Chap. XXIX Of Colds and Coughs
It has already been observed, that colds are the effect of an obstructed perspiration; the common causes of which we have likewise endeavoured to point out, and shall not here repeat them. Neither shall we spend time in enumerating all the various symptoms of colds, as they are pretty generally known. It may not however be amiss to observe, that almost every cold is a kind of fever, which only differs in degree from some of those that have already been treated of.
No age, sex, or constitution, is exempted from this disease; neither is it in the power of any medicine or regimen to prevent it. The inhabitants of every climate are liable to catch cold, nor can even the greatest circumspection defend them at all times from its attacks. Indeed, if the human body could be kept constantly in an uniform degree of warmth, such a thing as catching cold would be impossible: but as that cannot be effected by any means, the perspiration must be liable to many changes. Such changes, however, when small, do not affect the health; but, when great, they must prove hurtful.
When oppression of the breast, a stuffing of the nose, unusual weariness, pain of the head, &c. give ground to believe that the perspiration is obstructed, or, in other words, that the person has caught cold, he ought immediately to lessen his diet, at least the usual quantity of his solid food, and to abstain from all strong liquors. Instead of flesh, fish, eggs, milk, and other nourishing diet, he may eat light bread-pudding, veal or chicken broth, panado, gruels, and such like. His drink may be water-gruel sweetened with a little honey; an infusion of balm, or linseed sharpened with the juice of orange or lemon; a decoction of barley and liquorice, with tamarinds, or any other cool, diluting, acid liquor.
Above all, his supper should be light; as small posset, or water-gruel sweetened with honey, and a little toasted bread in it. If honey should disagree with the stomach, the gruel may be sweetened with treacle or coarse sugar, and sharpened with the jelly of currants. Those who have been accustomed to generous liquors may take wine-whey instead of gruel, which may be sweetened as above.
The patient ought to lie longer than usual a-bed, and to encourage a gentle sweat, which is easily brought on towards morning, by drinking tea, or any kind of warm diluting liquor. I have often known this practice carry off a cold in one day, which in all probability, had it been neglected, would have cost the patient his life, or have confined him for some months. Would people sacrifice a little time to ease and warmth, and practice a moderate degree of abstinence when the first symptoms of a cold appear, we have reason to believe, that most of the bad effects which flow from an obstructed perspiration might be prevented. But, after the disease has gathered strength by delay, all attempts to remove it often prove vain. A pleurisy, a peripneumony, or a fatal consumption of the lungs, are the common effects of colds which have either been totally neglected or treated improperly.
Many attempt to cure a cold, by getting drunk. But this, to say no worse of it, is a very hazardous experiment. No doubt it may sometimes succeed, by suddenly restoring the perspiration; but when there is any degree of inflammation, which is frequently the case, strong liquors, instead of removing the malady, will increase it. By this means a common cold may be converted into an inflammatory fever.
When those who labour for their daily bread have the misfortune to catch cold, they cannot afford to lose a day or two, in order to keep themselves warm, and take a little medicine; by which means the disorder is often so aggravated as to confine them for a long time, or even to render them ever after unable to sustain hard labour. But even such of the labouring poor as can afford to take care of themselves, are often too hardy to do it; they affect to despise colds, and as long as they can crawl about, scorn to be confined by what they call a common cold. Hence it is, that colds destroy such numbers of mankind. Like an enemy despised, they gather strength from delay, till at length they become invincible. We often see this verified in travellers, who, rather than lose a day in the prosecution of their business, throw away their lives by pursuing their journey, even in the severest weather, with this disease upon them.
It is certain, however, that colds may be too much indulged. When a person, for every slight cold, shuts himself up in a warm room, and drinks great quantities of warm liquor, it may occasion such a general relaxation of the solids as will not be easily removed. It will therefore be proper, when the disease will permit, and the weather is mild, to join to the regimen mentioned above gentle exercise; as walking, riding on horseback, or in a carriage, &c. An obstinate cold, which no medicine can remove, will yield to gentle exercise and a proper regimen of the diet.
Bathing the feet and legs in warm water has a great tendency to restore the perspiration. But care must be taken that the water be not too warm, otherwise it will do hurt. It should never be much warmer than the blood, and the patient should go immediately to bed after using it. Bathing the feet in warm water, lying in bed, and drinking warm water-gruel, or other weak liquors, will sooner take off a spasm, and restore the perspiration, than all the hot sudorific medicines in the world. This is all that is necessary for removing a common cold; and if this course be taken at the beginning, it will seldom fail.
But when the symptoms do not yield to abstinence, warmth, and diluting liquors, there is reason to fear the approach of some other disease, as an inflammation of the breast, an ardent fever, or the like. If the pulse therefore be hard and frequent, the skin hot and dry, and the patient complains of his head or breast, it will be necessary to bleed, and to give the cooling powders recommended in the scarlet fever every three or four hours, till they give a stool.
It will likewise be proper to put a blistering-plaster on the back, to give two table-spoonfuls of the saline mixture every two hours, and in short to treat the patient in all respects as for a slight fever. I have often seen this course, when observed at the beginning, remove the complaint in two or three days, when the patient had all the symptoms of an approaching ardent fever, or an inflammation of the breast.
The chief secret of preventing colds lies in avoiding, as far as possible, all extremes either of heat or cold, and in taking care, when the body is heated, to let it cool gradually. These and other circumstances relating to this important subject, are so fully treated of under the article Obstructed Perspiration, that it is needless here to resume the consideration of them.
Of a Common Cough
A cough is generally the effect of a cold, which has either been improperly treated, or entirely neglected. When it proves obstinate, there is always reason to fear the consequences, as this shews a weak state of the lungs, and is often the forerunner of a consumption.
If the cough be violent, and the patient young and strong, with a hard quick pulse, bleeding will be proper; but in weak and relaxed habits, bleeding rather prolongs the disease. When the patient spits freely, bleeding is unnecessary, and sometimes hurtful, as it tends to lessen that discharge.
When the cough is not attended with any degree of fever, and the spittle is viscid and tough, sharp pectoral medicines are to be administered; as gum ammoniac, squills, &c. Two table-spoonfuls of the solution of gum ammoniac may be taken three or four times a-day, more or less, according to the age and constitution of the patient. Squills may be given various ways; two ounces of the vinegar, the oxymel, or the syrup, may be mixed with the same quantity of simple cinnamon water, to which may be added an ounce of common water and an ounce of balsamic syrup. Two table-spoonfuls of this mixture may be taken three or four times a-day.
A syrup made of equal parts of lemon-juice, honey, and sugar-candy, is likewise very proper in this kind of cough. A table-spoonful of it may be taken at pleasure.
But when the defluxion is sharp and thin, these medicines rather do hurt. In this case gentle opiates, oils, and mucilages, are more proper. A cup of an infusion of wild poppy leaves, and marsh-mallow roots, or the flowers of coltsfoot, may be taken frequently; or a tea-spoonful of the paregoric elixir may be put into the patient’s drink twice a-day. Fuller’s Spanish infusion is also a very proper medicine in this case, and may be taken in the quantity of a tea-cupful three or four times a-day108.
When a cough is occasioned by acrid humours tickling the throat and fauces, the patient should keep some soft pectoral lozenges almost constantly in his mouth; as the Pontefract liquorice cakes, barley-sugar, the common balsamic lozenges, Spanish juice, &c. These blunt the acrimony of the humours, and by taking off their stimulating quality, help to appease the cough109.
In obstinate coughs, proceeding from a flux of humours upon the lungs, it will often be necessary, besides expectorating medicines, to have recourse to issues, setons, or some other drain. In this case I have often observed the most happy effects from a Burgundy-pitch plaster applied between the shoulders. I have ordered this simple remedy in the most obstinate coughs, in a great number of cases, and in many different constitutions, without ever knowing it fail to give relief, unless where there were evident signs of an ulcer in the lungs.
About the bulk of a nutmeg of Burgundy-pitch may be spread thin upon a piece of soft leather, about the size of the hand, and laid between the shoulder-blades. It may be taken off and wiped every three or four days, and ought to be renewed once a fortnight or three weeks. This is indeed a cheap and simple medicine, and consequently apt to be despised; but we will venture to affirm, that the whole materia medica does not afford an application more efficacious in almost every kind of cough. It has not indeed always an immediate effect; but, if kept on for some time, it will succeed where most other medicines fail.
The only inconveniency attending this plaster is the itching which it occasions; but surely this may be dispensed with, considering the advantage which the patient may expect to reap from the application; besides, when the itching becomes very uneasy, the plaster may be taken off, and the part rubbed with a dry cloth, or washed with a little warm milk and water. Some caution indeed is necessary in discontinuing the use of such a plaster; this however may be safely done by making it smaller by degrees, and at length quitting it altogether in a warm season110.
But coughs proceed from many other causes besides defluxions upon the lungs. In these cases the cure is not to be attempted by pectoral medicines. Thus, in a cough proceeding from a foulness and debility of the stomach, syrups, oils, mucilages, and all kinds of balsamic medicines do hurt. The stomach cough may be known from one that is owing to a fault in the lungs by this, that in the latter the patient coughs whenever he inspires, or draws in his breath fully; but in the former that does not happen.
The cure of this cough depends chiefly upon cleansing and strengthening the stomach; for which purpose gentle vomits and bitter purgatives are most proper. Thus, after a vomit or two, the sacred tincture, as it is called, may be taken for a considerable time in the dose of one or two table-spoonfuls twice a-day, or as often as it is found necessary, to keep the body gently open. People may make this tincture themselves, by infusing an ounce of hiera picra111 in an English pint of white wine, letting it stand a few days, and then draining it.
In coughs which proceed from a debility of the stomach, the Peruvian bark is likewise of considerable service. It may either be chewed, taken in powder, or made into a tincture along with other stomachic bitters.
A nervous cough can only be removed by change of air and proper exercise; to which may be added the use of gentle opiates. Instead of the saponaceous pill, the paregoric elixir, &c. which are only opium disguised, ten, fifteen, twenty, or twenty-five drops of liquid laudanum, more or less, as circumstances require, may be taken at bed-time, or when the cough is most troublesome. Immersing the feet and hands in warm water will often appease the violence of a nervous cough.
When a cough is only the symptom of some other malady, it is in vain to attempt to remove it without first curing the disease from which it proceeds. Thus when a cough is occasioned by teething, keeping the body open, scarifying the gums, or whatever facilitates the cutting of the teeth, likewise appeases the cough. In like manner, when worms occasion a cough, such medicines as remove these vermin will generally cure the cough; as bitter purgatives, oily clysters, and such like.
Women, during the last months of pregnancy, are often greatly afflicted with a cough, which is generally relieved by bleeding, and keeping the body gently open. They ought to avoid all flatulent food, and to wear a loose easy dress.
A cough is not only a symptom, but is often likewise the forerunner of diseases. Thus, the gout is frequently ushered in by a very troublesome cough, which affects the patient for some days before the coming on of the fit. This cough is generally removed by a paroxysm of the gout, which should therefore be promoted, by keeping the extremities warm, drinking warm liquors, and bathing the feet and legs frequently in lukewarm water.
Of the Hooping-Cough, or Chin-Cough
This cough seldom affects adults, but proves often fatal to children. Such children as live upon thin watery diet, who breathe unwholesome air, and have too little exercise, are most liable to this disease, and generally suffer most from it.
The chin-cough is so well known, even to nurses, that a description of it is unnecessary. Whatever hurts the digestion, obstructs the perspiration, or relaxes the solids, disposes to this disease: consequently its cure must depend upon cleansing and strengthening the stomach, bracing the solids, and at the same time promoting perspiration and the different secretions.
The diet must be light, and of easy digestion; for children, good bread made into pap or pudding, chicken-broth, with other light spoon meats, are proper; but those who are farther advanced may be allowed sago-gruel, and if the fever be not high, a little boiled chicken, or other white meats. The drink may be hyssop, or penny-royal tea, sweetened with honey or sugar-candy, small wine-whey; or, if the patient be weak, he may sometimes be allowed a little negus.
One of the most effectual remedies in the chin-cough is change of air. This often removes the malady, even when the change seems to be from a purer to a less wholesome air. This may in some measure depend on the patient’s being removed from the place where the infection prevails. Most of the diseases of children are infectious; nor is it at all uncommon to find the chin-cough prevailing in one town or village, when another, at a very small distance, is quite free from it. But whatever be the cause, we are sure of the fact. No time ought therefore to be lost in removing the patient at some distance from the place where he caught the disease, and, if possible, into a more pure and warm air112.
When the disease proves violent, and the patient is in danger of being suffocated by the cough, he ought to be bled, especially if there be a fever with a hard full pulse. But as the chief intention of bleeding is to prevent an inflammation of the lungs, and to render it more safe to give vomits, it will seldom be necessary to repeat the operation; yet if there are symptoms of an inflammation of the lungs, a second or even a third bleeding may be requisite.
It is generally reckoned a favourable symptom when a fit of coughing makes the patient vomit. This cleanses the stomach, and greatly relieves the cough. It will therefore be proper to promote this discharge, either by small doses of ipecacuanha, or the vomiting julep recommended in the Appendix113.
It is very difficult to make children drink after a vomit. I have often seen them happily deceived, by infusing a scruple or half a drachm of the powder of ipecacuanha in a tea-pot, with half an English pint of boiling water. If this be disguised with a few drops of milk and a little sugar, they will imagine it tea, and drink it very greedily. A small tea-cupful of this may be given every quarter of an hour, or rather every ten minutes, till it operates. When the child begins to puke, there will be no occasion for drinking any more, as the water already on the stomach will be sufficient.
Vomits not only cleanse the stomach, which in this disease is generally loaded with viscid phlegm, but they likewise promote the perspiration and other secretions, and ought therefore to be repeated according to the obstinacy of the disease. They should not however be strong; gentle vomits frequently repeated are both less dangerous, and more beneficial than strong ones.
The body ought to be kept gently open. The best medicines for this purpose are rhubarb and its preparations, as the syrup, tincture, &c. Of these a tea-spoonful or two may be given to an infant twice or thrice a-day, as there is occasion. To such as are farther advanced, the dose must be proportionally increased, and repeated till it has the desired effect. Those who cannot be brought to take the bitter tincture, may have an infusion of senna and prunes, sweetened with manna, coarse sugar, or honey; or a few grains of rhubarb mixed with a tea-spoonful or two of syrup, or currant jelly, so as to disguise the taste. Most children are fond of syrups and jellies, and seldom refuse even a disagreeable medicine when mixed with them.
Many people believe that oily, pectoral, and balsamic medicines possess wonderful virtues for the cure of the chin-cough, and accordingly exhibit them plentifully to patients of every age and constitution, without considering that every thing of this nature must load the stomach, hurt the digestion, and of course aggravate the disorder114.
The millepedes, or woodlice, are greatly recommended for the cure of a chin-cough. Those who chuse to make use of these insects, may infuse two ounces of them bruised in an English pint of small white-wine for one night. Afterwards the liquor may be drained through a cloth, and a table-spoonful of it given to the patient three or four times a-day.
Opiates are sometimes necessary to allay the violence of the cough. For this purpose a little of the syrup of poppies, or five, six, or seven drops of laudanum, according to the age of the patient, may be taken in a cup of hyssop or penny-royal-tea, and repeated occasionally115.
The garlic ointment is a well-known remedy in North Britain for the chin-cough. It is made by beating in a mortar garlic with an equal quantity of hogs lard. With this the soles of the feet may be rubbed twice or thrice a-day; but the best method is to spread it upon a rag, and apply it in the form of plaster. It should be renewed every night and morning at least, as the garlic soon loses its virtue. This is an exceeding good medicine both in the chin-cough, and in most other coughs of an obstinate nature. It ought not however to be used when the patient is very hot or feverish, lest it should increase these symptoms.
The feet should be bathed once every two or three days in lukewarm water; and a Burgundy-pitch plaster kept constantly between the shoulders. But when the disease proves very violent, it will be necessary, instead of it, to apply a blistering-plaster, and to keep the part open for some time with issue ointment.
When the disease is prolonged, and the patient is free from a fever, the Peruvian bark, and other bitters, are the most proper medicines. The bark may either be taken in substance, or in a decoction or infusion, as is most agreeable. For a child, ten, fifteen, or twenty grains, according to the age of the patient, may be given three or four times a day. For an adult, half a drachm or two scruples will be proper. Some give the extract of the bark with cantharides; but to manage this requires a considerable attention. It is more safe to give a few grains of castor along with the bark. A child of six or seven years of age may take seven or eight grains of castor, with fifteen grains of powdered bark, for a dose. This may be made into a mixture with two or three ounces of any simple distilled water, and a little syrup, and taken three or four times a-day.