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681. Against fear the mind is to be fortified as well as possible, by inspiring a favourable idea of the power of preservative means; by destroying the opinion of the incurable nature of the disease; by occupying men's minds with business or labour; and by avoiding all objects of fear, as funerals, passing bells, and any notice of the death of particular friends.
682. A full diet of animal food increases the irritability of the body, and favours the operation of contagion; and indigestion, whether from the quantity or quality of food, has the same effect.
683. Besides giving attention to obviate the several circumstances (610, 679, to 682), which favour the operation of contagion, it is probable that some means may be employed for strengthening the bodies of men, and thereby enabling them to resist contagion.
For this purpose it is probable, that the moderate use of wine, or of spiritous liquors, may have a good effect.
It is probable also, that exercise, when it can be employed, if so moderate as to be neither heating nor fatiguing to the body, may be employed with advantage.
Persons who have tried cold bathing, and commonly feel invigorating effects from it, if they are snywjse secure against having already received infection, may possibly be enabled to resist it by the use of the cold bath.
It is probable, that some medicines also may be useful in enabling men to resist infection: but amongst these I can hardly admit the numerous alexipharmicS formerly proposed; or, at least, very few of them, and those only of tonic power. Amongst these last we reckon the Peruvian bark; and it is perhaps the most effectual. If any thing is to be expected from antiseptics, I think camphire, whether internally or externally employed, is one of the most promising.
Every person is to be indulged in the use of any means of preservation of which he has conceived a good opinion, whether it be a charm or a medicine, if the latter be not directly hurtful.
"Whether issues be useful in preserving from, or in moderating the effects of contagion, I cannot determine from the observations I have yet read.
684. As neither the atmosphere in general, nor any considerable portion of it, is tainted or impregnated with the matter of contagions; so the lighting of fires over a great part of the infected city, or other general fumigations in the open air, are of no use for preventing the disease, and may perhaps be hurtful.
685. It would probably contribute much to check the progress of infection, if the poor were
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enjoined to make a frequent change of clothing, and were suitably provided for that purpose; and if they were, at the same time, induced to make a frequent ventilation of their houses and furniture.
Of the cure of the Plague,
686. Tn the cure of the plague, the indications are the same as those of fever in general (126); but here they are not all equally necessary and important.
687. The measures for moderating the violence of reaction, which operate by diminishing the action of the heart and arteries (128), have seldom any place here, excepting so far as the antiphlogistic regimen is generally proper. Some physicians, indeed, have recommended bleeding; and there may occur cases in which bleeding may be useful; but, for the most part, it is unnecessary, and in many cases it might be very hurtful.
Purging has also been recommended: and, in some degree, it may be useful in drawing off the bile, or other putrescent matters frequently present in the intestines; but a large evacuation this way may certainly be hurtful.
688. The moderating the violence of reaction, Bo far as it can be done by taking off the spasm of the extreme vessels (151) is a measure of the utmost necessity in the cure of the plague, and the whole of the means (152 to 200) suited to this indication are extremely proper.
689. The giving an emetic at the very first approach of the disease,, would probably be of great service; and it is likely, that at some other period* of the disease emetics might be useful, both by evacuating bile abundant in the alimentary canal, and by taking off the spasm of the extreme vessels.
690. From some principles with respect to fever in general, and with respect to the plague in particular, I am of opinion, that, after the exhibition of the first vomit, the body should be disposed to sweat; which ought to be raised to a moderate degree only, but continued for at least twenty-four hours, or longer if the patient bear it easily.
.691. The sweating Should be excited and conducted agreeably to the rules laid down in 168. It is to be promoted by the plentiful use of diluents, rendered more grateful by vegetable acids, or more powerful by being impregnated with some portion of neutral salts.
692. To support the patient under the continuance of the sweat, a little weak broth, acidulated
with juice of lemons, may be given frequently 5 and sometimes a little wine, if the heat of the body be not considerable.
693. If sudorific medicines are judged to be necessary, opiates are the most effectual and safe; but they should not be combined with aromatics; and probably may be more effectual, if joined with a portion of emetics, and of neutral salts.
694. If, notwithstanding the use of emetics and sudorifics, the disease should still continue, the cure must depend upon the employment of means for obviating debility and putrescency; and, for this purpose, the various remedies proposed above (from '201 to 227) may all be administered, but especially the tonics; and of those the chief are cold drink and the Peruvian bark.
695. In the cure of the plague, some attention is due to the management of buboes and carbuncles: but we do not touch this, as it belongs to the province of surgery.