The diseases of women with child, and in child-bed

CHAP. XXXIII. Of the small Pox and Meazels in Infants.

THe small Pox is a contagious Disease to little Infants; which somtimes also happen, though more rarely, to persons already advanced in age, in which abundance of Pustules all alike do break forth throughout the superficies of the Skin, en∣gendred from the impurity of the Blood and other Humours which nature there casts out, as an uni∣versal emunctory to cleanse the whole body of them.

Many antient as well as modern Physicians at∣tribute

the cause of this disease to the residue of the menstruous blood, wherewith the Infant was nou∣rished in the Mothers Womb, which after its birth coming to be heated, and to boil in the Ves∣sels, is separated from the whole Mass of Blood which hath been since engendred, and is spread throughout all the superficies of the Body, to be in that manner rejected and expelled. This rea∣soning (according to my opinion) is not very probable, for we daily see many Men and Women, who though very aged, have never had this Malady, which they could never have avoided, if it proceed∣ed from the remainder of the menstruous Blood, wherewith every one without exception is nou∣rished in their Mothers Womb. They which main∣tain this opinion, reply, that though some persons be exempted from this Disease, 'tis because their strong and robust nature could digest and consume those superfluities, or else purge them off by other wayes, as by a Loosness, or in some manner more insen∣sible: However they must confess and agree, that this menstruous Blood (if it were that) could not remain hid and quiet in the Body for 30, 40, or 50 years after Birth, without producing its effects, as we see in several that have not this disease 'till those years; but 'tis much more credible, that the cause of the small Pox is the corruption of a contagious Air, which doth principally infect and spoil the blood of Infants and Youth, who are more disposed to it than they that are further ad∣vanced in years, because of the tenderness and softness of their Bodies, and more at certain years and some seasons than at others, as it may easily be perceived every day; for in pestilential times, the

small Pox is much more common in the Spring and Summer, than at the end of Autumn or in Win∣ter.

The small Pox doth differ from the Meazels, though they are so like in the beginning, that often it is difficult to distinguish them one from the o∣ther 'till after the second or third day, when the small Pox, which at first appeared like the Mea∣zels, begins to rise into Pustules, and to whiten. The Meazels are caused of a Blood bilious and over∣heated, which only makes red spots throughout the Skin, without or with but very little elevati∣on, which comes soonest and principally on the Face; but the small Pox proceeds from a sanguine and pituitous matter, which being more thick and viscous, produceth many Pustules rising high, and by degrees growing white and ripening, after which their matter drying away, they are con∣verted into Scabs.

Of the Signs of the small Pox, some precede and others accompany them; they that precede are a Fever, Sottishness, Dizziness and Pain in the Head, very troubled Urine, wea∣riness and pains in the Reins and Loins, reachings and vomitings, difficulty of breathing, frequent Yawnings, Sneezing, itching of the Nose, redness of the Eyes, and universal weariness all over the Body: but when the small Pox begins to come forth, there appears about the third or fourth day many Pimples rising every where, which grow and augment as well in bigness as number, 'till the eighth or ninth day, during which time they ripen and whiten by degrees, the Head and Face swells, the Eyes are closed by a great flux of hu∣mours

thither, the Nose is stopped with excrements which there dry, the Patient is troubled with a hoarse Voice, a dry Cough, sore Throat and great difficulty to breath; and then all the parts of the Body are so swelled through the abundance of Pimples, that it appears blown up and monstrous.

There may be two kinds of small Pox, according as it is more or less malignant; the first is that which is accompanied with but a simple emotion of a Fever, only stirred up by an ebullition of Blood and Humours, soon ceasing from the beginning without any evil accident, which ripens, suppu∣rates, and is easily and speedily cured; the Pu∣stules of these do rise full, and the matter is white, smooth and well concocted, and the Infants easily escape it, if they are but well tended.

But the other sort of small Pox, totally malignant, is that which is caused from some contagious and pestilential humour; where the Pustules are flat, brown, obscure or livid, having small black spots in their middle, they come forth but slowly, and no Suppuration follows, or 'tis very bad, sanious, watry, and accompanied with pernitious accidents, as a malignant Feaver, Phrenzy, great difficulty of Breathing, Faintness, Dysenterie, and others which often are mortal, or at least malignant Ul∣cers, foulness of the bone, loss of sight, disfigure∣ment and great deformity of the Face, or lameness of some member, according to the places where these vitious humours are conveyed and retained. These havocks are caused by that which all Women call usually the Master-pock, which is nothing else but many Pimples, by their neerness and bigness joining together, and mixing their matter, which

being thus in great quantity amassed into one place, gnawes and corrodes the part deeper, than if they were spread and disperst in many distinct Pustules; for which cause its cavity remains much more hol∣low and deformed, by reason of the great loss of substance there usually made, and depositing or transporting this villanous matter upon the Bones or other parts, it foules them, or causes their other accidents, as we have recited.

The Prognostick is drawn from the different nature, which we have now explicated: for if the Fever be small, and that it ceases proportionably to the coming forth of the Pimples, if they be not in too great quantity, and that they ripen and whiten speedily, it is a good sign; but if the Feaver be violent in the beginning, and augments every day with difficulty of Breathing and other acci∣dents, according as the Pimples come forth; if they are in great number, black, flat, dry, and without Suppuration, it is a sign of death: besides Infants are not in so great danger as elder persons, in as much as this Disease is more agreeable to their Age and Nature, and that they also have a thinner and softer Skin, through which this matter is easier expelled than through theirs that is harder, and whose Pores are less open.

As to the Meazels, they are never so dangerous as the small Pox, because its matter being more sub∣tile, is much easier and sooner evaporated, which usually terminates in three or four daies, at the end of which sometimes follows the small Pox, which often makes some, as we have said, take them one for another in the beginning, at which time they appear almost the same.

The Cure of the small Pox particularly consists in the force and vertue of nature, that endeavours to expel these malignant humours; wherefore it must be assisted to overcome them as much as may be, and fortified that it may be able to finish the work it hath undertaken, being very careful not to di∣vert it from its operation by an untimely bleeding, or a Medicine unseasonably given. To remedie this Malady, keep the Child to a good diet, avoiding solid meats all the time, giving it only Spoon∣meats, as Broaths made with Veale and Fowl, or a little of a good Jelly; let his drink be Ptysan, made with cleansed French-Barly, the roots of Dogs-grass and Liquorice, and a few Raisons of the Sun. If it be a sucking Infant, he must have no Pap 'till he be perfectly cured; and since then by reason of his age he cannot receive Remedies often enough, nor other food at the Mouth than Nurses milk, let her observe a good Diet her self, to re∣fresh and temper her Milk, as much as may be; let her not carry the Child into the Aire, but keep it in a close Room neither too hot nor cold: for too hot Air weakens it extreamly, by greatly resol∣ving and dissipating the spirits; and a too cold Air drives the Humours back into the Body, and hin∣ders the coming forth of the small Pox. Some ad∣vise it to be kept in a Bed hung round with Red Curtains, because this Colour doth ordinarily move the Humours from the Centre outwards; but this often hurts the Eyes, and inflames them by its vivacity, to which also in this disease there happens a great flux; wherefore I believe a softer Colour, what ever it be, ought to be preferred; but custome will have it so. The Infants sleep must be

moderate, that the Humours being thereby better concocted and digested, the coming forth of the Pustules may be the freer; it ought not to be to a Stupidity, for that would be a sign nature were opprest; let the Belly be kept moderately open with gentle Clysters, that the Excrements may be thence evacuated, if too long retained.

But when the Small Pox is in the beginning ac∣companied with a great Fever, difficulty of Breath∣ing and other Accidents, the principal Remedy is Bleeding, although most Women not understand∣ing the Case do condemn it, and will not suffer it to be done to their Children, imagining that it would hinder the coming forth of the small Pox; and if it happens that the Children after bleeding die, although it be through the greatness and ma∣lignity of the Disease, they will not fail to impute it to Bleeding: but it is very certain this is a pro∣fitable Remedy in the beginning of this Disease, for by this means all the Humours are cooled, and the fulness of them being evacuated, Nature easily comands and overcomes the rest. As to purging, it ought not to be used in the beginning, lest by the agitation it makes in the humours, Nature be hindered and diverted from doing its work; but towards the end it will be very convenient to empty the remaining impurities, lest these reliques fall∣ing upon some parts should spoil them.

All this while such things must be used as may fortifie the Heart; as Cordials, not of the sort of those pretended Cordial and Threacle Waters, which ordinarily are made use of, and rather cause one to vomit, than fortifie the Heart; nor those powders of Pearl and Bezoar, and other such like

trifles, which many superstitiously believe, with∣out any reason, to have a specifick quality to this purpose; but the truer and more salutary Cordials are, the breathing of sweet and clear Air, and wholesom diet, with the moderate use of things agreeable to the Stomack, and which please and comfort it; such as are Syrup of Lemmons and Pome-granats, mixed with the Childs Ptysan; or a little Wine well allayed with Water, which is the Cordial of Cordials: if the Fever be not great, and that it is a sucking Child, the Nurses Milk ought to be sufficient for all.

As to outward Remedies, or application to the Pustules, 'tis best to leave it to Nature, only assist∣ing it as we have said. And to the end they may ripen easier, assoon as they begin to appear, which is about the third or fourth day, anoint them, principally those of the Face, with oile of sweet Almonds, rubbing them with a Feather dipt in it: some mix a little Cream with it, others use only a a little fresh Butter, and others again old Hogs∣grease melted, and often washed in Rose-water, and well beaten in a marble Mortar, with which they anoint them 'till they are perfectly healed: and when the Pustules are ripe enough, which is known by the whiteness and itching that follows, and is usually about the ninth day, the biggest of them may then be pierced to empty the matter, lest by its too long stay there it ulcerates and cor∣rodes the parts too deeply. This may be done with a gold or silver Needle, or by cutting off the tops with Scissers; afterwards to dry them up, anoint the Face with a Liniment made with fresh Cream mixed with white Chalk, continuing this Remedy

'till the Scabs be quite fallen off, using it Nights and Mornings; or else with Ointment of Roses mixed with a little fine powdred Ceruse.

To hinder that the small Pox do not cause too great a flux of humours upon the Eyes, 'tis good using from the beginning some cooling Remedies, that, by moderately driving back, may hinder it. There is ordinarily used Rose-water and Plantane-water mixed together, with which they bathe them from time to time; most Women steep a little Saffron in it; but because of its strong scent, I chuse rather the Waters alone: The Nurses Milk is likewise very good to appease the pain. Care must be also taken from time to time to unstop the Infants Nostrils, that he may breath the freer, which may be done with small linnen tents; and to help the Throat, which is alwaies hoarse, a lit∣tle Syrup of Violets mixed with his Ptysan may be used; and to cut the phlegm that sticks there, give it a little Syrup of Lemmons or Pomegranats, or a Gargarism of Vinegar and Water; but the Milk only is sufficient for sucking Children. Let us now see how a sucking Child must be governed in the French Pox.