THE REMARKABLE EFFECTS OF FIXED AIR In Mortifications of the Extremities.
[1]MRS. BUDWORTH, a midwife, of Epſom, aged 90, was ſeized, on the 19th of January, 1780, with a violent inflam⯑mation on the calf of the leg, attended with excruciating pain. It came out, upon enqui⯑ry, that ſhe had been ſubject, for five or ſix months before, to occaſional chills, or ſhiver⯑ings, which were attributed to her years; but, upon the whole, ſhe had been as well as people commonly are at ſo advanced an age. She had frequently experienced erratic pains in the lower [2]extremities for many years preceding, and lat⯑terly her legs and feet would occaſionally be⯑come oedematous; but ſhe had never been at⯑tacked by any complaint of conſequence, which probably was owing to a very regular, or rather abſtemious, mode of living. Not⯑withſtanding there was a very conſiderable in⯑flammation of the part, the pulſe was neither hard nor very quick. Indeed the degree of fever was by no means ſo ſtrongly marked in the pulſe as it was in the tongue, which was dry, rough, and diſcoloured. I applied the Saturnine poultice to the leg, and directed four ſpoonfuls of the following mixture to be taken every ſix hours:
Take of decoction of the bark, 6 oz. and a half; Huxham's tincture of bark, one ounce; Thebaic tincture, one drachm and a half; cordial confection, one drachm; ſolutive ſyrup, two drachms; Mix them together.
The next day the pain and inflammation were much the ſame, and the poultice and mixture were continued as before.
[3]21ſt. The medicines had not been regularly given. The inflammation was extended as low down as the heel, with a livid appearance; and veſications here and there, with a black⯑neſs underneath, denoted the mortification to be begun. I applied a poultice, of linſeed⯑flour with elder-ointment, over the whole leg and heel, renewing it twice a day, and conti⯑nued the mixture. Her diet was ſago, ſalop, and water-gruel, with the addition of a little brandy, cinnamon, and nutmeg.
From this time to February the 20th, the mortification ſpread ſlowly, and at length reached the heel. The medicines were taken very irregularly; but, when ſhe did take them, it was obſerved they relieved the pain. The body was occaſionally kept open by an infuſion of ſena, and ſometimes an emollient clyſter was thrown up. She took brandy and wine freely with her gruel and ſago, and ſometimes would get down a bit of veal or chicken.
She now (February 20) refuſed medicine al⯑together: I therefore reſolved to try the effects of a fermenting poultice. I applied a compo⯑ſition of flour, yeſt, and honey, in the act of [4]fermentation, laying it on thick over the whole affected part. Upon taking it off, at the end of thirty-ſix hours, I muſt acknow⯑ledge I was ſurpriſed to ſee the alteration. There was a free diſcharge of thin matter; the lividneſs was abated; and the painful twitch⯑ings, which for ſome days paſt had been very troubleſome, were conſiderably leſſened.
February 23, 24, 25. The cataplaſm was renewed daily, and the ſloughs (which were about-half an inch deep) ſeparated faſt: the twitchings leſs painful, and leſs frequent.
March the 1ſt. The ſloughs were quite ſeparated, and the ulcer began to cicatriſe. The pain was gone, and her health viſibly im⯑proved.
March the 2d. A ſpot upon the os ſacrum was ſhewn me this day, of the ſize of a half⯑crown, black and mortified. I directed ſome of the ſame poultice to be made, ſtiffer than the former, and applied upon leather. By the 7th a digeſtion was effected, and the part put on the appearance of healing. In the mean time the ſore in the leg continued to heal.
[5]March the 8th. She was taken with a faint⯑ing-fit, from which ſhe was recovered with ſome difficulty. I directed a cordial mixture, but ſhe could take but little of it; and, refu⯑ſing all nouriſhment, ſunk gradually, and ex⯑pired the next day.
The day before ſhe died, I examined the leg. The ſore looked very pale, and rather dry; but there was not the leaſt appearance that threatened a return of the mortification. The ſore had contracted about a fifth part.
The fermenting cataplaſm I made uſe of in this caſe, was made thus: Take of honey two parts, yeſt one part, wheat-flour a ſufficient quantity to form a conſiſtence neither ſtiff nor ſoft; ſet it before the fire, and apply it when it begins to riſe.
* CHRISTOPHER BUCKLE, Eſq. of Banſtead, near this place, aged 70, was at⯑tacked with a mortification of the great toe, January the 11th, 1780, without any prece⯑ding illneſs. It appeared in the form of a [6]black ſpeck at the top of the toe cloſe to the nail, and the ball of the toe was livid and em⯑phyſematous. I directed him to make uſe of the following fomentation twice or three times a day, an hour at a time:
Take of crude ſalt of ammoniac, an ounce; camphorated ſpirits of wine, two pints; Mix them together.
After ſomenting, the toe was dreſſed with balſam of copaiba, warm, and a large poultice was applied of linſeed flour with a little lard. A drachm of the bark, in powder, was given every four hours; and he was to keep his body open with the Scotch pills.
January the 14th. The toe was very flaccid, which induced me to make an inciſion into it; when I diſcharged, without pain, a pale watery fluid. I now wiſhed him to try opium in conjunction with the bark; but, as I could not perſuade him to take opium internally, I contented myſelf with diſſolving two ounces of it in the fomentation.
By January the 22d, the mortification was ſpread, and veſications appeared on the ſe⯑cond, third, and fourth, toes. I now pre⯑vailed [7]upon Mr. Buckle to allow the addition of Thebaic tincture, of which he took 120 drops every twenty-four hours, and an ounce of bark, in ſubſtance, in the ſame ſpace of time.
January the 25th. The mortification was ſtopped; but, the event being ſtill very du⯑bious, I requeſted farther aſſiſtance. A gen⯑tleman of the firſt eminence (Mr. Pott) in ſurgery was ſent for from London; who ap⯑proved of what had been done, and directed the continuation of the ſame applications and medicines.
January the 28th. Some faint ſigns of di⯑geſtion appeared; but, to cut the hiſtory ſhort, it was not until the 28th of February that the ſloughs were all ſeparated. In the mean time my patient was repeatedly brought to the brink of the grave, by a violent* car⯑dialgia and† diarrhoea at firſt, and afterwards by an accumulation of excrement in the‡ rec⯑tum, which I, with great difficulty, unloaded by means of a large marrow-ſpoon.
[8]April the 16th. The ſore was healed, and I took my leave; but, July the 1ſt, Mr. Buc⯑kle relapſed. On the ſide of the* metatarſal bone of the little toe a bliſter had ariſen; which being ſnipped, it formed an eſchar as black as ink. At his requeſt I applied the fermenting poultice mentioned in the firſt caſe, for he was determined to die rather than ſub⯑mit to the former courſe of medicine.
Auguſt the 2d. He was completely cured, without any internal medicine whatſoever. Mr. Sanxay, of this neighbourhood, paid three viſits during the cure, and faw the progreſs of it with admiration.
November the 10th. He relapſed again. A large veſication aroſe on the inſide of the heel, which, being ſnipped, formed an eſchar as before. The fermenting poultice was ap⯑plied. This eſchar was rather larger than a crown-piece, and almoſt as deep as the heel⯑bone. It was healed, with great difficulty, on the 24th day of October, 1781, when it was firmly cicatriſed without any other application [9]ſave that of daily waſhing the ulcer with tinc⯑ture of myrrh before the poultice was applied.
Mr. Buckle, from October the 24th, 1781, to the 3d of December, 1782, had no return of his mortification, but received a ſtroke of the palſy on that day, for which, on the 5th, two bliſters were applied to the calves of the legs; they were prevented from mortifying by the timely application of the fermenting poul⯑tice.
December the 26th. The bliſters were healed; and, on the 10th of January, 1783, this worthy gentleman, after having ſupport⯑ed himſelf with great fortitude and patience, ſunk under the diſeaſe, and, I cannot forbear adding, to the great regret of all thoſe who were acquainted with his excellent character.
THE HISTORY OF SOME WORM-CASES, With an INTRODUCTION.
[]THE frequent inſtances I ſaw of the moſt deplorable effects from worms, both in infants and adults, during my reſidence at Charles-Town, in South Carolina, induced me to make many trials of various remedies re⯑commended to me in that country for their* anthelmintic virtues. I had very early op⯑portunities in life of becoming acquainted with the medicines commonly employed in ſuch caſes, and had often reaſon to lament the [12]inefficacy of ſome of them and the dangerous roughneſs of others. The tender age and re⯑duced ſtate of thoſe who are the greateſt mar⯑tyrs to this diſeaſe ſeem evidently to point out the mildeſt remedies as moſt deſirable, whilſt, at the ſame time, the common obſtinacy of the complaints as loudly calls for the moſt powerful aſſiſtance. Thoſe, therefore, who have truſted to rhubarb, Aethiop's mineral, worm-ſeed, powder of tin, and the expreſſed oils, have frequently had the mortification to be ſpectators of the daily progreſs of the diſ⯑eaſe; and the bolder practitioner, who has ſcoured the ſtomach and bowels with antimo⯑nials, mercurials, and the violent draſtic pur⯑ges, has had but little reaſon to boaſt of the ſuperior efficacy of his medicines, when the o⯑riginal complaints have been ſucceeded by a lingering and fatal hectic.
The remedies, which I hereby recommend to the patronage of the public, are the reſult of ten years experience, during which time I have never known an inſtance of their failing; but, efficacious as they are, they operate with the greateſt mildneſs, and are ſubject to no ill [13]conſequences whatever afterwards. They may be taken at any time, requiring not the leaſt confinement; on the contrary, gentle ex⯑erciſe aſſiſts the medicine as well as the pa⯑tient. It is not only in the more evident and marked worm-caſes that they are of uſe; they are equally ſerviceable in that ſlow fever which is ſo frequent in the metropolis, and which is commonly called the worm-fever, though of⯑tentimes the patient is cured without the diſ⯑charge of actual worms. In ſhort, in all foul bowels, attended with coſtiveneſs, ſhortneſs of breath, and ſallow countenance, I can moſt conſcientiouſly recommend theſe medicines, as they never fail to remove the ſymptoms gra⯑dually, clearing the ſkin and reſtoring health.
Notwithſtanding theſe medicines may be gi⯑ven without any riſk from cold, they neverthe⯑leſs require to be altered, and proportioned to the ſtrength, age, habit, and other circum⯑ſtances, of the patient; which renders it ab⯑ſolutely neceſſary that he ſhould be attended both before and during the time of taking them, otherwiſe it will not be poſſible to ad⯑miniſter them with any degree of certainty.
[14]I cannot conclude without attempting an a⯑pology for the intruſion of an unknown medi⯑cine upon the courteſy of the public: but, as I cannot at preſent reveal the ſecret, and am perfectly ſatisfied that, upon trial, its own merits will ſufficiently recommend it, I ſhall only beg leave to add, that no one, who is ac⯑quainted with the virtues of James's powder, will think himſelf authoriſed to diſpenſe with its uſe becauſe he is ignorant of the pre⯑ciſe form of the compoſition.
I ſubjoin a curſory hiſtory of a few caſes, by way of adding weight to what I have advanced above.
CASE the FIRST.
1781. October 30. A boy, aged about e⯑leven years, ſon of Charles Greenfield, a la⯑bouring man, who ſupplies the village of Ep⯑ſom with water, was attacked with St. Vitus's dance. I gave him a mixture of liquid lauda⯑num two drachms, aſſafoetida-tincture four drachms, made into a ſix-ounce mixture; of which he took a large ſpoonful at a time, often, without relief.
[15]November 2. Being of opinion, that worms are the moſt common cauſe of convul⯑ſions in young people, I gave him three worm-purges, which brought away ſeveral worms, and he gradually recovered.
1782. May 29. He relapſed, and was cu⯑red by taking ſix doſes.
1783. January 20. He relapſed again; for which I made him continue the medicines, once every three days, for twenty-five days.
October 20. He is ſtronger and heartier than ever; and is at this time perfectly well.
His friends would not permit him to take a few doſes while he was well, by way of pre⯑vention, or, in my opinion, he would not have relapſed.
CASE the SECOND.
1782. June 21. The child of Eſau Ar⯑cher, a labouring man, aged between two and three years, was brought to me in ſtrong con⯑vulſions. I gave her eight doſes of the medi⯑cines. She voided ſeveral worms, and was perfectly cured.
CASE the THIRD.
[16]1782. March 19. The Reverend Mr. Price's cook-maid, a young woman, aged twenty-three, was ſeized with violent convul⯑ſion-fits, for which, being very* plethoric, ſhe was bled; and an emetic was preſcribed, with a nervous anodyne draught at bed-time, and a purging mixture to take the next morning.
March the 20th. Continuing almoſt in the ſame ſtate, a mixture of liquid laudanum and aſſafoetida-tincture was preſcribed, without relief.
21ſt. A purge of jalap and a few grains of prepared mercury were preſcribed; after the operation, the mixture with laudanum and aſ⯑ſafoetida was continued.
22d. A phyſician of eminence was called. He recommended half an ounce of the herb called ladies-mantle, to be divided into eight doſes, of which one was to be taken three times a day.
[17]24th. At times ſhe put on the appearance of being relieved. The flowers of ladies mantle were continued until April the 5th, when ſhe relapſed, and was convulſed as ſe⯑verely as at the beginning. An electary, of valerian, Ruſſia caſtor, and conſerve of roſe⯑mary, with an infuſion of rue and ſoot-tinc⯑ture, in a mixture, after it, was preſcribed.
April the 7th. Extremely ill. A perpe⯑tual bliſter was made between the ſhoulders.
17th. From the 7th to this day never en⯑tirely free from the convulſions. An ounce of valerian-powder was divided into four doſes, one of which was taken every ſix hours in four ſpoonfuls of the rue-mixture. In the even⯑ing of this day, ſhe was ſo ill as to be ſcarcely able to ſwallow. A muſk-draught was direct⯑ed to be taken every eight hours, as it could be got down.
April the 22d. No ſucceſs having attended the medicines preſcribed, it made the doctor determine to try a noſtrum; which was two ſcruples of the lungs of a calf, dried in an o⯑ven and powdered, twice a day, in three ſpoonfuls of ſtrong rue tea. After taking [18]theſe powders a few days, her complaint put on the appearance of mending, and we hoped for ſucceſs; when, to our great mortification, on the 7th of May, ſhe was attacked as vio⯑lently as ever. The bliſter was renewed.
May the 8th. A box of pills, compoſed of wood-ſoot and balſam of amber, was directed; three or four to be taken three times a day.
May the 12th. The pills were continued; but the doctor deſpaired of her getting the better of the fits, as they generally laſted four or five hours without intermiſſion.
May the 20th. A quack-medicine was re⯑commended, which had the appearance of ſweet ſpirit of vitriol; one phial was ſaid to be a cure for all convulſions. She took two phi⯑als with no apparent ſucceſs.
June the 6th. The doctor gave her over, declaring it was not poſſible for her to live. This being the caſe, I informed her friends of a worm-medicine which I gave with great ſucceſs, and recommended it to her; to which they conſented. I ſent eight doſes, one to be taken morning and evening. Before ſhe had taken all, ſeveral worms were voided; and [19]once more her complaint put on the appear⯑ance of mending.
May the 11th. The powders were conti⯑nued; and ſhe diſcharged an amazing large quantity of worms, knotted. She was much altered for the better.
17th. Her countenance began to aſſume the appearance of returning health. The convulſions had entirely left her. Appetite good; ſtrength increaſing; daily voiding worms.
25th. Almoſt able to do her buſineſs. Ne⯑vertheleſs, as ſhe had voided ſo large a quan⯑tity of worms, I continued the medicines once a day by way of ſecurity, and left them off in three days.
June the 30th. Perfectly recovered.
July the 2d. I thought it neceſſary to give her three doſes more of the medicines, to ſe⯑cure her health.
18th. Gave her three doſes for the ſame reaſon.
1783. June 18. Gave her three doſes by way of prevention.
[20]October the 30th. She is in good health, and better than ſhe had been for years before.
CASE the FOURTH.
1783. July 20. — Graham, Eſq. M. P. requeſted me to ſee his ſon, an infant, aged two years, ill, as I was informed, of a worm⯑fever. I found his belly very large and ſwel⯑led, his countenance ſallow, a ſlow fever, pulſe quick and ſmall, his mouth full of little ulcers, and coſtive. The firſt doſe of the worm-medicine gave him a large, foetid, ſli⯑my, ſtool, very looſe, which afforded him great relief.
21ſt. The medicine was repeated, which gave him another ſtool. He was much better.
22d. The medicine was repeated again.
26th. The gentleman, who attended, wrote, that the child was recovering faſt, and needed no more of the medicine.
CASE the FIFTH.
Auguſt the 4th. Stephen Caleb, of Ban⯑ſtead, a village near Epſom, brought his ſon [21]to me, a boy about eight or nine years old. He had, for ſeveral months paſt, languiſhed under a ſlow fever, pain of the ſtomach, and now and then was thrown into a convulſion⯑fit. He was much emaciated; could hardly walk alone. I gave three doſes of the medi⯑cines, which brought away ſeveral long worms. He had leſs fever, and was much better.
17th. Repeated the medicines. He void⯑ed more worms. His pain in the ſtomach, and fits, entirely left him.
September the 30th. Recovered.
CASE the SIXTH.
1783. Auguſt 20. James Edes, a ſhoe⯑maker, at Banſtead, brought his ſon to me, a boy aged nine years, who had been very ill ſe⯑veral months with a worm-fever, pain in the ſtomach, a cough, and enflamed eyes. I cu⯑red him with eleven doſes of the medicines. He voided many worms.
CASE the SEVENTH.
[22]1783. April 11. Mrs. Foreman's footman, at Epſom, aged twenty-two or twenty-three, applied to me. He complained of a fixed pain in the pupils of his eyes, which ſeemed re⯑markably dejected; a florid countenance, fluſhing often, pain of the right ſide and ſto⯑mach, a tickling cough; a ſmall, thready, un⯑equal, pulſe; hectic heats and night-ſweats. An emetic was adminiſtered, and the next morning a cooling purge. He was adviſed to eat little fleſh; to take butter-milk for break⯑faſt and ſupper, or whey, or milk-porridge; and to eat freely of ſallad and other vegeta⯑bles.
April the 27th. A bliſter was applied be⯑tween the ſhoulders, and made perpetual for ſeveral weeks; and, as he grew worſe, he was directed to abſtain from animal food. To ſhorten the hiſtory, he continued in this ſtate until the ſeventh of Auguſt following, when he was adviſed to go and try his native air in Suſſex.
[23]September the 9th. He returned much in the ſame ſtate, excepting that the pain was fix⯑ed in the ſtomach; conſtant and ſevere, always, after eating ever ſo little; to uſe his own words, it had the feel of ſomething ſtriking gently againſt his ſtomach.
26th. Daily growing weaker, I recom⯑mended him to take the* anthelmintic, appre⯑hending that worms might be the cauſe of his complaint.
October the 1ſt. He had taken eight doſes, and voided ſeveral knotted worms of various ſizes.
16th. From the 26th of September to this day, he took, morning and evening, a doſe of the medicine, and every day voided ſome worms. His pain in the ſtomach, cough, hectic heats, &c. have all diſappeared, and he is now well.
20th. He voided more worms. On that account, I ſent him three more doſes of the medicines. He is perfectly well, without any complaint, October the 23d, 1783.
February the 28th, 1785. Remains well.
THE END.
