Fowle's New Hampshire Gazette And General Advertiser

Observations and Remarks on the putrid malignant SORE THROAT, which has prevailed for three years past.

(Continued from our last.)

ADULTS may take half a drachm of the powder in an ounce and a half of the decoction, warmed with any grateful compound water, every two or three hours; taking particular care to prevent any considerable tendency to a diarrhoea, from the use of the medicine. Free, but not cold air, plenty of liquid nutriment, and generous, with constant attention to keep the patients clean, their mouths and throats often washed, and their linen often changed, contribute greatly to the cure of this disease. While their skin is covered with that deep efflorescence, if they are at all sensible, they often complain of the least admission of cold air, and very frequently of much sickness and oppression, if the efflorescence disappears.

To favour the eruption it will always be proper to put those who are seized with this distemper to bed as early after the seizure as possible, and to give the mild and cordial diaphoretics. And, as a preservative, I have often recommended the Bark to be given both in decoction and substance, with the addition of such a quantity of the volatile tincture of Guaiacum, as may render it gently purgative.

The author will now take the liberty of communicating the method that has been generally pursued by the practitioners in this place, and which, at present, he believes they find no occasion essentially to alter.

In many cases the disorder is so mild as to require little more than keeping warm, at bed time taking a draught of cyder or wine whey, a little sage being previously boiled in the milk; the mouth and throat may be washed with barley water, rose leaves and sage tea with a little vinegar, and as much honey as will leave it agreeably acid.

In cases where the attack is more severe, beginning with sickness, and vomiting, it has been thought advisable to encourage it by a few grains of Ipecac: or camomile flowers tea; If after the operation of the medicine the symptoms do not abate, the following julep will, for the most part, effectually restrain the stomach.

R. Sal. Austrih vel. Tartar. gr. xx. Succ. Limon. ℥ fs. Oi. Menth. pip. gut. iij. vel. Essent. Ment. pip. gut. xx. Tinct. Thebaic. gut. xl. Aq. Font. oz ij M. F. Julep

If the oil of peppermint is used instead of the essence, it should be previously rubbed with a little sugar, and the water added by degrees; a spoonful of this julep, more or less, according to the age and circumstances of the patient, is directed to be taken every hour until the stomach is quieted. In cases where there is no sickness, or disposition to puking, an emetic has seldom been prescribed, but rather have directed them to take a Spoonful of Mindererus's spirit, taking care that the acid should predominate, rather than the salt, in the preparation of the medicine, and this medicine is continued every four or six hours, as occasion may require through the disease.

But where the symptoms are more urgent, the tendency to putrefaction great, the sloughs large and thick, and the breath offensive, recourse must be had to more efficacious remedies: Six ounces of bark, four ounces of camomile-flowers, and two ounces of Virginia snake-root are directed to be boiled or rather infused for four hours, in three quarts of water, in a close vessel, and the patient to soak his feet and legs in this infusion, made a little more than lukewarm, one hour at least, morning and evening, and oftener if the symptoms are alarming: A decoction of bark, snake-root and camomile flowers is likewise to be taken once in four or six hours, and the bark freely in substance, if it can be got down. And here it may be observed that not an instance has been seen, even where a most phlogistic diathesis appeared to prevail, that the symptoms were the least exaggerated from this treatment of the disorder, but on the contrary, the heat and restlessness have abated, a gentle diaphoresis taken place, which is far from being natural in this disease, the skin, in general, being remarkably dry:

In cases where delirium comes on in the evening, and the patient has been any time costive, a milk clyster is directed, taking care, if more than one or two stools are procured (which will sometimes be the case) to restrain the bowels with a proper dose of the Electuary of Scordio or Paregoric Elixir.

In the evening when the accession has been very great, and the patient uncommonly restless, it has been found necessary to give some gentle sedative draught.

With regard to the throat, they are directed to receive the steam of boiling vinegar, honey, and myrrh into the mouth through an inverted funnel, or the nose of a coffee pot; and where a gargarism can be used, the following one has been found very efficacious in bringing off the sloughs, and deterging the ulcers.

R Aqg. Fontan. oz. vi. Mel. com. oz. i. Tinct. Myrrh oz. fs. Spt. Salis. Marini. q. L. M F. Gurg.

Here the quantity of spirit of Salt is not mentioned, as this must be regulated by the throat, if the sloughs have separated and come off, very little can be endured, otherwise, from ten to twenty drops may be found sufficient: The patient need not be anxiously careful to avoid swallowing any of this gargarism, the myrrh as well as spirit of salt are powerful antiseptics.

It is with great difficulty that children can be brought to manage either the steam or gargarisms properly, and with infants impossible; great attention however should be paid to the cleansing the nose, mouth and throat by washings, injections, and every method that can be devised.

It frequently happens that the parotid glands are much swelled, painful, and hard, in such cases, the following volatile liniment has been used with advantage.

R. Camphor. drachm ij. Ol. Amygd. vel Olivar. oz. ij. Spl. Sal. Ammoniac. drachm ij misce.

a small quantity of this may be rubbed into the part, afterwards a fermenting cataplasm of milk, beer grounds, or yeast, with oatmeal may be applied.

As to Blisters. a promiscuous use of them is far from being thought advisable, in some languid cases they may be serviceable, yet, the inflammation, painful sloughs, deep ulcerations, and even mortifications, that have taken place seem to be more than a counter balance for all their good effects, but it is impossible to overcome the prejudices of some, and we often find blisters applied without consulting the physician; in such cases, and when any of the above disagreeable appearances take place, the before mentioned cataplasm, with the addition of some onions sliced small and previously boiled in the milk will be found one of the easiest and best applications.

The author in September 1782. attended the wife of Mr. B--j--n R--g--rs. of York, she had the disorder severely indeed: the whole of the tonsils were mortified, a blister had been drawn on one arm and leg, these limbs were swelled to an astonishing degree, no description can give an idea of the pain she suffered in them, the parts where the blisters had been laid were also mortified; yet; with a constant use of the pediluvium with bark, camomile flowers, and snake-root; the red bark taken freely in substance, and the frequent use of the gargarism before mentioned, she recovered; there was so great a loss of substance in the throat that she could scarcely utter a word intelligibly, and for many months whatever she attempted to swallow returned as freely by the nose: The mortified blisters separated and came out, leaving the bones nearly bare, and it was some months before they were fully incarned and healed, and nature has in a surprising and unexpected manner overcome the difficulty in her throat.

- In cases where blisters are thought necessary it has been found much better to apply them to the neck than on the limbs:

In some cases the putrid foetor from the breath is not only intolerably offensive to the attendants, but to the patients themselves: The fixed air emitted from the effervescence of chalk. and sharp vinegar, mixed in pretty large quantities, in a bowl, and placed near the patient's mouth will be found very advantageous,

Faintness is frequently a symptom in this disorder; genuine Madeira Wine will be found the best antiseptic cordial that can be taken.

If after the disorder is gone off, a swelling and hardness of the parotid glands remain; keeping the part warm, frictions with soft flannel, and in obstinate cases, a small quantity of mercurial ointment rubbed into the part: and a dose or two of calomel with rhubarb will remove the complaint.

It has happened with some patients, especially those more advanced in life, that on the decline of this disorder. they have been attacked with violent pains of the limbs, not unlike those of the rheumatism; and in some few instances, they have so far lost the use of them, as to be unable to stand on their feet, or make use of. their hands: in these cases the volatile tincture of gum Guaiacum, the shavings of the Guaiacum, or the saw-dust of the Lignumvita, which is more readily obtained, has speedily put an end to those complaints.

The cough and cedematous swelling of limbs that sometimes remain after the disease, are best removed by a continuance of the Bark.

It may be objected by some that few remedies are proposed. It was not the author's intention to prescribe for every symptom that might arise in this disorder; his endeavour was to point out the real nature and tendency of a disease that has become so general, under so many names and titles; as also to adopt some rational
method of cure instead of the numberless remedies constantly recommended: indeed, in all cases, more especially in one where so little can be swallowed, a few well chosen powerful remedies are to be preferred to a farrago of insignificant stuff that can serve only to tease the patient and obstinately determine him against every remedy however important and necessary.

The author is sufficiently sensible he has trespassed too much on the public's patience in taking up so much of the paper with a subject altogether professional, he will therefore conclude with the translation of a sentence often prefixed as a motto to performances of this kind.

If any one know any thing better, let him as candidly impart it, if not, use this with me.

HUMANUS.