Observations on the Diseases of SeamenBlane, Gilbert, Sir
History
Observations on the Diseases of Seamen
Blane, Gilbert, Sir
Medicine, Naval -- Early Works To 1800; Sailors -- Diseases
[98] Great nicety is required in all cases with regard to the times
and doses of cordials; for it by no means follows that these should
be in proportion to the lowness and loss of strength. This is well
illustrated by Mr. Hunter in his Lectures, where he explains the
distinction between the powers of the body and its _actions_. There
must be a certain degree of strength to bear the excitement occasioned
by stimulating and strengthening medicines or diet; for nothing is
more pernicious, or even fatal, than that any part or function should
make exertions beyond its strength; and there is the more danger in
ill-timed remedies of this kind, as a state of weakness is generally a
state of irritability.
[99] See a method proposed for obviating this, page 358.
[100] Page 381 et seq.
[101] Sailor’s fever.
[102] See pages 161, 181, and 380-1.
[103] I have in the whole of this work been extremely cautious in
reasoning concerning causes, from an opinion that they are very
obscure, and that the theoretical part of physic is very imperfect
and fallacious. This is perhaps in no instance more remarkable than
in those opinions that prevail concerning the nature and influence of
bile in producing diseases. An increased secretion of bile commonly
attends the feverish complaints of hot climates, and those of the
hot seasons of temperate and cold climates. It is not unnatural,
therefore, to impute the disease then prevailing to this redundancy of
bile: but, upon considering the matter more closely, it will appear
to be rather a concomitant symptom, or effect, than a cause of those
fevers; for, in the first place, in those cases in which there is
the greatest secretion of bile, as in the _cholera morbus_, there is
no fever. The only danger in this disease arises from the violent
irritation produced in the bowels by such an extraordinary quantity of
this secretion which commonly passes downwards; though I have seen it
prove fatal when it flowed into the stomach, and produced perpetual
retching and excoriation of the fauces; but in this case also without
any fever. Secondly, in the most fatal of all fevers, in the West
Indies, there are no marks of an increased secretion of bile, but,
on the contrary, a preternatural defect of it, as appears by its not
being evacuated either by stool or vomiting, by the white stools which
sometimes attend the yellow fever, and by its not appearing in the
first passages, nor in its own receptacles after death. Perhaps also
that state of the bowels which renders it so difficult to procure
stools may be in part owing to the want of this natural stimulus. It
is nevertheless true, that in the intermitting and remitting fevers of
hot climates and seasons there is perhaps always an accumulation of
bile at the beginning, and an increased secretion of it during their
course. It is farther true, that this adds to the patient’s uneasiness,
and aggravates the symptoms, and that the cure consists partly in the
evacuation of the bile.
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