable mistakes are com­mitted; and here I cannot but observe how many ignorant conceited Coxcombs [Page 25]ride out under a shew of business with their lancet in their pocket, and make diseases instead of curing them, drawing their weapon upon every occasion, right or wrong, and upon every complaint ery out, E-gad I must have some of your blood, give the poor wretches a disease they never might have had, draining the body and the purse, torment them in this world, and send them perhaps to another before their time, to keep them­selves the longer from that day of rec­koning where they must account for the quantity of innocent blood they have shed in this World.

The Evacuation by vomiting is often a very necessary one, especially where a Nausea or an inclination to vomit ap­pears, but it is not to be ventured upon at all hazards, or with all sorts of Pa­tients, many circumstances may forbid its use, and plainly contraindicate it, or it may be necessary previously to lessen the quantity by bleeding, after which by the action of vomiting the stomach [Page 26]is not only discharg'd of its disagreeable load, but by the universal shock it gives to the solids, it raises their action, at­tenuates the fluids, drives through ob­structions, and sits and prepares the hu­mours in general for their several secre­tions.

Another Evacuation in the disease under consideration is blistering, and which is frequently of very great use, not so much on account of the discharge, as its property of stimulating and adding to the force of the fibres, its tempering the viscidities, and separating the pre­ternatural cohaesions; it makes a revul­sion of the humours from a particular part, viz. from the brain, by which a Delirium or perhaps a Phrenzy, not un­common in this Fever, is either prevent­ed or taken off. But pointing out ge­ral rules for the use of blisters will not do for particular cases, nor is it safe up­on all occasions to lay on blisters before Evacuations of other kinds have pre­pared the humours in some measure and [Page 27]pav'd the way to them; and I believe it has often been a case, whereby an un­skilful management of blisters instead of relieving the brain, by the great stimu­lation upon the solids, the blood and humours have been thrown in upon its tender vessels with such a force, as they have not been able to bear, especially if the blisters have been accompanied as they often, I may say, almost always are, with other violently warm stimulating medicines.

The Evacuation by sweating, I mean that artificially made, demands our con­sideration in the next place, its being attempted at all adventures, and with­out good reason is often of the worst consequence to the Patient.

If the present Epidemic Fever has for its Cause an accumulation of fluids in too great proportion to the lessen'd elastic force of the solids, and those be­come an heavy sizey putrid and inactive mass, and peculiarly viscid through the [Page 28]great exhalations of their siner and more fluid parts by the extream heats of the season, who is there but sees how pre­posterous it is to be flinging in violently hot sudorifics, in this present state of the fluids thus unprepar'd for them? Hence Petechiae, spots and eruptions of several kinds, if not before by nature made, are now by this method propell'd and di­stributed to the surface from a stagnating putrid mass; hence the Deliria we fre­quently meet with among these Patients. But that such medicines as these may not with safety be made use of in some time or other of the distemper cannot be as­serted, but it must be at a time that the fluids are properly prepared and fitted for this particular excretion.

So much for general visible Evacuati­ons. It may be expected perhaps I should give a detail of the materials or medicines which are to be made use of in the foregoing described cases, but that was not in my intention, as thinking the giving Recipe's and strings of medi­cines [Page 29]can be of no use to the real Phy­sician, so it might be of ill consequence, and made an ill use of by the Pretender; I apprehend I have given such hints, and made such observations through the course of these Papers, as to lay down a foundation for a rational method of cure in the present Epidemic Fever. I must observe, as I hinted before, in the affair of bleeding, that a disease is often brought on a patient by an officious ill judging, ill-timing hand, rather than any present one removed, in like manner it falls out, that by the administration of many medicines improperly and un­skilfully apply'd, the disease is made a new one, and quite chang'd from what it was at first; and we need not wonder at the ill success that is observed from the variety and great quantities of A­lexipharmacs (as they are termed) pour'd down the throat in an undistinguishing manner, perhaps more for the sake of the Apothecary than the Patient, I say we need not be surpriz'd to see the Pa­tient [Page 30]yield to the burthen, and fall a victim to the disease of Medicine.

Since we have pointed out a method of cure, and of relieving the Patient in this Epidemic Fever, it will not be dis­pleasing I imagine, to recommend a me­thod of prevention; and as we have proved, that health in a great measure depends upon a due balance, and just proportion between the solids and fluids of our bodies, that is, between the force or strength of the former, and the quan­tity or quality of the latter, so 'tis our highest concern, and ought to be our principal Care, to endeavour as near as we can to keep to this standard. Since the immoderate heats of the present season, as we have reason to think, have so constituted the air, whereby it has a tendency of taking off that Equilibrium we have been describing, and which is absolutely necessary for health, by sink­ing the solids, and increasing the quan­tity of fluids, so it seems to be highly necessary, we should lessen this quantity, [Page 31]and raise that force. And in these cir­cumstances there seems to be no safer or speedier method of prevention than pre­viously to empty the vessels by losing some blood, and then to use the cold bath, which has unspeakably good ef­fects, in giving force to the fibres, where­by the blood is enabled to drive through all obstructions, to scour the Glands, to attenuate the viscidities, and prevent a stagnating putrid state, the cause, nay the very essence of the disease itself.

Gentle exercise, such as riding on horseback, or in a Coach, or walking at proper seasons, not to sweat much, a temperate way of living, tho' not too low, but indulging now and then in a glass of some generous liquor, all con­tribute to keep up an Equilibrium, and prevent the reigning distemper. In a word, a due and regular use and appli­cation of the non-naturals is the most likely means to preserve health, such as calming the Passions and Affections of the mind, proportioning our exercise and [Page 32]use of the Air to our strength, and the Food we take in, not watching over much, but taking our usual moderate hours of sleep, and above all, taking care the natural Evacuations of every kind be not immoderate and to excess.

I am, SIR, Yours, &c.

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