IN Compliance with your Desire, I shall now communicate to you some of those Obser­vations I have made upon that extraordi­nary Disease, which has made such awful Desolations in the Country, commonly called the Throat-Distemper.

This Distemper first began in these Parts, in Febr. 1734,5 The long Continuance and universal Spread of it among us, has given me abundant Opportunity to be acquainted with it in all its Forms.

The first Assault was in a Family about ten Miles from me, which proved fatal to eight of the Children in about a Fortnight. Being called to visit the distressed Family, I found upon my arrival there, one of the Children newly dead, which gave me the Advantage of a Dissection, and thereby a better Acquaintance with the Nature of the Disease, than I could otherwise have had: From which (and other like) Observations, I came [Page 2] pretty early into the Methods of Cure that I have not yet seen Reason to change.

There have few Distempers been ever known, that have put on a greater variety of Types, and appear'd with more different Symptoms, than this has done; which makes it necessary to be some­thing particular in describing it, in order to set it in a just View, and to propose the Methods of Cure necessary in its several Appearances. And

1. I take this Disease to be naturally an Erup­tive milliary Fever: and when it appears as such, it usually begins with a Shivering, a Chill, or with Stretching, or [...]; which is quickly succeed­ed with a sore Throat, a Tumefaction of the Ton­sils, Uvula and Epiglottis, and sometimes of the Jaws, and even of the whole Throat & Neck. The Fever is often acute, the Pulse quick & high, and the Countenance florid. The Tonsils first, and in a little Time the whole Throat covered with a whitish Crustula, the Tongue furr'd, and the Breath fetid. Upon the 2d, 3d, or 4th Day, if proper Methods are used, the Patient is cover'd with a milliary Eruption, in some exactly resem­bling the Measles, in others more like the Scarlet Fever (for which Distemper it has frequently been mistaken) but in others it very much re­sembles the confluent Small Pox When the E­ruption is finished, the Tumefaction every where subsides, the Fever abates, and the Slough in the Throat casts off and falls. The Eruption often disappears about the 6th or 7th Day; tho' it sometimes continues visible much longer. After the Eruption is over, the Cuticle scales and falls off, as in the Conclusion of the Scarlet Fever. If after [Page 3] the Crise of this Disease Purging be neglected, the Sick may seem to recover Health & Strength for a while; yet they frequently in a little Time fall again into grievous Disorders; such as a great prostration of Strength, loss of Appetite, hectical Appearances, sometimes great Dimness of Sight, and often such a weakness in the Joints as de­prives them of the Use of all their Limbs; and some of them are affected with scorbutick Symp­toms of almost every Kind.

When this Distemper appears in the Form now described, it is not very dangerous: I have sel­dom seen any die with it, unless by a sudden Looseness, that calls in the Eruptions; or by some very irregular Treatment. But there are several other very different Appearances of the Disease, which are attended with more frightful & deadly Consequences.

2. It frequently begins with a flight Indisposi­tion, much resembling an ordinary Cold, with a liftless Habit, a flow & scarce discernible Fever, some soreness of the Throat and Tumefaction of the Tonsils; and perhaps a running of the Nose, the Countenance pale, and the Eyes dull and heavy. The Patient is not confin'd, nor any Danger apprehended for some Days, till the Fe­ver gradually increases, the whole Throat, and sometimes the Roof of the Mouth and Nostrils, are covered with a cankerous Crust, which cor­rodes the contiguous Parts, and frequently ter­minates in a mortal Gangreen, if not by seasona­ble Applications prevented. The Stomach is sometimes, and the Lungs often, covered with the same Crustula. The former Case is discover­ed [Page 4] by a vehement Sickness of the Stomach, a perpetual vomiting; and sometimes by ejecting of black or rusty and fetid Matter, having Scales like Bran mixed with it, which is a certain Index of a fatal Mortification.—When the Lungs are thus affected, the Patient is first afflicted with a dry hollow Cough, which is quickly succeeded with an extraordinary Hoarseness and total Loss of the Voice, with the most distressing asthmatick Symptoms and difficulty of Breathing, under which the poor miserable Creature struggles, until released by a perfect Suffocation, or stoppage of Breath.—This last has been the fatal Symptom, under which the most have sunk, that have died in these Parts. And indeed there have compa­ratively but few recovered, whose Lungs have been thus affected. All that I have seen to get over this dreadful Symptom, have fallen into a Ptyalism or Salivation, equal to a petit Flux de Bouche, and have by their perpetual Cough ex­pectorated incredible Quantities of a tough whi­tish Slough from their Lungs, for a considerable Time together. And on the other Hand, I have seen large Pieces of this Crust, several Inches long and near an Inch broad, torn from the Lungs by the vehemence of the Cough, without any Signs of Digestion, or possibility of obtaining it.

Before I dismiss this Head, I must observe, that the Fever which introduces the terrible Symptoms now described, does not always make such a slow and gradual Approach: but some­times makes a fiercer Attack; and might proba­bly be thrown off by the Eruptions, and this [Page 5] Train of Terrors prevented, if proper Methods were seasonably used.

3 This Distemper sometimes appears in the Form of an Erysipelas. The Face suddenly in­flames and swells, the Skin appears of a darkish Red, the Eyes are closed with the Tumefaction which also sometimes extends through the whole Neck and Chest. Blisters or other small Ulcers here and there break out upon the Tumor, which corrode the adjacent Parts; and quickly bring on a Mortification, if not by some happy Means prevented. Some that are thus affected, are at the same Time exercised with all the terrible in­ternal Symptoms above described; and some with none of them. If this inflamed Tumor be not quickly discussed, it will (I think) always prove mortal.

4 Another Appearance of this Disease is in external Ulcers: which break out frequently be­hind the Ears; sometimes they cover the whole Head and Forehead; sometimes they appear in the Arm-Pits, Groins, Navil, Buttocks or Seat; and sometimes in any of the extream Parts. These are covered with the same Kind of whitish Crustula, above described, which also corrodes the contiguous Parts; and quickly, if not pre­vented, ends in a Mortification. I have ordina­rily observed, that if these outward Ulcers are speedily cured, the Throat and internal Parts remain free from the above mentioned terrible Symptoms; otherwise the miserable Patient must pass thro' the whole tragical Scene of Terrors before represented, if an external Gangreen don't terminate his Agony and Life together.

[Page 6]5. Sometimes this Disease appears first in Bubo's under the Ears, Jaws, or Chin, or in the Arm­Pits, or Groin. These, if quickly ripened, make a considerable Discharge; which brings a salutary End to the Disease; otherwise they quickly end in a fatal Mortification; or else bring on the whole foremention'd Tragedy.

6. This Disease appears sometimes in the Form of a Quinsey. The Lungs are inflamed, the Throat and especially the Epiglottis exceedingly tumefied. In a few Hours the Sick is brought to the Height of an Orthopnoea; and cannot breathe but in an erect Posture, and then with great Diffi­culty and Noise. This may be distinguished from an Angina, by the Crustula in the Throat, which determines it to be a Sprout from the same Root with the Symptoms described above. In this Case the Patient sometimes dies in twenty four Hours. I have not seen any one survive the third Day. But thro' the divine Goodness these Symptoms have been more rarely seen among us, and there have been but few in this Manner snatch'd out of the World.

As the Symptoms of this Distemper are very different, so the Methods of Cure should be res­pectively accommodated to them; and I shall therefore consider them distinctly.

When this Distemper makes its Attack with the Symptoms of a high Fever, a florid Counte­nance & c. (as in the first Case described) the first Intention, to be pursued towards a Cure, is to bring out the Eruptions as soon as possible; to which End, I order the Patient to be confin'd in [Page 7] Bed, and put into a gentle breathing Sweat, till they appear. A Tea made with Virginian Snake­Root and English Saffron, with a few Grains of Cochineal; A Posset made with Carduus Mariae boil'd in Milk, and turn'd with Wine, the Lapis contrayerva, or Gascoign-Powder; any or all of these, as Occasions requires, answer to this Pur­pose, and seldom fail of Success.

One of the most dangerous Circumstances that attend this Disease, is a Looseness, that frequently happens upon the first Appearance of the Erup­tions; which must be speedily restrain'd, and the Belly kept bound, left the morbisick Matter, eva­porated by the Pores, be recalled into the Blood, and prove suddenly fatal.—To that Purpose, I ordinarily advise to Venice-Treacle, or liquid Lau­danum, which commonly answer all Intentions. But if the Patient should be in a dozing Habit, that these cannot be used, or if these should fail of Success, any other Astringent may be used that is proper in a Diarrhoea.

The Ulcers in the Throat should be constantly cleansed, from the Time of their first Appearance. I have found the following Method most suc­cessful to this Purpose. Take Roman Vitriol, let it lie as near the Fire as a Man can bear his Hand, till it be thoroughly calcined and turn'd white. Put about eight Grains of this into half a Pint of [...]: Lay down the Tongue with a Spatula; and gently wash off as much of the Crust as will easily separate, with a fine Ragg fastned to the End of a Probe, or Stick, and wet in this Liquor made warm. This Operation should be repeated every three or four Hours.

[Page 8]After the Eruptions are quite gone, the Patient should be purged two or three Times, to prevent the Consequences above described; and this Rule should be observed in every Form of the Disease.

If after the Crise of this Disease, in any of its Appearances, the Sick should fall into any of the Disorders mentioned under the first Head, such as Loss of Strength, a feverish Habit, Dimness of Sight, Weakness of the Joynts &c. Repeated Purging, as far as the Patient's Strength will bear, with Elixir Proprietatis given twice a Day in a Glass of generous Wine, will constantly remove these Difficulties.

When this Disease makes a more slow and lei­surely approach with a lingering Fever, pale Coun­tenance &c as described in the second Case; all Attempts to bring out the milliary Eruptions seem in vain. And therefore, tho' the Sick may be very much relieved by the diaphoretick Medicines above mentioned, if repeatedly used during the Course of the Illness; yet these are not to be depended upon for a Cure. But a brisk Purge should be also directed every third Day, and those Catharticks that are mixt with Colomel or Mercu­rius dulcis, are most likely to be serviceable, where the Age and Strength of the Patient will bear it.

If there be an extream nauseating, and vehe­ment Sickness of the Stomach, that can't be o­therwise quieted, an Emetick seems necessary; tho' I have not found Encouragement to use vo­miting Physick in any other Case.

The internal Ulcers of the Throat should be treated as above directed; but if there be a great [Page 9] Tumefaction of the Glands, I order externally a Plaister of Diachylon cum Gummi and de Ranis cum Mercurio mixt; and internally the following Fumigation. Take Wormwood, Penny-royal, the Tops of St. John's Wort, Camomile-Flowers and Elder-Flowers, of each equal Parts; both very strong in Water; when boil'd, add as much Brandy or Rum as of this Decoction; steam the Throat thro' a Tun­nel, as hot as can be born, three or four Times a Day.

When the Lungs are seized with this cankerous Crustula, which is indicated by the Cough and Hoarseness above described, Mercurial Cathar­ticks frequently repeated, seem the best of any Thing to promote Expectoration. I have also found Success in the Use of the Syrup of red Poppies and Sperma Ceti mixt.

When this Distemper appears in the Form of an Erysipelas, I have used the following Fomenta­tion with good Success. Take Wormwood, Mint, Elder-Flowers, Camomile Flowers, the Tops of St. John's Wort, Fennel Seeds pounded, and the lesser Centaury, equal Parts: Infuse in go [...]d Brandy or Jamaica Rum, in a Stone-Jugg well stop'd, and kept hot by the Fire: wet a Flannel Cloth with this; and after moderately squeezing out the Liquor, apply three or four double to the Tumor, as hot as can be born, every Hour.—In this Case I repeat Purging, as above directed.

As for the external Ulcers above described (un­der the 4th Head) they may be always safely and speedily cured, by applying once or twice a Day a good thick Pledget of fine Tow dipt in the above described vitriolick Water. I have ne­ver [Page 10] known this fail in a single Instance, when seasonably used. But then it must be observed, that some of these Ulcers will require this Water much sharper with the Vitriol, than others will bear. It should be so sharp as to bring off the Slough, dry up the flow of corrosive Humours, and promote a Digestion: but it must not be made a painful Caustick. In this the Practitioner's Discretion will guide him.

I need not say any more respecting the Bubo's, mentioned under the fifth Head; but that they must by all possible Means be ripen'd as quick as they can; and launced as soon as they are di­gested and found to contain any Pus.

I have not yet found any effectual Remedy in the 6th and last Case described.

Upon the Disease in general, I have made the following Remarks; which perhaps may be of some Use.

I have observ'd, that the more acute the Fever is on the first Seizure, the less dangerous; because there's more Hope of bringing out the Eruptions.

I have observ'd, that there's more Danger of receiving Injury from a cold Air in this, than in any eruptive Fever I [...]ve seen. The Eruptions are easily struck in; and therefore there ought to be all possible Care, that the Sick be not at all exposed to the Air, till the Eruptions are quite over and gone.

I have also observ'd, that there's much greater Danger from this Disease in cold Weather, than in hot. In cold Weather it most commonly appears in the Form described under the second Head; [Page 11] while on the contrary, a hot Season very much forwards the Eruptions.

I have frequently observ'd, that once having this Disease is no Security against a second Attack. I have known the same Person to have it four Times in one Year; the last of which prov'd mortal. I have known Numbers, that have passed thro' it in the eruptive Form in the Summer Season, that have died with it the succeeding Fall or Winter: tho' I have never seen any upon whom the Eruptions could be brought out more than once.

I have ordinarily observ'd, that those who die with this Disease, have many Purple-Spots about them; which shews the Height of Malignity and Pestilential Quality in this terrible Distemper.

Thus, SIR, I have endeavour'd in the most plain and familiar Manner to answer your De­mands. I have not attempted a Philosophical Inquiry into the Nature of this Disease, nor a Rationale upon the Methods of Cure. I have meant no more than briefly to communicate to you some of my Experiences in this Distemper, which I presume is all you expect from me. If this proves of any Service, I shall have Cause of Thankfulness: If not, you'll kindly accept my willingness to serve you, and to contribute what I can towards the Relief of the afflicted and mi­serable.