A TREATISE ON THE HOOPING COUGH.
OBSERVATIONS ON THE TUSSIS CONVULSIVA, OR, HOOPING COUGH, AS READ AT THE Lyceum Medicum Londinenſe.
WHEREIN THE NATURE, CAUSE, AND CURE OF THIS DISEASE ARE ENDEAVOURED TO BE DEMONSTRATED, AND THE PRACTICE OF EXHIBITING EMETICS, SHEWN TO BE PERNICIOUS AND USELESS.
By JOHN GALE JONES.
STAT SUA CUIQUE DIES; BREVE ET IRREPABILE TEMPUS OMNIBUS EST VITAE; SED FAMAM EXTENDERE FACTIS HOC VIRTUTIS OPUS—
LONDON: PRINTED FOR ALLEN AND WEST, No 15, PATER⯑NOSTER-ROW.
[PRICE ONE SHILLING.]
TO THE PRESIDENT AND MEMBERS OF THE Lyceum Medicum Londinenſe.
[]PERMIT me to dedicate to you, and to pre⯑ſent for your Acceptance, the following little Treatiſe on the Hooping Cough. I regret that both in its Compoſition and its intrinſic Merit it is ſo little worthy of your Attention, and ſo little capable of affording either Amuſement or Information. You will readily perceive that it is the Work of a young, and perhaps of an inexperienced Man, but you will alſo acknow⯑ledge, that the intereſting Nature of the Sub⯑ject, and its being a firſt Performance, entitle it to a candid and liberal Allowance. As a Member of the Lyceum Medicum Londi⯑nenſe, I feel myſelf intereſted in its Welfare and Proſperity, and as a medical Practitioner, I am anxious to contribute my feeble Efforts towards the Advancement and Promotion of [vi]ſo valuable a Science. I have to lament that my preſent Embarraſſments and the ſurrounding Situation of Affairs, have for a while diverted my Attention towards thoſe Subjects, which though not leſs uſeful are generally conſidered as improper to be purſued by thoſe who are educated in the medical Profeſſion. How far the Obſervation may be juſt, or the Cenſure merited, can be decided only, by an Inveſti⯑gation of preſent Circumſtances, and an impartial Enquiry into the Probability of future Events. I can only add, that ſhould the pre⯑ſent little Trifle be ſo fortunate as to experi⯑ence a favourable Reception; I truſt it will be received but as an Earneſt of future Exertions, and that I ſhall be readily believed when I aſ⯑ſert, that my moſt ſincere and anxious Deſire is to purſue thoſe Labours and thoſe Studies which are found from Experience to be the moſt uſe⯑ful and beneficial to all Mankind.
INTRODUCTORY PREFACE.
[]THE following little Eſſay was firſt writ⯑ten ſomewhat more than a Twelvemonth ago, and read as a Paper at the Lyceum Medi⯑cum Londinenſe. It profeſſes to be, rather a few practical Obſervations than a complete and regular Treatiſe. Its having occupied the Attention of the Society for twelve ſucceſſive Weeks, during which, it underwent a long and critical Examination, although it afford no demonſtrative Proof of its poſſeſſing any Share of Merit, will furniſh at leaſt, an Apology for its Publication.
[viii]The Author is neither unwilling nor aſham⯑ed to confeſs, that he has eſtabliſhed his Mode of Reaſoning upon the fundamental Principles of the Brunonian Syſtem; nor to take this Opportunity to declare that he entertains the moſt profound Veneration and Eſteem for its celebrated Author; and that it is his Intention, ſhould his future Leiſure and Avocations per⯑mit, and no material Obſtacles intervene, to preſent before an impartial and diſcerning Pub⯑lic, a Commentary and Defence of this truly valuable though much perſecuted Doctrine.
A TREATISE ON THE TUSSIS CONVULSIVA.
[]BEING called upon by this Society rather ſooner than I expected, to furniſh a paper for their diſcuſſion; and anxious to comply with their requiſition, although not ſufficiently pre⯑pared, I have endeavoured to bring forward to their notice, a Treatiſe on the Tuſſis Convulſiva; or, as it is more frequently denominated, the Hooping Cough: and this, not with a view, pre⯑ſumptuouſly to advance any poſitive or decided Opinion, but from a ſincere deſire to excite the attention, and provoke the diſcuſſion of thoſe, whoſe abilities and experience, while they entitle them to ſuperior reſpect, afford them alſo, the means of ſuperior information!
The Tuſſis Convulſiva, is a diſeaſe, which, al⯑though well known, has been ſeldom deſcribed; few authors having given us any regular deſcription [10]of it, or, till lately, recommended any peculiar plan of treatment: nor do they ſeem to have diſ⯑criminated it from any other cough, excepting only by that diſtinguiſhing ſymptom, which has given it the name of Hooping Cough. Specifics, in⯑deed, have been propoſed, and cicuta, by ſome practitioners, hath been highly extolled: Opium, alſo, has been eſteemed of ſuperior efficacy, and Emetics have been almoſt univerſally employed.
As the expreſs purpoſe of my introducing this ſubject to the Society, was to combat ſome pre⯑vailing opinions, and to endeavour to controvert ſome peculiar prejudices, which I conceive to have been adopted; it will unavoidably happen, that I may ſeem to deliver my ſentiments too freely, and to be guilty of great temerity in ven⯑turing to oppoſe the ſolitary teſtimony of the youth⯑ful practitioner, to the reſpectable authority of the experienced Phyſician!
But it will, I hope, be remembered, that altho' a juſt deference ſhould certainly be paid to the reſearches of Antiquity, and to the obſervations of Experience; yet it is, ſurely, a very dangerous experiment, to deſiſt from enquiry, and grow weary of inveſtigation: the diſcovery of truth has ſeldom or never been completely effected by [11]the labours of one, but by the collective and united induſtry of many: what, therefore, has eſcaped the wiſdom of the former, may happily have been granted to the perſeverance of the latter; and of the republic of letters, at leaſt, it may be ſaid, that the only Road to improvement, is through the Path of Innovation!
If, however, in what I have to offer, I ſhould ſeem eſſentially to differ in opinion and practice from the majority of this Society, I entreat them to acquit me of any imputation of obſtinate pre⯑ſumption, or affected ſingularity; and I ſolemnly aſſure them that it is from a full conviction of the truth of what I ſhall aſſert, and from a ſenſe of the duty I owe to this Society in particular, as a member, and to the public in general as a medical practitioner, that I bring forward to their notice the conſideration of a diſeaſe, frequent in occur⯑rence, always hazardous, and often fatal: in the progreſs of which, conſcious of the Inaccuracies and ſenſible of the Defects, but too viſible in this compoſition; I feel it neceſſary, while I ſolicit their attention, to claim alſo, their uſual Indul⯑gence.
I was, inſenſibly, led to this digreſſion, becauſe, upon mature deliberation, I cannot but entertain [12]very different notions of the nature and properties of the Cauſe and Cure of this Diſeaſe, and have been induced, conſequently, to adopt a very different treatment. I ſhall endeavour to give the Society, as far as I am enabled, my opinion of the diſeaſe itſelf, ſhew what are its uſual cauſes and effects, and by relating to them ſome remarkable Caſes, demonſtratively prove, what plan of treatment I have found to be ſucceſsful.
The Tuſſis Convulſiva is that diſeaſe, which, together with the ſymptoms, uſually attendant upon pulmonary affections, is accompanied with a Contagion of a peculiar and malignant nature; hence it has alſo obtained the name of Tuſſis Feri⯑na. I ſhall not heſitate here, to define it to be, a diſeaſe of clear and evident debility; and one which never takes place, but in thoſe who have either been previouſly weakened by ſome other diſeaſe, or who from ſome unknown or unforeſeen cauſe are prediſpoſed to this ſtate.
The perſons moſt liable to it are thoſe who poſ⯑ſeſs a weak, lax fibre; who uſe little exerciſe; and in fine, thoſe who, from whatever cauſe, have a deficient perſpiration. Hence Children from 4 months to 12 years, are in a remarkable manner affected by it: and indeed, I have ſeen [13]but one inſtance of its taking place in any one of riper years; and this was in a young Lady of a very delicate habit, who might be about nineteen years of age.
Its primary cauſe is contagion, which, whether it be ſui generis, or of the ſame nature with that, whereby all infectious diſeaſes are produced, and which, differing only in modification, or degree, occaſions ſometimes Small Pox, or Meaſles, ſometimes Typhus, or Hooping Cough, is at pre⯑ſent ſuggeſted, I confeſs, as conjecture only; yet perhaps not unreaſonably, ſince in a family where the Meaſles have prevailed, the Hooping Cough has frequently followed; and in the ſame child, I have experienced both diſeaſes to be at one and the ſame time preſent, cauſing however no eſſential difference in the treatment.
The proximate cauſes will be found to be all ſuch as tend to induce debility: hence at a moiſt ſeaſon, and in a damp ſituation, it is found to rage with the utmoſt violence: frequently indeed, no other cauſe than this can be traced, as I lately expe⯑rienced in attending three children, whoſe parents had juſt removed to a new and damp habitation: together with this, a relaxed habit, where the pores being more patulous, are moſt liable to the [14]impreſſion of Contagion, Pulmonary Affections in general, and in fine, any cauſe capable of inducing a languid ſtate of the ſyſtem.
Its immediate ſeat is in the exhalant and mucous arteries: the ſecreted Fluids of which, being in⯑ſpiſſated by ſtagnation in the Bronchia, form the matter of Expectoration. In this, as in any other Cough, it is the ſerous and mucous Fluids, that chiefly flow to the Bronchia, which continue to bear their preſſure for a while, till diſtended by the load, they can bear it no longer: the unplea⯑ſant ſenſation of the ſtimulus, excites a commotion in the vitality of the labouring part, and rouzes the whole excitement; a Cough ariſes and throws off its cauſe, the collected humours*.
At this time, and during a fit of Coughing, the air is violently expelled; and as an animal cannot exiſt, for any conſiderable interval without the admiſſion of air, as ſoon as poſſible, it inſtinctively makes an effort of inſpiration; when the air ſuddenly ruſhing as it were into a vacuum, cauſes that remarkable found, which from its ſuppoſed reſemblance to the articulation of the word Hoop, has given it the name of Hooping Cough.
[15]Hence it is eaſy to account for the effects pro⯑duced by this diſeaſe. They are indeed, of a very formidable nature, and are frequently of a moſt alarming and fatal tendency: ſometimes after a violent fit of Coughing, the Patient is ſeized with convulſions and inſtantly expires. This may hap⯑pen from two cauſes; firſt from the continued action of the Lungs urged by the Irritation of the Cough, preventing Inſpiration, and thus inducing ſtrangulation; or ſecondly, from the lungs, being unable to recover their tone, yielding to the im⯑pulſe of the external atmoſphere, and being over⯑whelmed by its ſudden intromiſſion. An inſtance of which I knew in a beautiful Child of about three years of age whoſe Mother had not the leaſt apprehenſion of her child's being in any danger. Sometimes, on account of the continued obſtruction of the circulation, the lungs being violently diſtend⯑ed, yield to the impetus of the ſhock, a Blood Veſſel burſts, and the patient is cut off. If, however, the patient have the good fortune to eſcape theſe dangers, the diſeaſe by gaining ground, and the cough returning more frequently, continue to weary and exhauſt, till he gradually ſink under its preſſure.
In tracing the riſe and progreſs of this diſ⯑eaſe, it will not, I hope, be deemed foreign to the ſubject, to ſay a few words reſpecting conta⯑gion, more eſpicially, as I think it will tend to [16]illuſtrate what I have hitherto conſtantly kept in view, viz. the being guided in the treatment of a diſeaſe, more by the general ſtate of the patient than by any particular ſymptom or ſet of ſymp⯑toms.
Contagion is a certain ſubtle, imperceptible matter, of an unknown nature, reſembling moſt natural phenomena, which are only in any meaſure open to our enquiry by their evident effects. Taken from the body of one affected with it, or from groſs ſubſtance (ſuch as cloathes, or furniture, where it happens to have been lurk⯑ing) and received into a healthy body; it ferments without any change of the ſolids or fluids, fills all the veſſels, and is gradually ejected by the pores; paſſing out more copiouſly or ſcantily, in propor⯑tion as the perſpiration is more free or impeded*.
As the iſſue of the matter is here promoted, by inducing a free perſpiration, ſo whatever part of it be obſtructed, and detained below the cuticle, acquires by this delay, a certain acrimony produ⯑cing little inflammations, and conducting them when produced to ſuppuration. Upon this princi⯑ple, are the ſmall pox, meaſles, and other exan⯑thematous diſeaſes to be accounted for.
[17]As contagion however requires a certain time for its tranſmiſſion; it follows, that the moſt favour⯑able ſtate for this purpoſe, will be that where the different ſecretions are moſt perfectly performed, and where, conſequently, the ſyſtem comes the neareſt to the healthy ſtate: for it is very evident from daily experience, that in weakened or vitiated habits, where the functions are ill performed, and where perſpiration is deficient, it is capable, by its detention, of infecting peculiar fluids, and con⯑verting them into a matter, ſimilar to itſelf.
Yet as contagion, by its ſubtle and peculiar nature, is found to be imbibed by all habits (per⯑fect health perhaps alone excepted) I am unwilling to allow, that it poſſeſſes any ſhare in producing general diatheſis; but that it kindles up only a ſymptomatic pyrexia, ſtrictly entitled to the ap⯑pellation of local diſeaſe, and, by its entrance into a healthy, or unhealthy conſtitution, produces thoſe different effects, which are ſeen to proceed from it.
And this imperceptibly leads me to the conſide⯑ration of ſpecifics. A medicine is denominated ſpe⯑cific, when it is applied for the cure of any peculiar diſeaſe, and is ſuppoſed to be the only [18]medicine, poſſeſſed of the power of removing or eradicating that diſeaſe.
As poiſons applied, or admitted into the ſyſ⯑tem, were found to produce certain mechanical effects, and ſeemed in ſome degree, to act in an uniform manner; the reſtleſs ſpirit of curioſity and active ingenuity of mankind, prompted them to reſearches after ſome antidote which might be peculiarly adapted to it, and prove efficacious in its diſperſion: hence Mercury, by proving ſucceſs⯑ful in the cure of lues venerea, has been denomi⯑nated its ſpecific, and ſome Practitioners have not heſitated to declare cicuta to be, a certain ſpecific for the Hooping Cough. Yet I conceive it will readily be granted, that for a medicine to be fairly entitled to the denomination of a ſpecific, it is neceſſary that it ſhould be uniform in its operation and certain in its ſucceſs: now beſide the great difficulty of actually proving the exiſtence of a ſpecific in nature, ſeveral caſes are upon record of lues venerea reſiſting the moſt vigorous applica⯑tions of mercury, in all its forms and varieties, and yielding to medicines of a very different nature. With reſpect to cicuta* ſo warmly praiſed by ſome [19]and recommended by others, I muſt frankly con⯑feſs that it becomes me to ſpeak of it with doubt and heſitation, having partly through fear, and partly through incredulity, ſeldom or never em⯑ployed it.
This diſeaſe then originating from contagion, will be found like all others of that claſs to produce in its incipient ſtate no material change or altera⯑tion. A cough is the firſt ſymptom, which differs very little from any common cough or cold. The appetite is not in general impaired; the countenance remains in its uſual ſtate; nor is it ſometimes known, that this diſeaſe is preſent, except by a knowledge of its having prevailed at any place, whence it might be ſuppoſed to be imbibed. As it proceeds, however, it becomes more clearly marked; the excretory veſſels of the lungs, being crammed with a colluvies of fluids, create a ſenſe of tightneſs in the ſternum, and great difficulty of breathing; the ſtomach begins to reject its contents, and together with theſe, great quantities of viſcid phlegm are either vomited or coughed up. The countenance grows pale, alternate heats and chills with other hectic ſymptoms take place, and the ſound reſembling the word hoop is now diſtinctly obſerved.
[20]In the laſt ſtage, the ſymptoms become more urgent and diſtreſſing: putrid ſymptoms, the uſual conſequence of contagion, manifeſtly appear; foul breath, crude dark coloured feces or violent diarrhoea; ſpaſmodic twitches of the tendons, but particularly a convulſive motion of the noſtrils; great anxiety, with high and laborious reſpiration, all but too clearly foretel the approach of death; and every day's experience brings with it ſome ſad monument of the tyranny of this dreadful diſeaſe.
To apply a ſuitable remedy in the treatment of a diſeaſe, nothing more ſeems to be neceſſary than to poſſeſs a competent knowledge of its cauſe: ſince if the cauſe be exactly aſcertained, the effects reſulting from it will be better underſtood: and as identity of known cauſe always produces identity of known effect, if the cauſe be uniform, the effect will be uniform alſo.
Unfortunately, however, in treating the diſeaſes incident to humanity, we are too apt to loſe ſight of this general and fundamental principle, and depart from the guidance of reaſon: confiding in hidden powers, which have no exiſtence, and relying on miracles which cannot take place, we ſometimes expect from a random and contradictory treatment, the moſt complete and unequivocal ſucceſs.
[21]Hence while Hooping Cough has been generally admitted to be a diſeaſe of debility, the practice of vomiting has been warmly recommended and followed; and the evacuation of an already exhauſt⯑ed ſyſtem has been, by ſome, eſteemed the moſt infallible method of reſtoring health and vigour!
An emetic, if it act according to its intention, operates by a diſcharge of the contents of the ſtomach and of ſome of the mucous fluids; and this it does, either by ſome mechanical power which it poſſeſſes, of acting on the nervous ſenſi⯑bility of its inner ſurface, or by that relaxant property, of rendering the ſtomach unable to retain its contents.
Yet as the immediate ſeat of this diſeaſe is in the mucous veſſels of the lungs, and as the ſtomach is already in a relaxed and weakened ſtate; a parti⯑cular medicine applied ſolely to that organ, and one whoſe profeſſed object is to evacuate, muſt ſurely be pernicious and uſeleſs. For although by its local effect, and by the exertion of ſtraining, expectoration may be promoted, and a temporary relief be obtained; yet the cauſe being increaſed which gave riſe to this collection, and a rude ſhock being given to an already weakened ſyſtem; the exhibition of an emetic, however it may ſeem at [22]firſt to relieve, muſt eventually tend to exaſperate the diſeaſe.
The cauſe of the collection which takes place in the veſſels of the lungs, is, as we have already ſtated, a deficient perſpiration, wherein the ſyſtem is unable to throw off its redundant fluids: by ſtagnation they inſpiſſate and form mucus; and by occupying more ſpace than is natural create a difficulty of breathing. Now if deficient perſpira⯑tion be the effect of debility, debility will be the original cauſe; and any medicine capable of pro⯑ducing that effect, will be capable alſo of en⯑creaſing the cauſe.
An emetic by depriving the ſtomach of its contents, deprives it of that which might enable it to reſiſt the diſeaſe. It exhauſts and weakens an organ which requires ſupport and nouriſhment, and encreaſes that debility which was already too pre⯑valent: mucus or phlegm as it is termed, it is true, is during the action of vomiting diſcharged; but in trifling proportion, and with conſiderable diſadvantage, the thinner parts alone being rejected and the denſer retained.
But if any one ſhould take occaſion to ſay, "we admit the truth of what you have aſſerted, that [23]this is a diſeaſe of debility, and that emetics though they afford a temporary relief, ultimately debilitate; yet as theſe fluids are already collected, and as the patient is in a ſtate of fuffocation by their retention; what remedy can be found to ſupply the place of an emetic, and ſucceed ſo well in diſcharging them from the ſyſtem?" To this I immediately anſwer; ſtrengthen the ſyſtem and the fluids will be diſperſed; encreaſe the perſpiration and they will be reſolved; preſcribe cordials and they will be expelled.
This diſeaſe then being admitted to be a diſeaſe of debility, any medicine capable of invigorating the whole ſyſtem will be found to be beneficial; and it is upon this principle and no other that bark, opium, cicuta, and other remedies have proved ſucceſsful. That they frequently fail, ariſes perhaps from this cauſe, that they are depended upon ſin⯑gly, and conſidered as ſpecifics; but as I have already endeavoured to ſhew the non-exiſtence of a ſpecific in nature, if my poſition be granted, it will be eaſy to prove that where the principle is falſe, the ſucceſs muſt be uncertain.
It has been obſerved by the late Dr. Johnſon, that nothing has ever been well done by a receipt; and I muſt confeſs that I have attended patients [24]with the Hooping Cough, where neither bark, opium, nor cicuta have been employed, and where notwithſtanding the recovery was complete.
It is not from any one particular form or ſyſtem that diſeaſes are to be eradicated and health eſtab⯑liſhed; yet as example is at all times more effica⯑cious than precept, a few authentic Caſes, while they demonſtrate a plan of treatment, may ſerve to explain the principles upon which that treatment was founded.
And as I have ever deemed it to be the indiſpen⯑ſible duty of a Practitioner to give a faithful relation of facts though they may include events of an unpleaſant nature; ſo have I always thought that the relation of unſucceſsful caſes is more than ever requiſite, when any conſideration of importance or means of improvement are to be deduced from them.
CASE I.
[25]On the 26th of Auguſt 1793, I was deſired to ſend an emetic to a child of about four years of age, who was troubled with the Hooping Cough; as I never before had an opportunity of ſeeing a complete caſe of this diſeaſe, and as I had ſome doubts reſpecting the propriety of emetics, I con⯑ſidered this as a favourable opportunity of watching the progreſs and event; and as I attended in the Family, profited by the occaſion. The child poſſeſſing a tolerable ſhare of health, and with the exception of the cough having no other particular ſymptom of diſeaſe, had rendered any previous attendance unneceſſary. Upon calling the next day I was informed that the emetic had been given, and as uſual, had brought up a conſiderable quan⯑tity of phlegm; the cough, however, was more troubleſome, and the patient very reſtleſs. The following medicine was immediately preſcribed.
On the 28th the child was ſomething better.
On the 29th Meaſles began to appear, and as he ſeemed ſomewhat feveriſh the following was pre⯑ſcribed.
On the evening of this day the child's breathing being much obſtructed, the mother procured a leech and applied it to his breaſt. The ill conſe⯑quence of this, was but too ſoon viſiblē; at night I was ſent for, and found the patient in a very alarming and dangerous ſituation; the leech had cauſed a profuſe Hemorrage, and round the orifice was a livid circle. The breathing was become high and laborious; the countenance pale, and the convulſive motion of the noſtrils was very evident; together with theſe formidable ſymptoms, a violent Diarrhoea came on, and it ſeemed to be the general opinion that the patient could not ſurvive. The following medicines were immediately pre⯑ſcribed.
[27]A clyſter of mutton broth was directed to be given warm; a pap-ſpoonful of red port between each doſe of the mixture; and the feet to be put into warm water.
On the 30th the ſymptoms much the ſame.
Diet ordered to be ſtrong beef tea, ſago, with wine, &c. &c.
[28]31ſt. Slight alteration for the better, but diarrhoea very violent.
1ſt of September the breathing very difficult and the diarrhoea ſtill continues.
2nd. The Patient conſiderably better, the purging leſs violent, the countenance more lively, and he began for the firſt time to ſpeak and call for vari⯑ous things.
On the 3d ſtill mending.
And on the 4th ſo much better that I judged it expedient for him to take his medicine at greater intervals.
On the 6th he took his medicines, with the Omiſſion of Tr Opii. and
On the 7th diſcontinued them; and being ſent into a neighbouring village for a ſhort time, for the benefit of a change of air, has ſince returned and is at this time in perfect health.
CASE II.
On the 20th of September, I was called to a child of about 8 months old with the Hooping Cough. He was of a weak puny habit from the birth, and had a ſevere illneſs ſome time before.
21ſt. The cough very troubleſome.
22nd. Being better the medicine was neglected.
23d. Breathing difficult and cough bad.
24th. Cough ſtill continues.
On the 25th the breathing being very labo⯑rious,
26th. Contin. Miſs. Card.
27th. A little better.
28th. A clyſter of mutton broth directed to be given.
29th. The child conſiderably better, but on the
30th, a relapſe. Breathing very laborious, and countenance pale with diarrhoea: weather very rainy.
1ſt October. A little better.
3d. Much better, begins to ſuck, which he had before been unable to do; and to conclude, in the courſe of about a fortnight at fartheſt, by a con⯑tinuance of cordial medicines with ſmall doſes of P. Rhab. the Patient completely recovered, and has been well ever ſince.
I have particularized this caſe, not becauſe I think that there was any thing very remarkable in it, but becauſe it was confidently aſſerted that the child could not recover; the mother and nurſe had at one time given it up as hopeleſs, and but for my perſuaſion would have left it to its fate, and becauſe no emetic had been given from the commencement to the concluſion of the diſeaſe.
On the 3d of October I was called to a Family where four children had the Hooping Cough; but as I think it would be needleſs to enter into a parti⯑cular detail of the medicines which were given, it will be ſufficient to ſay, that with the aſſiſtance of temperate cordials, light and nouriſhing diet, gentle exerciſe, and clear air, they all completely recovered.
[33]I have ſince attended ſeveral children, who by the ſame treatment, and with the excluſion of emetics, have all recovered; but I muſt paſs them over to come to a Caſe which proved unſucceſsful.
On the 1ſt of December, I viſited a child about four years old with this diſeaſe: he was very reſtleſs and rather coſtive.
2nd. The cough being troubleſome, I was ſolicited for an emetic, but gave an evaſive anſwer, expreſſing my doubt of its efficacy. The medicine was continued; but on the
3d. As the patient ſeemed to be very much op⯑preſſed in his breathing, and choaked with phlegm, I yielded to ſolicitation, and an emetic was ſent. From that time the patient gradually drooped, and notwithſtanding the utmoſt vigilance and attention, and the moſt vigorous application of medicines of the moſt powerful kind, on the 7th in the even⯑ing died.
[34]I am ſo well convinced in this caſe of the eme⯑tic's proving pernicious, that I ſhall never conſent to hazard the experiment a ſecond time; and if any one ſhould aſſert that he has given an emetic for a cough, and experienced its efficacy, I ſhall anſwer, "It is poſſible you may have cured a cough by emetics, but I do not believe that cough was the Hooping Cough."
The laſt caſe which I ſhall offer is that of an infant of ſomething more than three months old; who from being in a very imminent ſtate of danger, was happily recovered in leſs than a fortnight's time.
The medicines were of the cordial kind; clyſters were given; nutritive broths with a moderate quantity of wine: and I can here with truth and confidence aſſert, that (excepting the one I have mentioned) I have never had a caſe of Hooping Cough which did not yield to this plan of treat⯑ment.
As I have rather exceeded the limits of a paper, I muſt haſten to a concluſion. To thoſe who may think that I have been preſumptuous in my opi⯑nions and confident in my aſſertions, I ſhall beg [35] leave to oppoſe the authority of a celebrated Phyſi⯑cian. ‘"In Hooping Cough,"’ ſays he, ‘"change of climate is an idle tale, and the practice of vomiting death."’
I have ſaid that this diſeaſe is rapid in its pro⯑greſs and fatal in its effects; and I cannot bring a better inſtance than that of a child who going to a baker's, in whoſe family it prevailed, to purchaſe a roll, caught it, returned home, and being ſeized with a fit of coughing, burſt a blood-veſſel and inſtantly expired: and that of a mother who was bereft of two children, both of whom were cut off in ſomewhat leſs than eight and forty hours, with⯑out having received any treatment: and no other medicine than that abominable cuſtom, which can⯑not be too ſtrongly reprobated, and which is ſo pre⯑valent among the Poor eſpecially, viz. of giving their children repeated doſes of Vin. Antim. or Tart. Emet. without either knowledge to aſſiſt, or judgment to direct them: ſo bigotted indeed are they to theſe medicines, that they think them uni⯑verſal noſtrums; and I am acquainted with a family where Vin. Antim. is regularly adminiſtered to the children once or twice a week; by way, as it is termed, of clearing the bile from their ſtomachs! Good God! are there not already ſufficient calami⯑ties for ſuffering humanity, that we ſhould ſo [36]ſtudiouſly endeavour to create diſeaſes, where none previouſly exiſted, and thus dig pitfalls for our own deſtruction!
It is not with medicine, as with other arts and ſciences, where a miſtake may be rectified, and an amendment adopted: alas! dear-bought experience frequently comes too late, and the nature and cauſe of a complaint may be diſcovered when the occaſion for it is paſt.
I call therefore upon this Society, in their indivi⯑dual as well as in their collective capacity, to diſ⯑countenance and check the imprudent exhibitions of em [...]tics. I have brought forward proofs of their in [...]acy and ill effects: I have ſhewn the ſucceſs of a different plan of treatment: and I conjure them, by all that is valuable and ſacred, to let not theſe teſtimonies be brought in vain.
- Citation Suggestion for this Object
- TextGrid Repository (2020). TEI. 5591 Observations on the tussis convulsiva or hooping cough as read at the Lyceum Medicum Londinense By John Gale Jones. University of Oxford Text Archive. . https://hdl.handle.net/21.T11991/0000-001A-5D51-1