OF FEVERS IN GENERAL.
AS more than one half of mankind is said to perish by fevers, it is of importance to be acquainted with their causes. The most general causes of fevers are, infection, errors in diet, unwholesome air, violent emotions of the mind, excess or suppression of usual evacuations, external or internal injuries, and extreme degrees of heat or cold. As most of these have already been treated of at considerable length, and their effects shewn, we shall not now resume the consideration of them, but shall only recommend it to all, as they would wish to avoid fevers and other fatal diseases, to pay the most punctual attention to these articles.
FEVERS are not only the most frequent of all diseases, but they are likewise the most complex: In the most simple species of fever there is always a combination of several different symptoms. The distinguishing symptoms of fever are, increased heat, frequency of pulse, loss of appetite, general debility, pain in the head, and a difficulty in performing some of the vital or animal-functions. The other symptoms usually attendant on fevers are, nausea, thirst, anxiety, delirium, weariness, wasting of the flesh, want of sleep, or the sleep disturbed and not refreshing.
WHEN the fever comes on gradually, the patient generally complains first of languor or listlessness, soreness of the flesh, or the bones, as the country people express it, heaviness of the head, loss of appetite, sickness, with clamminess of the mouth; after some time come on excessive heat, violent thirst, restlessness, &c.
WHEN the fever attacks suddenly, it always begins with an uneasy sensation of excessive cold, accompanied with debility and loss of appetite; frequently the cold is attended with shivering, oppression about the heart, and sickness at stomach, or vomiting.
FEVERS are divided into continual, remitting, intermitting, and such as are attended with cutaneous eruption or topical inflammation, as the small-pox, erysipelas, &c. By a continual fever is meant that which never leaves the patient during the whole course of the disease, or which shews no remarkable increase or abatement in the symptoms. This kind of fever is likewise divided into acute, slow, and malignant. The fever is called acute when its progress is quick, and the symptoms violent; but when these are more gentle, it is generally denominated slow. When livid or petechial spots shew a putrid state of the humours, the fever is called malignant, putrid, or petechial.
A REMITTING fever differs from a continual only in degree. It has frequent increases and decreases, or exacerbations and remissions, but never wholly leaves the patient during the course of the disease. Intermitting fevers, or agues, are those which, during the time that the patient may be said to be ill, have evident intervals or remissions of the symptoms.
AS a fever is only an effort of Nature to free herself from an offending cause, it is the business of those who have the care of the sick, to observe with diligence which way Nature points, and to endeavour to assist her operations. Our bodies are so framed, as to have a constant tendency to expel or throw off whatever is injurious to health. This is generally done by urine, sweat, stool, expectoration, vomit, or some other evacuation.
THERE is reason to believe, if the efforts of Nature, at the beginning of a fever, were duly attended to and promoted, it would seldom continue long; but when her attempts are either neglected or counteracted, it is no wonder if the disease proves fatal. There are daily instances of persons who, after catching cold, have all the symptoms of a beginning fever; but by keeping warm, drinking diluting liquors, bathing their feet in warm water, &c. the symptoms in a few hours disappear, and the danger is prevented. When fevers of a putrid kind threaten, the best method of obviating their effects is by repeated vomits.
OUR design is not to enter into a critical enquiry into the nature and immediate causes of fevers; but to mark their most obvious symptoms, and to point out the proper treatment of the patient with respect to his diet, drink, air, &c. in the different stages of the disease. In these articles the inclinations of the patient will, in a great measure, direct our conduct.
ALMOST every person in a fever complains of great thirst, and calls out for drink, especially of a cooling nature. This at once points out the use of water, and other cooling liquors. What is so likely to abate the heat, attenuate the humours, remove spasms and obstructions, promote perspiration, increase the quantity of urine, and, in short, produce every salutary effect in an ardent or inlammatory fever, as drinking plentifully of water, thin gruel, or any other weak liquor, of which water is the basis? The necessity of diluting liquors is pointed out by the dry tongue, the parched skin, and the burning heat, as well as by the unquenchable thirst of the patient.
MANY cooling liquors, which are extremely grateful to patients in a fever, may be prepared from fruits, as decoctions of tamarinds, apple-tea, orange-whey, and the like. Mucilaginous liquors might also be prepared from marshmallow roots, linseed, lime-tree buds, and other mild vegetables. These liquors, especially when acidulated, are highly agreeable to to the patient, and should never be denied him.
AT the beginning of a fever the patient generally complains of great lassitude or weariness, and has no inclination to move. This evidently shews the propriety of keeping him easy, and, if possible, in bed; lying in bed relaxes the spasms, abates the violence of the circulation, and gives Nature an opportunity of exerting all her force to overcome the disease. The bed alone would often remove a fever at the beginning; but when the patient struggles with the disease, instead of driving it off, he only fixes it the deeper, and renders it more dangerous. This observation is too often verified in travellers, who happen, when on a journey, to be seized with a fever. Their anxiety to get home induces them to travel with the fever upon them, which conduct seldom fails to render it fatal.
IN fevers the mind as well as the body should be kept easy. Company is seldom agreeable to the sick. Indeed every thing that disturbs the imagination increases the disease; for which reason every person in a fever ought to be kept perfectly quiet, and neither allowed to see nor hear any thing that may in the least affect or discompose his mind.
THOUGH the patient in a fever has the greatest inclination for drink, yet he seldom has any appetite for solid food; hence the impropriety of urging him to take victuals is evident. Much solid food in a fever is every way hurtful. It oppresses nature, and, instead of nourishing the patient, serves only to feed the disease. What food the patient takes should be in small quantity, light, and of easy digestion. It ought to be chiefly of the vegetable kind, as panada, roasted apples, gruels, and such like.
POOR people, when any of their family are taken ill, run directly to their rich neighbours for cordials, and pour wines, spirits, &c. into the patient, who perhaps never had been accustomed to taste such liquors when in health. If there be any degree of fever, this conduct must increase it, and if there be none, this is the ready way to raise one. Stuffing the patient with sweetmeats and other delicacies, is likewise very pernicious These are always harder to digest than common food, and cannot fail to hurt the stomach.
NOTHING is more desired by a patient in a fever than fresh air. It not only removes his anxiety, but cools the blood, revives the spirits, and proves every way beneficial. Many patients are in a manner stifled to death in fevers, for want of fresh air; yet such is the unaccountable infatuation of most people, that the moment they think a person in a fever, they imagine he should be kept in a close chamber, into which not one particle of fresh air must be admitted. Instead of this, there ought to be a constant stream of fresh air into a sick person's chamber, so as to keep it moderately cool. Indeed its degree of warmth ought never to be greater than is agreeable to one in perfect health.
NOTHING spoils the air of a sick person's chamber, or hurts the patient more, than a number of people breathing in it. When the blood is inflamed, or the humours in a putrid state, air that has been breathed repeatedly will greatly increase the disease. Such air not only loses its spring, and becomes unfit for the purpose of respiration, but acquires a noxious quality, which renders it in a manner poisonous to the sick.
IN fevers, when the patient's spirits are low and depressed, he is not only to be supported with cordials, but every method should be taken to cheer and comfort his mind. Many, from a mistaken zeal, when they think a person in danger, instead of solacing his mind with the hopes and consolations of religion, fright him with the views of hell and damnation. It would be unsuitable here to dwell upon the impropriety and dangerous consequences of this conduct; it often hurts the body, and there is reason to believe seldom benefits the soul.
AMONGST common people, the very name of a fever generally suggests the necessity of bleeding. This notion seems to have taken its rise from most fevers in this country having been formerly of an inflammatory nature; but true inflammatory fevers are now seldom to be met with. Sedentary occupations, and a different manner of living, have so changed the diseases in Britain, that there is now hardly one fever in ten where the lancet is necessary. In most low, nervous, and putrid fevers, which are now so common, bleeding is really hurtful, as it weakens the patient, sinks his spirits, &c. We would recommend this general rule, never to be bled at the beginning of a fever, unless there be evident signs of inflammation. Bleeding is an excellent medicine when necessary, but should never be wantonly performed.
IT is likewise a common notion, that sweatting is always necessary in the beginning of a fever. When the fever proceeds from an obstructed perspiration, this notion is not ill-founded. If the patient only lies in bed, bathes his feet and legs in warm water, and drinks freely of water-gruel, or any other weak, diluting liquor, he will seldom fail to perspire freely. The warmth of the bed, and the diluting drink, will relax the universal spasm, which generally affects the skin at the beginning of a fever; it will open the pores, and promote the perspiration, by means of which the fever may often be carried off. But instead of this, the common practice is to heap clothes upon the patient, and to give him things of a hot nature, as spirits, spiceries, &c. which fire his bIood, increase the spasms, and render the disease more dangerous.
IN all fevers a proper attention should be paid to the patient's longings. These are the calls of Nature, and often point out what may be of real use. Patients are not indeed to be indulged in every thing that the sickly appetite may crave; but it is generaliy right to let them have a little of what they eagerly desire, though it may not seem altogether proper. What the patient longs for, his stomach will generally digest; and such things have sometimes a very happy effect.
WHEN a patient is recovering from a fever, great care is necessary to prevent a relapse. Many persons, by too soon imagining themselves well, have lost their lives, or contracted other diseases of an obstinate nature. As the body after a fever is weak and delicate, it is necessary to guard against catching cold. Moderate exercise in the open air will be of use, but great fatigue is by all means to be avoided; agreeable company will also have a good effect. The diet must be light, but nourishing. It should be taken frequently, but in small quantities. It is dangerous at such a time to eat as much as the stomach may crave.