n™ ft C // ISU EVERY MAN HIS OWN DOCTOR; OB, A TREATISE ON THE PREVENTION AND CURE OF DISEASES, BY REGIMEN AND SIMPLE MEDICINES. Br WILLIAM BUCHAN, M. D. OBO WHICH IS ADDED, A TREATISE ON THE MATERIA MEDINA ; IN WHICH THE MEDICINAL QUALITIES OE INDIGENOUS PLANTS ABE GIVEN AND ADAPTED TO COMMON PRACTICE. AN APPENDIX, Containing a Complete Treatise on the Art of Farriery ; with Direc- tions to the Purchasers of Horses ; and Practical Receipts for the Cure of Distempers incident to Horses, Cattle, Sheep, and Swine — To all of which are added, A Choice Collection of Receipts, useful in ever?/ branch of Domestic Life — Making in all a Complete Family Directory. NEW-HAVEN: PUBLISHED BY NATHAN WHITING. 1810. ^ 5>°\ ^ District of Connecticut, ss. r%E IT REMEMBERED, That on the thirteenth L. S. I -tJ day of April, in the fortieth year of the independence * L. S. * * # the said district, hath deposited iu this office the title of a book, the right whereof he claims as Proprietor, in the words follow- ing, viz. " Every Man his own Doctor ; or, a Treatise on the Prevention M and Cure of Diseases, by Regimen and Simple Medicines. By Wil- " liam Buchan, M. D. To which is added, a Treatise on the Materia " Medica; in which the Medicinal Qualities of Indigenous Plants are " given and adapted to Common Practice. With an Appendix, Con- " tainiog a Complete Treatise on the Art of Farriery ; With Directions " to the Purchasers of Horses ; and Practical Receipts for the Cure of " Distempers incident to Horses, Cattle, Sheep, and Swine—To all M of which are added, a Choice Collection of Receipts, useful in «' every branch of Domestic Life — Making in all a Complete Family M Directory." In Conformity to the Act of the Congress of the United States, en- titled, " An Act for the encouragement of learning, by securing the copies of maps, charts, and books, to authors and proprietors of such copies during the limes therein mentioned," (Signed) HENRY W. EDWARDS, Clak of the District of Connecticut. EXTRACT OF PREFACE BY DR. BTJCHAN. IN the treatment of diseases, I have been peculiarly attentive to regi- men. The generality of people lay too much stress upon Medicioe and trust too little to their own endeavours. It is always in the power of the patient or of those about him, to do as much towards his recovery as can be effected by the physician. By not attending to this, the de- signs of mediciue are often frustrated ; and the patient, by pursuing a wrong plan of regimen, not only defeats the Doctors endeavours, but renders them dangerous. I have often known patients killed by an errer in regimen, when they were using very proper medicines. It will be said, the physician always orders the regimen when he pre- scribes a medicine. I wish it Were so, both for the honour of the faculty and the safety of their patients : but physicians, as well as other people, are too little attentive to this matter. . Though many reckon it doubtful whether physic is beneficial or hurtful to mankind, yet all allow the necessity and importance of a proper regimen in diseases. Indeed the very appetites of the sick prove its propriety. No man in his senses, ever imagined that a per- son in a fever, for example, could eat, drink, or conduct himself in the same manner as one in perfect health. This part of medicine, there- fore, is evidently founded in Nature, and is every way consistent Avith reason and common sense. Had men been more attentive to it, and Jess solicitous in hunting after secret remedies, medicine had never be- come au object of ridicule. To render this book more generally useful, however, as well as oiore acceptable to the intelligent part of mankind, I have in most dis- eases, besides regimen, recommended some of the most simple and ap- proved forms of medicine, and added such cautions and directions as seemed necessary for their safe administration. It would no doubt have been more acceptable to many, had it abounded with pompous prescriptions, aod promised great cures in consequence of their use, but this was not my plan ; I think the administration of medicines al- ways doubtful, and often dangerous, and woidd much rather teach men how to avoid the necessity of using them, than how they should be used. Several medicines, and those of considerable efficacy, may be ad- ministered with great freedom aad safety. Physicians generally trifle a long time with medicines before they learn their proper use. Many peasants at present know better how to use some of the most important articles in the materia medica, than physicians did a century ago ; *» and doubtless the same observations will hold with regard to others some time hence. Wherever I was convinced that medicine might be used with safety, or where the cure depended chiefly upoa it, I have riaken care to recommend it, but where it was either highly dangerous^ , aar mt very necessary, it is omitted . r RE FACE TO THE PRESENT EDITION. IN all the Revised Edidons of Dr. Bucharfs Domestic Medicine, or Family i'hysiiian, none have been abie to make any iniprove- inui'.s on hi* system ot practice, uuicsb it has been done by way of ad- dition. This fact, together with the deservedly high estimation the Public entertain for the original work, alter die experience of many years ; is the best recommendation that can be given. In tlii:- first Edition, of Every manhii) own Doctor, the Treatise on the prevention and cure of Diseases, as laid down by Dr. Buchan, has been followed without any alteration, except the omission of some gen- eral observations, winch were designed, principally, for Physicians : anii tame artieh - v hich have become obsolete; such as the Small Pox, the biles cf Poisonous Animals, &c. The emission of these, has given room for much to be added, which has greatly enhanced the value of this Edition. It has long been the opinion of Naturalists, and men of Science, that there were m< dicinal pi. perties in many ol the Plnnis in this country, that were equal, if not superior, to the exotic drugs and medicines that are so much used. ]\:ueh has been dene within a few years, in the Bcience ol Botany ; and great discoveries have been made, which will be of la. -ting benefit to mankind. In this volume, a tieatise is given of the Materia Medica, in which the medicinal properties of indigenous plants, that are most generally known in the United States, are given, and clearly explained accord- ing to the latest aid most approved discoveries. The. Reader will at once see the advantage of such a plan, by being made acquainted with the virtues of the herbs that he is daiiy treading under foot ; and which were given fci the use of mar.; and having them described, and clas- sed, according to their different properties, an) person of common ob- servntion, need net be at a lots in most casts to know which are the most proper to be used. Id tin Appendix to this work, is also contained a valuable collec- ted, of Receipts an various subjects; among which will be found a complete s}stem oi Cookery for the sick ; and directions how to pre- pare all kii (Is of drinks, soups, 1 roths, wheys, &c. &c. Also, a highly approved Treatise on Farrier j , containing directions end ptactkal Receipts, in all cases ct accidents and distempers, to which hones, cattle, sheep, and swine are subject. CONTENTS. PART I. Of the general causes of diseases, Of Children - Page 1 7 Diseased Parents - - 2^1 Clothing of Children - 23 Food of ditto - - 26 Exercise of ditto - - 30 Bad effects ot unwholesome Air upon ditto - - 36 Nurses - - .38 The laborious, &c. - 41 The Sedentary - -47 The Studious - - 51 Aliment - - - 56 Air .... 71 Exercise - - - 75 Sleep ... 79 Clothing - - - 81 Intemperance - - 84 Cleanliness - - - 83 Infection - - 92 the Passions - - 96 Anger - - - ib. Fear ... ib. Grief - - - 99 Love - - - 100 Religious Melancholy 1 1 the Common evacuations 102 Stool - - ib. Urine - - - 103 Perspiration - - 105 being affected by Changes in the Atmosphere - ib. Wet Clothes - - 106 Wet Feet - - ib. Night Air - - ib. Damp Beds - - 107 Damp Houses - - 108 Sudden Transitions from Heat to Cold - - ib. PART II. Of Diseases. Of the Knowledge and Cure of Diseases - Page 1 1 1 Fevers in general - 114 Intermitting Fevers or A- gues - - - 119 an Acute Continual Fever 1 25 the Pleurisy - - 129 [ Bustard ditto - 133 Paraphrenias - ib. Inflammation of the Lungs ib. Of Consumptions - - 135 t) t Slow or Nervous Fever 1 44 Malignant, Putrid or Spotted Fever - - - 1 43 Miliary Fever - - 155 Remitting Fever - - 158 Of the Yellow Fever - 161 Cow pox audits Inoculation 1 68 TheMeaslef^ - - 175 Scarlet Fever - 1 78 Bilious ditto - 179 St. Anthony's Fire - 180 Inflammatici; of the Brain 184 of'ihe Eves 187 The Quinsey - - 190 MaKg-ant ditto - 195 Colds and C< ughs - - 197 A Common Cough - 200 Hooping Cough - - 202 U! itnmaiiou of the Stomach 206* of the Intestines 207 Of the Colic - - - 210 ^inanimation of the Kidneys 213 of the Bladder 215 of the Liver 216 Of (he Chopra Morbus, & oth- er (■_<■■■■■: ■-"• dis< I iiifesfrom the Stomach and Bowels 218 CONTENTS. Of a Diarrhoea, or Looseness P.220 Vomiting - • - 222 Disorders of the Kidneys and Bladder - - - 224 Of the Diabetes or excessive Discharge of Urine - ib. Suppression of ditto - 226 the Gravel and Stone 227 Involuntary Discharges of Blood 230 Bleeding at the Nose - 232 Bleeding and Blind Piles 234 Spitting of Blood - - 236 Vomiting of ditto - - 23S Blocdy Uriue - - 239 Flux - - 240 Cceliac Passion - - 244 Of the Head-ache - 245 Tooth-ache - 248 Ear-ache - - "250 Pain of the Stomach, &c. 251 Of Worms - - - 253 the Jaundice - - 257 Dropsy - - 259 Gout - - - 263 Rheumatism - 267 Scurvy - - 270 Scrophula - - 274 Itch - - - 276 Asthma - - 278 Apoplexy - - 281 Of Costiveness - - 233 Want of Appetite - - '285 Heart-burn - - - 286 Of Nervous diseases - 287 Melancholy - - 291 the Palsy - - - 293 the Epilepsy, or Falling Sickness - - 295 the Hickup - - 297 Cramp of the Stomach 298 the Night Mare - 298 S*woouin«s - - ib. Flatulencies, or Wind 301 Low Spirits - - 303 Hysteric affections - 304 Of Hypochondriac affec- tions - - - Page 306 The Tetanus, or the Locked Jaw --.. 309 Disorders of the Senses - 311 of the Eye - ib. A Gutta Serena - - 312 A Cataract - - - 313 Short Sightedness - - ib. Seeing only at too great a dis- tance - ib. Squinting - ib. Spots or Specks - ib. Bloodshot Eye - - ib. Watery or Weeping Eye 314 01 the Ear - - - ib. Taste and Smell - 316 Touch - - 317 Of a Scirrhous and Cancer 318 Poisons - - - 322 Mineral Poisons - 323 Vegetable diito - - ib. Diseases of Women - 324 Of the Menstrual Discharge 325 Pregnancy - - 330 Child birth - - 332 Barrenness - - 337 Diseases of Children. - 339 Of the Meconium - - 349 The Aphthae or Thrush - ibu Of Acidities - - - 341 Galling and Excoriation 342 Stoppage of the Nose - 343 Of Vomiting ... j^ a Looseness - - 344 Eruptions - - - 345 The Croup or Hives - 347 Teething - . . 349 The Rickets - - ?50 Convulsions - - 352 Water in the Head - 353 Surgery - - - 355 Bleeding - - - ib. Inflammations and Abscess- - 357 Wound* 359 UU1> J. Of Burns and Scalds Page 361 jar* j. a. PART III. via Bruises - - - 364 Of Indigenous Plants. Ulcers - - -365 Sweet Flag - P agt :4!7 Dislocations - - 367 Black Snake-root - 418 Dislocation of the Jaw - ib. Herb Christopher - - ib. of the neck - 368 Horse Chesnut - ib. of the Ribs - 369 Agrimony - 419 of the Shoulder ib. Garlic - ib. of the Elbow 370 Marsh Mallow - 420 of the Wrist and Andromeda Mariana . ib. fingers - ib. Sweet Fennel - 421 of the Thigh ib. Dill - ib. of the Knees ib. Chamomile - ib. of the Aucles ib. Bearberry * - 422 of the Toes ib. Burdock T 423 Of Broken Boues,^ &c. - 371 Prickly Poppy - ib. Strains - - - 373 Virginia Snake Root - ib. Ruptures - 374 Common Wormwood - 424 Casualties - - - 375 Indian Turnip - ib. Substances stoptbetween the Asa rum Canadecse - 42i Mouth and Stomach 377 Swailow-wort . ib. Drowned Persons - 380 Silk weed, or Milk weed 428 Noxious Vapours - S83 Oats - 42? Effects of extreme Cold 335 American Senna . ib. Heat 386 Jerusalem Oak . ib. Of Fainting Fits, and other Ca- Cleome Dodecandra - 423 ses which require immediate Horse Radish - ib. Assistance - ib. Garden Scurvy Grass - 429 Intoxication - - 389 Coriander . ib. Suffocation and Strangling 391 Common Dogwood . ib. Persons who expire in Con- Red Willow . 430 vulsion Fits - - 392 Wild Carrott . 431 Cautions concerning Cold Bath- Linn, or Skunk Cabbage ib. ing, and drinking; the Mineral Philadelphia Flea-Bane 432 Waters - - 395 Thorough Wort . ib. Observations concerning Diet, Columbo of Marietta . 438 recommending a method of Virginia- Goats- rue . 434 living less expensive, and Mountain Tea - ib. more conducive to health Crane's Bill, or Crowfoot ib. than (he present - - 403 Common Avens, Herb-bennet, General observations on Ali- or Tr oat-root . ib. ment ..... 405 Liquorice . 435 Of Bread - - - 406 Witch-hazel . ib, Boiled Grain - - 410 Heienium Autumnale, or Butter - - - 433 Sneeze-weed . ib, Broths acd Soups - 415 Gold- thread - m viii CONTENTS. American Sanicle, or Allum- root - - tage 436 The common Hop - 437 Hydrastis Canadensis - ib. Hyssop - - - ib. Elecampane - - 438 Butternut, or White- Walnut ib. Juniper - - - 439 Common Red Cedar Tree ib. Common Garden Lettuce ib. Spicewood - - - 440 Sassafras - - - ib. Lavender - - ib. Dandelion - - - 441 Motherwort - - ib. Common Flax - - 442 Sweet-Fern - - 2b. Tulip bearing Poplar - 443 Cardinal-Flower - - ib. Common Mallow - - ib. White Horthound - ib. Balm - - - 444 Spearmint - - - ib. Peppermint - - ib. Dwarf Candleberry Myrtle, or Bayberry - - 445 Virginian Broom rape, or Cancer-root - - ib. Ginseng - - - ib. American Nightshade, or Garget - - - 446 Anise - - - 447 Plantain - - 448 May Apple, or Mandrake ib. Seneka, or R.ttle Snake Root ib. Winter Berry, or Black Al- der - - 450 Wild Cherry Tree Page 450 Ground-Holly, or Pippsisseva 451 Oak - - .4*2 Celery-leaved Crowfoot ib. Narrow leaved Sumach 453 Pennsylvanian ditto - ib. Virginian Sumach, Stag's Horn, or Vinegar Plant - ib. Currant Tree - - 454 Black Currant - - ib. Red Rose - - ib. Damask ditto - - ib. Water dock - - 455 Narrow Dock - - ib. Cuiltd ditto - - ib. Rue - - 456 White Willow - - ib. Sage - - ib. Ground-Pink - - 457 B!ne Scull cap, or Hooded Willow Herb - - ib. White Mustard - - 458 Biack ditto - - ib. Bitter Sweet, or Woody Night Shade - - 459 Wild Indigo - - ib. Carolina Pink - - 460 Indian Physic - - 461 M9rsh Rosemary, or Laven- der Thrift - - ib. Common Tansy - - 462 Triosteum perfoliatum - ib. Coltsfoot - - - ib. American Elm - - ib. Common Nettle - - 464 March Violet - - ib. Veratrum viride - - ib. INTRODUCTION BEFORE we enter upon the prevention or cure of diseases, it may not be improper to take a cursory view of the human body, respecting the functions immediately connected with life. So wonder- ful is the structure of our frame, as displayed by aintomy, that athe- istical persons, obdurate to every other evidence of the existence of a God, who created the universe, have on witnessing a dissection, been instantly convinced of their mistake, and have acknowledged with, equal astonishment and shame, that nothing less than a Being of infinite wisdom and power could have contrived and executed such a wonder- ful piece of mechanism as that of the human body. The primary agent in the circulation of the blood is the heart, a large muscle situated in the left side of the breast (thorax, or chest) and endowed with great irritability. In the first rudiments of animal life, even before the brain is formed, the punctum saliem, as it is called, points out the embryo heart in miniature, and marks its primaeval irri- tability as a sure presage of its future importance in supporting the vital motions. As this singular organ exhibits irritability the first, so it never relinquishes it till the last; whence it has been called the pri- mum mobile, and ultimum moriens, that is, " the first part that moves, and the last that dies," of the animal machine. It is observable, that the motion of the heart not only survives that of the organs of volun- tary motion, but continues a considerable time even after it is separated, from the body of many animals. Hence in drowning, or suffocation, though the pulse be imperceptible, and apparently extinguished, yet the heart still preserves this latent power or susceptibility of motion, and wants only to be gently excited by suitable means to renew its action. This organ is surrounded by the pericardium, or heart-purse, an* exceeding strong membrane, which covers the heart, even to its basis. Its uses are to keep the heart from having any friction with the lungs, and to contain a fluid to lubricate or moisten its surface. From the right ventricle or cavity of the heart, the irritability of which is excited into action by the circulating fluid, the blood is pro- pelled through the lungs, which are situated on the right and left side of the heart, from which they differ on appearing to be void »f h> U INTRODUCTION. ritabiiity. They are divided into two lobes, and these into more di- visions, three on the right side, and two oa the left. The trachea, or wind-pipe, descends into the lungs, and forms innumerable cells, which, have a communication with each other, and give the whole the appear- ance of a honey-comb or sponge. The blood, after passing through the lungs, arrives again at the heart, and from the left ventricle is expelled into the aorta, or great ar- tery; which dividing into two branches, one upwards, and the other downwards, distributes the blood through the. whole body; from tin, extremities of which it returns, by various veins, through the ascend- ing and (descending cava,* and is transmitted again to-the heart. The heart is ihe grand organ which actuates the vital functions; and to this purpose it is admirably fitted by its own irritability.; but it is necessarily supported in its action by the powerful influence of the nerves, which are the ultimate instruments both of motion and sensation, and have their ori.;i:i in the brain. The diaphragm cr midriff is a large broad muscle, which divides the thorax from the abdomen,! or belly. In its natural state, it is con- cave or vaulted towards the abdomen, and convex towards the thorax. J Ilaller calls it " the mast noble bowel next to the heart;" and, like the latter, it is in constant action. At the time of inspiration it approaches towards a plane. Besides being a muscle of inspiration, it assists in vomiting, and the expulsion of the fa?ces.[| From the exertion of this muscle likewise proceed sighing, yawning, caughing, and laughing. If is effected by spasms, as in the hickup, &c. It is both a muscle of voluntary*aud involuntary action. We may observe in this muscle strong characters of admirable contrivance. It separates posteriorly into two slips, between which the descending aorto passes. A little above this, and towards the left side, in the most fleshy part of the midriff, there is a direct opening for the passage of the (esophagus or .gullet. There is also on the right side a large triangular hole for the passage of the ascending cava. The gullet is composed both of longitudinal and circular fibres, but chiefly si-radar, much more so than the intestines ; because this has no foreign power to asti^t it, and because it is necessary that the food should make a shorter stay in the throat than in the bowels. The in- ner surface is a smooth membrane, well supplied with mucilage, Jo sheath the organ, and render the passage of the aliment or food easy. ■ Cava is th< in which conveys the refluent blood to tht heart. f. Abdomen, from abdo to hide, as its contents lie hidden. t Qerivcdfrotn the Greek, signifying the breast. || This word with chymists is used to express the ingredients aci sEitliug after distillation and infusion; here it means excrement. INTRODUCTION. 11 ^he stomach lies across the upper part of the abdomen, and is cov- ered by the liver; when distended it presses on the spleen. It nearly resembles in figure the pouch of a bag-pipe, its upper side being con- cave, and the lower convex. Its left end is the most capacious. On the left side is the entrance from the gullet; on the right is the open- ing, called pyloi us, by which the chyle passes into the intestines. Ii.ere is a circular Valve, or sphincter-muscle, which prevents a regurgita- tion of the aliment. The stomach has circular and longitudinal fibres, and its inner membrane is covered with a strong viscid mucus. The liver, the largest gland in the body, is situated immediately un- der the vaulted -cavity- of the midriff, chiefly on the right side, and somewhat on the left over the stomach. Exteriorly, or anteriorly, it is convex, inwardly it is concave ; very thick in its superior part, and thin in its inferior. The upper side adheres to the midriff: and it is fixed to this, a.nd 'the Sternum, or breast bone, by a broad ligament. It is also tied to the navel by a ligamentous band, which is the umbili- cal vein of the unborn infant, degenerated into a ligament. Both these bands serve to suspend it, while laying on the back, from bearing too much on the subjacent cava ; otherwise it might press on this important returning vessel, stop the circulation, and put a period to life. Dogs, cats, and other animals who are designed for leaping, have their liver divided into many distinct lobules, to prevent too great a concussion of the organ. The liver is the viscus or bowel which performs the secre- tion of the bile. The gall-bladder is situated under the great lobe of tire liver, a little to the right. In a standing posture it lies forwards and downwards . Its bottom is raised by a fulness, and depressed by the emptying of the stomach. The use of the gall-bladder is to serve as a receptacle for the bile. The intestines are destined to receive the food from the stomach, and after exposing the useful part of it to the lacteals, a set of extremely, small vessels, to convey the remainder out of the body. The intesti- nal canal is usually five times the length of the individual; it is curi- ously convoluted in 'the abdomen, and is extremely irritable. Anato- mists have divided tills canal, although one continued pipe, into six portions, three of which are termed the small intestines,* and the three last, the greed. In the small intestines there are numerous plaits to de- tain the food, and allow a larger surface for its absorption. These arc larger, and far more numerous near the stomach, where the food is * The three smaller are, the duodenum, (from its length being about that of the breadth of twelve fingers) jejunmn, and illium, from the Greek signifying to turn about, because it makes many convolutions. The three larger are, the caz&im, or blind gut (so called from its be- iag perforated at one end onlj ) the colon, signifying holloWj a -vroM ■-&o?n the Greek, and the rectum^ or straight gut. 12 INTRODUCTION. thinner, than they are towards the other extremity. At the entrance of (he illium into the colon, there are two very large valves, which prevent the regress of the faeces into the illium The cacuin and colon, two of the intestines towards the lower extremity, besides having strong- er muscular coats than the small intestines, are furnished with three ligamentous bands, running lengthwise on their outside, dividing their surfaces into three portions nearly equal. Though appearing exter- nally like ligaments; they are composed, in their inner structure, of true muscular fibres. The ligament-like bands, which in the ctccum and colon are collected into three portions, are spread equally over the surface of the rectum, or lower extremity of the intestines. This is a wise precaution of Mature, that no part of it may be weaker than auolher, lest it should give way in the efforts for expelling the faces. The plaits are considerably fewer in the great intestines. They have all an inner membrane, covered with an infinite number of arteries or glands, which discharge a lubricating fluid. They are furnished with inuscular fibres, both circular and longitudinal. The spleen, or milt, is situated immediately under the edge of the midriff, above the left kidney, and betweeu the stomach and ribs. la figure, it resembles a depressed oval, near twice as long as broad, and almost twice as broad as thick. Cheseld en informs us, that it has been taken from dogs without any observable inconvenience to them. Its use is still problematical. The paacreas, or sweet bread, is situated transvei sly under the stom- ach. Its shape resembles a dog's tongue. Along the whole length of it there is a duct, which terminates in the upper part of the intestines near the stomach. The pancreatic juice resembles the saliva, but is less viscid or slimy, and contains a larger proportion of the salts of the blood. It is probably intended for the solutiou of onr aliment. The Lidueys are two oval bodies, situated in the lines, contiguous to the two last short ribs ; the right under the liver, and the left under the spleen. The structure of the kidneys is curiously fitted for secu- ring the urine, which is canied from each of them by canals termed the ureters, into the bladder, the reservoir of that fluid, situated in the lower part of the belly. They enter the bladder near its neck, mu- lling for the space of an inch obliquely between its coats, and forming, as it were, to themselves, two valves; so that, upon the contraction of the bladder, the urine is directed along the urethra, which is its prop- er passage out of the body. Over the upper part of the abdomen is spread the omentum, or caul, consisting of two broad, thin, and transparent membranes, joined togeth- er by cellular texture, in the cells of which a quantity of fat is deposi- ted. The uses of it are to interpose between the pcritonoum,* or li- * Signifying near to, stretching round, or about, as pcriosieum, rcri earpium, near to the bone, heart, &c. INTRODUCTION. 13 aing the intestines, and the stomach, to keep all these parts moist, warm, slippery, and to prevent their adhesion. Last of all comes the peritonaeum, a strong membrane, which con- fines, as in an enclosure, the intestines and contents of the abdomen. Such, in a general view, are the contents of the cavities of the breast and belly, which perform, respectively, the vital motions, and those natural functions that are subservient to the support of our frame. But shere remains to be mentioned another essential cavity, with its de- pendent system, to the primary influence of which all the other parts of the body are indebted for their action and energy. The cavity to which I allude is the skull, the receptacle of the brain. The brain is divided into two portions, namely, the cerebrum and cerebellum ;* the former situated in the upper part of the skull, and the latter under it, in the hind part. The brain is a soft pulpy substance, surrounded by two membranes; one called aura, and the other pia, matter. It has also a third, called arachnota, from its fineness, as being similar to a spider's web. It contains some sinuses, which are nothing more thai* large veins or receptacles for blood, and four cavities called ventricles, moistened, in a healthful state, with a fine vapour, which increasing gives rise to diseases. Like other parts of the body, it has a variety of arterial branches from the heart, which diffuses through its substance, and on the membranes. The brain is the great elaboratory, where the animal spirits, or nervous influences which actuate our frame, are supposed to receive their existence. The nature of this fluid, if really a fluid, has not yet been sufficiently investigated. It is certain, how- ever, that from this source the nerves derive their origin. These are white, fijem solid cords, which arise from the brain and spinal marrow, which is only an elongation of the brain, and are spread over every part of the body endowed with sensibility, by innumerable filameuts. Ten pair of nerves issue from the brain itself, and thirty from the spinal marrow. Those that go to the organs of sense are considerably larger than the rest, and are in part divested of their outer covering. Whether an immaterial and invisible Being can positively be said to exist in any place, it might appear presumptuous to determine ; but it is a prevailing opinion in physiology, that the brain is the seat of the soul; and the pineal gland, in the penetralia of the brain, has been as- signed as the sacred mansion of this immortal inhabitant. Human vision can discover no signs to confirm this opinion ; but the man would be blind, and utterly void of understanding, who could not trace through die whole of the animal system the most evident marks of Divine Intel- ligence and wisdom : of intelligence which excites admiration, and of wisdom beyond conception. * Cerebellum, the little brain as it were; both are often called thus, wljen the bruin is spoken ofin small animals. JNTRbDUCTIOX. The ivonderful contrivance exhibited in the human frame i = ?iblc, still move manifest from the curious formation of the eye and car; of which only a very imperfect idea could he conveyed by verbal description. J shall therefore not attempt to delineate those admirable prgans: nor need I mention (he construction of the limbs; of the arms and legs; of the hands and feet; so nicely united with joints, aud so, happily supplied with muscles and tendons, with ligaments and d< rvi , that they are adapted tp all the various purposes of convenience awl utility in motion. I shall conclude tills imperfect sketch of the human body with a brief account of digestion, that important pro':' ss in the animal econo- my, by means of which the continual and unavoidable waste of the constitution is regularly supplied. The aliment being received into the mouth, the first operation it un- dergoes is to be masiicated by the action of the teeth and several mus- cles,. This mastication is of greater moment than is generally imagin- ed ; and the seed effects of it are further promoted by mixing widi the food a quantity of saliva, discharged from the glands of the mouth, and which is greatly conducive to digestion. When the food is carried down the gullet into the stomach, it there meets with an additional supply of juices, called the gastric juices, of a nature yet more effica- cious than the former, besides a small portion of bile. During its con- tinuance in the stomach, it experiences the effects of heat and muscu- lar action, from the coats of that organ, and the motion and warmth of ■ he surrounding parts. It thence passes out gradually by the right ori- ffce of the stomach, and there meets with an additional quantity of bile from the gallbladder and liver, besides the pancreatic juice, or that of the sweet bread, of a nature similar to the saliva, but rather more thick, and the fluids separated by the intestines. It now receives the action o\' the bowel?, or the peristaltic motion, by which they churn, as It were, the whole maps, minutely mixing together the food, and the different juices, collected in the passage from the mouth. A fluid is now produced called chyle, which is separated from the grosser mate- rials, and taken up by a set of extremely small absorbent vessels called lactcals. These have their origin in the iuner coat of the inter-tines, and, passing thence, discharge themselves into a duet named the recp p- 'taclc of the chyle, whence this fluid proceeds along the thoracic' duel, which terminates in the left subclavianf vein. la the passage from the intestines to the receptacle, there is a number of glands, which sepa? rate a watery liquid, for the purpose of giving t!:e chyle a thinner consistence. To pi event the chyle from falling back in ils progress through the lacteals, the construction of these vessels is admiral t rived. They are furnished with a number of valves, which opea • From thorax the breast. •' A term applied to any tiling under the arm-pit or shoulder. INTRODUCTION. 15. •nly forwards, and are shut by any fluid pressing backwards. From the subclavian vein, the chyle is poured into the biocd, and thence im- mediately thrown into the right auricle and ventricle* of the heart; from which, now mixed with the blood, it passes into the lungs. It undergoes in that organ a considerable change from the act of respira- tion. From, the lungs it proceeds through the pulmonary vein to the left auricle of the heart, and then into the left ventricle; whence, at last endowed with all the qualities of blood, it passes into the aorta, and is diffused universally through the frame; the wants of which it is fit- ted to supply by the addition of nourishing particles. Is it possible to contemplate this admirable mechanism without breaking forth in the exclamation of the Psalmist, that " we are wonderfully made ?" I may justly add, that considering the great variety of ways in which the hu- man body may be affected, both from without and within, with the ne- cessity for the perpetual motion of the vital powers, and the millions of vessels, invisible to the naked eye, through which the fluids ought to pass, it is a matter of real astonishment that we should subsist a single day. And doubtless it would be impossible, were not the machine con- stantly sustained by the same Almighty and Beneficent Being who formed it. * Two muscular bags, one on each side, are termed its auricles, from the Latin, signifying ears. PART I. OF THE GENERAL CAUSES OF DISEASES. CHAPTER I. Of Children. THE better to trace diseases from their original causes, we shall take a view of the common treatment of mankind in the state of in- fancy. In this period of our lives, the foundations of a good or bad constitution are laid ; it is therefore of importance, that parents be well acquainted with the various causes which may injure the health of their offspring. It appears from the annual registers of the dead, that almost one half of the children born in Great Britain die under twelve years of age. To many, indeed, this may appear a natural evil; but on due exami- nation, it will be found to be one of our own creating. Were the death ©f infants a natural evil, other animals would be as liable to die young as man ; but this we find is by no means the case. It may seem strange that man, notwithstanding his superior reason, should fall so far short of other animals in the management of his young; but our surprise will soon cease, if we consider that brutes, guided by instinct, never err in this respect; while man, trusting solely to art, is seldom right. Were a catalogue of those infants who perish annually by arc alone exhibited to public view, it would astonish most people. If parents are above taking care of their children, others must be employed for that purpose : these will always endeavour to recom- mend themselves by the appearance of extraordinary skill and address. By this means such a number of unnecessary and destructive articles have been introduced into the diet, clothing, &c. of infants, that it is no wonder so many of them perish. JSTothirsg can be more preposterous than a mother who thinks it be- low her to take care of her own child, or who is so ignorant as not t® 3 J 8 OF CHILDREN. know what is proper to be done for it. If we search Nature through- out, we caunot find a parallel to this. Every other animal is the nurse of its own offspring, ami they thrive accordingly. "Were the brutes to bring up their young by proxy, they would share the same fate with those of the human species. We mean not, however, to impose it as a task upon every mother to suckle her owu child. This, whatever speculative writers may al- lege, is in some cases impracticable, and would inevitably pvove des- tructive both to the mother and child. Women of delicate consti- tutions, subject to hysteric fits, or other nervous affections, make very bad nurses j* and these complaints arc now so common, that it is rare to find a woman of fashion free from them ; such women therefore, gup- posing them willing, are often unable to suckle their own children. Almost every mother would be in a condition to give suck, did man- land live agreeably to Nature ; but whoever considers how far many tr.others deviate from her dictates, will not be surprised to find some of them unable to perform that necessary office. Mothers who do not eat a sufficient quantity of solid food, nor enjoy the benefit of fresh air and exercise, can neither have wholesome juices themselves, nor afford proper nourishment to an infant. Hence children who arc suckled by delicate women, cither die young, or continue weak and sickly all their lives. When we say that mothers are not always in a condition to suckle their own children, we would not be understood as discouraging that practice. Every mother who can, ought certainly to perform so ten- der and agreeable an office.^ But suppose it to be out of her power, she may, nevertheless, be of great service to her child. The business of nursing is by no means confined to giving suck. To a woman who abounds with milk, this is the easiest part of it. Numberless other of- • I have known an hysteric woman kill a child, by being seized with a fit in the night. f Many advantages would arise to society, as well as to individuals, from mothers suckling their own children. It would prevent the temp- tation which poor womt'i: are laid under of abandoning their children to suckle those of the rich for the sake of gain ; by which means so- ciety loses many o( its most useful members, and mothers become in some sen^e the murderers of their own offspring. 1 am sure I speak within the truth when I say, that not one in twenty of those children live, who are thus abandoned by their mothers. For this reason no mother should be allowed to tackle another's child, till her own is eith- er dead, or fit to be weaned. A regulation of this kind would save many lives among the poorer sort, and could do no hurt to the rich, as most women who make good nurses are able to suckle two childn c succession upon the same Bulk. OF CHILDREN. 12 Sees are necessary for a child, which the mother ought at least ;o see done. A mother who abandons the fruit of her womb, as soon as it is born, to the sole care of an hireling, hardly deserves that name. A child by being brought up under the mother's eye, not only secures her ail'ec- tioo, but may reap all the advantages of a parent's care, though it be suckled by another. How can a mother be better employed than in superintending the nursery ? This is at once the most delightful and im- portant office ! yet the most trivial business or insipid amusements are often preferred to it ! A strong proof both of the bad taste and wrong education of modern females. It is indeed to be regretted, that more care is not bestowed in teach- ing the proper management of children to these whom Nature has de- signed for mothers. This, instead of being made the principal, is sel- dom considered as any part of female education. Is it any wonder, when females so educated come to be mothers, that they should be quite ignorant of the duties belonging to that character ? However strange it may appear, it is certainly true, that many mothers, and those of fashion too, are as ignorant, when they have brought a child into the world, of what is to be done for it, n.s the infant itself. Indeed, the most ignorant of the sex are generally reckoned the most knowing in the business of nursing. Hence sensible people become the dupes of ignorance and superstition; and the nursing of children, instead of bas- ing conducted by reason, is the result of whim and caprice.* Were the time that is generally spent by females in the acquisition of trifling accomplishments, employed in learning how to bring up their children ; how to dress them so as not to hurt, cramp, or confine their motions ; how to feed them with wholesome and nourishing food ; how to exercise their tender bodies, so as best to promote their growth and strength : were these made the objects of female instruction, mankind would derive the greatest advantages from it. But while the education of females implies little more than what relates to dress ancf public show, we have nothing to expect from them but ignorance even in the most important concerns. Hid mothers reflect on their own importance, and lay it to heart, they would embrace every opportunity of informing themselves of the duties which they owe to their infant offspring. It is their province, * Tacitus, the celebrated Roman historian, complains greatly of the degeneracy of the Roman ladies in his time, with regard to the care of their offspring. He says that, in former times, the greatest women in Rome used to account it their chief glory to keep the house and attend their children ; but that now the young infant was committed to the sole «are of some poor Grecian wench, or other menial servant. — We are afraid, wherever luxury and effeminacy prevail, tiiere will be loo much ground for this complaint. 20 OF CHILDREN, wot only to form the body, but also to give the mind Its most early bis?. They have it very much in their power to make men healthy or vale- tudinary, useful in life, or the pests of society. But the mother is not the only person concerned in the management of children. The father has an equal interest in their welfare, and ought to assist in every thing that respects either the improvement of the body or mind. It is a pity that the men should be so inattentive to this matter. Their negligence is one reason why females know so little of it. Wo- men will ever be desirous to excel in such accomplishments as recom- mend them to the other sex. But men generally keep at such a dis- tance from even the smallest acquaintance with the affairs of the nurse- ry, that many would reckon it an affront, were they supposed to know any thing of them. Not so, however, with the kennel or the stable? : a gentleman of the first rank is not ashamed to give directions concern- ing the management of his dogs or horses, yet would blush Averc he sur- prised in performing the same office for that being who derived its ex- istence from himself, who is the heir of his fortunes, and the future hope of his country. Nor have physicians themselves been sufficiently attentive to the management of children : this has been generally considered as the sole province of old women, while men of the first character in physic, ■Slave refused to visit infants even when sick. Such conduct in the fac- ulty has not only caused this branch of medicine to be neglected, but has also encouraged the other sex to assume an absolute title to pre- scribe for children in the most dangerous diseases. The consequence is, that a physician is seldom called till the good women have exhaust- ed all their skill; when his attendance can only cerve to divide the blame, and appease the disconsolate parents. Nurses should do all in their power to prevent diseases - ; but when a child is taken ill, some person of skill ought immediately to be consult- ed. The diseases of children are generally acute, and the least delay is dangerous. Were physicians more attentive to the disease? of infants, they would net only be better qualified to treat them properly when sick, but like- wise to give useful directions tor their management when well. The diseases of children are by no means so difficult to be understood as many imagine. It is true, children cannot tell their complaints ; but the causes of them may be pretty certainly discovered by observing the symptoms, and putting proper questions to the nurses. B< sides., the diseases of infants being less complicated, are easier cured than those of adults.* * The common opinion, that the diseases of infants are hard to dis- cover and difficult to cure, has deterred rr?ny physicians from paying that attention fo them which they deserve. • r ?n. however, from ex- OF CHILDREN. 2) It is really astonishing, that so little attention should in general be paid to the preservation of infants. What labour and expense are dai- ly bestowed to prop an old tottering carcase for a few years, while thousands of those who might be useful in life, perish without being re- garded ! Mankind are too apt to value tilings according to their pres- ent, not. their future usefulness. Though this is of all others the most erroneous method of estimation; yet upon no other principle is it possi- ble to account for the general iudifferense with respect to the death of infants. Of Diseased Parents. One great source of the diseases of children is, the UnheaUhine&s of Parents. It would be as reasonable to expect a rich crop from a barren soil, as that strong and healthy children should be born of pa- rents whose constitutions have been worn out with intemperance and disease. An ingenious writer f observes, that on the constitution of mothers depends originally that of their offspring. JXo one who believes this, will be surprised, on a view of the female world, to find diseases and death so frequent among children. A delicate female, brought up with- in doors, an utter stranger to exercise and open air, who lives on tea and other slops, may bring a child into the world, but it will hardly be fit to live. The first blast of disease will nip the tender plant in the bud : or should it struggle through a few years of existence, its feeble frame, shaken with convulsions from every trivial cause, will be unable to perform the common functions of life, and prove a burden to society. If to the delicacy of mothers, we add the irregular lives of fathers, we shall see further cause to believe that children are often hurt by the constitution of their parents. A sickly frame may be originally indu- ced by hardships and intemperance, but chiefly by the latter. It is impossible that a course of vice should not spoil the best constitution : and did the evil terminate here, it would be a just punishment for the folly of the sufferers : but when once a disease is contracted and rivited in the habit, it is entailed on posterity. What a dreadful inheritance is the gout, the scurvy, or the king's evil, to transmit to our offspring! how happy had it been for the heir of many a great estate, had he been born a beggar, rather than to inherit his father's fortunes, at the expense of inheriting his diseases ! A person labouring under any incurable malady, ought not to marry. He thereby not only shortens his own life, but transmits misery to perience declare, that this opinion is without foundation; and that the diseases of infants are neither so difficult to discover, nor so ill to cure, as those of adults, | Rosseau,. •21 OF CHILDREN. others; but when both parties are deeply tainted with the scrophuia. the scurvy, or the like, the effects must still be worse. If such have any issue, they must be miserable indeed. Want of atteution to these things, in forming connections for life, has rooted out more families than plague, famine, or the sword; and as long as these connections are formed from mercenary views, many bandages is now, in some, measure, laid aside; but it would still be a difficult task to persuade the generality of mankind, that the shape of an infant does not entirely depend on the care cf the midwife. So far, however, are all her endeavours to mend the shape from being successful, that they constantly operate the contrary way, and mankind become deformed in proportion to the means used to prevent it. How little deformity of body is to be found among uncivilized nations ? So little indeed, that it is vulgarly believed they put all their deformed child- ren to death. The truth is, they hardly know such a thing as a de- formed child. Neither should we, if we followed their example. Savage nations never think of manacling their children. They allow them the lull nse of every organ, carry them abroad in the open air, wash their bodies daily in cold water, &c. By this management, their children become so strong and hardy, that by the time our puny in- fants get oat of die uurte's arms, theirs are able to shift for themselves.* * A friend of mine, who was several years on the coast of Africa, l\ of Children. Among brute animals no art is necessary to procure a fine shape. Though many of them are extremely delicate when they come into the world, yet We never find them grow crooked for want of swaddling hands. Is Nature less generous to the humau kind ? No : but we take the business out of Nature's hands. Not only the analogy oi' other aniaials, but the very feeliugs cf in- fants tell us, they ought to be kept easy and free from all pressure- They cannot indeed tell their complaints ; but they can shew signs of pain : and this they never fail to do, by crying when hurt by their clothes. No sooner are they freed from their bracings, than they seem pleased and happy : yet, strange infatuation ! the moment they hold their peace, they are again committed to their chains. if we consider the body of an infant as a bundle of soft pipes, replen- ished with fluids in continual motion, the danger of pressure will ap- pear iu the strongest light. Nature, in order to make way for the growth of children, has formed their bodies soft and flexible; and lest they should receive any injury from pressure in the womb, has sur- rounded Ihe foetus every where with fluids. This shews the care which Nature takes to prevent all unequal pressure on the bodies of infants, and co defend them against every thing that might in the least cramp or confine their motions. Even the bones of an infant are so soft and cartilaginous, that they readily yield to the slightest pressure, and easily assume a bad shape, which can never after be remedied. Hence it is, that so many people appear with high shoulders, crooked spines, and flat breasts, who were as well proportioned at their births as others, but had the misfortune to be squeezed out ofbhapeby the application of stays and bandages. Pressure, by obstructing the circulation, likewise prevents the equal distribution of nourishment to the different parts of the body, by which means the growth becomes unequal. Oue part grows too large, while another remains too small; and thus in time the whole frame becomes disproportionate and misshapen. To this we must add, that when a child is cramped in its clothes, it naturally shrinks from the part that is hurl ; and by putting its body iuto unnatural postures, it becomes de- formed by habit. Deformity of body may indeed proceed from weakness or disease ; but in genera!, it is the effect of improper clothing. Nine-tenths, at least* of the deformity among mankind, must be imputed to this cause. A deformed body is not only disagreeable to the eye, but by a bad figure both the animal and vital functions must be impeded, and of course health impaired. Hence few people remarkably misshapeu are tells me, that the natives neither put any cloths upon their children' nor apply to their bodies bauduges of any kind, but lay them on a pal" let, and suffer them to tumble about at pleasure, yet they are all straight' ''ja have any disease. OF CHILDREN. 25 strong end healthy. The new motions which commence at the birth, as the circulation of the whole mass of blood through the lungs, respiration, the peristalic motion, Sic. afford another strong argument for keeping the body of an infant free from all pressure. These orgaus, not having been accustomed to move, are easily stopped ; but when this happens, death must ensue. Hardly any method could be devised more effectually to stop these motions, than braciug the body too tight with rollers* and ban- dages. Were these to be applied in the same manner to the body of an adult for an equal length of time, they would hardly fail to hurt the digestion and make him sick : how much more hurtful they must prove to the tender bodies of infants, we shall leave any one to judge. Whoever considers these things will not be surprised, that so many children die of convulsions soon after the birth. These fits are gene- rally attributed to some inward cause ; but in fact they oftener pro- ceed from our own imprudent conduct. I have known a child sei- zed with convulsion fits soon after the midwife had doae swaddling it, who, upon taking off the rollers and bandages, was immediately relie- ved, and neyer had the disease afterwards. Numerous examples of this might be given, were they necessary. It would be safer to fasten the clothes of an infant with strings than pins, as these often gall and irritate their tender skins, and occasion dis- orders. Pins have been found sticking above half an inch into the body of a child, after it had died of convulsion fits, which in all probability proceeded from that cause. Children are not only hurt by the tightness ot their clothes, but also by the quantity. Every child has some degree of fever after the birth ; and if it be loaded with too many clothes, the fever must be increased. But this is not all ; the child is generally laid in bed with the; mother, who is often likewise feverish ; to which we may add the heat of the bed-chamber, the wines, and other heating things, too frequently given to children immediately after the birth. When all these are combined, which dees hot seldom happen, they must increase the fever to such a degree as will endanger the life of the infant. The danger of keepiag infants too hot will further appear, if we con- sider that, after they have been for some time in the situation before- mentioned, they are often sent into the country to be nursed in a cold house. Is it any wonder, if a child, from such a transition, catches a mortal cold, or contracts some other fatal disease ? When aD infant is kept too hot, its lungs, not being sufficiently expanded, are apt to re- : main weak aad flaccid for life 5 hence proceed coughs, consumptions and other diseases of the breast. - * This is by no means inveighing against a thing that does not hap- pen. In many parts of Britain at this day, a roller eight or ten feet lb length, is applied tightly round the child's body as soon as it is bora, A 19 OF CHILDREN. It would answer little purpose to specify the particular spociea gP dress proper for an infant. These will always vary in different coun- tries, according to custom and the humour of parents. The great rule to be observed is, T/tat a child have )io more clothes than are necessa- ry to keep it warm, and that thty he quite easy for its body. Stays are the very baae of infants. A volume would not suffice to point out ail the b^ul effects of this ridiculous piece of dress both on children and adults. The madness in favour of stays seems however, to be fiftmewhat' abated; and it is to be hoped the world will, in time, become v, he enough to knoTS, that the human shape does not solely de- pend upon whale-bone and bend leather.*' I shall only add with respect to the clothe? of children, fhaithey ought to be kept thoroughly clean. Children perspire more than ad- opts : and if their clothes be not frequently chauged, they become very hurtful. .Dirty clothe? not only gall and fret the tender- skins of infants, but likewise occasion ill smells ; and what is worse, tend to produce vermin and cutaneeus diseases. Cleanliness is not only agreeable to lhe>ey-e, bat tends greatly topre- serve the health of children. It promotes the perspiration, and, by that means, frees the body from superfluous humours, which, if retained, could net fait to occasion diseases. No mother or nurse can have any excuse for allowing a child to be dirty. Poverty may oblige her to r;ve it coarse clothes ; but if biie does not keep them clean, it must be her owa fault,. Of the Food of Children. Nature not only points out the fond proper for an infant, but actaaf- fy prepares it. This however, is not sufficient to prevent some who k th< mselves wiser than Nature, from attempting to bring up their ren without her provision. Nothing can shew the disposition Which mankind ha*, e to depart from Nature more than their endeav- ouring to bring up children without the breast The mother's milk, «r that of a healthy curse, is- unquestionably the best foad for an infant. Neither art nor nature can afford a proper substitute for it. Childreu may seem to thrive for a few months without the breast; but when ''"Stays made of bend leather are worn by all the women of lower station in many parts of England. I am sorry to understand, that there are still mothers mad enough to lace their daughters very tight in order to improve their shape. A* reasoning would be totally lost upon such people, T shall beg leave jusi to ask tUem, Why there are ten deformed women for one man? and like- wise to recommend to their perusal a short moral precept, whh bids us to Dtroax the human eody. OF CHILDREN 27 feethiug, tlie smallpox, and other diseases incideut to childhood, come >on, tiiey generally perish. A child, soon after the birth, shews an inclination to suck ; and there is no reason why it should not be gratified. It is true, the niother's milk, does not always come immediately after the birth; but this is the way to bring it: besides, the first milk that the child can squeeze out of the breast answers the purpose of cleansing, better than all the drugs in the apothecary's shop, and at the same time prevents inflammations of the breast, fevers, and other diseases incident to mothers. It is strange how people came to think that the first thing given to a child should be drugs. This is beginning with medicine by limes, and no wonder if they generally end with it. It sometimes happens, indeed, that a child does not discharge the meconium so soon as could be wish- ed; this has induced physicians, in such cases, to give something of an opening nature to cleanse the first passages. Midwives have improved upon this hint, aud never fail to give syrups, oils, &c. whether they be necessary or not. Cramming an infant with such indigestible stuff as ^oon as it is born, can hardly fail to make it sick, and is more likely to occasion diseases than to prevent them. Children are seldom long af- ter the birth without having a passage both by stool and urine; though these evacuations may be wanting for some time without any danger. But if children must have something before they be allowed the breast, let it be a little thin water pap, to winch may be added an equal quan- tity of new milk ; or rather water alone, with the addition cf a little raw sugar. If this be given without any wines orspiceries, it will nei- ther heat the blood, load the stomach, nor occasion gripes. Upon the first sight of an infant, almost every person is struck with the idea of its being weak, feeble, and wanting support. This natur- ally suggests the need of cordials. Accordingly wines are universally mixed with the first food of children. Nothing can be more fallacious than this way of reasoning, or more 'hurtful to infants than the conduct founded upon it. Children require very little food for some time after the birth ; and what they receive should be thin, weak, light, and of a cooling quality. A very small quantity of wine is sufficient to heat and inflame the blood of an infant ; but every person conversant in these matters must know, that most of the diseases of infants proceed from the heat of their humours. If the mother or nurse has enough of milk, the child will need little or oo food before the third or fourth month. It will then be proper to give it, once or twice a day, a little of some food that is easy of digest- ion, as water-pap, milk- pottage, weak broth with bread in it, and such like. This will ease the mother, will accustom the child by degrees to take food, and will render the weaning both lese difficult and less dan- gerous. All great and sudden transitions are to be avoided in nursing, For this purpose, the food of children ought not only to be simple, but ?o resemble, asaearly as possible, the properties of milk. Indeed milfc P OP CinlDRExV. itself should make a principal part of their food, not only before ihfy are weaned, but for some time after. Next to milk, -we would recommend good light bread. Bread mar be given to a child as soon as it shews an inclination to chew ; and it way at all times be allowed as much piaiu bread as it will eat. The very chewing of bread will pfio Le the' cutting of the teeth, and the discharge of saliva, while by mixing with the nurse's milk in the stom- ach, it will afford an excellent nourishment. Children discover an ear- ly inclination to chew Arhatevcr is put into their hands. Parents ob- serve the inclination, btit generally mistake the object. Instead oi giv- ing the child something which may at odcC exercise its gums and af- ford it nourishment, they commoohj put into its hands a piece of hard metal, or impenetrable coral. A crust ot bread is the best gum stick. It net only answers the purpose better than any thing else, but has the additional properties of nourishing the child aud carrying the saliva down to the stomach, which is too valuable a liquor to be lost. Bread, besides being used dry, may be many ways prepared into food for children. Our of the best methods is to boil it injvaier, af- terwards pouring the. water off, and mixing with the bread a proper quantity of new milk unboiled. Milk is bolh more wholesome and nourishing this way than boiled, and is less apt to occasion costiveness. For a child further advanced, bread may be mixed in veal or chickec broth, made into puddings or the like. Bread is a proper food for chil- dren at ail times, provided it be plain, made of wholesome grain, and well fermented ; but when enriched with traits, sugars, or such things, it becomes ve-rpTtajtfhplesonie;. It is soon enough to allow children animal food when they have got teeth to eat it. They should never taste it till after they are weaned, and even then they ought to use it sparingly. Indeed, when children live wholly on v^etable food, it is apt to sour on their stomachs ; but, on the other hand, .'on much flesh heats the body, and occasions fevers and other inflammatory diseases. This plainly points out a due mixt- ure of animal and vegetable food as most proper for children. Few things prove more hurtful to infants than the common method of sweetening their food. It entices them to take more than they ought to do, which makes them grow fat aud bloated. It is pretty certain, if the food of children were quite plain, that they would never take more than rnoM;;h Their excesses are entirely owing to nurses. If a child be gorged with food at all hours, and eniiced to take it, by ma- king it ^weet and agreeable to the palate, is it any wonder that such a child should in time be induced to crave more food than it ought to ■ have ? Children may be hurt by too little a? well ;:s too much food. After a child is weaned, it ought to he fed four or 6ve tirr.es a day ,; but should never be accustomed to est in the night; neither should it have too -touch at a time. Children thrive bc?t with small ouantities of foo$ OF CHILDREN. 29 frequently given. This neither overloads the stomach nor hurts the digestion, and is certainly most agreeable to nature. Writers on nursing have inveighed with such vehemence against giv- ing children too much food, that many parents, by endeavouring to shun that error, have run into the opposite extreme, and ruined the consti- tutions of their children. But the error of pinching children in their food is more hurtfal than the other extreme. Nature has many ways of relieving herself when overcharged ; but a child, who is pinched with hunger, will never become a strong or healthy man. That errors are frequently committed on both sides, we are ready to acknowledge; but where one child is hurt by the quantity of its food, ten suffer from the quality. This is the principal evil, and claims our strictest atten- tion. Many people imagine, that the food which they themselves love, can- not be bad for their children: but this notion is very absurd. In the more advanced periods of life we often acquire an inclination for food, which when children we could not endure. Besides, there are many things that by habit may agree very well with the stomach of a gro-vvu person, which would be hurtful to a child ; as high-seasoned, salt, and smoke-dried provisions, &c. It would also be improper to feed chil- dren with fat meat, strong broths, rich soups, or the like. All strong liquors are hurtful to children. Some parents teach their ehildren to guzzle ale, and other fermented liquors, at every meal. Such a practice cannot fail to do mischief. These children seldom escape the violence of the small pox, measles, hooping-cough, or some inflam- matory disorder. Milk, water, butter-milk, or whey, are the most proper for children to drink. If they have any thing stronger, it may be fine small beer, or a little wine mixed with water. The stomach of children can digest well enough without the assistance of w*nn stimu- lants ; besides, being naturally hot, they are easily hurt by every thing of a heating quality. Few things are more hurtfal to children than unripe fruits. They weaken the powers of digestion, and sour and relax the stomach, by which means it becomes a proper nest for insects. Children indeed show a great inclination lor fruit, and I am apt to believe, that if good ripe fruit were allowed them in proper quantity, it would have no bad effects. We never find a natural inclination wrong, if properly regu- lated. Fruits are generally of a cooling nature, and correct the heat and acrimony of the humours. This is what most children require 5 only care should be taken lest they exceed. Indeed the best way to prevent children from going to excess in the use of fruit, or eatiDg that which is bad, is to allow them a proper quantity of what is good.* * Children are always sickly in the fruit season, which may be thus accounted for. Two thirds of the fruit which comes to market in this country is really unripe, and children not being in a condition to judge &u OP CHILDREN. Roets which contain a crude viscid juice should be sparingly givec io children. They fill the body with gross humours, and teDd to pro- duce eruptive diseases. This caution is peculiarly necessary for the poor; glad to obtain at a small price what will fill the bellies of their children, they stuff them two or three limes a day with crude vegeta- bles. Child ten had better eat a smaller quantity of food which yields a wholesome nourishment, than be crammed with what their digestive powers are unable properly to assimilate. Butter ought likewise to be sparingly given to children. It both relaxes the stomach, and produces gross humours. Indeed, most things that ace fat or oily have this effect. Butter when salted becomes stijl more hurtful. Instead of butter, so liberally given to children in most parts cf Britain, we would recommend hooey. Hooey is not only whole- some, but cooling, cleansing, and tends to sweeten the humours. Chil- dren who eat hone)' are seldom troubled with worms : they are also Hess subject to cutaneous diseases, as itch, scabbed head, Arc- Many persons err iu thinking that the diet of children ought to be al- together moist. When children live entirely upon slops, it relaxes their solids, renders them weak, and disposes them to the rickets, scro- phula, and other glandulai disorders. Relaxation is one of the most general causes of the diseases of children. Every thing therefore which tends to unbrace their solids, ought to be carefully avoided. We would not be understood by these observations as confining chil- dren to any particular kind of food. Their diet may be frequently va- ried, provided always that sufficient regard be had to simplicity. ■Of the Exercise of Children. Of all the caases which conspire to render the life of m?m short and miserable, none have greater influence than the want of proper Exer- cise : Healthy parents, wholesome food, and proper clothing, will avail little, where exercise is neglected. Sufficient exercise will make up for several defects in nursing; but nothing can supply the want of it. It is absolutely necessary to the health, the growth, and the strength of childres. The desire of exercise is coeval with life itself. Were this principle attended to, many diseases might be prevented. But while indolence and sedentary employments prevent two thirds of mankind from either taking sufficient exercise themselves, or giving it to their children, what have we to expect but diseases and deformity amongtheir offspring ? The Tickets, so destructive to children, never appeared in Britain until nian- for themselves, eat whatever they can lay their hands upon, which of- ten proves little better than poison to their tender bowels. Servants, and others who have the care of children, should be strictly forbid to give them any fruit without the knowledge of their parents. 6F CHILDREN". 31: ttfactures began to flourish, and people, attracted by the love of gain, left the country to follow sedentary employments in great towns. It is amongst these people that this disease chiefly prevails, and not only deforms but kills many of their offspring. The conduct of other young animals shews the propriety of giving ex- crcise to children. Every other animal makes u?e of its organs of mo- tion as soon as it can, and many of them, even when under no neces- sity of moving in quest of food, cannot be restrained without force. This is evidently the case with the calf, the lamb, and most other young animals. If these creatures were not permitted to frisk about and take exercise, they would soon die or become diseased. The same inclina- tion appeal's very early in the human species ; but as they are notable to take exercise themselves, it is the business of their parents and nurses to assist them. Children may be exercised , various ways. The best method, while they are light, is to carry them about in the nurse's arms.* This gives the nurse an opportunity of talking to the child, and of pointing out every thing that may please and delight its fancy. Besides, it is much safer than swinging an infant in a machine, or leaving H to the care of such as are not fit to take care of themselves. JSbthing can be more absurd than to set one child to keep another ; this conduct has proved fatal to many infants, and has rendered others miserable for life. When- children begin to walk, the safest and best method of leading them about is by the hands. The common way, of swingieg them in leading strings, fixed to their backs, has several bad consequences. It makes them throw their bodies forward, and press with their whole weight upon the stomach and breast ; by this menus the breathing is ob- structed, the breast flattened, and the bowels compressed ; which must hurt the digestion, a;jd occasion consumptions of the Jungs aud other dis- eases. Ft is a common notion, that if children are set upon -their feet too soon, their legs will become crooked. There is reason to believe, that the very reverse of this is true. Every member acquires strength in pro- portion as it is exercised. The limbs of children are weak indeed, but their bodies are proporiionably light ; and had they skill to direct thein- serve?, they would soon be able to support their own weight. Whoever heard of any other animal that became crooked by using its legs toe» soon ? Indeed, if a child is not permitted to make any use of its legs till a considerable time after the birth, and be then set upon them with its- whole weight at once, there may be some danger; but this proceeds 1 '.fhe nurse ought to be careful to keep the child in a proper position ; as deformity is often the consequence of inattention to this circumstance, Its situation ought aed;dly at sea. ft may either be mixed with the water they drink, . < -n in their food. Such animals as can be kept alive, ought likewise to be carried on board, as hens, ducks, pigs-, Ac. Fresh broths made of portable soup, and puddings made of peas or other vegetables, ought to be used plenti- other things will readily occur to people conversant 48 Aim THE STUDIOUS. these matters, which would tend to preserve the health of that brave and useful set of men.* We have reason to believe if due attention were paid to the diet, air, detaining, and above all tilings to the cleanlinessf of seafaring people, they would be the most healthy set of men in the world j but when these are neglected, the very reverse will happen. The best medical antidote that Ave can recommend to sailors or sol- diers on foreign coasts, especially where dampness prevails, is the Pe- ruviau bark. This will often prevent fevers, and other fatal diseases. About a drachm of it may be chewed every day ; or if this should prove disagreeable, an ounce of bark, with half an ounce of orange peel, and' two drachms of snake-root coarsely powdered, may be infused for two or three days in an English quart of brandy, and lxdf a wine glass of U may be taken twice or thrice a- day, when the stomach is empty, This has been found to be an excellent antidote against fluxes, putrid, intermitting, and other fevers, in unhealthy climates. It is not mate- rial in what form this medicine is taken. It may either be infused in. water, wine, or spirits, as recommended above, or made into aa electu- ary with syrups of lemons, oranges, or the like. The Sedentary. • Though nothing can be more contrary to the nature.of man than a sedentary life, yet this class comprehends by far the greater part of the species. Almost the whole female world, and in manufacturing countries, the major part of the males, may be reckoned sedentary.^ * The celebrated Captain Cook has shown how far, by proper care and attention, the diseases formerly so fatal to seamen may be prevent- ed. In a voyage of three years and eighteen days, during which he was exposed to every climate, from the 52 deg. north, to the 71 deg. of south latitude, of one hundred and eighteen men, composing the ship's company, he lost only one, who died of a Phthisis Pulmonalis. The principal means he used were, to preserve a strict attention to cleanli- ness, to procure abundance of vegetable and fresh provisions, espe- cially good water, and to allow his people sufficient time for resi. f A regulation on board the United States' Navy, requiring evcry individual, at least once a week to wash their feet clean, is worthy oC general attention, as a means of preserving health. \ The appellation of sedentary has generally been given only to the studious; we can- see no reason, however, for restricting it to them alone. Many artificers may, with as much propriety, be denominated sedentary as the studious, with this particular disadvantage, that they are often obliged to sit in very awkward postures, which ftre studiciss need not do, unless Chev olease-. 48 THE LABORIOUS, THE SEDENTARY, Agriculture, the first and most healthful of all employments, is now followed by few who are able to carry on any other business. Bat those who imagine that the culture of the earth is not sufficient to em- ploy all its inhabitants, are greatly mistaken. An ancient RomaB, we are told, could maintain his family from the produce of one acre of ground. So might a modern Briton, if he would be contented to live like a Roman. This shews what an immense increase of inhabitants Britain might admit of, and all of them live by the culture of the ground. Agriculture is the great source of domestic riches. Where it is neglected, whatever wealth may be imported from abroad, poverty aDd misery Mill abound at home. Such is, and ever will be, the fluctuating state of trade and manufactures, that thousands of people may be in full employment to-day and in beggary tomorrow. This can never hap- pen to those who cultivate the ground. They can eat the fruit of their labour, aod always by industry obtain, at least, the necessaries of life. Though sedentary employments are necessary, yet there seems to be no reason why any persou should be confiued for life to these alone. Were such employments intermixed with the more active and laborious, they would never do hurt. It is constant confinement that ruins tfce health. A man may not be hurt by sitting five or six hours a-day; but if he is obliged to sit ten or twelve, he will soon become diseased. But it is not want of exercise alone which hurts sedentary people ; they likewise suffer from the confiued air which they breathe, it is very common to see ten or a dozen taylors,* or stay-makers, for exam- ple, crowded into one small apartment, where there is hardly room for one person to breathe freely. In this situation they generally contin- ue for many hours at a time, often with the addition of several candles, which tend likewise to waste the air, and render it less fit for respira- tion. Air that is breathed repeatedly becomes unfit for expanding the lungs. This is one cause of the phthisical coughs, and other complaints of the breast, so incident to sedentary artificers. Even the perspiration from a great number of persons pent up to- gether, renders the air unwholesome. The danger from this quarter will be greatly increased, if any one of them happens to have bad lungs, or to be otherwise diseased. Those who sit near him, being forced to breathe the same air, can hardly fail to be infected. It would be a rare thing, however, to find a dozen of sedentary people all in good * A person of observation in that line of life told me, that most tay* Inrs die of consumptions ; which lie attributed chiefly to the unfavoura- ble postures in which they sit, -and the unwholesomeness of those places where their business is carried on. If more attention was not paid to profit than to the preservation of human lives, this evil might be easily remedied ; but while masters only mind their own interest, nothing will be done for the safety of their servants. AND THE STUDIOUS. 4& .health. The danger of crowding them together must therefore bs evi- dent to every one. Many of those who follow sedentary employments are constantly in a bending posture, as shoemakers, taylors, cutlers, &c. Such a situa- tion is extremely hurtful. A bending posture obstructs all the vital motions, and of coarse must destroy the health. Accordingly we find such artificers generally complaining of indigestions, flatulencies, head-achs, pains of the breast, &c. The aliment in sedentary people, instead of being pushed forwards by an erect posture, and the action of the muscles, is in a manner con- fined in die bowels. Hence indigestion, costiveness, wind, and other hypochondrical affections, the constant companions of the sedentary. Indeed none of the excretions can be duly performed where exercise is wanting; and when the matter which ought to be discharged in this way is retained too long in the body, it must have bad effects, as it is again taken up into the mass of humours. A beading posture is likewise hurtful to the lungs. When this orgaa is compressed, the air cannot have free access in all its parts, so as to expand them properly. Hence tubercles, adhesions, &c. are formed, which often end in consumptions. Besides, the proper action of the lungs being absolutely necessary for making good blood, when the or- gan fails, the humours soon become universally depraved, and the whole constitution goes to wreck. Sedentary artificers are not only hurt by pressure on the bowels, but also on the inferior extremities, which obstructs, the circulation in these parts, and renders them weak and feeble. Thus taylors, shoe- makers, &c. frequently lose the use of their legs altogether; besides the blood and humours are, by stagnation, vitiated, and the perspiration is obstructed ; from whence proceed the scab, ulcerous sores, foul blotches, and other cutaneous diseases so common among sedentary ar- tificers. A bad figure of body is a very common consequence of close application to sedentary employments. The spine, for example, by being continu- ally bent, puts on a crooked shape, and generally remains so ever af- ter. But a bad figure of body has already been observed to be hurt- ful to health, as the vital functions are thereby impeded. A sedentary life seldom fails to occasion an universal relaxation of the solids. This is the great source from whence most of the diseases of sedentary people flow. The scrophula, consumption, hysterics, and nervous diseases, now so common, were very little known in this coun- try before sedentary artificers became so numerous; and they are very little known still among such of our people as follow active employ- ments without doors, though in great towns at least two thirds of the Inhabitants are afflicted with them. It is very difficult to remedy those evils, because many who have Seen accustomed u> a sedentary life, like rickety children, lose all iu- 7 *> THE LABORIOUS, THE SEDENTARY, clination for exercise ; we shall, however, throw out a few hiutd wit& respect to the most likely meaus for preserving the health of this useful set of people, which some of them, we hope, will be wise enough to take. It has been already observed, that sedentaxy artificers are oftea hurt by their bending posture. They ought therefore to stand or sit as erect as the nature of, their employments will permit. They should likewise change their posture frequently, and should nsver sit too long at a time, but leave off work, and walk, ride, run, or do any thing that will promote the vital functions. Sedentary artificers ane generally allowed too little time for exer- cise; yet short as it is, they seldom employ it properly. A journey-. maq taylor or weaver, for example, instead of walking abroad for ex- ercise and fresh air, at his hours of leisure, chuses ofteu to spend them in a public house, or in playing at some sedentary game, by which ha generally looses both his time and his money. The awkward postures in which many sedentary artificers work, seem rather to be the effect of custom than necessity. For example, a table might surely be contrived for ten or a dozen lay lors to sit round with liberty for thu've legs either to hang down, or rest upon a foot- board as they should ciiuse. A place might likewise be cut out for each person, in such a manner that he might sit as conveniently for working as in the present mode of sitting cross-legged. All sedentary artificers ought to pay the most religious regard to cleanliuess. Both their situation and occupations render this highly- necessary. Nothing would contribute more to preserve their health, than a strict attention to it ; and such of them as neglect it, not only run the hazard of losing health, but of becoming a nuisance to their neighbours. Sedentary people ought to avoid food that is windy or hard of di- gestion, and should pay the strictest regard to sobriety. A person who works hard without doors will soon throw off a debauch ; but one who sits has by no means an equal chance. Heqce it often happens, that sedentary people are seized with fevers after hard drinking. When such peiscns fcel their spirits low, instead of running to the tavern for relief, they should ride or walk in die field. This would remove the ou be impaired. Jaundice, indigestion, loss of appetite, and a wast- ing of the Avhoie body, seldom fail to be the consequences of a vitiated ,• tate of the liver or obstructions of the bile. Few diseases prove more fatal to the studious than consumptions of (he Kings. It has already been observed, thatlhis organ cannot be du- AND THE STUDIOUS. 5$ ly expanded iu (hose who do not lake proper exercise ; and where this is the case, obstructions and adhesions will ensue. Not only want of exercise, but the posture in which studious persons generally sit, is very hurtful to the lungs. Those who read or write much are ready to contract a habit of bending forwards, and often press with their breast upon a table or bench. This posture cannot fail to hurt the lungs. The functions of the heart may likewise by this means be injured. I remember to have seen a man opened, whose pericardium adhered to the breast-bone in such a manner as to obstruct the motion of the heart, and occasion his death. The only probable cause that could be as- signed for this singular symptom was, that the man, whose business was writing, used constantly to tit in a bending posture, with his breast pressing upon the edge of a plain table. No person can enjoy health who does not properly digest his food. But intense thinking and inactivity never fail to weaken the powers of digestion Hence the humours become crude and vitiated, the solids weak and relaxed, and the whole constitution goes to ruin. Long and intense thinking often occasions grievous head achs, which bring on virtigoes, apoplexies, palsies, and other fatal disorders. The best way to prevent these is, never to study too long at one time, and to keep the body regular, either by proper food, or taking frequently a little of some opening medicine. Those who read or write much are often afflicted with sore eyes. Studying by candle-light is peculiarly hurtful to the sight. This ought to be practised as seldom as possible. When it is unavoidable, the eyes should be shaded, and the head should not beheld too low. When the eyes are weak or painful, they should be bathed every night and morning in cold water, to which a little brandy may be added. It has already been observed, that the excretions are very defective in the studious. The dropsy is often occasioned by the retention of those humours which ought to be carried off in this way. Any person may observe, that sitting makes his legs swell, and that this goes off by exercise; which clearly points out the method of prevention. Fevers, especially of the nervous kind, are often the effect of study. Nothing affects the nerves so much as intense thought. It in a man- ner unhinges the whole human frame, and not only hurts the vital mo- tions, but disorders the mind itself. Hence a delirium, melancholy, and even madness, are often the effect of close application to study. In fine, there is no disease which can proceed either from a bad state of the humours, a defect of the usual secretions, or a debility of the nervous system, which may not be induced by intense thinking. But the most afflicting of all the diseases which attack the studious is the hypochondriack. This disease seldom fails to be the companion of deep thought. It may rather be called a complication of maladies than a single one. To what a wretched condition are the best of men 5* THE LABORIOUS, THE SEDENTARY, often reduced by it ! Their strength aod appetite fail; a perpetual gleoin liangs over their minds ; they live in the constant dread of death, and are continually in search of relief from medicine ; where, alas ! it is not to be found. Those who labour under this disorder, though they are often made the subject of ridicule, justly claim our highest sympa* thy and compassion. Hardly any thing can be more preposterous than for a person to make study his sole business. A mere student is seldom an useful member of society. He often neglects the most important duties of life, in or- der to pursue studies of a very trifling nature. Indeed it rarely hap- pens that any useful invention is the effect of mere study. The farther men dive into profound researches, they generally deviate the more from common sense, and too often loose sight of it altogether. Profound speculations, instead of making men wiser or better, generally render them absolute sceptics, and overwhelm them with doubt and uncertain- ty. All that is necessary for a man to know, in order to be happy, is easily obtained ; and the rest, like the forbidden fruit, serves only to increase his misery. Studious persons, in Order to relieve their minds, must not only dis- continue to read and write, but engage in some employment or diver- sion that will not so far occupy the thought as to make them forget the business of the closet. A solitary ride or walk are so far from relax- ing the mind, that they rather encourage thought. Nothing can divert the mind when it gets into a train of serious thinking, but attention to subjects of a more trivial nature. These prove a kind of play to the mind, and consequently relieve it. ^Learned men often contract a contempt for what they call trifling company. They are ashamed to be seen with any but philosophers. This however is no proof of their being philosophers themselves. No man deserves that name who is ashamed to unbend his mind, by asso- ciating with the cheerful and gay. Even the society of children will relieve the mind, and expel the gloom which application to study is too apt to occasion. As studious people are necessarily much within doors, they should make choice of a large and well aired place for study. This would uot only prevent the bad effects which attend confined air, but would cheer the spirits, and have a most happy influence both on the body and mind. It is said of Euripides the tragedian, that he used to retire to a dark cave to compose his tragedies, aud of Demosthenes the Gre- cian orator, that he chose a place for a study where nothing could be either heard or seen. With all deference to such venerable names, we cannot help coHiiemning their taste. A man may surely think to a» good purpose iu an elegant apartment as in a cave; and may have ai happy conceptions where the all-cheering rays of the sun vender *h% *ir wholesome, as in places where they never enter. AND THE STUDIOUS. 55 Those who read or write much should be very attentive to their pos- ture. They ought to sit and stand by turns, always keeping as nearly in an erect posture as possible. Those who dictate, may do it walk- ing. It has an excellent effect frequently to read or speak loud. This not only exercises the lungs, but almost the whole body. Hence stu- dious people are greatly benefited by delivering discourses in public. Public speakers, indeed, sometimes fyurt themselves, by overacting their part ; but that is their own. fault. The martyr to mere vociferation merits not our sympathy. The morning has, by all medical writers, been reckoned the best time for study. It is so. But it is also the most proper season for ex- ercise, while the stomach is empty, and the spirits refreshed with sleep. Studious people should therefore sometimes spend the morning in walk- ing, riding, or some manly diversions without doors. This would make them return to study with greater alacrity, and would be of more sex- vice than twice the time after their spirits are worn out with fatigue. It is not sufficient to take diversion only when we can think ao longer. Every studious person should make it a part of his business, and should let nothing interrupt his hours of recreation more than those of study. Music has a very happy effect in relieving the mind when fatigued with study. It would be well if every studious person were so far ac- quainted with that science as to amuse himself after severe thought, by playing such airs as have a tendency to raise the spirits, and inspire cheerfulness and good humour. It is a reproach to learning, that any of her votaries, to relieve the mind after study, should betake themselves to the use of strong liquors.^ This indeed is a remedy; but it is a desperate one, and always proves destructive. Would such persons, when their spirits are low, get ob horseback, and ride ten or a dozen miles, they would find it a more ef- fectual remedy than any cordial medicine in the apothecary's shop, or all the strong liquors in the world. The following is my plan, and I cannot recommend b, better to oth* ers. When my mind is fatigued with study, or other serious business, I mount my horse, and ride ten or twelve miles into the country, where I spend a day, and sometimes, two with a cheerful friend ; after which * " To such persons," says. Dr. Rush, " it may be a discovery to know, that tea is a much better remedy for that purpose. By its grate- ful and gentle stimulus, it removes fatigue, restores the excitement of the mind, and invigorates the whole system. I am no advocate for the excessive use of tea. When taken too strong, it is hurtful, especially to the female constitution ; but, when taken of a moderate degree o£ strength, and in moderate quantities, with sugar and cream, pr milk, I believe it is, in general, innoxious, and, at all times, to be preferred tQ «rdent spirits, as a cordial for studious men." a. s. SO OF ALIMENT. I never fail to return to town with new vigour, and to pursue my stu- dies or business xy'v'u fresh alacrity. It is much to be regretted, that learned men, while in health, pay so little regard to thc?e things ! There is not any thing more common than to see a miserable object over- run with nervous diseases, bathing, walk- ing, riding, and, in a word, doing every thing tor health after it is gone; yet, if any one had recommeuded these things to him by way of pre^ ventiou, the advice would, in all probability, have been treated with contempt, or, at least, with ueglect. Such is the weakness and folly of mankind, and sucli the want of foresight, even in those who ought to be wiser than others ! With regard to the diet of the studious, we see no reason why they should abstain from r;ny kind of food that is wholesome, provided they use it in moderation. They ought, however, to be sparing in the use of every thing that is windy, rancid, or hard of digestion. Their sup- pers should always be light, or taken soon in the evening. Their drink may be water, fine mail liquor, not too strong, good cyder, wine and water, or, if troubled with aeidities, water mixed with a little brandy, rum, or any other genuine spirit. We shall only observe, with regard to those kinds of exercise which are most proper for the studious; that they should not be too violent, oor ever carried to the degree of excessive fatigue. They ought like- wise to be frequently varied so as to give action to all the different parts of the body ; and should, as often as possible, be taken in the open air. In general, riding on horseback, walking, working in a gar- den, or playing at some active diversions, are the best. We would likewise recommend the use of the cold bath to the studi- ous. It will, in some measure, supply the place of exercise, and should not. be neglected by persons of a relaxed habit, especially in the warm season. No person ouglit either to take violent exercise or to study iuuredi-. ately after a full meal. CHAPTER HI. OF ALIMENT, UNWHOLESOME feed, and irregularities of diet, o«casi©D many diseases. There is no doubt but the whole constitution of body may be changed by diet alone. The fluids may be thereby attenuated or condensed, rendered mild or accrimonious, coagulated or diluted, to almost any degree. Nor are its effects upon the solids less OF ALIMENT. 5? considerable. They may be braced or relaxed, have their sensibility, motions, &c. greatly increased or diminished, by different kinds of ali- ment. A very small attention to these things will be sufficient to she -, how much the preservation of health depends upon a proper rfc;iraeu of the diet. Nor is an attention to diet necessary for the preservation of health ®nly ; it is likewise of importance in the cure of diseases. Every in- tention in the cure of many diseases, may be answered by diet alone. Its effects Indeed are not always so quick as those of medicine, but they are generally more lasting ; besides, it is neither so disagreeable to the patient, nor so dangerous as medicine, and is always more easily ob- tained. .Our intention here is not to inquire minutely into the nature and prop- erties of the various kinds of aliment in use among mankind ; nor to show their effects upon the different constitutions of the human body ; but to mark some of the most pernicious errors which ptople are apt to fall into, with respect both to the quantity and quality of iheir food, and to point out their influence upon health. It is not indeed an easy matter to ascertain the exact quantity of food proper for every age, sex, and constitution; but a scrupulous ni- . cety here is by no means necessary. The best rule is to avoid all ex- tremes. Mankind were never intended to weigh and measure their food. Nature teaches every creature when it has enough ; and the calls of thirst and hunger are sufficient to inform them when more is necessary. Though moderation is the chief rule with regard to the quantity, yet the quality of food merits a farther consideration. There are many ways by which provisions may be rendered unwholesome. Bad sea<- sons may either prevent the ripening of grain, or damage it afterwards. These, indeed, are acts of Providence, and we must submit to them ; but surely no punishment can be too severe for those who suffer pro- visions to spoil by hoarding them, on purpose to raise the price, or who promote their own interest by adulterating the necessaries of life.* Animal, as well as vegetable food, may be rendered unwholesome, by being kept too long. All animal substances have a constant ten- dency to putrefaction; and, when that has proceeded too far, they not only become offensive to the senses, but hurtful to health. Diseased animals, and such as die of themselves, ought never to be eaten. It is a common practice, however, in some grazing countries, for servants * The poor, indeed, are generally the first who suffer by unsound provisions; but the lives of the labouring poor are of great importance to the state : besides, diseases occasioned by unwholesome food often prove infectious, by which means they reach people in every station. It is therefore the interest of all to take care that no spoilt provisions s great distance to market, by which means their tender flesh is bruis- ed, and many of their vessels burst, No people in the wovld eat such quantities of animal fosd as the Eng- lish, which is one reason why they are so generally tainted with the scurvy, audits numerous train of consequences, indigestion, low spirits 9 hypochoudriacism, &z. Animal food was surely designed for man, and with a proper mixture of vegetables, it will be found the most whole- some ; but to gorge beef, mutton, pork, fish, and fowl, twice or thrice a- day, is certainly too much. All who value health ought to be con- tented with makiDg one meal of flesh in twenty-four hours, and this ought to consist of one kind only. The most obstinate scurvy has often been cured by a vegetable di~ et; nay, milk alone will frequently do more in that disease than any medicine. Hence it is evident, that if vegetables and milk were more used in diet, we should have less scurvy, and likewise fewer putrid and inflammatory fevers. Fresh vegetables, indeed, come to be daily more ^ised in diet; this laudable practice we hope will continue to gaife ground. Our aliment ought neither to be too moist nor too dry. Moist ali ! meut relaxes the solids, and renders the body feeble. Thus we see females, who live much on tea and other watery diet, generally be- come weak and unable to digest solid food ; hence proceed hysterics, and all their dreadful consequences. On the other hand, food that is too dry, renders the solids in a manner rigid, and the humours viscid, which disposes the body to inflammatory fevers, scurvies, and the like., Much has been said on the ill effects of lea in diet. They are, no doubt, numerous; but they proceed rather from the imprudent use of it, than from any bad qualities in the tea itself. Tea is now the uni- versal breakfast in this part of the world, but the morning is surely the most improper time of the day for drinking it. Most delicate personF> who, by the bye, are the greatest tea drinkers, cannot eat any thing in the morning. If such persons, after fasting ten or twelve hours, drink four or five cups of green tea, without eating scarcely any bread, it must hurt them. Good tea, taken in a moderate quantity , not too strong, nor too hot, hbr drank upon ah empty' stomach, will seldom do harm ; but if it be bad, which is often the case, or substituted in the room of solid food, it must have many ill effects. The arts of cookery render many things unwholesome, which are not so in their own nature. By jumbling together a number of diffe- rent ingredients, ib order to make a poignant sauce, or rich soup, the composition proves almost a poison. All high seasoning, pickles, &c. are only incentives to luxury, and never fail to hurt the stomach. It were well for mankind, if cookery, as an art, were entirely prohibit- ed. Plain roasting or boiling is all that the stomach requires. These alone are sufficient for people iu health, and the sick have still lefc "toeed of a cook, 60 OF ALIMENT. The liquid part of our aliment likewise claims our attention. Water is not only the basis of most liquors, but also composes a great part of our solid food. Good water must therefore be of the greatest impor- tance in d;et. The best water is that which is most pure, and free from any mixtare of foreign bodies* Water takes up parts of most bodies With wjucn it comes into contact ; by this means it is often impregna- ted with metals or minerals of a hurtful or poisonous nature. Hence tue inhabitants of some hilly countries have peculiar diseases, which ic ail probability proceed from the water Thus the people who live Alps in Switzerland, and the inhabitants of the Peak of Der- by iu Englaud, have large tumours or wens on their necks. This dis- ease ia generally imputed to the snow water ; but there is more reason to believe it is owing to the minerals in the mountains through which the waters p.tss. When water is impregnated with foreign bodies, it generally appears by its weight, colour, taste, smell, heat, or some other sensible quality. Our business therefore is to choose such water, for common use, as is lightest, and without any particular colour, taste, or smell. In most places of Britain the inhabitants have it in their power to make choice Djf raeir water, and tew tilings would contribute more to health than a due attention to this article. But mere iudoleuce often induces people to make use of the water that is nearest to them, without considering its qualities. Before water is brought Into great towns, the strictest attention ought to be paid to its qualities, as many diseases may be occasioned or ag- gravated by bad water ; and when once it has been procured at a great expence, people are unwilling to give it up. The common methods of rendering water clear by filtration, or soft, by exposing it to to the sun and air, which exhausts the spirits, inflames the bloody and disposes the body to numberless diseases* But fermented liquors may be too Weak as Well as too strong ; when that is the case, they must either be drank new, or ibey become sour and dead : when such liquors are drank new, the fermentation not be- ing over, they generate air in the bowels, and occasion flatulencies ; and, when kept till stale, they turn sour on the stomach, and hurt di- gestion. For this reason all malt liquor, cider, &c. ought to be of such strength as to keep till they be ripe, and then they should be used. "When such liquors are kept too long, though they should not become sour, yet they generally contract a hardness which renders them ul> wholesome* All families, who can, oUght to prepare their own liquors. Since preparing and vending of liquors became one of the most general branch- es of business, every method has been tried to adulteratethem. The great object both to the makers and venders of liquors is, to render it intoxicating* and to give it the appearance of age. But it is well known that this may be done by other ingredients, than those which ought to be used for making it strong. It would be imprudent even to name those things which are daily made use of to render liquoxs heady Suf- fice it to say, that the practice is very common, and that all the ingre- dients used for this purpose are of a narcotic or stupefactive quality. But as all opiates are poisonous, it is easy to see what must be the con- sequence of their general use. Though they do not kill suddenly, yet they hurt the nerves, relax and weaken the stomach, and spoil the di- gestion. . Were fermented liquors faithfully prepared, kept to a proper age, and used in moderation, they would prove real blessings to mankind. But, while they are ill prepared, various ways adulterated, /ind taken to excess, they must have many pernicious effects. We would recommend it to families, not oaly to prepare their owo liquors, but likewise their bread. Bread is so necessary a part of di- et, that too much care cannot be bestowed in order to have it sound and wholesome. For this purpose, it is not only necessary that it be made of good grain, but likewise properly prepared, and kept free from all unwholesome ingredients. This, how T ever, we have reason to believe is not always the case with bread prepared by those who make a trade t*f vending it. Their object is rather to please the eye, thaH to consult tfee health. The best bread is that which is neither totf coarse nor toe % OF ALIMENT. fine; well fermented, and made of wheat flower, or rather of v, and-rye mixed together. To specify the different kinds of aKmeut, to explain their nature and "properties, and to point out their effects in different constitutions, would far exceed the limits of our design. Instead of a detail of this kind, ■which, would not be generally understood, and of course little attended to, we shall only mention the following easy rules with respect to the choice of aliment. Persons whose solids are weak and relaxed, ought to avoid all viscid fcod, or such things as are hard of digestion. Their diet, however, ought to be nourishing; and they should take sufficient exercise in the open air. Such as abound with blood should be sparing in the use of every thing that is highly nourishing, as fat meat, rich wio.es, strong ale, and such like. Their food should consist chiefly of bread and other vege- table substances ; and their drink ought to be water, whey or small beer. Fat people should no^ eat freely of oily nourishing diet. They ought frequently to use horse-raddhh, garlic, spices, or such things as are beating and promote perspiration and urine. Their drink should be water, coffee, tea, or the like; and they ought to take much exercise and little sleep. Those who are too lean must follow an opposite course. Such as are troubled with acidities, or whose "food is apt to sour oh the stomach, should live much on animal food ; and those who are af- flicted with hot billious eructations, ought to use a diet consisting chief- ly of acid vegetables. People who are afflicted with the gout, low spirits, hypochondriac or hysteric disorders, ought to avoid all flatulent food, every thing that is viscid, or hard of digestion, all salted or smoke-dried provisions, and what- ever is austere, acid, or apt to turn sour on the stomach. Their food should be light, spare, cool, and of an opening nature. The diet ought not only }o be suited to the age and constitution, but also to the manner of life; a sedentary or studious person should live more sparingly than one who labours hard without doors. Many kinds of food will nourish a peasant very well which would be almost indi- gestible to a citizen; and the latter '"will'live upon a diet ou which the former would starve. Diet ought not to be too uniform. The constant use of one kind of food might have some bad effects. Nature teaches us this, by the #re:tt variety of aliment which she has provided for man, and likewise »y giving him an appetite for different kinds of food. Those who labour under any particular disease, ought to avoid such aliments as have a tendency to increase it; for example, a gouty per- son should not indulge in rich wines, strong soups, or gravies, and Should avoid all acids. One who is troubled with the gravel ought & . OF ALIMENT. ©$ * ( $»uri, all- austere and astringent aliments ; and those who are scorbutic should be sparing in the use of salted provisions, &c. la the first period of life, our food ought to be light, but nourishing, r and frequently taken. Food that is solid, with a sufficient degree of tenacity, is most proper for the state of manhood; The diet suited to the last period of life, when nature is upon the decline, approaches nearly to that of the first. It should be lighter and more succulent thaa that of vigorous age, and likewise more frequently taken. It is not only necessary for health that our diet be wholesome, but also that it be taken at regular periods. Some imagine that long fasting wilS atone for excess; but this, instead of mending the matter, generally makes it worse. When the stomach and intestines are over distended with food, they lose their proper tone,-and, by long fasting, they become weak, and inflated with wind. Thus, either gluttony or fasting des- troys the powers of digestion. The frequent repetition of aliment is not only necessary for repair- ing the continual waste of our bodies, but likewise to keep the fluids Bound and sweet. Our humours, even in the most healthy state, have $ constant tendency to putrefaction, which can only be prevented by frequent supplies of fresji nourishment : when that is wanting too long, the putrefaction often proceeds so far as to occasion very dangerous fee vers. From hence we may learn the necessity of regular meals. No person can enjoy a good state of health, whose vessels are either fre- quently overcharged, or the humours long deprived of fresh supplies of chyle. Long fasting is extremely hurtful to young people ; it not only viti- ates their humours, but prevents their growth. Nor is it less injurious to the aged. Most persons, in the decline of life, are afflicted with wind : this complaint is not only increased, but even rendered dange- rous, and often fatal, by long* fasting. Old people, when their stomachc are empty, are frequently seized with giddiness, head-achs, and faint- saess. These complaints may generally be removed by a piece of bread ^ad a glass of wine, or taking any other solid food ; which plainly points cut the method of preventing them. It is more than probable, that many of the sudden deaths, which liappen in the advanced periods of life, are occasioned by fasting too long, as it exhausts the spirits, and fills the bowels with wind : we would therefore advise people in the decline of life, never to allow their stom- achs to be too long empty. Many people take nothing but a few cups of tea and a little bread, from nine o^lock at night till two or three $ext afternoon. Such maybe said to fast almost tiiree fourths of then time. This can hardly fail to ruin the appetite, vitiate the humours., and fill the bowels with wind ; all which might be prevented by a solid breakfast. It is a very common practice to eat a light breakfast and a heavy fyjpper. This custom ought to be reversed. When people sup late s 64 OF ALIMENT. tbeir supper should be very light; but the breakfast ought always te> be solid. If any one eats a licht supper, goes soon to bed, and rises betimes in the morning, he will be sure to find an appetite for his break- fast, and he may freely indulge it. The strong and healthy do not indeed suffer so mnch from fasting as the weak and delicate; but they run great hazard from its opposite, viz. repletion. Many diseases, especially fevers, are the effect of a plethora, or too great fullness of the vessels. Strong people, in high health, have generally a great quantity of blood and other humours. When these are suddenly increased, by an overcharge of rich and Dourishing diet, the vessels become too much distended, and obstruct- ions and inflammations ensue. Hence so many people are seized with inflammatory and eruptive fevers, apoplexies, &c. after a feast or de- bauch. AH great and Hidden changes in diet are dangerous. What the stomach has been long accustomed to digest, though less wholesome, will agree better with it than food of a more salutary nature to which it has not been used. When therefore a change becomes necessary, it ought always to be made gradually ; a sudden transition from a poor and low, to a rich and luxurious diet, or the contrary, might so dis- turb the functions of the body as to endanger health, ox even to occa- sion death itself. When we recommend regularity in diet, we would not be understood as condemning every small deviation from it. It is next to impossible for people at all times to avoid some degree of excess, and living too much by rule might make even the smallest deviation dangerous. It may therefore be prudent to vary a little, sometimes taking more, some- times less, than the usual quantity of meat and drink, provided always that a due regard be had to moderation. § Notwithstanding" our author's omission T>f a general account of the qualities of the different kinds of animal and vegetable food most com- monly used in diet, we think the following not unworthy attention. " Beef. — Wlieu this is the flesh of a bullock of middle age, it affords good and stroug nourishment, and is peculiarly well adapted to those who labour, or take much exercise. It will often sit easy upon the stomachs that can digest no other kind of food ; and its fat is almost as easily digested as that of veal. " real is a proper food for persons recovering from an indisposition, and may even be given to febrile patients in a very weak state, but it affords less nourishment than the flesh of the sanfe animal in a state of maturity. The fat of it is lighter than that of any other animal, and shows the least disposition to putresceucy. Veal is a rcry suitable food OF ALIMENT. 6$ fa costive habits; but of all meat it is the least calculated for removing an acid from the stomach. " Mutton, from the age of four to six years, and fed on dry pasture, is an excellent meat. It is of a middle kind between the firmness of beef and the tenderness of veal. The lean part of mutton, however, is the most nourishing, and conducive to health ; the fat being hard of digestion. The head of the sheep, especially when divested of the skin, is very tender ; and the feet, on account of the jelly they contain, highly nutritive. " Lamb is not so nourishing as mutton ; but it is light, and extreme- ly suitable to delicate stomachs. " House-lamb, though -much esteemed by many, possesses the bad qualities common to the flesh of all animals reared in an unnatural way. " Pork affords rich and substantial nourishment ; and its juices are wholesome when properly fed, and when the animal enjoys pure air and exercise. But the flesh of hogs reared in towns is both hard of digestion and unwholesome. Pork is particularly improper for those who are liable to any foulness of the skin. It is almost proverbial, that a dram is good for promoting its digestion : but this is an erroneous notion : for, though a dram may give a momentary stimulus to the coats of the stomach, it tends to harden the flesh, and of course, to make it more indigestible. " Srnoakedhqrqs are a strong kind of meat, and rather fit for a rel- ish than for diet. It is the quality of all salted meat that the fibres be- come rigid, and therefore more difficult of digestion ; and when to this is added smoaking, the heat of the chimney occasions the salt to concentrate, and the fat between the muscles to become rancid. " Bacon is also of an indigestible quality, and is apt to turn rancid on weak stomachs. " The flesh of goats is hard and indigestible ; but that of kids is tender, as well as delicious, and affords good nourishment. " Venison, or the flesh of deer, and that of hares, is of a nourishing quality; but is liable to one inconvenience ; which is, that though much disposed to putrescency of itself, it must be kept for a little time before it becomes tender. " The blood of animals is used as aliment by the common people : but they could not long subsist upon it unless mixed with oatmeal, &c. for it is not soluble alone by the digestive powers of the human stom- ach, and therefore cannot be nourishing. •' Milk is of very different consistence in different animals ; but that of cows being the kind used in diet, is at present the object of our attention. Milk, where it agrees with the stomach, affords excellent nourishment for those who are weak, and cannot digest other aliments,. Though an animal production, it does not readily become putrid, as being possessed of the properties of Vegetable aliment ; but it is apt to become sour on the stomach, and thence to produce flatulence, the heart : 9 S3 OF ALIMENT. barn, or gripes, and, in some constitutions, a loosenes?. The be si milk., is from a cow at three or four years of age, about two months after pro- ducing a calf. It is lighter, but more watery, than the milk of sheep. and goats ; while, on the other hand, it is more thick and heavy thau the milk of asses and mares, which are the uext in consistence to hu- man milk. " On account of the acid which is generated after digestion, milk coagulates in all stomachs ; but the caseous or cheesy part is again dis- solved by the digestive juices, and rendered fit for the purpose of nu- trition. It is however, improper to eat acid substances with milk, ao these would tend to prevent the due digestion of it. " Cream is veiy nourishing, but ou account of its fatness is difficult to be digested in weak stomachs. Violent exercise after eating it, will in a little time convert it into butter, " Some writers inveigh against the use of Butter as universally per- nicious ; but they might with equal reason condemn all vegetable oils, which form a considerable part of diet in the southern climates, and seem to have been beneficently intended by nature for that purpose. Butter, like every other oily substance, has doubtless a relaxing qual- ity, and, if long retained in the stomach, is liable to become rancid ; but, if eaten iu moderation, it will not produce those effects in any hurtful degree. It is, however, improper in billious constitutions. The worst consequence produced by butter, when eaten with bread, is, that it obstructs the discharge of the saliva in the act of mastication or chewing ; by which means the food is not so readily digested. To obviate this effect, it would be a commendable practice at breakfast, first to eat some dry bread, and chew it well, till the salivary glands were exhausted, and afterwards to eat it with butter. By these means such a quantity of saliva might be carried into the stomach as would be sufficient for ','ie purpose of digestion. " Cheeseis likewise reprobated by many as extremely unwholesome- It is doubtless not easy of digestion ; and, when eaten in a great quan- tity, may load the stomach; but, if taken sparingly, its tenacity may be: dissolved by the digestive juices, and it may yield a wholesome, though not a very nourishing chyle. Toasted cheese is agreeable to most palatfs, but is rendered more indigestible by that process. " The flesh of Birds differs in quality according to the food on "which they li\*e. Such as feed on grain and berries afford, in general, good nourishment, if we except %ccse and ducks, which are hard of digestion. A young hm or chicken is tender and delicate food, and extremely well adapted when the digestive powers are weak. But of all tame fowls the capon is the most nutritious. Turkies. as well as Guinea er India fowls, afford a substantial ali- ment, but are not so easy of digestion as the common domestic fowls. |u a}l birds these parts are the meet firm which arc most exercised ; OF ALIMENT. CV lb the email birds, therefore, the wings, and in the larger kinds, the legs, are commonly the most difficult of digestion. " The flesh of wild birch, in general, though more easily digested, fa less nourishing than that of quadrupeds, as beinj? more dry, on ac~ count of their almost constant exercise. Those birds are not whole- some which subsist. upon worms, insects, and fishes. u Bggs. In the last class of terrestrial animal food we may rank the eggs of birds, which are a simple and a wholesome aliment. Those of the turkey are superior in all the qualifications of food. The white of eggs is dissolved in a warm temperature, but by much heat it is ren- dered tough and hard. The yolk contains much oil, and is highly nourishing, but. has a strong tendency to putrefaction; on which ac- count eggs are improper for people of, weak stomachs, especially when they are not quite fresh. Eggs hard boiled or fried are difficult of di- gestion, and are rendered still more indigestible by the addition of but- ter. AH eggs require a sufficient quantity of salt, to promote their solution in the stomach. " Fish, though some of them be light, and easy of digestion, afford less nourishment than vegetables, or the flesh of quadrupeds, aud are of all animal tribes the most disposed to putrefaction. Salt-water fish are, in general, the best; but when salted, though less disposed to pu- trescency, they become more difficult of digestion. Whitings and flounders are the most easily digested. Acid sauces and pickles, by resisting putrefaction, are a proper addition to fish, both as they retard putresceney, and correct the relaxing tendency of butter, £o generally used with this kind of aliment. " Oysters are eaten both raw and dressed ; but in the former slate they are preferable ; because heat dissipates considerably their nutri- tious parts, as well as the salt-water, which promotes their digestion in the stomach ; if uot eaten very sparingly, they generally prove laxa- tive. " Muscles are far inferior to oysters, both in point of digestion and nutriment. Sea muscles are by some supposed to be of a poisonous nature ; but though this opinion is not much countenanced by experi- ence, the safest way is to eat them \vith vinegar, or some other vegeta- ble acid. , " Bread. At the bead of the vegetable class stands bread, that arti- cle of diet, which, from general use, has received the name of the staff of life. Wheat is the grain chiefly used for the purpose in this coun- try, and is among the most nutritive of all the farinaceous kinds, as it contains a great deal of mucilage. Bread is very properly eaten with animal food, to correct the disposition to putresceney ; but is most expedient with such articles in diet as contain much nourishment in a small bulk, because it then serves to give the stomach a proper de- gree of expansion. But as it produces a slimy chyle, and disposes to sostiveness, it ought not to be eaten in a large quantity. To render 63 OF ALIMENT. bread easy of digestion, it ought to be well fermented and baked ; and it never should be used till it has stood twenty four hours after beiug taken out of the oven, otherwise it is apt to occasion various complaints in those who have weak bowels ; such as flatulence, the heart-burn, watchfulness, and the like. The custom of eatiug butter with bread hot from the oven is compatible only with strong digestive powers. " Pastry, especially when hot, has all the disadvantages of hot bread and butter ; and even buttered toast, though the bread is stale, is scarce- ly inferior in its effects on a weak stomach. Dry toast without butter is by far the wholesomest breakfast. " Bread made of Rye is apt to sour on the stomach, and to excite heart-burn in certain constitutions — is of a laxative nature, ond there- foie, better suited to costive habits, either alone, or mixed with wheat i But on account of its disposition to ace9cency, fermentation, and flatu- lency, may not be so well adapted for persons of choleric tempera- ments, and those afflicted with dyspeptic, hypochondriac, and hysteric symptoms : yet, it is the best to prevent or cure the scurvy. " That made of Indian Corn appears to agree well with most people who like it : and when mixed with wheat or rye, or both, it makes them palatable, and keeps moist a considerable time. " Buck wheat being somewhat liable to an acescent fermentation in the stomach, does not agree well with all constitutions. The grain should, previous to being ground, be freed from the dust and grit. It is supposed that its use occasions itchings and cutaneous eruptions — and constantly used, is not thought so wholesome as other bread. " Oats, when deprived of the husk, and particularly barley, when properly prepared, are each of Ihem softening, and afford wholesome and cooling nourishment. Rice likewise contains a nutritious muci- lage, and is less used in this country than it deserves, both on account r>f its wholesomeness and economical utility. The notion of its being hurtful to the sight is a vulgar error. In some constitutions it tends to make them costive ; but this seems to be owing chiefly to flatulence, and may be corrected by the addition of some spice, such as caraway, anise seed, and the like. " Potatoes are an agreeable and wholesome food, and yield as much nourishment as any of the roots used in diet. The farinaceous or mealy kind is in general the most easy of digestion ; and they are much im- proved by being roasted. " Green ■pease and Turkey beans, boiled in their fresh state, are both agreeable to the taste, and wholesome; being neither near so flatulent, nor difficult of digestion, as in their ripe state; in which they resemble the other legumiuous vegetables. French beans possess much the same qualities, but yield a more watery juice, and have a greater disposition "to produce flatulence. The leguminous vegetables in general ought t'c $ie eaten with some spice. OF ALIMENT m " Sallads, being eaten raw, require good digestive powers, especiaU ly those of the cooling kind ; and the addition of oil and vinegar, though quailed with mustard, hardly renders the free use of them consistent with the weak stomach. " Spinage affords a soft lubricating aliment, but contains little nour- ishment. In weak stomachs it is apt to produce acidity, and frequent- ly a looseness. To obviate these effects, it ought always to be well beaten, and but little butter mixed with it. " Asparagus is a nourishing article in diet, and promotes urine ; but^ in common with the vegetable class, disposes a little to flatulence. " Articlwkes resemble asparagus in their qualifes, but seem to be more nutritive and less diuretic. " White cabbage is one of the most conspicuous plants in the garden, it does not afford much nourishment, but is an agreeable addition to animal food, and not quite so flatulent as the common greens. It is likewise diuretic, and somewhat laxative. Cabbage has a stronger ten- dency to putrefaction than most other vegetable substances ; and, du- ring their putrefying state, sends forth an offensive smell, much resem- bling that of putrefying animal bodies. So far, however, from promo- ting a putrid deposition in the human body, it is on the contrary, a whole- some aliment in the true putrid scurry. "Turnips are a nutricious article of vegetable food, but not very easy of digestion, and are flatulent. This effect is, in a great measure, ob- viated by pressing the water out of them before they are eaten. " Carrots contain a considerable quantity of nutritious juice, but are among the most flatulent of vegetable productions. " Parsnips are more nourishing and less flatulent than carrots, which they also exceed in the sweetness of their mucilage. By boiling them in two different waters, they are rendered less flatulent, but their other qualities are thereby diminished in proportion. " Parsley is of a stimulating and aromatic nature, well calculated to make agreeable sauces. It is also a gentle diuretic, but preferable in all its qualities when boiled. " Celery affords a root both. wholesome and fragrant, but is difficult of digestion in its raw state. It gives an agreeable taste to soups, as well as renders them diuretic. " Onions, garlic, and shallots, are all of a stimulating nature, by which they assist digestion, dissolve slimy humours, and expel flatulen- cy. They are, however, most suitable to persons of a cold and phleg- matic constitution. " Radishes of all kinds, particularly the horseradish, agree with the three preceding articles in powerfully dissolving slimy humours. They excite the discharge of air lodged in the intestines ; but this pro- ceeds from the expulsion of air contained in themselves. ., ■■ " Applesare a wholesome vegetable aliment, and in many cases medi- cinal, particularly in diseases of the breast and complaints arising frori % Of AhiMENV. phlegm. But, in general, they agree begt with the stomach when etii- en either roasted or boiled. The more aromatic kinds of apples are the finest for eating raw. *.' Pears resemble much in their effects the sweet kind of apples, hut have mere of a laxative quality, aud a greater tendency to flatu- lence. " Cherries arc, in genera!, a wholesome fruit, when they agree with the stomach, and they are beneficial in many diseases, especially those of the putrid kind. " Plumbs are nourishing, and have besides an attenuating, as well as a laxative quality 5 but, are apt to produce flatulence If eaten fresh, and before they,are quite ripe, especially in large quantities, they occasion cholics and other complaints of the bowels. " Peaches are not of a very nourishing quality, but they abound in juice, and are serviceable in billious complaints. " Apricots are more pulpy than peaches, but are apt to ferment and produce acidities in weak stomachs. Where they do not disagree they are cooling, and tend likewise to correct a tendency to putrescency. "Gooseberries, as well as currants, when ripe, are similar in their qnalities to cherries, and, when used in a green state, they are agreeably cooling. *' Strawberries are an agreeable, cooling aliment, and are accounted good against the gravel. " Cucumbers are cooling, and agreeable to the palate ia hot weather $ but to prevent them from proving hurtful to the stomach the juice ought Jo be squeezed out after they are sliced, and vinegar, pepper, and saltj afterwards added. " Tea. By some the use of this exotic is condemned in terms the most vehement and unqualified, while others have either asserted its innocence, or goue so far as to ascribe to it salubrious and even extra- ordiaary virtues. The truth seems to lie between these extremes ; there is however an essential difference in the effects of green tea aud of black, or bohea; the former of which is much more apt to affect the nerves of the stomach than the latter, especially when drank w ithout cream and likewise without bread and butter. That when taken in a large quantity, or at a later hour than usual, it often produces watch- fulness, is a point which cannot be denied ; but if used in moderation, and accompanied with the addition just now mentioned, it does not sen- sibly discover any hurtful effects, but greatly relieves an oppression of the stomach, and abates a pain of the head. Bought always to be made of a moderate degree of strength ; for, if too weak it certainly relaxes she stomach. As it has an astringent taste, which seems uot very con- sistent v ith a relaxing power, there is ground for ascribing this effect Itpt ho much to the herb itself, as to the hot water, which not being im- pregnated with a sufficient quantitity of tea to conect its own tmolient feadency, produces a relaxation unjustly imputed to some noxious quai' OF ALIMENT* ^ %ij of the plant. But tea, like every other commodity, is liable to damage, and when this happens, it may produoe effects not necessarily Connected with its original qualities " Coffee. It is allowed that coffee promotes digestion, and exhila- rates the animal spirits ; besides which various other qualities are as- cribed to it, such as dispelling flatulency, removing dizziness of the head, attenuating viscid humours, increasing the circulation of the blood, and consequently perspiration; but if drank too strong it affects the nerves, occasions watchfulness, and tremor of the hands, though in some phlegmatic constitutions it is apt to produce sleep. Indeed it is to persons of that habit that coffee is well accommodated ; for to people of a thin and dry habit of body it seems to be injurious. Tur- key eoffee |s greatly preferable in flavour to that of the West- Indies. Drunk only in the quantity-of one dish after dinner to pro- mote digestion, it answers best without either sugar or milk : but if ta- ken at other limes it should have both, or in place of the latter rather cream, which not only improves the beverage but tends to mitigate the effect of coffee upon the nerves. " Chocolate is a nutritive and wholesome composition if taken in small quantity, and not repeated too often ; but is generally hurtful to the stomach of those with whom a vegetable diet disagrees. By the; addition of vanilla and other ingredients it is made too heating, and so much affects particular constitutions as to excite nervous symptoms, ©specially complaints of the head. CHAPTER IV, OF AIR. * UNWHQLESOME air is a very common cause of disease^ Few are aware of the danger arising from it. People generally pay some attention to what they eat or drink, but seldom regard what goes into the lungs, though the latter proves often more suddenly fatal than the former. Air, as well as water, takes up parts of most bodies with which it comes in contact, and is often so replenished with those of a noxious quality, as to occasion immediate death. But such violent effects sel- dom happen, as people are generally on their guard against them. The less perceptible influences, of bad air proves more generally hurtful to mankind ; we shall therefore endeavour to point out some of these, and to show whence the danger chiefly arises. 72 OF AIR. Air may become noxious many ways. Whatever greatly alters its degree of heat, cold, moisture, &c renders it unwholesome ; for example, that which is too hot dissipates the watery parts of the blood, exalts the bile, and renders the whole humours adust and thick. Hence proceed billious and inflammatory fevers, cholera morbus, &c. Very cold air obstructs the perspiratiou, constringes the solids, and condenses the fluids. It occasions rheumatisms, coughs, and catarrhs, with other diseases of the throat and breast. Air that is too moist de- stroys the elasticity or spring of the solids, induces phlegmatic or lax constitutions, and disposes the body to agues, pr intermitting fevers, dropsies, &c. Wherever great numbers of people are crowded into one place, if the air has not a free circulation, it soon becomes unwholesome. Hence it is that delicate persons are so apt to turn sick or faint in crowded churches, assemblies, or any place where the air is injured by breath- ing, fires, candles, or the like. In great cities so many things tend to contaminate the air, that it is no wonder it proves so fatal to the inhabitants. The air in cities is not only breathed repeatedly over, but is likewise loaded with sulphur, smoke, and other exhalations, besides the vapors continually arising from innumerable putrid substances, as dunghills, slaughter houses, &c. All possible care should be taken to keep the streets of large towns open and wide, that the air may have a free current through them. They ought likewise to be kept very clean. Nothing tends more to pollute and contaminate the uir of a city than dirty streets. It is very common in this country to have church-yards in the mid- dle of populous cities. Whether this be the effect of ancient supersti- tion, or owing to the increase of such towns, is a matter of no conse- quence. Whatever gave rise to this custom, it is a bad one. It is habit alone which reconciles us to these things ; by means of which the most ridiculous, nay pernicious customs, often become sacred. Cer- tain it is, that thousands of putrid carcasses, so near the surface of the earth, irffci place where the air is confined, cannot fail to taint it; and. that such air, when breathed into the lungs, must occasion diseases.* Burying within churches is a practice still more detestable. The air in churches is seldom good, and the effluvia from putrid carcasses must render it still worse. Churches are commonly old buildings with arched roofs. They are seldom open above once a week, are never ventilated by fires nor open windows, and rarely kept clean. This occasions that damp, musty, unwholesome smell which one feels upon entering a church, and renders it a very unsafe place for the weak and * In mest eastern countries it was custom -vy to bury the dead at some distance from auy town. As this practice obtained among the Jews, the Creeks, and also the Romans, it is strange that this country should not have followed their example in a custom so truly laudable , ft OF AIR. 73 valetudinary. These inconveniences might, in a great measure, be ob- viated, by prohibiting all persons from burying within churches, by keeping them cleau, and permitting a stream of fresh air to pass fre- quently through them, by opening opposite doors and wiudows.* Wherever air staguates long, it becomes unwholesome. Hence the unhappy persons coufiued in jails not only contract raalignaut fevers themselves, but ofteu communicate them to others. Nor are nnany of the holes, for we cannot call them hou^.S, 'possessed by the poor in great towns, much better than jails. These low dirty habitations are the very lurking places of bad air and contagious diseases. Such as live in them seldom enjoy good health ; and their children commonly die young. In the choice of a house, those who have it in their pow- er ought always to pay the greatest attention to open free air. The various methods which luxury has invented to make houses close and warm, contribute not a little to render them unwholesome. No house can be wholesome unless the air has a free passage through it. For which reason houses ought daily to be ventilated by opening opposite windows, and admitting a current of fresh air into every, room. Beds, instead of being made up as soon as people rise out of them, ought to be turned down, and exposed to the fresh air from the open windows through the day. This would expell any noxious vapour, and could not fail to promote the health of the inhabitants. In hospitals, jails, ships, &c. where that cannot be conveniently done, ventilaters should be used. The method of expelling foul and introdu- cing fresh air, by means of ventilators, is a most salutary invention, and is indeed the most useful of all our modern medical improvements. It is capable of universal application, and is fraught with numerous advan- tages, both to those in health and sickness. In all places, where num- bers of people are crowded together, ventilation becomes absolutely ne- cessary. Air which stagnates in mines, wells, cellars, &c. is extremely nox- ious. That kind of air is to be avoided as the most deadly poison. It often kills almost as quickly as lightning. For this reason, people should be very cautious in opening cellars that have been long shut, or going down into deep wells or pits, especially if they have been kept close covered f Many people who have splendid houses, chuse to sleep in v small apartments. This conduct is very imprudent- A bed chamber ought * One cannot pass through a large church or cathedral, even in sum- mer, without feeling quite chilly. f We have daily accounts of persons who lose their lives by going down Into deep wells and other places where the air stagnates ; all these acci- dents might be prevented by only letting down a lighted candle before them, and stopping when they percieve it go out ; yet this precaution, simple as it is, is seldom used. U OF AIR. always to be well aired ; as it is generally occupied in the night oni), when all doors and windows are shut. If a fire be kept in it, the dan- ger from a small room becomes still greater. Numbers have been sti- fled when asl • p by a fire in a small apartment, which is always hurtful. Those who are obliged, on account of business, to spend the day in close towns, ought if possible, to sleep in the country. Breathing free air in the night jrill, in some measure, make up for the want of it through the day. This prftcfoe would have a greater effect in pie- serving the healfh of citizens than is commonly imagined. Delicate persons ought, as much as possible, to avoid the air of great towns. It is peculiarly hurtful to the asthmatic and consump- tive. Such persons should avoid cities as they would the plague. The hypochondriac ave likewise much hurt by it. I have often seen persons so much afflicted with this malady while in town, that it seemed impossible for them to live, who, upon being removed to the country, were immediately relieved. The same observation holds with regard to nervous and hysteric women. Many people, indeed, have it not in their power to change their situation in quest of better air. ' All we can say to such persons is, that they should go as often abroad into the open sir as they can, that they should admit fresh air frequently into their houses, and take care to keep them very clean. It was necessary in former times, for safety, to surround cities, col- leges, and even single houses, ivith high walls. These, by obstructing the free current of air, never fail to render such places damp and un- wholesome. As such walls are now, in most parts of this country, be- come useless, they ought to be pulled down, and every method taken to admit a free passage to the air. Proper attention to Air and Clean- liness would tend more to preserve the health of mankind, than all the prescriptions of the faculty. Surrounding houses too closely with planting or thick woods, likewise tends to render the air unwholesome. Wood not only obstructs the free current of the air, but sends forth great quantities of moist exha- lations, which render it constantly damp. Wood is very agreeable at a proper distance from a house, but should never be planted too near it, especially in a flat country. Many of the gentlemen's seats in England arc rendered very unwholesome from the great quantity of wood which surrounds them. Houses situated in low marshy cpuntries, or near large lakes of stag- nating water are likewise unwholesome. Waters which stagnate not only render the air damp but load it with putrid exhalations, which pro- duce the most dangerous and fatal diseases. Those who ave obliged to inhabit marshy countries, ought to make choice of the dryest situa- tions they can find, to live generously, and to pay the strictest regard tc cleanliness. If fresh air be necessary for those in health, it is still more so for file sick, w ho ofteo lose their lives for want of it. The notion tlirt sick people must be kept very hot, is so common that on§ can hardly enter % Of exercise. r$ chamber where a patient lies, without being ready to faint, by reason of the hot suffocating smell. How this must affect the sick, any one may judge. JNo medicine is so beneficial to the sick as fresh air. It is the most reviving cf all cordials, if it be administered with prudence. We are not however, to throw open doors and windows at random upi- on the sick. Fresh air is to be let into the chamber gradually, and if possible, by opening the windows of some other apartment. The air of a sick person's chamber may be greatly freshened, and the patient much revived, by sprinkling the floor, bed, &c. frequently with vinegar, juice of lemon, or any other strong vegetable acid. * In places where numbers of sick are crowded into the same house, or which is often the case, into the same apartment, the frequent ad- mission of-fresh air becomes absolutely necessary. Infirmaries, hospi- tals, &c are often rendered so noxious, for want of proper ventilation, that the sick run more hazard from them than from the disease. This is particularly the case when putrid fevers, dysealaries, and other infec- tious diseases prevail. Physicians, surgeons, and others who attend hospitals, ought, for their own safety, to take care that they be property ventilated. Such persons as are obliged to spend the most of their time amongst the sick, run greatf hazard of being themselves infected when the air is bad. All hospitals, and places of reception for the sick, ought to have an open situation, at some distance from any great town, and such patients as labour under any infectious disease ought never to be suffered to come War the rest.* CHAPTER V. OF EXERCISE, MANY people look upon the necessity man is under of earning his bread by labour, as a ctfrse. Be this as it may, it is evident from the structure of the body, that exercise is not less necessary than food for the preservation of health : those whom poverty obliges to la- bour for daily bread, are not only the most healthy, but generally the most happy part of mankind. Industry seldom fails to place them above # A year seldom passes that we do aot hear of some hospital physi- cian or surgeon having lost his life by an hospital fever,caught from his patients. For this they have themselves alone to blame. Their pa- tients are either in an improper situation, or they are too careless with 'regard to their own conduct. ?6 OF EXERCISE: want, and activity serves them instead of physic. This Is peculiarly the case with those who live by the culture of the ground. The great increase of inhabitants in infant colonies, aud the longevity of such as fol- low agriculture, every where evidently prove it to be the most healthy as well as the most useful employment. The love of activity shews itself very early in man. So strong ia this principle, that a healthy youth cannot be restrained from exercise, even by the fear of punishmeut. Our love of motion is surely a strong proof ot its utility. Nature implants no disposition in vain. It seems tobe a catholic law throughout the whole animal creation, that no crea- ture, without exercise, should enjoy health, or be able to find subsist- ence. Every creature, except man, takes as much of it as is necessa- ry. He alone, and such animals as are under his direction, deviate from this original law, and they suffer accordingly. Inactivity never fails to induce an universal relaxation of the solids, ■which disposes the body to innumerable diseases. When the solids me relaxed, neither the digestion nor any of the secretions can be duly performed. In this case the worst consequences must ensue. How can persons who loll all day in easy chairs, and sleep all night on beds of down, fail tobe relaxed? Nor do such greatly mend the matter, who never stir abroad but in a coach, sedau, or such like. These el- egant pieces of luxury are become so common, that the inhabitants of great towns seem to be in some danger of losing the use of their limbs altogether. It is now below any one to walk, who can afford tu be car* ried How ridiculous would it seem, to a person unacquainted with modern luxury, to behold the young nod healthy swinging along on the shoulders of their fellow creatures! or to Fee a fat carcase, over-run with diseases occasioned by inactivity, dragged through the streets by half a dozen horses.* Glandular obstructors, now ro common, generally proceed from in- activity. These are the most obstinate maladies. So long as the liver, kidnejs, and other glands, duly perform their functions, health is sel- dom impaired; but when they fail, nothing can restore it. Exercise is almost the only cure we know for glandular obstructions; indeed it does not always succeed as a remedy : but there is reason to believe that it would seldom fail to prevent these complaints, were it used in clue time. One thing is certain, that amongst those who take sufficient * It is not necessity, but fashion, which makes the use of carriages fo common. There are many people who have not exercise enough to keep their humours wholesome, who yet dare not venture to make a visit to their next neighbours, but in a coach or sedan, lot they should be looked down upon. Strange, that men should be such fools as (o be laughed out of the use of their limbs, or to throw away their health, in order to gratify a piece of vanity, or to cemply with a ridiculous fash- OF EXERCISE. 77 ♦xercise, glandular diseases are very little known; whereas the indolent and inactive are seldom free from them. Weak nerves are the constant companions of inactivity. Nothing but exercise and open air can brace and strengthen the nerves, or pre- vent the endless train of diseases which proceed from a relaxed slate of these organs. We seldom hear the active or laborious complain of oervoas diseases ; these are reserved for the sons of ease and affluence. Many have been completely cured of these disorders by being redu- ced, from a state of opulence, to labour for their daily bread. This plainly points out the sources from whence nervous diseases flow, and the means by which they may be prevented. It is absolutely impossible to enjoy health, where the perspiration is not duly carried on : but that can never be the case where exercise is neglected. When the matter which ought to be thrown off by perspi- ration is retained in the body, it vitiates the humours, and occasions the gout, fevers, rheumatism, &c Exercise alone would prevent many of those diseases which cannot be cured, and would remove others where medicine proves ineffectual. A late author,* in his excellent treatise on health, says that the weak and valetudinary ought to make exercise a part of their religion. We would recommend this, not only to the weak and valetudinary, but to all whom business does not oblige to take sufficient exercise, as sedenta- ry artificers,! shopkeepers, studious persons, &c. Such ought to use exercise as regularly as they take food. This might generally be done without any interruption to business or real loss of time. jNo piece of indolence hurts the health more than the modern custom of lying a-bed too long in a morning. This is the general practice in great towns. The inhabitants of cities seldom rise before eight or nine o'clock ; but the morning is undoubtedly the best time for exercise, while the stomach is empty, and the body refreshed with sleep. Besides * Cheyne. f Sedentary occupations ought chiefly to be followed by women. They bear confinement much better than men, and are fitter for every kind of business which does not require much strength. It is ridiculous enough to see a lusty fellow making pins, needles, or watch wheels, while many of the laborious parts of husbandry are carried on by the other sex. The fact is, we want men for laborious employments, while one half of the other sex are rendered useless for want of occupations suited to their strength, &c. Were girls bred to mechanical employ- ments, we should not see such numbers of them prostitute themselves fcr bread, nor find such a want of men for the important purposes of navi- gation, agriculture, &c. An eminent silk manufacturer told me, that he found women answer better for that business than men ; and that he had lately taken a great many girls apprentices as bilk weavers. I hope his example will be followed by many others. OF EXERCISE. the morning air braces and strengthens the nerves, and in some measure answers the purpose of a cold bath. Let any one who has been ac- customed to lie a-bed till eight or nine o'clock, rise by six or seven, spend a couple of hours in walking, riding, or any active diversion ■without doors, and he will find his spirits cheerful and serene through the day, his appetite keen, and his body braced and strengthened. Custom soon renders early rising agreeable, and nothing contributes more to the preservation of health. The inactive are continually complaining of pains of the stomach, flatulencies, indigestions, &c. These complaints, which pave the way to many others, are not to be removed by medicines. They can only be cured by a vigorous course of exercise, to which indeed they sel- dom fail to yield. Exercise, if possible, ought always to be taken in the open air. When that cannot be done, various methods may be contrived for exercising the body within doors, as the dumb bell, dancing, fencing, &c. It is jjot necessary to adhere strictly to any particular kind of exercise. The best Avay is to take them by turns, and to use that longest which is most suitable to the strength and the constitution. Those kinds of exercise which gave action to most of the bodily organs, are always to be preferred, as walking, running, riding, digging, rubbing furniture, and such like. It is much to be regretted, that manly and active diversions are now ao little practised. Diversions make people take more exercise than they otherwise would do, and are of the greatest service to such as are not under the necessity of labouring for their bread. As active diver- sions lose ground, those of a sedentary kind seem to prevail. Sedenta- ry diversions are of no other use but to consume time. Instead of re- lieving the mind, they often require more thought than either study or business. Every thiug that induces people to sit still, unless it be some necessary employment, ought to be avoided. The diversions which afford the best exercise are, hunting, shooting, playing at cricket, hand-ball, golff* &c. These exercise the limbs, promote perspiration and the other secretions. They likew ise strength- en the lungs, and give firmness and agility to the whole body. Such os can, ought to spend two or three hours a-day on horse-back; these who cannot ride, should employ the same time in walking. Ex- ercise should never be continued too long. Over- fatigue prevents the benefit of exercise, and instead of strengthening the body tends to weak- en it. GoltV is a diversion very common in North Britain. It is well cal- culated lor exercisiug the body, and may always be taken in such mod- eration, as neither to over-heat nor fatigue. It has greatly the prefe- rence over cricket, tennis, or any of those games which cannot be pl»y- M without violence^ ©F SLEEP AND CLOTHING. 7* Every man should lay himself under some sort of necessity to take pxercise. Indolence, like other vices when indulged, gains ground, «md at length. becomes agreeable. Hence many who were fond of ex- ercise in the early part of life, become quite averse to it afterwards: This is the case of most hypochondriac aud gouty people, which ren- ders their diseases in a great measure incurable. In some countries laws have been made, obliging every man, of what- ever rank, to learn some mechanical employment. Whether such laws were designed for the preservation of health, or the encouragement of manufacture, is a question of no importance. Certain it is, that if gen- tlemen were frequently to amuse and exercise themselves in this way, it might have many good effects. They would at least derive as much honour from a few masterly specimens of their own workmanship, aa from the character of having ruined most of their companions by ga- ming or drinking. Besides men of leisure, by applying themselves to the mechanical arts, might improve them, to the great benefit of society. Indolence not only occasions diseases, and renders men useless to society, but promotes all manner of vice. To say a man is idle, is little better than to call him vicious. The mind, if not engaged in come useful pursuit, is constantly in quest of idle pleasures, or impres- sed with the apprehension of some imaginary evil. From these sources proceed most of the miseries of mankind. Certainly man was never intended to be idle. Inactivity frustrates the very design of his crea- tion ; whereas an active life is the best guardian of virtue, and th§ greatest preservative of health. CHAPTER VI. OF SLEEP AND CLOTHING. (T< LEEP, as well as diet, ought to be duly regulated. Too little sleeg ^ weakens the nerves, exhausts the spirits, and occasions diseases; and too much renders the mind dull, the body gross, aud disposes to apoplexies, lethargies, and other complaints of a similar nature. A medium ought therefore to be observed; but this is not easy to fix. Children require more sleep than grown persons, the laborious than the idle, and such as eat and drink freely, than those who live abstemious- ly. Besides the real quantity of sleep cannot be measured by time; as one person will be more refreshed by five or six hours sleep, thasi ^pother by eight or ten. 80 OF SLEEi* AND CtOTHISG. Children may always be allowed to take as much sleep as they please ; but for adults, six or seven hours is certainly sufficient, and no one ought to exceed eight. Those who lie a-bed more thao eight hours may slumber, but they can hardly be said to sleep ; such geuerally toss and dream away the fore-part ot the night, sink to rest towards morning, and dose till noon. The best' way to make sleep sound and refreshing is to rise betimes. The custom of laying a-bed for nine or ten hours, not only makes the sleep less refreshing, but relaxes the solids, and greatly weakens the constitution. Nature points out night as the proper season for sleep. Nothing more certainly destroys the constitution than night- watching. It is great pity that a practice so destructive to health should be so much in fashion. How quickly the want of rest in due-season will blast the most blooming complexion, or ruin the best constitution, is evident from the ghastly countenances of those who, as the phrase is, turn day int* uiglit, and night into day. To make sleep refreshing, the following things are requisite : First, to take sufficient exercise in the open air ; to avoid strong tea or coffee ; next, to eat a light supper; and lastly, to lie down with a mind as cheerful and serene as possible. It is certain that too much exercise will prevent sleep, as well as to* little. We seldom however hear the active and laborious complain of restless nights. It is the indolent and slothful who generally have these complaints. Is it any wonder that a bed of down should not be re- freshing to a person who sits all day in an easy chair ? A great part of the pleasure of life consists in alternate rest and motion ; but they who neglect the latter can never relish the former. The labourer enjoys more true luxury in plain food and sound sleep, than is to be found ia sumptuous tables and downy pillows, where exercise is wanting. That light suppers cause sound sleep, is true even to a proverb. Many persons, if they exceed the least at that meal, are sure to have uneasy nights ; and, if they fall asleep, the load and oppression oa their stomach and spirits occasion frightful dreams, brokeu and dis- turbed repose, the uight-mare, &c. Were the same persons to go to bed with a light supper, or sit up till that meal was pretty well digested, they would enjoy sound sleep, and rise refreshed and cheerful. There are indeed some people who cannot sleep, unless they have taken some solid food at night, but this does not imply the necessity of a heavy supper ; besides, these are generally persons who have accustomed themselves to this method, and who do not take a sufficient quantity of solid food and exercise. Nothing more certainly disturbs our repose than anxiety. Whea the mind is not at ease, one seldom enjoys sound sleep. This greatest of human blessings flies the wretched, and visits the happy, the cheer- ful and the gay. This is a sufficient reason why every man should endeavour to be as easy in mind as possible when he goes to rest. Ma- OF SLEEP AND CLOTHING. «1 ny, by indulging grief and aaxious thought, have banished sound sleep ,so long, that they could never afterwards enjoy it. Sleep, when taken in the fore-part of the night, is generally reckon- ed most refreshing. Whether this be the effect of habit or not, is hard to say ; but as most people are accustomed to go early to bed when young, it may be presumed that sleep, at this season, will prove most refreshing to them ever after. Whether the fore-part of the night be best for sleep or not, surely the fore-part of the day is (litest, both for business and amusement. I hardly ever knew an early riser, who did not enjoy a good state of health.* Of Clothing. The clothing ought to be suited to the climate. Custom has no doubt, a very great influence in this article ; but no custom can ever change the nature of things so far, as to render the same clothing fit for an in- habitant of Nova Zembla and the Island of Jamaica. It is not indeed necessary to observe an exact proportion between the quantity of clothes we wear, and the degree of latitude which we inhabit ; but, at the same time, proper attention ought to be paid to it, as well as to the openness of the country, the frequency and violence of storms, &c. In youth, while the blood is hot and the perspiration free, it is less necessary to cover the body with a great quantity of clothes; but in the decline of life, when the skin becomes rigid and the humours more cool, the clothing should be increased. Many diseases in the latter pe- riod of life proceed from a defect of perspiration : these may, iu some measure, be prevented by a suitable addition to the clothing, or by wea- ring such as are better calculated for promoting th» discharge from the skin, as clothes made of cotton, flannel, e blood, and tear the tender vessels of the hiBgs to pieces ; yet so great is the consumption of them in this country, that one would almost be induced to think Uiat the in- habitants lived upon them.* * We may form some notion of the immense quantity of ardent spr- vits consumed in Great Britain from this circumstance, that iu the city of Edinburgh aud its environs, besides the great quantity of foreign spi- rits duly cnteied, and the still greater quantity which is supposed to bn s^usgled, it is computed that above tiro thousand private stills tir^ OF INTEMPERANCE. 87 The habit o>f drinking proceeds frequently from misfortunes in life^ The miserable fly to it for relief. It affords them indeed a temporary ease. But, alas ! this solace is short-lived ; and when it is over, the spirits sink as much below their usual tone as they had before beeu raised above it. Hence a repetition of the dose becqmes necessary, and every fresh dose makes way for another, till the unfiappy wretch becomes a slave to the bottle, and at length falls a sacrifice to what at first perhaps was taken only as a medicine. No man is so dejected as the drunkard when his debauch is gone off. IJence it is that those who have the greatest flow of spirits while the glass circulates freely, are of all others the most melancholy when sober^nd often pat an end to their own miserable existence in a fit of spleen or ill humour. Drunkenness not only proves destructive to health, but likewise to the faculties of the mind. It is strange that creatures who value them- selves on account of a superior degree of reason to Uiat of brutes, should take pleasure in sinking so far below them. Were such as voluntarily deprive themselves of the use of reason, to continue ever after in that condition, it would seem but a just punishment. Though this be not the consequence of one act of intoxication, it seldom fails to succeed a course of it. By a habit of drinking, the greatest genius is often re- duced to a mere idiot.f Intoxication is peculiarly hurtful to young persons. It heats their blood, impairs their strength, and obstructs their growth ; besides the frequent use of strong liquors in the early part of life destroys any be- nefit that might arise from them afterwards. Those who make a prac- tice of drinking generous liquors when young, cannot expect to reap any benefit from them as a cordial in the decline of life. constantly employed in preparing a poisonous liquor called Molasses. The common people have got so universally into the habit of drinking this base spirit, that when a porter or labourer is seen reeling along the streets, they say, he has got mqlassed. f It is amazing that our improvements in arts, learning and politeness have not put the barbarous custom of drinking to excess out Of fashiorr. It is indeed less common in South Britain than it was formerly; but it still prevails very much in the North, where this relic of Barbarity fs mistaken for hospitality. There no man is supposed to entertain his guests well, who does not make them drunk. Forcing people to drink is certaiidy the greatest piece of rudeness that any man can be guilty of. Manliness, complaisance; or mere good-nature, may induce amaa to take his glass, if urged to it, at a time when he might as well take poison. The custom of drinking to excess has long been out of fashion in France; and, as it begins to lose ground among the politer part of liie English, we hope k wiil soon be banished from every part of *1% .island. 35 OF CLEANLINESS. Drunkenness is not only iu itself a roost abominable vice, bnt is an inducement to many others. There is hardly aDy crime so horrid that the drunkard will not perpetrate for the love of liquor. We have known mothers sell their children's clothes, the food that they should have eat, and afterwards even the infants themselves, in order tp pur- chase the accursed draught. CHAPTER VIII. OF CLEANLINESS. THE want of cleanliness is a fault which admits of no excttse. Where water can be had for nothing, it is surely in the power of every person to be clean. The continual discharge from our bo- dies by perspiration, renders frequent change of apparel necessary. Changing apparel greatly promotes the secretion from the skin, so ne- cessary for health. When that matter which ought to be carried off by perspiration, is either retained in the body, of reabsorbed from dirty clothes, it must occasion diseases. Diseases of the skin are chiefly owning to want of cleanliness.* They may indeed be caught by infection, or brought on by poor living, un- wholesome food, &c. but they will seldom continue long where cleanli- ness prevails. To the same cause must we impute the various kinds of vermin which infest the human body, houses, &c. These may always be banished by cleanliness alone, and wherever they abound, we have reason to believe it is neglected. One common cause of putrid and malignant fevers is the want of cleanliness. These fevers commonly begin among the inhabitants of close, dirty houses, who breathe unwholesome air, take little exercise, and wear dirty clothes. There the infection is generally hatched, which often spreads far and wide, to the destruction of many. Hence cleanliness may be considered as an object of public attention. It is * Mr. Pot, in his surgical observations, mentions a disease which he ♦ alls the chimney sweeper's cancer, as it is almost peculiar to that un- happy set of people. This he attributes to neglect of cleanliness, and with great justness. I am convinced, that if that part of the body which is the 6eat of this cruel disease was kept clean by frequent washing, it would never happen. The climbing boys as thry are called, are cer- tainly the most miserable wretches on the face of the earth ; yet, for cleaning chimneys, no such persons are necessary. OF CLEANLINESS, 29 Hot sufficient that I be clean myself, while the want of it in my neigh-* bour affects my health as well as his. If dirty people cannot be re- moved as a common nuisance, they ought at least to be avoided as infec- tious. All who regard their health should keep at a distance even from their habitations. In places where great numbers of people are collected, cleanliness becomes of the utmost importance. It is well known that infectious diseases are communicated by tainted air. Every thing therefore which tends to pollute the air, or spread the infection, ought with the utmost care to be guarded against. For this reason, in great tow^s, no filth, of any kind, should be permitted to lie upon the streets. Noihiug is more apt to convey infection than the excrements of the diseased. In many great towns the streets are little* better than dunghills, be- ing frequently covered with ashes, dung, and nastiness of every kind. Eveii slaughter-houses, or killing shambles, are often to be seen in the very centre of great towns. The putrid blood, excrements* &c. with Which these places are generally covered, cannot fail to taint the air, and render it unwholesome. How easily mi^ht tfris be prevented by active magistrates who have it always in their power to make proper laws relative to things of this nature, and to enforce the observance of them. We are sorry to say, that the importance of general cleanliness dees not seem to be sufficiently understood by the magistrates of most grtat towns in Britain; though health, pleasure, and delicacy, all couspire to recommend an attention to it. Nothing can be more agreeable to the Sedses, more to the honour of the inhabitants, or more conducive to their health, than a clean town; nor can any thing impress a stranger with a- inOre disrespectful idea of any people than its opposite. Whatever pretensions people may make to learning, politeness, ot civilization, we will venture to affirm, that while they neglect cleanliness, they are in a state of barbarity.* The peasants in most countries seem to hold cleanliness in a sort of contempt. Were it not for the open situation of their houses, they would often feel the bad effects of this disposition. One seldom sees a farm-house without a dunghiil before the door, and frequently the cat- tle and their masters lodge under the same roof. Peasants are likewise * In ancient Rome the greatest men did not think cleanliness an ol> j«ct unworthy of their attention. Pliny says, the Cloacai, or com- mon sewers for the conveyance of filth and nastiness from the city, ■were the greatest of all the public works ; and bestows higher encomi- ums upon Tarquinius, Agrippa, and others who made and improved them, than on those who achieved the greatest conquests. . How truly great does the emperor Trajan appear, when giving di- rections to Fliny his proconsul, concerning the making of a common aewer for the health and convenience ef a conquered city J 12 ?:xii. V cr. 12, !o. OF CLEANLINESS. -il The eastern custom of washing tlie f«et, though less necessary in this country, is nevertheless a very agreeable piece of cleanliness, and con- tributes greatly to the preservation of health. The sweat and dirt with whieh these parte are frequently covered, cannot fail to obstruct the perspiration. This piece of cleanliness would often prevent colds and fevers. Were people careful to bathe their feet and legs in hike warm water at night, after being exposed to cold or wet through the day, they would seldom experience the ill effects which ofteu proceed from these causes. A proper attention to cleanliness is no where more necessary* than on ship board. If epidemical distempers breakout there, no one can be safe. The best way to prevent them, is to take care that the whole company be cleanly in their clothes, bedding &c. When infectious dis- eases do break out, cleanliness is the most likely means to prevent their spreading : it is likewise necessary to prevent their returning afterwards, or being conveyed toother places. For this purpose the clothes, bed- ding, &c. of the sick ought to be carefully washed, aud fumigated with brimstone. Infection will lodge a long time in dirty, clothes, and after- wards break out in the most terrible manner. In places where great numbers of sick people are collected together, cleanlieess ought to be most religiously observed. The very smell in such places is often sufficient to make one sick. It is easy to imagine what effect that is likely to have upon the diseased. In ao hospital or infirmary, where cleanliness is neglected, a person in perfect health has a greater chance to become sick, than a sick person has to get well. Few things are more unaccountable than that neglect, or rather dread of cleanliness, which appears among those who have the: care ofHbe sick; they think it almost criminal to suffer any thing that is clean to come near a person in a fever; for example they would rather allow him to wallow io all manner of filth, than change the least bit of his linen. If cleanliness be necessary for persons in health, it is certainly more so for the sick. Many diseases may be cured by cleanliness alone; most of them might be mitigated by it; and, where it is neg- lected, the slightest disorders are often changed into the most malignant. The same mistaken care which prompted people to prevent the least admission of fresh air to the sick, seems to have induced them to keep them dirty. Both these destructive prejudices will, we hope be soon eradicated. Cleanliness is certainly agreeable to our nature. We cannot help approving it in others, even though we should not practice it ourselves. It sooner attracts our regard than even finery itself, and often gains esteem where that fails. It is an ornament to the highest as well as to the lowest station, and cannot be dispensed with in either. Few virtue* are of more importance to society than general clanlinees. It oflrght to Q2 OF INFECTION. be carefully cultivated every where; but id populous cities it should be almost revered.* CHAPTER IX, OF INFECTION. MANY diseases are infectious. Every person ought there fore, m far as he can, to avoid all communication with the diseased. The common practice ofvisitiugthe sick, though often well meant; has many ill consequences. Far be it from me to discourage any act of charity or benevolence, especially towards those in distress ; but I cannot help blaming such as endanger their own or their neighbours' lives by a mistaken friendship, or an impertinent curiosity. The houses of the sick, especially in the country, are generally crowded from mornisg till night with idle visitors. It is customary in such places, for servants and young people to wait upon the sick by tur.j? and even to sit up with them all night. It would be a miracle in. it- i should such always escape. Experience teaches us the danger of this conduct. People often catch fevers ju this way, and communi* cate them to others, till at length they become epidemic. It would be thought highly improper for one who had not had the smill-pox, to wait upon a patient in.that disease; yet manj other fevers ore almost as infectious as the small- pox, and not less fatal. Some im- agine that fevers prove more fata! in villages than in great towns for want of proper medical assistance. This may sometimes be the case; but I am inclined to think it oftener proceeds from the cause above mentioned. Were a plan to be laid down for communicating infection, it could not be doue more effectually than by the common method of visiting the * As it is impossible to be thoroughly clean without a sufficient quan- tity of water, we would earnestly recommend it to the magistrates of great towns to be particularly attentive to this article. Most great towns in Britain are so situated as to be easily supplied with water ; and those persons who will not make a proper use of it, after it is brought to their hand, certainly deserve to be severely punished. The streets of great towns, where water can be had, ought to be washed every day. This is the only effectual method for keeping them thoroughly clean; and, upon Uial, we are persuaded it will be found the cheapest. Some of the most dreadful diseases incident to human nature, migh*. (n my opinio-' j be entirely eradicated by cleanliness. OF INFECTION. 6? i^ck. Such visitors not only endanger themselves and their connections, but likewise hurt the sick. By crowding the house they render the air ■unwholesome, and by their private^ whispers and dismal countenances disturb the imagination of the patient, and depress his spirits. Per- sons who are ill, especially in fevers, ought to be kept as quiet as possi- ble. The sight of strauge faces, and every thing that disturbs the mind hurts them. The common practice in country places of inviting great numbers of people to funerals, and crowding them into the same apartment where the corpse lies, is another way of spreading infection. The infection does not always die with the patient. Every thing that comes into contact witk his body while alive, receives the contagion, and some of them, as clothes, blankets, &c. will retain it for a long time. Persons who die of infectious disorders ought not to lie long unburied; and peo- ple should keep as much as possible at a distance from them. It would tend greatly to prevent the spreading of infectious diseases, if tnose in health were kept at a proper distance from the sick. The Jewish Legislator, among many other wise institutions for preserving health, has been peculiarly attentive to the means of preventing infec- tion, or defilement as it is called, either from a diseased person or a dead body. In many cases the diseased were to be separated from those in health ; aid it was deemed a crime even to approach their habitations. If a person only touched a diseased or dead body, he was appointed to wash himself in water, and to keep for some time at a distance from society. Infectious diseases are often communicated by clothes. It is ex- tremely dangerous to wear apparel which has been worn by the disea- sed, unless it has been well washed and fumigated, as infection may lodge a long time in it, and afterwards produce very tragical effects. This shews the danger of buying at random the clothes which have been worn by other people. Infectious disorders are frequently imported. Commerce, together with the riches of foreign climes, bring us also their diseases. These do often more than counterbalance all the advantages of that trade by means of which they are introduced. It is to be regretted, that so lit- tle care is commonly bestowed, either to prevent the introduction or spreading of infectious maladies. Some attention indeed is generally paid to the plague ; but other diseases pass unregarded.* * Were the tenth part of the care taken to prevent the importation ©f diseases, that there is to prevent smuggling, it would be attended with many happy consequences. This might easily be done by appoint- ing a physician at every considerable sea-port, to inspect the ship's company, passengers, &c. before they came ashore, and, if any fe- ver or other infectious disorders prevailed, to order the ship to per- form a shoj-t quarantine, and to send the sick to some hospital or prop- 54 OF INFECTION. Infection is off en spread through cities, by jails, hospitals, &C These arc frequently situated iu the very middle of populous towns ; ■and when infectious diseases break out in them, it is impossible for the inhabitants to escape. Did magistrates pay any regard to the health of the people, this evil misfit be easily remedied. Many are the causes which tend to diffuse infection, through popu- lar cities. The whole atmosphere of a large town is one contaminated piass, abounding with various kinds of infection, and must be pernicious ?o health. The best adv ice that we can ^ive to such as are obliged t© live iu large cities, is to chuae an open situation; to avoid narrow, dir- ty, ?;rects ; to keep their cwn houses and offices cleaa ; and to be as ?nuch abroad in the open air as their time will permit. It would tend greatly to prevent the spreading of infectious diseases, were proper nurses every where employed to take care of the sick. This might often save a family, or even a whole town, from being i«- fected by one person. We do not mean that people should abandon their friends or relations in distress, but only to put them on their guard against being too much in company with "those who are afflicted with diseases of an infectious nature. Such as wait upon the sick in infectious diseases run very great ha- zard. They should stuff their noses with tobacco, or some other strong smelling herb, as rue, tansy, or the like. They ought likewise to keep the patient very clean, to sprinkle the room where he lies with vinegar, or other strong acids, frequently to admit a stream of fresh air into it, and to avoid the smell of his breath as much as they can. They ought never to' go into compauy without having changed their clothes and washed their hands ; otherwise, if the disease be infectious, they will in all probability carry the contagion along with them.* er place to be cured. He might likewise order all the clothes, bedding, oner expel grief than the most sprightly amusements. 1*50 OF THE PASSIONS. It has already been observed, that the body cannot be healthy unless St be exercised ; neither can the mind Indolence nourishes grief. When the mind has noihing else to think of but calamities, no wonder that it dwells there. Few people who pursue business with attention, are hurt by grief. Instead therefore of abstracting ourselves from the world or business when misfortunes happen, wo ought to engage in it with more than usual attention, to discharge with double diligence the functions of our station, and to mix with friends of a cheerful and social temper Innocent amusements are by no means to be neglected. These, by leading the miud insensibly to the contemplation of agreeable objects, help to dispel the gloom which misfortunes cast over it. They make time seem less tedious, and have many other happy effects. Some persons, when overwhelmed with grief, betake themselves to drinking. This is making the care woise than the disease. It seldom fails to end in the ruin of fortune, character, and constitution. Of Love. Love is perhaps the strongest of all the passions ; at least, when it becomes violent, it is lets subject to the controul either of the under- standing or will, than any of the rest. Fear, anger, and several other passions, are necessary for the preservation of the individual, but love is necessary for the continuation of the species itself: it was therefore proper that this passion should be deeply rooted in the human breast. Though love be a strong passion, it is seldom so rapid in its pro-" gTess as several of the others. Few persons fail desperately in love all at once. We would therefore advise every one, before he tampers with this passion, to consider well the probability of his being able to obrain the object of his wishes. Wheu that is not likely, he should avoid every occasion of increasing it. He ought immediately to flee the company of the beloved object; to apply his mind attentively to business or study ; to take every kind of amusement ; and above all, to endeavour, if possible, to find another object which may engage his af- fections, and which it may be in his power to obtain. There is no passion with which people are 60 ready to tamper as love, although none is more dangerous. Some men make love for amusement, others from mere vanity, or on purpose to show their conse- quence with the fair. This is perhaps the greatest piece of cruelty which any one can be guilty of. What we eagerly wish for we easily credit. Hence the too credulous fair are often betrayed into a situa- tion which is truly deplorable, before they are able to discover that the pretended lover was only in jest. But there is no jesting with this passion, Whea love has got to a certain height, it admits of no other OF THE PASSIONS. 101 cure but the possession of its object, which in this case ought always, if possible, to be, obtained.* Of Religious Melancholy. Many persons of a religious turn of mind behave as if they thought it a crime to be cheerful. They imagine the whole of religion consists in certain mortifications, or denying themselves the smallest indulgence, even of the most innocent amusements. A perpetual gloom hangs over their countenances, while the deepest melancholy preys upon their minds. At length the fairest prospects vanish, every thing puts on a dismal appearance, and those very objects which ought to give delight, afford nothing but disgust. — Life itself beconus a burthen, and the un- happy wretch, persuaded that no evil can equal what he feels, often puts an end to his miserable existence. It is great pity that ever religion should be so far perverted, as to become the cause of those very evils which it was designed to cure. Nothing can be better calculated than True Religion, to raise and sup- port the mind of its votaries under every affliction that can befall them. It teaches men that even the sufferings of this life are preparatory to the happiness of the next; and that all who persist in a course of vir- tue shall at length arrive at complete felicity. Persons whose business it is to recommend religion to others, shonld beware of dwelling too much on gloomy subjects. That peace and tranquillity of mind, which true religion is calculated to inspire, is a more powerful argument in its favour than all the terrors that can be uttered. Terror may indeed deter men from outward acts of wicked- ness, but can never inspire them with that love of God, and real good- ness of heart, in which alone true religion consists. To conclude; the best way to counteract the violence of any passion., is to keep the mind closely engaged in some useful pursuit. * The conduct ef parents with regard to the disposal of their children in marriage is often very blameable. An advantageous match is the constant aim of parents ; while their children often suffer a real mar- tyrdom betwixt their inclinations and duty. The first thing which pa- rents ought to consult in disposing of their children in marriage, is cer- tainly their inclinations. Were due regard always paid to these, there would be fewer unhappy couples, and parents would not have so oft- en cause to repent the severity of their conduct, after a ruined consti- tution, a lost character, or a distracted mind, has shown them their mistake. &2 OF THB COMMON EFACVATIONS, CHAPTER XI. OF THE COMMON EVACUATIONS. THE principal evacuations from the human body are those by stool, urine, and insensible perspiration. None of these can be long ob- structed without impairing the health. When that which ought to be thrown off the body is long retained, it not only occasions a plethora, ©r too great fullness of the vessels, but acquires qualities whici) are hurtful to the health, as acrimony, putrescence, &c. Of the Evacuation by Stool. Few things conduce more to health than keeping the body regular. When the faeces lie too long in the bowels, they vitiate the humours; and when they are too soon discharged, the body is not sufficiently nour- ished. A medium is therefore to be desired, which can only be obtained by regularity in diet, sleep, and exercise.— Whenever the body is not regular, there is reason to suspect a fault in one or other of these. Persons who eat and drink at irregular hours, and who eat various kinds of food, and drink of several different liquors at every meal, have no reason to expect either that their digestion will be good, or their discharges regular. Irregularity in eating and drinking disturbs eve- ry part of the animal economy, and never fails to occasion diseases. Either too much or too little food will have this effect. The former indeed generally occasions looseness, and the latter costiveuess; but both have a tendency to hurt the health. It would be difficult to ascertain the exact number of stools which may be consistent with health, as these differ in the different periods of life, in different constitutions, and even in the same constitution under a different regimen of diet, exercise, &c. It is howtver generally al- lowed, that one stool a day is sufficient for an adult, and that less is hurtful. But this, like most general rules, admits of many exceptions. I have known persons in perfect health who did not go to stool above once a- week. 4 * Such a degree of costiveoes* however is not safe ; chough the person who labours under it may for some time enjoy tole- rable health, yet at length it may occasion diseases. * Some persons have told me that they did not go t« stool above OF THE COMMON BrjOUjiTIONS. 109 One Biethed of procuring a stool every day is to rise betimes, and go abroad io the oped air. Not only the posture io bed is unfavoura- ble to regular stools, but also the warmth. This, by promoting tlie perspiration, lessens all the other discharges. The method recommended for this purpose by Mr. Locke is like- wise very proper, vis. to solicit nature, by going regularly to stool every morning whether one has a call or noL Habits of this kind may be acquired, which will in time become natural. Persons who have a frequent recourse to medicines for preventing costiveness, seldom foil to ruin their constitution. Purging medicines frequently repeated, weaken the bowels, hurt the digestion, and every dose makes way for another, till at length they become as necessary as daily bread. Those who are troubled with costiveness ought rather, if possible, to remove it by diet than drugs. They should likewise g6 thinly cloathed, and avoid every thing of an astringent or of an heat- ing nature. The diet and other regimen necessary in this case wil! be found under the article Costiveness, where this state of the bowels is treated as a disease. Such persons as are troubled with an habitual looseness ought like- wise to suit their diet to the nature of their complaint. They should use food which braces and strengthens the bowels, and which is rather of an astringent quality, as wheat-bread made of the finest flour* cheese, eggs, rice boiled in milk, &c. Their drink should be red port, claret, brandy and water, in which toasted bread has been boiled, and such like. As an habitual looseness is often owing to an obstructed perspiration, persons affected with it ought to keep their feet warm, to Wear flannel next their skin, and take every other method to promote the perspira- tion. Further directions with regard to the treatment of this complainfe will be found under the article Looseness. Of Urine. So many things tend to change both the quantity and appearances ef the urine, that it is very difficult to lay down any determined rules forjudging of either.* Dr. Cheyne says, the urine ought to be equal * It has long been an observation among physicians, that the appear- ances, of the urine, are Very uncertain, and very little to be depended on. No one will be surprised at this wb» considers how many ways it smay be affected, and consequently have its appearance altered.— The passions, the state of the atmosphere, the quantity and quality of the food, the exercise, the clothing, the state of the other evacuations, and numberless other causes, are sufficient to induce a change either in the quantity or the appearance of the urine. Any one who attends to this ■will be astonished at the impudence of those dariDg quacks, who pre- 104 OF THE COMMON EVACUATIONS. to three-fourths of the liquid part of our aliment. But suppose any one were to take the trouble of measuring both, he would find that ev- ry thing which altered the degree of perspiration, would alter this proportion, and likewise that different kinds of aliment would afford very different quantities of urine. Though for these, and other reasons, do rule can be given for judging of the precise quantity of urine which ought lo be discharged, yet a person of common sense will seldom be at a loss to know when it is in either extreme. As a free discharge of uriae not only prevents but actually cures many diseases, it ought by all means to be promoted; and every thing that may obstruct it should be carefully avoided. Both the secretion and discharge of urine are lessened by a sedentary life, sleeping on beds that are too soft and warm, food of a dry and heating quality, li- quors which are astringent and heating, as red port, claret, and such like. Those who have reason to suspect that their urine is in too small quantity, or who have any symptoms of the gravel, ought not only to avoid these tilings, but whatever else they find has a tendency to lessen the quantity of their urine. V\ hen the urine is too long retained, is is not only reabsorbed, or taken up agaiu into the mass of fluids, but by stagnating in the bladder it becomes thicker, the more watery parts flying off first, and the more gross and earthly remaining behind By the constant tendency which these have to concrete, the formation of stones and gravel in the blad- der is promoted. Hence it comes to pass that indolent and sedentary* people are much more liable to these diseases, than persons of a more active life. Many persons have lost their lives, and others have brought on very tedious, and even incurable disorders by retaining their urine too long, from a fal.-e delicacy. When the bladder has been over distended, it often loses its power of actiou altogether, or becomes paralytic, by which means it is rendered unable either to retain the urine, or expel it pro- perly. The calls of nature ought never to be postponed. Delicacy is doubtless a virtue, but that can never be reckoned true delicacy, which induces any one to risk his health or hazard his life. But the urine may be in too great rs well as too small a quantity. This may be occasioned by drinking large quantities of weak and wa- tend to find out diseases, and prescribe to patients, from the bare in- spection of their urine. These impostors, however, are very common all over Britain, and, by the amazing credulity of the populace, many of them amass considerable fortunes. Of all the medical prejudices which prevail in this country, that in favour of crine doctors is the strongest. The common people have still an unlimited faith in their skill, although it has been demonstrated that no one of them is able to distinguish the mine of a horse or any other animal, from that of a man. OF THE COMMON EVACUATIONS. loi tevy liquors, by the excessive use of alkaline salts, or any thing that stimulates the kidneys, dilutes the blood, &c. This disorder very sooa weakens the body, and induces a consumption. It is difficult to cure, but may be mitigated by strengthening diet and astringent medicines, such as are recommended under the article Diabetes, or excessive dis-, charge of uriue. Of the Perspiration. Tnseusible perspiration is generally reckoned the greatest of all the discharges from the human body. It is of so great importance to health, tViat few diseases attack us while it goes properly on; but when it is obstructed, the whole frame is soon disordered. This discharge how- ever, being less perceptible than any of the rest, is consequently less at- tended to. Hence it is, that acute fevers, rheumatisms, agues, &c. oft- en proceed from obstructed perspiration, before we are aware of its having taken place. On examining patients, we find most of them impute their diseases either to violent colds which they had caught, or to slight ones which had been neglected. • For this reason, instead of a critical inquiry into the nature of the perspiration, its difference in different seasons, cli- mates, constitutions, &c. we shall endeavour to point out the causes which most commonly obstruct it, and to show how far they may either be avoided, or have their influence counteracted by timely care. The want of a due attention to these, costs Britain annually some thousands of useiul lives. Changes in the Atmosphere. One of the most common causes of obstructed perspiration, or catch- ing cold, in this country, is the changeableness of the weather, or state of the atmosphere. There is no place where such changes happen more frequently than in Great- Britain : With us the degrees of heat and cold are not only very different in the different seasons of the year, but often change almost from one extreme to another in a few days, and sometimes even in the course of one day. That such changes must affect the state of the perspiration is obvious to every one.* • # I never kuew a more remarkable instance of the uncertainty of the weather in this country, than happened when I was writing these notes. This morning, August 14, I 783, the thermometer in the shade was down at fifty-three degrees, and a very few minutes ago it stood above eighty. No one who reflects on such great and sudden changes in the atmosphere, will be surprised to find colds, coughs, rheums, with other affections of the breast and bowels, so common in this country,, 14 Tffl 0F THE COMMON EVACUATIONS. The best method of fortifying the body against the changes o weather, is to be abroad every day. Those who keep must w doors are most liable to catch colds. Such persons general!) render themselves so delicate as to feci even the slightest changes mi the at- Bfiosphere, and by their pah s, coughs, and oppressions of the bi &c. they become "a kind of living barometers. Wei Clothes. Wet clothes not only by their coldness obstruct the perspiration, but their moisture by being absorbed, or taken up intu the b< greatly increases the danger. The most robutt constitution is not proof against the danger arising from yet clothes; they da ly occasion fevers, rheumatisms, and other fatal disorders, eveu iu the young and healthy. it is impossible for people who frequently go abroad to avoid some- times being wet. But the danger might generallj be lessened, if not wholly prevented, by changing their clothes soon ; when 1 1 1 is* cawjot be done, they should keep in motion till they dry. So far are man} frorb taking this precaution, that the} often sit or lie d/.un in the fields with their clothes wet, and frequently sleep even whole nights in this condi- tion. The frequent instances which we have oi~ the fatal effects of this conduct, ought certainly to deter all from being guilty of it. Wd Fed. Even wet feet often occasion fatal diseases. The cholic, inflamwa- "ions of the.ineast and of the bowels, the iliac passion, cholera morbus^ A'c. are often occasioned by wet feet. Habit will, no doubt render ibis less dangerous ; but it ought, as far as possible, to be avoided. The •lelicate, and those who are not accustomed to have their clothes or feel wet, shot! Id be peculiarly careful in this respect. Night, Air. The. perspiration is often obstructed by yight air ; even in summer, this ought to be avoided. The dews which fall plentifully after the hottest day, make the night more dangerous, than when the weather b cool. Hence, in warm countries, the evening dews are more hurtful than where the climate is more temperate. It is very agreeable after a warm day to be abroad in a cool cve- UiDg ; but this is a pleasure to be avoided by all who value their health. The effects ef evening dews are gradual indeed, and almost imper- ceptible; but they are not the less to be dreaded : we would therefore advise travellers-, labourers, and all who are much heated by day, care- fully to avoid them. When the perspiration has been great, these, be- OF THE COMMON EVACUATIONS. 107 ferine dangerous in proportion. By not attending to this, in flat marshy con itiies, where Use exhalations and dews are copious, labourers are '■often seized with intermitting fevers, quinseys, and other dangerous diseases. Damp Beds. Beds become damp, either from their not being used, standing iu clamp houses, or in rooms without fire, or from the linen not being dry when laid on the bed. Toothing is more to be dreaded by travellers tlini) damp beds, which are very common in ail places where fuel is scarce. When a traveller, cold and wet, arrives at an inn, he may by means of a good fire, warm diluting liquor, and a dry bed, have the perspiration restored; but if he be put into a cold room, and laid in a damp bed, it will be more obstructed, and the worst consequences will ensue. Tiavellers should avoid inns which are noted for damp beeit. OF INTERMITTING FEVERS, OR AGUES. 123 fever often approaches towards an inflammatory nature, it will be safer to keep out the aromatics, and to add salt of tartar in their stead. But in an obstinate tertian or quartan, in the end of autumn or beginning o f winter, warm and cordial medicines are absolutely necessary.* As autumnal and winter agues generally prove much more obstinate than those which attack the patient in spring or summer, it will be ne- cessary to continue the use of medicines longer in the former than in the latter. A person who is seized with an intermitting lever in the beginning of winter, ought frequently, if the season proves rainy, to take a little medicine, although the disease may seem to be cured, to prevent a relapse, till the return of the warm season. He ought like- wise to take care not to be much abroad in wet weather, especially in cold easterly winds. When agues are not properly cured, they often degenerate into ob- stinate chronical diseases, as the dropsy, jaundice, &e. For this rea- son all possible care should be taken to have them radically cured, be- fore the constitution has been too much weakened. Though nothing is more rational than the method of treating inter- mitting fevers, yet by some strange infatuation, more charms and whim- sical remedies are daily used for removing this than any other disease. There is hardly an old woman who is not in possession of a nostrum for stopping an ague^ and it is amazing with what readiness their preten- sions are believed. Those in distress eagerly grasp at any thing that promises sudden relief; but the shortest way is not always the best in the treatment of diseases. The only method to obtain a safe and last- ing cure, is gradually to assist Nature in removing the cause of the dis- order. Some indeed try bold, or rather fool-hardy experiments to cure agues, as drinking great quantities of strong liquors, jumping into a river, taking arsenic, &c These may sometimes have the desired eflect, but must always be attended with danger.f When there is any degree of inflammation, or the least tendency to it, such experiments may prove fatal. The only patient whom I remember to have lost in an intermit- ting fever, evidently killed himself by drinking strong liquor, which some person had persuaded him would prove an infallible remedy. * In obstinate agues, when the patient is old, the habit phlegmatic, the season rainy, the situation damp, or the like, it will be necessary to mix with two ounces of the bark, half an ounce of Virginian snake- root, and a quarter of an ounce of ginger, or seme other warm aromat- ic ; but when the symptoms are of an inflammatory nature, half an ounce of salt of wormwood or salt of tartar may be added to the above quantity of bark. t Arsenic has of late been recommended as an infallible remedy in the ague ; but I would advise that it should be used only under the eye <*f a physician. 124 OF INTER1IITTIXG FEVER'S, OR AGUES. Many dirty things are extolled for the cure of intermitting fevers, as spiders, cobwebs, snuffings of candles, -water, or allowing it to stand for some hours, and afterwards taking off the cream. If it should notwith- standing prove heavy on the stomach, a small quantity of brandy or rum. with a little of sugar, may be added, which will render it both mort light and nourishing. It is not to be wondered, that milk should for some time disagree with a stomach that has not been accustomed to digest aoy thing but flesh and strong liquors, which i« the case with many of those who fall into '.on-umptions. We do not however advise those who have been accustomed to animal food and strong liquors, to leave them off all at ouc This might be dangerous. It will be necessary for such to eat a little once a-day of the tlesn of some young animal, or rather to use the broth made of chickens, veal, lamb, or such like. They ought likewise to drink a little wine, made into negus, or diluted with twice or thrice its quantity of water, and to make it gradually weaker till they can leave it off* altogether. . These must be used only as preparatives to a diet consisting chiefly of milk and vegetables, which the sooner the patient can be brought to bear, the better. Rice and milk, or barley and milk, boiled with a little sugar, is very proper food. Ripe fruits roasted, baked or boil- ed, are likewise proper, as gooseberry or currant tarts, apples roasted, or boiled in milk, &c. The juices, conserves, and preserves, &c. of ripe subacid fruits, ought to be eaten plentifully, as the jelly of currants, conserves of roses, preserved plumbs, cherries, &c. Wholesome air, proper exercise, and a diet consisting chiefly of these and other vegetables, with milk, is the only course that can be de- pended on in a beginning consumption. If the patient has strength and sufficient resolution to persist in this course, he will seldom be disap- pointed of a cure. In a populous town iu England,* where consumptions are very com- mon, I have frequently seen consumptive patients, who had been sent to the country with orders to ride, and live upon milk and vegetables, return in a few months quite plump, and free from any complaint. Tbis indeed was not always the case, especially when the disease was he- reditary, or far advanced; but it was the only method in which suc- cess was to be expected : where it failed, I never knew medicine suc- ceed. If the patient's strength and spirits flag, he must be supported by strong broths, jellies, and such like. Some recommend shell fish in tbis disorder, and with some reason, as tbey are nourishing and resto- Sheffield. OF CONSUMPTIONS. Hi rative.* All the food and drink ought however to be taken in small quantities, lest an overcharge of fresh chyle should oppress the lungs, and too much accelerate the circulation of the blood. The patieut's mind ought to be kept as easy and cheerful as possi- ble. Consumptions are often occasioned, and always aggravated, by a melancholy cast of mind ; for which reason music, cheerful company, and every thing that inspires mirth, are highly beneficial. The patient ought seldom to be left alone, as brooding over his calamities is sure to render him worse. MEDICINE. — Though the cure of this disease depends chiefly upon regimen and the patient's own endeavours, yet we shall mention a few things which may be of service in relieving some of the more vio- lent symptoms. In the first stage of a consumption, the cough may sometimes be ap- peased by bleeding ; and the expectoration may be promoted by the following medicines. Take fresh squills, gum-ammoniac, and powdered cardamum seeds, of each a quarter of an ounce; beat them together in a mortar, and if the mass proves too hard for pills, a little of any kind of syrup may be added to it. This may be formed into pills of a mod- erate size, and four or five of them taken twice or thrice a-day, ac- cording as the patient's stomach will bear them. The lac ammoniacum, or milk of gum-ammoniac, as it is called, is likewise a proper medicine in this stage of the disease. It may be used as directed in the pleurisy. A mixture made of equal parts of lemon juice, fine honey, and syr- up of poppies, may likewise be used. Four ounces of each of these may be simmered together in a sauce-pan, over a gentle fire, and a ta- ble-spoonful of it taken at any time when the cough is tronblesome. It is common in this stage of the disease to load the patient's stomach with oily and balsamic medicines. These, instead of removing the cause of the disease, tend rather to increase it by heating the blood, while they pall the appetite, relax the solids, and prove every way hurtful to the patient. Whatever is used for removing the cough, be- sides riding and other proper regimen, ought to be medicines of a sharp and cleansing nature; as oxymel, syrup of lemon, &c. Acids seem to have peculiarly good effects in this disease; they both tend to quench the patient's thirst and to cool the blood. The vegeta- ble acids, as apples, oranges, lemons, &c. appear to be the most prop- er. I have known patients suck the juice of several lemons every day with manifest advantage, and would for this reason Tecommend acid vegetables to be taken in as great quantity as the stomach will bear. * I have often known persons of a consumptive habit, where the symp- toms were not violent, reap great benefit from the use of oysters. They generally eat them raw, and drink the juice along with them. 142 OF CONSUMPTIONS. For the patient's drink, we would recommend infusions of the bilte? plants, as ground-ivy, the lesser centaury, camomile- flowers, or water- tresoil. These infusioos may be drank at pleasure. They strengthen the stomach, promote digestion, and at the same time answer all the purposes of dilution, and quench thirst much belter than things that are luscious or sweet. But if the patient spits blood, he ought to use, for his ordinary driuk, infusions or decoctions of the vulnerary roots, plants, &c. There are many other mucilaginous • plants and seeds, of a healing and agglutiuatiug nature, from which decoctions or infusions may be prepared with the same intention; as the others, the quince-seed, col's- foot linseed, sarsaparilla, &c. It is not necessary to mention the dif- ferent ways in which these may be prepared. Simple infusion or boil- ing is all that is necessary, and the dose may be at discretion. The conserve of roses is here peculiarly proper. It may either b« put iuto the decoction above prescribed, or eaten by itself. Wo bene- fit is to be expected from trifling doses of this medicine. I never knew it of any service, unles.i where three or four ounces at least were used daily for a considerable time. In this way I have seen it produce very happy effects, and would recommend it wherever there is a discharge of blood from the lungs. When the spitting up of gross matter, oppression of the breast, and the hectic symptoms, shew that an imposthume is formed in the lungs, we would i ecommt ud the Peruviau bark, that being the only drug which lias any chance to counteract the general tendency which the humours then iiave to putrefaction. An ounce of the bark in powder may be divided iuto eighteen or twenty doses, of which one may be taken every three hours through the day, in a little syrup, or a cup of horehound tea. If the bark should happen to purge, it may be made into an electua- ry, with the conserve of roses, thus : Take old conserve of roses a quar- ter of a pound, Peruvian bark a quarter of an ounce, syrup of orange or lemon, as much as will make it of the consistence of honey. This quantity will serve the patient four or five days, and may be repeated as there is occasion. Such as cannot take the bark in substance, may infuse it in cold wa- ter. This seems to be the best menstrum for extracting the virtues of that drug. Half an ounce of bark in powder may be iofused for twenty- feux hours in half an English pint of water. Afterwards let it be pass- ed through a fine strainer, and an ordinary tea-cupful of it taken three or four times a- day. We would not recommend the bark while there are any symptoms of an inflammation of the breast ; but when it is certainly known that matter is collected there, it is one of the best medicines which can be used. Few patients indeed have resolution enough to give the bark a OF CONSUMPTIONS. H3 fair trial at this period of the disease, otherwise we have reason to be- lieve that some benefit might be reaped from it. When it is evident that there is an iaiposthume in the breast, and the matter can neither be spit up nor carried off by absorption, the patient Mtust eudeavour to make it break inwardly, by drawing in the steams of warm water, or vinegar, with his breath, coughing, laughing, or bawl- ing aloud, &c. When it happens to burst within the lungs, the matter may be discharged by the mouth. Sometimes indeed the bursting of the vomica occasions immediate death by suffocating the patient. When the quantity of matter is great, and the patient's strength exhausted, this is commonly the case. At any rate the patient is ready to fall into a swoon, and should have volatile salts or spirits held to his nose. If the matter discharged be thick, and the cough and breathing be« come easier, there may be some hopes oi a cure. The diet at this time ought to be light, but restorative, as chicken-broths, sago-gruel, rice-milk, &c. the drink, butter-milk or whey, sweetened with honey. This is likewise a proper time for using the Peruvian bark, which may be taken as directed above. If the vomica or imposthume should discharge itself into the cavity of the breast, between the pleura and the lungs, there is no way of getting the matter out but by an incision, as has already been observed. As this operation must always be performed by a surgeon, it is not ne- cessary here to describe it. We shall only add, that it is not so dread- ful as people are apt to imagine, and that it is the orJy chance the pa- tient in this case has for his life. A NERVOUS CONSUMPTION is a wasting or decay of the whole body, without any considerable degree of fever, cough, or diffi- culty of breathing. It is attended with indigestion, weakness, and want, of appetite, &c. Those who are of a fretful temper, who indulge in spirituous liquors, er who breathe an unwholesome air, are most liable to this disease. We would chiefly recommend, for the cure of a nervous consump- tion, a light and nourishing diet, plenty of exercise in free open air, and the use of such bitters as brace and strengthen the stomach ; as the Peruvian bark, gentian root, camomile, horehound, &c. These may be infused in water or wine, and a glass of it drank frequently. It will greatly assist the digestion, and promote the cure of this dis- ease, to take twice a-day twenty or thirty drops of the elixir of vitriol in a glass of wine or water. The chalybeate wine is likewise an ex- cellent medicine in this case. It strengthens the solids, and powerfully assists Nature in the preparation of good blood. Agreeable amusements, cheerful company, and riding about, are how- ever preferable to all medicines in this disease. For which reason, whea the patient can afford it, we would recommend a long journey of pleas- ure, as the most likely means to restore his health. 144 OF THE NERVOUS FEVER. What is called a symptomatic consumption, cannot be cured without first removing the disease by which it is occasioned. Thus, when a consumption proceeds from the scrophula, or king's evil, from the scur- vy, the asthma, the venereal disease, &c a due attention must be paid to the malady from wheuce it arises, and the regimen and medicine di- rected accordingly. When excessive evacuations of any kind occasion a consumption, they must not only be restrained, but the patient's strength must be restored by gentle exercise, nourishing diet, and generous cordials. Young and delicate mothers often fall into consumptions, by giving suck too long. As soon as they perceive their strength and appetite begin to fail, they ought immediately to wean the child, or provide another nurse, oth- erwise they cannot expect a cure. Before we quit this subject, we would earnestly recommend it to all, as they wisli to avoid consumptions, to take as much exercise, without doors, as they can, to avoid unwholesome air, and to study sobriety. Consumptions owe their present increase not a little to the fashion of sit- ting up late, eating hot suppers, and spending every evening over a bowl of hot punch or other strong liquors. — These liquors, when too freely used, not only hurt the digestion, and spoil the appetite, but heat and inflame the blood, and set the whole constitution on fire. CHAPTER XIX. OF THE SLOW OR NERVOUS FEVER. NERVOUS fevers have increased greatly of late years in this isl- and, owing doubtless to our different manner of living, and the in- crease of sedentary employments; as they commonly attack persons of a weak relaxed habit, who neglect exercise, eat little solid food, study hard, or indulge in spirituous liquors. CAUSES. — Nervous fevers may be occasioned by whatever de- presses the spirits, or impoverishes the blood ; as grief, fear, anxiety, want of sleep, intense thought, living on poor watery diet, unripe fruits, cucumbers, melons, mushrooms, &c. They may likewise be occasion- ed by damp confined, or unwholesome air. Hence they are very com- mon in rainy seasons, and prove most fatal to those who live in dirty low houses, crowded streets, hospitals, jails, or such like places. OF THE NERVOUS FEVER. T415 Persons whose constitutions have been broken by excessive venery, frequent salivations, too free an use of purgative medicines, or any oth- er excessive evacuations, are most liable to this disease. Kee»j-)g ; on wet clojhes, lying on the damp ground, excessive fatigue, and whatever obstruqjs the perspiration, or causes a spasmodic strict- ure of the salids, may likewise occasion nervous fevers. We shall on- ly add, frequent and great irregularities in diet. Too great abstinence as well as excess, is hurtful. Nothing tends so much to preserve the body in a sound state as a regular diet ; nor can any thing contribute more to occasion fevers of the worst kind than its opposite. SYMPTOMS. — Low spirits, want of appetite, weakness, weariness after motion, watchfulness, deep sighing, and dejection of mind, are generally the forerunners of this disease. These are succeeded by a quick low pulse, a dry tongue without any considerable thirst, chilli- ness and flushing in turns, &c. After some time the patient complains of a giddiness and pain of the head, has a nausea, with retchings and vomiting ; the pulse is quick, and sometimes intermitting; the urine pale, resembling dead small beer, and the breathing is difficult, with oppressions of the breast, and slight alienations of the mind. If towards the ninth, tenth, or twelfth day, the tongue becomes more moist, with a plentiful spitting, a gentle purging, or a moisture upon the skin; or if a suppuration happens in one or both ears, or large pus- tules break out about the lips and nose, there is reason to hope for a favourable crisis. But if there is an excessive looseness or wasting sweats, with fre- quent fainting fits ; if the tongue, when put out, trembles excessively, and the extremities feel cold, with a fluttering or slow creeping pulse j if there is a starting of the tendons, an almost total loss of sight and hearing, and an involuntary discharge by stool and urine, there is great reason to fear that death is approaching. REGIMEN.— It is very necessary in this disease to keep the pa- tient cool and quiet. The least motion would fatigue him, and will be apt to occasion weariness, and even faintings. His mind ought not on- ly to be kept easy, but soothed and comforted with the hopes of a spee- dy recovery. Nothing is more hurtful in low fevers of this kind than presenting to the patient's imagination gloomy or frightful ideas. These of themselves often occasion nervous fevers, and it is not to be doubted but they will likewise aggravate them. The patient must not be kept too low. His strength and spirits ought to be supported by nourishing diet and generous cordials. For this purpose his gruel, panado, or whatever food he takes, must be- mixed with wine according as the symptoms may require. Pretty strong wine- whey, or small negus sharpened with the juice of orange or lemon, will be proper for his ordinary drink. Mustard- whev is likewise a very 19 146 OF THE NERVOUS FEVER. proper drink id tliis fever, and may be rendered an excellent cordial medicine by the addition of a proper quantity of white wine. Wine in this disease, if it could be obtained genuine, is almost the only mediciye that would be necessary. GootKwine posses*** all the virtues of the cordial medicines, while it is free SVom many oMheir bad qualities. I say good wine; for however common this article of luxu- ry is now become, it is rarely to be obtained geuuiue, especially by the poor, who are obliged to purchase it in small quantities. I have often seen patients in low nervous fevers where the pulse could hardly be felt, with a constant delirium, coldness of the extremities, and almost every other mortal symptom, recover by ushag in whey, gruel, and negus, a bottle or two of strong wine every day. Good old sound claret is the best, and may be made into negus, or given by itself, as circumstances may require. In a word, the great aim in this disease is to support the patient's strength, by giving him frequently small quantities of the above, or other drinks of a warm and cordial nature. He is not however to be overheated either with liquor or clothes ; and his food ought to be light, and given in small quantities. MEDICINE. — When a nausea, load, and sickness at the stomach, prevail at the beginning of the fever, it will be necessary to give the patient a gentle vomit. Fifteen or twenty grains of ipecacuanha in fine powder, or a few spoonsful of the vomiting julep, will geuerally answer this purpose very well. This may be repeated any time before the third or fourth day, if the above symptoms continue. Vomits not only clean the stomach, but by the general shock Avhich they give, promote the perspiration, and have many other excellent effects in slow fevers, where there ars no signs of inflammation, and nature wants rousing. Such as dare not venture upon a vomit may clean the bowels by a small dose of turkey rhubarb, or an infusion of senna and manna. In all fevers, the great poiut is to regulate the symptoms so as to pre- vent them from going to either extreme. Thus, in fevers of the inflam- matory kind, where the force of the circulation is too great, or the blood dense, and the fibres too rigid, bleeding and ether evacuations are necessary. But in nervous fevers, where nature flags, where the blood is vipid and poor, and the solids relaxed, the lancet must be spa- red, and wine, with other cordials, plentifully administered. It is the more necessary to caution people against bleeding in this disease, as there is generally at the beginning an universal stricture up- on the vessels, and sometimes an oppression and difficulty of breathing, which suggest the idea of a plethora, or too great a quantity of blood. I have known even some of the faculty deceived by their own feelings in this respect, so far as to insist upon being bled, when it was evident from the consequences that the operation was improper. Though bleeding is generally improper in this disease, yet blistering is highly necessary. Blistering pkisters may be applied at all times of OP THE NERVOUS FEVER. 147 the fever with great advantage. If the patient is delirious he ought to be blistered ou the neck or head, and it will be the safest course, when the insensibility continues, as soon as the discharge occasioned by one blistering-plaster abates, to apply another to some other part of the bo- dy, and by that means keep up a continual succession of them till he be out of danger. I have been more sensible of the advantage of blistering in this than in any other disease. Blistering plasters not only stimulate the solids to action, but likewise occasion a continual discharge, which may in eome measure supply the want of critical evacuations, which seldom happen in this kind of fever. They are most proper, however, either towards the beginning, or after some degree of stupor has come On, in which last case it will always be proper to blister the head. If the patient is costive through the course of the disease, it will be necessary to procure a stool, by giving him every other day a clyster of milk and water, with a little sugar, to which may be added a spoon- ful of common salt, if the above does not operate. Should a violent looseness come ou, it may be checked by small quantities of Venice treacle, or giving the patient for his ordinary drink the white decoction. A miliary eruption sometimes breaks out about the ninth or tenth day. As eruptions are often critical, great care should be taken not to retard Nature's operation in this particular. The eruption ought neither to be checked by bleeding nor other evacuations, nor pushed out by a hot regimen; but the patient should be supported by gentle cordials, as wine-whey, small negus, sago-gruel with a little wine in it, and such Jike. He ought not to be kept too warm ; yet a kindly breath- ing sweat should by no means be checked. Though blistering and the use of cordial liquors are the chief things to be depended on in this kind of fever; yet for those who may chuse to use them, we shall mention one or two of the forms of medicine which are commonly prescribed in it.* In desperate cases, where the hickup and starting of the tendons have already come on, we have sometimes seen extraordinary effects from doses of musk frequently repeated. Musk is doubtless an antispas- modic, and may be given to the quantity of a scruple three or four * When the patient is low, ten grains of Virginian snake-root, and the same quantity of contraerva-root, with five grains of Russian cas- tor, all in fine powder, may be made into a bolus with a little of the cordial confection of syrup of saffron. One of these may be taken ev- ery four or five hours. The following powder may be used with the same intention : Take wild Valerian- root in powder one scruple, saffron and castor each four grains. Mix these by rubbing them together in a mortar, and give one in a cup of wine-whey, ^rce *: four times a-day. 143 PUTRID OR SPOTTED FEVER. times a- day, or ofteuer if necessary. Sometimes it may be proper to" add to the musk a few grains of camphire, and salt of hartshorn, as these tend to promote perspiration and the discharge of urine. Thus fifteen grains of musk, with three grains of camphire, and six grains of salt of hnrtshora, may be made into a bolus with a little syrup, and giv- en as above. It" the fever should happen to intermit, which it frequently does to- wards the decline, or if the patient's strength should be wasted with col- liquative sweats, &c. it will be necessary to give him the Peruvian bark. Half a drachm, or a whole drachm, if the stomach will bear it, of the bark in fine powder, may be given four or five times a-day in a glass of red port or claret. Should the bark in substance not sit easy on the stomach, an ounce of it in powder may be infused in a bottle of Lisbon or Rhenish wiue for two or three days, afterwards it may be strained, and a glass of it taken frequently.* Some give the bark in this and other fevers, where there are no symptoms of inflammation, without any regard to the remission or in- termission of the fever. How far future observation may tend to es- tablish this practice, we will not pretend to say ; but we have reason to believe that the bark is a very universal febrifuge, and that it may be administered with advantage in most fevers where bleeding is not necessary, or where there are no symptoms of topical inflammation. CHAPTER XX. * OF THE MALIGNANT, PUTRID OR SPOTTED FEVER. fryHlS may be called the pestilential fever of Europe, as in many of J. its symptoms it bears a great resemblance to that dreadful disease the plague. Persons of a lax habit, a melancholy disposition, and those whose vigour has been wasted by long fasting, watching, hard labour excessive venery, frequent salivations, «fcc. are most liable it. * The bark may likewise be very properly administered, along with other cordials, in the following manner : Take 3n ounce of Peruviau bark, orange peel half an ounce, Virginian snake-root two drachms, saffron one drachm. Let all of them be powdered, and infused in a pint ot the best brandy for three or four da) s. Afterwards the liquor may be strained, and two tea-spoonsful of it given three or four times fe-day io a glass of small wine or negus. PUTRID OR SPOTTED FEVER. 149 CAUSES. — This fever is occasioned by foul air, from a number of people being confined in a narrow place, not properly ventilated : from putrid animal and vegetable effluvia, &c. Hence it prevails in camps, jails, hospitals, and infirmaries especially where such places are too much crowded, and cleanliness is neglected. A close constitution of the air, with long rainy or foggy weather, likewise occasion putrid fevers. They often succeed great inundations in low and marshy countries, especially when these are preceded or followed by a hot and sultry season. Living too much Upon animal foood, without a proper mixture of vegetables, or eating fish or flesh that has been kept too long, are like- wise apt to occasion this kind of fever. Hence sailors on long voyages, and the inhabitants of besieged cities, are very often visited with pu- trid fevers. Corn that has been greatly damaged by rainy seasons, or loDg keep- ing, and water which has become putrid by stagnation, &c. may like- wise occasion this feverw Dead carcases tainting the air, especially in hot seasons, are very apt to occasion putrid diseases. Hence this kind of fever often pre-* Vails in countries which are the scenes of war and bloodshed. This shows the propriety of removing burying-grounds, slaughter-houses, &c. at a proper distance from great towns. Want of cleanliness is a very general cause of putrid fevers. Hence they prevail amongst the poor inhabitants of large towns, who breathe a confined unwholesome air, and neglect cleanliness. Such mechanics as carry on dirty employments, and are constantly confined within doors are likewise Very liable to this disease. We shall only add, that putrid, malignant, or spotted fevers, are highly infectious, and are therefore often communicated by contagion. For which reason all persons ought to keep at a distance from those affected with such diseases, unless their attendance is absolutely neces- sary. SYMPTOMS.— The malignant fever is generally preceded by a remarkable weakness or loss of strength, without any apparent cause. This is sometimes so great, that the patient can scarce walk, or even sit upright, without being in danger of fainting away. His mind too is greatly dejected ; he sighs, and is full of dreadful apprehensions. There is a nausea, and sometimes a vomiting of bile ; a violent pain of the head, with a strong pulsation or throbbing of the temporal arteries; the eyes often appear red and inflamed, with a pain at the bottom of the orbit ; there is a noise in the ears, the breathing is laborious and often interrupted with a sigh ; complaints of a pain about the region of the stomach, and in the back and loins ; the tongue is at first white, but afterwards it appears black and chaped; and his teeth are covered ■With a black crust. He sometimes passes worms both upwards and 1>0 PUTRID OR SPOTTED FEVER. downwards, is affected with tremors or shaking, and often becomes deli* lious. If blcod is let, it appears dissolved, or with a very small degree of cohesion, and soon becomes putrid; the stools smell extremely foetid, and are sometimes of a greenish, black, or reddish cast. Spots of a pale purple, dun, or black colour, often appear upon the skin, and sometimes there are violent haemorrhages or discharges of blood from the mouth, eyes, nose, &c. Putrid fevers may be distinguished from the inflammatory by the sraalluess of the pulse, the great dejection of mind, the dissolved state of the blood, the petechia?, or purple spots, aad the putrid smell of the excrements. They may likewise be distinguished from the low or nervous fever, by the heat and thirst being greater, the urine of a high- er colour, and the loss of strength, dejection of mind, and all the other symptoms more violent. It sometimes happens, however, that the inflammatory, nervous, and putrid symptoms are so blended together, as to render it very difficult to determine to which class the fever belongs. In this case the great- est caution and skill are requisite. Attention must be paid to those symptoms which are most prevalent, and both the regimen and medi- cines adapted to them. Inflammatory and nervous fevers may be converted into malignant and putrid, by too hot a regimen or improper medicines. The duration of putrid fevers is extremely uncertain; sometimes they terminate between the seventh and fourteenth day, and at other times they are prolonged for five or six weeks. Their duration depends greatly upon the constitution of the patient, and the manner of treating the disease. The most favourable symptoms are, a gentle looseness after the fourth or fifth day, with a warm mild sweat. These, when continued for a considerable time, often carry off the fever, and should never be impru- dently stopped. Small miliary pustules appearing between the pete- chia? or purple spots, are likewise favourable, as also hot scabby erup- tions about the mouth and nose. It is a good sign when the pulse rises upon the use of wine, or other cordials, and the nervous symptoms abate; deafness coming on towards the decline of the fever, is likewise often a favourable symptom,* as are abscesses in the groin or parotid Among the unfavourable symptoms may be reckoned an excessive looseness, with a hard swelled belly; large black or livid blotches break- ins: out upon the skin ; aphthae in the mouth ; cold clammy sweats ; blindness; change of the voice; a wild starting of the eyes; difficulty *>f swallowing ; inability to put out the tongue; and a constant inclina- * Deafness is not always a favourable symptom iu this disease. Per- haps it h cnly so when occasioned by abscesses formed within the ears. \ PUTRID OR SPOTTED FEVER. lil lion to uncover the breast. When the sweat and saliva are tinged with blood, aud the urine is black, or deposits a black sooty sediment, the patient is in great danger. Starting of the tendons, and foetid ichorous, involuntary stools, attended with coldness of the extremities, are gener- ally the forerunners of death. REGIMEN. — In the treatment of this disease we ought to endeav- our as far as possible to counteract the putrid tendency of the humours; to support the patient's strength and spirits ; and to assist nature in ex- pelling the cause of this disease, by geutly promoting perspiration and the other evacuations. It has been observed, that putrid fevers are often occasioned by un- wholesome air, and of course they must be aggravated by it. 0tre should therefore be taken to prevent the air from stagnating in the patient's chamber, to keep it cool, and renew it frequently, by opening the doors or windows of some adjacent apartment. The breath and perspiration of persons in perfect health soon render the air of a sniall apartmeut noxious; but this will sooner happen from the perspiration and breath of a person whose whole mass of humours are in a putrid state. Besides the frequent admission of fresh air, we would recommend the use of vinegar, verjuice, juice of lemon, Seville orange, or any kind of vegetable acid that can be most readily obtained. These ought frequently to be sprinkled ©n the floor, the bed, and every part cf the room. They may also be evaporated with a hot iron, or by boiling, tic. The fresh skins of lemons or oranges ought likewise to be laid iu different parts of the room, and they should be frequently held t^ the patient's nose. The use of acids in this manner would not only pfove very refreshing to the patient, but would likewise tend to prevent the infection from spreading among those who attend him. Strong scented herbs, as rhue, tansy, rosemary, wormwood, &c. may likewise be laid in different parts of the house, and smelled to by those who go near the patient. I The patient must not only be kept cool, but likewise quiet aud easy. The least noise will affect his head, and the smallest fatigue will be apt to make him faint. f Few things are of greater importance in this disease than acids, whkh ought to be mixed with all the patient's food as well as drink. Orange, lemon, or vinegar- whey, are all very proper, and may be drank fey turns, according to the patient's inclination. They may be rendered cordial by the addition of wine iD such quantity as the patient's strength seems to require. When he is very low, he may drink negus, with only one half water, and sharpened with the juice of orange or lemton. Iu some cases a glass of wine may now and then be allowed. The most proper wine is Rhenish, or Madeira : but if the body be o^en, red port, or claret is to be preferred. When the body is bound, a tea-spoonful of the cream of tartar may be put into a cup of the patient's drink, ss there is occasion; or hemaj Ii2 PUTRID OR SPOTTED FEVER. drink a decoction of tamarinds, which will both quench his thirst, and promote a discharge by stool. If camomile-tea will sit upon his stomach, it is a very proper drink; an this disease. It may be sharpened by adding to every cup of the lea ten or fifteen drops of the elixir of vitriol. The food must be light, as panado, or water gruel, to which a little wine may be added, if the patient be weak and low ; and they ought all to be sharpened with the juice of orange, the jelly of currants, or tht: like. The patient ought likewise to eat freely of ripe fruits, as roasted apples, currant or goosberry tarts, preserved cherries, or plains, &c. Taking a little food or drink frequently, not only supports the spir- its., but counteracts the putrid tendency of the humours ; for which reason the patient ought frequently to be sipping small quantities of some of the acid liquors mentioned above, or any that may be more agreeable to his palate, or more readily obtained. If he is delirious, his feet and hands ought to be frequently foment- ed! with a strong infusion of camomile flowers. This or an infusion of the; bark ; to such as can afford it, caunot fail to have a good effect. Fomentations of this kind not only relieve the head, by relaxing the vet- ;els in the extremities, but as their contents are absorbed, and taken into the system, they may assist in preventing the putrescency of the humours. MEDICINE. — If a vomit be given at the beginning of this fever, it will hardly fail to have a good effect ; but if the fever has gone on for some days, and the symptoms are violent, vomits are uot quite so safe;. The body however is always to be kept gently open by clys- ters, or mild laxative medicines. Bleeding is seldom necessary iu putrid fevers. If there be signs of nn inflammation, it may sometimes be permitted at the first onset ; but the repetition of it generally proves hurtful. Blistering-plasters are never to be used unless in the greatest ex- tremities. If the petechias or spots should suddenly disappear, the pa- tient's pulse sink remarkably, and a delirium, with other bad symptoms come on, blistering may be permitted. In this case the blistering-plas- ters are to be applied to the; head, and inside of the legs or thighs. But atj they are sometimes apt to occasion a gangrene, we would rather recommend warm cataplasms or poultices of mustard and vinegar to be applied to the feet, having recourse to blisters only iu the utmost ex- tremities. It is common in the beginning of this fever to give the emetic tartar in small doses, repeated e\ ery second or third hour, till it shall either vomit, purge, or throw the piatient into a sweat. This practice is very proper, provided it be not pushed so far as to weaken the patient. A very ridiculous notion lias long prevailed of expelling the poison- ous matter of malignant diseases by trifling doses of cordial or alexi? PUTRID OR SPOTTED FEFER. 153 pharmic medicines. In consequence of this notion, the conlrayerva- root, the cordial confection, the raithridate, &c. have been extolled as infallible remedies. There is reason however to believe, that these seldom do much good. Where cordials are necessary, we know none that is superior to good wine ; and therefore again recommend it botb as the safest and the best. Wine, with acids and antiseptics, are the only things to be relied on in the cure of malignant fevers. In the most dangerous species of this disease, when it is attended, with purple, livid, or black spots, the Peruvian bark must be adminis- tered. I have seen it, when joined with acids, prove successful, even in eases where the petechias had the most threateuiog aspect. But fo answer this purpose it must not only be given in large doses, but duly persisted in. The best method of administering the bark is certainly in substance. An ounce of it in powder may be mixed with a half pint of water, and. the same quantity of red wine, and sharpened with the elixir or the spirit of vitriol, which will both make it sit easier on the stomach, and render it more beneficial. Two or three ounces of the syrup of lemon may be added, and two table-spoonsful of the mixture taken every two hours, or oftener, if the stomach is able to bear it. Those who cannot take the bark in substance may infuse it in wine, as recommended in the preceding disease. If there be a violent looseness, the bark must be boiled hi red wine -with a little cinnamon, and sharpened with the elixir of vitriol, as above. Nothing can be more beneficial in this kind of looseness than plenty of acids, and such things as promote a gentle perspiration. If the patient be troubled with vomiting, a dram of the salt of worm- wood, dissolved in an ounce and a half of fresh lemon juice, and made into a draught with an ounce of simple cinnamon- water, and a bit of sujrar, may be given and repeated as often as it is necessary. If swellings of the glands appear, their suppuration is to be promoted by the application of poultices, ripening cataplasms, &c. And as soon as there is any appearance of matter in thern, they ought to be laid open and the poultices continued. I have known large ulcerous sores break out in various parts of the body, in the decline of this fever, of a livid gangrenous appearance, and a most putrid cadaverous smell. These gradually healed, and the patient recovered, by the plentiful use of Peruvian bark and wine, sharpened wiih the spirits of vitriol. For preventing putrid fevers we would recommend a strict regard to cleanliness; a dry situation; sufficient exercise in the open air; wholesome food, and a moderate use of generous liquors. Infection ought above all things to be avoided. No constitution is proof against it. I have known persons seized with a putrid fever, by only making a single visit to a patient in it; others have caught it by lodging fos 29 154 PUTRID OR SMTTED FEVER. one night in a town where it prevailed ; and some by atteDdiog the fu- neral of such a3 died of it. # When a putrid fever seizes any person in a family, the greatest at- tention is necessary to prevent the disease from spreading. The sick ought to be placed in a large apartment, as remote from the rest of the family as possible; he ought likewise to be kept extremely clean, and should have fiesh air frequently let into Iris chamber; whatever comes from him should be immediately removed, his linen should be frequent- ly changed, and those in health ought to avoid all unnecessary com* tnunication with him. Any one who is apprehensive of having caught the infection, ought Immediately to take a vomit, and to work it off by drinking plentifully of camomile tea. This may be repeated in a day or two, if the appre- hensions still continue, or any unfavourable symptoms appear. The person ought likewise to take an iufm-ion of the bark and camo- mile flowers for his ordinary drink ; and before he goes to bed he may drink a pint of pretty strong negus, or a few glasses of generous wine. I have been frequently obliged to follow this course when malignant fevers prevailed, anel have likewise recommended it to others with constant success. People generally fly to bleeding and purging as antidotes against in- fection ; but these are so far from securing them, that they often, by debilitating the body, increase the danger. Those who wait upon the sick in putrid fevers, ought always to have a piece of spunge or a handkerchief dipt in vinegar, or juice of lemon, to smell to while near the patient. They ought likewise to wash their hands, and, if possible, to change their clothes, before they go into com- pany. * The late Sir John Priugle expressed a concern lest these cautions should prevent people from attending their friends or relations when afflicted with putrid fevers. I told him I meant only to dicourage unnecessary attendance, and mentioned a number of instances where putrid fevers had proved fatal to persons, who w*re rather hurtful than beneficial to the sick. This sagacious physician agreed with me, in thinking thai a good doctor and a careful nurse were the only ne- cessary attendants ; and that all others not only endangered themselves, but, generally, by their solicitude and ill-directed care, hurt the sick. QF THE MILIARY FEFUB. 155 CHAPTER XXI. OF THE MILIARY FEVER. THIS fever takes its name from the small pustules or bladders which appear on the skin, resembling in shape and size, the seeds of mil- let. The pustules are either red or white, and sometimes both are mixed together The whole body is sometimes covered with pustules ; but they are generally more numerous where the sweat is most abundant, as on the breast, the back, &c. A gentle sweat, or moisture on the skin, great- ly promotes the eruption ; but when the skia is dry, the eruption is both more painful and dangerous. Sometimes' this is a primary disease ; but it is much ofteoer only a symptom of some other malady, as the small pox, measles, ardent, pu- trid, or nervous fever, &c. In all these cases it is generally the effect of too hot a regimen or medicines. The miliary fever chiefly attacks the idle and phlegmatic, or per- sons of a relaxed habit. The young and the aged are more liable to it than those in the vigour and prime of life. It is also more incident to women than men, especially the delicate and the indolent, who neg- lecting exercise, keep continually within doors, and live upon weak and watery diet. Such females are extremely liable to be seized with this disease in childbed, and often lose their lives by it. CAUSES.— The miliary fever is sometimes occasioned by violent passions or affections of the mind ; as excessive grief, anxiety, thought- fulness, &c. It may likewise be occasioned by excessive watching, great evacuations, a weak watery diet, raiDy seasons, eating too fre- quently of cold, crude, unripe fruits, as plumbs, cherries, cucumbers, melons, &c. Impure waters, or provisions which have been spoiled by rainy seasons, long keeping, &c. may likewise cause miliary fevers. They may also be occasioned by the stoppage of any customary evac- uation, as issues, setons, ulcers, the bleeding piles in men, or the meu- struel flux in women, &c. This disease in child-bed women is sometimes the effect of great eostiveness during pregnancy ; it may likewise be occasioned by their excessive use of green trash, and other unwholesome things, in which pregnant women are too apt to indulge. But its most general cause is indolence. Such women as lead a sedentary life, especially during pregnancy, and at the same time live grossly, can hardly escape this disease in child-bed. Hence it proves extremely fatal to won^en of fashion, and likewise to those women in manufacturing towns, who, m 156 OF THE MILIARY FEFER. order to assist their husbands, sit close within doors for almost the whole of < Jipir time. But among women who are active and laborious, who live in the country, and take sufficient exercise without doors, (his disease is very little known. SYMPTOMS. — When this is a primary disease, it makes its at- tack, like most other eruptive fevers, with a slight shivering, which is succeeded by heat, loss of strength, faintishness, sighing, a low quick pulse, difficulty of breathing, with great anxiety and oppression cf the breast The patient is restless, and sometimes delirious ; the tongue appears white, and the hands shake, with often a burninc heat in the palms; and in child bed- women the milk generally goes away, and the other discharges stop. The patient feels an itching or pricking ps'n under the skin, af;rr which innumerable small pustules of a red or white colour begin to ap- pear. Upon this the symptoms generally abate, the pulse becomes more full and soft, the skin grows moister, and the sweat, as the dis- ease advances, begins to have a peculiar foetid smell ; the great load on the breast, and oppression of the spirits, generally go off, and the customary evacuations gradually return. About the sixth or seventh day from the eruption, the pustules begin to dry, and fall off, which occasions a very disagreeable itching in the skin. It is impossible to ascertain the exact time when the pustules will either appear or go off. They generally come out on the third or fourth day, when the eruption is critical ; but, when symptomatica!, they may appear at any time of the disease. Sometimes the pustules appear and vanish by turns. When that is the case, there is always danger : but when they go in all of a sudden, and do not appear again, the danger is very great. Jn childbed-women the pustules are commonly at first filled with clear water, afterwards they grow yellowish. Sometimes they are interspersed with pustules of a red colour. When these only appear, the disease goes by the name of a rash REGIMEN. — Tn all eruptive fevers of whatever kind, the chief point is to prevent the sudden disappearing of the pustules, and to pro- mote their maturation. For this purpose the patient must be kept in Ftich temperature, as neither to push out the eruption too fast, nor to cause it to retreat prematurely. The diet and drink ought therefore to be in a moderate degree nourishing and cordial ; but neither strong nor heating. The patient's chamber ought neither to he kept too hot nor too cold : and he should not be too much covered with clothes. Above all, the mind is to be kept easy and cheerful. Nothing so cer- tainly makes an eruption go in as fear. The food must be weak chicken brotli wit!) bread, panado, sa- go, or groat-gruel, &c. to a gill of which may be added a spoonful or two gf wine, as the patient's strength requires, with a few grains of salt and a little sugar. Good apples roasted or boiled, with other ripe fruit* of an opeoing cooling nature may be eaten. OF THE MILIARY FEVER. 15? The drink may be suited to the state of the patient's strength and. spirits. If these be pretty high, the drink ought to be weak ; as water- gruel, balm-tea, or the decoction mentioned below.* When the patient's spirits are low, and the eruption does not rise suffi- ciently, his drink must be a little more generous; as wine-whey or small negus ; sharpened with the juice of orange or lemon, and made stronger or weaker as circumstances may require. Sometimes the miliary fever approaches toward a putrid nature, in which case the patient's strength must be supported with generous cordi- als, joined with acids; and, if the degree of putrescence be great, the Peruvian bark, must be administered. If the head be much affected, the body must be kept open by emolient clysters.f MEDICINE. — If the food and drink be properly regulated, there will be little occasion for medicine in this disease- Should the erup- tion however not rise, or the spirits flag, it will not only be necessary to support the patient with cordials, but likewise to apply blistering-plas- ters. The most proper cordial, in this case, is good wine, which may either be taken in the patient's food or drink ; and if there be signs of putrescence, the bark and acids may be mixed with wine, as directed in the putrid fever. * Take two ounces of the shavings of hartshorn, and the same quantity of sarsaparilla, boil them in two English quarts of water. To the strained decoction add a little white sugar, and let the patient take it for his ordinary drink. f In the Commekcium Literarifm for the year 1735 we have the history of an epidemical Miliary Fever, which raged at Stras- burg in the months of November, December, and January ; from which •we learn the necessity of a temperate regimen in this malady, and like- wise that physicians are not always the first who discover the proper treatment of diseases. " This fever made terrible havoc even among men of robust constitutions, and all medicine proved in vain. They were seized in an instant with a shivering, yawning, stretching, and pains in the back, succeeded by a most intense heat ; at the same time there was a great loss of strength and appetite. On the seventh or 9th day the miliary eruptions appeared, or spots like flea-bites, with great anxiety, a delirium, restlessness and tossing in bed. Bleeding was fatal. While matters were in this unhappy situation, a midwife of her own ac- cord, gave to a patient, in the height of the disease, a clyster of rain water and butter without salt, and for his ordinary drink a quart of spring water, half a pint of generous wine, the juice of a lemon, and yix ounces of the whitest sugar, gently boiled till a scum arose, and this with great success ; for the belly was soon loosened, the grievous symp- toms vanished, and the patient was restored to his senses, and snatched from the jaws of death." This practice was imitated by others with the like happy effect. 158 OF THE REMTTING FEVER. Some recommend blistering through the whole course of this disease? nnd where Mature flags, and the eruption conies and goes, it may be necessary to keep up a stimulus, by a continual succession of small blis- tering-plasters ; but we would not recommend above one at a time. If however the pulse should sink remarkably, the pustules fall in, and the head be affected, ii will be necessary to apply several blistering- plastcre to the most sensible parts, as the inside of the legs and thighs, S:c. Bleeding is seldom necessary in this disease, and sometimes it does much hurt, as it weakens the patient, and depresses his spirits. It is therefore never to be attempted unless by the advice of a physician. We mention tins, because it has been customary to treat this disease in childbed women, by plentiful bleeding, and other evacuations, as if it were highly inflammatory. But this practice is generally very un- safe. Patients in this situation bear evacuations very ill. And indeed the disease seems often to be more of a putrid than of au inflammatory nature. Though this fever is often occasioned in childbed-women by too hot a regimen, yet it would be dangerous to leave that off all of a sud- den, and h ;ve recourse to a very cool regimen, and large evacua- tions. We have reason to believe, that supporting the patient's spi- rits, and promoting the natural evacuations, is here much safer than to have recourse to artificial ones, as these, by sinking the spirits, seldom fail to increase the danger. If the disease proves tedious, or the recovery slow, we would re- commend the Peruvian bark, which may either be taken in substance or infused in wine or water, as the patient inclines. The miliary fever, like other eruptive diseases, requires gentle purging, which should not be neglected, as soon as the fever is gone off, and the patient's strength will permit. To prevent this disease, a pure dry air, sufficient exercise, and wholesome food, are necessary. Pregnant women should guard against costiveness, and take daily as much exercise as they can bear, avoiding all green trashy fruits, and other unwholesome things ; and when in childbed, they ought strictly to observe a cool regimen. CHAPTER XXII. OF THE REMITTING FEVER. THIS fever takes its^name from a remission of the symptoms, which happens sometime's sooner, and sometimes later, but generally be- fore the eighth day. The remission is commonly preceded by a gen- tle sweat, after which the patient seems greatly relieved, but in a few OF THE REMITTING FEVER. 159 hours the fever returns. These remissions return at very irregular periods, and are sometimes of longer, sometimes of shorter duration : The nearer however that the fever approaches to a regular intermit- tent, the danger is the less. CAUSES. — Remitting fevers prevail in low marshy countries, abounding with wood and stagnating waters ; but they prove most fatal m places where great heat and moisture are combined, as in some parts of Africa, the province of Bengal in the East-Indies, &c. where remit- ting fevers are generally of a putrii* kind, and prove very fatal. They are most frequent in close calm weather, especially after rainy seasons, great inundations, or the like. No age, sex, or constitution is exempt- ed from the attack of this fever ; but it chiefly seizes persons of a re- laxed habit, who live in low dirty habitatious, breathe an impure stag- nating air, take little exercise,-and use unwholesome diet. SYMPTOMS. — The first symptoms of this lever, are generally yawning, stretching, pain, aad giddiness in the head, with alternate fits of heat and cold. Sometimes the patient is affected with a delirium at the first attack. There is a pain, and sometimes a swelling, about the region of the stomach, the tongue is white, the eyes and skin frequently appear yellow, and the patient is often afflicted with bilious vomitings. The pulse is sometimes a little hard, but seldom full, and the blood, ■when let, rarely shows any signs of inflammation. Some patients are exceedingly costive, and others are afflicted with a very troublesome looseness. It is impossible to describe all the symptoms of this disease s as they vary according to the situation, the season of the year, and the constitu- tion of the patient. They may likewise be greatly changed by the method of treatment, and by many other circumstances too tedious to mention. Sometimes the bilious symptoms predominate, sometimes the nervous, and at other times the putrid. Nor is it at all uncommon to find a succession of each of these, or even a complication of them at the same time in the same person. REGIMEN. — The regimen must be adapted to the prevailing symptoms. When there are any signs of inflammation, the diet must be sleuder, and the drink weak and diluting. But when any nervous or putrid symptoms prevail, it will be necessary to support the patient with food and liquors of a more generous nature, such as are recom- mended in the immediately preceding fevers. We must however be very cautious in the use of things of a heating quality, as this fever h frequently changed into a continual by an hot regimen, and improper medicines. Whatever the symptoms are, the patient ought to be kept cool, qui- et, and clean. His apartment, if possible, should be large and frequent- ly ventilated by letting in fresh air at the doors and windows. It ought likewise to be sprinkled with vinegar, juice of lemon, or the like His linen, bed-clothes, &cv should be frequently changed, aad m his ex- 160 OF THE REMITTING FEVER. crements immediately removed. Though these things have been re- commeuded before, we thiuk it necessary to repeat them here, as they are of more importance to the sick than practitioners are apt to ima- gine.* MEDICINE. — In order to cure this fever, we must endeavour to bring it to a regular intermission. This intention may be promoted by bleeding, if there be any signs of inflammation ; but when that i» uot the case, bleeding ought by no means to be attempted, as it will •weaken the patient and prolong the disease. A vomit however will seldom be improper, and is generally of great service. Tweuty or thirty grains of ipecacuauha will answer this purpose very well ; but where it can be obtained, we would rather recommend a grain or two of tartar emetic, with five or six giains of ipecacuanha, to be made into a draught, and given for a vomit. This may be repeated once or twice at proper intervals, if the sickness or nausea continues. The body ought to be kept open either by clysters or gentle laxa- tives, as weak infusions of senna and manna, small doses of the leni- tive electuary, cream of tartar, tamarinds, stewed prunes, or the like, but all strong or drastic purgatives are to be carefully avoided. By this course the fever in a few days may generally be brought to a pretty regular or distinct iutermission, in which case the Peruvian bark may be administered, and it will seldom fail to perfect the cure. — It is needless here to repeat the methods of giving the bark, as we bave already had occasion frequently to mention them. The most likely way to avoid this fever is to use a wholesome and nourishing diet, to pay the most scrupulous attention to cleanliness, to keep the body warm, to take sufficient exercise, and in hot countries to avoid damp situations, night air, evening dews, and the like. In * The ingeuious Dr. Lind, of Windsor, in his inaugural dissertation concerning the putrid Remitting Fever of Bengal, has the following observation : " Iudusia, lodices, ac stragula, saepius sunt mutanda, ac ceri exponenda; faeces sordesque quam primum removendae oportet etiam ut loca quibus segri decumbent sint 6alubria et aceto conspersa ; denique ut aegris cura quanta maxima prospiciatur. Compertum ego habeo, medicum hajcsedulo observautem, quiqueea exequi potest nml- to magis aegris profuturum, quam medicum peritiorem hisse commodis, destitutum." " The patient's shirt, bedclothes, and bedding, ought frequently to be changed and exposed to the air, and all his excrements immediately be removed ; the bed chamber should be well ventilated, and frequent- ly sprinkled with vinegar ; in short, every attention should be paid tt» the patient. I can affirm, that a physician who puts these in practice will much oftener succeed thau one who is even more skilful, but has not an opportunity of using these means." OF THE YELLOW FEVER. 16) countries where it is endemical, the best preventative medicine which we can recommend is the best Peruvian bark, which may either be chewed, or infused in brandy or wine, &c Some recommend smoak- iag tobacco as very beneficial in marshy countries both for the pre- vention of this and intermitting fevers. CHAPTER XXIIL OF THE YELLOW FEVER. TO enter into a minute investigation of the disputed Origin of this disease, (and whether it be imported and contagious, or Domestic and Epidemic) under existing circumstances, would be to assume a province, unwarrantable as it regards the present work. So early as the year 1699, we learn the existence of Yellow Fe- ver in this citv. At that, and for some time subsequent, it was consid- ered an infectious distemper, and in 1748, Dr. Lining pronounced it an imported disease and contagious. — The most learned of the Faculty agree, " That as almost all fevers are generally Epidemic, it is prob- able that some matter floating in the atmosphere, and applied to the bodies of men, ought to be considered as the remote cause of fevers : and these matters present in the atmosphere and thus acting upon men, may be considered cither as contagions, (that is, effluvia arising di- rectly or originally from the body of a man under a particular disease, and exciting the same kind of disease in the body to whom they ate applied) or miasmata, that is effluvia arising from other substances than the bodies of men, producing a disease in the person to whom they are applied"— Hence we may infer, that this latter term embraces what is meant by Epidemic when applied to divers places or Endemic when we speak of any one place. It is however evident, that the terms Epidemic and Contagious are so connected, as not to be Capable of an entire disjunction : The effluvia arising from other substances than the body of man, contaminating the air, and producing disease in persons predisposed— what is the consequence ? By the accumulation of disease, a combination of Causes proceeding from miasmata, combined with the effluvia arising from the bodies of the dis- eased — or in other words, Animal and Vegetable effluvia uniting — ■ must of necessity produce a species of contagion or at least a variety. Dr. Cullen admits the probability of a variety in contagions. Yet observes that though they have now been observed and distinguished 21 162 OF THE YELLOW FEVER, for many ages, and in mauy different parts of the world, they hare been always found to retain the same general character, and to differ only in circumstances, that may be imputed to season, climate, and other exteraal causes, or to the peculiar constitutions of the several persons affected. He rather inclines to admit the probability, that in each of these species the contagion is of one Specific nature, which we apprehend consists in the union of the two effluvias already mentioned. Hence, whenever it can be proved, that any disease has been commu- nicated from a combination of these, we may pronounce it contagious, and vice versa. Then with respect to the Contagious or Non-Contagious nature of the Yellow Fever, as it occurred in Charleston, we need only demand, has it in any known instance been communicated from one person to an- other? The learned and experienced Dr. Ramsay of Charleston, in a letter to Dr. Miller of New- York, says " There is but one opinion among the Physicians and Inhabitants, and that is, that the disease was neither Imported nor Contagious. This was the unanimous sentiment of the Medical Society, who in pursuance of it, gave their opinion to the Government last summer" (i. e. the summer of 1800) that the rig- id enforcement of the quarantine laws was by no means necessary on account of the Yellow Fever. " The doctor concludes by observing " my private opinion is, that our Yellow Fever is a local disease origi- nating in the air of Charleston." Correspondent to this is the opinion of Dr. Tucker Harris, communicated to Dr. Currie : " with respect to the contagious nature of Yellow Fever, so far as it has occurred in this city, there is no instance, which can be cited to induce the small- est suspicion thereof. It appears, that not only Europeans and stran- gers from different states, who visit our city, take the disease and die, without communicating it to the 'physicians, nurses or attendants, but that people from the country, strangers to our atmosphere, on coming to town, often sicken in their way home, and die in houses on the road; yet iu no one instance, hath the disorder been transferred to any of the individuals of the family who received them in. This in my opinion, is an undeniable and convincing proof of the non-contagious nature of the Yellow Fever. Indeed I strongly doubt whether any disease, originating from vegetable or marshy miasma, can be contagious for as yet it never has been demonstrated : while on the other hand I am inclined to believe, that animal, perhaps it would be more correct to say Human effluvia, under certain modifications, prove the source of all such diseases as are of a contagious kind ; and the ope- ration of this contagion is not, as happens in the case of Yellow Fe- very confined to the autumnal months, but will exist at any season. This may perhaps, serve in some measure, to discriminate between Epidemic and contagious disorders, &c." These facts corroborated by such high and undoubted testimonies, will establish what I have OF THE YELLOW FEVER. 163 already advanced with regard to the locality of this disease and pro- ceed to give the Definition. — The Yellow Fever derives its appellation from the yellow suffusion which commonly appears in the eyes and on the skin, however, as this appearance is not universal, and frequently happening in many other cases, the term may not be strictly proper. It was du- ring the Revolution, termed Camp-Fever. It appears to be a fever of the Typhus kind, and by Dr. Cullen is very properly called Typhus icterodes. The term Yellow fever is most generally applied to it, and as such we presume it will continue to be handed down to the latest posterity. CAUSES. — Authors appear to be divided as to the cause of Yel- low Fever, which may be collected from what has been already said. It is however believed that a particular idiosyncrasy, i. e. constitution or derangement of the atmosphere, probably effected by the strong light and intense heat of the sun, depriving that portion nearest the earth of its proper quautity of vital air, leaving the Mephitic or heavier part near to the surface of the earth, forms one not among the least of caus- es. The loss of a small portion of vital air renders this lower stratum very unfit for respiration, consequently very unwholesome ; when this circumstance takes place, and the atmosphere seems vitiated slowly and by degrees, the effect of Yellow Fever or indeed any other is not so considerable ; in proportion to the suddenness and degree of this idi- osyncrasy and vitiated state of the atmosphere, so is the violence of its appearance. Marsh miasma, as has been already observed is produc- tive of Epidemics, and none deny that contagious disorders are produ- ced by the exhalations from putrifying animal and vegetable substan- ces. It may also be remarked, that most climates experience an un- healthy and pestilential atmosphere, soon or immediately after the ex- halations from the putrifying collections of vegetable and animal matter begin to rise, which diffusing themselves in the air, bring on diseases of different forces of malignity, according to the contaminated state of the atmosphere, in conjunction with other predisposing circumstances, and that these exhalations are principally produced by heat combined with some peculiar state of the atmosphere, is an opinion backed by good authority. Dr. Harris, whose opinion I have before taken the liberty to introduce, observes, after having objected to the generally assigned causes, " I am however decidedly of opinion, that heat combining with some unknown modification of the atmosphere of our city, has, in tep eut of the last thirteen years, given existence to this dreadful disease." SYMPTOMS.— There is little or no difference among authors of the present day with regard to these, I have consulted eight or ten of the greatest celebrity, and observe an almost unique of opinion-^-Before the fever forms itself, the most usual sign of A its approach is a sudden and universal pain of the head generally above one or both eyes, which 3jj.8ome remit with short intervals, causing a giddiness or vertigo, rath- 164 OF THE YELLOW FEVER. er than sharp pain, attended with an unusual feebleness and languor of the body. Dr. Rush states among other premonitory symptoms, a sudden drying up, or breaking out of an old sore, fresh eruptions in different parts of the body ; a cessation of a chronic disease or a coo^ veision of a periodical into a continual disease — a peculiar sallowness of the complexion — a head ache, a decay or increase of appetite, cos- tiveuess ; a diminished or increased secretion of urine, a hot and offen- sive breath, constant sweats, and sometimes of a foetid nature, or a dry skin; wakefulness, or a disposition to early or protracted sleep, a pre- ternaturally frequent pulse; unusual vivacity, or depression of spirits, fatigue or sweats from light exertions; the hands when rubbed, emiting a smell like hepar (liver) of sulphur, and lastly a sense of burning in tin mouth. The fever is commonly ushered iu with alternative slight chills and heats, nausea, pains of the head, back, loins, and at the pit of the stomach. These symptoms are often followed, in less than 24 hours with violent retchings and vomiting of a green or yellow bile, the smell of which i? very offensive. The learned Dr. Mitchel very ingeniously arranges the pathogno- mic, (peculiar or always attendant) symptoms of this disease into the six following particulars. I A very great and sudden debility with- out any manifest cause. 2, A feverish anxiety, generally very griev- ous. 3. A short quick and difficult vrthopnaic respiration, (i. e. the patient caDnot draw his breath with ease unless in an upright posture) after the fever is formed. 4. A contracted deep pulse; the artery feels tense, but the pulse is compressible, to which succeeds a depressed, or soft and low pulse, after the state of the disease, or alter the yellow effu- sion appears. 5. A pain of the scorbiculus cordis, (pit of the stomach) either much complained of or to be felt on* squeezing that part ; and more or less severe according to the severity of the disease. 6. A yellowness' in the eyes, or all over the body at the height of the disease ; UDless prevented by colliquative or critical discharges, to which may be added, a violent and unusual kind of pain of the head, unless it is drown- ed as it were in the more grievous complaint about the pracordia, (the vitals or particularly the heart.) The three latter are symptoms most pe- culiar to this fever. At other times the patient is attacked with very great anxiety, sickness and pain of the stomach, attended with an excessive convulsive vomiting, which no medicine seems likely to relieve — After the first day the surface of the body is generally either cold, or dry and parched, the head-ache and stupor often ending in a delirium which proves suddenly fatal in many cases. It is to be observed that the vomiting sometimes occurs as early as the first or second day, but more commonly on the third, when it brings on hickup, inflammation of the stomach and viscera, with a large discharge by vomit of a black atra- bilious matter, (anciently denominated black choler) like coffee grounds, mixed with a bloody lymph, or coagulated blood. The atrabilious humcur is often highly acrid ; sometimes viscid, iu which latter ca^e it OF THE YELLOW FEVER. 165 is villi difficulty ejected, and hence by its great acrimony it renders this symptom violent and often fatal. We have been thus prolix in describing the symptoms, because we think much depends thereon, and indeed much more. might be said did •we not presume, a due attention to these, Avould discover to any careful observer the premonitory as well as concomitant advances thereof—' with regard to Prognostics, we decline advancing any observations, and proce«d to the REGIMEN". — It may not be amiss to describe under this particu- lar, what are considered as preventatives of fever — these are severally pointed out by that eminent physician, Dr. Rush. He advises first, where it is practicable, the flight of persons exposed to its attack, but where this is impracticable, safety should be sought for in such means as reduce the preternatural tone and fullness induced in the blood ves- sels by the stimulus of the miasmata and the suppression of customary secretions. These are, 1 . A diet accommodated to the greater or less exposure of the body to the action of the miasmata and to the greater or less degree of labour or exercise, which are taken. In cases of great exposure to an infected atmosphere, with but little exercise, the diet should be simple in its quality and small in its quantity. Fresh meats and wiues should be avoided. A little salted meat and Cayenne pep- per with vegetables, prevent an undue languor of the stomach, from the want of its usual cordial aliments. But where a great deal of ex- ercise is taken, broths, a little wine or malt liquors may be used with the fruits and garden vegetables of the season with safety and advant- age. The change from a full to a low diet should be made gradually. When made suddenly it predisposes to an attack of the disease. 2. Laxative medicines — 3. A plentiful perspiration kept up by means of warm clothing and bed-clothes. The excretion which takes place by the pores is of the first necessity ; as is a particular attention to clean linen or flannel ; and 4. Blood letting. All these depleting remedies, whether used separately or together, induce such an artificial debility in the system, as disposes it to vibrate more readily under the impress- ion of the miasmata. A second class of preventatives, are such as obviate the internal ac- tion of miasmata, by exciting a general or partial determination to the external surface of the body. These are — 1. The warm bath; it serves the treble purposes of keeping the skin clean, the pores open, and of defending what are called the vital organs from disease, by in- viting its remote cause to the external surface of the body. This can- not be too highly recommended. 2. The cold bath. 3. Washing the body morning and evening with salt water. 4. Anointing the body with oil or fresh butter. 5. Issues, setons and blisters. A third class of preventatives are such as excite a general action, more powerful than that which the miasmata are disposed to create iu Jbe system, or an action of a contrary nature. These are — 1. Onions 166 OF THE YELLOW FEVER. and garlic. The liberal use of these condiments in food hath exempted all those who used them in 1793, from yellow fever. 2. Calomel ta- ken in such small doses as gently to affect the gums. Several other controverted or atleast doubtful particulars are enumerated, which we pass over in order to point out the necessity of avoiding all its exciting causes. These are — 1. Heat and cold: While the former has excited the yellow fever in thousands, the latter has excited it in ten thousands. It is not in middle latitudes only, that cold awakens this disease in the body. 2 The early morning and evening air, even in warm weather. 3. Fatigue from amusements; such as fishing, gunning, dancing, and from unusual labour or exercise. 4. Intemperance in eating and drink- ing. 5. Partaking of new aliments and drinks. 6. Violent emotions or passions of the mind. 7. The entire cessation of moderate labour. 9. The continuance of hard labour. These are the principal means of prevention which have been enumerated as necessary. The Regi- men to be observed after an attack, consists in the following : The pa- tient should abstain from animal food; the diet should consist of gruel, panado, sago, chicken-broth, and other spoon meats ; he should use cool: diluting drinks, such as barley-water, toast and water, lemonade, ap- ple tea, tamarind water, hop-tea, and also small quantities of ripe fruits, which tend to keep the bowels soluble. The chamber of the sick should be spacious and airy, and frequently ventilated through the day : vinegar, sprinkled on hot bricks, should be introduced into the apartment frequently, and impregnated with aromatic herbs repeat- edly sprinkled over the floor, bed-clothes, &c. The passions of the mind ought also to be regularly attended to, and the excrements should rot be suffered to remain a moment in the apartment. These circum- stances are of iufiuile importance, as well to the sick, as to those whd frequent them. MEDICINE. — Here a particular necessity compels us to be minute in our observations. This publication was originally, and is now iatended,. as an assistant and guide to Families, and to such as are out of the reach of Physicians. Happily for mankind, where this disease prevails, there are generally a sufficient number of eminent Physicians. Need we observe the importance of an early application to an honest and skilful: practitioner ? — Where however this highly prudent plan is neglected, or impracticable, we would recommend the following mode of treatment : In this fever the first indication is to subdue it by the most speedy means in our power. The second is to prevent the putrescent state that follows so rapidly after the febrile stage, or to oppose its progress vhen begun, and at the same time to support the strength of the patient.. The first intention is best accomplished by bleeding and purgatives : Weeding is best performed within the first twenty-four hours from an attack, or at most within thirty-six. Some practitioners have pointed out the exact quantity of blood to be drawn, but; as an implicit attention to that rule may subject us to error* we decline the insertion. In geu-- OF THE YELLOW FEVER. ]67 tsral, when the lise of the lancet is indicated, one or more bleedings may- be admitted, with a view to alleviate the violent pains of the head, eyes, &c. provided it be performed within the time prescribed. In order to moderate the violent determination to the head, the feet should be hatr- ed in warm water, and an opening clyster administered immediately. As obstinate costiveness generally prevails, and the stomach is seldom long capable to retain the common purgatives, we ought to improve the time to advantage. It may be here observed that if perspiration can be promoted soon after the attack, it may be a means to subdue the fe- ver : with this view, if there be no inclination to vomit, and the skin is dry and parched, the following may be administered to advantage, during the iirst twenty-four hours. Take antimonial powder, and cal- omel, of each one scruple, syrup enough to make a mass, of which eight pills may be made. Four of these may be taken immediately, and two more repeated every second or third hour after, till they ei- ther procure a due discharge, or free perspiration. Should however the first dose occasion a retching or vomiting, we should immediately desist and resort to the other means hereafter laid down. If the pre- scription operates plentifully by sweat and by stool, the patient will in all probability recover, as by this means the fever is often prevented from forming itself. Should the stomach not retain the foregoing, forty grains of jalap and twenty of calomel, or twenty of calomel with the like quantity of Crab's- eyes or magnesia, may be rubbed together, and divided into ten powders; one of these maybe given every two hours, in a little cold tea, or they may be formed into ten pills, one of which to be taken at the same periods, and continued during the whole of the febrile stage, or untill the gums are affected. When this fortunate circumstance takes place, the medicine must be suspend- ed, and nourishment with a little wine given. 2. As bark in substance will rarely remain on the stomach, decoctions are to be preferred, and as in this stage it is necessary to exert every effort to resist a ten- dency to putrefaction, four table spoonsful of the decoction of bark may be given every two hours. If the stomach should reject it, or whether it does or not, we ought not to neglect repeated clysters of it, acidula- ted with vinegar or lime juice, at least every two hours, nor would it be amiss to rub the body with vinegar or lime-juice, as often as practi- cable. Some have recommended olive or sweet oil for this purpose also. Sometimes the strained juice of wood-sorrel given internally and by way of clyster, has been attended with good effects in. restraining the putrid tendency, and in one instance has been known to check the black vomit. Hops, being possessed of great antiseptic properties, an infusion of them may be taken in moderate draughts, at proper inter- vals. In case of vomiting, a blister applied to the epigastric region, particularly the pit of the stomach, is almost alone to be relied on. In this fever, an inflammation of the stomach and viscera are almost always present, and the tendency to putrescence is so gieat as to exclude the 16S OF THE COW-POX. remedies usually applied in other cases aUended with vomitiog. Her6 it is essentially and absolutely necessary to avoid all heating medicine. Wherefore, if the gums are not already affected, frictions of strong Mer- curial ointment, particularly over the hypochondriac and epigastric re- gions, may be used ; and if by this means the gums can be affected, a cure may be looked for. From what has been said we may collect, that the general plan of treatment for this Hydra-disease, consists of such remedies, as tend to subdue the inflammatory diathesis already pointed out- — Bleeding, warm bathing, and purgatives, appear to be the most approved, to which may be added blistering and the mercurial friction. Among the pur- gatives, calomel appears to claim the preference, aud when timely and prudently administered, seldom fails to prove successful. Hence we are again induced, earnestly to advise timely application to a Profes- sional Character. We shall now conclude with some remarks on the treatment of con- valescents. They should avoid every thing which may tend to bring on a relapse; among these may be reckoned a too early exposure to im- proper exercise, food, and drink. They should eat but little at a time, and that little should be easy of digestion. Their exercise should be gentle, and introduction to the air gradual : morning and night air should be avoided at all events. If wine had been used iu the fever, it must now be used more sparingly. Bark in substance or decoction, should be continued in moderate doses, untill the debilitated system is invigorated, the digestive faculty repaired and strengthened, and the patient returns to his usual mode of living. CHAPTER XXIV. OF THE COW POX, AND ITS INOCULATION'. THE method of inoculating for the small-pox has been retained, as having hitherto been successfully practised during a number of years; but by a fortunate discovery it is now found, that the infection may be introduced in a manner equally successful, and the disease ren- dered still less considerable than by the former kind of inoculation. This is done by inoculating with matter either taken from a cow affect- ed with the disease, or from some person who had received the infect- ion originally derived from that animal. It may be proper here to give a general account of the manner in which ?o surprising a discovery has been made. OF THE COW-POX. 169 In several parts of England, where cows are kept for the purposes of the dairy, a peculiar eruptive disease has been occasionally observ- ed among the ht>rcl, and which affects in particular the udders and teats of those anhnals. It has therefore pretty generally obtaiued the name of the cow pox (vaccinia or vacciola.) Till within these last two years, the knowledge of this distemper has been chiefly confined to the people employed in the dairies, and to far- riers and cow-doctors in the neighbourhood; but, by the latter, it ap- pears to have been observed with particular accuracy, and they have even employed means for its removal. It farther appears, that wherever the existence of this disease was known, the fact was likewise ascertained, that the disorder is communi- cated by the touch to the milkers who handle the teats of the diseased cows, and from them again is often spread through a numerous herd : that, when affecting the human species, it is not merely confined to the local disease of the hands and arms, but also occasions a general indis* positiou, often severe, but never fatal, which runs a regular course ; and that the person who has once undergone the disease so communica- ted, is ever after secure against the infection of the small-pox, either iu the natural way by contagion, or by inoculation All these circumstances, however though known, as we are told, from time immemorial in certain parts of the kingdom, still remained in obscurity till within these three years, when Dr. Jenner, of Berkley, in Gloucestershire, conceived the important idea of employing the cow- pox to annihilate the small- pox, and published several interesting par- ticulars concerning this disease, which works have now made it known to the publick in general. It appears, from observations made by those who are most conver- sant with cows, that several causes may produce sores upon the udder and teats of this animal, especially such as excite any irritation in those parts, during the season when the cows abound most in milk. The stinging of flies, or rough handling while milking, and other such exter- nal irritations, will often occasion small white blisters on the parts ; which never extended more than skin-deep, and are generally easy of cure. Another, and more serious disorder in those parts, is said to be some- times produced by suffering a cow, while in full milking, to remain for a day or two unmilked ; in order to distend the udder when naturally- small. This, it appears, is a common artifice practiced at fairs ancl cattle markets, with the view of increasing the price of the cow, a large udder being reckoned an important circumstance in the value of that animal. By this cruel and unwarrantable artifice, the vessels that sup- ply the udder are kept for an unusual length of time in a state of great distention, which terminates frequently iu a violent inflammation of those parts, succeeded by large eruptions upon the teats and udder (hat sometimes leave deep and troublesome sores. The matter discharged 22 I ft OF THE COW-VOX. from these ulcer? will communicate a disorder, like the other, into th* hands of the milkers, when the skin is broken in any part; and often produces foul and extensive ulcers, which sometimes occasion pustules on the arms and shoulders, and prove tedious and difficult of cure. The genuine cow-pox, however, is a distinct disease from those i.diieh have been just mentioned. It generally makes its appearance in the spring, and shows itself in irregular pustules on the teats or uip- p'.es ofthe udder. They are at first of a palish blue,or rather a livid colour, and contain a thin, watery, and sharp fluid. The surround- ing parts are inflamed and hardened. These pustules, it seems are very apt to degenerate into deep corroding ulcers, which as the cow- doctors term it, eat into the flesh, and constantly discharge a matter, which commonly increase in thickness, and hardens at last into a scab. jYow and then the cow becomes evidently indisposed, loses her appe- tite, and gives less milk than usual ; but it often happeos, that the disor- der, though severe, is entirely local. It appears that the cow-pox never proves fatal to cows, nor is it in- fectious in the usual mauner of contagious distempers, but can only be communicated to them or to the human species by actually touching the matter which proceeds from the sores. Hence, the cows which are not in milk escape the disease entirely, though constantly in the same field with those that are highly infected ; and it seems to be only from the circumstance of the milker handling tho teats of the sound cows, after touching the diseased, that the cow-pox ever spreads among the herd. We are informed that the cow-pox is familiar to the inhabitants of the Hundred of Berkley in Gloucestershire. It has likewise been dis- in various parts of the counties of V.'ilts, Somersets, Bucking- item, Devon, and Hants; iu a few places of Suffolk and Norfolk, where it is sometimes called the pap pcx ; and iu Leicestershire and Staffordshire. I'Tor is it unfrequent in the very large milk-farms con- tiguous to the metropolis on the Middlesex side. It is here observed general!; first some cow newly introduced to the herd, and is supposed to originate in a sudden change from a poor to a very rich and partly unnatural diet which it is the practice to use, in order to bring the yield of'milk to i's highest point. According to Dr. Jenner, the origin of the cow-pox is ascribed to a derivation from the horse. The horse is well known to be subject to an inflammation and swelling in the heel, called the grease, from which is discharged a very sharp matter, capable of producing irritation and ulcers in any other animal to the surface of which k is applied. Jt is supposed that this matter is conve}ed to the cow by the men-servants of the farm, who in several of the dairy counties, assist in milking. One of these, having dressed the horse, goes immediately to his occu- pation of milking ; and having upon his hand some particles of the dis- eiarge horn the grease, he, of course, applies it to the udder of the cow.. OF THE COIF-POX. 171 ^hcre, if the animal be in a state for receiving the infection, it pro- duces that specific change in those parts which gives rise to the dis- ease of the cow-pox. The origin here ascribed to this disorder is principally founded on '-(be circumstance, that wherever the cow pox appears, the .grease is generally found to have preceded it; aud the opinion of the propaga- tion of the disease from the horse to the cow is likewise current in some of the dairy counties where the disease is known. Eat this opin- ion requires to be ascertained by further observations. Thi.i conjecture, respecting lite origin of the cow-pox, was no sooner ■started by Dr. Jeuner, than attempts were made repeatedly, but with- out success, to introduce the disease in the nipple of the cow by direct inoculation of the recent matter of the grease from the horse's heeL The cousequeuce of this experiment, when it took any effect, was a slight inflammation, and the production of a small pustule or pimple, but which disappeared in a few days, without exciting the specific dis- ease of the pox. .But the failure of these experiments by no means overthrows the opinion for the ascertainment of which they were made; since it is admitted that a certain predisposition in the constitution of the cow to receive the disease is also requisite for its production. It is remarked, that the matter discharged from the sores in the horse's heel is likewise found to occasion, at times, very troublesome ul- cers on the hands of the men that dress them, attended with a very con- siderable degree of indisposition; both of which appear to be fujl as severe as in the genuine cow-pox, and in many points to resemble this 'latter disorder. But the person who has been infected by the horse is not rendered thereby entirely secure -from afterwards receiving the small-pox. The pustular sores on the udder and teats of the cow, that constitute the genuine cow-pox, whatever be the way in which they are produ- ced, are found by experience to possess the power of infecting the hu- «nan species, when any part of the body, where the skin is broken, or naturally thin, comes into actual contact with the matter which they dis- charge. Hence it is, that with the milkers, the hands are the parts that acquire this disorder accidentally, and it there exhibits the follow- ing appearances : Inflamed spots begin to appear on the hands, wrists, and especially the joints and tips of the fingers; and these spots at first resemble the small blisters of a burn, but quickly proceed to suppura- tion. The pustule is quite circular, depressed in the middle, and of a blueish colour, and is surrounded with a considerable redness. The blue colour which the pustule almost invariably assumes, when the dis- order is communicated directly from the cow, is one of the most cha- racteristic marks by which the cow-pox may be distinguished from other diseases Avhich the milkers are likewise liable to receive from the cow. The matter of the pustule is at first thin and colourless; but, as Ifee disorder advances, it becomes yellower and more purulent. In -a 172 OF THE COW-POX. few days from the first eruption, a tenderness and swelling of the glands in the artp pit come on, and soon after the whole consthution becomes disordered, the pulse is increased in quickness, shivering succeed, with a senses of weariness, and pains about the loins, vomiting, head-ach, and sometimes a slight degree of delirium. These symptoms continue with more or less violence from one day to three or four, aud, when they abate, they leave sores about the hands, which heal very slowly; resembling, in this respect, the ulcers on the nipple of the cow, from which they derive their origin. i 'v= to oe oi served, that the cow-pox eruption, though very severe on the hands, and occasioning much general illness, never produces a crop of pustules over disiant parts of the body, arising spontaneously, as in the small-pox. It often happens, however, that pustules are form- ed in various parts which accideutly come in contact with the diseased hands, as on the nostrils, lips, and other parts of the face where tl 16 thin; or sometimes on the forehead, when the milker leans with that part upon the udder of an infected cow. From this account it appears, that the cow-pox as it affects the milkers, or what may be termed the c -sua' cow-pox in the human specie?, is often a severe disorder, some- times confining the patient to his bed during the period of fever, and generally leaving troublesome sores, but it has never been known to prove fatal ; nw are these sores, if properly attended to followed with any lasting injury of the affected parts, though they sometimes leave scars for life. In conseque-ice of the close investigation which this disorder has late- ly i rg< m , the following facts may be considered as fully ascertain- ed by the fairest experiments and most accurate observations : First. — The cow-pox,- in its natural state, or when propagated im- mediately from an infected cow. to the hands of the milkers, is capable of affecting the human species from one to another repeatedly to an in- definite number of times ; but after the first attack, it is generally much milder in its symptoms, and in particular it is much less liable to produce the fever and general indisposition which always attend the first infection. There are instances, however, where the second and even third attack have been as severe in every respect as the first ; but these are very rare. secondly — The small-pox in a considerable degree secures a person from the infection of the cow pox ; and in this rtspect appears to act in a manner very similar to a previous attack of the latter disease ; that is, to confine its operation to the forming of local pustules, but unattended with general fever. Hence it is, that where all the serv- ants of the dairy take the. infection from the cows, those of them who have previously undergone the small pox are often the only persons among them able to go through the usual work. Thirdly — The cow-pox, in its genuine state, when it has been ac- companied with general fever, and has run its regular course, ever zU OF THE COW-POX. 173 fcer preserves the person who has been infected with it from receiving the infection of the small-pox. This assertion is, however, to be taken with exactly the same limitations as that of re-infection with the small- pox preventing a second attack of the same disease. Wo previous in- fection will entirely counteract the local effect on the arm, produced by the insertion of variolous matter in common inoculation : this may in a few cabes go so far as to induce a degree of general fever, slight indeed, but perhaps equal to that of the mildest indisposition caused by a first infection with this disorder. By the inoculation of either disease, how- ever, the small-pox is equally and completely disarmed of its virulence against any subsequent attack, which is the circumstance that so much distinguishes and so strongly recommends this operation. Fourthly. — A comparison of the two diseases in respect of the mild- ness of their symptoms, and the hazard to life which they may occasion, wili show a very great advantage in favour of the cow-pox. Compa- red with the natural small pox, the natural or casual cow-pox is both milder and infinitely more safe ; no instance having ever been known of a fatal event in the cow-pox, so far as it effects the people employed in the dairies. When both diseases are introduced by artificial inocu- lation, they are each rendered much less severe; and here too the su- periority of the cow-pox as a safer aud milder disease is extremely evi- dent. Fifthly. — The cow-pox, even in its most virulent slate, is not commu- nicable by the air, nor by any other of the ordinary means of conta- gion, but can only be propagated, by the actual contact of matter of a pustule from the cow-pox with some part of the body of the person who* receives it. It is not yet ascertained, whether in all cases an insertion of specific infectious matter under the skin be necessary ; but in its most active state, as it is when formed in the cow's udder, the skin which covers the lips and nostrils readily receives the infection Avithout being broken. In this respect the contagion of the cow-pox seems to equal that of the small-pox in activity; but the striking difference between the two diseases in the cow-pox not being communicated by the air. &c. is a circumstance fully aud satisfactorily ascertained. In the dairy- farms, infected servants sleep with the uninfected : infants at the breast have remained with their mothers whilst only one of the two have had the disorder upon them ; and in no instance has the disease of one been communicated by contagion to the other- It is this circumstance which gives the cow-pox its decided superiority ; since, by adopting this dis- ease instead of the small-pox, all the dread and all the mischief Occa- sioned by the contagion of the latter are entirely removed. The inoculated cow-pox appears to have almost as great a superiori- ty in point of mildness and security over the ordinary inoculation of the small-pox, as this has over the natural small- pox; so that the same pre- cautions which would be highly requisite in communicating the latter becomes less so where the disorder is to be introduced by inoculation % Hi OF THE COW-POt. and still less where the cow-pox is substituted iu the room of the other.. With regard to the metitod of performing inoculation in the Cow-pox^ Dr. Woodville, whose industry, judgment, and accuracy, appear to *reat advantage iu his observations on this subject, advises "that the Bfccei should be held nearly at a right angle with the skin, in order that the infectious fluid may gravitate to the point of the instrument, which, an this direction, should be made to scratch the cuticle repeatedly, un- til it reach the true skin and become tinged with blood." The act of inoculation having been performed, the first proof of its success is a small inflamed spot at the part where the puncture has fetsen Wade, which is very distinguishable about the third day. This continues to increase in size, becomes hard, and a small circular hi, mour is formed, rising a little above the skiu. About the sixth day \ . ■■■■r < 5? ■ tfs M> OF THE MEASLES. 175 afiri repeatedly exposed to the infection of the disease ; and what is not less extraordinary, nearly a fourth part of this number were so blig : ■■ - ly affected with the cow-pox, that it neither produced any perceptible indisposition, nor pustules. From the beginning of the world, the cow, has, in all countries, beea esteemed a valuable animal. Besides cultivating the grouud which her species performs, she supplies us with an aliment of her own preparing, the most wholesome as well as nourishing in nature; but never befoie was it known, except, as appears in some particular districts in Eng- land, that even from a disease to which she is liable, she can likewise be further useful in preserving us from one of the most fatal calamities that ever infested human kind. CHAPTER XXV* OF THE MEASLES. THE measles appeared in Europe about the same time with ths small pox, and have a great affinity to that disease. They both came from the same quarter of the world, are both infectious, and sel- dom attack the same person more than once. The measles are most common in the spring season, and generally disappear in summer. The disease itself, when properly managed^ seldom proves fatal j but its con- sequences are often very troublesome. CAUSE. — .This disease, like the small-pox, proceeds from infection, and is more or less dangerous according to the constitution of the pa- tient, the season of the year, climate, &c. SYMPTOMS. — The measles, like other fevers, are preceded by alternate fits of heat and cold, with sickness and loss of appetite. The tongue is white, but generally moist. There is a short cough, heavi- ness of the head and eyes, drowsiness, and a running at the nose- Some- times indeed the cough does not come before the eruption has appear- ed. There is an inflammation and heat in the eyes, accompanied with a defluxioa of sharp rheum, and great acuteness of sensation, so that they cannot bear the light without pain. The eye-lids frequently swell so as to occasion blindness. The patient generally complains of his throat ; and a vomitiDg or looseness often precedes the eruption. The stools in children are commonly greenish ; they complain of an itching ©f the skin, and are remarkably peevish. Bleeding at the nose is com- siou, both before and ia the progress of the disease.- 176 OF THE MEASLES. About the fourth ihj, small spots resembling flea-bites, appear, first upon the face, then upon the breast, ami afterwards on the extremi- ties: these may be distinguished from the smallpox by their scarcely rising above the skin. The fever, cough, and difficulty of breathiug, iustead of being removed by the eruption as in the small- pox, are rath- er increased ; but the vomiting generally ceases. On the sixth or seventh day from the time of sickening, the measles begin to turu pale on the face, and afterwards upon the body ; so that by the ninth day they entirely disappear. The fever, however, and difficulty of breathiog, often continue, and especially if the patient has beeu kept upon too hot a regimen. Petechia;, or purple spots, may likewise be occasioned by this error. A violent looseness sometimes succeeds the measles, in which case the patient's life is in imminent danger. Such as die of the measles, generally expire about the ninth day from the invasion, and arc commonly carried off by a peripneumonyj or inflammation of the lungs. The most favourable symptoms are a moderate looseness, a moist skin, and a pleutiful discharge of urine. When the eruption suddenly falls in, and the patient is seized with a delirium, he is in the greatest danger. If the measles turn too soon of a pale colour, it is an unfavourable symptom, as are also great weak- ness, vomiting, restlessness, and difficulty of swallowing. Purple or black spots appearing among the measles are very unfavourable. When a. continual cough, with hoarseness, succeeds the disease, there is rea- son to suspect an approaching consumption of the lungs. Our business in this disease is to assist nature, by proper cordials, in throwing out the eruption, if her efforts be too languid ; but when they are too violent they must be restrained by evacuations, and cool diluting liquors, &c. We ought likewise to endeavour to appease the most urgent symptoms, as the cough, restlessness, and difficulty of breathing. REGIMEN. — The cool regimen is necessary here as well as in the small-pox. The food too must be light, and the drink diluting. Acids, however, do not answer so well in the measles as in the small-pox, as they tend to exasperate the cough. Small beer likewise, though a good drink in the small-pox, is here improper. The most suitable liquors are decoctions of liquorice, with marsh mallow roots and sarsaparilla, infusions of linseed, or of the flowers of elder, balm tea, clarified whey, barley-water, and such like. These, if the patient is costive, may be sweetened with honey ; or, if that should disagree with the stomach, a little manna may occasionally be added to them. MEDICINE. — The measles being an inflammatory disease, with- out any critical discharge of matter, as in the small-pox, bleeding is commonly neeeusary, (specially when the fever runs high, with difficul- OF THE MEASLES. Ill ty of breathing, and great oppression of the breast. But if the disease be of a mild kind, bleeding may be omitted* Bathing the feet and legs frequently in lukewarm, water, both tends to abate the violence of the fever, and to promote the eruption. The patient is often greatly relieved by vomiting. ' When there is a tendency this way, it ought to be promoted by drinking luke-warm wa- ter, 01 weak camomile tea. , When the cough is very troublesome, with dryness of the throat, and difficulty of breathing, the patient may hold his head over the steam of warm water, and draw the steam into his lungs. He may likewise lick a little spermaceti and sugar candy pounded together; or take now and then a spoonful of the oil of sweet almonds, with sugar candy dissolved in it. These will soften the throat, and re- lieve the tickling cough. If at the turn of the disease the fever assumes new vigour, and there appears great danger of suffocation, the patient must be bled according to his streugth, and blistering-plasters applied, with a view to prevent the load from being thrown on the luags, where if an inflammation should fix itself, the patient's life will be in imminent danger. In case the measles should suddenly disappear, it will be necessary to pursue the same method which we have recommended when the small' pox recede. The patient must be supported with wine and cordials. Blistering plasters must be applied to the legs and arms, and the body- rubbed ^U over with warm flannels. Warm poultices may likewise be applied to the feet and palms of the hands. When purple or black spots appear, the patient's drink should be sharpened with spirits of vitriol ; and if the putrid symptoms increase, the Peruvian bark must be administered in the same manner as direct- ed in the small-pox. Opiates are sometimes necessary, but should never be given except in cases of extreme restlessness, a violent looseness, or when the cough, is very troublesome. For children, the syrup of poppies is sufficient. A tea-spoonful or two may be occasionally given according to the pa- tient's age, or the violence of the symptoms. After the measles are gone off, the patient ought to be purged. This may be conducted in the same manner as directed in the small-pox. If a violent looseness succeeds the measles, it may be checked by taking for some days a gentle dose of rhubarb in the morning, and an opiate over night; but if these do not remove it, bleeding will seldom fail to have that effect Patients recovering after the measles should be careful what they gat or drink. Their food for some time ought to be light, and in small * I do not know any disease wherein bleeding is more necessary than in the measles, especially when the fever runs high : ia this case I have always found it relieve the patient. 23 173 OF THE SCARLET FEVER. quantities, and their drink diluting, and rather of an opening nature, »• butter -milk, whey, and such like. They ought also to beware of ess- pcsing themselves too soon to the cold air, least a suffocating catarrh, an asthma, or a consumption of the lungs, should ensue. Should a cough, with difficulty of breathing, and other symptoms of a consumption, remain after the measles, small quantities of blood may be frequently let at proper intervals, as the patieut's strength and con- stitution will permit. He ought likewise to drink asses milk, to re- move to a free air, if in a large town, and to ride daily on horseback. He must keep close to a diet consisting of milk and vegetables ; and lastly, if theae do not succeed, let him remove to a warmer climate.* OF THE SCARLET FEVER. THE scarlet fever iff so called from the colour of the patient's skin, which appeals as if it were tinged with red wine. It happens at any season of the year, but is most common towards the end of summer ; at which time it often seizes whole families; children and young persons are most subject to it. It begins like other fevers, with coldness and shivering, without any violent sickness. Afterwards the skin is covered with red spots, which are broader, more florid, and less uniform than the measles. They continue two or three days, and then disappear; after which the cuti- cle, or scarf-skin falls off. There is seldom any occasion for medicine in this disease. The pa- tient ought however to keep within doors, to abstain from flesh, strong liquors, and cordials, and to drink freely of cool and diluting liquors. If * Attempts have been made to communicate the measles, as well as the smallpox, by inoculation, and we make no doubt but in time the practice may succeed. Dr. Home of Edinburgh, says, he communi- cated the disease by the blood. Others have tried this method, and have not found it succeed. Some think the disease would be more cer- tainly communicated by rubbing the skin of the patient who has the measles with cotton, and afterwards applying the cotton to a wound as iu the small-pox ; while others recommend a bit of flannel which had been applied to the patient's skin all the time of the disease, to be after- wards laid upon the arm or leg of the person to whom the infection is to be communicated. There is no doubt but this disease, as well as the small-pox, may be communicated various ways; the most probable, however, is either from cotton rubbed upon the skin, as mentioned above, or by introducing a little of the sharp humour which distills from the eyes of the patient into the blood. It is agreed on all hands, that such patients as have been inoculated, had the disease very mild- ly ; we therefore wish the practice were wore general, as the measles have of late become very fata!. OF THE BILIOUS FEVER. I7ft nfch.e fever runs high, the body must be kept gently open by emolient ■clysters, or small doses of nitre and rhubarb. A scruple of the form- er, with five grains of the latter, may be taken thrice a-day, or ofteuer., if necessary. Children and young persons are sometimes seized at the beginning of this disease with a kind of stupor and epileptic fits. In this case the feet and legs should be bathed in warm water, a large blistering-plast- er applied to the neck, and a dose of the syrup of poppies given eve- ry night till the patient recovers.* The scarlet fever however is not always of so mild a nature. It is sometimes attended with putrid or malignant symptoms, in which case it is always dangerous. In the malignant scarlet fever the patient is not only affected with coldness and shivering, but with languor, sick- ness, and great oppression ; to these succeed excessive heat, nausea, and vomiting, with a soreuess of the throat ; the pulse is extremely quick, but small and depressed; the breathing frequent and laborious; the skin, hot, but not quite dry; the tongue moist, and covered with a whitish mucus ; the tonsils inflamed and ulcerated. When the erup- tion appears, it brings no relief: on the contrary, the symptoms gener- ally grow worse, and fresh ones come on, as purging, delirium, &c. When this disease is mistaken for a simple inflammation, and treated with repeated bleedings, purging and cooling medicines, it generally proves fatal. The only medicines that can be depended on in this case, are cordials and antiseptics, as the Peruvian bark, wine, snake- root, and the like. The treatment must be in general similar to that of the putrid fever, or of the malignant ulcerous sore throat.f OF THE BILIOUS FEVER. WHEN a continual, remitting, or intermitting fever is accompanied 'with a frequent or copious evacuation of bile, either by vomit or stool, the fever is denominated bilious. In Britain the bilious fever general- ly makes its appearauce about the end of summer, and ceases towards the approach of winter. It is most frequent and fatal in warm coun- tries, especially where the soil is marshy, and when great rains are succeeded by sultry heats. Persons who work without doors, lie in * Sydenham. t In the year 1774, during winter, a very bad species of this fever prevailed in Edinburgh. It raged chiefly among young people. The eruption was generally accompanied with a quinsey, and the inflamma- tory symptoms were so blended with others of a putrid nature, as to render the treatment of the disease very difficult. Many of the pa- tients, towards the decline of the fever, were afflicted with large swell- ings of the submaxillary glands, and not a few had a suppuration in oae •r both ears. 18© OF THE ERYSIPELAS, camps, or who are exposed to the night air, are most liable to this kirn? of fever. If there are symptoms of inflammation at the beginning of this fever, it wj!l b»i necessary to bleed, and to put the patient upon the cool dilu- ting regimen recommended in tb^ inflammatory fever. The saline drauglr may likewise be frequently administered, and the patient's b» dangerous, may be used in the space of twenty-four hours. The head should be shaved and frequently rubbed with vinegar and wise water. Cloths dipped in this mixture may likewise be applied to> the temples. The feet ought frequently to be bathed in lukewarm wa- ter, and soft poultices of bread and milk may be kept constantly ap- plied to them. If the disease proves obstinate, and does not yield to these medicines* it will be necessary to ?pp!y a blistering plaster to the whole head* ■OF THE OPHTHALMIA, &c„ IS? CHAPTER XXVIIL ®F THE OPHTHALMIA, OR INFLAMMATION OF THE EYES. THIS disease may be Occasioned by external injuries; as blows, burns, bruises, and the like. It may likewise proceed from dust s quick-lirne, or other substances, getting into the eyes. It is often caused by the stoppage of customary evacuations ; as the healing of old -sores, drying up of issues, the suppressing of gentle morning sweats, or of the sweating of the feet, &c. Long exposure to the night air, e pe- ciallyin cold northerly winds, or whatever suddenly checks the perspi- ration, especially after the body has been much heated, is very apt to cause an inflammation in the eyes. Viewing snow or other white bod- ies for a long time, or looking stedfastly at the sun, a clear fire, or any bright object, will likewise occasion this malady. A sudden transition from darkness to very bright light will often have the same effect. Nothing more certainly occasions an inflammation of the eyes than night-watching, especially reading or writing by candle-light. Drink- ing spirituous liquors, and excess of venery are likewise very hurtful to the eyes. The acrid fumes of metals, and of several kinds of fuel, are also pernicious. Sometimes an inflammation of the eyes proceeds from a venereal taint, and often from a scrophulous or gouty habit. It may likewise be occasioned by hairs in the eyelids turning inward and hurting the eyes. Sometimes the disease is epidemic, especially after wet seasons ; and I have frequently known it prove infeciious, partic- ularly to those who lived in the same house with the patient. It may be occasioned by moist air, or living in low damp houses, especially in persons who are not accustomed to such situations. In children it often proceeds from imprudently drying up of scabbed heads, a run- ning behind the ears, or any other discharge of that kind. Inflamma- tions of the eyes often succeed the small-pox or measles, especially in children of a scrophulous habit. SYMPTOMS. — An inflammation of the eyes is attended with acute pain, heat, redness, and swelling. The patient is not able to bear the light, and sometimes he feels a pricking pain, as if his eyes were pier- ced with a thorn. Sometimes he imagines his eyes are full of motes, or thinks he sees flies dancing before him. The eyes are filled with a scalding rheum, which rushes forth in great quantities, whenever the patient attempts to look up. The pulse is generally quick and hard* with some degree of fever. When the disease is violent, the neigh* 188 OF THE OPHTHALMIA, bouring parts swell, and there is a throbbing or pulsation in the tempo- ral arteries, &c. A slight inflammation of the eye?, especially from an external cause, is easily cured ; but when the disease is Violent, and continues long, it often leaves specks upon the eyes, or dimness of sight, and sometimes total blindness. If the patient be seized with a looseness, it has a good effect \ and ■when the inflammation passes from one ev e to another as it were by in- fection, it is no unfavourable symptom. But wheu the disease is ac- companied with a violent pain of the head, and continues long, the pa- tient is in danger of losing his sight. REGIMEN. — The diet, unless in scrophulous cases, can hardly be too spare, especially at the beginniog. The patient must abstain from every thing of a heating nature. His food should consist chiefly of u ild vegetables, weak broths, and gruels. His drink may be bar- ley- .vpier, balm-tea, common whey, and such like. The patient's chamber must be darkened, or his eyes shaded by a cover so as to exclude the light, but not to press upon the eyes. He should not look at a candle, the fireoranj luminous object; and ought to avoid all smoke, as the fumes of tobacco, or any thing that may cause coughing, sneezing, or vomiting. He should be kept quiet, avoid- ing all violent efforts, either of body or mind, and encouraging sleep as much as possible. MEDICINE. — This is one of those diseases wherein great hurt is often done by external applications. Almost every person pretends to be possessed of a remedy for the cure of sore eyes. These remedies generally consist of eve- waters and ointments, with other external ap- plications, which do mischief twenty times for once they do good. Peo- ple ought therefore to be very cautious how they use such things, as even the pressure upon the eyes often increases the malady. Bleeding in a violent inflammation of the eyes, is always necessary. This should be performed as near the part affected as possible. An adult may lose ten or twelve ounces of blood from the jugular vein, and the operation may be repeated according to the urgency of the symp- toms. If it should not be convenient to bleed in the neck, the same quantity may be let from the arm, or any other part of the body. Leeches are often applied to the temples, or under the eyes, with good effect. The wounds must be suffered to bleed for some hours, aud if the bleeding stop soon, it may be promoted by the application of cloths dipt in warm water. In obstinate cases, it Avill be necessary to repeat this operation several times. Opening and diluting medicines are by no means to be neglected : The patient may take a small dose of Glauber's salts, and cream of tartar, every second or third day, or a decoction of tamarinds with senna. If these be not agreeable, gentle doses of rhubarb and nitre, a little of the lenitive electuary, or any other mild purgative, will aft* OR INFLAMMATION OF THE EYES. 129 Swer the same end. The patient at the same time must drink freely of water-gruel, tea, whey, or any other weak diluting liquor. He ought likewise to take at bed-time, a large draught of very weak wine-whey, in order to promote perspiration. His feet and legs must frequently be bathed in lukewarm water, and his head shaved twice or thrice a- week, and afterwards washed in cold water. This has often a remarkable good effect. If the inflammation does not yield to these evacuations, blistering plasters must be applied to the temples, behind the ears, or upon the neck, and kept open for some time by the mild blistering-ointment. I -have seldom known these, if long enough kept open, fail to remove the most obstinate inflammation of the eyes; but for this purpose it is often necessary to continue the discharge for several Weeks. When the disease has been of long standing, I have seen very extra- ordinary effects from a seton in the neck, or between the shoulders* especially the latter. It should be put upwards and downwards, or in. the direction of the spine, and in the middle between the shoulder blades. It may be dressed twice a-day With yellow basilicon. I have known patients, who had been blind for a considerable time, recover sight by means of a seton placed as above. When the seton i3 put across the neck, it soon wears but, and is* both more painful and trou- blesome than between the shoulders ; besides, it leaves a disagreeable mark ; and does not discharge so freely. When the heat and pain of the eyes are very great, a poultice of bread and milk., softened with sweet oil or fresh butter, may be applied to them, at least all night; and they may be bathed with luke warn! milk and water in the morning. If the patient cannot sleep, which is sometimes the case, he may take twenty or thirty drops of laudanum, or two spoonsful of the syrup of poppies, over night, more or less according to his age, or the violence of the symptoms-. After the inflammation is gone off, if the eyes still remain weak and tender, they may be bathed every night and morning with cold water and a little brandy^ six parts of the former to one of the latter. A method should be contrived by which the eye can be quite im- mersed in the brandy and water, Where it should be kept tor some time. I have generally found this, or cold water and vinegar, as good a strehgthener of the eyes as any of the most celebrated collyriums. When an inflammation of the eyes proceeds from a scrophulous hab- it, it generally proves very obstinate. \ In this case the patient's diet must not be too low, and he may be allowed to drink small negus, or now and then a glass of wine. The most proper medicine is the Pe- ruvian bark, which may either he given in substance, or prepared in the following manner. Take an ounce of the bark in powder, with two drachms of Winter's %ark, and boil them in an English quart of water to a pint; when it hag 190 OF THE QUINSEY, boiled nearly long enough, add half an ounce of liquorice-root sliced. Let (he liquor be strained Two, three, or four table-spoonsful, ac- cording to the age of the p itient, maj be taken three or four times a- day It is impossible to say how long this medicine should be contin- ued, as the cure is sooner performed in some than in others ; but in gen- eral it requires a considerable lime to produce any lasting effects. Or. Cheyne says, " That yEthiop's mineral never fails in obstinate inflammations of the eyes, even scrophulous ones, if given in a sufficient dose, and duly persisted in." There is no doubt but this and other preparations of mercury may be cf singular service in ophthalmias of long continuance, but they ought always to be administered with the greatest caution, or by persons officii! in physic. It will be proper frequently to look into the eyes, to see if any hairs l)c turned inwards, or pressing upon them.* These ought to be re- moved by plucking them cut with a pair of small pincers. Those who are liable to frequent returns of this disease, ought con- stantly to have an is^ue on one or both arms. Bleeding or purging in the spring awl autumn, will be very beneficial to such persons. They ought likewise to live with the greatest regularity, avoiding strong li- quo s, and every thing of a heating quality. Above all, let them avoid *he night air, and late studies. CHAPTER XXIX, OF THE QUINSEY, OR INFLAMMATION OF THE THROAT. THIS disease is very common in Britain, and is frequently attend- ed with great danger. It prevails in the winter and spring, and 3s most fatal to young people of a sanguine temperament. CAUSES. — In general it proceeds from the same causes as other inflammatory disorders, viz. an obstructed perspiration, or whatever heats or inflames the blood. An inflammation cf the throat is often oc- casioned by omitting some part of the covering usually worn about the * Any foreign body lodged in the eye may be expeditiously removed Ly-pai-sjng a small hair pencil between the eye-lid, and the ball of the gye. In tome places the peasants do this very effectually, by usiii£ i. 1 !! ir tongue in the same manner. OR INFLAMMATION OF THE THROAT. 101 beck, by drinking cold liquor when the body is warm, by riding or walking against a cold northerly wind, or any thing that greatly cools the throat and parts adjacent. It may likewise proceed from the aeg- lect of bleeding, purging or any customary evacuation. Singing, speaking loud and long, or whatever strains the throat, rnr.y likewise cause an inflammation of that organ. I have often known the quinsey prove fatal to jovial companions, who after sitting long in a warm room, drinking warm liquors, and singing with vehemence, were so im- prudent as to go abroad* in the cold night air. Sitting with wet feet, or keeping on wet clothes, are very apt to occasion this malady. It is likewise frequently occasioned by continuing long in a moist place, sit- ting near an open window, sleeping in a damp bed, sitting in a room that has been uewly plastered, &c. I know people who never fail to> have a sore throat, if they sit even but a short time in a room that has been lately washed. Acrid or irritating food may likewise inflame the throat, and occa- sion a quinsey. It may also proceed from bones, pins, or other sharp substances sticking in the throat, or from the caustic fumes of metals or minerals, as arsenic, antimony, &c. taken in by the breath. This dis- ease is sometimes epidemic and infectious. SYMPTOMS.— The inflammation of the throat is evident from in- spection, the parts appearing red and swelled ; besides the patient com- plains of pain in swallowing. His pulse is quick and hard, with other symptoms of a fever. If blood be let, it is generally covered with a tough coat of a whitish colour, and the patient spits a tough phlegm. As the swelling and inflammation increase, the breathing and swallow- ing become more difficult; the pain afFects the ears; the eyes gener- ally apcear red; and the face swells. The patient is often obliged to keep himself in an erect posture, being in danger of suffocation ; there is a constant nausea, or inclination to vomit, and the drink, instead of passing into the stomach, is often returned by the nose. The patient is sometimes starved at last, merely from an inability to swallow any kind of food. When the breathing is laborious, with straitness of the breast, and anxiety, the danger is great. Though the pain ia swallowing be very great, yet while the patient breathes easy, there is not so much danger. An external swelling is no unfavourable symptom ; but if it suddenly falls, and the disease affects the breast, the danger is very great. When a quinsey is the consequence of some other disease, Avhich has already weakened the patient, his situation is dangerous. A frothing at the mouth, with a swelled tongue, a pale, ghastly countenance, and coldness of the extremities are fatal symptoms. REGIMEN. — The regimen in this dist ase is in all respects the same as in the pleurisy, or peripneumony. The food must be light, and in small quantity, and the drink plentiful, weak and diluting, mixed witfe -acids. *$2 OF THE QLINSEY, It is highly necessary that the patient be kept easy autl quiet. Vi- oleut affections of the mind, or great efforts of the body, may prove fa- tal. He should not even attempt to speak but in a low voice. Such a degree of warmth as to promote a constaDt gentle sweat, is proper. When the patient is in bed, his head ought to be raised a little higher, than usual. It is peculiarly necessary that the neck be kept warm ; for which purpose several folds of soft flannel may be wrapt round it. That alone will often remove a slight complaiut of the throat, especially if applied in due time. We cannot here omit observing the propriety of a Custom which prevails among the peasants of Scotland : When they feel an uneasiness of the throat, they wrap a stocking about it all night. So effectual is this remedy, that in many places it passes for a charm, and the stocking is applied with particular ceremonies ; the custom however, is undoubtedly a good one, and should never be neglected. When the throat has been thus wrapt up all night, it must not be ex- posed to the cold air through the day, but a handkerchief or a piece of flannel kept about it till the inflammation be removed. The jelly of black currants is a medicine very much in esteem for complaiuts of the throat ; and indeed it is of some use. It should be almost constantly kept in the mouth, and swallowed down leisurely. It may likewise be mixed in the patient's drink, or taken any other way. When it cannot be obtained, the jelly of red currants, or of mulberries, may be used in its stead. Gargles for the throat are very beneficial. They may be made of sage-tea, with a little vinegar and honey, or by adding to half a pint of the pectoral decoction, two or three spoonsful of honey, and the same quantity of currant-jelly, This may be used three or four times a-day ; and if the patient be troubled with tough viscid phlegm, the gargle may be rendered more sharp and cleansing, by adding to it a tea-spoonful of the spirit of ±al ammoniac. — Some recommend gargles made of a decoction of the leaves or bark of the black currant bush; but where the jelly can be had these are unnecessary. There is no disease wherein the benefit of bathing the feet and legs in lukewarm water is more apparent ; that practice ought therefore never to be neglected. If people were careful to keep warm, to wrap up their throats with flannel, to bathe their feet and legs iu warm wai- ter, and to use a spare diet, with diluting liquors, at the beginning of this disease, it would seldom proceed to a great height, or be attended with any danger ; but when these precautions are neglected, and th« disease becomes violent, more powerful medicines are uecessary. MEDICINE. — An inflammation of the throat being a most acute and dangerous distemper, which sometimes takes oil' the patient very suddenly, it will be proper, as soon as the symptoms appear, to bleed in the arm, or rather in the jugular vein, and to repeat the operation if circumstances require. OR INFLAMMATION OF THE THROAT. 193 The body should likewise be kept gently open. This may either be done by giving the patient for his ordinary drink a decoction of figs and tamarinds, or small doses of rheubarb and nitre, as recommended in the erysipelas. These may be increased according to the age of the patient, and repeated till they have the desired effect. I have often known very good effects from a bit of salprunel, or purified nitre, held in the mouth, and swallowed down as it melted. This promotes the discharge of saliva, by which means it answers the end of a gargle, while at the same time it abates the fever, by pro- moting the discharge of urine, &c. The throat ought likewise to be rubbed twice or thrice a-day with a little of the volatile liniment. This seldom fails to produce some gGod effects. At the same time the neck ought to be carefully covered with wool or flannel, to prevent the cold from penetrating the skin, as this application renders it very tender. Many other external applica- tions are recommended in this disease, as a swallow's nest, poultices made of the fungus called Jew's ears, album Graecum, &c. But as we do not look upon any of these to be preferable to a common poultice of bread and milk, we shall take no further notice of them. Some recommend the gura-guaiacum as a specific in this disease. Half a drachm of the gum in powder may be made into an electuary •with the rob of elder-berries, or the jelly of currants for a dose, and repeated occasionally.* Blistering upon the neck or behind the ears in violent inflammations of the throat is very beneficial ; and in bad cases it will be necessary to lay a blistering-plaster quite across the throat, so as to reach from ear to ear. After the plasters are taken off, the parts ought to be kept running by the application of issue ointment, till the inflammation is gone ; otherwise, upon their drying up, the patient will be in danger of a relapse. When the patient has beon treated as above, a suppuration seldom happens. This however is sometimes the case, in spite of all endeav- ours to prevent it. When the inflammation and swelling continue, and it is evident that a suppuration will ensue, it ought to be promoted by drawing the steam of Avarm water into the throat through a tunnel, or , the like. Soft poultices ought likewise to be applied outwardly, and the patient may keep a roasted fig constantly in his mouth. It sometimes happens, before the tumour breaks, that the swelling is so great, as entirely to prevent any thing from getting down into the stomach. In this case the patient must inevitably perish, unless he can be supported in some other way. This can only be done by nourish- ing clysters of broth, or gruel with milk, &c. Patients have often been supported by these for several days, till the tumour has broke ; and afterwards they have recovered. * flammatory, by the vomiting and looseness with which it is generally ushered in; the foul ulcers in the throat covered with a white or livid coa,t; and by the excessive weakness of the patient; with other symp- toms of a putrid fever. 195 QF THE MALIGNANT QUINSEY. Unfavourable symptoms are, an obstinate purging, extreme weakness, dimness of the sight ; a livid or black colour of tire spots, and frequent shiverings, with a weak fluttering pulse. If the eruption upon the skin suddenly disappears, or becomes of a livid colour with a discharge of blood from the nose or mouth, the danger is very great. If a gentle sweat break out about the third or fourth day, and con- tinue with a slow, firm, and equal pulse; if the slough? cast off in a kiodly manner, and appear clean aDd florid at the bottom ; and if the breathing be soft and free, with a lively colour of the eyes, there is rea- son to hope for a salutary crisis. REGIMEN. — The patient must be kept quiet, and for the most part in bed, as he will be apt to faint when taken out of it. His food must be nourishing and restorative ; as sago-gruel with red wine, jel- lies, strong broths, &c. His drink ought to be generous, and of an an- tiseptic quality: as red wine, negus, white-whine whey, and such like. MEDICINE — The medicine in this kind of quiuse} is entirely different from that which is proper in the inflammatory. All evacua- tions, as bleeding, purging, &c. which weaken the patient must be avoid- ed. Cooling medicines, as nitre and cream of tartar, are likewise hurt- ful. Strengthening cordiala alone can be used with safety; and these ought never to be neglected. If at the beginning, there is a great nausea, or inclination to vomit, the patient must take an infusion of green tea, camomile flowers, or car~ duus benedictus, in order to cleanse the stomach. If these are not suf- ficient, he may take a few grains of the powder of ipecacuanha, or any other gentle vomit. If the disease is mild, the throat may be gargled with an infusion of sage aod rose leaves, lo a gill of which may be added a spoonful or two of honey ; and as much vinegar as will make it agreeably acid ; but when the symptoms are urgent, the sloughs large and thick, and the breath very offensive, the following gargle may be used. To six or seven ounces of the pectoral decoction, when boiling, add half an ounce of contrayerva-root ; let it boil for some time, and after- wards strain the liquor ; to which add two ounces of white wine vine- gar, an ounce of fine honey, and an ounce of the tincture of myrrh. This ought not only to be used as a gargle, but a little of it should frequently be injected with a syringe to clean the throat, before the pa- tient takes any meat or drink. This method is peculiarly necessary for children Mho cannot use a gargle. It will be of great benefit if the patient frequently receives into his mouth, through an inverted funnel, thesteams of warm vinegar myrrh, aud honey. Rut when the putrid symptoms run high, and the disease is attended with danger, the only medicine that can be depended upon is the Peru- vian bark. It may be taken in substance, if the patient's stomach will bear it. If not, an ounce of bark grossly powdered, with two drachms OF COLDS AND COUGHS. 197 of Virginian snake-root, may be boiled in an English pint and a half, of water to half a pint; to which a tea spoonful of the elixir of vitriol may be added, and an ordinary tea-cupful of it taken every three or four hours. Blistering-plasters are veiy beneficial in this disease, es- pecially when the patient's pulse and spirits are low. They may be applied to the throat, behind the ears, or upon the back part of the neck. Should the vomiting prove troublesome, it will be proper to give the patient two t?Me spoonsful of the saline julep every hour. Tea made of mint and a little cinnamon will be very proper for his ordina- ry drink, especially if an equal quantity of red wine be mixed with it. In case of a violent looseuess, the size of a nutmeg of diascordiwn t or the japonic confection, may be laken two or three times a-day, or oftener if necessary. If a discharge of blood from the nose happens, the steams of warm vinegar may be received up the nostrils frequently ; and the drink must be sharpened with spirits of vitriol, or tincture of roses. In case of a stranguary, the body must be fomented with warm wo* ter, and emollient clysters given three or four times a-day. After the violence of the disease is over, the body should still be kept open with mild purgatives ; as manna, senna, rhubard, or the like. If great weakness and dejection of spirits, or night-sweats, with oth- er symptoms of a consumption, should ensue, we would advise the pa- tient to continue the use of the Peruvian bark, with the elixer of vitri- ol, and to take frequently a glass of generous wine. These together with a milk diet, and riding on horseback, are the most likely means for recovering his strength. CHAPTER XXX, OF COLDS AND COUGHS. IT has already been observed, that colds are the effect of an obstruc- ted perspiration; the common causes of which we have likewise en- deavoured to point out, andrshaU 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 in- OF COLDS AND COUGHS. habitants of every climate are liable to catch cold, nor can even thf greatest circumspection defend them at all times from its attat I tided, if the human body could be kept constantly iu an uniform degree of warmth, such a thing as catching cold would be impossible; but as (feat 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 staffing of the v.< se, unusual weari- ness, pain of the head, &c. give ground to believe that the perspiratfcjl is obstructed, or, in other words, that the person bus caught cold, he pught immediately to lessen his diet, at least th~ usual quantity of his' sold food, and to abstain from allstroug liquors Instead o! flesh, fish* eggs, milk, and other nourishing diet, he ma; read pudding, veal or chicken broth, pauado, gruels, and such hke. His drink may be water gruel sweetened with a little honey ; an iuf s'n.u of bairn or Unseed, sharpened with the juice of orange or lemon ; a decoction of barley and liquorice, with tamarind, or any other cool, diluting, acid liquor. Above all, his supper should be light; as small posset, or water grtf- el 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 vine-whey instead of gruel, which may be sweetened as above. The patient ought to lie longer than usual abed, 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 cot fined 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 pre- vented. But, after the disease has gathered strength by delay, all at- tempts 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 ;->o worse of it, is a very hazardous experiment. No doubt it may sometimes succeed, by suddenly restoring the peispiratiou ; 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 ma) be converted into an inflammatory fever. When those who labour for their daily bread have the misfortune to catch cold, they cannot afford to kse a day or two, iu order to keep themselves warm, and take a little medicine ; by which means the dis»- OF COLDS AND COUGHS. I9@ order 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 eveu such of the labouring poor as can afford to take Gare 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. Hi snct it is, that colds destroy such numbers of mankind. Like any cr.'f ;isv despised, they gather strength from delay, till at length they become invincible. We often see this verified in travellers, who, ra titer than lose a day in the prosecution of their business, throw away their lives by pursuing their journey, even in the severest weath- er, with diss disease upon them. It is certain however, that colds may be too much indulged. When a persm, for every slight cold, shuts himself up in a warm room, and driuks great quantities of warm liquor, it may occasion such a general relaxation -of the solids as will not be easily removed. It will there- fore 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 lias a great tendency to restore the perspiration But care mast be taken that the water be not too warm, otherwise it will do hurt. It should never be much warmer than the blood, aud the patieut should go immediately to bed after using it. Bathing the feet in warm water, lying in bed, and drink- ing warm water gruel, or other weak liquors, will sooner take off a spasm, and restore 'He perspiration, than all the hot sodorific medicines in the world. This k all that is necessary for removing a common cold ; and if i his course be taken at the beginning, it will seldom faiL But when the symptoms do not yield to abstinence, warmth, and di- luting liquors, there is reason to fear the approach of some other dis- ease, as an inflammation of the breast, an ardent fever, or the like. If the pulse therefore be hard and frequent, the skin hot and diy, and the patient complains of his head or breast, it will be necessary to bleed, and to give the cooling powders recommended io the scarlet fe- yer every three or four hours, till they give a stool. It will likewise be proper to put a blistering- plaster on the back, and CHAPTER XXXI. INFLAMMATION OF THE STOMACH, AND OTHER VISCERA. A LL inflammations of the bowels are dangerous, and require the .J~\ most speedy assistance ; as they frequently end in a suppuration, and sometimes in a mortification, which is certain death. CAUSES. — An inflammation of the stomach may proceed from any of the causes which produce an inflammatory fever; as cold liquor drank while the body is warm, obstructed perspiration, or the sudden striking in of any eruption. It may likewise proceed from the acri- mony of the bile, or from acrid and stimulating substances taken into the stomach; as strong vomits or purges, corrosive poisons, and such Jike. When the gout has been repelled from the extremities, either by cold or improper applications, it often occasions an inflammation of the stomach. Hard or indigestible substances taken into the stomach, as jbones, the stones of fruit, &c. may likewise have that effect. SYMPTOMS. — It is attended with a fixed pain and burning heat 5n the stomach ; great restlessness and anxiety; a small, quick, and hard pulse ; vomiting, or, at least, a nausea and sickness ; excessive thirst; coldness of the extremities; difficulty of breathing; cold clam- my sweats; and sometimes convulsions and fainting fits. The stomach 5s swelled, and often feels hard to the touch. One of the most certain signs of this disease, is the sense of pain, which the patient feels upon taking any kind of food or drink, especially if it be either too hot or too cold. When the patient vomits every thing he eats or drinks, is extremely restless, has a hickup, with an intermitting pulse, and fruquent faint- ing fits, the danger is very great. REGIMEN. — All acrimonious, heating and irritating food and drink, are carefully to be avoided. The weakness of the patient may deceive the bystanders, and induce them to give wines, spirits, or oth- er cordials ; but these never fail to increase the disease, and ofteu oc- casion suddeu death. The inclination to vomit may likewise impose on the attendants, and make them think a vomit necessary ; but that too is almost certain death. The fnod must be light, thin, cool, and easy of digestion. It must be given in small quantities, aod should neither be quite cold, nor too hot. This gruel made of barley or oatmeal, light toasted bread dis- solved in boiling water, or very weak chicken broth, is the most proper. The driok should be clear whey, barley-water, water in which toasted INFLAMMATION OF THE INTESTINES. 20 7 Bread has been boiled, or decoctions of emollient vegetables, as liquor- ice and marsh-mallow roots, sarsaparilla, or the like. MEDICLN'E. — Bleeding in this disease is absolutely necessary, and 'is almost the only thing that can be depended on. When the disease proves obstinate, it will often be proper to repeat this operation sever- al times, nor must the low state of the pulse deter us from doing so. The pulse, indeed generally rises upon bleeding, and as long as that is the case, the operation is safe. Frequent fomentations with lukewarm water, or a decoction of emol- lient vegetables, are likewise beneficial. Flannel cloths dipped in these must be applied to the region of the stomach, and removed as they grow cool. They must neither be applied too warm, nor be suffered to con- tinue till they become quite cold, as either of these extremes would ag- gravate the disease. The feet and legs ought likewise to be frequently bathed in luke- %varm water, and warm bricks or poultices may be applied to the soles of the feet. The warm bath, if it can be conveniently used, will be of great service. In this, and all other inflammations of the bowels, an epispastic, or blistering- plaster, applied over the part affected, is one of the best rem- edies I know. I have often used it, and do not recollect one instance wherein it did not give relief to the patient. The only internal medicines which we shall venture to recommend in this disease, are mild clysters. These may be made of warm water, or thin water-gruel; and if the patient is costive, a little sweet oil, hon- ey, or manna, may be added. Clysters simswer the purpose of an in- ternal fomentation, while they keep the body open, and at the same time nourish the patient, who is often in this disease unable to retain any food upon his stomach. For these reasons they must not be neg- lected, as the patient's life may depend on them. INFLAMMATION OF THE INTESTINES. THIS is one of the most painful and dangerous diseases that mankind is liable to. It generally proceeds from the same causes as the inflam- mation of the stomach ; to which may be added costiveness, worms, eat- ing unripe fruits ; or great quantities of nuts, drinking hard, windy malt liquors, as stale bottled beer or ale, sour wine cyder, &c. It may like- wise be occasioned by a rupture, by schirrhous tumours of the intes- tines, or by their opposite sides growing together. The inflammation of the intestines is denominated Iliac passion, Enter- itis, &c. according to the uame of the parts affected. The treatment however is nearly the same whatever part of the intestinal canal be the seat of the disease ; we shall therefore omit these distinctions, lest they should perplex the rende-r. 208 INFLAMMATOm OF THE INTESTINES, The symptoms here are nearly the same as in the foregoing disease! only the pain, if possible, is more acute, and is situated lower. The vomiting is likewise more violent, and sometimes even the excrements, together with the clysters, are discharged by the mouth. The pa- tient is continually belching up wind, and has often an obstruction of his urine. While the pain shifts, and the vomiting only returns at certain inter- vals, and while the clysters pass downwards, there is ground for hope ; but when the clysters and faces are vomited, and the patient is excee- ding weak, with a low fluttering pulse, a pale countenance, and a disa- greeable or stinking breath, there is great reason to fear that the conr sequences will prove fatal. Clammy sweat, black fcetid stools, with a small intermitting pulse, and a total cessation of pain, are signs of a mortification already begun, and of an approaching death. REGIMEN. — The regimen in this disease is in general the same as in an inflammation of the stomach. The patient must be kept quiet, avoiding cold, and all violeut passions of the mind. His food ought to be very light, and given in small quantities ; his drink weak, and diluting ; as clear whey, barley-water, and such like. MEDICINE. — Bleeding in this, as well as in the inflammation of the stomach, is of the greatest importance. It should be performed as soon as the symptoms appear, and must be repeated according to the strength of the patient, and the violence of the disease. A blistering plaster is here likewise to be applied immediately over the part where the most violent pain is. This not only relieves the pain of the bowels; but even clysters and purgative medicines, which before had no effect, will operate when the blister begins to rise. Fomentations and laxative clysters are by no means to be omitted. The patient's feet and legs should frequently be bathed in warm water ; and cloths dipped into it applied to his belly. Bladders filled with ■warm water may likewise be applied to the region of the naval, and warm bricks, or bottles filled with warm water, to the soles of the'feet. The clysters may be made of barley-water or thin gruel with salt, and softened with sweet oil or fresh butter. These may be administer- ed every two or three hours, or ofteuer, if the patient continues costive. If the disease does not yield to clysters and fomentations, recourse must be had to pretty strong purgatives : but as these, by irritating the bowels, often increase their contraction, and by that means frustrate their own intention, it will be necessary to join them with opiates, which by allayiog the pain, and relaxing the spasmodic contractions of the guts, greatly assist the operation of purgatives in this case. What answers the purpose of opening the body very well, is a solu- tion of the bitter purging salts. Two ounces of these may be dissolv- ed in an English pint of warm water, or thin gruel, and a tea-spoonful of it taken every half hour till it operates. At the same time fifteen, twenty or twenty-five drops of laudanum may be given in a glass of INFLAMMATION OF THE INTESTINES. 209 peppermint or simple cinnamon- water, to appease the irritation, and pre- vent the vomiting, &c. Acids have often a very happy effect in staying the vomiting, and appeasing the other violent symptoms of this disease. It will therefore be of use to sharpen the patient's drink with cream of tartar, juice of lemon ; or, when these cannot be obtained, with vinegar. But it often happens that no liquid whatever will stay on the stomach. In this case the patient must take purging pills. I have generally found the following answer very well : Take jallap in powder, and vitriola-r ted tartar, of each half a drachm, opium one graiu, Castile soap as much as will make the mass fit for pills. These must be taken at one dose, and if they do not operate in a few hours, the dose may be repeated. If a stool cannot be procured by any of the above means, it will be necessary to immerse the patient in warm water up to the breast. I have often seen this succeed when other means had been tried in vain. The patient must continue in the water as long as he can easily bear it without fainting, and if one immersion has not the desired effect, it may- be repeated as soon as the patient's strength and spirits are recruited. It is more safe for him to go frequently into the bath, than to continue too long at a time, and it is often necessary to repeat it several times before it has the desired effect. It has sometimes happened, after all other means of procuring a stool had been tried to no purpose, that this was brought about by immersing the patient's lower extremities in cold water, or making him walk on a wet pavement, and dashing his legs and thighs with the cold water. This method, when others fail, at least merits a trial. It is indeed at- tended with some danger ; but a doubtful remedy is better than none. In desperate cases it is common to give quicksilver. This may be given to the quantity of several ounces, or even a pound, but should not exceed that.* When there is reason to suspect a mortification of the guts, this medicine ought not to be tried. In that case it cannot cure the patient, and will only hasten his death- But when the ob- struction is occasioned by any cause that can be removed by force, quicksilver is not only a proper medicine, but the best that can be administered, as it is the fittest body we know for making its way through the intestinal canal. If the disease proceeds from a rupture, the patient must be laid with his head very low, and the intestines returned by gentle pressure with the hand. If this, with fomentations and clysters, should not succeed, * When quicksilver is given in too large quantities, it defeats its own intention, as it drags down the bottom of the stomach, which pre- vents its getting over the Pylorus. In this case the patient should be hung up by the heels, in order that the quicksilver may be discharged by his mouth. 210 OF THE COLIC. recourse must be bail to a surgical operation, which may give tiie ]/?*• tient relief. Such as would avoid this excruciating and dangerous disease, must . take care never to be too loug without a stooi. Some who have died of it have had several pounds of hard dry faeces taken out of their gufts. They should likewise beware of eating too freely of sour or unripe fruits, or drinking stale windy liquors, &c. I have known it brought on by living too much on baked fruits, which are seldom good. It likewise proceeds frequently from cold caught by wet clothes, &c. but especially frcaa wet feet, OF THE COLIC. THE colic has a great resemblance to the two preceding diseases, both in its symptoms and method of cure. It is generally attended with costiveness and acute pain of the bowels; and requires diluting diet, evacuations, fomentations, Arc. Colics are variously denominated according to their causes, as the flatulent, the bilious, the hysteric, the nervous, &c. As each of these require a particular method of treatment, we shall point out their most general sj mptoms, and the means to be used for their relief. The flatulent, or wind colic, is generally occasioned by an indiscreet use of unripe fruits, meats of hard digestion, windy vegetables, fer- menting liquors, and such like. It may likewise proceed from an obstructed perspiration, or catching cold. Delicate people, whose digestive powers are weak, are most liable to this kind of colic. The flatulent colic may either affect the stomach or intestines. It is attended with a painful stretching of the affected part. The patient feels a rumbling in his guts, and is generally relieved by a discharge of wind, either upwards or downwards. The pain is seldom confiued to any particular part, as the vapour wanders from one division of the bowels to another till it finds a vent. When the disease proceeds from windy liquor, green fruit, sour herbs, or the like, the best medicine on the first appearance of the symptom is a dram of brandy, gin, or any good spirits. The patieut should likewise sit with his feet upon a warm hearth stone, or apply warm bricks to them ; and warm cloihs may be applied to his stomach and bowels. This is the only colic wherein ardent spirits, spiceries, or any thing c.- a hot nature, may be ventured upon. ]S"or indeed are they to be used here unless at the very beginning, before any s} mptoms of inflam- mation appear. We have reason to believe, that a colic occasioneel by wind or Hatulent food might always be cured by spirits and warm liquors, if they were taken immediately upon perceiving the first un- easiness; but when the pain has continued for a considerable time, and there is reason to fear an inflammation of the bowels is already begun* Vf THE COLIC. 2U pji hot things are to be avoided as poison, and the patient is to be treated in the same manner as for the inflammation of the intestines. Several kinds of food, as honey, eggs, &c. occasion colics in some particular constitutions. I have generally found the best method of cure for these, was to drink plentifully of small diluting liquors, as water-giuel, small posset, waier with toasted bread soaked in it, &c. Colics which proceed from excess and indigestion generally cure themselves by occasioning vomiting ot purging. These discharges are by no means to be stopped, but promoted by drinking plentifully of warm water, or weak posset. When their violence is oyer, the pa- tient may take a dose of rhubarb, or any other gentle purge, to carry off the dregs of his debauch. Colics which are occasioned by wet feet, or catching cold, may generally be removed at the beginning, by bathing the feet and legs in warm water, and drinking such diluting liquors as will promote the perspiration, as weak whey, or water gruel, with a small quantity of spirits in it. Those flatulent colics, which prevail so much among country peo- ple, might generally be prevented were they careful to change their clothes when they get wet. They ought likewise to take a dram, or to drink some warm liquor after eating any kind of green trash. We do not mean to recommend the practice of dram drinking, but in this case ardent spirits prove a real medicine, and indeed the best that can be administered. A glass of good peppermint- water will have nearly the same effect as a glass of brandy, and in some cases is rather to be preferred. The bilious colic is attended with very acute pains about the region cf the naval. The patient complains of great thrist, and is generally cos- tive. He vomits a hot, bitter, yellow -oloured bile, which being dis- charged, seems to afford some relief, but is quickly followed by the same violent pain as before. As the distemper advances, the propen- sity to vomit sometimes increases so as to become almost continual, and the proper motion of the intestines is so far perverted, that there are all" the symptoms of impending iliac passion. If the patient be young and strong, and the pulse fall and frequen'.* it will be proper to bleed, after which clysters may be administered. Clear whey or gruel, sharpened with the juice of lemon, or cream of tartar, must be drank freely. Small chicken broth, with a little manna dissolved in it, or a slight decoction of tamarinds, are likewise very proper, or any other thin, acid, opening liquor. Besides bleeding and plentiful dilution, it will be necessary to foment the beliy with cloths dipped in warm water, and if this should not suc- ceed, the patient must be immersed up to tlie breast in warm water. In the bilious colic the vomiting is often very difficult to re ■ strain. When this happens, the patient may drink a decoction of toast- ed bread, or an infusion of garden mint in boiling water. Should these 212 OP THE COLIC not have the desired effect, the saline draught, with a few drops of latl* dajmoi in it, may be given, and repeated according to the urgency of the symptoms. A. small quantity of Venice treacle may be spread in lorm of a cataplasm, and applied to the pit of the stomach. Clysters, with a proper quantity of Venice treacle or liquid laudanum in them, may likewise be frequently administered. The hysteric colic bears a great resemblance to the bilious. It is attended with acute pains about the region of the stomach, vomiting, &c. What the patient vomits in this case is commonly of a greeuish colour. There is a great sinking of the spirits, with dejection of mind and difficulty of breathing, which are the characteristic symp- toms of this disorder. Sometimes it is accompanied with the jaundice, but this generally goes off of its own accord in a few days. In this colic all evacuations, as bleeding, purging, vomiting, &c. do hurt. Every thing that weakens the patient, or sinks the sprits, is to be avoided. If however the vomitiug should prove violent, luke warm water, or small posset, may be drank to cleanse the stomach. Afterwards the patient may take fifteen, twenty, or twenty-five drops of liquid laudanum in a glass of cinnamon-water. This may be re- peated every tenor twelve honrs till the symptoms abate. The patient may likewise take four or five of the foetid pills every six hours, and drink a cup of penny-royal tea after them. If asafceti- da should prove disr-greeable, which is sometimes the case, a tea-spoon- fid of the tincture of castor in a cup of penny royal tea, or thirty or forty drops of the balsam of Peru dropped upon a bit of loaf sugar may be taken in its stead. The anti-hysteric plaster may also be used which has often a good effect. The nervous colic prevails among miners, smelters of lead, plumb- ers, the manufacturers of white had, &c. It is very common in the cyder counties of England, and is supposed to be occasioned by the leaden vessels used in preparing that liquor. It is likewise a fre- quent disease in the West-Indies, where it is termed the diy belly-ache. No disease of the bowels is attended with more excruciating pain than this. Nor is it toon at an end. I have known it continue eight or ten days with very little intermission, the body all the while con- tinuing bound in spite of medicine, yet at length yield, and the patient recover.* It generally however, leaves the patient weak, and often ends in a palsy. The general treatment of this disease is so nearly the same with that of the iliac passion, or iuflammaiion of the guts, that we shall not insist * As the smoke of tobacco thrown into the bowels will often pro- cure a stool when all other means have failed, an apparatus for this purpose ought to be kept by every surgeon. It may be purchased at a small expense, and will be of service in several ether cases, as the recover}- of drowned persons, &c INFLAMMATION OF THE KIDNEYS. 215 Upon it. The body is to be opened by mild purgatives given in small doses, and frequently repeated, and their operation must be assisted by soft oily clysters, fomentations, &c. The castor oil is reckoned peculiarly proper in this disease. It may both be mixed with the clys- ters and given by the mouth. f The Barbadoes tar is said to be an efficacious medicine in this com- plaint. It may be taken to the quantity of two drachms three times a-day, or ofteaer if the stomach will bear it. This tar, mixed with an «qual quantity of strong rum, is likewise proper for rubbing the spine, in case any tingling or other symptoms of the palsy are felt. When the tar cannot be obtained, the back may be rubbed with strong spirits, or a little oil of nutmegs, or of rosemary. If the patient remains weak and languid after this disease, he must take exercise on horseback, and use an infusion of the Peruvian-bark in wine. When the disease ends in a palsy, the Bath- waters are found to be extremely proper. To avoid this kind of colic, people must shun all sour fruits, acids, and austere liquors, &c. Those who work in lead Wight never to go to their busiuess fasting, and their food should be oily or fat. They may take a glass of sallad oil, with a little brandy or rum, every morn- ing, but should never take spirits alone. Liquid aliment is best for them ; as fat broths, Arc but low living is bad. They should frequent- ly go a little out of the tainted air ; and should never suffer themselves to be costive. In the West-Indies and on the coast of Guinea, it has been found of great use for preventing this colic, to wear a piece of flannel round the waist, and to drink an infusion of ginger by way of tea. Sundry other kinds of this disease might be mentioned, but too ma- ay distinctions would tend only to perplex the reader. Those already mentioned are the most material, and should indeed be attended to, as their treatment is very different. But even persons who are not in a condition to distinguish very accurately in these matters, may never- theless be of great service to patients in colics of every kind, by only observing the following general rules, viz. To bathe the feet and legs in warm water; to apply bladders filled with warm water; or cloths wrung out of it, to the stomach and bowels ; to make the patient drink freely of diluting mucilaginous liquors ; and to give him an emollient clyster every two or three hours. Should these not succeed, the pa- tient ought to be immersed in warm water. INFLAMMATION OF THE KIDNEYS. CAUSES. — This disease may proceed from any of those causes which produce an inflammatory fever. It may likewise be occasion- f The doae is from one table-spoonful to two or three, if necessary tm open the body. 21 -4 INFLAMMATION OF THE KIDNEYS. ed by wounds or bruises of the kidneys ; small stones or gravel lodg- ing within them ; by Strong diuretic medicines, as spirits of turpentine, tincture of candiarides, &c. Violent motion, as hard riding or walk- ing, especially in he' weather, or whatever drives the blood too forci- bly into the kidneys, may occasion the malady. It may likewise pro- ceed from 1} ing too soft, too much on the back, involuntary contrac- tions, or spasms in the urinary vessels, &c. SYMPTOMS. — There is a sharp pain about the region of the kidneys, with some degree of fever, and a stupor or dull pain in the thigh ofthe affected side. The mine is at first clear, and afterwards of a reddish colour ; but in the worst kind ofthe. disease it generally continues pale, is passed with difficulty, and commonly in small quan- tities at a time. The patient feels great uneasiness when he endeav- ours to walk or sit upright. He lies with most case on the affected side, and has generally a nausea or vomiting, resembling that which happens in the colic This disease however may be distinguished from the colic by the pain being seated farther back, and by the difficulty of passing urine •with which it is constantly attended. REGIMEN. — Every thing of a heating or stimulating nature is to be avoided. The foed must be thin and light; as panado, small broths, with mild vegetables, and the like. Emollient and thin liquors must be plentifully drank ; as clear whey, or balm- tea sweetened with boney, decoction of marsh mallow roots : with barley and liquorice, «fcc. The patient, notwithstanding the vomiting, must constantly keep sipping small quantities of these or other diluting liquors. Nothing «o safely and certainly abates the inflammation, and expel's the ob- structing cause, as copious dilution. The patient must be kept easy, cjuiet, and free from cold, as long as any symptoms of inflammation tremain. MEDICINE — Bleeding is generally necessary, especially at the beginning. Ten or twelve otmcers may be let from the arm or foot ■with p. lancet, and if the pain and inflammation continue, the operation may be repeated in twenty four hours, especially if the patient be of a full habit. Leeches may likewise be applied to the hemorrhoidal veins, as a discharge from these will geatly relieve the patient. Cloths dipped in warm water, or bladders filled with it, must be ap- plied as near as possible to the part affected, and renewed as they grow «ool. If the bladders be filled with a decoction of mallows and camomile flowers, to which a little saffron is added, and mixed with about a third part of new milk, it will be still more beneficial. Emollient clysters ought frequently to be administered ; and if these do not open the body, a little salt and honey or manna may be added to them. The same course is to be followed where gravel or stone is lodzed »c the kidney, but when the gravel or stone is separated from the kid- INFLAMMATION OF THE BLADDER. 2'1> »ey, and lodges io the Ureter,* it will be propel", besides the fomenta- tions, to rub the small of the back with sweet oi!, and to give gentle diuretics ; as juniper-water, sweetened with the syrup of marsh-mal- lows : a tea-spoonful of the sweet spirits of nitre, with a few drops of laudanum, may now and then be put in a cup of the patient's drink. He ought likewise to take estercise on horseback, or in a carriage, if he be able to bear it. Whcj tiie disease is protracted beyond the seventh or eighth days. and the patient complains of a stupor and heaviness of the part, has frequent returns of dullness, shivering, &c. there is reason to suspect that matter is forming in the kidney, and that an abscess will ensue. When matter in the urine shews that an ulcer is already formed in- the kidney, the patient must be careful to abstain from all acrid, sour and salted provisions, and to live chiefly upon mild mucilaginous herbs and fruits, together with the broth of young animals, made with bar- ley, and common pot herbs, &c. His drink may be whey, and but- ter milk that is Dot sour- The latter is by some reckoned a specific remedy in ulcers of the kidneys. To answer tbijS character however it must be drank tor a considerable time. Chalybeate waters have likewise been found beneficial in this disease. This medicine is easily obtained, as it is fouud in every part of Great- Britian. It must like- wise be used for a considerable time, iu order to produce any salutary- effects. Those who are liable to frequent returns of inflammation, or obstruc- tions of the kidneys, must abstain from wines, especially such as abound with tartar; and their food ought to be light, and of easy diges- tion. They should use moderate exercise, and should not lie too hot^ nor too much on their back. INFLAMMATION OF THE BLADDER. THE inflammation of the bladder proceeds, in a great measure, from the same causes as that of the kidneys. It is known by an acute pain towards the bottom of the belly, and difficulty of passing urine, with some degree of fever, a constant inclination to go to stool, and a perpet- ual desire to make water. This disease must be treated on the same principles as the one im- mediately preceding. The diet must be light and thin, and the drink of a cooling nature. Bleeding is very proper at the beginning, and u> robust constitutions it will often be necessary to repeat it. The lower ' part of the belly should he fomented with warm water or a decoction * The ureters are two long and small canals, one on each side which carry the urine from the bason of the kidneys to the bladder. They are sometimes obstructed by small pieces of gravel falling down from'- the- kidneys,, and lodging in them. 216 INFLAMMATION OF THE LIFER. of mild vegetables ; and emollient clysters ought frequently to be ad- ministered, &c. The patient should abstain from every thing that is of a hot, acrid and stimulating quality, and should live entirely upon small broths, gruels, or mild vegetables. A stoppage of urine may proceed from other, causes besides an in- flammation of the bladder ; as a swelling of the hemorrhoidal veins, hard faces lodged iu the rectum, a stone in the bladder, excrescences in the uriuary passages, a palsy of the bladder, hysteric affections, ought likewise to beware of cold moiftHre P or whatever may obstruct the perspiration, an! should wear flannel nert the skin. All violent passicus, as fear, anger, Sic. are like* wise carefully to be guarded fgniust. OF VOMITING. VOMITING may proceed from various causes; as excess in eat' ing and drinking; foulness of ttoe stomach; the acrimony of the ali- ment; a translation of 'ie morbific matter of ulcere, of (he gout, the erysipelas, or other diseases, to the stomach. It may likewise proceed from a looseness having been too suddebh stopped ; from the stoppage of any customary evacuation, as the bleeding piles, the menses, &c. from a weakness of the stomach, the colic, the iliac passion, a rupture, a fit of the gravel, worms ; or from any kind of poison taken into the stomach. It is an usual symptom of injuries done to the brain; as contusions, compressions, &c. It is likewise a symptom of M-ounds ©r inflammations of the diaphragm, intestines, spleen, liver, kidneys, &c. Vomiting may be occasioned by unusual motions, as sailing, being drawn backwards in a carriage, Arc. It may likewise be excited by violent passions, or by the idea, of nauseous or disagreeable objects especially of such things as have formerly produced vomiting. Some- times it proceeds from a regurgitation of the bile into the stomach : in this case, what the patient vomits is generally of a yellow or greenish colour, and has a bitter taste. Persons who are subject to nervous affections are often suddenly siezed with violent fits of vomiting. Lastly, vomiting is a common symptom of pregnancy. In this ca6e it generally comes on about two weeks after the stoppage cf the memes, and continues during the first three or four months. OF VOMITING. 22$ When vomiting proceeds from a foul stomach or indigestion, it m »ot to be considered as a disease, but as the cure of a disease. It ought therefore to be promoted by drinking lukewarm water, or thia gruel, ft' this does not put a stop to the vomiting, a dose of ipecac- uanha may be taken, and worked off with weak camomile-tea. When the retrocession of the gout, or the obstruction of customary- evacuations, occasion vomiting, all means must be used to restore these discharges f or, if that cannot be effected, their place must bo supplied by others, as bleeding, purging, bathing the extremities in warm water, opening issues, setons, perpetual blisters, &c. When vomiting is the effect of pregnancy, it may generally be mitigated by bleeding, and keeping the body gently open. The bleeding however ought to be in small quantities at a time, and the purgatives should be of the mildest kiud, as figs, stewed prunes, man- na, or senna. Pregnant women are most apt to vomit in the morning immediately after getting out of bed, which is owing partly to the change of posture, but more to the emptiness of the stomach. It may generally be prevented by taking a disii of coffee, tea or some light breakfast in bed. Pregnant women who are aiflicted with vomiting, ©ught to be kept easy both in body and mind. They should neither allow their stomachs to be quite empty, nor should they eat much at once. Cold water is a very proper drink iu this case ; if the stomach be weak, a* little brandy may be added to it. If the spirits are low, and the person apt to faint, a spoonful of cinnamon- water, with a little marmalade of quinces or oranges, may be taken. If vomiting proceeds from weakness of the stomach, bitters will be of service.. Peruvian bark infused in wine or brandy, with as much rhubarb as will keep the body gently open, is an excellent medicine in this case. The elixir of vitriol is also a good medicine. It may be taken in the dose of fifteen or twenty drops, twice or thrice a- day, iu a glass of wine or water. Habitual vomitings are sometimes allevia- ted by making oysters a principle part of diet. A vomiting which proceeds from acidities in the stomach, is relieved by alkaline purges. The best medicine of this kind is the magnesia alba, a tea-spoonful of which may be taken in a dish of tea or a little milk, three or four times a- day, or oftener if necessary, to keep the feody open* When vomiting proceeds from violent passions, or affections of the mind, all evacuants must be carefully avoided, especially vomits. These are exceedingly dangerous. The patient in this case ought to be kept perfectly easy and quiet, to have the mind soothed, and to take some gentle cordial, as negus, or a little brandy and water, lo which a few drops of laudanum may occasionally be added. When vomiting proceeds from spasmodic affections of the stomach, wmsk castor, and other antispasmodic medicines are of use. Warm and aromatic plasters have likewise a good effect. The stomach- 224 OF THE DIABETES, &e. plaster of the London or Edinburgh dispensatory may be applied to the pit of the stomach, or a piaster of theriaca, which will an- swer rather better. Aromatic medicines may likewise be taken inward- ly, as cinnamon or mint tea, wine with spiceries boiled in it, &c. The region of the stomach may be rubbed with aether, or if that cannot be had, with strong brandy or other spirits The belly should be fo- mented with warm water, or the patient immersed up to the breast in a warm bath. I have always found the saliue draughts taken in the act of efferves- cence, of singular use in stopping of vomiting, from whatever cause it proceeded. These may be prepared by dissolving a drachm of the salt of tartar in an ounce and a half of fresh lemon juice, and adding to it an ounce of pepper-mint water, the same quantity of simple cinna- mon water, and a little white sugar. This draught must be swallowed before the effervescence is quite over, and may be repeated even two hours, or oftener, if the vomiting be violent. A violent vomiting has sometimes been stopped by cupping on the region of the stomach after all other means hail failed. As the least motion will often bring on the vomiting again, even after it has been stopped, the patient must avoid all manner of action. The diet must be so regulated as to sit easy upon the stomach, and nothing should be taken that is hard of digestion. We do not however mean that the patient should live entirely upon slops. Solid food, in this case, often sits easier on the stomach than liquids. CHAPTER XXXIII. OF THE DIABETES, AND OTHER DISORDERS OF THE KIDNEYS AND BLADDER. THE diabetes is a frequent and excessive discharge of urine. It is seldom to be met with among young people ; but often attacks persons in the decline of life, especially those who follow the more violent employments, or have been hard drinkers in their youth. CAUSES. — A diabetes is often the consequence of acute diseases, as fevers, fluxes, &c. where the patient has suffered by excessive evacuations; it may also be occasioned by great fatigue as riding long journies upon a hard trotting horse, carrying heavy burdens. Sec. It may be brought on by hard drinking, or the use of strong stimulating diuretic medicines, as tincture of cantharides, spirits of turpentine, audi such like. It is often the effect of drinking too great quantities of rui*- OF THE DIABETES, &c. 22* £ral waters. Many imagine that these will do them no service unless they be drank in great quantities, by which mistake it often happens lhat they occasion worse diseases than those they were intended to cure. In a word, this disease mayeither proceed from too great a laxity of the organ, which secrete the urine, from something that stimulates the kid- neys too much, or from a thin dissolved state of the blood, which makes too great a quantity of it run off by the urinary passages. SYMPTOMS.— In a diabetes, the urine generally exceeds in quan- tity all the liquid food which the patient takes. It is thin and pale, of a sweetish taste, and an agreeable smell. The patient has a continued thirst, with some degree of fever : his mouth is dry, and he spits fre- quently a frothy spittle. The strength fails, the appetite decays, and the flesh wastes away till the patient is reduced to skin and bone- There is a heat of the bowels, and frequently the loins and feet are swelled. This disease may generally be cured at the beginning ; but after it has continued long, the cure becomes very difficult. In drunkards, and very old people, a perfect cure is not to be expected. REGIMEN.--Eyery thing that stimulates the urinary passages, or tends to relax the habit, must be avoided. For this reason the patient should live chiefly on solid food. His thirst may be quenched with acids ; as sorrel, juice of lemon, qr vinegar. The mucilaginous vegeta- bles, as rice, sago, and salop, with milk, are the most proper food. Of animal substances, shell fish are to be prefered ; as oysters, crabs, &c. The drink may be Bristol- water. When that cannot be obtained, Jirae-water, in which a due proportion of oak bark has been macer- ated, may be used. The white decoction, with isinglass dissolved in it, is likewise a very proper drink. The patient ought daily to take exercise, but it should be so gentle as not to fatigue him. He should lie upon a hard bed or matrass. Nothing hurts the kidneys more than lying too soft. A warm dry air, the use of a flesh 7 brush, and every thing that promotes perspiration is of service. For this reason the patient ought to wear flannel next to his skin. A large strengthening plaster may be applied to the" back ; or, what will answer better, a great part of the body may be wrapped in plaster. MEDICINE. — Gentle purges, if the patient be not too much weakened by the disease, have a good effect. They may consist of rhubarb, with cardamum seeds, or any other spiceries, infused in wine, and may be taken in such quantities as to keep the body gently open. The patient must next have recourse to astringents and corroborants. Half a drachm of powder made of equal parts of alum and the inspis- sated juice commonly called Terra Japonica, may be taken four times a-day, or oftener, if the stomach will bear it. The alum must first be melted in a crucible, afterwards they mav both be pounded together, 29 22-6 OF A SUPPRESSION. OF URINE. Along willi every dose of this powder the patient may take a tea-cup- ful of the tincture of roses. If the patient's stomach cannot bear the alum in substance, whey may be made of it, and taker, in the dose of a tea-cupful three or four times a-khxy. The alum whey is prepared by boiling two English quarts of milk over a slow fire, with three drachms of alum, till the curd separates Opiates are of service in this disease, even though the patient rests well. They take off spasm and irritatioD, and at the same time lessen the force of the circulation. Ten or twelve drops of liquid laudanum may be taken iu a cup of the patient's drink three or foirr times a-day. The hot corroborants which we know, are the Peruvian bark, and wine. A drachm of bark may be taken in a glass of red pert or claret three times a day. The medicine will be buih more efficacious and less disagreeable, if fifteen or twenty drops of the acid elixir of vitriol be added to each dose. Such as cannot take the bark in sub- stance may use the decoction, mixed with an equal quantity of red wine, aud sharpened as above. There is a disease incident to labouring people in the decline of life, called incontinence of urine. But this is very different from a diabetes, as the water passes off involuntarily by drops, and does not exceet the usual quantity. This disease is rather troublesome than dangerous. It ia owing to a relaxation of the &phiacture of the bladder and is often the effect of a palsy. Sometimes it proceeds from hurts or injuries occasioned by blows, bruises, preternatural labours, &c« Sometimes it is the effect of a fever. It may likewise be occasioned by a long use of strong diuretics, or of stimulating medicines injected into the bladder. This disease may be mitigated by the use of astringent and corroba- rating mediciues, such as have been mentioned above ; but we do uot remember ever to have seeu it cured- In an iucontinency of urine, from whatever cause, a piece of sponge ought to be worn, or a bladder applied in such a manner as to prevent the urine, from galling and excoriating the parts.* OF A SUPPRESSION OF. URINE. IT has already been observed that a suppression of urine may pro- ceed from various causes; as au inflammation of the kidneys or blad- der; small stones or gravel lodging in the urinary passages, hard faces l)'wi Though the soap-lees and lime-water are the most powerful meii* cines which have hitherto been discovered for the stoae; yet there are some things of a more simple nature, which in certain cases are found to be beneficial, and therefore deserve a trial. An infusion of the seeds of daucus sylvestris or wild carrot, sweetened with honey, has been found to give considerable ease in cases where Uie stomach could not bear any thin? of an acrid nature. A. decoction of raw coffee-berries, taken morning and eveniog, :o the quantify ol eight or ten ounces, with ten drops of sweet spirits of nitre, has likewise been found very efficacious in bringing away large quantities of earthy matter in flake3. Honey is likewise found to be of considerable ser- vice, and may be taken in gruel, or in any other form that is more agreeable. The ooly other medicine which we shall mention is the uva vrsi. It has been greatly extolled of late both for the gravel and stone. It seems however to be in all respects inferior to the soap and limc-wa- » er ; but it is less disagreeable, and has frequently to my knowledge, relieved gravelly complaints. It is generally taken in powder from half a drachm to a whole drachm, two or three tunes a day. It may however be taken to the quantity of &even or eight drachms a-day, vith great safety and good effect. CHAPTER XXXIV. OF INFOLVNTARY DISCHARGES OF BLOOD. SPONTANEOUS or involuntary discharges of blood often hap pen from various parts of the body. These, however, are so far from being always dangerous, that ?hey often prove salutary. When Euch discharges are critical, which is frequently the ca?e in fevers, they ought not to be stopped. Nor indeed is it proper at any time t© stop them, unless they be so great as to endanger the patient's life. Most people, afraid of the smallest discharge of blood from any part of the body, fly immediately to the use of styptic and astringent medi- cines, by which means an inflammation of the brain, or some other fa- tal disease, is occasioned, which, had the discharge been allowed to go on, might have been prevented. lime with one of pot-ashes, and suffering them to stand till the lixivium be formed, which must be carefully filtrated before it be used. If the solution does not happen readily, a small quantity of water may b» sdded to the mixture. mVOLVNTARY DISCHARGES, &c. m Periodical discharges of blood, from whatever part of the body they proceed, must not be stopped. They are always the efforts of Nature to relieve herself; and fatal diseases have often been ihe consequence of obstructing them. It may indeed be sometimes necessary to check the violence of such discharges ; buf even this requires the greatest; caution. Instances might be given where the stopping of a small peri- odical flux of blood, from one of the fingers, has proved fatal Jo th© health. In the early period of life, bleeding at the nose is very common. Those who are farther advanced in years are more liable to hemop- toe, or discharge of blood from the lungs After the middle period of life, hemorrhoidal fluxes are most common: and in the 'decline of, life, discharges of blood from the urinary passages. luvoluutary fluxes of blood may proceed from very different and quite opposite causes Sometimes they are owing to a particular con- stitution of the body, as a sanguine temperament, a laxity of the ves- sels, a plethoric habit, &c, At other times they proceed from a de- termination of the blood towards one particular part, as the head, the hemorrhoidal veins, &zc. They may likewise proceed from an in- flammatory disposition of the blood, in which case there is generally some degree of fever : this likewise happens when the flux is occa- sioned by an obstructed perspiration, or a stricture upon the skin, the bowels, or any particular part of the system. But a dissolved state of the blood will likewise occasion haemorrha- ges. Thus, in putrid fevers, the dysentar,y, the scurvy, the malig- nant small pox, &c. there are often very great discharges of blood from different parts of the body. They may likewise be brought on by too liberal an use of mediciue, which tends to dissolve the blood, as can- tharides, the volatile alkaline salts, &c. Food of an acrid or irritating quality may likewise occasion hernorihages ; as also strong purges and vomits, or any thing that greatly stimulates the bowels. Violent passions or agitations of the mind will likewise have this ef- fect. These often cause bleeding at the nose, and I have known thera sometimes occasion an hemorrhage in the brain. Vioient efforts of the body, by overstraining or heating the vessels, may have (he same effect, especially when the body is long kept ha an unnatural posture, as hanging the head very low, &c. The cure of an hemorrhage must be adapted to its cause. Whea it proceeds from too much blood, or a tendency to inflammation, bleed- ing, with gentle purges and other evacuations, will be necessary. It will likewise be proper for the patient in this case to live chiefly upoa a vegetable diet, to avoid all strong liquors, and food that is of an acrid, hot, or stimulating quality. The body should be kept coo!, and the mind easy. When an hosmorrhage is' owing to a putrid or dissolved state of the biood; the patient ought to live shiefly upon acrid fruits with milk an«i 2S3 OF BLEEDING AT THF. NOSE. vegetables of a nourishing nature, as sago, salop, &c. His drink may' be wine diluted with water, and sharpened with the juice of lemon, vinegar, or spirits of vitriol. The best medicine iu this case is the Peruvian bark, which may be taken according to the urgency of the symptoms. When a flux of blood is the effect of acrid food, or of strong stimu- lating medicines, the cure is to be effected by soft mucilaginous diet. The patient may likewise take frequently about the bulk of a nut- meg of Locatelli's balsam, or the same quantity of spermaceti. When au obstructed perspiration, or a stricture upon any part of the system, is the cause of an haemorrhage, it may be removed by driukins: warm diluting liquors, lying a-bed, bathing the extremities in warm water, &c. OF BLEEDING AT THE NOSE. BLEEDING at the nose is commonly preceded by some degree oi quickness of the pulse, flushing in the face, pulsation of the temporal arteries, heaviness in the head, dimness of the sight, heat and itching of the nostrils, &c. To persons who abound with blood this discharge is very salutary. It often cures a vertigo, the head ache, a phreuzy, and even an epi- lepsy. In fevers, where there is a great determination of blood to- wards the head, it is of the utmost service. It is likewise beneficial in inflammations of the liver and spleen, and often in the gout and rheuma- tism. In all diseases where bleeding is necessary, a spontaneous dis- charge of blood from the nose is of much more service than the same quantity let with the lancet. In a discharge of blood from the nose, the great point is to deter- mine whether it ought to be stopped or not. It is a common practice to stop the bleeding, without considering whether it be a disease, or the cure of a disease. This conduct proceeds from fear ; but it has often bad, and sometimes fatal consequences. When a discharge of blood from the nose happens in an inflammatory disease, there is always reason to believe that it may prove salutary ; and therefore it should be suffered to go on, at least as long as the patient is not weakened by it. When it happens to persons in perfect health, who are full of blood, it ought not to be suddenly stopped, especially if the symptoms of ple- thora, mentioned above, have preceded it. In this case it cannot be stopped without risking the patient's life. In fine, whenever bleeding at the nose relieves any bad symptom, and does not proceed so far as to endanger the patient's life, it ought not to be stopped. But when it returns frequently, or continues till the pulse becomes low, the extremities begin to grow cold, the lips pair:. 0.F BLEEDING AT THE NOSE. 233 at the patient complains of being sick or faint, it must immediately be plopped. For this purpose the patient should be set nearly upright, with Iris head reclining a little, and his legs immersed ia water about (he warmth of new milk. His hands ought likewise to be put in lukewarm wa- ter, and his garters may be tied a little tighter than usual. Ligatures may be applied 'to the arms, about the place where they are usually made for bleeding, and with nearly the same degree of tightness. These must be gradually slackened as the blood begins to stop, and remoter! entirely as soon as it gives over. Sometimes dry lint put up the nostrils will stop the bleeding. When this does not succeed, dossils oi lint dipped in strong spirits of wine, may be put up the nostrils, or if that cannot be had, they may be dipped in brandy. Blue vitriol dissolved in water may likewise be used for this purpose, or a tent dipped in the Avhite of an egg well beat up, may be rolled in a powder made of equal part? of white sugar, burnt alum, and white vitriol, and put up the nostril from whence the blood issues. Internal medicines can hardly be of use here, as they havr time to operate. It may not however be amiss to give the patient half an ounce of Glauber's salt, and the same quantity of manna, dissolved in four or five ounces of barley-water. This may be taken at a draught, and repeated, if it does not operate, in a few hours. Teu or twelve grains of nitre, ma y be taken in a glass of cold water and vinegar every hour, or oftener, if the stomach will bear it. If a stronger medicine be necessary, a tea-cupful of the tincture of roses, •with twenty or thirty drops of the weak spirit of vitriol, may be taken every hour. When these things cannot be had, the patient may drink water, with a little common salt in it, or equal parts of water and vinegar.* If the genitals be immersed for some time in cold water, it will gen- erally stop a bleeding at the nose. I have not known this fail. Sometimes when the bleeding is stopped outwardly, it continues in- wardly. This is very troublesome, and requires particular attention, as the patient is apt to be suffocated with the blood, especially if he falls asleep, which he is very ready to do after losing a great quantity of blood. When the patient is in danger of suffocation from the blood getting into his throat, the passages may be stopped by drawing threads up the nostrils, and bringing them out at the mouth, then fastening pieces of sponge, or small rolls of linen cloth to the extremities ; afterwards * From ten to twenty drops of the oil of turpentine in a little water given frequently, seldom fails to stop a bleeding at the nose, or from any other part. 30 234 OF THE BLEEDING AND BLIND Til drawing them back, and tying thcin on the outside with a siifficie&t degree of tightm ss. After the bleeding is stopped, the patieut ought to be kept as easy an.l quiet as possible. He should not pick his nose, nor take away the tents or clotted hiood, till they fall off of their own accord, aud should not lie wi'h his head low. Those who are affected with frequent bleeding at the nose ought to bathe their feet often in warm water, and to keep them warm and dry. They ought to wear nothing tight about their necks, to keep their body as much in an erect posture as possible, and never to view any object obliquely. If they have too much blood, a vegetable diet, with uow and then a cooling purge, is the safest way to lessen it. But when the disease proceeds from a thin dissolved state of the blood, the diet should be rich and nourishing; as strong broths aud jejiics, sago-gruel, with wine and sugar, &c. Infusions of the Peru- vian bark in wine QMght likewise to be taken and persisted in for a con- qiderable time. OF THE BLEEDING AND BLIND PILES. A DISCHARGE of blood from the ha! morrhoidal vessels is called the ifletdmg piles. When the ve sets only swell, and discharge o<* blood, but are exceeding painfal, the disease is called the blind piles. Persons of a loose spungy fibre, of a bulky size, who live high, and lead a sedentary, inactive life, are r.v ist subject to this disease. It is often owing to an hereditary disposition. Where lh'13 is the case, it attacks persons more early in life than when it is accidental. Men are more liable to it than women, especially those of a sanguine plethoric, or scorbutic habit, or of a melancholy disposition. The piles may be occasioned by au excess of blood, by strong aloetic purges, high-seasoned food, drinking great quantities of sweet wines, viie neglect of bleeding, or other customary evacuations, much riding, great costivepess, or any thing that occasions hard or difficult stools. Anger, grief, or other violent pafsions, will likewise occasion the piles. 1 have often known them brought on by sitting on the damp ground. A pair of thin breeches will excite the disorder in a person who is subject to it, and sometimes even in those who never had it be- fore. Pregnant women are oi'eu atiiicted with the piles A flux of blood from the anus, is' not al\va}s to be treated as a dis- eise. It is even more salutary than bleeding at die nose, aud often prevents or carries off die-eases. It is peculiarly beneficial in the gout, rheumatism, asthma, and hypochondrical complaints, and often proves critical in colics, ami inflammatory fevers. In the management of the patient, vegaul must be had to Ids habit of body, his age, strength, an.l manner of living. A discharge which udglit be pxcessive and prove hurtful to one, may be very moderate^ Of The bleeding and blind files. 23s hid even salutary to another. That only is to be esteemed dangerous^ which continues too long, and is in such a quantity as to waste the pa- tient's strength, hurt the,digestion, nutrition, and other functions neces- sary to life. When this is the case, the discharge must be checked by a proper regimen, and astringent medicines. The DIET must be cool but nourishing, consisting chiefly of bread, milk, cooling vegetables, and broths. The drink may be chalybeate- water, orange whey, decoc- tions or infusions of the astringent and mucilaginous plants, as the tor- 'mentil root, bistort, the marsh-mallow-roots, &c. Old conserve of roses is a very good medicine in this case. It may be mixed in new milk, and may be taken in the quantity of an ounce three or four times a-day. This medicine is in no great repute, owing to its being seldom taken in such quantity as to produce any effects ; but when taken as here directed, and duly persisted in, I have known it perform'very extraordinary cures in violeut haemorrhages, especial- ly when assisted by the tincture of roses ; a tea spoontui of which may be taken about an hour after every dose of the conserve. The Peruvian bark is likewise proper in this case, both as a strength- ener and astringent. Half a drachm of it may be taken in a glass of red wine, sharpened with a few drops of the elixir of vitriol, three or four times a-day. The bleeding piles are sometimes periodical, and return regularly once a month, or once in three weeks. In this case they are always to be considered as a salutary discharge, and by no means to be stop- ped. Some have entirely ruined their health by stopping a period- ical discharge of blood from the hs&morrhoidal veins. In the Mind piles bleeding is generally of use. The diet must be light and thin, and the drink cool and diluting. It is likewise neces- sary that the body be kept gently open. This may be done bv small doses of the flour of brimstone and cream of tartar. These may be mixed in equal quantities, and a tea-spoonful taken two or three times a-day, or oftener if necessary. Or an ounce of the Hour of brimstone, and half an ounce of purified nitre ta\y be mixed with three or four ounces of the lenitive. electuary, and a tea-spoonful of it taken three or four times a day. Emollient clysters are here likewise beneficial ; but there is some- times such an astriction of the anus, that they cannot be thrown up. In this case I have known a vomit have a very good effect. When the piles are exceeding painful and swelled, but discharge nothing, the patient must sit over the steams of warm water. He may likewise apply a linen cloth dipped in warm spirits of wine to the part, or poultices made of bread and milk, or of leeks fried with butter. If these do # not produce a discharge, and the piles appear large, leeches must be applied as near them as possible, or, if they wilt Sat apoja the piles themselves, s® much the better. When leeches will 236 SPITTING OF BLOOD. not fix, the piles may be opened with a lancet. The operation is very easy, and is attended with no danger. "\Jarious ointments, and Eternal applications, are recommended in the piles; but I do ive seen any effects From these, worth mentioning, principle use is to ki;ep the part moist, which may be done as well by a soft poultice, or an emollient cataplasm. Y\ hen the pain , . is very great, a liniment made of two ounces of emollient oint- ment, and hall an " nnce of tiquid laudanum, beafrup with die yolk of an egg, niay he applied. Si'ITTING OF BLOOD. WE mean here to 1rcat of that discharge of blood from the lurigl ; an hanwptoe or spitting of blood. Persons of a . lax fibre, who have long uecks and strait breasts ase. It is most common in, the spring, and ge'.ieraUj atracl before they are at the prime or middle pe- lt ib a common observation, that those who have been . at the nose when young, are afterwards most liable to SES. — A.u h^emoptoe may proceed from excess of blood from a peculiar weakness of the lungs, or a bad conformation of the breast. It is often occasioned by excessive drinking, running, wrestling, sing- ing, or speaking aloud. Such as have weak lungs ought to avoid all violen! exertions of that organ, as they value life. They should likewise; guard agaiust violent passions* excessive drinking and every tiling Chat occasions a rapid circulation of the blood. dfs a.o may likewise proceed from wounds of the lungs. These may either be received from without, or they may be occasion- , ..id bodies getting into the wind-pipe, an.! to falling down upon s, and Kurting that tender organ. The obstruction of any cus- evacuation may occasion a spitting of blood; as neglect of at the usual seasous, the stoppage of the bleeding menses in women, &c. It may likewise proceed from a polypus, scirrhous concretions, or any thing that obstructs the the blood in the lungs It is often the effect of a long and violent cough , iu whicli e rally the forerunner of a >tion. A violent degree of cold suddenly applied to the exter- na! pails of the bod} will occasion an haemoptoe. It may likewise br occasioned b) I i which i? too much rarefied to be able . to expand the lungs. This is often the case with those who w »• k in hot places, as furnaces, glass-houses, or the like. It is like- a lb such as ascend to the tcp cf very high mouu- > the Peak of Teneriffe, <■ - ion great restlessness, anxiety, and even delirium. Some- times epileptic fit*, and other convulsive disorders, have been brought on try ■ rttei ;e pain in the ear- The -r ach" may proceed from any of the causes which produce inflammation, it of'eu proceeds from a sudden suppression of per- !, or freri! the head being exposed to cold when covered with It may also be occasioned by worms, or other insects getting in;.- the eat-, or being bred there ; or from any hard Lody sticking in ihc tar. Sometimes it proceeds from the translation of morbific mat- ter to the ear. This often happens in the decline of malignant fevers, and occasions deafness, which is generally reckoned a favourable symptom. When the ear-ache proceeds from insects, or any hard body stick- ing in the ear, every method must be taken to remove them as soon as possible. The membranes may be relaxed, by dropping into the ear, oil of sweet almonds, or olive oil. Afterwards the patient should be made to sneeze, by taking snuff, or some strong sternutatory. If this should not force out the body, it must be extracted by art. 1 have * This may- always be prevented by the operator strikiug upon the. teeth with any piece of metal, as this never fails to excite the pain S3 the carious tooth. PAIN ®$ THE STOMACH, &e. 25 f Seen insects, which had got into the ear, come out of their own accord iipon pouring in oil. When the pain of the ear proceeds from inflammation, it must be treated like other topical inflammations, by a cooling regimen, and opening medicines. Bleeding at the beginning, either in the arm or jugumr vein, or cupping in the neck will be proper. The ear may likewise be fomented with steams of warm water ; or flannel bags til- led with boiled mallows and camomile-flowers may be applied to it warm; or bladders filled with warm milk and water. An exceeding good method of fomenting the ear, is to apply it close to the mouth of a jug filled with warm water, or a strong decoction of camomile- flowers. The patient's feet should be frequently bathed in lukewarm water, and he ought to take small doses of nitre and rhubarb, viz. a scrapie of the former, and ten grains of the latter, three tunes a day. His drink may be whey, or a decoction of barley and liquorice, with figs or raisins. The parts behind the ear ought frequently to be rubbed with camphorated oh, or a little of the volatile liniment. When the inflammation cannot be discussed, a poultice of bread and milk, or coasted onions, may be applied to the ear, and frequently re- newed, till the abscess breaks^or can be opened. Afterwards the humours may be diverted from the part by gentle laxative blisters, or issues ; but the discharge must not be suddenly dried up by any ex- ternal application* PAIN OF THE STOMACH, &c. THIS may proceed from various causes, as indigestion; Wind? the acrimony of the bile ; sharp, acrid, or po*;ouous substances taken into the stomach, &c. It may likewise be occasioned by worms; the stoppage of customary evacuations ; a translation of gouty matter to the stomach, the bowels, &c. Women in the decline of life are very liable to pains of the stomach and bowels, especially such a? are afflicted with hysteric complaints. It is likewise very common to hypochondriac men of a sedentary and luxurious life, fo such persons it often proves so extremely obstinate as to baffle all 'he powers of medicine. When che*pain of the stomach is most violent after eating, there is reasori to suspect that it proceeds from some fault, either in the digest- '. ion or the food. In this case the patient ought to change his diet, till he finds what kind of food agrees best with his stomach, and should continue chiefly to use it. If a change of diet does not remove th& complaint, the patient may take a gentle vomit, and afterwards a dose for two of rhubarb. He ought likewise to take an infusion of camomile lowers, or some other stomachic bitter, eithef in wine or Water. X 252 Vim OF THE STOMACH, &c have oflen kuown exercise remove this complaint, especially sailing, or a Ions journey on horseback, or iu a carriage. When a pain of the stomach proceeds from flatulency, the patient is Constantly belching up wind, and feels an uneasy distention of the stom- ach after meals. T ins is a most deplorable disease, and is seldom thoroughly cured. In general, the patient ought to avoid all windy diet, and every thing that sours on the stomach, as greens, roots, &c. This rule however admits of some exceptions. There are many in- stances of persons very much troubled with wind, who have received. great benefit from eating parched pease, though that grain is generally siipposed to be of a windy nature * This complaint may likewise be greatly relieved by labour, espe- cially digging, reaping, mowing, or any kind of active employment by which the bowels are alternately compressed and dilated. The most obstinate ca?e of this kind I ever met with, was iu a person of a seden- tary occupation, whom 1 advised, after he had tried every kind of medicine in vain, to turn gardener, which he did, and has ever since enjoyed good health. When a pain of the stomach is occasioned by the swallowing of acrid or poisonous substances, they must be discharged, by vomit; this may be excited by butter, oils, or other soft things, which sheathe and de- fend the stomach from the acrimony of its contents. When a pain c'f the stomach proceeds from a translation of gouty matter, warm cordials are necessary, as generous wines, French bran- dy, &c. Some have drank a whole bottle of brandy or rum, in this case, in a few hours, without being in the least intoxicated, or even feel- ing the stomach wanned by it. It is impossible to ascertain the quantity necessary upon these occasions. This must be left to the feelings and discretion of the patient. The safer way however, is not to go too far. "When there is an inclination to vomit, it may be promoted by driuk- tog an infusion of camomile-tlot-ers, or carduus bcncdiclus. Jf the pain of the stomach proved from the stoppage of customary evacuations, bleeding will be necessary, especially in sanguine and very full habits. It will likewise be ia use to keep the body gently opsn by mild purgatives ; as rhubarb or senna. "When this disease affects women in the decline of life, after the stoppage *f the metises, making an issue in the leg or arm Avill be of peculiar service. When the disease is occasioned by worms, they must be destroyed, or expelled by such means as are recommended in the following sec- tion. When, the stomach is greatly relaxed and the digestion bad, which often occasion flatulencies, the elixir of vitriol will be of singular ser- * These are prepared by steeping or soaking pease in water, and afterwards drying them in a pot cv kiln, till they be quite hard. They rmy be used at pleasure, OF worms. tm Vjce. Fifteen or, twenty drops of it may be taken in a glass of wine 4v water twiCe or thrice a- day. Persons afflicted with flatulency are generally unhappy unless they be taking some purgative medicines: these, though they may give im- mediate ease, tend to weaken and relax the stomach and bowels, and Consequently increase the disorder. Their best method is to mix pur- gatives and stomachics together. Equal parts of Peruvian bark and rhubarb may be infused in brandy or wine, and taken in such quantity as to keep the body gebtly open. CHAPTER XXXVfe OF WORMS. fHESE are chiefly of three kinds, viz. the taenia, or tape wormf the teres, or round and long worm ; and the ascarides, or round and short worm. There are many other kinds of worms found in the human body; but as they proceed, in a great measure, Irom similar caus.es, have nearly the same symptoms, and require almost the same method of treatment as these already mentioned, we shall not spend time in enumerating them. The tape worm is white, very long, and full of joints. It is gener- ally bred either in the stomach or small intestines. The round and long worm is likewise bred in the small guts, and sometimes in the stomach. The round and short. Worms, commonly lodge in the rectum, or what is called the end gut, and occasion a disagreeable itching about the seat. The long round worms occasion squeamishness, vorrnting, a disagree- able breath, gripes, looseness, swelling of the belly, swoonings, loathing of food, and at other times a voracious appetite, a dry cough, Convul- sions, epileptic fits, and sometimes a privation of speech. These worms have been known to perforate the intestines, and get into the cavity of the belly. The effects of the tape-worm are nearly the same with those of the long and round, but rather more violent. Andry says, the following symptoms particularly attend the solium, which is a species of the tape- worm, viz. swoonings, privation of speech, and a voracious appetite. The round worms called ascarides, besides an itching of the anus, cause swoonings;, and tenesmus, or an inclina- tion to go to stool. CAUSE. — Worms may proceed from various causes ; but they &re seldom found except in weak and relaxed stomachs, where the di= 2o± OF WORMS. gestion is bad. Sedentary persons are more liable to them than ttte active and laborious. Those who eat great quantities of unripe fruit, or who lire much on raw herbs at id roots, are generally subject id worms. There ■•oems to be an hereditary disposition in some persous to this disease. I have often seen all the children of a family subject to worms of a particular kind. They seem likewise, frequently to be owing to the nurse. Children of the same family, nursed b) one wo- man, have often worms, when those nursed by auother have none: SYMPTOMS — The common symptoms of worms aie paleness of the countenance, and at other times, an universal tlusliing ot >he face j itching of the nose ; this however is doubtful, as children pick iieir noses in all diseases ; starting and grinding of the teeth in steep ; swell- ing of the upper lip; the appetite sometimes bad, at other times quite voracious ; looseness ; a sour or stinking breaih ; a hard swelled b< llj ; great thirst ; the urine frothy, and sometimes of a whitish colour ; pi- ping, or colic pains; an involuntary discharge of saliva, especially wheu asleep; frequent pains of the side, wkh a dry cough, ?mi une- qual pulse ; palpitations of the heart : swooniogs; cold sweats: palsy; epileptic fits, with many other uuaccountable nervous symptoms, which were formerly attributed to witch craft, or the influence of evil spirits, Small bodies in the excrements resembling melon or cucumber seed are symptoms of the tape- worm. I lately saw some very surprising effects of worms in a girl about iive yeais of age, who used to lie for whole houi* as if dead She at last expired, and upon opening her body, a number of the t:!iat they must sometimes be considered as a disease, is equally cer- tain ; hut this is not the case so often as people imagine. 'I he idea that worms occasion many diseases, gives an opportunity to the profesfr ed worm doctors of imposing on the credulity of mankind, and do- Sng much mischief. They find worms in every case, and liberally throw in their antidotes, which generally consist of strong drastic, pur- ges, I have known these given in delicate constitutions to the des- truction of the patient, where there was not the least s) mptcm of worms. f A medical writer of the present age has enumerated upwards of fifty British plants, all celebrated for killing and expelling worms. OB WORMS. 2a ^ The best purge for an adult is jalap and calomel. Five and twen- ty or thirty grains ef the former with six or seven of the latter, mix- jjd in syrup, may be taken early in the morning for a dose. It will be proper that the patient keep the house ail day, and drink nothing cold. The dose may be repeated once or twice a week for a fortnight or jfbree weeks Qn the . intermediate days the patient may take a drachm of the powder of tin, twice or thrice a-day, mixed with syrup- honey, or treacle. Those who do not choose to take calomel, may make use of the; bitter purgatives ; as aloes, hiera picra, tincture of senna, and rhu- barb, &c. Oily medicines are sometimes found beneficial for expelling worms. An ounce of salad oil and a table-spoonful of common salt may be taken in a glass of red port wine thrice a-day, or oftcner, if the stom- ach will bear it. But the more common form of using oil is in clys- ters Oily clysters sweetened with sugar or honey, are very effica- cious in bringing away the short round worms called ascarides, and likewise the ttres. The Harrowgate water is an excellent medicine for expelling worms, especially the ascarides. As this water is impregnated with sulphur, we may hence infer, that sulphur alone must be a good medicine in this case ; which is found to be a fact. Many practitioners give flour of sulphur in very large doses, and with great success. It should be made into an electuary with honey or treacle, and taken in such quan- tity as to purge the patient. Where Harrowgate water cannot be obtained, sear-water may be used, which is far from being a contemptible medicine in this case. If sea- water cannot be had, coinmon salt dissolved in water may be drank. I have often seen this used by country nurses Avith very good effect- Some flour of sulphur may be taken over night, and the salt water in the morning. But worms though expelled, will soon breed again, if the stomareh remains weak and relaxed ; to prevent which we would recommend the Peruvian bark Half a drachm of bark in powder may be taken in a glass of red port wine three or four times a-day, after the above medi- cines haye been used. Lime-water is likewise good for this purpose, or a table-spoonful of the chalybeate wine taken twice or thrice a-day. Infusions or decoctions of bitter herbs may likewise be drank ; as the infusion of tansy, water trefoil, camomile flowers, tops of wormwood, the lesser centaury, &c. For a child of four or five years old, six grains of rhubarb, five of jallap, and two of calomel, may be mixed in a spoonful of syrup or honey, and given in the morning. The child should keep the house all day, and take nothing cold. This dose may be repeated twice a-week for three or four weeks. On the intermediate days the child m'ij take a scruple of powdered tin and ten grains of sethiops ' mineral 256 OF WORMS. in a spoonful of treacle twice a-flay. This dose must be increase^ or diminished according to the age of the patient. Bisset says, the great bastard black hellebore, or bear's foot, is a most powerful vermifuge for the long round worm. He orders the decoction of about a drachm of the green leaves, or about fifteen grain? ol the dried leaves in powder for a dose to a child between four and seven years of age. This dose is to be* repeated two or three time?. He adds that the green leaves made into a syrup with coarse Siiiiai , U almost the only medicine he has used for round worms for three years past. Before pressing out the juice he moistens the bruised leaves with vinegar, which corrects the medicine. The dose is a tea spoonful at bed time, and one or two next morning. I have frequently known those big bribes, which in children are commonly reckoned a sign of worm?, quite removed by giving them white soap in their pottage, or other food. Tansy, garlic, ami rue, are ail good against worms, and may be used various ways. We might here mention many other plants, both for externa! and internal use, as the cabbage bark, &c. but think the powder of tin with sethiops mineral, a:>d the purges of rhubarb and calomel, are more tc be depended on. Ball's purging vermifuge powder is a very powerful medicine. It is made of equal parts of rhubarb, scammony, and calomel, with as much double refined sugar as is equal to the weight of all the other iu- gredients. These must be well mixed together, and reduced to a fine powder. The dose for a child is from ten grains to twenty, once or twice a week. An tdult may take a drachm for a dose.* Parents who would preserve their children from worms ought to al- i exercise in the open air; to take care that their : i.e wholesome and sufficiently solid ; and as far as possible, to nt their eating raw herbs, roots, or green trashy fruits. It will • amiss to allow a child who is subject to worms, a glass of red ifh meals; as every thing that braces and strengthens the stom- is gt od both for preventing and expelling these vermin.f * \ powder for the tape- worm resembling this, was long kept a se- .,- ret on the continent, it was lately purchased by the French king. t We think it necessary here to warn people of their danger who buy cakes, powders and other worm medicines, at random, from quacks, and give them to their children without proper care. The principle ingredients in most of these medicines is mercury, which is never to be trifled with. I lately saw a shocking instance of the dan- ger of this conduct. A girl who had taken a dose of worm powder, bought of a travelling quack, went out, and, perhaps, was so imprudent as to drink cold water during its operation. She immediately swelled, and died on the following day with all the symptoms of having been pojsoued. QF THE JAUNDICE. m CHAPTER XXXVII. OF THE JAUNDICE. OH II IS disease is first observable in the while of the eye, which JL appears yellow. Afterwards the whole skin pats ou-a-yelloW: appearance. The urine too is of a saffron hue, and dies a Mfbile. cloth of the same colour. There is likewise a species of ibis disease called the Black Jaundice. CAUSES. — The intermediate cause of the jaundice is an obstruc- tion of the bile. The remote or occasional causes are, the biics of poisonous animals, as the viper, mad dog, &c. the bilious or hys- teric colic ; violent passions, as g?ief, anger, &c. Strong purges or vomits will likewise occasion the jaundice. Sometimes it proceeds from obstinate agues, or from that disease being prematurely stopped by astringent medicines. In infants it is often occasioned bv the me- conium not being sufficiently purged off. Pregnant women are very subject to it. It is likewise a symptom in several kinds of fever. Catching cold, or the stoppage of customary evacuations, as the men- ses, the bleeding piles, issues, &c. will occasion the jaundice. SYMPTOMS. — The patient at first complains of excessive wea- riness, and has great aversion to every kind of motion. His skin is dry, and he generally feels a kind of itching or pricking pain over the whole body. The stools are of a whitish or clay colour, and the saline, as was observed above, is yellow. The breathing is difficult, and the patient complains of an unusual load or oppression on his breast. There is a heat in his nostrils, a bitter taste in the mouth, loathing of food, sickness of the stomach, vomiting, flatulency, and other symptoms of indigestion. If the patient be young, and the disease complicated with no other malady, it is seldom dangerous ; but in old people, where it continues long, returns frequently, or is complicated with the dropsy or hypo- chondriac symptoms, it generally proves fatal. The black jaundice is more dangerous than the yellow. REGIMEN. — The diet should be cool, light, and diluting, con- sisting chiefly of ripe fruits and miid vegetables; as apples boiled or roasted, stewed prunes, preserved plums, boiled spinnage, &c. Veal or chicken broth, with light bread, are likewise very proper. Many |;ave been cured by living almost wholly for some days on raw eggs. The drink should be butter-milk, whey sweetened with honey, or decoctions of cool opening vegetables; or marsh-mallow roots with U« Vutorice, &c. ' ' 33 258 OF THE JAUNDICE. The patient should take as much exercise as he can bear, either ok horseback ir in -? carriage; walking, ruuning and even jumping, are likewise proper, provided he can bear them without pain, anr' there be no symptoms of inflammation. Patient* have been often cured of this disease by a long journey, after medicines had proved ineffect- ual. Amusements 3re likewise of great use in the jaundice. The disease is often occasioned by a sedentary life, joined to a cull melancholy disposition. Whatever therefore tends to promote the circulation, and to cheer the spirits, must have a good effect; as dancing, laughing, MEDICINE — If the pntient be young, of a full sanguine habit, and complains of pain in die right side about the region of the liver, bleeding *:h he necessary. Alter this a vomit must be administered, and if the disease proves obstinate, it may be repealed once or twice: No me iicines are more beneficial in the jaundice lhau vomits, espe- cially where it is not attended with inflammation. Haifa drachm of Ipecacuanha in powder will be a sufficient dose tor an adult. It may be wrought off with weak camomile-tea, or lukewarm water. The body n as f likewise be kept open by taking a sufficient quantity ofcastile soap, or the pills for the jaundice recommended in the Ap- pendix. c Fomenting the parts about the region of the stomach. aud liver, and rubbing them with a warm hand or flesh-brush, are likewise benefi- cial; but it is still more so for ths patient to sit in a bath of warm wa- ter up to the breast. He ought to do this frequently, and should continue In it as loug as his strength will permit. Many dirty things are recommended for the cure of the jaundice ; as lice, millepedes, dice. Eut these do more harm than good, as peo- ple trust to them, and neglect more valuable medicioes; besides they are seldom taken in sufficient quantity to produce any effects. People always expect that such things should act as charms, and consequent- ly seldom persist in the use of them. Vomits, purges, fomentation?, and exercise, will seldom fail to cure the jaundice when it is a simple disease ; and when complicated with the drop-y, a scirrhus liver, or other chronic complaints, it U hardly to be cured by any means. Numberless British herbs are extolled for the cure of this disease. The author of the Medicina Britannica mentions near a hundred, all famous for curing the jaundice. The fact is, the disease often goes off of its own accord; in which case the last medicine is always said to have performed the cure. I have sometimes, however, speu consider- able benefit in a very obstinate jaundice, from a decoction of hemp- seed. Four ounces of the seed may be boiled in two English quarts of ale, a-id sweetened with coarse sugar. The dose is hnlf an Eng- lish piut every morning. It may be continued for eight or nine da;. r I have likewise known Harrowgate sulphur water cure a jaundice OF THE DROPST. 2$6 t-f very long standing. It should be used for some weeks, and the patient, must both drink and bathe. The soluble tartar is a very proper medicine in the jaundice. A drachm of it may be taken every Bight and rooming in a cup of tea or water gruel. If it does not open the body, ihe dose may be in- creased. Persons subject to the jaundice ought to take as much exercise as t)6ssible, and to avoid all heating and astringent aliments. CHAPTER XXXVIII. OF THE DROPSY. THE dropsy is a preternatural swelling of the whole body, or some part of it, occasioned by a collection of watery humour. It is dis- tinguished by different names, according to the part affected, as the anasarca, or collection of water under the skin ; the ascites, or collec- tion of water in the belly ; the hydrops pectoris, or dropsy of the breast ; the hydrobephalus, or dropsy of the brain, &c. CA.USES. — The dropsy is often owing to an hereditary disposition. It may likewise proceed from drinking ardent spirits, or other strong liquors. It is true almost to a proverb, that great di inkers die of the dropsy. The want of exercise is also a very common cause of the dropsy. Hence it is justly reckoned among the diseases of the seden- tary. It often proceeds from excessive evacuations, as frequeut and copious bleeding, strong; purges often repeated, frequent salivations, &c. The sudden stoppage of customary or necessary evacuations, as the menses, the haemorrhoids, fluxes of the belly, &c. may likewise cause a dropsy. I have known the dropsy occasioned by drinking large quantities of cold, Weak, watery liquor, when the body was heated by violent exer- cise. A low, damp, or marshy situation is likewise a frequent cause of it. Hence it is a common disease in moist, Oat, fenny countries. It may also be brought on by a long use of poor watery diet, or of vis- cous aliment that is hard of digestion. It is often the effect of other diseases, at, the jaundice, a schirrhus of the liver, a violent ague of long continuance, a diarhcea, dysentery, an empyema, or a consumption of the lungs. In short, whatever obstructs the perspiration, or prevents the blood from being duly prepared, may occasion a dropsy. SYMPTOMS. — The anasarca generally begins with a swelling of the feet and ancles towards night, which for some time disappears in the 260 OF THE DROPSY. morning. In the evening tlie pails, if pressed ivith the finger, will pit', The swelling gradually ascends, and occupies the trunk of the body, the arms, n;id the head. Afterwards the breathing becomes dif- ficult, the urme is in small quantity, and the thirst great; the body iff bound, and the perspiration is greatly obstructed. To these succeed torpor, heaviness, a slow wasting fever, and a troublesome cough. This ly a fataUymptom, as it shews that the lungs are affected. i ascites, besides the above symptoms, there is a swelling of the belly, and often a fluctuation, which may be perceived by striking the belly on one, bide, and laj ing the palm of the hand on the opposite, ay be distinguished from a tympany by the weight of the swell- ing, as well as by the fluctuation. When the anasarca and ascites are combined', the case is very dangerous. Even a simple ascites seldom admits of a radical cure. Almost all that can be done is, to let off the , tapping, which seldom affords more than a temporary n -lief. when the disease comes suddenly oa ; and the paiieut is young and strong, there i? reason, however, to hope for a cure, especially if med- icine :;e given early But if the patient be old, has led an irregular or a sedentary life, or if there be reason to suspect that the liver, lungs', or any of the viscera arc unsound, there is great reason to fear that the consequences will prove fatal". REGIMEN". — The patient must abstain as much as possible from all dunk, especially weak and watery liquors, arid must quench Ins thirst with mustard-whey, or acids, as juice of lemons, oranges, sorrel, or such like. His aliment ought to be dry, of a stimulating and di- uretic quality, as toasted bread, the flesh of birds or other wild ani- mals roasted ; pungent and aromatic vegetables, as garlic, mustard, on- ions, cresses, horse-radish, rocambole, shalot, "&c. He may also eat sea-biscuit dipt in wine or a little brandy. This is not only nourish- ing, but tends to quench thirst. Some have been actually cured of a drops} by a total abstinence from all liquids, and living entirely upon such things as are mentioned above. If the patient must have drink, the Spa water, or Rhenish wine, with diuretic medicines infused in it, are the best. Exercise is of the greatest importance in a dropsy. If the patient be able to walk, dig, or the like, he ought to continue these exercises as long as he can. If he is not able to walk or labour, he must ride on horseback, or in a carriage, and the more violent the motion so much the better, provided he can bear it. His bed ought to be hard, and the air ot his apartments warm and dry. If he lives in a damp country, he ought to be removed into a dry one, and if possible, into a warmer climate. In a word, eveiy method should be taken to promote the perspiration, and to brace the solids. For this purpose it will lile- wisc be proper to rub the patient's body two or three times a day, with a hard cloth, or the flesh-brush 5 and he ought constautlj to wear fla& U his skin. OF THE DROPSY. 25* MEDICINE.— If the patient be young, his constitution good, and Uie disease has come on suddenly, it may generally be removed by strong vomits, brisk purges, and such medicines as promote a discharge by sweat and urine. For au adult, half a'drachm of ipecacuan'ha hi powder, and half ah ounce of oxyniel of squills will be a proper vbitoitl This may be repeated as often as is necessary, three or four days in- tervening between the doses. The patient must a:>t dri.uk much ai'ler Sating the vomit, otherwise he destroys its effect. A wp or two of camomile tea wid be sufficient So work it off Between each vomit, on one of the inter raedi '.to dsys, the patient may take the following purge : Jalap in powder half a drachm, cream of tartar two drachms, calomel six grains. These a:ay be madie into a bolus with a little syrup of pale roses, and taken early in the morn- ing. The less the patient drinks after it, the better. If he be much griped, he may now aud then take a cup of chicken broth. The patieut may likewise take every night at bedtime the following bolus : To four or live grains of camphor add one grain of opium, and as much syrup of orange-peal as is sufficient to make them into a bo- lus. This will generally promote a gentle sweat, which should be en- eouraged by drinking now and then a small cup of wine-whey, with a tea-spoonful of the spirits of hartshorn in it. — A tea-cupful of the fol- lowing diuretic infusion may likewise be taken every four or five hours through the clay. Take -juniper berries, mustard-seed, and horseradish, of each half an ounce, ashes of broom half a pound ; infuse them in a quart of lihenish wine or strong ale for a few days, and afterwards strain off the liquor. Such as cannot take this infusion, may use the decoction of seneka-root, which is both diuretic and sudorific. I have known an obstinate anasarca cured by an infusion of the ashes ol broom in wine.' The above course will often cure an incidental dropsy, if the con- stitution be good ; but when the disease proceeds from a bad habit, or an unsound state of the viscera, strong purges aud vomits are not to be ventured upon. In this case, the safer course is- to palliate the symptoms by the use of such medicines as promote the secretions, and to support the patient's strength by warm and nourishing cordials. The secretion of urine may be greatly promoted by nitre. Bronkes says, he knew a young woman who was cured of a dropsy by taking a drachm of nitre every morning in a draught of ale, after she had been given over as incurable, The powder of squills is likewise a good diuretic. Six or eight grains of it, with a scruple of. nitre, may be given twice a-day in a glass of strong cinnamon- water. Ball says, a large spoonful of unbruised mustard-seed taken every night and mor- ning, and drinking half an English pint of the decoction of the tops of green broom after it, has performed a cure after other powerful Medicines had proved ineffectual. 262 OF THE DROPSY. I have sometimes seen good effects from cream of tartar in thii disease. It promotes the discharges by stool and urine, and will at least palliate, it' it does not perk rm a cure. '. y begirt by taking au c<;nce every second or third da , h mry increase the quantity to two or even to three ...uoces, if the . om.,eh will bear it. This quantity is not however to be takeu at once, but divided into three or four doses. To promo'* perspirati >n, the patient may use the decoction of sene^ ka-root, as directed above; or he may take two bole-spoons; d of Min- dereriio' spirit in a cup of wine- whey three, or four times a-day. To promote a discharge of urine, the following infusion of the London hos- pitals will likewise be beueficial -. Take of zedoary-root two drachms ; dried squills, rhubarb, and ju- niper berries bruised, of each a drachm; cinnamon in powder three drachms; salt of worm- wood, a drachm and a half; infuse in an Eng- lish pint and a half of old hock wine, and when fit for use, nitre die liquor. A vine glass of it may be taken three or tour times a-riay. In the anasarca it is usual to scarify the feet and legs By this means the water is often discharged ; but the operator must be cautious not to make the incisions too deep ; they ought barely to pierce through the skin, and especial care must be taken, by spirituous fomentations and proper digestives, to prevent a gangrene. In an ascites, when the disease does not evidently and speedily give ■way to purgative and diuretic medicines, the water ought to be let off by tapping. This is a Very simple and safe operation, and would often succeed if it were performed in due time ; but if it be delayed till the humours are vitiated, or the bowels spoiled, by loing soaking in water, it cpn hardly be expected that any permanent relief will be procured.* After the evacuation of the water, the patient is to be put on a course of strengthening medicines ; as the Peruvian bark; the elixir of vitri- ol ; warm aromatics, with a due proportion of rhubarb, infused in wine, and such like. His diet ought to he dry and nourishing, such as is recommended iri the beginning of the chapter, and he should take as much exercise as he can bear without fatigue. He should wear flan- nel nest his skin, and make daily use of the flesh- brush. * The very name of an operation is dreadful to most people, and they wish to try every thing before they have recourse to it. This is the reason why tapping so seldom succeeds to our wish. I have had a patient who was regularly tapped once a month for several years, anef who used \p eat her dinner as well after the operation as if nothiDg had happened; She died at last rather worn out by age than the dis- ease. QF-T-HB GOUT. 2m CHAPTER XXXIX. OF THE GOUT. THERE is no disease which shews more the imperfection of medi- cine, or sets the advantages of temperance and exercise in a strong- er light, than the gout. Excess and idleness are the true sources from whence it originally sprung, and all who would avoid it must be ac- tive and temperate. Though idleness and intemperance are the principal causes of the gout, yet many other things may contribute to bring on the disorder, and to induce a paroxysm in those who are subject to it ; as intense study ; too free an use of acidulated liquors ; night- watching ; grief or uneasiness of miud ; an obstruction or defect of any of the customary discharges, as the menses, sweating of the feet, perspiration, &c. SYMPTOMS— A fit of the gout is generally preceded by indi- gestion, drowsiness, belching of wind, a slight head-ache, sickness, and sometimes vomiting. The patientcompiains of weariness, and de- jectiou of spirits, and has often a pain in the limbs, with a sensation as if wind or cold water were passing down the thigh. The appetite is often remarkably keen a day or two before the fit, and there is a slight pain in passing urine, and frequently an involuntary shedding of tears. Sometimes these symptoms are much more violent, especially upon the near approach of the fit ; and it has been observed, that as is the fever which ushers in the gout, so will the fit be ; if the fever be short and sharp, the fit will be so likewise ; if it be feeble, long and lingering, the fit will be such also. But this observation can only hold with respect to very regular fits of the gout. The regular gout generally makes its attack in the spring or begin- ning of winter, in the following manner : About two or three in the morning, the patient is siezed with a pain in his great toe, sometimes in the heel, and at other times in the anc}e or calf of the leg. This pain is accompanied with a sensation as if cold water were poured up- on the part, which is succeeded by a shivering, with some degree of fever. Afterwards the pain increases, and fixing among the small bones of the foot, the patient feels all tlw different kinds of torture, as if the part were stretched, burnt, squeezed, gnawed, or torn to pieces. The part at length becomes so exquisitely sensible; that the patient cannot bear to have it touched, or even suffer any person to walk across the room. The patient is generally in exquisite torture for twenty-four hours from the time of the coming on of the fit; he then becomes easier, the part begins to swell, appears red, and is covered with a little moisture, OF THE GOVT. Towards morning he drops asleep, and generally falls into a : breathing sweat. This terminates the first paroxysm, a number of which constitutes a fit ci' the gout; which is longer or shorter, accor- ding to the patient's age, strength, the season of the je?r, and the dis- position of the body to this disease. The patient is always worse towards night, and easier in the morn- ing. The paroxysms however generally grow milder every day, till at length the di -led off by perspiration, urine and the other evacuations. Iu some patients this happens iu a few days; in others i: requires weeks ; and in some, months, to finish the fit. Those whom age and frequent fits of the gout have greatly debilitated, seldom get tVee from ii before '.he approach of snmmer, and sometimes not till it Lc pretty Car advanced. KEG IMEN.—As there are do medicines yet known that will cure the gout, we shall confine oui observations chiefly to regimen, both in and oat of the fit » Iu the fi*, it the patient be young and strong, his diet ought to be thin and cooling, and his drink of a diluting nature; but where the constitution L weak, and the patient has been accustomed to live high, t.iis is no; a proper time to retrench. In this case he must keep nearly tj bis usual rJteH, and should fake frequently a cup of strong negus, or i: glass of generous wine, Y*ine whey is a very proper drink in this ease, as it promotes the perspiration without greatly heating the pa- tient. It v.i'ii afiswtr this purpose better if a tea-spoonful of sat vola- tile oleosum, or spirits of hartshorn, be put into a cup of it twice a day. it wfll likewise be proper' to give at bedtime a tea-spoonful of the vola- tile tincture ofguafacum iu a large draught of warm wine-whey. This, will greatly promote perspiration through the night. As the most safe and efficacious method of discharging the gouty matter, i s by perspiration, this ought to be kept up by all means, espe- cially in the affected part. For this purpose the leg and foot should be v. rapt in soft flannel, fur, or wool. The last is most readily ob- tained, and seems to answer the purpose belter than any thing else. The people of Lancashire look upon wool as a kind of specific in the gout. They wrap a great quantity of it about the leg and foot af- fected, and co\er it with a skin of soft dressed leather. This they feuffer to continue for eight or ten days, and sometimes for a fortnight or three weeks, or longer, if the pain does not cease. I never knew ady external application answer so well in the gout. I have often seen 5 applied when the swelling and inflammation were very great, with violent pain, and have found ail these symptoms relieved by it in a few days. The wool which they use is generally greased, and card- ed or combed. They choose the softest which can be had, and sel- dom <-r never remove it till the fit be entirely gone off. The patient ought likewise to be kept quiet and easy during the fit. Every thing thai affects the mtud disturbs the paroxysm, and tends to OF THE GOUT, 26.5s ifyvow the gout upon the nobler parts. All external applications that repel the matter are to be avoided as death. They do not cure the disease, but remove it from a safer to a more dangerous part of the body, wberp it often proves fatal. A. fit of the gout is to be considered as Nature's method of removing something that might prove destruc- tive to the body, and all that we can do, with safety, is to promote her intentions, and to assist her in expelling the enemy in her own way. Evacuations by bleeding, stool, &c. are likewise to be used with cau- tion, they do not remove the cause of the disease, and sometimes by weakening the patient, prolong the fit; but where the constitution is sble to bear it, it will be of use to keep the body gently open by diet, or very mild laxative medicines. Many things will indeed shorten a fit of the gout, and some will sm or fit, the body is generally bound ; a purgiug clyster, with a solution of asafottida, ought therefore to be ad- ministered, and if there be occasion, it may be repeated two or three times. The patient's feet and legs ought to be immersed in warm wa- ter, and afterwards rubbed with a warm hand 01 dry cloth- Bleeding unless extreme weakness' or old age should forbid it, is highly proper. If there be a violent spasm about the breast or stomach, warm fomen- tations, or bladders filled with warm milk and water, may be applied to the part affected ; and warm cataplasms to the soles of the feet. The patient must drink freely of diluting liquors, and may take a tea-spoon- ful of the tincture of castor and of saffron mixed together, in a cup of valerian tea, twice or thrice a-day. Sometimes a vomit has a very good effect, and snatches the patient, as it were, from the jaws' of death. This however will be more safe after other evacuations have been pre- mised. A very strong infusion of roasted coffee is said to give ease in asthmatic paroxysms. In the moist asthma, such things as promote expectoration or spit- ting, ought to be used; as the syrup of squills, gum ammoniac, and such like. A common spoonful of the syrup or oxymel of squills, mixed with an equal quantity of cinnamon water, may be taken three or four times through the day, and four or five pills made of equal parts of asafceti- . da and gum ammoniac, at bed time.* For the convulsive or nervous asthma, antispasmodics and bracers are the most proper medicines. The patient may take a tea- spoonful of the paregoric elixir twice a-day. ' The Peruvian bark is sometimes * After copious evacuations, large doses of aether have been found very efficacious in removing a fit of the asthma. I have likewise known the following mixture produce, very happy effects ; To four or five ounces of the solution of gum ammoniac, add two ounces of simple cinnamon-water, the same quantity of balsamic syrup, and half an ounce of paregoric elixir. Of this, two table-spoonsful may be takea every three hours. OJ THE APOPLEXY. 231 found to be of use in this case. It may be taken in substance, or infu- sed in wine. la short, every thing that braces the nerves, or takes off spasm, niav be of use iu a nervous asthma. It is often relieved by the use of asses milk ; I have likewise known cow's milk drank warm in the morning, have a very good effect in this case. In every species of asthma, setons and issues have a good effect; they may either be set iu the back or side, and should never be allow- ed to dry up. We shall here, once for all, observe, that not only in the asthma, but in most chronic diseases, issues are extremely proper. They are both a safe and efficacious remedy; and though they do not always .sure the disease, yet they will often prolong the patient's life, CHAPTER XLIL OF THE APOPLEXY. THE apoplexy is a sudden loss of sense and motion, during which the patient is to all appearance dead ; the heart and lungs howev- er still continue to move. Though this disease proves often fatal, yet it may be sometimes removed by proper care. It chiefly attacks sed- entary persons of a gross habit, who use a rich and plentiful diet, and indulge in strong liquors. People in the decline of life are most subject to the apoplexy. It prevails most in winter, especially in rainy seas- ons, and very low states of the barometer. CAUSES. — The immediate cause of an apoplexy is a compression of the brain, occssioned by an excess of blood, or a collection of wa- tery humours. The former is called a sanguine, and the latter a se- rous apoplexy. It may be occasioned by any thiDg that increases the circulation towards the brain, or prevents the return of the blood from the head ; as intense study ; violent passions,! viewing objects for a long time obliquely ; wearing any thing too tight about the neck ; a rich and luxurious diet ; suppression of urine ; suffering the body to ccol suddenly after having been greatly heated ; continuing long iu a warm f I knew a woman, who in a violent fit of anger was seized with a sarjgiiine apoplexy. She at first complained of extreme pain, " as if daggers had been thrust through her head," as she expiessed it. Af- ter '.yards she became comatose, her pulse sunk very low, and was ex- ceeding slow. By bleeding, blistering and other evacuations, she was live for about a fortnight. When her head was opened, a large jtjuantity of extravasaled blood was found in the left ventricle of the 36 262 OF THE APOPLEXY. or cold bath ; the excessive use of spiceries, or high seasoned food ; excess of venery ; the sudden striking in of any eruption ; suffering issues, setons, &c suddenly to dry up, or the stoppage q[ any custo- mary evacuation ; a mercurial salivation pushed too far, or suddeuly checked by cold ; wounds or bruises on the head ; long exposure to excessive cold ; poisonous exhalations, <£c SYMPTOMS, and method of cure. — The usual forerunners of an apoplexy are giddines, pain and swimming of the head ; loss of memo- ry ; drowsiness, noise in the ear, the night mare, a spontaneous flux of tears, and laborious respiration. When persons of an apoplectic make observe these symptoms, they have reason to fear the approach of a fit. and should endeavour to prevent it by bleeding, a slender diet, sad opening medicines. In the sanguine apoplexy, if the patient does not die suddenly, the countenance appears florid, the face is swelled or puffed up, and the blood vessels., especially about the neck and tempk s, are turgid ; the breathing is difficult, and performed with a snorting noise. The ex- crements and urine are often voided spontaneously, and the patient is sometimes seized with vomiting. In this species of apoplexy every method must be taken to lessen the force of the circulation towards the head. The patient should be kept perfectly easy and cool. His head should be raised pretty high, and his feet suffered to hang down. His clothes ought to be loosened, es- pecially about the neck, and fresh air admitted into his chamber. His garters should be tied pretty tight, by which means the motion of the blood from the lower extremities will be retarded. As soon as the pa- tient is placed in a proper posture, he should be bled freely in the neck or arm, and if there be occasion the operation may be repeated in two or three hours. A laxative clyster, with plenty of street oil, or fresh butter, and a spoonful or two of common salt in it, may be admin- istered every two hours ; and blistering-plasters applied between the shoulders, and to the calves of the legs. As soon as the symptoms are a little abated, and (lie patient is able to swallow, he ought to drink freely of some diluting opening liquor, as a decoction of tamarinds and liquorice, cream tartar whey, or com- mon whey with cream of tartar dissolved in it. Or he may take any cooling purge, as Glauber's salts, manna dissolved in an infusion of sen- na, or the like. All spirits and other strong liquors are to be avoided. Eveu volatile salts held at the nose do mischief. Vomits, for the same reason, ought not to be given, or any thing that may increase the mo- tion of the blood towards the head. 1 1 the serous apoplexy, the symptoms are nearly the same, only the pulse is not so strong, the countenance is less florid, and the breathing less difficult. Bleeding is not so necessary here as in the former case. It may, however, generally be performed once with safety and ad- yaptagc, hut should not be repeated. The patient should be placed in. OF COSTIFENESS, &a 5.U the same posture as directed above, and should have blistering plasters applied, and receive opening clysters ia the same manner. Purges here are likewise necessary, and the patient may drink strong balm- tsa If he be inclined to sweat, it ought to be promoted by driukiog small wine-whey, or an infusion of carduus beuedictus. A plentiful sweat kept up for some considerable time, has often carried off a se- rous apoplexy. When Apoplectic symptoms proceed from opium, or other narcotic substances taken into the stomach, vomits are necessary. The patient is generally relieved as soon as he has discharged the poison in this way. Persons of an apopleptic make, or those Avho have been, attacked by it, ought to use a very spare and slender diet, avoiding all strong li- quors, spiceries, and high-seasoned food. They ought likewise to guard against all violent passions, and to avoid the extremes of heat and cold. The head should be shaved, and daily washed with cold water. The feet ought to be kept warm, and never suffered to continue long wet. The body must be kept open either by food or medicine, and a little blood may be let every spring and fall Exercise should by no means be neglected ; but it ought to be taken in moderation. Nothing has a more happy effect in preventing an apoplexy than perpetual issues or setons; great care however, must be "taken, not to suffer them to dry up, without opening others in their stead. Apopleptic persons Aught never to go to rest with a full stomach, or to lie with their heads low., "m- to wear any thing too tight about their necks. CHAPTER XLIIL OF COSTIVENESS, AND OTHER AFFECTIONS OF THE STOMACH AND BOWELS*, WE do not here mean to treat of those astiictiqns of the bowels, which are the symptoms of disease, as of the cholic, the iliac passion, &c. but ouly to take notice of that infrequency of stools which sometimes happens, and which in some particular constitutions may oc- casion diseases. Costiveness may proceed from drinking rough led wines, or other astringent liquors ; too much exercise, especially on horseback. It may likewise proceed from a long use of cold insipid food, which does not sufficiently stimulate the intestines. Sometimes it is owing to the Mle not descending to the intestines, as in the jaundice; and at othfc- times it proceeds from diseases of the intestines themselves, as a palsy*, Spasms, torpor, tumours, a cold dry state of the intestines, &c„ 234 OF C0ST1FEKESS, &c. Excessive costiveness is apt to occasion pains of the head, vomiting, colics, and other complaints of the bowels. It is peculiarly hurtful To hypochondriac and hysteric persons, as it generates wind and other grievous symptoms. Some people however, can bear costiveness to a great decree. I know persons who enjoy pretty good health, yet do not go to stool above once a week, and others not above ouce a fortnight. Indeed I have heard of some who do not go above once a month. Persons who are generally costive, should live upon a moistening and laxative diet, as roasted or boiled apples, pears, stewed prunes, raisins, gruels with currants, butter, honey, sugar, and such like. Broths with spiunage, leeks, and other soft pot" herbs, are likewise proper, Hye-bread. or that which is made of a mixture of wheat and rye to- gether, ought to be eaten. No person troubled with costiveness, should eat white bread alone, especially that which is made of fine flour. The best bread for keeping the body soluble, is what in some par;s of E igland they call nteslin. It is made of a mixture of wheat and rye, and is very agreeable to those who are accustomed to it. Costiveuess is increased by keeping the body too warm, and by ev^ the patient shall choose. The patient ought to take as much exercise as he can bear. This helps to dissolve the viscid humours, it removes obstructions, promotes tne perspiration, and all the other secretions. Every kind of madness is attended with a diminished perspiration ; all means ought therefore to be used to promote that necessary and salutary discharge. Nothing can have a more direct tendency to iucrease the disease than confiuing thu patient to a close apartment. Were he forced to ride or walk a certain number of miles every day, it would tend greatly to alleviate his disorder; but it would have still a better effect, if he were obliged to labour on a piece of ground. By digging, hoeing, planting, sowing, &c hoih the body and mind would be exercised. A long journey, or a voyage, especially towards a warmer. climate, with agreeable com- panions, have, often very happy effects. A plan of this kind, with a strict attention to diet, is a much more rational method of cure, than confining the patient within doors and plying him with medicines. MEDICINE. — In the cure of this disease particular attention must be paid to the mind. When the patient is in a low state, his mind ought to be soothed and diverted with a variety of amusements, as enter- taining stories, pastimes, music, &c. This seems to have been the method of curing melancholy among the Jews, as we learn from the story of King Saul; and it is a very rational &oe. Nothing can remove diseases of the mind so effectually as applications to the mind itself, the most efficacious of which is music. The patient's company ought likewise to consist of such persons as are agreeable to him. People in this state are apt to conceive unaccountable aversions to particular per- sons; and the very sight of such persons is sufficient to distract their minds, and throw, them into the utmost perturbation. When the patient'* strength is high, or the pulse admits of it. evacua- tions are necessary. In this case he must be bled, and have his body kept open by purging medicines, as manna, rhubarb, cream of tartar, or the soluble tartar. I have seen the last have very happy effects.. It may be taken in the dose of half an ounce, dissolved in water-gruel, every day, for several weeks, or even for months, if necessary. More or less may be given according as it operates. Vomits have likewise a •good effect ; but they must be pretty strong, otherwise they will not op- erate OF THE PALSY. 293 Whatever increases the evacuation of urine or promotes perspira- tion, has a tendency to remove this disease. Both these secretions may be promoted by the iise of nitre and vinegar. 'Half a diachin of purified nitre may be given three or four times a day, iu auy manner that is most agreeable to the patient ; and an ounce and an half of dis- tilled vinegar may be daily mixed with his drink. Br Locker seems to think vinegar the best medicine that can be given in this disease. Camphire and musk have likewise been used in this case with ad- vantage. Ten or twelve grains of camphire may be rubbed in a. mor- tar, with half a drachm of nitre, and taken twice a day, or oftener, if the stomach will bear it. If it Avili not sit upon the stomach in this form, it may be made into pills with gum- asafcetida and Russian castor, and taken in the quantity above directed. If musk is to be adminis- tered, a scruple or twenty-five grains of it may be made into a bolus with a little honey or common syrup, and taken fwjee or thrice a-day. We do not mean that all these medicines should be administered at once ; but which ever of them is given, must be duly persisted in* and where one fails another may be tried. As it is Very difficult to induce patients In this disease to take medi- cines, we shali mention a few outward applications which sometimes do 'good ; the principal of these are issues, setofis, and warm bathing. Is- sues may be made in any part of the body, but they generally have the best effect near the spine. The discharge from these may be greatly promoted by dressing them with the mild blistering ointment, and keep- ing what are commonly called the orrice pease in them. The most proper place for a seton is between the shCulder-blades; and it ought to be placed upwards and downwards, or in the direction of the spine. OF THE 'P1LS¥. THE palsy is a loss or diminution of sense or motion, or of both, an one or more parts of the body. Of all the affections called nervous, this is the most suddenly fatal. It is more or less dangerous, according to the importance of the part affected- A palsy of the heart, lungs, or any part necessary to life, is mortal. When it affects the stomach, the intestines, or the bladder, it is highly dangerous. If the face be affected, the case is bad, as it shows that the disease proceeds from the brain. When the part affected feels cold, is insensible, or wastes away, or when the judgment and memory begin to fail, there is small hope of a cure. CAUSES. — The immediate cause of palsy is any thing that prevents the regular exertion of the nervous power upon any particular muscle or part of the body. The occasional and predisposing causes are va- rious, as drunkenness ; wounds of the brain, or spinal marrow; pres- sure upon the brain, or nerves ; very cold or damp air, the suppres- sion of customary evacuations; sudden fear; want of exercise; ta 294 OF THE PALSY. ■whatever greatly relaxes the system, as drinking much tea,* or coffee. The palsy may likewise proceed from wounds of the uerves themselves, from the poisonous fumes of metals or miuerals, as mercury, lead, arsenic. In young persons of a full habit, the palsy must be treated in the same manner as the sanguine apoplexy. The patient must be bled, Mistered, and have his bady opened by sharp clysters or purgative medicines. But in old age, or when the disease proceeds from relaxa- tion or debility, which is generally the case, a quite contrary course must be pursued- The diet must be warm and invigorating, seasoned •with spicy and aromatic vegetables, as mustard . horse radish, &c. The drink may be generous wine, mustard, whey, or brandy aud water, Friction with the flesh-brush or a warm hand, is extremely proper, es- pecially on the parts affected. Blistering-plasters may likewise be ap- plied to the affected parts with advantage. When ihiscauuot be done, they may be rubbed with the volatile liniment, or the nerve ointment of the Edinburgh Dispensatory. One of the best external applica- tions is electricity. The shocks, or rather vibrations, should be re- ceived on the part affected, and they ought daily to be repeated for several weeks. Vomits are very beneficial in this kind of palsy, and ought frequent- ly to be administered. Cephalic snuff, or any thing that makes the patient sneeze, is likewise of use. Some pretend to have found great benefit from rubbing the parts affected with nettles; but this dots' not teem to be any way preferable to blistering. If the tongue is affected, the patient may gargle his mouth frequently with brand) and mustard; or he may hold a bit of sugar in his mouth wet with the palsy drops or compound spirits of lavender. The wild valerian root is a very j i roper medicine in this case. It may either be taken in an infusion with sage leaves, or half a drachm of it in powder may be given in a plass of wine three or four times a day. If the patient cannot use the Valerian, he may take of sal volatile deosum, compound spirits of la- vender, and tincture of castor each half an ounce; mix these together, and take forty or fifty drops in a glass of wine, three or four times :; day. A table-spoonful of mustard-seed taken frequently is a very food medicine. The patient ought likewise to chew cinnamon, bark, finger, or other warm spiceries. * Many people imagine that tea has no tendency to hurt the uerves, Prid that drinking the same quantity of warm water would be equally j>t:rnjcious. This however teems to be a mistake. Many persons . iink three or four cups of warm milk and water daily, without feeling i.*iy had consequences; }e! the same quantity of tea will make their hii) !s shake for twenty-four hours. That tea affects the nerves, is like- . ; lent 'ii-om its preventing sleep, occasioning giddiness, dimness Bicknessj &c. OF THE EPILEPSY, &c^ 2fts Exercise is of the utmost importance in the palsy; but the patient B»ust beware of cold, damp, and moist air. He ought to wear flannel" aext the skin; and if possible, should remove into a wanner climate. OF THE EPILEPSY, OR FALLING SICKNESS. THE epilepsy is a sudden deprivation of all the senses, wherein the patient falls suddenly down, and is affected with violent convulsive mo- tions. Children, especially those who are delicately brought up, are most subject to it. It more frequently attacks men than women, and is very difficult to cure. When the epilepsy attacks children, there is reason to hope it may go off in the time of puberty. When it attacks any person after twenty years of age, the cure is difficult ; but when after forty, a cure is hardly to be expected. If the fit continues only for a *hort space, and returns seldom, there is reason to hope ; but if it continues long, and returns frequently, the pros-pect is bad. It is a very unfavorable symptom whea the patient is seized with the fits in his sleep. CAUSES. — The epilepsy is sometimes hereditary. It may like- wise proceed from blows, bruises, or wounds on the head ; a collection of water, blood, or serous humours in the brain ; a polypus ; tumours or concretions within the skull ; excessive drinking ; intense study ; excess of venery ; worms; teething; suppression of customary evacua- tions ; too great emptiness or repletion ; violent passions or affections of the mind, as fear, joy, &c. hysteric affections ; contagion received into the body, as the infection of the small- pox, measles, &c. SYMPTOMS. — An epileptic fit is generally preceded by unusual weariness ; pain of the head ; dullness ; giddiness ; noise in the ears ; dimness of sight ; palpitation of the heart ; disturbed sleep ; difficult breathing; the bowels are inflated with wind; the urine > is in great quantity, but thin; the complexion is pale; the extremities are cold; and the patient often feels, as it were, a stream of cold air ascending towards the head. In the fit the patient generally makes an unusual noise; his thumbs are drawn in towards the palms of the hand ; his eyes are distorted ; he starts and foams at the mouth ; his extremities are bent or twisted various ways ; he often discharges his seed, urine, and faeces involun- tarily ; and is quite destitute of all sense and reason. After the fit is over, his senses gradually return, and he complains of a kind of stu- por, weariness, aud pain of the head ; but has no remembrance of what happened to him during the fit. The fits are sometimes excited by violent affections of the mind, a debauch of liquor, excessive heat, cold, or the like. This disease from the difficulty of investigating its causes, and its strange symptoms, was formerly attributed to the wrath of the gods, or the agency of evil spirits. In modern times it has often, by the vul- 295 OF THE EPILEPSY, &c. gar, been imputed to witchcraft or fascination. It depends however as much upon natural causes as any other malady; and its cure may often be affected by persisting in the use of proper means. REGIMEN. — Epileptic patients, ought, if possible, to breathe a pure and free air. Their diet should be light but nourishing. They ought to drink nothing strong, to avoid swine's flesh, water-fowl, and likewise all windy and oily vegetables, as cabbage, nuts, &c. They ought to keep themselves cheerful, carefully guarding against all vio- lent passions, as anger, fear, excessive joy and the like. Exercise is likewise of great use; but the patient must be careful to avoid all extremes either of heat or cold, all dangerous situations, a3 Standing upon precipices, riding, deep waters, and such like. MEJICINE — The intentions of cure must vary according to the cau-e of the disease.. If the patient be of r, sanguine temperament, and there be reason to fear an obstruction in the brain, bleeding and other evacuations will be uecessary. When the disease is occasioned by the stoppage of customary evacuations, these, if possible, must be restored; if this cannot be done, others may be substituted in their place. Is- sues or setona in this case have often a very good eflect. When there is reason to believe that the disease proceeds from worms, proper med- icines must be used to kill, or carry off these vermiu. When the dis- ease proceeds from teething, the body should be kept open by emolli- ent clysters, the feet frequently bathed in warm water, and if the fits prove obstinate, a blistering-plaster may be put between the shoulders. The same method is to be followed, when epileptic fits precede the eruption of the small-pox, or measles, &c. When the disease is hereditary or proceeds from a wrong formation of the brain, a cure is not to be expected. When it is owing to a de- bility, or too great an irritability of the nervous system, such medi- cines as tend to brace and strengthen the nerves may be used, as the Peruvian bark, and steel ; or the anti epileptic electuaries, recommend- ed by Fuller and Mead. The flowers of zinc have of late been highly extolled for the cure of the epilepsy. Though this medicine will not be found to answer the expectations which have been raised concerning it, yet in obstinate ep- ileptic cases it deserves a trial. The dose is from one to three or" four grains, which may be taken either in pills or a bolus, as the patient in- clines. The best method is to begin with a single grain four or five times a-day, and gradually to increase the dose as far as the patient can bear it. I have known this medicine, when duly persisted in, prove beneficial. Musk has sometimes been found to succeed in the epilepsy. Ten or twelve grains of it, with the same quantity of factitious cinnabar may be made up into a bolus, and taken every night and morning. Sometimes the epilepsy has been cured by electricity. ©F THE HICKUP, 297 ©onvulsion fits proceed from the same cause, and must be treated in, the same manner as the epilepsy. There is oue particular species of convulsion fits which commonly goes by the nam:; of St. Vitus's dance, wherein the patient is agitated with strange motions and gesticulations, which by the common people are generally believed to be the effects of witchcraft This disease may be cured by repeated bleedings and purges; and afterwards using the medicines prescribed above for the epilepsy, vis. the Peruvian bark and soake-roor, &c Chaiybeaie waters are found to be beneficial iu this case. The cold bath is likewise of singular service, and ought saever to be neglected when the patient can bear it. OF THE HICKUl\ THE hickup is a spasmodic or convulsive affection of the ston> $ch and midriff, arising from any cause that irritates their nervous fibres. It may proceed from excess in eating or drinking ; from a hurt of 4he stomach; poisons; inflammations or schirrous tumours of the stomach, intestines, bladder, midriff, or- the rest of the viscera. In gangrenes, acute and malignant fevers, a hickup is often the forerunner of death. When the hickup proceeds from the use of aliment that is flatulent, or hard of digestion, a draught of generous wine, or a drachm of any spirituous liquor, will generally remove it. If poison be the cause, plenty of milk aud oil must be drank, as has been formerly recom- mended. When ft proceeds from an inflammation of the stomach, &c. it is very dangerous. In this case the cooling regimen ought to be strictly observed. The patient must be bled, and take frequently a few drops of the spirits of nitre in a cup of wine His stomach should likewise be fomented with cloths dipped in warm water, or have blad- ders filled with warm mi!k and water applied to it. When the hickup proceeds from a gangrene or mortification, the Peruvian bark, with other antiseptics, are the only medicines which have a chance to succeed. When it is a primary disease, and pro- ceeds from a foul stomach, loaded either with a pituiious or a bilious humour, a gentle vomit and purge, if the patient be able to bear them, will be of service. If it arises from flatulencies, the carminitive medi- cines directed for the heart-burn must be used. When the hickup proves very obstinate, recourse must be had to the most powerful aromatic and antispasmodic medicines. The prin- cipal of these is musk ; fifteen or twenty grains of which may be made into a bolus, and repeated occasionally. Opiates, are likewise of ser- vice ; but they must be used with caution. A bit of sugar dipped in compound spirits of lavender, or the volatile aromatic tincture, may be taken frequently. External applications are sometimes also benefi- cial ; as the stomach olaster, or a cataplasm of the Venice treacle of 38 " ' 29» CRAMP OF THE STOMACH. the Edinburgh or London dispensatory, applied to the region oftft* stomach. I lately attended a patient who had almost a constant bickup for above Dine weeks. It was frequently stopped by the use of rausk, opi- um, wine, and other cordial and antispasmodic medicines, but always returned. JNTothiug however gave the patient so much ease as brisk small beer. By drinking freely of this, the hickup was often kept off for several days, which was more than could be done by the most pow- erful medicines. The patient was at length seized with a vomiting of blood, which soon put an end to his life. Upon opeuing the body, a large schirrous tumour was found near the pylorus or right orifice of the stomach. The hickup may be removed by taking vinegar; or by a few drops of the oil of vitriol taken in water. CRAMl' OF THE STOMACH. TUTS disease often seizes people suddenly, is very dangerous, and requires immediate assistance. It is most incident to persons in the de-* cline of life, especially the nervous, gouty, hysteric, and hypochon- driac. If the patient has any inclination to vomit, he ought to take some draughts of warm water, or weak camomile tea, to cleanse his stomach. After this, if he has been costive, a laxative clyster may be given. He ought then to take laudanum. The best way of administering it is. in a clyster. Sixty or seventy drops of liquid laudanum may be giv- en in a clyster of warm water. This is much more certain than lau- danum given by the mouth, which is often vomited, and in some cases increases the pain and spasms in the stomach. If the pains and cramps return with great violence, after the effects of the anodyne clysters are over, another, with an equal or larger quantity of opium, may be given ; and every four or five hours a bo- lus, with ten or twelve grains of Musk, and half a drachm of the Ven- ice treacle. In the mean time the stomach ought to be fomented with cloths dip- ped in warm water, or bladders filled with warm milk and water should be applied to it. I have often seen these produce the most happy ef- fects. The anodyne balsam may also be rubbed ou the part affected ; and an anti-hysteric plaster worn upon it for some time after the cramps are removed, to prevent their return. In very violent and lasting pains of the stomach, some blood ought to be let, unless the weakness of the patient forbids it. When the pains or cramps proceed from a suppression of the menses, bleeding is of use. If they be owing to the gout, recourse must be had to spirits, or some of the warm cordial waters. Blistering plasters ought likewise ?n this case to be applied to the ancles. I have often seen violent mw swoomms. $m •cramps and pains of the stomach removed by covering it with a larg* plaster of venice-treacle. OF THE NIGHT-MARE. IN this disease the patient, in time of sleep, imagines he feels an us- eommon oppression or weight about his breast or stomach, which he can by no means shake off. He groans and sometimes cries out, though 'oftener he attempts to speak in vain. -Sometimes he imagines himself •engaged with an enemy, and in danger of being killed, attempts to run away, but finds he cannot. Sometimes he fancies himself in a house that is on fire, or that he is in danger of being drowned in a river- He often ihinks be is falling over a precipice, and the dread of being dashed to pieces suddenly awakes him. This disorder has been supposed to proceed from too much blood ; 'from a stagnation of blood in the brain, lungs, &c. But it is rather « nervous affection, and arises chiefly from indigestion. Hence we find that persons of weak nerves, who lead a sedentary life, and live full, are most commonly afflicted with the night-mare. Nothing tends more to produce it than heavy suppers, especially when eaten late, or the patient goes to bed soon after. Wind is likewise a very frequent cause of this disease; for which reason those who are afflicted with it ought to avoid all flatulent food. Beep thought, anxiety, or afiy thing 4hat oppresses the mind, ought also to be avoided. As persons afflicted with the night mare generally moan, or make some noise in the fit, they should be waked> or spoken to by such aa Ihear them, as the uneasiness generally goes 6ff as soon as the patient is awake. Dr. Whytt says he generally fouod a dram of brandy, taken: at bed-time, prevent this disease. That however is a bad custom, anet in time looses its effect. We would rather have the patient depend upon the use of food of easy digestion, cheerfulness, exercise through •the day, and a light supper taken early, than to accustom himself to drams. A glass of peppermint water will often promote digestion as much as a glass of brandy, and is much safer. After a person of weak digestion, however, has eaten flatulent food, a dram may be necessary. Persons who are young and full of blood, if troubled with the night* mare, ought to take a purge frequently, and use a spare diet. of swoomms. PEOPLE of weak nerves or delicate constitutions are liable to swoonings or fainting-fits. These indeed are seldom dangerous when duly attended to : but when wholly neglected, or improperly treated, they often prove hurtful, and sometimes fatal. The general causes of swoonings are, sudden transitions from cold to &eatv$ breathing air that is deprived of its proper spring or elasticity £ W9 OF SWOONING*. f rea't fatigue; excessive weakness; loss of blood; long fasting; fear. grief, and other violent passions or affections of the mind. It is well k.io-.v.M, that pcisons who have been long exposed to cold often fain! or fall into a swoon, upon coming into the house, especially if they drink hot liq.ior. or sit near a large fire This might easily be prevented by people taking care not to go into a warm room immedi- ately af:er they have been exposed to the told air, to approach the fire gradually, and not ; eat or drink any thing hot, till the body has been gradually brought into a warm temperature. n any one, in consequence of neglecting these precautions, falls in'o a swoon, he ought immediately to be removed to a cooler apart- ment to have ligatures applied above his knees and elbows, and to nave face .-priukied with vinegar or cold water. He should likewise be made to smell 10 v'-upgar and should have a spoonful or two of wafer, if he can swallow, ^ith about a third par. of vinegar mixed with it, poured into his mouth. If ibese should not remove the complaint, i( will be accessary to bleed the patient, and afterwards to giro iiim a clyster. As air that is breathed frequently loses its elasticity or spring, it is no h ■■■ tier i persons who respire in it often fall into a swoon or fainting ey ire in this case deprived of the very principle of life, hence it is that fainti ig fits are so frequent in all crowded assemblies, espe- cially to hoi OP FLATtfLEKClES, OR Wi$D. ters, tinctures, and spirits, as the aromatic water, the tinctures of wood- 'soot, the volatile aromatic spirit, aether, &c. Dr. Whytt says, he found no medicines more efficacious in expelt- ing wind than aether and laudanum. He generally gave the lauda- num in a mixture with peppermint-water and tincture of castor, or sweet spirits of uitre. Sometimes in place of this, he gave opium ia pills with a?afcetida. He observes that the good effects of opiates are equally conspicuous, whether the flatulence be contained in the stom- ach or intestines; whereas those warm medicines, commonly called carminatives, do not often give immediate relief, except when the wind is in the stomach. With regard to aether, the Doctor says, he has often seen very good effects from it in flatulent complaints, where o'her medicines failed. The dose is a tea-spoonful, mixed with two table-spoousful of water.* In gouty cases he observes, that aether, a glass of French brandy, or of the aromatic water, or ginger, either taken in substance or infu- sed in boiling water, are among the best medicines for expelling wind. When the case of flatsJent patients is such as makes it improper te give them warm medicines inwardly, the Doctor recommends exter- nal applications, which are sometimes^f advantage. Equal parts of the anti hysteric and stomach plaster may be spread upon a piece of soft leather, of such size as to cover the greater part of the beliy. This should be kept on for a considerable time, provided the patient be able to bear it ; if it should give great uneasiness it may be taken off, and the following linament used in its Stead : Take of Bate's anodyne balsam, an ounce ; of the expressed oil of Tnace, half an ounce; oil of mint, two drachms. Let these ingredi- ents be mixed together, and about a table-spoonful well rubbed on the iparts at bed-time. For strengthening the stomach sad howels, and consequently for les- sening the production of flatulence, the Doctor recommends the Peru- vian bark, bitters, chalybeates, and exercise. In flatulent cases, he 'thinks some nutmeg or ginger should be added to the tincture of the Dbark and bitters, aud that the aromatic powder should be joined with the filings of iron. When windy complaints are attended with costiveness, which is of- ten the case, few things will be found to answer better than lour or five of the following pills taken every night at bed-time. Take of asafcetida two drachms; succotrine aloes, salt of iron, and ynwdered ginger, of each, one drachm ; as much of the ciixir prcprit- iatis as will be sufficient to form them into pills. * Though the patient may begin with this quantity, it will be neces- «iry to increase the dose gradually as the stomach can bear it. A ther Is now given hi coasiderably greater doses than it was in Dr. Wh)tt% %sme. OF LOW SPIRITS* mk ©nine other hand, when the body is too open, twelve or fifteen grains of rhubarb, with half a drachm or two scruples of the Japonic Confection j given every other evening, will have very good effects. In those flatulent complaints which come on about the time the mm- ?es cease, repeated small bleedings often give more relief thau any oth- er remedy. With regard to diet the Doctor observes, that tea, and likewise all flatulent aliments, are to be avoided; and that for drink, water with a, little brandy or rum, is, not only preferable to malt liquor, but in most cases also to wine. As Doctor Wbytt has paid great attention to this subject, and as his sentiments upon it in a great measure agree with mine, I have taken the liberty to adopt them; and shall only add to his observations, that ex- ercise is in my opinion superior to all medicine, both for preventing the production, and likewise for expelling of flatulencies. These ef- fects however are not to be expected from sauntering about, or lolling in' a carriage ; but from labour or such active amusements as give exercise |o every part of the body. OF LOW SPIRITS. All who haye weak nerves are subject to. low spirits in a greater or Jess degree. Generous diet, the cold bath, exercise, and amusements, are the most ltkety means to remove this complaint. It is greatly in- creased by solitiide and indulging gloomy ideas, but may often be re- lieved by cheerful company and sprightly amusements. When low spirits are owing to a weak relaxed state of the stomach and bowels, an infusion of the Peruvian bark with cinnamon or nutmeg will be proper. Steel joined with aroroatics may likewise in this case be used with advantage ; but riding and a proper diet are most to be de- pended on. When they arise from foujnesg of the stomach and intestines, or ob- structions in the hypochondriac viscera, aloetic purges will be proper. I have sometimes known the Harrowgate sulphur-water of service in flris case. When low spirits proceed from a suppression of the menstrual or of the hemorrhoidal flux, these evacuations may either be restored, or some other substituted in their place, as issues, setons or the like. Dr. Whytt observes, that nothing has such sudden good effects in this case as bleeding. When low spirits have been brought on by long continued grief, anxiety, or other distress of mind, agreeable company, variety of amusements, and change of place, especially travelling into foreign ^countries, will afford the most certain relief. Persons afflicted with low spirits should avoid all kinds of excess, Imperially of yenery and strong liquors. The moderate use of wine 30* OF HYSTERIC AFFECTIONS'. and other strong liquors is by no meaas hurtful; but when taken t« excess they weaken the stomach, vitiate the humours, and depress the spirits This cautiou is die more necessary, as the unfortunate and melancholy often fly to strong liquors for relief, by which means they never fail to precipitate their own destruction. OF HYSTERIC AFFECTIONS. THESE likewise belong to the numerous tribe of nervous diseases, ■which may be justly reckoned the reproach of medicine. — Women of a delicate habit, whose stomach and intestines arc relaxed and whose nervous system is extremely sensible, are most subject to h) steric complaints. In such persons an hysteric fit, as it is called, may be brought oq by an irritation of the nerves of the stomach or intestines, by wind, acrid humour, or the like. A sudden suppression of the 9nenses often give rise to hysteric fits They may likewise be exci- ted by violent passions or affections of the mind, as fear, grief, auger, or great disappointments. Sometime the hysteric fit resembles a swoon or fainting fit, during ■which the patient lies as in a sleep, only the breathing is t0 low as scarce to be perceived. At other times the patieot is affected with catchings and strong convulsions. The symptoms which precede hys- teric fits are likewise various in different persons. — Sometimes the fits come on with coldness of the extremities, yawning and stretching, low- ness of spirits, oppression and anxiety. At o her times the approach of the fit is foretold by a feeling, as if there were a ball at the lower part of the belly, which gradually rises towards the stomach, where it occasions inflation, sickness, and sometimes vomiting ; afterwards it ri- ses into the gullet, and occasions a degree of suffocatiou, to which quick breathing, palpitation of the heart, giddiness of die head, dimness of the sight, loss of hearing, with convulsive motions of the extremities and other parts of the body, succeed. The hj steric paroxysm is often introduced by an immoderate fit of laughter, and sometimes it goes off by crying. Indeed there is not much difference between the laughing and cryi'ug of an highly hysteric lady. Our aim in the treatment of this disease, must be to shorten the fit or paroxysm when present, and to prevent its return, The longer the fit* continue, aud the more frequently they return, the disease becomes the more obstinate. Their strength is increased by habit, and they induce so great a relaxation of the system, that it is with difficulty removed. It is customary during the hysteric fit or paroxysm, to bleed the pa- tient. In strong persons of a plethoric habit, and where the pulse is full, this may be proper: but in weak and delicate constitutions, or where the disease has been of long standius, or arises from inanition, it is not safe. The best course in such case is to rouse the patient by strong smells, as burnt feathers, asafatida, or spirits of hartshorn, held to the OF HYSTERIC AFFECTIONS. 305 i'jose. Hot bricks may also be applied to the soles of the feet, and the legs, arms and belly may be strongly rubbed with a warm cloth. But the best application is to put the feet acid legs into warm wafer. This is peculiarly proper when the fits precede the flow of the menses. la case of costiveness, a laxative clyster with asafoetida will be proper; and as soon as the patient can swallow, two table-spoonsful of a solution of asafoetida, or of some cordial julep, may be given.* The radical cure of this disorder will be best attempted at a time when the patient is most free from the fits. It will be greatly promoted by a proper attention to diet. A milk and vegetable diet, when duly per- sisted in, will often perform a cure. If however the patient has been accusiomed to a more generous diet, it will not be safe to leave it off all at once, but by degrees. The most proper drink is water with a small quantity of spirits, A cool dry air is the best. Cold bathing, and ev- ery thing that braces the nerves and invigorates the system, is benefi- cial ; but lying too long in bed, or whatever relaxes the body, is hurt- ful. It is of the greatest importance to have the mind kept constantly easy and cheerful, and, if possible, to have it always engaged In some agreeable and interesting pursuit. The proper medicines are those which strengthen the alimentary canal and the whole nervous system, as the preparations of iron, the Peruvian bark and other bitters. Twenty drops of the elixir of vitri- ol,, in a cup of the infusion of the bark, may be taken twice or thrice, a-day. The bark and iron may likewise be taken in substance, provi- ded the stomach can bear them ; but they are generally given in too* small doses to have any effect. The chalybeate waters generally prove beneficial in this disorder. If the stomach is loaded with phlegm, vomits will be of use; but ihey should not be too strong, nor frequently repeated, as they tend to relax and weaken the stomach. If there be a tendency to costiveness^ si most be removed eftbei by diet, or by taking an opening pill as often, as it shall be found necessary. To lessen the irritability of the system, antispasmodic medicines wilt lie of use. The best antispasmodic medicines are musk, ppium, and castor. When opium disagrees with the stomach, it may either be ap- plied externally, or given in clysters. It is often successful in remo- ving those periodical head-aches, to which hysteric and hypochondri- # When hysteric fits are occasioned by sympathy, they may be cu- red by exciting an opposite passion. This is said to have been the case of a whole school of young ladies in Holland, who were all cured by being told', that the first who was seized should be burnt to death. But this method of cure, to my knowledge, will not always succeed. | would therefore advise, that young ladies who are subject to hysteric fits should not be sent to boarding schools, as the disease maybe caught by imitations I have knowa madness itself brought on by sympathy. 39 SOfi OF HYPOCHONDRIAC AFFECTIONS. ?.c patients are subject. Castor has hi some cases been found to pro- cure sleep where opium failed; for which reason, Dr. Whytt advises, that they should be joined together. He likewise recommends the au- tt hysteric plaster to be applied to the abdomen.* Hysteric women are often afflicted with cramps, in various parts of the body, which are most apt to seize them in bed, or when asleep. The most efficacious medicines in this case are opium, blistering- plasters, and warm bathing or fomentations. When the cramp or spasm is very violent, opium is the remedy most to be depended on. In milder cases, immersing the feet and legs in warm water, or apply- ing a blistering-plaster to the part affected, will often be sufficient to remove the complaint. In patients whose nerve* are uncommonly delicate and sensible, it will be better to omit the blistering-plaster, and to attempt the cure by opiates, musk, camphire and the warm bath. Cramps are often prevented or cured by compression. Thut cramps in the legs are prevented, and sometimes removed, by tight bandages ; and when convulsions arise from a flatulent distention of the iutestines, or from spasms beginning in them, they may be often lessened or cured by making a pretty strong compression upon the abdomen by means of a broad belt. A roll of brimstone held in the hand is frequently used as a remedy for cramps. Though this seems to owe its effects chiefly to imagination, yet, as it sometimes succeeds, it merits a trial. f When spasms or convulsive motions arise from shaip humours in the stomach or intestines, no lasting relief can be procured till these are either corrected or expelled. The Peruvian bark has sometimes cured periodic convulsions after other medicines had failed. OF HYPOCHONDRIAC AFFECTIONS. THIS disease generally attacks the indolent, the luxurious, the un- fortunate, and the studious. It becomes daily more common in this country, owing no doubt to the increase of luxury and sedentary em- ployments. It has so near a resemblance to the immediately preceding, that many authors consider them as the same disease, and treat them accordingly. They require however, a very different regimen; and the symptoms of the latter, though less violent, are more permanent than those of the former. * Though antispasmodics and anodynes are universally recommend- ed in this disease, yet all the extraordinary cures that I ever knew in hysteric cases, were performed by means of tonic and corroborating medicines. t Some persons afflicted wilh cramps pretend to reap great benefit from small bundles of rosemary tied all night about their feet, ancles, and knees. OF HYPOCHONDRIAC AFFECTIONS. 30? Men of a melancholy temperament, whose minds are capable of great attention, and whose passions are not easily moved, are in. the advau- ced periods of life, most liable k to this disease. It is usually brought en by long and serious attention to abstruse subjects, grief, the sup- pression of customary evacuations, excess of venery, the repulsion of cutaneous eruptions, long continued evacuations, obstruction in some of the viscera, as the liver, spleen, &c. Hypochondriac persons ought never to fast long, and their food should be solid and nourishing. All ascesent and windy vegetables are to be avoided. Flesh meats agree best with them, and their drink should be old Claret, or good Madeira. Should these disagree with the stomach, water with a little brandy or rum in it may be drank. Cheerfulness and serenity of mind are by all means to be cultivated. Exercise of every kind is useful. The cold bath is likewise benefi- cial; and / where it does not agree with the patient, frictions with the flesh-brush or a coarse cloth may be tried. If the patient has it in his power, he ought to travel either by sea or land. A voyage or a long journey, especially towards a warmer climate, will be of more service than any medicine. The general intentions of cure in this disease, are to strengthen the alimentary canal, and to promote the secretions. These intentions will be best answered by the different preparations of iron and the Peruvi- an bark, which, after proper evacuations, may be taken in the same manner as directed in the preceding disease. If the patient be costive, it will be necessary to make use of some gentle opening medicines, as pills composed of equal parts of aloes, rhubarb, and asafoetida, with as much of the elixir proprietatis as is necessary to form the ingredients into pills. Two, three, or Jour of these may be taken as often as it shall be found needful, to keep the body gently open. Such as cannot bear the asafoetida, may substitute Span- ish soap in its place. Though a cheerful glass may have good effects in this disease, yet all manner of excess is hurtful. Intense study, and every thing that de- presses the spirits, are likewise pernicious. Though the general symptoms and treatment of nervous disorders were pointed out in the beginning of this chapter, yet, for the benefit of the unhappy persons afflicted with those obstinate and complicated maladies, I have treated several of their capital symptoms under dis« tinct or separate heads. These however are not to be considered as different diseases, but as various modifications of the same disease. They all arise from the same general causes, and require nearly the same method of treatment. There are many other symptoms that mer- it particular attention, which the nature of my plan will not permit me to treat of at full length. I shall therefore omit them altogether, and conclude this chapter with a few general remarks on the most obvious aaeaps of preventing or avoiding nervous disorders 308 OF HYPOCHONDRIAC AFFECTIONS. In all persons afflicted with nervous disorders, there is a great deli- cacy; and sensibility of the whole nervous system, and an uncommon decree of weakness of the organs of digestion. These maybe either nalu: »1 or acquired. When owing to a defect in the constiiution, they are hardly to be removed; but maybe mitigated by proper care. When induced by diseases, as long or repeated fe\ ers, profuse haemorr- hages or the like, they prove also very obstinate, and will }ield only to a course of regimen calculated to restore and invigorate the habit. But nervous affections arise more frequently from causes, which it is in a great measure in our own power to avoid, than from diseases, or an original fault in the constitution, &c. Excessive grief, intense study, improper diet, and neglect of exercise, are the great sources of this extensive class of diseases. It has been already observed, that grief indulged destroys the appe- tite and digestion, depresses the spirits, and induces an universal relax- ation and debility of the whole system. Instances of this are daily to fee seen The less of a near relation, or any other misfortune in life, is often sulTicieit to occasion the most complicated series of nervous symptom 5 . Such misfortunes indeed are not to be avoided, but surely their effects, by a vigorous and proper exertion of the mind, might be rendered less hurtful. For directions in this matter, we must refer the reader to the article Grief, in the chapter on the passions. The effects of intense study are pretty similar to those occasioned by grief. It preys upon the animal spirits, and destroys the appetite and digestion. To prevent these effects, studious persons ought accor- ding to the Poet, to toy with their books* They should never study too long at a time; nor attend long to one particular subject, especial- ly if it be of a serious nature. They ought likewise to be attentive to their posture, and should take care frequently to unbend their minds by music, diversions, or going into agreeable company. With regard to diet, 1 shali enly observe, that nervous diseases may be induced either by excess or inanition. Both of these extremes hurt digestion, and vitiate the humours. When nature is oppressed with fresh loads of food before she has had time to digest and assimi- late the former meal, her powers are weakened, and the vessels are fib led wih crude humours. On the other hand, when the food is not suf- ficiently nourishing, or is taken too seldom, the bowels are inflated -with wind, and the humours, for Avant of regular fresh supplies of wholesome chyle, are vitiated. These extremes are therefore with equal care to be avoided. They both tend to induce a relaxation, and debility of the nervous system, with all its dreadful train of consequen- ces. But the most general cause of nervous disorders, is indolence — The active aud laborious are seldom troubled with them. They are reser- * Armstrong on Health. TETANUS, OR LOCKED JAW. 300 y-ad for the children of ease and affluence, who generally feel their keenest force. AJl we shall say to such persons, is, that the means of prevention and cure are both in their owu power. If the constitution of human nature be such, that man must either labour or suffer diseases, surely no individual has any right to expect an exemption from the general rule. Those however who are willing to take exercise, but whose occupa- tions confine them to the house, and perhaps to an unfavourabe post- ure, really deserve our pity. We have in a former part of the book, endeavoured to I fey down rules for their conduct; and shall only add, that where these cannot be complied with, their place may, in some measure, be supplied by the use of bracing and strengthening medi- cines, as the Peruvian bark, with other bitters ; the preparations of steel; the elixir of vitriol, &c. OF THE TETANUS, OR THE LOCKED JAW. UNDER this term may be comprehended the spasmodic affections, called emprosthotonos, opisthotonos, and trismus, being one disease, dif- fering only in the degree of its violence. When the body aud head are bended forwards, it is called emprosthotonos, when they are car- ried backwards, and immovably fixed, it bears tiie appellation of opist- hotonos; and when the body is sustained in an erect position, by the muscle on the fore and batk part of the trunk acting with equal strength, the disease is called tetanus. — When the muscles of the jaw become more particularly affected, it is called trismus or the locker! jaw. These spasmodic complaints affect both sexes, and no age is exemp- ted from their violence. They affect the male oftener than tiie female, and more particularly those people who inhabit warm climates, and every climate at the warm season of the year. Sometimes they occur in winter independent of wounds. CAUSES. — Wounds in any part of the body are sometimes suc- ceeded by this disease. But more particularly from those in tendons 1 , where a trifling injury will not unfrequteutly produce this complaint', when it is least expected. Whereas, fit other times, a wound of con- siderable magnitude, under apparently similar circumstances, will have no such effect ; and, even after operations in tendenous parts, it is by no means a frequent occurrence; when at other times, a simple frac- ture of the leg will produce it in all its force. Cold, when accompa- nied with moisture, will produce this disease ; particularly when thfi body is exposed while asleep on a damp pavement, or in a damp cel- lar, immediately after being heated and fatigued by exercise. Chil- dren are frequently siezed with this disease in a short time after de- livery. SYMPTOMS.— This disease, if it is from the effects of cold, gen- erally comes on of a sudden. But when from a wound, it gradually* JS10 TETANUS, OR LOCKED J AIT. approaches about the tenth, fourteenth, or twentieth days after the ac- cidcut. It often comes oa at a time when the wound gives but little uneasiness, and is nearly healed. The patient first complains n\ an urrcasy sensation at the lower part of the breast bone, with a stiffness in the back part of the neck and muscles of the lower jaw, which in- crease with a painful sensation at the root of the tongue, and a slight difficulty in swallowing But no appearance of swelling can be ob- served iu the throat. The muscles of the back now become rigid. This rigidity in a short time extends to those of the neck, attended with a pain in the direction of the spine of the back; At length the head, neck, and back bone are forcibly bent backwards. The body becomes fixed iu that position. The muscles of the jaw are now vio- lently affected, attended with an impossibility of swallowing. Even liquids are thrown forcibly back through the uosr. These symptom* generally take place on the second or third day, when die body is fre- quently siezed with violent convulsive spasms; and the pain at the part of the breast boue i'.'-j,rea3c- 9 which shoots through towards Lh ack. The muscles of the limbs now become rigid, and the body is so much bent ha U wards as to rest on the back part of the head and heels. As the disease advauces, the convulsive spasms become more violent. At length tetanus is produced, from the muscles on the fore and back part of the trunk, acting with an equal degree of vigour, sus- taining the bo ly in an erect position. The pulse is generally frequent with the other symptoms of fever, particularly when the disease is the consequence of cold. The bowels are generally costive, attended with a retraction of the belly. The urine is discharged with difficulty, and sometimes a suppression of that evacuation takes place. — The face ap- pears prde, expressive of great anxiety and distress. The patient is seldom, if ever, delirious, although he slumbers but little, from which he frequently awakes oa a sudden, with violent spasms At length the muscular system becomes more generally affected, and one univer- sal convulsion closes the miserable existauce of the patient. MEDICINE. — In our attempt to cure this disease, the indications ■are nearly the same, wheu produced from cold or the consequence of a wound, except wheu the wound is without swelling and inflamma- tion It should then be dilated and dressed, with lint dipped in warm basilicon. or any other stimulating application. After this, two, three, or even four grains of opium should be given three or four times a-day Ifitg to the urgency of the symptoms, and tendency to induce sleep'; for astonishing quantities of this medicine may be given with- rsut having the leasi tendency to make the patient slumber. Thisreme- v should be administered early, as well as large quantities of Madeira . before the swallowing becomes interrupted; and the system ; with mercury with as much expedition as possible. ■mov this puvpose two or Uuee drachms of mercurial ointment must b? DISORDERS OF THE SENSES,. 31 % Tubbed into the inside of the legs, thighs and arms, morning and even- ning, and likewise into the muscles more particularly affected with spasms. To co operate with those medicines, the cold bath must be used, or cold water thrown over the body. The boTels should be kept open with calomel, castor-oil, and clysters. All those remedies must 1>e used at an early period of the complaint, so as to make as formida- ble an attack as* possible on this very formidable disease, which too frequently terminates in the death of the patient, in spite of every ef- fort to save him. When it is about to take place in infants, the bowels must be opened with calomel or castor oil. But where it has actually taken place, lit- tle can be done. However, a similar plan may be used with that re- commended in grown, persons. CHAPTER XLV. DISORDERS OF THE SENSES. WE do not mean to treat of the nature of our sensations, or to give a minute description of the various organs by which they are performed ; but to point out some of the diseases to which these organs are most liable, and to show how they may be prevented or remedied* OF THE EYE. No organ of the body is subject to more diseases than the eye; nor ie there any one of which the diseases are more difficult to cure. Though more ignorant persons pretend to cure these than any other class of diseases ; yet a very superficial acquaintance with the structure of the eye, and the nature of vision, will be sufficient to convince any one of the danger of trusting to them. These diseases often exceed the skill ©f the most learned physician ; hence we may easily infer the danger of trusting them to ignorant quacks, who, without doubt, put out more eyes than they cure. But, though the diseases of the eye can seldom fee cured, they might often, by due care, be prevented ; and, evea where the sight is totally lost, many things might be done, which are generally neglected, to render the unhappy person both more useful ta himself and society.* * It is a pity those who have the misfortune to be born blind, or who lose their sight when youcg, should be suffered to remain io ignorance, 312 OF THE EYE. The eyes are hurt by viewing bright or luminous objects ; keeping the head too long iu a hanging posture; violent head-aches; excessive veaery ; the long use of bitters; the effluvia from acrid or volatile sub- stances; various diseases ; as the small pox, measles, d:c. but above all from night watching, and candle-light studies. Loug fasting is likewise hurtful to the eyes, and frequent heals and colds are no less pernicious. The eyes are often hurt by the stoppage of customary evacuations: as morning sweats ; sweating of the feet, the menses in women ; and the bleeding piles in men. — All kind? of excess are likewise hurtful to the sight, particularly the immoderate use of ardeut spirits and other strong liquors. In all diseases of the eyes, especially those atteuded with inflamma- tion, the cool regimen ought to be observed. The patient must abstain from all spirituous liquors. The smoke of tobacco, smoky rooms, the vapours of onions and garlic, and all vivid lights and glaring colours, are carefully to be avoided The drink may be water, whey, or small beer; and the aliment must be light and of easy digestiou. For preventing disorders of me eyes, issues and setons are of prime use. Every person whose c>e: are lender, o.ight to have one or more of these in some part of the body. It will likewise be of use to keep the body gently open, and either to bleed or purge every spring and fall. Alf excess and night studies are to be avoided. _ Such as do not choose a seton or an issue, will reap benefit from wearing a small Bur-r gundy pitch plaster between the shoulders. A gutta serena or amaurosis is an abolition of the sight without any apparent cause or fault in the eyes. When it is owing to a decay or casting of the optic nerve, it does not admit of a cure; but when it proceeds from a compression of the nerves by redundant humours, these may iu some measure be drained off, and the patient relieved. For this purpose, the body must be kept open with the laxative mercurial pills. If the patieut be young and of a sanguine habit he may be bled. Cupping. With scarifications on the back part of the head, will like- wise be of use. A running at the nose may be promoted by volatile salts, stimulating powders, &c. But the most likely means for reliev- ing tiie patieut are issues or blisters kept ©pen for a long time ou the or to beg. This is both cruelty and want of economy. There are many employments of which blind persons are very capable, as knit- ting, carding, turning a wheel, teaching languages, &c. Nor are in- sWces wanting of persons who have arrived at the highest pitch ot learning, without having the least idea of light. Witness the late fa- mous Nicholas Sanderson of Cambridge, and my worthy friend Dr. Thomas Blacklock of Edinburgh. The former was one of the first mathematicians of his age, and the latter, besides being a good peet and philosopher, is master of all the learned languages, and a, very conside- rable adept in the libera! arts. OF THE EYE. 813 back part of the head, behind the ears, or on the neck. I have known ttiese restore sight, even after it had been for a considerable time lost. Should these fail, recourse must be had to mercurial sain tv as; or ■what will perhaps answer the purpose better, twelve grains of corro- sive sublimate of mercury may be dissolved in an English pint and an half of brandy, and a table-spoonful of it taken twice a-day, drinking half a pint of the decoction of sarsaparilla after it. A cataract is an obstruction of the pupil, by the interposition of some opaque substance which either diminishes or totally extinguishes the sight. It is generally an opacity of chrystalliae humour To a re- cent or beginning cataract, the same medicines are to *je used as in die gutta serena ; and they will sometimes succeed But when this does iiot happen, and the cataract becomes firm, it must be couched, or rather extracted. I have resolved a recent cataract by giving the pa- tient frequent purges with calomel, keeping a poultice of fresh hem- lock constantly upon the eye and a perpetual blister pu the ueck. # The myopia or short sigMedness, and the presbyopia or seeing only at too great a distance, are disorders which depeud on the original structure or figure of the eye, therefore admit of no cure. The incon- veniences arising from them may however be, in some measure, reme- died by the help of proper glasses, The former requires the aid of a concave, and the latter of a convex glass. A strabismus or squinting, depends upon an irregular contraction of the muscles of the eye from a spasm, palsy, epilepsy, or an ill habit. Children often contract this disorder by having their eyes unequally exposed to the light. They may likewise acquire it by imitation from a squinting nurse or play-fellow, &c. As this disorder can hardly be cured, pavents ought to be careful to prevent it. Almost the only thing -which can be done for it is to contrive a mask for the child to wear, which Avill only permit him to see in a straight direction. Spots or specks on the eyes are generally the effect of iuflaramat-on, and often appear after the small pox, the measles, or violent ophthalmi- as. They are very difficult to cu v e, and often occasion total blindness. If the specks are soft and thin, they may sometimes he. taken off by gentle caustics and discutients; as vitriol, the juice of celandine &c. When thesft do not succeed, a surgical operation may be tried ; the success of this however is always very doubtful. The blood-shot eye may be occasioned b vomiting, violent coughing, &c. I have frequently known it happen to children in the hoopiug-cough. It appears at first like a bii of scarlet, and is afterwards of a livid or blackish colour, This disorder general- ly goes oft" without medicine. Should it prove obstinate, the patient way be bled, and have his eyes fomented with a decoction of cumphry %,in both these cases electricity merits a trial. 40 9U OF THE EAR, roots and elder flowers. A soft poultice may be applied to the eyes ^ arjd the body should be kept open by gentle purgatives. The watery or weeping eye is generally occasioned by a relaxation or weakness of the glandular parts of that organ. These may be bra- ced and strengthened by bathing the eye with brandy and water, Hun- gary-water, rose water, with white vitriol dissolved in it, &c. Medi- cines which make a revulsion are likewise proper ; as mild purgatives, perpetual blisters on the neck, bathing the feet frequently iu luke-warm water, &c. When this disease proceeds from an obstruction of the lachrymal duct, or natural passage of the tears, it is called & fistula lachryinalis, As this gentleman, however willing, is only able to teach a few, and as the far greater part of those who are born deaf cannot afford to attend him, it would be an act of great humanity, as well as of public utility to erect an academy for their benefit. * A gentleman on whose veracity I can depend, told me, that after using many things to no purpose for an obstinate deafness, he was at last advised to put a few drops of his own urine warm into his ears every night and morning, from which he received great benefit. It is probable that a solution of sal ammoniac in water would produce the ^same effect. t An obstinate deafness has been cured by electricity. :1P OF THE TASTE AND SMELL OF THE TASTE AND SMELL. THOUGH these senses are not of so great importance toman in ft State of socie.y, is the sight and hearing; yet, as the loss of them is attended with some iuconveniency they deserve our notice. They aj. seldom to be restored when lost; which ought to make us very at- tentive to .heir preservation, by carefully avoiding whatever may in the least prove injurious to them. As there is a very great affinity bel reea tfhre Wg&m of tasting and smelling, whatever hurts the one, generally aul-cL-. the other. L rsiiry is highly injurious to ihf so organs. When the nose and palate are frequently stimulated by fragrant and poignant dishes, they Sbo i lose dip power of distinguishing tastes and odours with any degree of nicety, Man; in a state of nature, may perhaps have these faculties a.' acute as any oth< r animal. The sense of smelling may be diminished or destroyed by diseases; as, the moisture, dryness, inflammation or suppuration of that meat* i. ide of the nose, commonly called die olfactory membrane; the compression of the nerves which supply this mem- brane, or some fault in the brain itself at their origin. A defect or too great a i idity, of the small spungy boi.es of the upper jaw, :js of the forehead, &c. may likewise impair the sense of smcll- ij.t- it may also be injured by a collection of foetid matter in those caverns, which keeps constantly exhaling from them. Few things are more hurtful to the sense of smelling, thau taking great quantities of snuff. When the noss abounds with moisture, after gentle evacuations, such things as tend to take off irritation, and coagulate the thin sharp serum, may be applied ; as the oil of anise mixed with tine flour; camphire dissolved in oil of almonds, Sic. The vapours of amber ; frankin- cense, gum mastic, and benjamin, may likewiie be received into the nose and mouth. For moistening the mucus w 7 hen it is too dry, some recommend snuff marie of the leaves of marjoram, mixed with the oil of amber, marjoram and aniseed ; or a sternutatory of calcined white vitriol.; twelve grains of -which may be mixed with two ounces of marjoram- water, and filtrated. The steam ov vapour of vinegar upon hot iron received up the nostrils is likewise of use for softening the mucus, opening obstructions, &c. If there is au ulcer in the nose, it ought to be dressed with some emollient ointment, to which if the pain be very great, a little lauda- num may be added. If it be a venereal ulcer, it is rot to be cured ■without mercury. In that case, the solution of the corrosive sublimate in brandy may be taken, as directed in the gutta serena. The ulcer ought likewise to be washed with it; and the fumes of cinnabar may be received up the nostrils. of the touch. ait If there be reason to suspect that the nerves which supply the organs 'tof smelling are inert, or want stimulating, volatile salts, strong snuffs* and other things wnich occasion sneezing, may be applied to the nose. 9Phe forehead may likewise be annointed with balsam of Peru, to which may be added, a little of the oil oi amber. S e taste amy be diminished by crusts, filth, mucus, aphthae, pelicles, foarts, cfrc. covering the tongue; it may be depraved by a fault of the saliva, which being discharged into the mouth, gives the same sensa- tions as if the food which the person takes had real!}' a bad taste; or it may be entirely destroyed by injuries done to the -nerves of the tongue and palate. Few things prove more hurtful either to the sense of last- ing or smelling than obstinate colds, especially those which affect the head. When the taste is diminished by filth, mucus, &c. the tongue ought to be, scraped and frequently washed with a mixture of water, vinegar, and honey or some other detergent. When the saliva is vitiated, which seldom happens unless in fevers or other diseases, the curing of the dis- order is the cure of this symptom. To relieve it however in the mean time, the following things may be of use; if there be a bitter taste, it may be taken away by vomits, purges, and other things which evacuate bile. What is called a uidorous taste, arising from putrid humours, is corrected by the juice of citrons, oranges, and other acids. A salt taste is cured by plentiful dilution with watery liquors. An acid taste i3 destroyed by absorbents, and alkaline salts, as powder of oyster- shells, salt of wormwood, &c. When the sensibility of the nerves which supply the organs of taste is diminished, the chewing of horse-radish, or other stimulating sub- stance, will help to recover it. OF THE TOUCH. THE sense of touching may be hurt by any thing that obstructs the nervous influence, or prevents its being regularly conveyed to the or- gans of touching; as pressure, extreme cold, &c. It may likewise be hurt by too great a degree of sensibility, when the nerve is not sufficient- ly covered by the cuticle or scarf-skin, or where there is too great a tension of it, or it is too delicate. - Whatever disorders the functions of the brain and nerves, hurts the sense of touching. Hence it appears to proceed from the same general causes as palsy and apoplexy, and requires nearly the same method of treatment. In a stupor, or defect of touching, which arises from an obstruction of the cutaneous nerves, the patient must first be purged; afterwards such medicines as excite the action of the nerves, or stimulate the sys- 'tem, may be used. For this purpose, the spirit of hartshoru, sal vola- tile oleosum, horse-radish, &c. may be taken inwardly; the disordered parts, at the same time, be frequently rubbed with fresh nettles ov spi- OF A SCIRRHUS AND CANCER. lit of sal ammoniac. Blistering plasters and sinapisms applied to (tit j>arts will likewise be of use, as also warm bathing, especially in the -natural hot baths. CHAPTER XL VI. OF A SCIRRHUS AND CANCER. ASCI R RHUS is a hard indolent tumour usually seated in some of the glands; as the breasts, the aim-pits, &c. If the tumour bero ties Urge, unequal, of a livid, blackish, or leaden colour, and is attended with violent pain, it gets the name of an o cult cancer. When the ski.i is broken, and a sanies orichoio;ts matter of m; abomi- nable '"op'.'k! smell is discharged from the soie, it is called an open «f ' oer. Persons after the age of forty five, particularly Women, and thdse who lead an indolent sedentary hie, are most subject to .his disease. CAUSES. — This disease is often owing to suppressed evacuations; hence it proves si frequently fatal to women of a gross habit, particu- larly old maids and widows, about the time when the menstrual flux ceases. It may likewise be occasioned by excessive fear, grief, anger, religious melancholy, or any of the depressing passions. Hence the unfortunate, (he choleric, and those persons who devote themselves to a religious life in convents or monasteries, are often afflicted with it. It may also be occasioned by the long continued use of food that is toe hard oi digestion, or of an acrid nature; by barrenness; indolence J celibacy; cold; blows; friction; pressure; or the like. Women of : ten suffer from the last of these by means of their stays, which squeeze and compress their breasts so as to occasion great mischief. Sometimes the disease is owing to an hereditary disposition. SYMPTOMS. — This disorder seems often very trifling at the be- ginning* A hard tnmour about the size of a hazle-nut, or perhaps small c. is generally the first symptom. This will often continue for a long time without seeming to increase or giving the patient great un- easiness; bnt ii the constitution be hurt, or the tumour irritated by pressure or improper treatment of any kind, it begins to extend itself towards the neighbouring parfs by pushing out a kind of roots or limbr. It then gets the name of cancer, from a fancied resemblance between abs and the claws of a crab. The colour of the skin begins to which is first red, afterwards purple, then bluish, livid, and at ck. The patient complains of heat, with a burning, gnawing, The tumour is very hard, rough, and unequal, with ? OF- A SCIRRHUS AND CANCER* 21 §, protuberance or rising in the middle; its size increases drily, - neighbouring veins become thick, knotty, and of a blackish colour The skiu at length gives way, and a thin sharp ichor, begins to Rom which corrodes the neighbouring parts till it forms a large unsrghUy ulcer More occult cancers arise, and communicate with die neigh- bouring gimtds. Th© paiu and stench become intolerable; the appe- tite frills ; thestrength, is exhausted bj acoi k, lever; 't last a violent hremonhage, or discharge of bloo.!, from some part ei the body., with fnintings, or convulsion fits, generally put an end to the Biiserabie patient's life. REGIMEN".— The diet ought to^be light, but nourishing— All strong liquors, and high seasoned or salted provisions, are to be avoid- ed. Fhe patient may take as much -'^: ■':■--■ ~~ ho «>^ n e a-ily b^arj and should use every method to dive*! the g y. All kinds of external injury are carefully to be guarded against, par- ticularly of the affected part, which ought to be defended from all pressure, and even from the external air, by covering it with fur or soft flannel. MEDICINE — This is one "of those diseases for which no certain remedy i? yet known. Its progress however may sometimes be retard- ed, and some of its most disagreeable symptoms mitigated, by proper applications One misfortune attending the disease is, that the unhap- py patient often conceals it too long. Were proper mesas used in due time, a can?er might often be cured ; but after ihe disorder has arrived at a certain height, it generally sets all medicine at defiance. When a scirrhus tumour is first discovered, the patient ought to ob- serve a proper regimen, and to take twice or thrice a-week a dose of the common purging mercurial pill. Some blood may also be let, and the part affected may ■ be gently rubbed twice a-day with a little of the mercurial ointment, and kept warm with fur or flannel. The food must be. light and a pint of the decoction of woods or sarsaparilla may be drank daily. I have sometimes discussed hard tumours, which had the appearance of beginning cancers., by a course of this kind. Should the tumour however not yield to this treatment, but, on the contrary, become larger and harder, it will be proper to extirpate it, either by the knife or caustic. Indeed, whenever this can be done with safety, the sooner it is done the better. It can answer no pur- pose to extirpate a cancer after the constitution is ruined, or the whole mass of humours are corrupted by it. This, however, is the common way, which makes the operation so seldom succeed. Few people will submit to the extirpation til! death stares them in the face; whereas, if it were done early, the patient's life would not be endangered by the operation, and it would generally prove a radical cure. When the cancer is so situated that it cannot be cut off, or if the pa- tient will not submit to the operation, such medicines as will mitigate #r relieve the most urgent symptoms, may be used. Dr. Home says. S20 OF A SCIRRHUS AND CANCER. that half a gram of the corrosive sublimate of mercury, dissolved in a proper quantity of brandy, aud taken night and morning; will often be of service iu cancers of the face and nose, lie likewise recommends an infusiou of the solatium or night shade, in cancers of the breasts. " But the medicine most in repute at present for this disease is hem- lock. Dr. Stork, physician at Vienna, has of late recommended the extract of this plant as very efficacious iu cancers of every kind. The. Doctor says, he has given some hundred weights of it without ever hurting any bodv, and often with manifest advantage. He advises the patient however to begin with very small doses, as two or *ii>ee grains, and to increase the dose gradually till some good eiFect be perceived, aud there to rest without further increase. — From two or three grain? at first, the Doctor says he has increased the dose to two '!*- -e. or four drachms a-day, and finds that such, doses may be continued for several ■weeks without any bad consequences. The regimen which the Doctor recommends during U;e use o r the medicine, is to avoid farinaceous substances not fermented, and too acrid aromalics. He says, good wine will not be hurtful to those who are accustomed to it, nor a moderate use of acids; and adds, patient should live in a pure free air, and keep his mind as quiet and cheerful as possible. The Doctor does not pretend to fix the time in which a cancer may be resolved by the use of hemlock, but says he has given it for above two years in' large doses without any apparent benefit ; nevertheless the patient has been cured by persisting in the use of it for half a year longer. This is at least encouragemeut to give it a fair trial. Though we are far from thinking the hemlock merits those extravagaut enco- miums which the Doctor has bestowed upon it, yet in a disease which has so long baffled the boasted powers of medicine, we thiuk it ought always to be tried. The powder of hemlock is by some preferred to the extract. — They are both made of the fresh leaves, and may be used nearly in the same manner. Dr. Nicholson of Berwick, says, he gradually increased the dose of the powder from a few grains to half a drachm, and gave near four drachms of it in the day with remarkably good effects. The hemlock may also be used externally either as a poultice or fomenta- tion. The sore may likewise be kept clean by injecting daily a strong decoction of the lops aud leaves into it. Few things contribute more to the healing of foul sordid ulcers of any kind than keeping them thoroughly clean. This ought never to be neglected. The. best application for this purpose seems to be the car- rot poultice. The root of the common carrot may be grated, and moistened with as much water as will bring it to the consistence of a poultice or cataplasm. This must be applied to the sore, aud renewed twice a-day. It geuerally cleans the sore, eases the pain, aud takes OF. A SCIRRHUS AND CANCER. 321 away the disagreeable smell, which are objects of no small importance an such a dreadful disorder.* ' Wort, or an infusion of malt, has been recommended not only as a proper drink, but as a powerful medicine in this disease. It must be frequently made fresh, and the patient may take it at pleasure. Two, three, or even four English pints of it may be drank every day for a considerable time. Wo benefit can be expected from any medicine in this disease, unless it be persisted in for a long time. It is of too obsti- nate a nature to be soon removed ; and, when it admits of a cure at all, it must be brought about by inducing an almost total change of the hab- it, which must always be a work of time. Setons or issues in the neigh- bourhood of the cancer have sometimes good effects.! When all other medicines fail, recourse must be had to opium, as a kind of solace. This will not indeed cure the disease, but it will ease the patient's agony, and render life more tolerable while it continues. To avoid this dreadful disorder, people ought to use wholesome food ; to take sufficient exercise in the open air; to be as easy and cheerful as possible ; and carefully to guard against all blows, bruises, arid every kind of pressure upon the breasts, or other glandular parts/f; * London Medical Essays. f In a cancer which had set all medicines, and even surgery, at de- fiance, I lately saw remarkable effects from an obstinate perseverance in a course of antiseptics. I ordered the deep ulcers to be washed to the bottom by means of a syringe, twice or thrice a- day, either with an infusion of the bark, or a decoction of carrot, and that the patient should take four or five times a-day, a glass of good wine, with half a drachm of the best powdered bark in it. — The sores, after being wash- e 1, were likewise sprinkled with the same powder. When the paliect began this course, her death was daily expected. She continued it for a'oove two years with manifest advantage ; but being told by an emi- nent surgeon, that the bark would not cure a cancer, and that the sores ought not to be washed, she discontinued the practice, and died in a few weeks. This course was not expected to cure the cancer, but to prolong the patient's life, which it evidently did almost to a miracle. | As hemlock is the principal medicine recommended in this disease, we would have given some directions for the gathering and preparing of that plant; but as its different preparations are now kept in the shops, we think it much safer for people to get them there, with prop- ections for. using them. 41 *28 OF POISONS. CHAPTER XLVII OF < OISONS, EVERY person ought, in some measure, to be acquainted wilU the nature and cure of poisons. They are generally taken una- wares, and their effects are often so sudden and violent, as not to admit of delay, or allow time to procure the assistance of physicians Hap- pily indeed no great degree of medical knowledge is here necessary ; (he remedies for most poisons being generally at hand, or easily obtain- ed, and nothing but common prudence needful in the application of them. The vulgar notion that every poison is cured by some counter poi- son, as a specific, has done much hurt. People believe they can do nothing for ihe patient, unless they know the particular antidote to that kind of poison which he has taken. Whereas the cure of all poisons taken into the stomach, without exception, depends chiefly on discharg- ing them as soon as possible. There is no case w herein the indications of cure are more obvious. Poison is seldom long in the stomach before it occasions sickness, with an inclination to vomit. This shows plainly what ought to be done. .Indeed common sense dictates to every one, that, if any thins has been taken into the stomach which endanger? life, it ought immedi- ately to be discharged. "Were this, duly regarded, the. danger arising from poisons might generally be avoided. The method of prevention is obvious, nn<\ the means are in the hands of every one- We shall not take up the reader's time with a detail of the ridic- ulous notions which have prevailed among ignorant people in different ages with regard to poisons ; neither shall we mention the boasted anti- dotes which have been recommended either for preventing or obvi- ating their effects; but shall content ourselves with pointing out the poisons most common in thi? country, and the means of avoiding their dangerous consequences. Poisons either belong to the mineral, the vegetable, or the animal kingdom. Mineral poisons are commonly of an acrid or corrosive qualify; as arsenic, cobalt, the corrosive sublimate of mercury, &c. Those of the vegetable kind are generally of a narcotic or stupe* factive quality ; as poppy, hemlock, henbane, berries of the deadly night-shade, &c. Poisonous animals communicate their infection either by the bite or sting. This poison is very different from the former, aud only produ- ces its effects when received into the body by a wound. OF POISONS. Mi MINERAL POISONS.— Arsenic is the most common of this 'slass ; and, as the whole of them are pretty similar both in their effects and method of cure, what is said with respect to it will be applicable to every other species of corrosive poison- When a person has taken arsenic, he soon perceives a burning heat, and a violent pricking pain in his stomach and bowels, with an intoler- able thirst, and an inclination to vomit. The tongue and throat feel rough and dry ; and, if proper means be not soon administered, the patient is seized with great anxiety, hickuping, faintiogs, and coldness of the extremities. To these succeed black vomits, foetid stools, with a mortification of the stomach and intestines, which are the immediate forerunners of death. On the first appearance of these symptoms the patient should drink large quantities of new milk and salad oil till he vomits ; or he may drink warm water mixed with oil. Fat broths are likewise proper, provided they can be got ready in time. Where no oil is to be had fresh butter may be melted and mixed with the miik or water. These things are to be drank as long as the inclination to vomit con- tinues. Some have drank eight or ten English quarts before the vom- iting ceased ; and it is never safe to leave off drinking while one par- ticle of the poison remains in the stomach. These oily or fat substances not only provoke vomiting, but likewise blunt the acrimony of the poison, arid prevents its wounding the bowels; but if they shoidd not make the person vomit, half a drachm or two scru- ples of the powder of ipecacuanha must be given, or a few spoonsful of the oxymel, or vinegar of squills may be mixed with the water which he drinks. Vomiting may likewise be excited by tickling the inside of the throat with a feather. Should these methods however fail, half a drachm of white vitriol, or five or six grains of emetic tartar, must be administered. If tormenting pains are felt in the lower belly, and there is reason to fear that the poison has got down to the intestines, clysters of milk and oil must be very frequently thrown up ; and the patient must drink emollient decoctions of barley, oat-meal, marsh-mallows, and such like. He must likewise take an infusion of senna and manna, a solution of Glauber's salts, or some other purgative. After the poison has been evacuated, the patient ought for some time, to live upon such things as are of a healing and cooling quality ; to abstain from flesh and all strong liquors, and to live upon milk, broth, gruel, light puddings, and other spoon-meats of easy digestion. His drink should be barley- water, linseed-tea, or infusions of any of the wild mucilaginous vegetables, VEGETABLE POISONS, besides heat and pain of the stomach, commonly occasion some degree of giddiness, and often a kind of stu- pidity or folly. Persons who have taken these poisons mast be treated $a the same manner as for the mineral or corrosive. DISEASES OF WOMEN. Though the vegetable poisons, when allowed to remain in the stom- ach, often prove fatal, yet the danger is generally over as soon as they are discharged. Not being of such a caustic or corrosive nature, they are less apt to wound or inflame the bowels than the mineral substances; no time, however, ought to be lost in having them discharged. Opium, being frequently taken by mistake, merits particular atten- tion It is use! as a medicine both in a solid and liquid form, which lat'ev commonly goes by the name of laudanum. It is indeed a valua- ble medicine .vnen taken in proper quantity; but as an overdose proves a strong poison, we shall point out its commou effects, together with the method of cure. An over-dose of opium generally occasions great drowsiness, with stupor and other apopl ciic symptoms. Sometimes the person has so g-eat an inclination to sleep, that it is almost impossiole to keep him awake. Every method must however be tried for this purpose. He should be tossed, shaked and moved about. Sharp blistering-plasters should be applied to his legs or arms, and stimulating medicines, as salts of hartshorn, &c. held under his no^e. It will also be proper to let blood. At the sime fime every method must be taken to make him discharge the poison. This may be done in the manner directed above, viz by the use of strong vomits, driuking plenty of warm water with oil, &c Mead, beside- s vomits, in this case, recommends acid jr.edicines with lixivial salts. He says, that he has often given salt of worm-wood mix- ed with juice of lemon in repeated doges with great success. If the body should remain weak and languid after the poison has been extracted, nourishing diet and cordials will be proper ; but when there is reason to fear that the stomach or bowels are inflamed, the greatest circumspection is necessary both with regard to food and medicine. CHAPTER XLVIII; DISEASES OF WOMEN. W r OMEN in all civilized nations, have the management of domes* tic affairs, and it is very proper they should, as Nature has made them less fit for the more active and laborious employments. This indulgence, however, is generally carried too far; and females, instead of being benefited by it, are greatly injured from the want of exercise and free air. To be satisfied of this, one need only compare the fresh and ruddy looks of a milk-maid, with the pale complexion of OF THE MENSTRUAL DISCHARGE, $25 (hose females whose whole time is spent within doors. Though Na- ture has made an evident distinction between the mate and temale with regard to bodily strength and vigour, yet she certainly never meant, either that the one should be always without, or the other always with- in doors. The confinement of females, besides hurting their figure and com- plexion, relaxes their solids, weakens their minds, and disorders all the functions of the body. Hence proceed obstructions, indigestion, flat- ulence, abortions, and the whole train of nervous disorders. These not only unfit women for being mothers and nurses, but often render them whimsical and ridiculous. A sound mind depends so much upoa a healthy body, that where the latter is wanting, the former is rarely to be fou: do I have always observed that women who were chiefly employed without doors, in the different branches of husbandry, gardening and the like, were almost as hardy as their husbands, and that their chil- dren were likewise healthy. But as the bad effects of confinement and inactivity upon both sexes have been already shown, we shall proceed to point out those circumstances in the structure and desiguof females, which subject them to peculiar diseases ; the 'chief of which are their monthly evacuations, pregnancy and child bearing. These indeed cannot properly be called diseases, but, from the delicacy of the sex, and their being often improperly managed in such situations, they be- come the source of numerous calamities. OF THE MENSTRUAL DISCHARGE. FEMALES generally begin to menstruate about the age of fifteen, and leave it off about fifty, which renders these two periods the most critical of their lives. About the first appearance of this discharge, the constitution undergoes a very Considerable change, generally in- deed for the better, though sometimes for the worse. The greatest care is now necessary, as the future health and happiness of the female depends in a great measure upon her conduct at this period.* * It is the duty of mothers, and those who are intrusted with the education of girls, to instruct them early in the conduct and manage- ment of themselves at this critical period of their lives. False modes- ty, inattention, and ignorance of what is beneficial or hurtful at this time, are the sources of many diseases and misfortunes in life, which a few sensible lessons from an experienced matron might have prevented. JN"or is care less necessary in the subsequent returns of this discharge. Takiog improper food, violent affections of the mind, or catching cold at this period, is often sufficient to ruin the health, or to render the fe- male ever after incapable of procreation. 32"3 OF THE MENSTRUAL DISCHARGE. If a girl about (his lime of life be confined to the house, kept >?o8* stantly sitting, and neither allowed to romp about, nor employed in any* active business, which gives exercise to the whole body, she becomes weak, relaxed, and puny; her blood not being duly preparer.', ehe looks pale and wan ; her health, spirits, and vigour decline, and she sinks into a valetudinarian for life. Such is the fate of numbers of those unhappy females, who, either from too much indulgence, or their own narrow circumstances, are, at this critical period, denied the benefit of exercise ami Wet air, A lazy indolent disposition proves likewise Very hurtful to girls at this period. One seldom meets with complaints from obstructions among the more active and industrious part of the sex; whereas the indolent and lazy are seldom free from them. These are in a manner eateu up by the chlorosis, or greeu sickness, and other disease? of this na- ture. We would therefore recommend it to all who wish to escape these calamities, to avoid indolence and inactivity', as their greatest enemies, aud to be as much abroad in the opeu air as possible. Another thing which proves very hurtful to girls about this period of life, is unwholesome food. Fond of all manner of trash, they often indulge in it, till their whole humours are quite vitiated. Hence en- sue indigestions, wa it of appetite, and a numerous train of evils. If the fluids be not duty prepared, it is utterly impossible that the secre- tions should go properly on. Accordingly we find that such girls as lead an indolent life, and eat great quanti ies of trash, are not only sub- ject to obstructions of the menses, but likewise to glandular obstruct- ions; as the scrophvla, or king's evil, &c. A dull disposition is also very hurtful to girls at this period. It is a rare thing to see a sprightly girl who does not enjoy good health, while the grave, moping, melancholy creature, proves the very prey of vapours and hysterics. Youth is the season for mirth and cheerful- ness. Let it therefore be iudulged. It is an absolute dnh To lay in a stock of health in time of youth, is as necessary a piece of pru- dence, as to make provision against the decays of old age. — While therefore, wise Nature prompts the happy youth to join 5:i sprightly amusements, let not the severe dictates of hoary age forbid the useful impulse, nor damp, with serious gloom, the season destined to mirth and innocent festivity. Another thing very hurtful to females about this period of life, is straight clothes. They are fond of a fine shape, and foolishly imagine that this can be acquired by lacing themselves tight. — Hence, by squee- zing the stomach and bowels, they hurt the digestion, aud occasion many incurable maladies. This error is not indeed so common as it has been ; but. as fas! inns change, it may come about again: we there- fore think it not improper to mention it. I know many females, who, to this day, feel the direful effects of that wretched custom which pre- vailed some years ago, of squeezing every girl into as small a size in m THE MENSTRUAL DISCHARGE, 32$ '*he middle as possible. Human invention could not possibly have de-, fised a pracuce more destructive to health. After a female has arrived at that period of life when the menses usually begin to flow, and they do not appear, but, on the contrary, h£; netdth ami spirits begin to decline, we would advise, instead of shuUing (tie poor girl up in the house, and dosing her with steel, asafce- tida, and other ;museous drugs, to place her in a situation where she car.' enjoy the benefit of fresh air and agreeable company. There let her eat wholesome food, take sufficient exercise, and amuse herself in the most agreeable manner ; and we have little reason to fear, but Na- ture, thus assisted, will do her proper work. — Indeed she seldom fails, unlo.T where the fault is on our side. This discharge in the beginning is seldom so instantaneous as to sur- prise females unawares. It is generally preceded by symptoms which foreiel its approach ; as a sense of heat, weight, and dull pain in the loins; distention and hardness of the breasts ; head- ache ; loss of appe- tite; lassitude; paleness of the countenance; and sometimes a flight degree of fever. When these symptoms appear about the age at which the menstrual flux usually begins, every thing should be carefully avoided which may obstruct that necessary and salutary evacuation ; anci all means used to promote it ; as sitting frequently over the steams of warm water, drinking warm diluting liquors, &c. After the menses have once begun to flow, the greatest care should be takeq to avoid every thing that may tend to obstruct them. Females ought to be exceeding cautious of what they eat or drink at the time they are out of order. Every thing that is cold, or apt to sour on the stomach, ought to be avoided; as fruit, butter- milk, and suchlike. Fish, and all kinds of food that are hard of digestion, are also to be avoided. As it is impossible to mention everything that may disa- gree with individuals at this time* we would recommend it to every female to be very attentive to what disagrees with herself, and care- fully to avoid it. Cold is extremely hurtful at this particular period. More of the sex date their diseases from colds, caught while they are ought of or- der, than from all other causes. This ought surely to put them upon their guard, and to make them very circumspect in their conduct at such times. A degree of cold that will not in the least hurt them at another time, will at this period be sufficient entirely to ruin their health and constitution i The greatest attention ought likewise to be paid to the mind, which should be kept as easy and cheerful as possible. Every pa; t of the an- imal economy is influenced by the passions, but none more so than this. Anger, fear, grief, and other affections of rlie mind.often occasion obstructions of the menstrual flux, which prove absolutely incurable. From whatever cause this flux is obstructed, except in the stale of pregnancy, proper means should be used to restore it. For this pur- ?& OF THE MENSTRUAL DISCHARGE. pose we would recommend sufficient exercise in a dry, open, and rath- er cool air ; wholesome diet, and. if the body be weak and languid, generous liquors ; also cheerful company and ail manner of amufeenientsj If these fail recourse must be had to medicine. When obstruction proceed from a weak relaxed state of the solids, such medicines as tend to promote digestion, to brace the solids, and assist the body in preparing good blood, ought to be used. The principle of these are iron and die Peruvian bark, with other bitter and astringent medicines. Filings of irou may be infused in wine or ale, two or three ouuces to an English quart, and after it has stood for two or three weeks it may be filtered, and about half a wine glass of it taken twice a-day ; or prepared steel may be takeu in the dose of half a drachm, mixed with a little honey or treacle, three or four limes a-day. The bark and other bitters may either be taken in substance or infusion, as is most agreeable to the patient When obstructions proceed from a viscid state of the blood ; or from ■women of a gross or fall habit, evacuations, and such medicines as at- tenuate the humours are necessary. The patient in this case ought to be bled, to bathe her feet frequently in warm water, to take now and then a cooling purge, and to live upon a spare thin diet. Her drink should be whey, water, or small beer ; and she ought to take sufficient exercise. A tea spoonful of the tincture of black hellebore raaj also be taken twice a-day in a cup of warm water. When obstructions proceed from affections of the mind, as grief, fear, anger, &c. every method should- be takeu to amuse aud divert the patient. And (bat she may the more readily forget the cause of her affliction, she ought, if possible, to be removed from the place where it happened. A change of place, by presenting the mind with a variety of new objects, has often a very happy influence in relieving it from the deepest distress A soothing, kind, and affable behaviour to females in this situation, is also of the first importance An obstruction of the menses is often the effect of other maladies. When this is the case, instead of giving medicines to force that discharge, which might be dangerous, we ought by all means to endeavour to re- store the patient's health aud strength. When that is effected, the other will return of course. But the menstrual flux may be too great as well as too small. When this happens, the patient becomes weak, the colour pale, the appetite and digestion arc bad, and cedematous swellings of the feet, dropsies and consumptions often ensue. This frequently happens to women about the age- of forty five or fifty, aud is very difficult to cure. Jt may proceed from a sedentaiy life; a full diet, consisting chiefly di salted, high-seasoned, or acrid food, the use of spirituous liquo cessive fatigue ; relaxation ; a dissolved state of the blood ; violent- passions of the mind, &c. ®F THE MENSTRUAL DISCHARGE. 32fli The treatment of this disease must be varied according to its cause When it is occasioned by any error in the patient's regimen, an oppo- site course to that which induced the disorder must be pursued, and such medicines taken as have a tendency to restrain the flux, and coun- teract the morbid affections of the system from whence it proceeds. To restrain the flux, the patient should be kept quiet arid easy both m body and miud. If it be very violent, she ought to lie in bed, with her head low ; to live upon ai cool and slender diet, as veal or chicken broths with bread ; and to drink decoctions of aettle roots, or the greater comfrey. If these be not sufficient to stop the flux, stionger astringents may be used, as Japan earth, alum, elixir of vitriol, the Peruvian bark, &c* The uterine flux may offend in quality as well as in quantity. What is usually called the fiour albus, or whites, is a very common disease, and proves extremely hurtful to delicate women. This dis- charge, however, is not always white, but sometimes pale, yellow, green, or of a blackish colour ; sometimes it is sharp and corrosive, sometimes foul and foetid, &c. It is attended with a pale complexion* pain in the back, loss of appetite, swelling of the feet, and other signs of debility. It generally proceeds from a. relaxed state of the body, arising from indolence, the excessive use of tea, coffee, or other weak and watery diet. To remove this disease, the patient must take as much exercise as ghe can bear without fatigue. Her food should be solid and nourish- ing, but of easy digestion ; and her drink rather generous, as red port or claret mixed with Pyrmont, Bristol, or liaie- water . Tea and cof- fee are to be avoided. I have often known strong broths have an ex- ceeding good effect, and sometimes a milk diet alone will perform a cure. The patient ought not to lie too long a bed. When medicine is necessary, we know none preferable to the Peruvian bark, which in this case ought always to be taken in substance. In warm weather the cold bath will be of considerable service. That period of life at which the menses cease to flow, is likewise very critical to the sex. The stoppage of any customary evacuation, how- ever small, is sufficient to disorder the whole frame, and often to des- troy life itself, |Ience it comes to pass, that sp many women either * Two drachms of alum and one of Japan earth may be pounded together, and divided into eight or nine doses, one of which may be taken three times a-day. Persons whose stomachs cannot bear the alum may take two table- spoonsful of the tincture of roses three or four times a-day, to each dose of which ten drops of laudanum may be added. If these should fail, half a drachm of the Peruvian bark, in powder, with ten (hops of the elixir of vitriol may be taken in a glass of red E'jtie, four times a-day 1 . 42 $S» OF PREGNANCY. fall into chronic disorders, or die about this time. — Such of them, how- ever, as survive it, without contracting any chronic disease, often be- come more healthy and hardy ihan they were before, and enjoy strength and vigour to a very great age. If the menses cease all A a sudden in women of a full habit, they ought to abate somewhat of their usual quantity of food, especially of the more nourishing kind, as flesh, eggs, &c. They ought likewise to take sufficient exercise, and to keep the body open. This may bo done by taking, once or twice a- week, a little rhubarb, or an infusion of hiera picra iu win* 1 or brandy. It often happens that women of a gross habit, at this period of life, have ulcerous sores break out about their ancles, or in other parts of the body. Such ulcers ought to be considered as critical, and should either be Suffered to continue open, or have artificial drains fcubstituted iu their stead. Women who will have such sores dried up, aie often soon after carried off by acute diseases, or fail into those of a chronic nature. OF I'REGNAN Y. THOUGH pregnancy is uot a disease, yet that state is oftpn at- tended with a variety of complaints which merit attention, and which sometimes require the assistance of medicine. Some women indeed are more healthy during their preguancv than at any other time; but this is by no means the general case: most of them breed iu sorrow, and are frequently indisposed during the whole time of pregnancy. Few fatal diseases, however, happen during that period; and hardly any except abortiou, that can be called dangerous. We shall there- fore pay particular attention to it, as it pioves generally fatal to the child, and sometimes to tiie mother. Pregnant women are often afflicted wi'h the heart-burn. — The meth- od of treating thi* complaint has been already pointed out. They are likewise in ihe mure early peiiods of pregnancy, often harrassed with sickness and vomiiing, especially in the morning. The method of re- lieving these complaints has also been shown, lioth the head ache and tooth ache are very troublesome symptoms of pregnancy. The for- mer may generall) be removed by keeping the body gently open, by the use of prunes, figs, roasted apples, and such like. When the paiu is very violent, bleeding may be necessary. For the treatment of the latter, we must refer to that article. Several other complaints incident to pregnant women might be mentioned, as a cough and difficulty of breathing, suppression and incontinency of urine, &c. but as all of these have been taken notice of before, it is needless to repeat them. Every pregnant woman is more or less in danger oi abortion. . This should be guarded against with the greatest care, as it not only Weak- eps the constitution, but renders the Avomau liable to the ^rae a OF PREGNANCY. 381 f&ne afterwards.* Abortion may happen at any period of pregnancy, font it is most common in the second or third month. — Sometimes, how- ever, it happens in the fourth or fifth, It it happens within the first month it is usually called a false conception; if after the seventh month, the child may often be kept alive by proper care. The common causes of abortion are, the death of the child; weak- ness or relaxation of the mother ; great evacuations ; violent exercise ; raising great weights ; reaching too high ; jumping or stepping from, an eminence; vomiting; coughing; convulsion fits; blows on the bel- ly; falls; fevers; disagreeable smells; excess of blood; indolence; high living, or the contrary ; violent passions or affections of the mind, as fear, grief, &c The signs of approaching abortion are, pain in the loins, or about the bottom of the belly; a dull heavy pain in the inside of the tiiigii ; a slight degree of coldness, or shivering ; sickness, palpitation of the heart ; the breasts become flat and soft; the belty falls ; and there is a, discharge of blood or watery humours from the womb. To prevent abortion, we would advise women of a weak or relaxed habit to use solid food, avoiding great quantities of tea, and other weak and watery liquors; to rise early and go soon to bed ; to shun damp houses; to take frequent exercise in the open air, but to avoid fatigue* and never to go abroad in damp foggy weather, if they can shun it. Women of a full habit ought io use a spare diet, avoiding strong li- quors, and every thing that may tend to heat the body, or increase the quantity of blood. Their diet should be of an opening nature, consist- ing principally of vegetable substances. Every woman with child ought to be kept cheerful and easy in her mind. Her appetites, even though depraved, ought to be indulged as far as prudence will permit. When any signs of abortion appear, the woman ought to be laid in bed on a mattress, with her head low. She should be kept qui- et, and her mind so6thed and comforted She ought not to be kept too hot, nor to take any thing of a heating nature. Her food should consist of broths, rice and milk, jellies, gruels made of oat-mtal and the like, all of which ought to be taken cold. If she be able to bear it, she should lose at least half a pound of Wood from the arm. Her drink ought to be barley water sharpened with juice of lemon; or she may take half a drachm of powdered * Every mother who procures an abortion does it at the hazard of Aer life; yet there are not a few who run this risk merely to prevent the trouble of bearing and briuging up children. It is surely a most unnatural crime, and cannot, even in the most abandoned, be viewed without horror; but in the decent matron, it is still more unpardonable. Those wretches who daily advertise their assistance to women in this lousiness, deserve, in my opinion, the mast severe of all human punish* meats. 532 OF CHILD-BIRTH. aitre, io a cup of water-gruel, every Ave or six hours. If the womaii be seized with a violent looseness, she ought to drink the decociion of calcined hartshorn prepared. If she be allected^witb vomiting, let her take frequently two table spoonsful of the salioe mixture. In general, opiates are of service ; bin they should always be given with caution. SaDguine robust women, who are liable to miscarry at a certain time of pregnancy, ought always to be bled a few days before that pe- riod arrives. E> this means, and observing the regimen above pre- scribed, they might often escape that misfortune. Though we recommend due care for preventing abortion, we would Dot be understood as restraining pregnant women from their usual exer- cises. This would generally operate a quite contrary way. Want of exercise not only relaxes ttie body, but induces a plethora, or too great a fulness of the vessels, which are the two piincipal causes of abortion. There are. however, some women of so delicate a 'exture, that it is oecessaiy for them to avoid almost every kind of exercise during the whole period of pregnancy. OF CHILD-BIRTH. MANY diseases proceed from the want of due care in child-bed ; and the more hard) part of the sex are most apt to despise the necessa- ry precautions iu this state. This is peculiarly the case with )oung ■wives. They think, when the labour-pains are ended, the danger is over; but in truth it may only then be said to bp begun. Nature, if left to herself, will seldom fail to expel ihefcrius; but proper care aud wiauagement are certainly necessary for the recovery of the mother. No doubt mischief may be done by too much as well as by too little care, tieuce females Mho have the greatest number of attendants in child-bed general!) recover worst. But this is not peculiar to the state of child l>ed. Excessive care always defeats its own intention, and is genera ly more dangerous than none at all * * Though the management of women in child-bed has been practised as an employment siuce the earliest accounts of time ; 5 et it is still in most countries on a very bad footing —Few women think of following this employment till they are reduced to the necessity of doing it for bread- Hence not one in an hundred of them have any education, Or proper knowledge of their business. It is true, that Nature, if left to herself, will generally expel the icetus ; but it is equally true, that most women in childbed require to be managed with skill and atten- tion, and that they are often hurt by the superstitious prejudices of ig- norant and officious midwives. The mischief done in this way is much greater than is generally imagined ; most of which might be prevented by allowing no woman to practice midwifery, but such as are properly qualified. Were due attention paid to this, it would not oBly be the 'OF CHILI)-BIRm. :m 'During actual labour, nothing of a heating nature ought to be given. The woman may now and then take a little panada, and her drink nought to be toast and water, or thin groat gruel. Spirits, wines, cordi- al waters, and ether things which are given with a vie% to strengthen the mother, and promote the birth, for the most part, tend only to in- crease the fever, inflame the womb, and retard the labour. Besides, they endanger the woman afterwards, as they often occasion violent and mortal haemorrhages, or dispose her to eruptive and other fevers. When the labour proves tedious and difficult, to prevent inflamma- tions, it will be proper to bleed An emollient clyster might likewise frequently to be administered ; and the patient should sit over the steams of warm water. The passage ought to be gently rubbed with a little soft pomatum or fresh better, and cloths wrung out of warm water applied over the belly. If nature seems to sink, and the womau is great- ly exhausted with fatigue, a draught of generous wine, or some other cordial, may be given, but not otherwise. These directions are suffi- cient in natural labours ; and in all preternatural cases, a skilful sur- geon, or man-midwife, ought to be called as soon as possible. After delivery, the woman ought to be kept as quiet and easy as possible.* Her food should be light and thin, as gruel, panada, &c and fier drink weak and diluting. To this rule, however, there are many exceptions. I have known several women, whose spirits could not be supported in child bed without solid food and generous liquors ; to such* a glass of wine and a bit of chicken must be allowed. Sometimes an excessive haemorrhage or flooding happens after de- livery. In this case the patient should belaid with her head low, kept cool, and be in all respects treated as for an excessive flux of the menses. If the flooding proves violent, linen cloths, which have been wrung out of a mixture of equal parts of vinegar and water, or red wine, should be applied to the belly, the loins, and the thighs : these must be changed as they grow dry ; and may be discontinued as soon as the flooding . abates, j means of saving many lives, but would prevent the necessity of em- ploying men in ihis indelicate and disagreeable branch of medicine, which is, on many other accounts, more proper for the other sex. * We cannot help taking notice of that ridiculous custom which still prevails in some parts of the country, of collecting a number of women, together upon such occasions. These, instead of being useful, serve only to crowd the house, arid obstruct the necessary attendants. Be- sides they hurt the patient With their noise : and often, bv their un- timely and impertinent advice, do much mischief. f In a violent flooding after delivery, I have seen very good effects from the following mixture : Take of penny-royal water, simple cinna- mon-water, and syrup of poppies, each two ounces, elixir of vitriol a drachm. Mix, and take two table- spoonsful every two hours, or often* tear* if necessary. 334 6F CHILD-BIRTH. If there be violent pains after delivery, the patient ought to drink plentifully of warm diluting liquors, as gruel, or tea with a Utile saf- i ; and to take small oroths. with carrtway-seeds, or a bit of aa ,,them ; an ounce of the oil of s.veet almonds may like- wise be : : a cup of any of the above liquors; and if the patie less, a spoonful of the syrup of poppies, m?y now and then be mix :d with a cup of her drink. II she be hot or fever- ish, Oiieof the following powders may be taken in a cup of her usual drink every five or s'x hours.:}; An inflammation of the wonib is a dangerous and not unfrequent dis- ease after delivery. It is knosvn by pams in the lower part of the bel- li are greatly increased upon toucl.i^ ; by the tentiou or tight- ness of the pws; great weakness; change of countenance; a constant fever, with a iveak and hard puise; a slight delirium or raving ; some- times incessant vomitkig; a bickup ; a discharge of reddish, stinkmg, sharp wa'er from the womb; an incliuatiou to go frequently to sluulj a heat, and sometimes total suppression of urine. This m ist b? treated like othei inflammatory disorders, by bleeding and plentiful dilution. The drink may be ihiu gruel or barley-water; in a cup of which half a drachm of nitre may be dissolved, and takea three or four times a-day. Clysters of warm milk and wafer must be frequently administered; and the belly should be fomented by cloths wrung out of warm water, or by applying bladders tilled with warm milk and water to it. A suppression of the lochia or usual discharges after delivery, and r, must be treated nearly in the same maimer as an iu- tte womb. In all these ca c es, the safest course is plen- tiful dilution, gentle evacua'ions i (Fected. In the milk fever, the ! rocated <'.ith a little warm p mai he applied to them. Tie be often put to the breast, or it should be drawu by some other person. Nothing would tend more to prevent the mill: fever fhau putting the child early to the brea-t. Tne cus'oni of uol trilowiug children to suck for the first two or thr»e bleed in the first months, and to avoid all sharp air. When the labour js coming on, it is not to be hastened with forcing medicines, which in* fiame the blood and humours, or put them into unnatural commotions- Care should be taieu after the birth, ihat the natural excre*io;is pro- ceed regularly ; and if the pulse be quick, a little uitrous powder, or some other cooling medicines, should be administered. The most fatal disorder consequent upon delivery is the puerperal, or child-bed fever. It generally makes its attack upon the second or third day after delivery. Sometimes indeed it comes on sooner, and at other times, though rarely, it does not appear before the fifth or sixth day. It begins like most other fevers, with a cold or shivering fit, which is succeeded by restlessness, pain of the head, great sickness at the stomach, and bilious vomiting. The pulse is generally quick, the tongue dry,- aud there is a remarkable depression of spirits and loss of strength. A great pain is usually felt in the back, hips and region of the womb; a sudden chauge in the quantity or quality of the lochia also takes place; aud die patient is frequently troubled wirh a t:ne$~ Wins, or constant inclination to go to stool. The urine, which is very high coloured, is discharged in small quantity, and generally with pain. The belly sometimes swells to a considerable bulk, and becomes sus- ceptible of pain from the slightest touch. When the fever has contin- ued for a few days, the symptoms of inflammatioa usually subside, and ihe disease acquires a more putrid form. At this period, if not soea- &SQ OF CHILD-BIRTH, er, a bilious or putrid looseness, of an obstinate and dangerous naiura, come» on, aud accompanies the disease through all its future progress. There is net aoy disease that requires to be treated with more skill aud attention than this; consequently the best assistance ought to be obtained as soon as possible. In women of plethoric constitutions, bleeding will generally be proper at the beginning ; it ought however to be used with caution, and not to be repeated unless where the sigus of inflammation rise high; in which case it will also be necessary to apply a blistering plaster to the region of the wamb. During the rigour, or cold fit, proper means should be used to abate its violence and shorten its duration. For this purpose the patienj may drink freely of warm diluting liquors, and, if low. may take now and then a cup of wine-whey ; warm applications to the extremities, as heated bricks, bottles or bladders filled with warm water, and such like, may also be used with advantage. Emollient clysters of milk and water, or of chicken water, ought to be frequently administered through the course of the disease. These prove beneficial by promoting a discharge from the intestines, and also by acting as a kindly fomentation to the womb and parts adjacent. Great care however is requisite in giving them, on account of the ten- derness of the parts in the pelvis at this time. To evacuate the offending bile frosa the stomach, a vomit is gener- ally given. But as this is apt to increase the irritability of the stom- ach, already too great, it will be safer to omit it, and to give in its stead a gentle laxative, which will both tend to cool the body, and to procure a free discharge of the bile* The medicine which I have always found to succeed best in this disease, is the saline draught. This, if frequently repeated, will often put a stop to the vomiting, and at the s :me time lessen the violence of the fever. If it runs off by stool, or if the patient be restless, a few drops of laudanum, or some syrup of poppies, may occasionally be added. If the stools should prove so frequent as to weaken and exhaust the patient, a starch clyster, with thirty or forty drops of laudanum in it, may be administered as occasion shall require; and the drink niay be rice-water, in every English pint of which half an ounce of gum-arabic has been dissolved Should these fail, recourse must be had to Co- lumbo-root, or some other strong astringent Though in general the food ought to be light, and the drink diluting, yet when the disease has been long protracted, and the patient is great- * Midwives ought to be very cautious in administering vomits ov purges to women in child-bed. I have known a woman who was re- covering extremely well, thrown into the most imminent danger by a strong purge which was given h«r by an officious midwife. OF BARRENNESS. 33? ly spent by evacuations, it will be necessary to support her with nour- ishing diet and generous cordials. It was observed that this fever, after continuing for some time, often acquires a putrid form. In this case the Peruvian bark must be giv- en, either by itself, or joined with cordials, as circumstances may re- quire. As the bark in substance will be apt to purge, it may be given in decoction or infusion mixed with the tincture of roses, or other gentle astringents ; or a scruple of the extract of bark with half an ounce of spirituous cinnamon- water, two ounces of common water, and ten drops of laudanum, may be made into a draught, and given every second, third, or fourth hour, as shall be found necessary. When the stomach will not bear any kind of nourishment, the pa- tient may be supported for some time by clysters of beaf-tea, or chick- in water. To avoid this fever, every woman in child-bed ought to be kept perfectly easy ; her food should be light and simple, and her bed- chamber cool, and properly ventilated. There is not any thing more hurtful to a woman in this situation than being kept too warm. She ought not to have her body bound too tight, nor to rise too soon from; bed after delivery ; catching cold is also to be avoided ; and a proper attention should be paid to cleanliness. To prevent the milk-fever, the breasts ought frequently to be drawn; and if they are filled previous to tho onset of a fever, they should, upon its first appearance, be drawn, to prevent the milk from becom- ing acrid, and its being absorbed in this state. Costiveness is likewise to be avoided. This will be best effected by the use of mild clysters and a laxative diet. We shall conclude our observations on child-bed women by recom- mending it to them, above all things, to beware of cold. — Poor women, whose circumstances oblige them to quit their bed too soon, often con- tract diseases from cold, of which they never recover. It is a pity the poor are not better takeu care of in this situation. But the better sort of women run the greatest hazard from too much heat. Thejrare generally kept in a sort of bagnio for the first eight or ten days, and then dressed out to see company. The danger of this conduct must be obvious to every one. The superstitious custom of obliging women to keep the house till they go to church, is likewise a very common cause of catching cold, All churches are damp, and most of them cold ; consequently they are the very worst places to which a woman can go to makie her first visit, after having been confined in a warm room for a month. OF BARRENNESS. BARRENNESS may be very properly reckoned among the dis- eases of females, as few married women who have not children enjoy a 43 338 OF BARRENNESS. •oorl state of health. It may proceed from various causes, as higfr Uving, grief, relaxation, &c. but it is chiefly owing to an obstruction or irregularity of the menstrual flux It is very certain that high living vitiates the humours, and prevents fecundity. We seldom find a barren woman among the labouring poor, while nothing is more common anions; the rich and affluent. The in- habitants of every country are prolific iu proportion to their poverty ; and it would be an easy matter to adduce maoy instances of women, ■who, by being reduced to live entirely upon a milk and vegetable diet, have conceived and brought forth children, though they never had any before. Would the rich use the same sort of food and exercise as the better sort of peasants they would seldom have cause to envy their poor vassals and depeudaois, the blessing of a numerous and healthy offspring, while they pine in sorrow for the want of even a sm gle heir to their extensive domains. Affluence begets indolence, which not only vitiates the humours, but induces a general relaxation of the solids; a state highly unfavoura- ble to procreation. To remove this, we would recommend the follow- in" course ; First, sufficient exercise in the open air ; secondly, a diet consisting chiefly of milk and vegetables ; * thirdly, the use of astrin- gent medicines, as steel, alum, dragon's blood, elixir of vitriol, and the Spaw or Tunbridge waters, Peruvian bark, &c; and lastly, above all, the cold bath. Barrenness is often the consequence of grief, sudden fear, anxiety, or any of the passions which tend to obstruct the menstrual flux. When barrenness is suspected to proceed from affections of the mind the per- son ought to be kept as easy and cheerful as possible ; all disagreeable objects" are to be avoided, and every method taken to amuse and en- tertain the fancy. * Dr. Cheyne avers, that want of children is oftener the fault of the male than of the female, and strongly recommends a milk and vegeta- ble diet to the former as well ns the latter ; adding, that Ijs friend Dr. Taylor, whom he calls the Milk-doctor of Croydon, luuflbrought sun- dry opulent families in his neighbourhood, who had continued some years after marriage without progeny, to have several fine children, by keeping both parents for a considerable time, to a milk and vegeta? ble diet. DISEASES OF CHILDREN. 93* CHAPTER XLIX. DISEASES OF CHILDREN. MISERABLE indeed is the lot of man in the state of infancy i He comes into the world more helpless than any other animal, and stands much longer in need of the potection and care of his pa- rents; but, alas! this care is not always bestowed upon him; and when it is, he often suffers as much from improper management as he \vould have done from neglect. Hence the officious cave of parents, nurses, and mid wives, becomes one of the' most fruitful sources of the disorders of infants.* It must be obvious to every attentive person, that the first diseases of children arise chiefly from their bowels. Nor is this in the least to be wondered at, as they are in a manner poisoned with indigestible drugs and improper diet as soon as they come into the world. Every- thing that the stomach cannot digest may be considered as a poison; and unless it can be thrown up, or voided by stool, it must occasion sickness, gripes, spasmodic affections of the bowels, or what the good women call inward fits, and at last convulsions and death. As these symptoms evidently arise from somewhat that irritates the intestines, doubtless the proper method of cure must be to expel it as soon as possible. The most safe and effectual method of doing diis is by gentle vomits. -Five or six grains of the powder of ipecacuanha may be mixed in two table spoonsful of water, and sweetened with a little sugar. A tea-spoonful of this may be given to the infant every quarter of an hour till it operates ; or, what will more certainly answer the purpose, a grain of emetic tartar may be dissolved in three ounces of water, sweetened with a little syrup, and given as above. Those who are willing to use the emetic tartar, may give six or seven drops * Of the officious and ill-judged care of midwives, we shall adduce only one instance, viz. the common practice of torturing infants, by squeezing their breasts, to draw off the milk, as they call it. Though a small quantity of moisture is generally found in the breasts of infants, yet, as they are certainly not intended to give suck, this ought never to be drawn off. I have seen this cruel operation bring on hardness, inflammation and suppuration of the breast ; but never knew any ill consequences from its being omitted. When the breasts are hard, the only application that we would recommend, is a soft poultice, or a lit- tle of the diachylon plaster, spread thin upon a bit of soft leather, about the size of half a crown, and applied over each nipple. These may be suffered to continue till the hardness disappears* 340 OF THE MECONIUM. of the antimouial wine, in a tea-spoonful of water or thin gruel. Small doses of the ipecacuanha wine will be found more gentle tliaa any of the above, aod ouglv to be preferred. These medicines will not only cleanse the stomach, but will general- ly likewise open the body. Should this however not happen, aud if the child be costive, some gentle purge will be uecessaiy : for this pur- pose, some manna and pulp of cassis may be dissolved in boiling wa- ter, and given in small quantities till it operates; or, what will answer rather better, a few graius of magnesia alba may be mixed in any kind of food that is given to the child, and continued till it has the de- sired effect. If these medicines be properly administered, and the child's belly and limbs frequently rubbed with a warm hand before the fire, they will seldom fail to relieve those affections of the stomach and bowel* f-om which infants suffer so much. These general directions include most of what can be done for re- lieving die internal disorders of infants. They will likewise go a con- siderable way in alleviating those which appear externally, as the rash, gum, ovj'dloyi, &c These, as was formerly observed, are principally owiug to too hot a regimen, and consequently will be most effectually Relieved by gentle evacuations. Indeed, evacuatious of one kind or other constitute a principal part of the medicine of infants, and will seldom, if administered with prudeuce, in anj of their diseases, fail to give relief. OF THE MECONIUM. THE stomach and bowels of a newborn infant are filled with a blackish coloured matter of the consistence of syrup, commonly called the meconium. Tim is generally passed soon after the birth, by the mere effort of nature; in which case it is not necessary to give the in- fant any kind of medicine But if it should be retained, or not suffi- ciently carried off a little manna or mag?icsia alba may be given as mentioned above; or, if these should not be at hand, a common spoon- ful of whey, sweetened with a little honey, or raw sugar, will answer the purpose. The most proper medicine for expelling the meconium is the mo- ther's milk, which is always at first of a purgative quality. Were children allowed to suck as soon as they show au inclination for the breast, 'hey would seldom have occasion for medicines to discharge the meconium ; but even where this is not allowed, they ought never to have daubs of syrup, oil, and other indigestible stuff, crammed down their throats. THE AFHTUM, OR THRUSH. THE aphthre are little whitish ulcers affectiug the whole inside of the mouth, tongue, throat, and stomach of infauts. Sometimes they OF ACIDITIES. 341 reach through the whole intestinal canal; in which case they are very dangerous, arid often put an end to the iifant's life. if the aphthae are of a pale colour, pellucid, few in number, soft, superficial, and fall easily off, they are not dangerous ; but if opake, yellow, brown, black, thick, or running together, they ought to be dreaded. It is generally "thought that the aphthae owe their origin to acid hu- mours ; we have reasou however to believe, that they are more fre- quently owing to too hot a regimen both of the mother and child. It is a rare thing to find a child who is not dosed with wine, punch, cin- namon-waters, or some other hot and inflaming liquors, almost as soon as it is born. It is Weil known that these will occasion inflammatory disorders even in adults; is it any wonder then that they should heat and inflame the tender bodies of infants, and set as it were the whole constitution in a blaze ? The most proper medicines for the aphtha? are vomits, such as have been already recommended, and gentle laxatives. Five grains of rhubarb, and half a drachm of magnesia alba may be rubbed together, and divided into six doses, one of which may be given to the infant every four or five hours till they operate. These powders may either be given in the child's food, or a little of the syrup of pale roses, and may be repeated as often as is found necessary to keep the body open. It is common in this case to administer calomel ; but as that medicine sometimes occasions gripes, it ought always to be given to infants with caution. Many things have been recommended for gargling the mouth and throat in this disease ; but it is not easy to apply these in very young children ; we would therefore recommend it to the nurse to rub th» child's mouth frequently with a little borax and honey ; or with the following mixture ; Take fine honey an ounce, borax a drachm, burnt alum half a drachm, rose wafer two drachms; mix them together. A very proper application in this case, is a solution of ten or twelve grains of white vitriol in eight ounces of barley-water. These may be applied with the finger, or by means of a bit of soft rag tied to the end of a probe. OF ACIDITIES. THE food of children being for the most part of an acescent nature, it readily turns sour upon the stomach, especially if the body be any way disordered. Hence most diseases of children are accompanied with evident signs of acidity, as green stools, gripes, &c. These ap- pearances have induced many to believe, that all the diseases of chil- dren were owing to an acid abounding in the stomach and bowels ; but whoever considers the matter attentively, will find that these symptoms of acidity are oftener the effect than the cause of their dis- eases. 342 GALLING AND EXCORIATION. Ka'ure evidently.intended that the food of children should be aces* cent; an 1 unless the bod_> be disordered, or the digestion hurt, from some other cause, we will venture to say, that the acescent quali'y of their food is seldom injurious to them \cidity, however, is often a symptom of disorders in children, and, as it is sometimes a troublesome one, we shall point out the method of relieving it. ; greet] stools, gripes, pnrgiugs, sour smells, too great an irritability of the nerves of the stomach, such medicines as have a tendency to brace and strengthen that organ, and to abate its sensibility, must be used. The first of these iuteotious may be an- swered by a slight infusion of the Peruvian bark, with the addition of a little rhubarb and orange peel ; and the second by the saline draughts, to which a few drops of liquid laudanum may be occasionally added. In obstinate vomitings the operation of internal medicines may be as- sisted by aromatic fomentations made with wine, applied warm to the pit of the stomach ; or the use of the stomach-plaster, with the addition of a little Theriaca. OF A LOOSEiXESS, A LOOSENESS may generally be reckoned salutary when the stools are sour, slimy, green, or curdled. It is not the discharge, but the production of such stools, which ought to be remedied. Even "where the purging is thin and watery, it ought not to be checked too suddenly, as it often proves critical, especially when the child has caught cold, or an eruption on the skin has disappeared. Sometimes an evacuation of this kind succeeds a humid state of the atmosphere, in which case it may also prove of advantage, by carrying off a quan- tity of watery humours, which would otherwise tend to relax the habit. As the principle intention of the cure of a looseness is to evacuate the offending matter, it is customary to give the patient a gentle vomit of ipecacuanha, and afterwards to exhibit small and frequent doses of rhubarb ; interposing absorbent medicines, to mitigate the acrimony of the humours. The best purge, however, in this case, is magnesia al- ha. It is at the same time absorbent and laxative, and operates with- out exciting gripes. The antimonial wine, which acts both as an emetic and purge, is also an excellent medicine in this case. By being diluted with water, it may be proportioned to the weakest constitution ; and, not being disagreeable to the palate, it may be repeated as often as occasion re- quires. Even one dose Avill frequently mitigate the disease, and pave the way for the use of absorbents. If, however, the patient's strength will permit, the medicine ought to be repeated every six or eight hours, till the stools begin to assume a more natural appearance; after- wards a longer space may be allowed to intervene between the doses. When it is uecessary to repeat the medicine frequently, the dose ought always to be a little increased, as its efficacy is generally diminished by use. Some upon the first appearance of a looseness, fly immediately to the use of absorbent medicines and astringents. If these be adminis- tered before the offending humours are discharged, though the disease may appear to be mitigated for a little time, it soou afterwards break* OF ERUPTIONS, m &rth with greater violence, and often proves fatal. After proper evac- uations, however,, these medicines may be administered, with consider- able advantage. Should any gripings or restlessness remain after the stomach and bowels have been cleansed, a tea-spo©aful of the syrup of poppies may be given in a little simple cinnamon- water* three or four times a-day 9 till these symptoms have ceased, OF ERUPTIONS. CHILDREN, while on the breast, are seldom free from eruptions of one kind or other. These, however, are not often dangerous, and sought never to be dried up but with the greatest caution. They tend to free the bodies of infants from hurtful humours, which, if retained, might produce fatal disorders. The eruptions of children are chiefly owing to improper food and neglect of cleanliness. If a child be stuffed at all hours with food that its stomach is not able to digest, such food not being properly assimila- ted, instead of nourishing the body, fills it with gross humours. These must either break out in form of eruptions upon the skin, or remain in the body, and occasion fevers and other internal disorders. That neg- lect of cleanliness is a very general cause of eruptive disorders, must 1>e obvious to every one. The children of the poor, and of all who des° pise cleanlinees, are almost constantly found to swarm with vermin, and are generally covered with the scab, itch, and other eruptions. When eruptions are the effect of improper food,/ or want of cleanli- ness, a proper attention to these alone will generally be sufficient to remove them. If this should not be the case, some drying medicines will be necessary. When they are applied, the body ought at the same time to be kept open, and cold is carefully to be avoided. We know no medicine that is more safe for drying up cutaneous eruptions than sulphur, provided it be prudently used. — A little of the flour of sulphur may be mixed with fresh butter, oil, or hog's lard, and thq parts affected frequently touched with it.^ * The following method for drying and curing cutaneous eruptions,- h deemed not unworthy attention — It is an extract of a letter(taken from a Calcutta paper) from a Gentleman of the Faculty, at Fort St. George, to the Doctor of the Bengal Establishment : " Sir Paul Joddrel, from his skill in botany, has made a discovery which is likely to prove of importance to the health and ease of the Europeans iu India ; and will tend to the extirpation of that cruel malady, the ringworm ; and the remedy is as simple as it is effica- cious. It consists in nothing more than a frequent embrocation or friction of the parts where the eruption prevails, with common mush- room ketchup. This remedv, simple as it appears, has never bfea 44 346 OF ERUPTIONS. The most obstinate of all the eruptions incident to children, are th* tinea capitis, or scabbed head, and chilblains. The scabbed head is. often exceeding difficult to cure, and sometimes indeed the cure proves "worse than the disease. I have frequently known children seized with internal disorders, of which they died soon alter their scabbed heads had been healed by the application of diying medicines.* The cure ought always first to be attempted by keeping the head very clean, cutting off the hair, combing and brushing away the scabs, &c. If this is not sufficient, let the head be shaved once a week, washed daily with soap suds, and gently anointed with a liniment made of train oil eight ounces, red precipitate, in fine powder, one drachm. And if there be proud flesh, it should be touched with a bit of blue vitriol, or sprinkled with a little burnt alum. While these things are doing, the patient must be confined to a regular light diet, the body should be kept gently open; and cold, as far as possible, ought to be avoided. To prevent any bad consequences from stopping this discharge, it will be proper, especially in children of a gross habit, to make an issue in the neck or arm, which may be kept open till the patient becomes more strong, and the constitution be somewhat mended. known to fail in removing the ring-worm, itch, or any other cutaneous eruption, after every nostrum has failed. " Sir Paul accounts for this efficacy of the vegetable curative, in the known noxious property of the mushroom to all animalcula. The so- lution or essence of this fungus is proved, by this discovery, to bear such enmity to the minute insect which is the occult cause of this dis- order, that it immediately perforates the cuticle, and totally extirmi- uates the infection. The experiment is easy, and a trial is recom- mended to those afflicted with ring-worms, tetters, or eruptions of any kind." a. e. * I sometime ago saw a very striking instance of the danger of sub- stituting drying medicines in the place of cleanliness and wholesome food, in the Foundling Hospital at Ackworth, where the children were grievously afflicted with scabbed heads, and other cutaneous disorders. Upon inquiry it was found, that very little attention was paid either to the propriety or soundness of their provisions, and that cleanliness was totally neglected; accordingly it was advised, that they should have more wholesome food, and be kept thoroughly clean. — This advice, however, was not followed. It was too troublesome to the servants, su- perintendants, &c. The business was to be done by medicine ; which was accordingly attempted, but had nearly proved fatal to the whole house. Fevers, and other internal disorders immediately appeared, and at length a putrid dysentery, which proved so infectious, that it carried off a great many of the children, and spread over a consider- able part of the neighbouring country. OF THE CROUP, OR HIVES. 841 Chilblains commonly attack childreu in cold weather. They are generally occasioned by the feet or hands being kept long wet or cold, and afterwards suddenly heated. When children are cold, instead of taking exercise to warm themselves gradually, they run to the fire. This occasions a sudden rarefaction of the humours, aud an infraction of the vessels ; which being often repeated, the vessels are at last over- distended, and forced to give way. To prevent it, violent cold and sudden heat must be equally avoid- ed. When the parts begin to look red aud swell, the patient Ought to be purged, aud to have the affected parts frequently rubbed with mus- tard and brandy, or something of a warming nature. They ought like- wise to be covered with flannel, and kept warm aud dry. Some apply warm ashes between cloths, to the swelled parts, which frequently help to reduce them. When there is a sore, it must be dressed with Tur- ner's cerate, the ointment of tutty, the plaster of cerus, or some other drying ointment. These sores are indeed troublesome, but seldom dan* gerous. They generally heal as soon as the warm weather sets in. OF THE CROUP, OR HIVES. CHILDREN are often seized very suddenly with this disease, which, if not quickly relieved, proves mortal. It is known by various names in different parts of Britain* On the east coast of Scodand it is called the croup. On the west they call it the chock or stuffing In some parts of England, where I have observed it, the good women call it the rising of the lights, and in America, the hives* It seems io be a species of asthma attended with very acute and violent catarrhal symptoms. This disease generally prevails in Cold and wet seasons. It is most common upon the sea-coast, and in low marshy countries. — Children of a gross and lax habit are most liable to it. I have sometimes known it hereditary. It generally attacks childreu in the night, after having been much exposed to damp cold easterly winds through the day. Damp houses, wet feet, thin shoes, wet clothes, or any thing that ob- structs the perspiration, may occasion the croup. It is attended wdth a frequent pulse, quick and laborious breathieg, which is performed with a peculiar kind of croaking noise, that may- be heard at a considerable distance. The voice is sharp and shrill, and the face is generally much flushed, though sometimes it is of a liv- id colour. When a child is seized with the above symptoms, his feet should be immediately put into warm water. He ought likewise to be bled,* aud to have a laxative clyster administered as soon as possible; He should * In this disease bleeding is not always proper ; but in very full hafe* Ita it certainly mast be of use. 348 QF THE CROUP, OR HIVES. be made to breathe over the steams of warm water and vinegar; or §9 emollient decoction, and emollient cataplasms or fomentations may be applied round his neck. If the symptoms do not abate, a blistering- plaster must be applied round the neck, or between the shoulders, and the child may lake Frequently a table spoonful of the following julep : T-ike p( rroy- royal water three ounces, syrup of althea and of poppies, each one ounce, ivAx theiia together: Asafcetida is found to hue a good effect in this case. It may be both given in form of cl)ster, and taken by the mouth. Two drachms of asafcetida may be dissolved in one ounce of Mindercrus' spirit, and three ounces of penny royal water. A table spoonful of this mixture may be given every hour, or ofteuer, if the patient's stomach be able to bear it. If the child cannot be brought to take this medicine, two drachms of the asafcetida may be dissolved io a common clyster, and administered every six or eight hours, till the violence of the disease abate*.* To prevent a return of the disorder, all those things which occasion it mils' carefully be avoided; as wet feet, cold, damp, easterly winds, &c. Children who have had frequent returns of this disease, or whose constitutions seem to dispose them to it, ought to have their diet prop- erly regulated; all food that is viscid or hard of digestion, and all crude, raw, trashy fruits are to be avoided. They ought likewise to have a drain constantly kept open in some part of their body, by means of a seton or issue^ I have sometimes koowu a Burgundy-pitch plas- ter, worn continually between the shoulders for several years, have a very happy effect io preventing the return of this dreadful disorder. * I was lately favoured with a letter from Dr. William Turnbull in London, a physician of great experience, and who, from his former sit- uation on the northeast coast of England, had many opportunities of observing the symptoms and progress of this dangerous disease. I ain sorry the letter came too late to be inserted at length ; but as the Doc- tor's sentimen's differ very little from my own, this misfortune is the less to be regretted. The Doctor indeed observes, that he never found blistering of any service; but recommends cataplasms of garlic, camphor and Venice treacle, to be applied both to the throat and soles of the feet. He likewise recommends bolusses of camphor, castor, va- lerian root, salt of hartshorn, and musk, adapted to the age, strength, &c of the patient; after which he advises two spoonsful of the follow- ing decoction : Take of garlic and distilled vinegar each an ounce, h) sop-v ater eif*ht ounces ; beat up the ingredients together, gradually mixing the water, aid adding three ounces of honey. Let the whole t>e simmered over a gentle fire ; and afterwards strained for use. m teethim. im OF TEETHING. i)r. Arbuthnot observes, that above a tenth part of infants die iti ieething, by symptoms proceeding from the irritation of the tender ner- vous parts of tiie jaws, occasioning inflammations, fevers, convulsions, gangrenes, &c. These symptoms are in a great measure owing to the great delicacy and exquisite sensibility of the nervous system at this time of life, which is too often increased by an effeminate education. Hence it comes to pass, that children who are delicately brought up, always suffer most in teething, and often tall by convulsive disorders. About the sixth or seventh month the teeth generally begin to make their appearance ; first, the iricisores, or fore- teeth ; next, the caning or dog-teeth ; and lastly, the mdares, or grinders. About the seventh year, there comes a new set ; and about the twentieths the two inner grinders, called denies sapienice, the teeth of wisdom. Children about the time ot cutting their teeth, slaver much, and have generally a looseness. When the teething is difficult, especial- ly when the dog-teeth begin to make their way through the gums, the child has startings in his sleep, tumours of the gums, watchings, -gripes, green stools, the thrash, fever, difficult breathing and convul- sions. Difficult teething requires nearly the same treatment as an inflam- matory disease. If the body be bound, it must be opened either by emollient clysters or gentle purgatives ; as manna, magnesia alba, rhubarb, senna or the like. The food should be light, and in small quantify ; the drink plentiful, but weak and diluting, as infusions of balm, or of the lim^tree flowers ; to which about a third or fourth part of milk may be added. If the fever be high, bleeding will be necessary ; but this in very- young children ought always to be sparingly performed. It is an evac- uation which they bear the worst of any. Purging, vomiting, or sweat- ing, agree much better with them, and are generally more beneficial. Harris, however, observes, that when an inflammation appears, the physician will labour ia vain, if the cure be not begun with applying a leech under each ear. If the child be seized with convulsion fits, a blistering-plaster may be applied between the shoulders, or one behind each ear. Sydenham says, that in fevers occasioned by teething, he never found any remedy so effectual as two, three, or four drops of spirits of hartshorn in a spoonful of simple water, or other convenient vehicle, given every four hours. The number of doses may be four, five, or Six. I have often prescribed this medicine with success, but always found a laiger dose necessary. It may be given from five drops to fifteen or twenty, according to the age of the child, and when costive- cess does not forbid it, three or four drops of laudanum may be added ko each dose. 350 OF THE RICKETS. In Scotland, it is very common, when children are catting their teet?H to put a small Burgundy pi'ch plaster between their shoulders. Xhif generally eases the tickling cough which attends teething, and is by no means an useless application. When the teeth are cut with difficulty;, it ought to be kept on during the whole time of teething. It may be enlarged as occasion requires, and ought to be renewed at least once a fortnight. Several things have been recommended for rubbing the gums, as oils, mucilages, &c. but from these, much is not to he expected. If any thing of this kind is to be used, we would recommend a little fine honey, which ma >' he rubbed on with the finger three or four limes a-day. Children are generally at this time disposed to chew whatever Ihey get into their hands. For this reason they ought never to be without somewhat that will yield a little to the pressure of their gums, as a crust of bread, a wax caudle, a bit of liquorice root, or such like. With regard to cutting the gums, we have seldom known it of any great benefit. In obstinate cases, however, it ought to be tried. It may be performed by the Auger nail, the edge of a six penny piece that is woru thin, or any sharp body which can be with safety intro- duced into the mouth ; but a lancet, in a skilful hand, is certainly the most proper. In order to render the teething less difficult, parents ought to take care that their children's food be light and wholesome, and that their nerves bo braced by sufficient exercise without doors, the use of the cold bath, &c. Were these things duly regarded, they would have a much better effect than teething necklaces, or other nonsensical amu- lets worn for that purpose. OF THE RICKETS. THIS disease generally attacks children between the age of nine months and two years. It appeared first in Englaud, about the time when manufactures began to flourish, and still prevails most in towns ■»»here the inhabitants follow sedentary employments, by which means they neglect either to take proper exercise themselves, or to give it to their children. CAUSES. — One cause of the rickets is diseased parents. Mothers of a weak relaxed habit, who neglect exercise, and live upon weak wa- tery diet, can neither be expected to bring forth strong and healthy child- ren, or to be able to nurse them after thev are brought forth. Accord- ingly we find, that the children of such women generally die of the rickets, the scrophula, consumptions, or such like diseases. Children begotten by men in the decline of life,*who are subject to the gout, the gravel or other chrouic disease, or who have been often afflicted with the venereal disease in their youth, are likewise very liable to the rickets. OF- THE RICKETS. a*l Any disorder that weakens the constitution, or relaxes the habit of children, as the smallpox, measles, teething, the hooping-cough, &c. disposes them to this disease It may likewise be occasioned by im- proper diet, as fqod that is either too weak and watery, or so viscid that the stomach cannot digest it.- Bad nursing is the chief cause of this disease. When the nurse is either diseased, or has not enough of milk to nourish the child, it can- not thrive.. Bat children suffer oftener by want of care in nurses than want oi food. Allowing an infant to lie or sit too much, or not keeping; it thoroughly clean in its clothes, has the most pernicious effects. The want of free air is likewise very hurtful to children in this res- pect. When a nurse lives in a close small house, wlitre the air is damp and confined, and is too indolent to carry her child abroad into the open air, it will hardly escape this disease. A healthy child should always be in motion, unless when asleep; if it be suffered to lie or git, instead of being tossed and dandled ahout it will not thrive. SYMPTOMS.— At the beginning of this disease the child's flesh grows soft, and flabb) ; its strength is diminished ; it loses its wonted » cheerfulness, looks more grave and composed than is natural for its age, and does not choose to be moved. The head and belly become too large in proportion t" the other parts ; the face appears full, and the complexion florid. Afterwards the bones begin to be affected, especially in the more soft and spungy parts. Hence the wrists and ancles become thicker than usual ; the spine or back-bone puts on an unnatural shape; the breast is likewise often deformed; and the bones of the arms and legs grow crooked. All these symp- toms vary according to the violence of the disease. The pulse is gene- rally quick, but feeble; the appetite and digestion for the most part bad ; the teeth come slowly and with difficulty, and they often rot and fall out afterwards. Rickety children generally have great acuteuess of mind, and an understanding above their years. Whether this is ow- ing to their being more in the company of adults than other children, or. to the preternatural enlargement of the brain, is not material. REGIMEJN"*— As this disease is always attended with evident signs ©f weakness and relaxation, our chief aim in the cure must be to brace and strengthen the solids, and to promote digestion and the due preparation of the fluids. These important ends will be best answered by wholesome nourishing diet, suited to the age and streagth of the pa- tient, open dry air, and sufficient exercise. If the child has a bad nurse, who either neglects her duty, or doe6 not understand it, she should be changed. If the season be cold, the child ought to be kept warm ; and when the weather is hot, it ous;ht to be kept cool ; as sweat- ing is apt to weaken it, and too great a degree of cold has the same ef- fect. The limbs should be rubbed frequently with a warm hand, ani f|ie child kept as cheerful as possible. bo2 OF CONVULSIONS. The diet ought to be dry and nourishing, as good bread, roasted flesh* &c. Biscuit is generally reckoned the best bread ; and pigeons, pullets, veal, rabbits, or mutton roasted or minced, are the most prop- er flesh. If the child be too young for flesh-meats, he may have rice, millet, or pearl barley boiled with raisins, to which may be added a little wine and spice. His drink may be good claret mixed with an equal quantity of wnter. Those who cannot afford claret, may give the child now and then a wine glass of mild ale, or good porter. MED [C [JN"E.— Medicines art hereof little avail. The disease may often be cured by the nurse, but seldom by the physician. In children of a g^ross habit, gentle vomits and repeated purges of rhubarb may sometimes be of use, but they will seldom carry pff the disease ; that must, depend chiefly upon such things as brace and strengthen the system ; for which purpose, besides the regimen mentioned above, we "would recommend the cold bath, especially in the warm season. It must however be used with prudence, as some rickety children caunot bear it. The best time for using the cold bath is in the morning, and the child should be well rubbed with a dry cloth immediately after he comes out of it. Sometimes issues have been found beneficial in this disease. They are peculiarly necessary for children who abound with gross humours. An infusion of the Peruvian bark in wine or ale would be of service, were it possible to bring them to take it. We mijdit here mention many other medicines which have been recommended for the rickets; but as there is far more danger in trusting to these than in neglecting them altogether, we choose rather to pass them over, aud to recommend a proper regimen as the thing chiefly to be depended on. OF CONVULSIONS. THOUGH more children are said to die of convulsions than of any other disease, yet they are for the most part only a symptom of some other malady. Whatever greatly irritates or stimulates the nerves may occasion convulsions. Hence infants whose nerves are easily af- fected, are often thrown into convulsions by any thing that irritates the alimentary canal ; likewise by teething; strait clothes ; the approach of the small pox, measles, or other eruptive diseases. When convulsions proceed from an irritation of the stomach or bowels, whatever clears them of their acrid contents, or renders these mild and inoffensive, will generally perform a cure; wherefore, if the child be costive, the best v ay will be to begin with a clyster and after- wards to give a gentle vomit, which may be repeated occasionally, and the body in the mean time kept open b) gentle doses of magnesia al- ba, or small quantities of rhubarb mixed with the powder of crab'? claws. OF WATER IN THE HEAD. S53 Convulsions which precede (he eruption of the small-pox ot mea-^ jsies, generally go off upon these making their appearance. The prin- cipal danger in this case arises from the fears and apprehensions of those who have the care of the patient. Convulsions are very alarm- ing, and something must be done to appease the affrighted pareuts, nurs- es, &e. Hence the unhappy infant often undergoes bleeding, blister- ing, and several other operations, to the great danger of its life, when a little time, bathing the feet in warm water, and throwing in a mild clyster, would have set all to rights. When convulsion-fits arise from the cutting of teeth, besides gentle evacuations, we would recommend blistering, and the use of antispas- modic medicines, as the tincture of soot, asafoetida, or castor A few drops of any of these may be mixed in a cup of white wine whey, and given occasionally. When convulsions proceed from any external cause, as the pressure occasioned by straight clothes or bandages, &c these ought immedi- ately to be removed ; though in this case taking away the cause will not always remove the effect, yet it it ought to be done. It is not likely that the patient will recover, as long as the cause which first gave rise to the disorder continues to act. When a child is seized with convulsions without having any com- plaint in the bowels, or symptoms of teething ; or any rash or other dis- charge which has been suddenly dried Up ; we have reason to conclude that it is a primary disease, and proceeds immediately from the brain- Cases of this kind, however, happen but seldom, which is very fortu- nate, as little can be done to relieve the unhappy patient. When a dis- ease proceeds from an original fault in the formatien or structure of the brain itself, we cannot expect that it should yield to medicine. But as this is not always the cause, even of convulsions which proceed imme- diately from the brain, some attempts should be made to remove them. The chief intention to be pursued for this purpose, is to make some derivation from the head, by blistering, purging, and the like. Should these fail, issues or setons may be put in the neck, or between the shoulders. OF WATER IN THE HEAD. THOUGH water in the head, or a dropsy of the brain, may affect adult? as well as children, yet, as the latter are more peculiarly liable fro it, we thought that it would be most proper to place it among the diseases of infants C4USES. — A dropsy of the brain may proceed from injuries done to the brain itself by falls, blows, or the like; it may also proceed from an original laxity or weakness of the brain ; from scirrhous tu- mours or excrescences within the skull ; a thin watery state of the frood ; a diminished secretion of urine ; a sudden check of the perspiration | 45 054 OF WATER IN THE HEAD. and lastly, from tedious and lingering diseases, which waste and torn* suroe the patient. SYMPTOMS. — This disease has at first the appearance of a slow fever ; the patient complains of a pain in the crown of his head or over his eyes; he 6huns the light; is sick, and sometimes vomits; his pulse is irregular and generally low ; though he seems heavy and dull, yet he does not sleep ; he is sometimes delirious, and frequently sees ob- jects double ; towards the end of this commonly fatal disease, the pulse becomes more frequent, the pupils are generally dilated, the cheeks flushed, the patient becomes comatose, and convulsions ensue.* MEDICINE. — No medicine lias hitherto been found sufficient to carry off a dropsy of the brain. It is laudable, however, to make some attempts, as time or chance may bring many things to light, of which at present we have no idea. The medicines generally used are, purges of rhubarb or jalap, with calomel or blistering- pi asters applied to the neck or back part of the head. To which we would beg leave to add diuretics, or medicines which promote the secretion of urine, such as are recommended in the common dropsy. A discharge from the nose ought Irkewise to be promoted by causing the patient to snuff the powder of asarum, white hellebore or the like. • Some practitioners have of late pretended to cure this disease by the use of mercury. I have not been so happy as to see any instances of a cure being performed iu a confirmed dropsy of the brain ; but in so desperate a malady every thing deserves a trial.f * I very lately lost a patient in this disease, where a curious metas- tasis seemed to take place. The water at first appeared to be in the abdomen, afterwards in the breas, and last of all it mounted up to the brain, where it soon proved fatal f One reason why this disease is seldom or never cured, may be, that it is seldom known till not far advanced to admit of a remedy. Bid parents watch the firsteyroptoms, and call a physician in due time, I am inclined to think that something might be done. But these symp- toms are not yet sufficiently known, and are often mistaken even by physicians themselves. Of this I lately saw a striking instance in a patient, attended by an eminent practitioner of this city, who had all along mistaken the disease for teething. @F SURGERY. m CHAPTER L. OF SURGERY* fliO describe all the operations of surgery, and to point out the dif- JL fereot diseases in which these operations are necessary, would ex- tend this article far beyond the limits allotted to it : we must therefore confine our observations to such cases as most generally occur, and in which proper assistance is either not asked, Or not always to be obtain- ed. Though an acquaintance with the structure of the human body is in- dispensably necessary to qualify a man for being an expert surgeon ; yet many things may be done to save the lives of their fellow-men, in emergencies, by those who are no adepts in anatomy. It is amazing with what facility the peasants daily perform operations upon brute animals, which are not of a less difficult nature than many of those performed on the human species ; yet they seldom fail of success. Indeed every man is in some measure a surgeon whether he will be or not. He feels an inclination to assist his fellow-men in distress, and accidents happen every hour which give occasion to exercise this feel- ing. The feelings of the heart, however, when not directed by the judgment are apt to mislead. Thus one, by a rash attempt to save his friend, may sometimes destroy him ; while another, for fear of doing amiss, stands still and sees his bosom friend expire without so much as attempting to relieve him, -even when the means are in his power. As every good man would wish to steer a course different from either of these, it will no doubt be agreeable to him to know what ought to be. doae upon such emergencies. OF BLEEDING, NO operation of surgery is so frequently necessary as bleeding; it ought therefore to be very generally understood. But though prac- ticed by midwives, gardeners, blacksmiths, &c. we have reason to be- lieve that very few know when it is proper. Even physicians them- selves have been so much the dupes oT theory in this article, as to ren- der it the subject of ridicule. It is, however, an operation of great importance, and must, when seasonably and properly performed, be of singular service to those in distress. * Late Practice has fully proved, that all Surgical instruments, ex« cept the lancet for Vaccination, dipped ia oil at the instant of using, lessens the pain — It ia salutary also to have all instruments at blood Iteat. a. s; 356 OF SURGERY, Bleeding is prope-r at the beginning of all inflammatory fevers, al pleurisies, peripneumonies, &c It is likewise proper in all topical inflammations, as tho^e of the intestines, womb, bladder, stomach, kid- nies. throat, eyes, &c as also in the asthma, sciatic pains, coughs, head-aches, rheumatisms, the apoplexy, epilepsy, and bloody-flux. After falls, blows, bruises or any violent hurt received either exter- nally or internally, bleeding is necessary. It is likewise necessary for persons who have had the misfortune to be strangled, drowued, suffo- cated with foul air, *he fumes ot melot easily healed. Would those who practice bleeding take a little Biore pains, aod accustom themselves to bleed children, they would Bot find it such a difficult operation as they imagine. Certain hurtful prejudices with regard to bleeding still prevail among the country people. They talk, for instance, of head-veins, heart- veins, breast-veius, '•:;-,! be then drained off, and kept in bottles, properly labelled, readtf .. immediate use. OF BRUISES. :RUrSE3 are generally productive of worse consequences than mds. The danger from them does not appear immediately, by V;;;di means it often happens that they are neglected. It is needless any defi .iiio;i of a disease so Universally known ; we shall therefore proceed lo point out the method of treating it. lit slight bruises il will be sufficient to bathe the part with warm vin- r, io which a li tie brandy or rum may occasionally be added, and to keep cloths wet frith this mixture constantly applied to it. This is more proper than rubbing it with brandy, spirits of wine, or other ar- Oi ut spirits, Which are commonly used in such cases. I i some pins of 'he country the peasants apply to a recent bruise a catapjasm of fresh cow dung. I have often seen this cataplasm appli- ed to violent contusions occasioned by blows, falls, bruises, and such lik and never knew it: fail to have a good effect. Alien a bruise is very violent, the patient ought immediately to be bled, and put upon a proper regimen. His food should be light and cool, and his drink weak aud of an opening nature : as whoy sweeten* td with hr.'it y. decoctions of tamarinds, barley, cream tartar whey, and such like. The bruised part must be bathed with vinegar aud Ava.er, as directed above ; and a poultice made by boiling crumbs of bread, elder flowers, and camomile flowers, in equal quantities of vinegar and water applied to it. This poultice is peculiarly proper when a wouud is joined to the bruise. It may be renewed two or three times a-day. As the structure of the vessels is totally destroyed by a violent bruise, there of en ensues a gieat loss of substance, which produces an ulcerous sore very difficult to cure. If the bone be effected, the sore will not heal before an exfoliation takes place ; that is, before the dis- eased part of the bone separates, aod comes out through the wound. This is often a very slow operation, and may even require several years to be completed. Hence it happens, that these sores are fre- quently mistaken for the king's evil, and treated as such though in fact they proceed solely from the injury which the solid parts received from the blow. Patients in this situation are pestered with different advices. Every one who sees them proposes a new remedy, till the sore is so much irritated with various aud opposite applications, that it is often at length rendered absolutely incurable. The best method of managing such sores is, to take care that the patient's constitution does not suffer by confinement or improper medicine, and to apply nothing to them tie- sides simple ointment spread upon soil lint, over which a poultice of OF ULCERS. &ok b'reacl and milk, with boiled camomile flowers, or the like, may be pat to nourish the part, and keep it soft and warm Nature, thus assisted, will geuerally in time operate a cure, by throwing oil the diseased parts of the bone, after which the sore soon heals. OF ULCERS. ULCERS may be the consequence of wounds, bruises, or impos- thumes improperly treated ; they may Hkewise proceed from an ill slate of the humours, or what may be called a bad habit of body. In the latter case they ought not to be hastily dried up, otherwise it may prove fatal to the patient. Ulcers happen most commonly in the decline of life ; and persons who neglect exercise, and live grossly, are most liable to them. They might often be prevented by retrenching some part of the solid food, or by opening artificial drains, as issues, setons, or the like. An ulcer may be distinguished from a wound by its discharging a thin watery humour, Which is often so acrid as to inflame and corrode the skin ; by the hardness and perpendicular situation of its sides or edges ; by the time of its duration, &c. It requires considerable skill to be able to judge whether or not au ulcer ought to be dried up. In general, all ulcers which proceed from a bad habit of body, should be suffered to continue open, at least till the constitution has been so far changed by proper regimen, or the use of medicine, that they seem disposed to heal of their own accord. Ulcers which are the effect of malignant fevers, or other acute diseas- es, may generally be healed with safety after the health has been res- tored for some time. The cure ought not however to be attempted too soon, nor at any time without the use of purging medicines and a proper regimen. When wounds or bruises have, by wrong treatment, degenerated into ulcers, if the constitution be good, they may general- ly be healed with safety. When ulcers either accompany chronic dis- eases, or come in their stead, they must be cautiously healed. If an ulcer conduces to the patieut's health, from whatever cause it pro- ceeds, it ought not to be healed ; but if, on the contra v*, ii wastes the strength and consumes the patient by a slow fever, it should be healed as soon as possible. We would earnestly recommend a strict attention to these particu- lars to all who have the misfortune to labour under this disorder, par- ticularly those in the decline of life ; as we have frequently kuown people throw away their lives by the want of it, while they were ex- tolling and generously rewarding those whom they ought to have look- ad upon as their executioners. The most proper regimen for promoting the cure of ulcers, is to avoid all spices, salted and high seasoned food, all strong liquors, and to Ipssen the usual quantity of flesh meat. The body ought to be kept gent- 306 OF ULCERS. ly open by a diet consisting chiefly of cooiing laxative vegetables, and by drinking butter-milk, whey sweetened with honey, or the like* The patient ought to be kepi cheerful, an) should take as much exer- cise as he cau easily hear. When the bottom and sides of an ulcer seem hard and callous, they m?y be sprinkled twice a-day with a little red precipitate of mercury, and afterwards dressed with the yellow basiheum ointment Some- times it will be necessary to have the edges of the ulcer scarified with the lancet Lime-water has frequently been known to have happy effects in the cure of obstinate ulcers It may be used in the same manner as direct- ed for the stone and gravel. My late learned and ingenious friend Dr. Whytt strongly recom- mends the use of die solution of corrosive sublimate of mercury in bran- dy, for the cine of obstinate ill-conditioned ulcers. I have frequently found this medicine, when giyen according to the Doctor's directions, prove very successful This dose is a table-spoonful night and morn- ing; at the samp dine washing the. sore twice or thrice a-day with it. In a letter which I had from the Doctor a little before his death, he informed me. " That he observed washing the sore thrice a day with the solution ot a tr-pple strength was very beneficial."* A fistulous uicer can seldom be cured without au operation. It must either be laid open so as to have its callous parts destroyed by some corrosive application, or they must be entirely cut away by the knife; but as this operation requires the hand of an expert surgeon, there is no occasion to describe it. Ulcers about the anus are most apt to be- come fistulous, and are very difficult to cure. Some indeed pretend to have found Ward's fistula paste very successful in this complaint. It is not a dangerous medicine, and being easily procured, it may de- serve a trial; but as these ulcers generally proceed from an ill habit of body, they will seldom yield to any thing except a long course of regimen, assisted by medicines which are calculated to correct that particular habit, and to induce an almost total change in the constitu- tion. * In ulcers of the lower limbs great benefit is often received from tight rollers, or wearing a laced stocking, as this prevents the flux o£ humours to the sores, and disposes them to heal. OF DISLOCATIONS, <&e. m CHAPTER LI. OF DISLOCATIONS. WHEN a bone is moved out of its place or articulation, so as tq impede its proper functions, it is said to be luxated or disloca- ted. As this often happens to persons in situations where no medical assistance can be obtained, by which means limbs, and even lives, are frequently lost, we shall endeavour to point out the method of reducing the most common luxations, and those which require immediate assist- ance. Any person of common sense and resolution, who is present when a dislocation happeus, may often be of more service to the pa- tient, than the most expert surgeon can alter the swelling and inflam- mation have come on. When these are present, it is difficult to know the state of the joint, and dangerous to attempt a reduction, and by wait- ing till they are gone off, the muscles become so relaxed and the cavity filled up, that the bone can never afterwards be retained in its place. A recent dislocation may generally be reduced by exlention alone, which must always be greater or less according to the strength of the muscles which move the joint, the age, robustness, and other circum- stances of the patient. When the boue has been out of its place for a considerable time, and a swelling or inflammation has come on, it will .be necessary to bleed the patient, and, after fomenting the part, to ap- ply soft poultices with vinegar to ii for some time before the reduction h attempted. All that is necessary after the reduction, is to apply cloths dipped in vinegar or camphorated spirits of wine to the part, and to keep it perfectly easy. Many bad consequences proceed from the neglect of this rule. A dislocation seldom happens without the tendons and lig- aments of the joint being stretched and sometimes torn. When these are kept easy till they reeover their strength and tone, all goes on very well ( but if the injury be increased by too frequent an exer- tion of the parts, no wonder if they be found weak and diseased ever after. DISLOCATION OF THE JAW. THE lower jaw may be luxated by yawning, blows, falls, chewing bard tiubstaoces, or the like It is easily known from the patient's being unable to shut his mouth, or to eat any thing, as the teeth of the under jaw do not correspond with those of the upper ; besides, the chin either hangs down, or is thrown toward one side, and the patient Is neither able to speak distinctly, nor to swallow without considerable difficulty. 368 DISLOCATION OF THE NECK. The usual method of reducing a dislocated jaw is to set the patient upon a low stool, so as an assistant may hold die head firm by pressing it against his breatt. The operator is then to thrust his two thumbs, beiug first wrapped up with liunen cloths that they may not slip as far back into the patient's mou'h as he can, while Im fingers are applied to the jaw externally. Afer he has got firm hold of the jaw, he is to press it strongly downwards and backwards by which means the elap- sed heads ot the jaw may be easily pushed into their former cav- ities. The peasants in some parts of the country have a peculiar way of performing this operation. One of them puts a handkerchief under the patient's chin, then turning his back to that of the patient, pulls him up by the chin so as to suspend him from the ground. This method often succeeds, but we think it a dangerous one, and therefore recom- mend the former. DISLOCATION OF THE NECK. THE neck may be dislocated by falls, violent blows, or the like. In this case, if the patient recehes no assistance, he soon dies, which makes people imagine the neck was broken; it is however, for the most part only partially dislocated, and may be reduced by almost any person who has resolution enough to attempt it. A complete disloca- tion of the neck is instantaneous death. When the neck is dislocated, the patient is immediately deprived of all sense and motion; his neck swells, his countenance appears bloat- ed ; his chin lies upon his breast, and his face is generally turned to- wards one side. To reduce this dislocation, the unhappy person should immediately be laid upon his back on the ground, and, the operator must place himself behind him so as to be able to lay hold of his head with both hands, while he makes a resistance by placing his knees against the patieut's shoulders. In this posture he musi pull the head with con- siderable force, gently twisting it at the same time, if the face be turned to one side, till he perceives that the joint is replaced, which may be known from the noise which the bones generally make when going in, the patient's beginning to breathe, and the head continuing in its natu- ral posture. This is one of those operations which is more easy to perform than describe. I have knowu instances of its being happily performed even by women, and often by men ol no medical education. After the neck, is reduced, the patient ought to bebied, and should be suffered to rest for some days, till the parts recover their proper tone. DISLOCATION OF THE RIBS, &e. 368 DISLOCATION OF THE RIBS. AS the articulation of the ribs with the back bone is very strong, ihey are not often dislocated. It does however sometimes happen, ;which is a sufficient reason for our taking notice of it. When a rib is dislocated either upwards or downwards, in order to replace it, the patient should be laid upon his belly on a table, and the operator must .endeavour to push the head of the bone into its proper place. Should ihis method not succeed, the arm of the disordered side may be sus- pended over a gate or ladder, and, while the ribs are thus sketched asunder, the heads of such as are out of place may be thrust into their former situation. Those dislocations wherein the heads of the ribs are forced inwards, are both more dangerous and the most difficult to reduce, as neither the hand nor any instrument can be applied internally to direct the lux- ated heads of the ribs. Almost the only thing that can be done is, to lay the patient upon his belly over a cask, or some gibbous body, and to move the fore part of the rib inward towards the back, some- times shaking it ; by this means the heads of the luxated ribs may slip .into their former place. DISLOCATION OF THE SHOULDER. THE humerus or upper bone of the arm may be dislocated in va- rious directions ; it happens however most frequently downwards, but very seldom directly upwards. From the nature of its articulation, as well as from its exposure to external injuries, this bone is the most subject to dislocation of any in the body. A. dislocation of the hu- merus may be know by a depression or cavity on the top of the shoul- der, and an inability to move the arm. When the dislocation is downward or forward, the arm is elongated, and a ball or lump is perceived under the ana pit ; but when it is backward, there appears a protuberance behind the shoulder, aad the arm is thrown forwards .towards the breast. The usual method of reducing dislocations of the shoulder is to seat the patient upon a low stool, and to cause au assistant to hold his body so that it may not give way to the extension, while another lays hold of the arm a little above the elbow, and gradually extends it. The operator then puts a napkin under the patient's arm, and causes it to be tied behind his own neck; by this, while a sufficient extension is marie, he lifts up the head of the bone, and with his hands directs it into its proper place. There are various machines invented for faciii» tating this operation, but the hand of an expert surgeon is always more safe. In young and delicate patients, I have generally found it a very easy mattef to reduce the- shoulder, by extending the arm with om 170 DISLOCATION OF THE ELBOW, &t. Band, and thrusting in the head of the bone with the other. In rac- king the extension, the arm ought always to be a little bent. DISLOCATION OF THE ELBOW. THE bones of the fore arm may be dislocated in any direction. "When this is the case, a protuberance may be observed on that side of the arm towards which the bone is pushed, from which, and the pa- tient's inability to beud his arm, a dislocation of this joint may easily be known. Two assistants are generally necessary for reducing a dislocation of the elbow ; one of them must lay hold of the arm above, and the other below the joint, and make a pretty strong extension, while the operator returns the bones into their proper place. Afterwards the arm must be bent, and suspended for som« time with a sling aboui the neck. Luxations of the wrist and fingers are, to be reduced in the same manner as those of the elbow ; viz. by making an extension in different directions, and thrusting the head of the bone into its place. DISLOCATION OF THE THIGH. When the thigh-bone is dislocated forward and downward, the knee and foot are turned out, and the leg is longer than the other, but whea it is displaced backward, it is usually pushed upward at the sara« time, by which means the limb is shortened, and the foot is turned in- wards. When the thigh-bone is displaced forward and downward, the pa- tient, in order to have it reduced, must be laid upon his back and mad* fast by bandages, or held by assistants, while by others an extension is made bv means of slings fixed about the bottom of the thigh a little above the knee. While the extension is made, the operator must push the head of the bone outward, till it gets into the socket. If the dis- location be outward, the patient must be laid upou his face, and, during the extention, the head of the bone must be pushed inward. Dislocations of the knees, ancles, and toes, are reduced much in the same manner as those of the upper extremities, vis. by making an ex- tention in opposite directions, while the operator replaces the bones. In many cases, however, the extention alone is sufficient, and the bene wiil slip into its place merely by pulling the limb with sufficient force. It is not hereby meant, that force alone is sufficient for the reductioa of dislocations. Skill and address will often succed better than force. I have known a dislocation of the thigh reduced by one man, after all the force that could be used by six had proved ineffectual. OF BROKEN BONES. SU CHAPETR LIL OF BROKEN BONES, &e. THERE is, in most villages, some person who pretends to the art of reducing fractures. Though in genera! such persons are very ignorant, yet some of them are very successful ; which evidently proves, that a small degree of learning, with a sufficient share of com- mon sense and a mechauical head, will enable a man to be useful id this way. We woidd, however, advise people never to employ such operators, when an expert and skillful surgeon can be had ; but when this is impracticable, they must be employed ; we shall therefore re- commend the following hints to their consideration : When a large bone is broken, the patient's diet ought in all respects to be the same as in an inflammatory fever. He should likewise be kept quiet and cool, and his body open by emollient clysters ; or, if these cannot be conveniently administered, by food that is of an open- ing quality ; as stewed prunes, apples boiled in milk, boiled spinuage, and the like. It ought however td be here remarked, that persons who have been accustomed to live high, are not all of a sudden to be reduced to a very low diet. This might have fatal effects. There is often a necessity for indulging even bad habits, in some measure, where the nature of the disease might require a different treatment. It will generally be necessary to bleed the patient immediately after a fracture, especially if he be young, of a full habit, or has at the same time received any bruise or contusion. This operation should not on- ly be performed soon after the accideut happens, but if the patient be very feverish, it may be repeated next day. When several of the ribs are broken, bleeding is peculiarly necessary. If any of the large bones which support the body are broken, the patient must keep his bed for several weeks. It is by no means ne- cessary, however that he should lie all that time, as is customary upon his back. This situation sinks the spirits, galls and frets the patient's skin, and renders him very uneasy. After the second week he may be gently raised up, and may sit several hours, supported by a bed chair, or the like, which will greatly relieve him. Great care, however, must be taken in raising him up and laying him dowu, that he make no exertions himself, otherwise the action of the muscles may pull the feoae out of its place.* * Various pieces of machinery have been contrived for counteract- ing the force of the muscles, and retaining the fragments of broken bases ; but as descriptions ef these without drawings would be of Utth 372 OF BROKEN BONES. It is of great importance to keep the patient dry and clean while id thu situation By neglecting (his, he is often so galled and excoriated, tha< he is forced to keep shifting places for ease. 1 have known a fractured thigh bone, after it had been kept straight for above a fort- night, -displaced by this means, and continue bent for life, in spite of all tha could be done. It has been customary when a bone was broken, to keep the limb for five or six weeks continually upon the stretch. But this is a bad posture. Ii is both uneasy to the patient, and unfavourable to the cure. Tiie be t situation i> to keep the limb a little bent. This is the pos- tun inio which 'very animal puts his limbs when it goes to rest, and id h inch fewest muscles are upon the stretch. It is easily effected, by en 'ier laying the ps. ien f upon his side, or making the bed so as to fa- vo iv this position of the bmb Bone-setters twght carefully to examine whether the bone be not sha tered or broken into several pieces In this cape it will sometimes be necessary to have the limb immediately taken off, otherwise a gan- grene or mortification may < nsue The horror which attends the very idea of an amputation, often occasions its being delayed in such cases till too late, j have known this principle operate so strongly, that a limb where the bones were shattered into more than twenty pieces, was not amputated before the third day after the accident, when the gangrene hdd proceeded 60 fur a<- to render the operation useless. When a fracture is accompanied with a wound, it must be dressed in all respects as a common wound. All thai art can do towards the cure of a broken bone, is to lay it perfectly straight, and to kftep it quite easy. Ali tight bandages do hurt They had much better be wanting altogether. A great many of the bad consequences which succeed to fractured bones are owing to tight Bandages, i his is one of the ways in which excess of art, or rather the abuse of it, docs more mischief than would be occasioned by the want of it. Some of the most sudden cures of broken bones which were ever known, happened where no bandages were applied at all. Some niftliod however must be taken to keep the member steady ; but this may be doi.e man) ways without bracing it with a tight ban- dage. use I stall refer 'he reader to a chop and useful performance " on the nature and cure of fractures." lately published by my ingenious friend Mr. Aiikutup by gentle pressure. Alter it is returned, a pirce of sticking .plaster may be applied over the part, and a proper truss or bandage must be constant!) worn for a considerable time. The method of making and applying these rupture bandages for children is pretty well known. The child must, as far as possible, be kept from crying, and from all violent exertions, till the rupture is quite healed. Iu adults, when the gut has been forced down with great violence, or happens from any cause to be inflamed, there is often great difficulty in returning it. and sometimes the thing is quite impracticable without an operation ; a description of which is foreign to our purpose. As I have bfcen fortunate enough, however, always to succeed in my at- tempts to return the gut, without having recourse to any other means than what are in the power of every man, I shall briefly mention the method which I generally pursue. After the patient has been bled, he'must be laid upon his back with his head very low, and his breach raised high with pillows. In this situation flannel cloths wrung out of a decoction of mallows and camo- mile floweis, or if these are not at hand, of warm water, must be appli- ed for a cousidera-ble time. A cluster made of this decoction, with a large spoonful of butter and an ounce or two of salt, may be afl .erwards thrown up. If these should not prove successful, recourse must be had to pressure. If the tumour be very hard, considerable force will be ne- cessary : but it is not force alone which succeeds here. The operator at the same time that he makes a pressure with the palms of his hands, or viuegar and oat-meal, camphorated spirits of wine, Miudererus's fpiiit, volatile linament, volatile aromatic spirit diluted with a double quantity of water, and the common fomentation, with the addiiiou of or spirit of wine. OF CASUALTIES. 373 BHist with his fingers artfully conduct the gut in by the same aperture through which it came out. The manner of doing this can be much easier conveyed than described. Should these endeavours prove in- effectual, clysters of the smoke of tobacco may be tried. These have been often known to succeed where every other method failed. There is reason to believe that, by persisting in the use of these,* and such other means as the circumstances of the case may suggest, most hernias might be reduced without an operation. Cutting for the hernia rs a nice and difficult matter. [ would therefore advise sur- geons to try every method of returning the gut before they have re- course to the knite. I have once and again succeeded by persevering iu my endeavours, after em'ncut surgeons had declared the reduction of the gut impracticable without an operation.* An adult, after the gut has been returned, must wear a steel ban- dage. Tt is needless to describe this, as it may always be had ready- made from the artists. Such bandages are generally uneasy to th© "wearer for some time, but by custom tiiey become quite easy. No person who has had a rupture after he arrived at mau's estate should ever be without one of these bandages. Persons who have a rupture ought carefully to avoid all violent ex- ercise, carrying great weights, leaping, running and the like. They should likewise avoid windy aliment and strong liquors ; and should} carefully guard against catching cold, CHAPTER MIL OF CASUALTIES. IT is certain that life, when to all appearance lost, may often, by due care, be restored. Accidents frequently prove fatal, merely because proper means are not used to counteract their effects. No person ought to be looked upon as killed by any accident unless where the structure of the heart, brain, or some organ necessary to * I would here beg leave to recommend it to every practitioner, when his patient complains of pain iu the belly with obstinate costive- Bess, to examine the groins and every place where a rupture may hap- pen, in order that it may be immediately reduced. By neglecting this, many perish who were not suspected to have had ruptures, till af- ter they were dead, f itave known this happen where half a dozen of Ihe faculty were in attendance, ;m OF CASUALTIES. life, is evident! y destroyed. T!ic action of these organs may be so fii* impaired as even to be for some sime imperceptible, when life is by no means gone. In this case, however, if the fluids be suffered to grow coM, it will be impossible to put them again in motion, even though the solids should recover their power of acting. Thus, when the mo- tion of the lungs have been stopt by unwholesome vapour, the action of the heart by a stroke on the breast, or the fuuetions of the brain by n blow on the head, if the person be suffered to grow cold, he will in all probability coutinue so; but, if the body be kept warm, as soon as the injured part has recovered its power of actios;, the fluids will again be- gin to move, ami all the vital functions will be restored. It is a horrid cm'om immediately to consign over to death every person who has the misfortune, by a fall, a blow, or the like to be de- prived of the appearance of life. The unhappy person, instead of be- • ins carried into a warm house, and laid by the fire, or put to a warm bed, is generally hurried away to church, or a barn, or some other cold damp house, where, after a fruitless attempt has been made to bleed him, perhaps by one who knew nothing of the matter, he is given over for dead, and no further notice taken of him. This conduct seems to be the result of ignorance, supported by an ancient superstitious notion which forbids the body of auy person killed by accident to be laid in an house that is inhabited. What the ground of this supers ition may be, we shall not pretend to iuquire ; but surety the condu- 1 founded upon it is contrary to all the principles of reason, humanity, and com- mon sense. When a person seems to be suddenly deprived of life, our first bu- siness is to inquire into the cause. We ought carefully to observe whether any substance be lodged in the windpipe or gullet; and if that is the case, attempts must be made to remove it. When unwholesome air is the cause, the patient ougfit immediately to be removed out of it. If the circulation be suddenly stopped from any cause whatever, except mere weakness, the patient should be bled. If the blood does not flow, he may be immersed in warm water, or rubbed with warm cloths, (tec. to promote the circulation. When the cause cannot be suddenly removed, our great aim must be to keep up the vital warmth, by rubbing the patient with hot cloths, or salt, and covering his body ivitii warm sand, ashes or the like. I should n w proceed to treat more fully of those accidents, which without immediate assistance, would often prove fatal, and to point out the most likely means for relieving the unhappy sufferers ; but as I have been happily anticipated in this part of my subject by the learned and humane Dr. Tissot, I shall content myself with selecting such of his oujpp- itions as seem to be the most important, and adding such of my own as have occured iu the course of practice. SUBSTANCES BETWEEN MO UTH <& STOMACH. 37 J OF SUBSTANCES STOPT BETWEEN TEE MOUTH AN® STOMACH. THOUGH accidents of this kind are very common, and extremely (dangerous, yet they are generally the effect of carelessness. Children should be taught to chew their food well, and to put nothing into their mouths which it would be dangerous for them to swallow. But chil- dren are not the only persons guilty of this piece of imprudence. I know many adults who put pins, nails, and other sharp pointed sub- stances into their mouths upon every occasion, and some who even sleep with the former there all night. This conduct is exceedingly injudicious, as a fit of coughing, or twenty other accidents, may force over the substance before the person is aware.* When any substance is retained in the gullet, there are two ways of removing it, vis. either by extracting it, or pushing it down. The sa- fest and most certain way is to extract it 5 but this is not always the easiest; it may therefore be more eligible sometimes to thrust it down, especially when the obstructing body is of such a nature, that there is no dauger from its reception into the stomach. The substances which may be pushed down without danger, are all common nourishing ones,, as bread, flesh, fruits, and (he like. All indigestible bodies, as cork, wood, bones, pieces of metal, and such like, ought if possible to be ex- tracted, especially if these bodies be sharp pointed, as pins, needles, fishbones, bits of glass, &c. When such substances have not passed iu too deep, we should en- deavour to extract them with our fingers, which method often suc- ceeds. When they are lower, we must make use of nippers, or a small pair of forceps, such as surgeons use. But this attempt to extract rarely succeeds, if the substance be of a flexible nature, and has de- scended far into the gullet. If the fingers and nippers fail, or cannot be duly applied, crotchets, a kind of hdoks, must be employed. These may be made at once, by bending a piece of pretty strong iron wire at one end, it must be intro- duced in the flat way ; and for the better conducting it, there should likewise be a curve or bending at the end it is held by, to serve as a kind of handle to it ; which has this further use, that it may be secu- red by a string tied to it, a circumstance not to be omitted in any in- strument employed on such occasions, to avoid such ill accidents as have sometimes ensued from these instruments slipping out of the ope- rator's hand. After the crotchet has passed below the substance that obstructs the passage, it is drawn up again, and hooks up the body * A woman in one of the hospitals of this city lately discharged a great number of pins, which she had swallowed in the course of her busines^ through an ulcer in her side. 378 SUBSTANCES BETWEEN MOUTH & STOMACH. along with it. The crotchet is also very convenient, when a substance somewhat flexible, as a pin, or fish-bone sticks across the gullet, tho hook, in such cases, seizing them about their middle part, crooks and thus disengages them ; or, if they are very brittle substances, serves to break them. When the obstructing bodies are small, and only stop up a part of the passage, and which may either easily elude the hook, or straighten it by their resistance, a kind of rings, made either of wire, wool, or silk, may be used. A piece of fine wire of a proper length may be bent into a circle, about the middle, of about au inch diameter, and the long unbent sides brought parallel, and near each other : these are to be held in the hand, and the circular part or ring introduced into the gullet, in order to be conducted about the obstructing body, and so to extract it. More flexible rings may be made of wool, thread, silk, or small pack-thread, which may be waxed for their greater strength and consistence. One of these is to be tied, fast to a handle of iron wive, whalebone, or any kind of flexible wood, and by this means introduced, in order to surround the obstructing substance, and to draw it out Several of these rings passed through one another may be used, the more certainly to lay hold of the obstructing body; which may be involved by one, if another should miss it. These rings have one ad- vantage, which is, that when the substance to be extracted is once laid hold of, it may then, by turning the handle, be retained so strongly in the ring thus twisted, as to be moved every way, which must in many cases be a considerable advantage. Another material employed on these unhappy occasions, is the sponge. Its property of swelling considerably on being wet is the principle foundation of its usefulness here. If any substance is stopt in the gul- let, but without filling up the whole passage, a bit of sponge may be in- troduced into that part which is unstopt, and beyond the substance. The sponge soon dilates, and grows larger in this moist situation; and indeed the enlargement of it may be forwarded by making the patient swallow a few drops of water. Afterwards it is to be drawn back by the handle to which it is fastened ; and as it is now too large to return through the small cavity by which it was conveyed in, it draws out the obstructing body aloug with it. The compressibility of sponge is another foundation of its usefulness in such cases. A pretty large piece of sponge may be compressed or ecjeezed into a small size, by winding a string of tape closely about if, which may be easily unwound, and withdrawn, after the sponge has been introduced. A bit of sponge may likewise be compressed b} a piece of whale bone split at one end ; but this can hardly be introduced in such a manner as not to hurt the patient. I have often known pin< and other sharp bodies, which had stuck in the throat, brought up by causing the peison to swallow a bit of toush meat tied to a thread, aud drawing it quickly up again. This is s. 1 WBSTJNCES BETWEEN MO UTH & STOMACH, m than swallowing a sponge, and will often answer the purpose equall j well- When all these methods prove unsuccessful, there remains one more, which is, to make the patient vomit ; but this can scarcely be of any service, unless when such obstructing bodies are simply engagtd in, and not hooked or stuck into the sides of the gullet, as in this case vomiting might sometimes occasion further mischief. If the patient can swallow, vomiting may be excited by taking half a drachm or two scruples of ipecacuanha in powder made into a draught. II' he is not able to swallow, an attempt may be made to excite vomiting, by tick- ling his threat with a feather ; and, if that should not succeed, a clyster of tobacco may be administered. It is made by boiling an ounce of to- bacco in a sufficient quantity of water; this has often been found to succeed, when other attempts to excite vomiting had failed. When the obstructing body is of such a nature tliat it may with safe- ty be pushed downwards, this may be attempted by means of a wax- candle oiled, and a little heated, so as to make it flexible ; or a piece cf whale-bone, wire, or flexible wood, with a sponge fastened to one end. Should it be impossible to extract even those bodies which it is dan- gerous to admit into the stomach, we must then prefer the least of two evils, and rather run the hazard of pushing them down than suffer the patient to perish in a few minutes; and we ought to scruple this resolu- tion the less, as a great many instances have happened, where the swal- lowing of such hurtful and indigestible substances have been followed fey no disorder. Whenever it is manifest that all endeavours, either to extract or push down the substance, must prove ineffectual, they should be dis- continued ; because the inflammation occasioned by persisting in them might be as dangerous as the obstruction itself. Some have died in consequence of the inflammation, even after the body which caused the obstruction had been entirely removed. While the means recommended above are making use ot, the pa- tient should often swallow, or, if he cannot, he should frequently re- ceive by injection through a crooked tube or pipe that may reach down to the gullet, some emollient liquor, as warm milk and water, barley-water, or a decoction of mallows. Injections of this kind not only soften and sooth the irritated parts, but, when thrown in with force, are often more successful in loosening the obstruction than all attempts with instruments. When, after all our endeavours, we are obliged to leave the ob- structing body in the part, the patient must be treated as if he had an inflammatory disease. He should be bled, kept upon a low diet^, and have his whole neqk surrounded with emollient poultices. The like treatment must also be used, if there be any reason to suspect an inflammation of the passages, though the obstructing body be m* •moved. 380 OF BROWNED PERSONS. A proper degree of agitation has sometimes loosened the inhering body more effectually than instruments. Thus a blow on the back has often forced up a substance which stuck in the gullet ; but this is still more proper and efficacious when the substance gets iuto the wind- pipe In this case vomiting and sneezing are likewise to be excited. Pi.js which stuck in the gullet hare been frequently discharged by riding on horseback, or in a carriage. When any indigestible substance has been forced down into the stomach, the patient should use a very mild aud smooth diet, consist- ing chiefly of fruits and farinaceous substances, as puddings, pottage, and soups. He should avoid all heating aud irritating things, as wine, punch, pepper, aud such like ,• aud his drink should be milk aud wa- ter, barley-water, or whey. When the gullet is so strongly and fully closed, that the patient can receive no food by the moUih, he must be nourished by lysters of soup, jelly, and the like. When i he patient is iu danger of being immediately suffocated, and all hope of freeing the passage is vanished, so that death seems at respirati : be not restored ; the operation of broncholomy> or opening the wind-pipe, must be directly performed. As this opera- tion is neither difficult to an expert surgeon, nor very painful to the patient, and is often die only method which can be taken to preserve life in these emergencies, we thought proper to mention it, though it should on!) be attempted by persous skilled in surgery. OF DROWNED PERSONS. "WHEN a person has remained above a quarter of an hour under water, there can be no considerable hopes of his recovery. But as several circumstances may happen to have continued life, in such an unfortunate situation, beyond the ordinary term, we should never too soon resign the unhappy object to his fate, but try every method for his relief, as there are many well attested proofs of the recovery of persons to life and health who had been taken out of the water ap- parent!) dead, and who remained a considerable time without exhibit- ing any signs of life. The first thing to be done, after the body is taken out of the water, is to convey it as soon as possible to some convenient place where the necessary operations for its recovery may be performed. Iu doing this, care must bo taken not to bruise or injure the body by carrying it iu any unnatural posture with the head downwards, or the like. If an adult body, it ought to be laid on a bed, or on straw with the head a litde raised, aud carried on a carl or men's shoulders, and kept iu as natural aud easy a position as possible. A small body may be carried In the arms. In Attempting to recover persons apparently drowned, the principal Intention to be pursued is, to restore the natural warmth, upon which OF DROtVNED PERSONS. ggl all the vita! functions depend ; and to excite these functions by the ap- plication of stimulants, not only to the skin, but likewise to the lungs, intestines, &c. Though cold was by no means the cause of the person's death, yet it will prove an effectual obstacle to his recovery. For this reason, stripping him of his wet clothes, his body must be strongly rubbed for a considerable time with coarse linen cloths, as warm as they caa be made ; and as soon as a well- heated bed can be got ready, he may belaid in it, and the rubbing should be continued. Warm cloths ought likewise to be frequently applied to the stomach and bowels, and hot bricks, or bottles of warm- water, to the soles of his feet, and trf the palms of his hands. Strong volatile spirits should be frequently applied to the nose ; and the spine of the back and pit of the stomach may be rubbed with warm brandy or spirit of wine. The temples ought also to be chafed with volatile spirits ; and stimulating powders, as that of tobacco or marjoram, may be blown up the nostrils. To renew the breathing a strong person may blow his own breath into the patient's mouth with all the force he can, holding his nostrils at the same time. When it can be perceived by the rising of the •chest or belly that the lungs are filled with air, the person ought to de- sist from blowing, aud should press the breast and belly so as to expell the air again ; and this operation may be repeated for some time, al- ternately inflating and depressing the lungs so as to imitate natural res- piration. If the lungs cannot be inflated in this manner, it may be attempted by blowing through one of the nostrils, and at the same time keeping the other close. Dr. Monro for this purpose recommends a wooden pipe fitted at one end for filling the nostril, and at the other for being blown into by a person's mouth, or for receiving the pipe of a pair of bellows, to be employed for the same purpose, if necessary. When air cannot be forced into the chest by the mouth or nose, it may be necessary to make an opening into the wind- pipe for this pur- pose. It is needless, however, to spend time in describing this opera* tion, as it should not be attempted unless by persons skilled in surgery. To stimulate the intestines, the fume of tobacco may be thrown tip in form of clyster. There are various pieces of apparatus contrived for this purpose which may be used when at hand ; but where these cannot be obtained, the business may be done by a common tobacco pipe. The bowl of the pipe must be filled with tobacco well kindled, aud, after the small tube has been introduced into the fundament, the smoak may be forced up by blowing through a piece of paper full of holes wrapped round the mouth of the pipe, or by blowing through ad empty pipe, the mouth ©f which is applied close to that of the other. This may also be done in the following manner : A common clyster- jpipe with a bag mounted upon it may be introduced into the funda- : :.2 OF DROWNED PERSONS. nient, and the mouth of the bag may be applied round the small ehd of a tobacco- pipe, in tbe bowl of which touacco is L o be kimlleu, and the sraoke btawu up as directed above. Should it he found i.npi.icli- cable to throw up the smoke of tobacco, clystf is 01 war>b water, with the addition of a little salt and some wiue or spirits, ma) be fre- quently administered. This may be dooe by a common cl) ster bag and pipe ; but, as it ought to be thrown well up, a pretiy large s) riuge will answer the purpose better. While these things are doing, some of the attendants ou^ht to be preparing a warm bath, into which the person should be put, if the abv)ve endeavours prove ineffectual. Where there are no corn ententes lor using the warm bath, the body mav be coveied with warm ShiL sand, ashes, grains, or such like. Tissot mentions an instance ol a girl who was restored to life, after she had beeu taken out of Urn water, scal- ed, bloated, and to all appearance dead, by laying her naked body upon hot ashes, covering her with others equally not, putting a bou- uet round her head, and a stocking round hei ueck, scuffed witb die tame, and heaving coverings over all After she had reaiaiued half an hour in this situation, her puise returned, .'Ue recovered speech, and cried out, lfrc(~e ; I freeze ; a little cherry brand) was given her, and she remained buried as it were under ;ne ashes tor eight hours ; afierwards she was taken out, without any other compaiut except that of lassitude or weariness, which went off iu a few days. The Doctor mentions likewise an instance of a man who was restored to life, after he had remained six hours under water, by the heat of a dung- hill. Till the patient shows some signs of life, and is able :! that persons who had remained in the snow, or had been ex> 49 386 EFFECTS OF EXTREME HEAT, &c, posed to the freezing air during five or six successive days, and wb* had discovered no marks of life for several hours, have nevertheless been revived. I have always thought that the whitloes, kibes, chilblains, and other inflammations of the extremities which are so commou among the peas- ants m (he cold season, were chiefly occasioned by their sudden transi- tions from cold to heat. After they have beeu exposed to an extreme degree of cold, they immediately apply their hands and feet to the fire, or, if ihey hare occasion plunge them into warm water, by which means, if a mortification does not happen, an inflammation seldom fails to ensue. Most of the ill consequences from this quarter might be easily avoided, by only observiug the precautions mentioned above. EFFECTS OF EXTREME HEAT. THE effects of extreme heat, though not so common in this country, are no less fatal and much more sudden than those of cold. In hot coun- tries people frequently drop down dead in the streets, exhausted with heal and fatigue. Iu this case, if auy warm cordial can be poured into the mouth, it ought to be done. If this cannot be effected, they may be thrown up in form of a clyster. Volatile spirits and other thing? of a simulating nature, may be applied to the skin, which should he W( 'I rubbed with coarse cloths, whipped with nettles, or »>tlier slim*, ulaiins things. Some of the ancient physicians are said to have resto- ltd to life persons apparently dead by beating them with rods. CHAPTER LIV. OF FAINTING FITS, AND OTHER CASES WHICH REQUIRE IMMEDIATE ASSISTANCE. STRONG and healthy persons, who abound with blood, ave often seized with sudden fainting fits, after violent exercise, drinking freely ef warm or strong liquors, exposure to great heat, intense ap- plication to study, or the like. Iu such cases the pruieut should be made to smell to some vinegar. His temples, forehead and wrists, ought at the same time to be bathed with vinegar mixed with an equal quantity of warm water; and two or thiee spoonsful of vinegar, with lour or five times as much water, May, if he can swallow, be poured into hi. mouth. If the fainting proves obstinate, or degenerates into a syncope, that is, an abolition of feeling and understanding, the patient must be bled. After the bleeding, a clyster will be proper, and then he should b? OF FAINTING FITS, &h. U1 kept easy and quiet, only giving him every half hour a cup or two of an infusion of any mild vegetable, with the addition of a little sugar and vinegar. When swoonings, which arise from this eause occur frequently in the same person, he should, in order to escape them, confine himself to a light diet, consisting chiefly of bread, fruits, and other vegeta- bles. His drink ought to be water or small beer, and he should sleep but moderately, and take much exercise. But fainting fits proceed much oftener from a defect than an excess of blood. Hence they are very ready to happen after great evacua- tions of any kind, obstinate watching, want of appetite, or such like. In these, an almost directly opposite course to that mentioned above, must be pursued. The patient should be laid in bed, with his head low, and being co- vered, should have his legs, thighs, arms, and his Avhole body rubbed strongly with flannels. Hungary- water, volatile salts, or strong smell- ing herbs, as rue, mint, or rosemary, may be held to his nose. His mouth may be Wet with a little rum or brandy ; and if he can swal- low, some hot wine, mixed with sugar and cinnamon, which is an ex- cellent cordial, may be poured into his mouth. A compress of flannel dipt in hot wine or brandy must be applied to the pit of his stomach, and warm bricks, or bottles filled with hot water laid to his feet. As soon as the patient is recovered a little, he should take some strong soup or broth, of a little bread or biscuit soaked in hot spiced wine. To prevent the return of the fits, he ought to take often, but in small quantities, some light yet strengthening nourishment, as pana- da, made with soup instead of water, new laid eggs lightly poached, chocolate, light roast meats, jellies, and such like. Those fainting fits, which are the effect of bleeding, or of the vio- lent operation of purges, belong to this class. Such as happen after artificial bleeding, are seldom dangerous, generally terminating as soon as the patient is laid upon the bed ; indeed persons subject to this kind should always be bled lying, in order to prevent it. Should the fainting however continue longer than usual, volatile spirits may be held to the nose, and rubbed on the temples, &c. When fainting is the effect of tco strong or acrid purges or vomits, the patient must be treated in all respects as if he had taken poison. He should be made to drink pjeotifully of milk, warm water, and oil, barley water, or such like emmollieut ciysters will likewise be proper, and the patient's strength should afterwards be recruited, by giving him generous cordials, and anodyne medicines. JFaintings are often occasioned by indigestion. This may either proceed from the quantity or quality of the food. When the former of these is the cause, the cure will be best performed by^ vomitings which may be promoted by causing the patient to drink a weak iutw- %ioa of camomile flowers, car dam bsnsdicUis, qv the like. When tht 033 OF FAINTING FITS, &s. i proceeds from the rature of the food, the patient as io the* ease of weakness, must be revived by strong smells, &c. af'er which lie should be made to swallow a large quantity of light warm fluid, which may sferve to drown, as it were, the offending matter, to sofieu Its acrimony, and either to effect a discharge of it by vomiting* 01 force it down into the intestines. Even disagreeable smells will sometimes occasion swooniogs, espe- cially in people of weak nerves. When this happens, the patient should be carried in the open air, have stimulating things held to his nose, and those substances which are disagreeable to him ought immediately to be removed. But we have ahead) taken notice of swooning* winch arise from nervous disorders, and shall therefore say no more Upon that head. Fainting-fits often happen in the progress of diseases. In the be- ginning of putrid diseases they generally denote an oppression at the stomach, or a ma?.; of corrupted humours, and they cease after evac- najo be excited gradually ; the pulsations of the temporal artery were soon felt, the breathing became more frequent and free, and the eyes closed and opened alternately. At length the child fetched some cries expressive of his want ot the b-east "which being applied to his mouth, he catched at it with avidity and sucked as if nothing hid happened to him. Though the pulsations, of the arteries were by this time very well reestablished, and it was hot weather yet Mr. Janin thought it advisable to leave his little pa- tient three quarters of an hour longer under the ashes. He was alier- wards taken out, cleaned and dressed as usual; to which a gentle sleep succeeded, and he continued perfectly well. Mr Jvriu mentions likewise an example of a young man who had hanged himself through despair, to whom he administered help as ei- fectually as in the preceding case. Mr Glover Surgeon in Doctors commons, London, relates the case of. a person who was restored to life after twenty- nine minutes hanging, aii . continued in good health for many years after. ; The principal means used to restore this man to life were, opening the temporal artery and the external jugular; rubbing the back, mouth, and .neck with a quantity of volatile spirits and oil; administering the tobacco clyster by means of lighted pipes, and strong frictions of the lea 8 and arms. This course had been continued for about four hours when an incision was made into the windpipe, and air blown strongly triroii'h a canula into the lungs. About twenty minutes alter this, the bloods the artery began to run down the face, and a slow pulse *n ™i perceptible a't the wrist. The frictions were continued for son. p timeWer; his pulse became more frequent, and his moutfi and no^ brin- irritated with spirits of sal amoniac. he opened his eyes. W arm. cm dials were then administered to him, and in two da } s he was so well as to be able to walk ei^ht miles. These cases are sufficient to show what may be done for the reroyr. y of those unhappy persons who strangle themselves ia a fit ot despair. OF PERSONS WHO EXPIRE RY CONVULSION FITS. CONVULSION fits often constitute the last scene of acute or chronic disorders. When this is the case there can remain but smalt hopes of the patient's recovery after expiring in a fit. But when a person who an P e,.rs to be in perfect health, is suddenly seized wrthra co iviilrioa fit. and seems to expire, some attempts ought always to be made to restore him to life. Infants are most liable to envious , ami are often carr-e I off very suddenly by one or more fits about the June of teething. There are" many well authenticated accounts ol IN CONVULSION FITS. 393 having been restored to life, after they had to all appearance expired iu convulsions; but we shall onjy relate the following instance, mention-* ed by Dr Johnson, in his pamphlet on the practicability of recovering persons visibly dead Iu the parish of St. Clements in Colchester, a child of sis months old, lying upon its mother's lap, having had the breast, was ss ized with a strong Convulsion fit, which lasted so long, and ended with s total a privation of motion in the body, lungs, and pn se, that it was deemed absolutely dead. It was accordingly stripiv I, laid out, the pass- ing bell ordered to be tolled, and a. coffin lo be made , buj a oi igh- bouring gentlewoman who used to admire the child, hearing of i r s sad* den death, hastened to the house, and upon examining ine child, found it not cold, its joints limber, and fancied that a glass she held to its mouth and nose was a liitle damped widi the breath.- upon which she took, the child in her lap, sat dowu before the fire, rubbed it, and kept it in gentle agitation. In a quarter of an hour she felt the heart begin to beat faintly ; she then put a little of the mother's milk into its mouth, continued to rub its palms and soles, found the child begin to move, and the milk was swallowed ; and in another quarter of an hour she had the satisfaction of restoring to its disconsolate owner the babe quite recovered, eager to lay hold of the breast, and able to suck again. The child throve, had no more fits, is grown up, and at present alive. These means, which are certainly in the power of every person, were sufficient to restore to life an infant to all appearance dead, and who in all probability, but for the use of diese simple endeavours, would have remained so. There are however many other things which might be done in case the above should not succeed; as rubbing the body with strong spirits, covering it with warm ashes or salt, blowing air into the lungs, throwing up warm stimulating clysters or the smoke of tobacco into the intestines, and such like. When children are dead born, or expire soon after the birth, the same means ought fo be used for 'heir recovery, as if they had expired in circumstances similar to those mentioued above. These directions may likewise be extended to adults, attention being always paid to the age and other circumstances of the patiei r . The foregoing cases and observations afford sufficient proof of the success which may attend the endeavours of persons total!) ignorant of medicine, in assisting those who are suddenly deprived of life by any accident or disease. Many facts of sim'dar nature might be adduced, were it necessary ; but these, it is hoped, will be sufficient to call up the. attention of the public, and to excite the humane nnd benevolent to exert their utmost endeavour? for the preservation of the?? fellow-men. The society for the recovery of drowned persons, instituted at Am- sterdam in the year 1767, had ih** satisfaction to find that no fewer than 150 persons, in the space of four years, had been saved by the Beans pointed out by them, man-, of whom owed their preservations 50 S94 OF PERSONS WHO EXPIRE, &e. to peasants ami people of no medical knowledge. But the means used with so much efficacy io recovering drowned persons are, with equal success, applicable to a number of cases where the power of life see^n in reality to b*> suspended, and to remain capable of renewing n* their functions on being put into motion again. It is shocking to reflect, that for want of this consideration many persons have been ed to the grave in whom the principles of life might have been revived. The cases whereiu such endeavours are most likely to be attended with success, are all those called sudden deaths from an inevitable cause, as apoplexies, hysterics, faintings, and many other disorders wherein persons in a moment sink down and expire. The vaiious casualties in which they may be tried are, suffocations from the sulphurous damps of mines, coal pits, Arc. the unwholesome air of long unopened wells or caverns; the noxious vapours arising from fermenting liquors; the steams of burning charcoal ; sulphurous mineral acids ; arsenical effluvia, &c. The various accidents of drowning, strangling, and apparent deaths, by blows, falls, hunger, cold &c. likewise furnish opportunities of trying such endeavours. Those perhaps who to appearance are killed by lightning, or by any violent agitation of the passions, as fear, j'>y, surprise and such like, might also be frequently recovered by the use of proper beans, as blowing strongly into their lungs, &c. The means to be used for the recovery of persons suddenly depri- ved of life, are nearly the same in all cases ; they are practicable by every one who happens to be present at the accident, and require no xpense, and less skill. The great aim is to restore the warmth and vital motions. This may in general be attempted by means of beat, friction, bleeding, blowing air into the lungs, administering clysters and generous cordials. These must be varied according to circumstances. Common sense, and the situation of the patient, will suggest the proper manner of conducting them. Above all we would recom ne'fid perseverance. People ought never to despair 0:1 account of discouraging circumstances, or to leave off their endeavours as long as there is the least hope of success. Where much good and 00 hurt jean be done, no one ought to grudge his labour. It Were greatly to be wished, that an institution similar to that cf Amsterdam, was established upon a more extensive plan, in Great- liritaiu ; and that a reward was allowed to every one who would be instrumental in restoring to life a person seemingly dead * The author is happy to observe, tint since the first public: this work, several societies have been instituted in Britain with the same benevolent intention as that at Amsterdam, and that their ei ours have proved no less successful. He is also happy tori jjjaj, premiums have been awarded to those who have been acti OF C0L3 BATHING, &c. m Will do much for fame, but still more for money. Should do profit* however, be annexed to those benevolent offices, the heart- felt pleasure which a good man must enjoy on reflecting that he has been the happy instrument of saving one of his fellow creatures from aa untimely grave is itself a sufficient reward. CHAPTER LV, 'CAUTIONS CONCERNtNCx COLD BATHING AND DRINK* ING THE MINERAL WATERS. AS it is now fashionable for persons of all ranks to plunge info the sea, and drink the mineral waters, I was desirous of rendering this work still more extensively useful, by the addition of some prac- tical remarks on these active and useful medicines. Finding it is im- possible to bring these observations within so narrow a compass as not to swell the book, already too large, into an enormous size, I resolved to confine myself to a few hints or cautions ; which may be of ser- vice to persons who bathe, or drink the mineral waters, without being able to put themselves under the care of a physician. No part of the practice of medicine is of greater importance, or merits more the attention of the physician, as many lives are lost, and numbers ruin their health, by cold bathing, and an imprudent use of mineral waters. On some future occasion I may probably resume this subject, as I knoiv not any work that contains a sufficient number of practical observations to regulate the patient's conduct in the use of these active and important medicines. We have indeed many books on the mineral waters, and some of them are written with much ingenuity ; but they are chiefly employ- ed in ascertaining the contents of the waters by chymical analysis. This no doubt has its use, but it is by no means of such importance aa some may imagine. A man may know the chymical analysis of all the articles in the materia nledica, Without being able properly to ap- ply any one of them in the cure of diseases. Oae page of practical observations is worth a whole volume of chymical analysis. But where are such observations to be met with ? Few physicians are in a situa- their endeavours to restore to life persons who have been drowned, or suddenly deprived of life by any accideut. How much is this supe- rior to the superstitious institution which allows any man a premium Who biiugs a dead person out of the water, so that he may receive Christian burial ; but allows nothing to the person who brings him oufc fciive, or who recovers him after he has been to all appearance deado 396 OF COLD BATHING. -■ make them, and fewer still are qualified for such a task. It accomplished by practitioners who reside at the fountains* j.issessiug minds, superior to local prejudices, are capable of ling diseases with accuracy, and ol forming a sound judg- • respecting the genuine effects of medicines. • ti ii a piop r discrimination with regard to the diseases and the - nstitutien of ihe paiieat, the most p.-werlul medicine is more likely ■in thau good. Every one knows that the -ame physician who, bathing, cured Augustus, by an imprudent use of the same ; Vi. heir. This induced the Roman- senate to make lating the baths, and preventing the numerous evils which imprudent arid promiscuous use of those elegant and fash- curj ii: as do su< h ; -.ivs exist in this country, -?■•■ ;« ••• does ihptl which is rigid iu hit, own eyes, and of course many ■ rei iii .. that the simple element of water can do ha .a j maj plunge into it at any ii.mj with impunity. Iu »hjs however, they are much mistaken. I have known apoplexies, occasioned by going into the cold bath, fevers excited by staying too long in if, and other maladies so much aggravated by its continued use, that they never coal. I be wholly eradicated. Nor are examples want- ing, either in ancient or modern times, of the baneful consequence! which bave arisen also from an injudicious application of the warm bath; but as warm baths are not so common in this country, and are seldom used but under the direction of a physician, I shall not enlarge on that part of the subject. Immersion in cold water is a custom which lays claim to the most remote antiquity: indeed it must have hem coeval with man himself. The necessity of water for the purpose of cleanliness, and the pleasure arisin« from i's application to the body in hot countries, must very early Jiave recommended it to the human species. Even (he example of oth- er animals was sufficient to give the hint to mao. By instinct man) cf them are led to apply cold water in this manner; and some, when de- prived of its use, have been known to languish and even to die. IJut whether the practice of cold bathing arose from necessity, reasoning, or imitation, is au inquiry of no importance ; our business is to point out the advantages which may be derived from it, and to guard peo- ple against an improper use of.it. The cold bath recommends itself in a variety of cases, and is pe> cuiiaily beneficial to the inhabitants of populous cities, who indulge in idleness edentar) lives. In persons of this description the action cf the solids is always too weak, which induces a languid circu- iatior:, a crude indigested mass of humours, aud obstructions in the papillary vestels ?.nd glandular system. Cold water, from its gravity ©s well as its tonic powers, is well calculated either to obviate or re- j$)0\ e these symptoms. It accelerates the motion of the blood, pro- OF COLD BATHING. 39? ftiotes the different secretions, and gives permanent vigour to the sol- ids But all these important purposes will be more essentially answer- ed by the application of salt water. This oueiit not only to be pre- ferred oa account of its superior gravity, but likewise for its greater power of stimulating the skin, which promotes the perspiration, and prevents the patient from catching cokL It is necessary, however, to observe, that cold bathing is move like- ly to prevent, than to remove obstructions of the glandular or lympha- tic system. Indeed, when these have arrived at a certain pitch, they are not to be removed by any means. In this case the cold bath will only aggravate the symptoms, and hurry the unhappy patient into an untimely grave. It is therefore of the utmost importance, previous to the patient's entering upon the use of the cold bath, to determine •whether or not he labours under any obstinate obstructions ot the lungs er other viscera; and where this is the case cold bathing ought strict- ly to be prohibited * In what is called a plethoric state, or too great a fullness of the body, it is likewise dangerous to use the cold hath, without due preparation* In this case there is great danger of bursting a blood- vessel, or occa- sinning an inflammation ot the brain or some of the viscera. This pre- caution is the more necesssary to citizens, as most of them live fall, and are of a gross habit. Yet what is very remarkable, these people re- sort in crowds every season to the sea- side, and plunge in the water without the least consideration'. No doubt they often escape with im- punity ; but does this give a sanction to the practice ? Persons of this description ought by no means to bathe, unless the body has been pre- viously prepared by suitable evacuations. Ano her class of patients who stand peculiarly in need of the bra- cing qualities of cold water, is the nervous. This includes a great number of the male, and almost all the female inhabitants of great cities. Yet even those persons ought to be cautious in using the cold bath. Nervous people have often weak bowels, and may, as well as others, be subject to congestions and obstructions of the viscera; and in this case they will not be able to bear the effects of cold water. For them, and indeed for all delicate people, the best plan would be to accustom themselves to it by the most pleasing and gentle degrees. They ought * The late celebrated Dr. Smollet has indeed said, that if he were persuaded he had an ulcer in the lungs, he would jump into the cold bath ; but here the Doctor evidently shows more courage than discre- tion ; and that he was more a man of wit than a physician, every one will allow. A nervous asthma, or an atrophy, may be mistaken for a pulmonary consumption ; yet, in the two former, the cold bath proves often beneficial, though I never knew it so in the latter. Indeed all the phthisical patients I ever saw, who have tried the cold bath, were evidently hurt by it. 3P8 OF COLD BATHING. to begin with the temperate bath, and gradually use it cooler, till at length the cold proves quite agreeable. Nature revolts against all great transitions ; and those who do violence to her dictates, have often cause to repent of their iemerity. Wherever cold bathing is practised, there ought likewise to be tepid baths for the purpose mentioned above. Indeed it is die practice of some countries to throw cold water over the patient as soon as he comes oat of the warm bath; but though this may not injure a Russian pea- sant, we dare not recommend it to the inhabitants of this country. The ancient Greeks and Romans, we are told, when covered with sweat and dust, used to plunge into the rivers, without receiving the smallest injury. Though they might often escape danger from this imprudent, conduct, yet it was certainly contrary to sound reason. I have known many robust men throw away their lives by such an attempt We ■would not however advise patients to go into the cold water when the body is chilly; as much exercise, at least, ought to be taken, as may excite a gentle glow all over the body, but by no means so as to over- heat it. To young people, and particularly to children, cold bathing is of the first importance. Their lax fibres render its tonic powers pecu- liarly proper. It promotes their growth, increases their strength,* and prevents a variety of diseases incident to childhood. Were infants early accustomed to the cold bath, it would seldom disagree with them ; and we should see fewer instances of the scrophula, rickets, and other diseases which .prove fatal to many, and make others miserable for life. Sometimes indeed, these disorders render infants incapable of bearing the shock of cold water; but this is owing to their not hav- ing been early and regularly accustomed to it. It is however neces- sary here to caution young men against too frequent bathing ; as I have known many fatal consequences result from the daily practice of plung- ing into rivers, and continuing there too long. The most proper time of the day for using the cold bath is no doubt the morning, or at least before dinner; and the best mode, that of quick immersion. As cold bathing has a constant tendency to propel the blood and other humours towards the head, it ought to be a rule always to wet that part as soon as possible. By due attention to this circum- stance, there is reason to believe, that violent head-aches, and other complaints* which frequently proceed from cold bathing, might be of- ten prevented. * The celebrated Galen says, that immersion in cold water is fit on- ly for the young of lions and bears; and recommends warm bathing, as conducive to the growth and strength of infants. How egregiously do the greatest men err whenever they lose sight of facts, and substitute Veasoniug in physic in place of observation and experience* OF DRINKING MINERAL WATERS. 39^ The cold bath, when too long continued in, not only occasions an ex* cessive flux of humours towards tlie head, bu> chills the blood, cramps the muscles, relaxes the nerves, and wholly defeats the intention of bathing. Hsnce, by not advening to this circumstance, expert swim- ers are often injured, and sometimes even lose their lives. All the ben- eficial purposes of cold bathing are answered by one immersion, at a time ; aud the patient ought to be rubbed dry the moment he comes out of the water, and should continue to take exercise for some time after. When cold bathing occasions dullness, loss of appetite, listlessness, paiu of the breast or bowels, a prostration of streugth, or violent head aches, it ought to be discontinued. Though these hints are by no means intended to point out all the cases where cold bathing may be hurtful, nor to illustrate its extensive utility as a medicine ; yet it is hoped they may serve to guard people against some of those errors into which, from mere inattention, they are apt to fall, and thereby not only endanger their own lives, bat bring an excellent medicine into disrepute. OF DRINKING THE MINERAL WATERS. THE internal use of water, as a medicine, is no less an object of the physician's attention thau the external. Pure elementary water is indeed the most inoffensive of all liquors, and constitutes a principal part of the food of every animal. But this element is often impreg- nated with substances of a very active and penetrating nature ; and of such an insidious quality, that, while they promote certain secretions, and even alleviate some disagreeable symptoms, they weaken the pow- ers of life, uudermine the constitution, and lay the foundation of worse diseases than those which they were employed to remove. Of this every practitioner must have seen instances ; and physicians of emi- nence have more than once declared that they have known more dis- eases occasioned than removed by the use of mineral waters This doubtless has proceeded from the abuse of these powerful medicines, which evinces the necessity of using them with caution. By examining the contents of the mineral waters which are most used in this country, we shall be enabled to form an idea of the danger which may arise from an improper application of them either externally or internally, though it is to the latter of these that the present observa- tions are chiefly confined. The waters most in use for medical purposes in Britain, are those impregnated with sails, sulphur, iron, and mephitic air, either sepa- rately, or variously combined. Of these the most powerful is the sa- - line sulphurous water of Harrowgate, of which I have had more occa- sion to observe the pernicious consequences, when improperly used, $isui of any other. To this, therefore, the following remarks will more 400 OF DRINKING MINERAL WATERS. immediately relate, though they will be found applicable to all i'h» purging waters iu the kingdom which are strong enough co merit at- tention.* The errors which so often defeat the intention of • pur- gative mineral waters, and which so frequency provi inj < patient, proceed from the manner of using them, u'to <; the regimeu pursued, or using them in cases where proper. A very hurtful prejudice still prevails in this country , that at! dis- eases must be cured by medicines taken into the stomach, and tnat the more violently these medicines operate, they are the mor< to have the desired effect. This opinion has proved fatal to thousands, and will in all probability, destroy many more before it can »>e whol- ly eradicated. Purging is often useful in acute diseases, and in chronical cases may pave the way for the operation of other medi- cines ; but it will seldom perform a cure ; and by exhausting the strength of the patient, will often leave him in a worse condition h-^n it found him. That this is frequently the case with regard to the jnore active mineral waters, every person conversant in these ma tters will readily allow. Sfcong stimulants applied to the stomach and bowels for a length of time, must tend to weaken and destroy their energy ; and what stimu- lants are more active than salt and sulphur, especially when these substances are intimately combined, and carried through the system liy the penetrating medium of water ? Those bowels must be strong indeed, which can withstand the daily operation of such active princi- ples for months together, and not be injured. This however is the plan pursued by most of those who drink the purging mineral waters, and whose circumstances will permit them to coutiuue long enough at those f 402 Capable of penetrating into every part of the body, and of stimulating the whole system. Henoe arises their efficacy in removing the most obstinate of all disorders, obstructions of the glandular and lymphatic system. Under this class is comprehended the scrophula or King's mil, indolent tumours, obstructions of the liver, spleen, kidnies, aud mesenteric glands. Whea these great purposes are to be effected, the waters must be used in the gradual manner mentioned above, and per- sisted in for a length of time. It will be proper however now and then to discontinue their use for a few days. The next great class of diseases where mineral waters are found to be beneficial, are those of the skin, as the itch, scab, tetters, ring- worms, scaly eruptions, leprosies, bloches, foul ulcers, &c. Though these may seem superficial, yet they are often the most obstinate which the physician has to encounter, and not unfrequently set his skill at defiance ; but they will sometimes yield to the application of mineral waters for a sufficient length of time, and in most cases of tins kind these waters deserve a trial. The saifne sulphureous waters, such as those of Moffat in Scotland, and Harrowgate in England, are the most likely to succeed in diseases of the skin ; but for this purpose it will be necessary not only to drink the waters, but likewise to use them externally. To enumerate more particularly the qualities of the different mine- ral waters, to specify those diseases in which they are lespectively in- dicated, and to point out their proper modes of application, would be an useful, and by no means a disagreeable employment; but as the lim- its prescribed to these remarks will not allow me to treat the subject at more length, I shall conclude by observing, that whenever the min- eral waters are found to exhaust the strength, depress the spirits, take away the appetite, excite fevers, distend the bowels, or occasion a cough, they ought to be discontinued. CHAPTER LVI. OBSERVATIONS CONCERNING THE DIET OF THE COMMON PEOPLE, RE* COMMENDING A METHOD OF LIVING LESS EXPENSIVE, AND MORE CONDUCIVE TO HEALTH THAN THE PRESENT, EXPERIENCE proves that not a few of the diseases incident to the inhabitants of this country, are owing to their mode of living. The vegetable productions they consume, fall considerably short of the proportion which they ought to bear to the animal part of their food,, The constant use of bread, and animal substances, excites an unnatural y«rst, and kads to the immoderate use of beer and other stimulating 404 OBSERVATIONS CONCERNING DIET, &c. liquors, which generate" disease and reduce the lower orders of people IV teach the poor rrtaa how to live cheaper and better, ;■. ti>^ design of the following pages. Tnotrgh the common people of tuis country live at a greater expense flian any where else, it does not follow that they live better. They me strong indeed, but by do m :ans healthy; and it is found that, from an attachment lo a particular mode oi living, they are more liable to disease and death iu foreign climes, than the inhabitants of any other com ry. If >s certainly proper that a poor man should be instructed in every thing il his little i amings go as far as possible, or which can add to toe comfort of himself and family. Nor can ceconomy in living be d ivial, in a country wiiere the riches depend on the cheapue.-s of >oiir. the English are so much attached to their own ho argument will induce them to m«ke the small- est cliai . iate things, especially those which r< late to die'; but there are picois that the English are not inflexible thi in itter. The mode of living among the lower orders has eatly changed iu my lime, and I am sorry to say, not for the better. The people of England have too much good sense not to listen to reason provided due care were taken to instruct them. But here the people ma> be truly said "to perish for want of knowledge" No means have been Used to give them proper instruction. Hurtful cus- toms have been suffered to prevail, till they have si ruck such deep roots that it will not be an easy matter to eradicate them. The diffi- culty, however, is not insurmountable. A !e\v experiments of reform would have the effect to render it as agreeable as il is salutary. Adults have many old prejudices to overcome, but the case is ditTer- ein in regard to children. They may be taught to use any kind of food, and what they use when young they will love when old. If I cau introduce a different method of feeding children, my purpose will ivered. lids alone will, in time, effect a total change in the general mode of living. • Tht latt distress of the poor has called forth many publications in- tended for their relief. Most of them, however, were adapted only for the particular occasion, and net calculated to prevent the return of Hk* evils. The following observations, it is hoped, will have a more permanent effect. They are intended to recommend a plan of living which will lender the people less dependent on bread and animal food for iheir subsistence, and consequently not so liable to suffer from a seas city or dearth of either of these articles in future. Particular attention has been paid to the substitutes for bread, as the pcarcit) of this article proves peculiarly distressing to the poor. It rom the following pages, that bread is by no means so GENERAL OBSERVATIONS ON ALIMENT. 405 Kiuch a necessary of life as generally imagined, and that its place may. in many instances', be supplied by a variety of other farinaceous substances. ' GENERdL .OBSERVATIONS ON ALIMENT. NO creature eats such a variety of food as man. Intended for aa inhabitant of every climate, he devours the productions of them all ; and if they do not suite his palate, or agree with his stomach, he c*!!s in the aid of cookery, an art peculiar to himself; by which many things that, in a crude stave, would prove hurtful, or even poisonous, are ren- dered wholesome and salutary. The obvious division of food is into animal and vegetable. To say that man was intended by nature for using either the one or the other alone, would be absurd. His structure and apperke prove that he was formed for both. Judgment, however, is requisite hi adjust- ing the due proportions of each, so as to avoid the inconveniences, arising from an extreme on either hand. Though animal food is more nourishing than vegetable, it is not safe to live on that alone. Experience has shewn that a diet consisting solely of animal food, excites thirst, and nausea, occasions putres- cence in the stomach and bowels, and finally brings on violent gri- ping pains with cholera and dysentery. Animal food is less adapted to the sedentary than the laborious, and least of all to the studious, whose diet, ought to consist chiefly of veg- etables. Indulging in animal food renders men dull, and unfit for the. pursuits of science, especially when it is accompanied with the free use of strong liquors. The plethoric, or persons of a full habit, should eat sparingly of animal food. It yields far more blood than vegetables taken in the same quantity, and of course may induce inflammatory disorders. It acts as a stimulus to the whole system, by which means the circula- tion of the blood is greatly accelerated. lam inclined to think, that consumptions, so common in England, are in part owing to the great use of animal food. Though the JPhthisis I'ulmonalis properly speaking, is not an inflammatory dis* ease, yet it generally begins with symptoms of inflammation, 'and is often accompanied with them through its whole progress. But the disease most Common to this country is the scurvy. One finds a dash of it in almost every family, and in some the taint is very deep. A disease so general must have a general cause, and there is none so obvious as the great quantity of animal food devour- ed by the natives. As a proof that scurvy arises from this cause, we are in possession of no remedy for that disease equal to the free use of fresh vegetables. 408 OP tinfiAb. By the Uninterrupted use of animal food a putrid diathesis is indu- ced in the system, which predisposes to a variety of disorders. I am fully convinced that many of those obstinate complaints for which we ar« at a loss to account,_and find it still more difficult to cure, are the effects of a scorbutic taint lurking in the habit. Improper diet affects the mind as well as the body. The choleric disposition of the English is almost proverbial. Were I to assign a Cause, it would be, their living so much on animal food. There is no doubt but this induces a ferocity of temper unknown to men whose food !s chiefly taken from the vegetab le kingdom. Though these and similar cousequeuees may arise from the excess of auimal diet, we are far from discouraging its use in moderation. In all culd countries it U certainly nece**ary; but the major part of the aliment ou^ht nevertheless to consist of vegetable substances. There is a co'iiiriua! tendency in animal food, as well as in the human body itself, to pu;refaction, which can only be counteracted by the fiee use «f vegetables. With regard to the proportion of vegetable food to that of animal, great nicety is by no means required. It must vary according to cir- cumstances, as the heat of the weather, the warmth of the climate, and the like. The vegetable part, however, where nothing forbids, ought certainly (o preponderate, and I think in the proportion of at least two to one. The excessive consumption of animal food is one great cause of the scarcity of grain. The food that a bullock affords bears but a &mall proportion to the quantity of vegetable matter he consumes. I am no enemy to good fruit, as an article of diet ; but t he greater part of what is used iu this country, by the lower orders of the people, is mere trash. Fruit should be eaten in the early part of the day. •wheu the stomach is not loaded with food, and it never ought to b«- cateu raw till it b§ thoroughly ripe. OF BREAD. BREAD, or something resembling it, makes a part of the diet of »U nations. Hence it is emphatically denominated the staff of life. It «iay, however, be used too freely. The late Dr. Fathergill was of opinion, and I perfectly agree with him, that most people eat more bread than is conducive to their health. I do not mean to insinuate that bread is unwholesome, but that the best things may prove hurtful when taken to excess. A. surfeit of bread is more dangerous than of «ny other food. Gmnis rcpletio tnala repktio pants pessitna. The French consume vast quantities of bread ; but its bad effects are pre- vented by their copious use of soups and fruits, which have little ot bo share in the diet of the common people of England. OF WREAD. 407 Oue important use of bread is to form a mass fit for filling up the alimentary canal, and carrying the nutritious juices along that passage in such a state as to render them fit to be acted upon by the lacteal absorbents, which take up the nourishment and convey it io the blood. In this light bread may be considered as a soil from whence the nourishment is drawn. I do not say thai bread contains uo nour- ishment, but that its use, as an article of diet, does not solely depend on the quantity of nutriment its contains, but in some measure, on its fitness as a vehicle for conveying the nutritious particles through the intestinal tubes. Hence it follows, that the finest bread is not always the best adapted for answering the purposes ef nutrition. The richest food will not nourish an animal, unless the alimentary canal is sufficiently distended. 4 dog has been fed on the richest broth, yet could not be kept alive ; while another, which had only the meat boiled to chip and water, throve very well. This shew* the folly of attempting to nourish men on alimentary powders and oth- er concentrated food. The great art therefore of preparing food, is to blend the nutritive part of the aliment with a sufficient quantity of some light farinaceous substance, in order to fill up the canal, without overcharging it with more nutritious panicles than are necessary for the support of the animal. This may be done either by bread, or other farinaceous substances, of which there is a great variety, as will appear from the sequel. Bread is one of the most expensive modes of using grain, and not adapted to the narrow circumstances of the lower orders of the people 3 as it is burthened with too heavy additional charges, in passing through the hands of both the miller and the baker. Besides, the former often grinds down extraneous matter with the wheat, and the latter as fre- queutly bakes it up with the addition of lime, chalk, alum, and other* pernicious substances. Since the articles of diet have become branch- es of manufacture, the publick neither know what they eat or what they drink. People imagine, as the finest flour contaius the greatest quantity of nourishment, that it must therefore be the most proper for making into bread; but this by no means follows. The finest flour comes the near- est to starch, which though it may occasionally prove a good medicine, makes bad bread. Household bread, which is made by grinding dowu the whole grain, and only separating the coarser bran, is without doubt the most wholesome. The best household bread I ever remember to have eat, was in the county ot York. It was what they called meslin bread, and consisted pf wheat aud rye ground together. I am not quite certain as to the proportion; but I think there might be two parts of the former to one of the latter. This bread, when well fermented, eat#light, is of apleas- jaot .taste, and soluble to the bowels. After using it for some years, i 408 OF BREAD. found that bread made entirely of flour was neither so agreeable to the palate, nor so conducive to health. Bread is often spoiled to please the eye. The artificially whitened, drying, stuffing bread, though made of the heart of the wheat, is «u reality the worst ot any ; yet this is the bread which most people pre- fer, aud the poorer sort will eat no other. All the different kinds of grain are occasionally made into bread, some giving preference to one and some to another, according to ear- ly custom and prejudice. The people of South Britain generally prefer bread made of the finest wheat flour, while those of the north- ern counties eat a mixture of flour and oatmeal, or ryemeai, aud many give the preference to bread made of oatmeal aloue. The com- mon people of Scotland also eat a mixed bread, but more frequently bread ot oatmeal only. In Germany the common bread is made of rye. and the American labourer thinks no bread so strengthening as that wtoch.Js n.a«i« ol Indian corn; nor do I much doubt but the Laplander things his bread, made of the bones of fishes, is the best of any. Bread made of different kinds of g 4 ain is more wholesome than \fiii' is made of one only, us their qualities serve to correct one an- other. For example, wheat flour, especially the finer kind, being of a starchy nature, is apt to occasion cons-tipation. Bread made of ryemeal, on the other hand, proves often too slippery for the bowels. A due proportion of these makes the best bread. For the more active and laborious I would recommend a mixture of rye with the stronger grains, as peas, beans, barley, oats, Indian corn, and the like. These may be blended in many different ways ; they make a hearty bread for a labouring man, and to use his own language, they lie longer on his stomach than bread made of wheat flour only. Barley bread passes too quickly through the alimentary canal to afford time for conveying the proper nourishment ; but bread made of barley mixed with peas is very nourishing. When potatoes, or boiled graiu, are used, bread ceases to be a necessary article of diet. During the late scarcity of bread, I made it a rtde not to eat above, one half the quantity I used to do, and I found no inconvenience whatever from the change. Nay, some told me, that for a considerable time they had left off the use of bread altogether, without experiencing any change in the state ol their health. A great nart of the bread consumed in this country is by childreu. It is always ready, and when childreu call for food, a piece of bread is put into their hands, to save the trouble of dressing any other kind j of victuals. Of mauy children this is the principal food, .bu far from being the most proper. Children are often troubled *ith acidities of tfce stomach and bowels; and it is well known that OF BREAD. - 40$ bread mixed with water, and kept in a degree of heat equal to that of the human stomach, soou turns sour. During the late scarcity, many of the labouring men, and even ar- tificers, could not earn as much money as was sufficient to keep their families in the article of bread only. It is certain, however, that on a different plan, such families might have lived very comfortably. Ma- ny of the articles of diet are cheaper than bread, and equally wholesome* Above one half of the expense of living might be saved by a due se- lection of the articles of diet. The English labourer lives chiefly on bread, which being ac- companied with other dry, and often salt food, fires his blood, and excites an unquenchable thirst, so that his perpetual cry is fou drink. But the greatest consumption of bread is occasioned by tea. It is paid that the subjects of Great Britain consume a greater quantity of that herb, than the whole inhabitants of all the other nations of this quarter of the globe. The poorest woman in England must have her tea, and the children generally share it with her. As tea contains no nourishment, cither for young or old, there must of course be bread and butter to eat along with it. The quartern loaf will not go far a- mong a family of hungry children, and if we add the cosi of tea, pugar, butter, and milk, the expense of one meal will be more than would be sufficient to fill their bellies with wholesome food three times a day. There is reason to believe that one half the bread consumed in Eng= land is used to tea, without one hearty meal ever being made of it. The higher ranks use tea as a luxury, while the lower orders make a diet of it. I had lately occasion to see a striking instance of this in a family that was represented to me as in distress for want of bread. I .pent them a litde money, and was informed that they ran away with if; directly to the tea-shop. To a heavy, sluggish, phlegmatic man, a moderate use of tea may not prove pernicious; but where there is a debilitated stomach and an irritability of fibre, it never fails to do much hurt. With many it has the effect to prevent sleep. Tea will induce a total change of constitution in the people of this country. Indeed it has g«ae a great way towards effecting* 1 that evii already. A debility and consequent irritability of fibre, are become bo common, that not only women but even men, are affected with them. That class of diseases which, for want of a better name, we call ner= vous, has made almost a complete conquest of the one sex, and is ma- king hasty strides towards vanquishing the other. Did women know the train of diseases induced by debility, and how disagreeable these diseases render thera to the other sex, they wouft! shun tea as the most deadly poison. No man can love a woman eaten ?ro with vapours, or washed down with diseases arising from relaxation 52 410 OF BOILED GRAIN. It is not tea taken as a beverage after a full meal, or in a crowded assembly, that I so much condemn, though I think something as elegant and less pernicious might be substituted in its place. The mischief oc- casioned by tea arises chiefly from its being substituted for solid food. This i» so much the case at present, that had I time to spare, I think it could not be better employed than in writing against this destructive drug. OF BOILED GRAIN. THOUGH farinaceous substances, of one kind or another, make a necessary part of the food of man, yet there can be no reason why- such substances should always assume the name and form of bread. Many of them are more wholesome, and uot less agreeable in other forms. Bread is often used merely to save the trouble of cookery ; and being portable, is the most convenient article of diet tor carrying a- broad. , ... It does not, however, admit of a doubt that more grain is eaten boiled though not in this country, than is made into bread ; and that this mode of cookery is the most wholesome. Simple boding pre- cludes all adulteration, and is an operation much less laborious an<. artificial than baking. m . The most general article of diet among maukiud, is rice. 1 nis may be made into a variety of dishes; but simple boding is all that is required, to render it a proper substitute for bread. It may either be eaten alone or with milk. In the East it is used with meat, in the same manner as we do bread. The people of this country believe that rice proves injurious to the eyes, but this seems to be without foundation ; it has no such effect on those who make it the principal part of their food. . Manv other kinds of grain will, when boiled, make good substitutes *br breid. Even those which make a harsh and unpleasant sort of bread, are often rendered very palatable by boiling. Tins is die case with all the leguminous class of plants, as peas, beans, &c. Even oats and barley are move agreeable, as well as more wholesome, when boiled, than made into bread. All allow that peas and beans boiled, when young, are a great lux- ury. But when old, they are equally wholesome, and, when proper- ly cooked, by no means unpleasant. There are few who do not rel- ish peas pudding, and even prefer it to bread. Beans are not so fit for this purpose"; but they make an excellent ingredient in the poor man's broth, and whoever eats this broth will find little occasion loi- ^Peas and bean? contain an equal quantity of sugar with wheat, oats, «r barley, and at the same time a greater proportion of oil, conss* ®F BOILED GRAlfr. 411 gently are more nourishing. This feet is confirmed by daily expe- rience. On those farms where peas and beans are raised in great abundance, the labourers are much fed ou that sort of grain ; but when removed to farms where they are fed with other kinds of grain, they soon com- plcin of a diminution of strength, and request a supply of peas meal as formerly. t Nature seems to have pointed out the propriety of the extensive use of peas and beans, it being a fact, that when crops of that kind are duly alternated with crops of wheat, barley, or oats, the fertility of the soil may be maintained without rest or manure, for many years together ; whereas, if the latter be raised on the same soil foi sever- al years successively, they render it barren, so that, without rest or manure, its fertility cannot be preserved. The people in England are but little accustomed to the use of boil- ed grain, though in many countries it is eaten as a luxury. Boiled barley is a great favorite with the Dutch, and is eaten with milk, but- ter, or molasses. It is the principal food of the Butch sailors, who in general, are both healthy and robust. Barley is one of the best ingredients in soup. Count Rumford says it possesses the quality of lithing, or thickening soups, in a superior degree to any other grain. We have reason, however, to believe, that grits, or coarse oatmeal, will answer that purpose still better. Oatmeal is frequently made into bread ; but it is a much morA wholesome, as well as agreeable food, when made into hasty pudding, and eaten with milk. The peasants in many parts of Britain mak«5 two meals a day cf it, while their children almost wholly subsist on it ; and it is well known that both old and young who are thus fed, are healthy and robust. The opinion of oatmeal being heating, and occasioning skin dis- eases, is wholly without foundation. Bread made of oatmeal, when not leavened, will sometimes occasiou the heart-burn ; btit this is no proof of its heating quality. Unleavened bread, of wheat or any other grain, produces the same effect on a debilitated stomach. Oat- meal thoroughly boiled seldom gives the heart-burn. Persons who are fed on oatmeal bread, or hasty pudding, are not more subject to diseases of the skin than those who live on wheatmeal. Cutaneous disorders proceed more from the want of cleanliness, than from any particular aliment. The French, so far from thinking that oatmeal is heating, speak of it as possessed of a cooling quality; and even the English give oatmeal, or grit gruel, to lying in women, and sick people of every description, which shows that they are inionsist- ■ent with themselves, in alledging that the blood is fired by the use of catmeal. A lieutenant of the army, residing at a country village within a few ifniles of Edinbargh, with a wife and ten children., having no othe* i« iT2 OF BOILED GRAIN. come iban his half pay led the whole of his children with hasty pud- ding ik1 buttermilk only, hem a conviction that it was the most whole- son,. a:;d full uifel that tell within the reach of his narrow circumstan- ces. The)' grew apace, and it was the universal remark of the neigh- bourhood, *hat they were as sprightly, healthy, and robust as other children, Arid at the same sime perfectly free from all skin diseases. Children are sekLm well, unless when their bodies are gently open. But this h move likely to be the c;se when fed on oatmeal and milk, thai! when Mien bellies are crammed with a starch) substance made 01 .lie n est flour; yet this in England is the common food of chil- .- u. J !>'ve seen an infant stuffed four or five times a day with id of food. There needs nocoujtitcr to tell the consequences. , late Author, a man of learning, but the dupe of prejudice, has liculous dcfiuiikhi, eudeavoured to represent cats as proper .: !.v ses only; I wfeh the horses in England devoured a smaller , . :,y . ; hat grain, and the people more. Few things would have . ii t'endeucj to lessen the expense of living. The oats in iNordi Britain are of a* superior quality, and I hope the people will long have the sense to use them as an article of diet. Indian coin is likewise said to make the best food when boiled. Count Humford observes, that of all things it makes the best pudding, and that he has made a hearty meal of it, sauce included, for five far- things. 'What makes good puddings will make good dumplings, aud these will, at any time, supply the place of bread The Count idso u marks, that the negroes in America prefer Indian com to rice; Sand thai the Bavarian peasants prefer it to wheat; that it might be ioi- b( rted from North America a", about fo»tr or five shillings ptr bushel; that when inadeln'o (lour, it would cost oily one penny farthing per pound; and that it is highly nutritious, and the cheapest food known. JJuring the iatc scarcity a large quantity of this <>rain was imported; but suel; is the aversion ol the common people of this country to every Wl of food to which they are not accustomed, that they refused to pur- chase it, aid the merchants were very great loosers by the importation; On die s;-me principle the Germans, till within a few years, could not he induced to eat potatoes, though now they are become extremely 1ond < f them. The American, the Italian, and the German, all cook Indian cora the same *o\ as the North Briton does his oat meal, by making it into hast) -pudding. It may be eaten in a variety of ways. Some eat it with a simcc composed of butter and brown sugar, or butter and mo- lasses. Others eat it with milk only. In either way it makes a goodi chesp and wholesome diet, b) no means disagreeable to those whoar* kcousiomce I-?) it. The onlj other grain we shall mention as best when boiled, is buck- Vheal : It is of a very mucilaginous nature, and of course highly nutri- '*»ur, j n teveral parts of Europe,, it constitutes a principle part of the 'OF BUTTER. A\% food of the lower people. Io former times it was eaten in Russia, not by the lower classes only, even the nobility madie use of it. Boiled and then buttered, it was so great a favouriie of the g&eat Gzar Peter, that he is said to have seldom supped on any thing else. OF BUTTER. IT has been Md that the English have a thousand religions, and but lone sauce - . It must be allowed that they use butter with almost every kind of food. Butter, though a good article of diet, may be used too freely, and in this country, I am convinced thatisihe i ase. To weak stomachs it is hurtful, even in small quantities, and when used freely, it proves prejudicial to the strongest. Butter, like odier things of an oily nature, has a constant tendency to turn rancid. This process, by the heat of the stomach, is greatly accelerated, insomuch that man* people, soon after eating butter, com- plain of its rising in their stomachs, in a state highly disagreeable. Oils of every kind are with difficulty mixed with watery fluids. This is the reason why butter floats on the stomach, and rises in such m unpleasant manner. Persons afflicted with bile should use butter very sparingly. Some sceptical authors doubt wSiether or rot aliment of any kind has an ef- fect on the bile. One thing, however, is certain, that many patients af. dieted with complaints which were supposed to be occasioned by bile, have been completely cured by a total abstinence from butter. The most violent bilious complaints that I ever met with were evi- dently occasioned by food that became rancid on the stomach, as the cholera morbus and the like. Jfor can such complaints be cured, till the rancid matter is totally evacuated by vomiting and purging. But supposing butter did not possess the quality of becoming rancid on the stomach, it may nevertheless prove hurtful to digestion. Oils of all kiods are of a relaxing quality, and tend to impede the action of digestion. Hence the custom of giving rich broths and fat meats to persons who have a voracious appetite. The free use of butter, and other oily substances, not only tends to relax the stomach, and impede its action/but to indnce a debility of the solids, which paves the way to many maladies. In a country where two thirds of the inhabitants lead sedentary lives, a debility of fibre must predominate. Whatever increases that debility ought to be avoided. Children, without exception, are disposed to diseases arising from relaxation. Butter of course, ought to be given to them with a sparing liand. But is this the case ? By no means. Bread and butter constitute a great part of the food of children, and I am convinced that the gross Iw.mours with which they are frequently troubled, are partly owing 't* *U OF BUTTER. this food. As children Abound with moisture, bread alone is, generally -speaking, better for theru than bread and batter. I have been astonished to see the quantities of butter eaten by gross ■women who lead sedentary lives. Their tea bread is generally contri- ved so as to suck up butter like a sponge. What quantities of crum- pets and muffins they will devour in a morning, soaked wilh this oil; and afterwards complain of indigestion, when they have eaten what would overload the stomach of a ploughman. Dr. i-othergill is of opinion, that butler produces the nervous or sick head-ache, so common among the women of this country. As a proof of this, it is often cured by an emetic. Oils, in certain quantities, excite nausea, and even vomiting. They must of course prove unfriendly to digestion. A Dutch sailor, we are told, can digest train oil. So may an English sailor; but it would be very improper food for a Loudon lady. To some of the leauer farinaceous substances, as the potatoe and the like, butter makes a very proper addition ; but eating it to flesh and fish of almost every description, is certainly wrong. The flesh eaten in this country is generally fat enough without the addition of butter, and the more oily kinds of fish, as salmon or herrings, are lighter on the stomach, and more easily digested when eaten without it. Butter is rather a gross food, and fitter for the athletic and laboii- ens, than the sedentary and delicate. It is less hurtful when eaten fresh than salted. Salt butler certainly tends to induce skin diseases, and I am inclined to think, the free use of it at sea may have some abate in bringing on that dreadful malady so destructive to our brave sailors,f/*£ seascurvy. There is a method of rendering salt butter less hurtful, but it seems not to be known in England. What I mean is to mix it with an equal quantity of hone) , and keep it for use. In this way it may be given to children with greater freedom. lu North Britain this method of mixing butter with honey is well known, and from the common proverb, I take the custom te be very ancient. Butter, in iiself, is not so hurtful, as when combined with certain other (kings. For example : bread madewith butter is almost indigestible, and pastries of every kind are little better : yet many people almost live upon pastry, and it is universally given to children. It is little better, huw- CFer, than poison, and never fails to disorder their stomaclis. The fond mother cannot pass a pastry shop, without treating her darling boy with some of the dainties, and then wonders how he got the cough, vr chotic. I have known a man seemingly in perfect bealth, who by eating a pennyworth of pastry, as he passed along the street, was seized with such an asthmatic fit, that he was obliged to be carried home, and hail oeatly lost his life. This occurred whenever he inadvertently ate any certainly poison, which, though it be sometimes slow iu its opera- (ion, never fails to produce fatal effects, even iu the strongest const]* tution, where the free use of it is continued for a considerable lci'gtfy of time. « A CONCISE ACCOUNT OF THE MEDICINAL QUALITIES; OF SOME OF THE MOST COMMON INDIGENOUS, AND NATURALIZED PLANTS, OF NEW ENGLAND, AND THE MIDDLE STATES, EXTRAGTED FROM ■fHACHEB-'s DISPENSATORY, AND BARTON'S COLLECTIONS. Acorus Calamus. Sweet flag. The root. The common calamus aromaticus, or sweet flag, grows in marshy situations, and in shallow water, and may be known by its long sword shaped leaves, resembling those of the flag, but narrower, of a brighter green, waved along one of the edges, and also its oblong, cylindric spike of flowers coming from the side of the stem at the edge of the leaf. The root is like that of the flag, long, cylindric, tuberous, spongy, marked with rings, and putting out abundance of fibres, which, indeed, are the prop- er roots. It has a strong aromatic smell, and a warm pungent, bitterish taste. The flavour is greatly improved by drying. It possesses carminative and stomachic virtues, and is fre- quently grated into water and given to children for pain in the stomach and bowels from flatulence. This root is also used as an ingredient in the morning bitters in this country, particular- ly in places subject to ague. According to Bechstein, the leaves may be employed for dis- pelling many noxious insects ; hence they are recommended against moths, infesting woollen cloth, and the destructive worms in books ; for which purpose they might every year be repla- ced in the corners of the drawers and shelves. Mr. Bautroh has used the whole plant for tanning leather ; and Dr. Bohmer re- marks that the French snuff, called a la violette, probably re* reives its peculiar scent from this fragrant root-, ■m 4ls MATERIA MEDICA AcT-EA RACEMOSA. The Actam racemosa, or Black Snake-root, is also a valuable medicine. It is sometimes called Squaw-root*, I suppose from its having been used as a medicine by our Indians- The root of this plant is astringent. In a putrid sore-throat, which pre- vailed in Jersey, many years ago, a strong decoction of the roots was used," with great benefit, as a gargle. Our Indians set an high value on it. A decoction of it cures the itch. In North-Carolina, it has been found useful, as a drench, in the disease of cattle, called the murrain. The Indians make use of a decoction of tins plant, along with other vegetables, as a remedy, given internally, for rheumatism : but they depend much more upon a decoction of the roots of th* kcfcsa, externally applied. It may not be incurious to mention their manner of employing it. They make a hole in the ground, into which they put a kettle, containing a quantity of the hot decoction. The rheumatic limb is laid over the ket- tle, in such a manner as to receive the influence of the steam. They keep up the heat of the decoction, by putting into it, oc- casionally, hot stones. I presume that the heat, independently of the vegetable employed, has something to do in the cure. Act^a Sficata Herb Christopher. The root. This vegetable is perennial, growing in woods and shady pla- ces. It attains the height of about two and a half feet, and flow- ers in the months of May or June ; and produces black, shining, pulpy berries in Autumn, about the size of peas. On account of its foetid smell, this plant is said to be frequented by toads. « The berries are exceedingly poisonous. Dr. Withering says, the plant is powerfully repellent ; and that the root is useful in some nervous cases, but it must be administered with caution. JEsculus HrppocASTANUM. Horse chesnut. The seed and bark. This is a very common and well known tree. The fruit is principally farinaceous, and produces excellent starch, and has been used for food for domestic animals, and even for men m times of scarcity. But its introduction into the Edinburgh phar- macopoeia was probably owing to its having been used and re- commended as a sternutatory in some cases of opthalmia and headach. With this view it was drawn up the nostrils, in the fo.-m of an infusion or decoction. The bark has been proposed as an indigenous substitute for the very expensive and often adulterated Peruvian bark. Many successful experiments of its effects, when given internally in intermittent and typhus fever, • It is also called Rich-weed, and Rattle-weed. MATERIA MEDICA. 41$ and also when applied externally in gangrene, sufficiently war* rant future trials. In powder, it may be given to the extent of a scruple and a half, or a drachm, for a dose. It rarely disa- grees with the stomach; but its astringent effects generally re- quire the use of some aperient medicine. Some species of a?s- culus are cultivated in the United States, on account of the beauty and agreeable shade of the tree. Medical knowledge might be promoted were practitioners to try the efficacy of the bark of our native species. Agrimonia Eupatoria. Agrimony. The root. This is a native of the United States. Blossoms on long ter- minating spikes ; yellow. By fences — July. It is said the Indi- ans used an infusion of the roots in inflammatory fevers with great success ; and, according to Kalm, the Canadians have great confidence in it for the same purpose. The leaves of this vegetable are said to be aperient, detergent, and to strengthen the tone of the viscera ; hence they have been used in laxity of the intestines, in scorbutic, and other disorders arising from de- bility. Digested in whey, agrimony affords a diet-drink, grate- ful to the palate and stomach and was formerly supposed to be an effectual remedy for the jaundice. Allium Sativum. Garlic. The root. Garlic is a perennial, bulbous rooted plant, all the parts of which, but more especially the roots have a strong, offensive, very penetrating and diffusive smell, and an acrimonious taste. It is a powerful and diffusive stimulant ; hence in cold phlegmatic habits, in rheumatalgia, catarrhous disorders of the breast, asth- ma, both pituitous and spasmodic, flatulent colics, hysterical and other diseases proceeding from laxity of the solids, garlic is emi- nently serviceable, proving expectorant, diuretic, and if the pa- tient lie kept warm, sudorific. Sydenham extols it in hydropic cases ; and assures us also, that, among all the substances which occasion a derivation or revulsion from She head, no one operates more powerfully than garlic applied to the soles of the feet. In hot bilious constitutions, where there is already a degree of irri- tation, where the juices are too thin and acrimonious, this stimu- lating medicine is obviously improper, and never fails to aggra- vate the distemper. Garlic may be exhibited in substance, seve- ral cloves of it cut into slices may be swallowed without chewing. In this manner it has been successfully directed for the cure of intermittent fever ; but the most commodious form for adminis- tering it, is that of bolus or pill ; the expressed juice, or even the infusion, is too acrimonious for coaimoii use.- Cotton moistened 41» MATERIA MED1CA. with the juice and introduced within the ear five or six times a day, lias afforded relief in deafness proceeding from atony or rheumatism. In the form of ointment applied externally, garlic is said to resolve and discuss indolent tumors ; and when applied under the form of poultice to the pubes, it has some times proved effectual in producing a discharge of urine, when its retention has arisen from want of due action of the bladder. Altikea Officinalis. Marsh Mallow, The root and leaves. The marsh mallow is a handsome perennial indigenous plant growing in salt marshes and on the banks of rivers and other wet places. It is also cultivated in gardens for its medical vir- tues- The upright cylindrical stem rises to three or four feet : is somewhat branched and cottony. The leaves are on leaf stalks, egg-spear shaped, obscurely lobed, serrated, and have a soft woolly surface, feeling like velvet. The flowers appear in August, from the bosom of the leaves on fruit stalks in a kind of panicle, and are of a white or pale flesh colour. Every part of the marsh mallow, and especially the root, upon boiling, yields a copious mucilage ; on account of which, it is frequently employ- ed in emollient cataplasms, and by way of infusion. In humid asthma, hoarseness, dysenteries, and likewise in nephritic and calculpus complaints, it is of eminent service ; as by lubricating and relaxing the vessels, it procures a more easy passage to the stagnant fluids. It is with equal advantage applied externally, for softening and maturing hard tumors, and when chewed, it is said to afford relief in difficult teething. An ointment and syrup are made from the roots of this plant, Andromeda Mariana. " A decoction of the Andromeda Mariana lias been " found useful as a wash in a disagreeable ulceration of " the feet, which is not uncommon among the slaves, &c in the " Southern states." This complaint is very common, particular- ly among the negroes, and the poorer sort of white people, in Carolina, Georgia, &c. It is called " toe-itch," and " ground- itch." It is a kind of ulcerous excoriation between the toes, sometimes extending as high as the instep, and is attended with most intolerable itching. It is, probably, in a great measure, the consequence of inattention to cleanliness. Is it occasioned by particular insects ? Some persons, with whom I have convers- ed on the subject, are oi" opinion, that it is owing to the great warmth of the waters to the southward, in which the inhabit- ants are accustomed to wade a great deal. The disease is $pmer times seen in Pennsylvania. MATERIA MEDICA. m The brown powder which is attached to the foot-stalks of the leaves of the Andromeda, is considerably errhine.. The powder about the seeds, in the seed-vessels of the same vegetable, pos- sesses a similar quality. Whether this powder may be advanta- geously employed in practice, I cannot say. Anethum Fceniculum. Fceniculwfl dales. Sweet fennel. The' root and seeds- This is a perennial plant, of which there are four varieties. One of these, the common fennel, is indigenous on chalky cliffs in England. The sweet fennel, the variety of which is officinal, grows wild in Italy, but is also cultivated in gardens. It is smaller in all its parts than the common, except the seeds, which are considerably larger. The seeds of the two sorts differ likewise in shape and colour. Those of the common are roundish, o]> long, flattish on one side, and protubex'ant on the other, of a dark, almost blackish colour; those of the sweet are longer, narrower, not so flat, generally crooked, and of a whitish or pale yellowish colour. The seeds of both the fennels have an aro- matic smell, and a moderately warm pungent taste : those of the fmniculum dulce are in flavour most agreeable, and have also a considerable degree of sweetness. The seeds yield an excellent aromatic oil, which is carminative, resolvent, and diuretic, with*, out heating the body. Anethum Gkaveolens. Dill. The seeds. Dill is an annual umbelliferous plant, cultivated in gardens, as well for culinary as medical use. The seeds are of a pale yel- lowish colour, in shape nearly oval, convex on one side, and flat on the other. Their taste is moderately warm and pungent ; their smell aromatic, but not of the most agreeable kind. The seeds are recommended as a carminative in flatulent colics. These seeds, with those of cummin, possess qualities and vir« tues similar to those of the anise and caraway, and are used for similar purposes, but are scarcely entitled to a place in the ma- teria medica. Cummin however affords an oil peculiarly grate^ ful to wild pigeons, and is frequently resorted to by the people in the country as a lure for those birds to the stand of the gunner, Anthemis Nobilis. Chamomile, The flowers. Chamomile is a perennial plant, indigenous to the south of England, but cultivated in gardens for the purposes of medicine. The flowers have a strong, not ungrateful aromatic smell, and a yery bitter nauseous taste. Their active constituents are bitter 122 MATERIA A1ED1CA. extractive, and essential oil. To the latter is to be ascribed, {heir antiseptic, carminative, cordial, and diaphoretic effects; to the former, their influence in promoting digestion. Chamomile flowers are a very common and excellent remedy, which is often used with advantage in spasmodic diseases, in hysteria, in spas- modic and flatulent colics, in suppression of the menstrual dis- charge, in the vomiting of puerperal women, in after pains, in gout, in intermittents, and typhus. From its stimulating and somewhat unpleasant essential oil, chamomile is also capable of exciting vomiting; and a strong infusion of the flowers is often used to promote the action of other emetics. In substance, it lias been frequently given as a remedy in intermittent fever, m a dose of a drachm, or more, three or four times in the day. Chamomile flowers are applied as a discutient and emollient, in the form of clyster or fomentation, in colic, dysentery, strangu- lated hernia, &c. Arbutus Uva-Ursi. Bearbetry. Bear's Whortleberry. The leaves. The uva-ursi is a low shrub, somewhat resembling the myrtle. The leaves have a bitterish, astringent taste ; and their astringent qualities are so considerable, that in certain places, particularly the provinces of Russia, they are used for tanning leather. A watery infusion of the leaves, immediately strikes a very black colour with chalybeates. Dr. de Haen of Vienna, has bestowed very high encomiums on the uva-ursi, against ulcerations of the kidneys, bladder, and urinary passages. He represents it as capable of curing almost every case of that kind; and even asserts, that in cases of calculus, much benefit is derived from its use ; patients after the employment of it, passing their urine without pain. It has not however answered the expectations, which, on these grounds, other practitioners formed of it. But in many affections of the urinary organs, it has proved to be a .remedy of considerable use ; and it has been particularly ser- viceable in alleviating dyspeptic symptoms in nephritic and cal- culous cases. From its astringency, uva-ursi has been employed in monorrhagia, and other fluxes, but more particularly in cys- tirrhoea, calculus, diabetes, and ulcerations of the urinary orgaHs, in some of which affections, its efficacy is greater than has of late been allowed. Professor Barton of Philadelphia, from long experience of its efficacy, is high in its commendation, in cases of nephritis depending on gout, and has found it serviceable in old gonorrhoea. It is sometimes exhibited in the form of decoc- tion, but most frequently in that of powder, from a scruple to a drachm for a dose, repeated twice or thrice in a day. In the New-England states, and in New-York and New-Jersey^ MATERIA MEDICA* 423 the uva-ursi, a low ever-green shrub, is found in great abundance trailing on the ground in dry, sandy soils, in woods, and on mountains. The inhabitants, to whom it is known by the name of wild cranberry, have recourse to it with much confidence as a remedy, under various circumstances attending affections of the urinary organs. More lately it has been recommended in phthisis, and it is probable deserving of trial. For medicinal use the green leaves alone should be selected and picked from the twigs, and dried by a moderate exposure to heat. Arctium Lappa. Burdock. The root and seeds. This is a common plant about way-sides, sufficiently known. from its scaly heads, or burs, which stick to the clothes. It bears purplish blossoms in July and August. The seeds have a bit- terish subacrid taste : they are recommended as very effica- cious diuretics, given either in the form of emulsion, or in pow- der, to the quantity of a drachm. The roots are esteemed ape- rient, diuretic, and sudorific ; and are said to act without irrita- tion, so as to be safely used in acute disorders. Decoctions of them have of late been employed in rheumatic, gouty, and ve^ Mereal disorders, and are by some preferred to sarsaparilla. Angemone Mexicana. Prickly Poppy. This abounds with a milky glutinous juice, turning in the air$ into fine bright yellow, and not distinguishable from gamboge ; said to be efficacious, in small doses, in dropsies, jaundice, and eutaneous eruptions ; deemed to be very detersive, and used in diseases of the eyes, the infusion is sudorific and resolutive ; the seeds are a stronger narcotic than opium, and frequently administered in the sugar colonies in diarrhaeas and dysenteries. In the West Indies it is called the yellow thistle. This appears to be a hardy annual, and without doubt can be cultivated ea- sily in the United States. Aristolochia Serpentaria. Virginia Snalce Root. The root.. A perennial medicinal plant, and a native production of the United States exclusively. The root consists of a number of small strings or fibres, matted together, issuing from one head, of a light brown colour, having a slightly aromatic smell and a pungent bitterish taste. This root is a warm stimulant, both diaphoretic, and diuretic, and esteemed one of the principal remedies in malignant fevers to support the powers of the sys- tem. It increases the pulse very perceptibly, and is improper 424 MATERIA MEDICA. whenever bleeding is required. It is given in substance in dd- ses of from twenty to thirty grains, and in infusion to a drachm, or more, or it may be administered in tincture, its active matter being entirely extracted by proof spirit. By decoction, its pow- ers are entirely destroyed. This root promotes the efficacy of cinchona in the cure of intermittents, and remittents, and is a remedy of considerable power in dyspepsia. Combined with calamus aromaticus, and infused in spirits, or water, it forms the common morning dram in aguish situations. Externally, it is used as a gargle, in putrid sore throat. Artemisia Absinthium, Common Wormwood. The leaves and flowering heads. The absinthium or common wormwood, is a perennial herb, growing wild on the road sides, and is cultivated in gardens. — It flowers in August ; the smell of the leaves is strong and disa- greeable ; their taste intensely bitter. The active constituents of this plant, are bitter extractive and essential oil. It is used in stomach complaints, and is of great service to hypochondri- acs. It is also employed in intermittent fevers, in cachectic and hydropic affections, in jaundice, and against worms. Ac- cording to Dr. Withering, an infusion of the leaves is a good stomachic, and, with the addition of fixed alkaline salts, proves a powerful diuretic in some dropsical cases. Their ashes produce a purer alkali, than most other vegeta- bles. The essential oil, is used both externally and internally, for destroying worms. The herb, being an excellent antiseptic, is often employed in fomentations, to resist putrefaction ; and if the plant be macerated in boiling water, and repeatedly ap- plied to a bruise, by way of cataplasm, it will not only speedi- ly remove the pain, but also prevent the swelling and discoloura- tion of the part. Arum triphyllum. Indian Turnip. The root. The acrimony of the recent root of this plant is well knowm. By drying, much of this is lost, it has been very beneficial m asthma, especially in old people ; in croup and whooping-cough. The recent root boiled in lard, to the consistence of ointment, has been found useful in tinea capitis. The dried root boiled in milk, in the proportion of one root to a half pint, has been advantageously employed in consumption. Some acrimony* should be percepible to the tongue and throat in its exhibition. It never afl'ects the general circulation, says Dr. Mease, but acts solely on the parts just named ; to the glands of which it is a powerful stimulus, causing a copious secretion of mucus. A fine MATERIA MEbfCA, 425 sago has been prepared from the roots, in the proportion of one part to four of the root, freed from its exterior coat. Asarum Canabekse. We have several species of the genus Asarum, or Asarabacca* t am best acquainted with the Asarum Canadense, which is well known by the name of Wild Ginger*. In Virginia, it is called Coltsfoot. Both the root and leaves may be used. The ex- pressed juice of the fresh leaves is a powerful emetic. Asclepias decumbent. Decumbent swallow-ivorL Pleurisy root* Butterfly-weed. The root. This species of swallow-wort is one of our most beautiful peren- nial plants, flourishing best in a light sandy soil, by the way side, under fences, and near old stumps in rye fields, &c. It abounds in the southern states, but with us is not so frequently found — » There are sometimes fifteen or twenty, or more stalks, the size of a pipe stem, proceeding from one rootj rising from one to two feet in height, and spreading to a considerable extent, gen- erally in a decumbent position. The stalks are round and wool- ly, of a reddish brown colour on the sun side ; the leaves stand irregularly, and are spear, or tongue shaped, with a short foot stalk, and covered with a fine down on the under surface* The umbels are compact at the extremities of the branches, and formed like the common silk weed, but differing from it in the colour of the flowers, being of a bright orange colour, while those of the silk weed are of a pale purple hue. The flowers appear in July and August, and are distinguished by their size and bril- liancy from all the flowers of tl*e field. These are succeeded by long slender pods, containing the seeds, which have a deli* eate kind of silk attached to them. This is probably the only variety of asclepias that is destitute of a milky juice. The root is spindle, or carrot shaped, of a light brownish colour, on the outer surface, white, coarse and striated within. The root of this plant is a valuable addition to our Materia Medica, having been found to possess medicinal virtues of no inconsiderable im- portance. It has been long celebrated in Virginia and the Carolinas, as a remedy in pleurisy, and in pneumonic affections in general. It is said to display a remarkable power of affect- ing the skin, inducing general and plentiful perspiration without heating the body. In the form of decoction it of acts, in destroying the worms, I do not know. I do not men* tion the anthelmintic virtue of the Cleome, merely on the au- thority of Dr. Schoepf* Cochlearia Armoracia. Horse Radish The leaves and root. An indigenous perennial plant, growing on the sides of ditch- es, the banks of rivers, and other damp places, flowering in the month of May. For medicinal and culinary uses, it is also cul- tivated in gardens. Horse radish root has a quick pungent smell, and a penetrating acrid taste ; it nevertheless contains in certa n vessHs a sweet juice which sometimes exudes upon the surface". By drying, it loses its acrimony ; but if kept in a cool place, covered with sand, it retains its qualities for a considera- ble time. Tiie medicinal effects of this root are to stimulate the solids,, and promote the fluid secretions ; it seems to extend its action through t (, e whole habit, and affect the minutest glands. It is recommended by Sydenham in dropsies, particularly such as succeed intermittent fevers. In paralytic complaints horse radish aas sometimes been applied with advantage as a si Dilating remedy to the parts affected. When steeped in vinegar during a fortnight, this root : s said effectually to remove freckles in the face. A syrup made by boiling scraped horse * See his Materia Medica, &c. p. 10& MATERIA MEDICA. 429 radish in brown sugar, is an excellent remedy in the decline of colds and of pleurisies, to promote expectoration, and remove hoarseness. , Cochlearia officinalis. Garden Sew&a Grass. The plant, This is an annual plant growing on the sea shore, and in mountainous situations, and is sometimes cultivated in gardens, It possesses a considerable degree of acrimony, and by distil- lation it affords an essential oil ? the smell of which is so strong as to make the eyes water. The fresh plant is a gentle stimulant and diuretic, and is chief* ly used for the cure of the sea scurvy. It is employed exter- nally as a gargle in sore throat, and scorbutic affections of the gums and mouth. It may be eaten in substance to any quanti- ty, or the juice may be expressed frdm it, or it may be infused in wine or water, or its virtues may be extracted by distillation. Dr. Withering says it is a powerful remedy in the pituitous asth- ma, and in what Sydenham calls the scorbutic rheumatism. — The juice is prescribed along with that of oranges, by the name of antiscorbutic juice, Corianbrum sativum. Coriander. The seeds. The seeds of coriander have commonly been imported from the south of Europe ; but the plant js frequently cultivated in our own gardens, and may be produced to any extent. It is an an- nual umbelliferous plant, and the seeds differ from all the others of that class in being spherical. These possess a pleasant fla- vour 5 and when encrusted with sugar are sold by the confec- tioners under the name of coriander comfits. Their taste is mode- rately warm. Like caraway, they are used as carminative, and likewise to cover the taste and flavour of some medicines par- ticularly senna, when given under the form of infusion or tincture. Cornus FlorIda. Common Dogwood,. Boxwood, The fruit and bark. This is one of our most beautiful and useful shrubs, growing in almost every part of the United States. In New England it is well known by the name of boxwood. It flowers very early in the' spring, and with so much regularity that some of our southern tribes were accustomed to name the Spring season from its flowering. The flowers generally make their appear- ance about the beginning of May, in the middle States, and ex- hibit a most beautiful appearance. The large white flowers ibrm a fine contrast with the green of the forest, and are the *3b MATERIA MEDICA, ornament of our woods. These are succeeded by oblong drupes or berries of a rich glossy crimson colour winch ripen in Sep- tember. They have a very bitter taste, and an infusion of them in rum or brandy is much esteemed as an agreeable morn- mg bitter. The bark both of the stem and root, is considerably astringent, and has long been employed in intermittent fevers. And as possessing properties closely allied to the Peruvian bark, this and the following article will be found excellent substitutes. Cornus Sericea, Or American red-rod cornel. Called also red willow ; swamp dogwood ; blue berried dogwood. It grows in a moist soil by the sides of creeks and rivers and in swamps, seldom attaining in height more than six or eight feet. In general a considerable number of stems arise from the rame root and are very straight. The bark of the young shoots is very smooth, shining, and of a rich dark red colour. The branches are placed opposite, as are also the leaves which a good deal resemble the cornus fio- rida. The flowers are produced in clusters or cymes at the ex- tremity of every branch, and give to this shrub a very elegant appearance, being of a whitish colour in June and July. They are succeeded by succulent drupes or berries, which are of a blue colour inclining to green when ripe. Both these American species of cornel are found by experi- ment? instituted by Dr. John M. Walker to possess the same ingredients with cinchona. The bark of cornus sericea forms a beautiful tincture with proof spirit, wbich has been useful in the latter stages of diarrhoea unaccompanied with fever. This and the powdered bark of both species are well deserving a place in the apothecaries' shops, as valuable additions to our Materia Medica. It is asserted by Dr. Walker that in what- ever form of disease the cinchona has been decidedly servicea- ble, the corni will be found equally so. They are like cinchona bark, bitter and astringent in the mouth, tonic and febrifuge in the stomach ; and their chemical analysis affortls results per- fectly analogous. Thirty-five grains of powdered bark of dog- wood is considered equal to thirty of cinchona. Professor Bar- ton adds his decided testimony relative to the efficacy of dog- wood as a valuable substitute for the Peruvian bark in the cure of intermittent fevers. This article as a remedy has attracted the attention of medi- cal practitioners' of the United States, many of whom have vouched for their tonic and astringent powers, as being little if any inferior to those of cinchona officinalis. If therefore our native productions are adequate to our exigencies let expensive exotics be rejected. MATERIA MEDICA. 481 Dauous Carota. Wild Carrot. The seeds. The seeds of wild carrot have a moderately warm pungent taste, and an agreeable aromatic smell. They are carminative, and are said to be diuretic. The roots of the cultivated variety, common carrot, contains much mucilaginous and saccharine mat- ter, and are therefore highly nutritious and emollient. When beaten to a pulp, they form an excellent application to cance- rous and other ill-conditioned ulcers, allaying the pain, check- ing the suppuration and foetid smell> and softening the callous edges. A marmalade of carrots, on account of their strong- antiseptic qualities, has been successfully used for prerenting and curing the sea-scurvy. An infusion of these roots has also been found to afford considerable relief to persons afflicted with the stone and worms, but especially the tape worm. Dbaconitum FffiTiDUM. Linn. Skunk Cabbage. The root and seeds. This singular plant abounds in the swamps and meadows throughout New-England, and is found native in North Ameri- ca only. The vulgar name by which it is here generally known, is taken from its very rank and disagreeable smell, nearly re- sembling that of a skunk, of pole cat, and from its leaves re- sembling those of the cabbage. The roots aad seeds when fresh, impart to the mouth a sensation of pungency and acri- mony. This valuable domestic article is found to be well deserving of a place in our Materia Medica, and may be ranked high in the class of antispasmodic. The roots dried and powdered have proved of excellent use in asthmatic cases, and often afford- ed relief in this distressing disease when other means are inef- fectual. It should be exhibited during the paroxysm, and re- peated as circumstances may require, in doses of thirty or for- ty grains. It will be proper to persevere in the use of it for some time after the paroxysm has gone off, or till the patient is perfectly recovered, which is said to have been the method pursued by the Indians for the cure of this disease. The Rev. for. Cutler has announced his opinion of its efficacy as experi- enced in his own particular case after other remedies had dis- appointed his expectations. The antispasmodic powers of the skunk cabbage root have been displayed when prescribed in oth- er diseases. In one of the most violent hysteric cases I ever met with, says a correspondent, where the usual atispasmodics and even musk had failed, two tea-spoonsful of the powdered root in spirits and water procured immediate relief, and on repeating the trials with the same patient,, it afforded more last- 4& MATERIA MEDICA. ing benefit than any other medicine. In those spasms frequent- ly affecting the abdominal muscles in parturition, he adds, it produces the desired effect in doses of one tea-spoonful repeat- ed occasionally. In numerous other instances of spasmodic affection, and also in chronic and acute rheumatism, this root either in powder or decoctioji has evinced its efficacy, and per- formed important cures, as attested by good authority, in con- firmation of my own experience. Two instances have been sta- ted in which this medicine has been supposed to be remarka- bly efficacious in the case of dropsy ; two tea-spoonsful of the powdered root being taken every morning successively till the cure was effected. The seeds of this plant are said by some to afford more relief in asthmatic cases than the root. A caution is suggested by Dr. Cutler, that in collecting the roots, poke root which some people call skunk weed, be not mistaken for this plant, as the consequence might be fatal. There is an obvioss distinction ; the hellebore has a stalk, but the skunk cabbage has none 5 and the roots of the latter are much larger than those of the former. Erigeron Philadelphicum. The Erigeron Philadelphicum, or Philadelphia Flea^Bane is one of the most common plants in many parts of the United States. A decoction or infusion of the plant has been used in Philadel- phia by several persons, for gouty and gravelly complaints, and some of them have informed me, that they have been much benefited by the use of the plant*. It operates powerfully as a diuretic, and also as a sudorific. This Erigeron is known in Pennsylvania by the name of Skevish, which I suspect is a cor- ruption of the word Scabious. But it must be confessed, that the genera Scabiosa (Scabious) and Erigeron are sufficiently re- mote from each other. I have never employed the ErigerOn Philadelphicum, in prac- tice : but I am led to believe, that there is some foundation for the assertions which I have noticed, because I find that the same plant is mentioned by Father Loureiro, as one of the remedies that are employed by the pleople of Cochinchina ; and he speaks of it as an active emmenagoguef . Eutatorium perfoliatum. Thorough Wort. The leaves and flowers. This is a native annual plant, flourishing abundantly in wet meadows and other moist places. The stalk is hairy and rises * See Elements of Botany, &c. Part Third, p. 123. t Flora Codiinchinensis, &c. Tom. II. p. 500. UJyssiponse : 1790. MATERIA MEDICA. 453 ifom two to four feet, perforating the leaves at each joint, from which it is sometimes called thorough stalk, or stem. The flow- ers are white and appear in July and August, forming a corym- hus at the termination of the branches. The leaves at each joint are horizontal, serrated and rough, from three to four inch- es long, and about one inch broad at their base, gradually les- sening to a very acute point, of a dark green, and covered with short hairs. Thorough wort certainly possesses active proper- ties, and deserves the attention of American physicians. It acts powerfully as a sudorific and emetic, and sometimes as a pur- gative, and has been successfully employed in intermittents and other fevers, either in decoction or the leaves in powder. Eve- ry part of the plant maybe advantageously employed, though the flowers appear most active. A watery infusion of the leaves is a powerful and not disagreeable bitter, and the flowers are deemed superior in this respect to those of camomile, and ought to be kept in the shops. The dried leaves in powder, or made into pills with lenitive electuary, given in doses of twelve or fif- teen grains, are of excellent effect as a mild laxativej obviating costiveness without inducing debility or heat ; correcting bile and promoting perspiration. This plant is frequently employ- ed in the country as a drench in diseases of cattle. There are several species in the United States- Frasera Carolinensis, Walth. ~) Columbo of Marietta. Frasera Waltheri, Mich. $ The root - It is a production of high land, a rich and loamy soil that is- covered with white oak, white thorn, and tufts of prairie grass. It flowers in July. The root as soon as it enters the earth shoots out in a horizontal direction ; is spindle shaped ; and when well grown is from eighteen to thirty inches in length, and two in diameter at the turn. Near the surface of the earth the root is wrinkled ; its colour in the young plant is a light yellow j and is solid and brittle. After the stalk is grown the root be- comes softer and less bitter. The proper time for collecting it seems to be in the spring of the third year. Dr. Hddreth asserts that from the experiments he has made with American colum- bo, he is induced to believe it fully equal, if not superior to the imported. It is in common use there, and has in one instance, in the heat of summer, put a stop to a wide spreading gangrene, on one of the lower extremeties, by internal use and external, application, when bark and other remedies had failed. The columbo plant is undoubtedly to be estimated as a valua- ble acquisition to our Materia Medica. The root, however, is found on examination to be of a lighter co'our, and to possess less of the bitter principle than the imported root. m 434 MATERIA MEDIC A. Galega Virginiana. The Galega Virginiana, or Virginia-Goats-rue, is one the moit beautiful of ihe known North-American plants of the class of Diadelphia. It is very common in many parts of Pennsylvania, New-Jersey, &c. In Jersey, it is called Cat-gut, from the re- semblance of some of its roots to the article of this name. A decoction of the roots is rpputed a powerful anthelmintic. J have never used it. It may be observed, in this place, that, notwithstanding the general character of the class of Diadeiphia, there are in this class some very active and even deleterious vegetables. It is somewhat in favour of the anthelmintic pow- er 01 the Galega Virginiana, that some West-India species of the same genus are said to intoxicate and poison fish. Gaulthekia procumbens. The Gaultheria procumbens, which Ave call Mountain-tea*, Is Spread very extensively over the more barren, mountainous parts of the United States. It belongs to the same class as the plants just mentioned- I have made use of a strong infusion of this plant, which is evidently possessed of a stimulant and ano- dyne quality, I am told it has been found an useful medicine in cases of asthma. But I have not learned to what particular forms of this disease it is best adapted, nor in what manner it operates. Geranium maculatum, or Crane's Bill. The plant and roots. This is a common plant near Philadelphia, and in many oth- er parts of the United Mates. It is commonly known by the English name of a Crowfoot? and flowers in the spring. It i» a powerful astringent, and will stop very violent bleedings, if ap- plied to the wounded vessel. A decoction of this plant lias al- so, on some trials, manifested great efficacy in restraining inter- na! hsemorrhagy. The root boiled in milk is a common domes- tic remedy for the bowel complaints of children. Geum rivals. Comnwn Avcns, or Herb-bennet. The roof. Avens. Throat root. Cureall. The blossoms are purplish. In boggy meadows. May. — The root is powerfully astringent. A decoction of it has been • It is klso called Berrieci-tea, Grouse-berry, and Deer-berries. If I do not mistake, this is one of the principal articles in the materia medi- ea of some of our Indian tribes. In the language of" some of the Indians of* Canada, it is cailed Follow. MATERIA MEBIGA. 4S$ used, with good success, as a gargle, and a drink, in inflamed and ulcerated sore throats, and cankers. It is said, that the powdered root will cure tertain agues, and that it is much used by the Canadians for that purpose. Glycyrrhiza glabra. Liquorice. The root and extract. Liquorice is a perennial plant, and a native of the south of Europe, but is cultivated in considerable quantities, for medici- nal purposes. The root of tins plant has a sweet agreeable taste. This sweetness is extracted by water, by infusion or de- coction ; and, by evaporation, a dark coloured extract, of the same sweet taste, is obtained, consisting principally of saccha- rine and mucilaginous matter. Liquorice root is a pleasant de- mulcent, which is frequently added to infusions of linseed or althaea. There is no doubt of its gentle deterging qualities, which ren- der, it an excellent medicine in coughs, hoarseness, asthma, &c. for lubricating the throat, softening acrimonious humours, and affording relief to the organs of respiration. But with this in- tention it ought to be taken as a diet drink in considerable por- tions by way of infusion. This plant is found in the state of Vermont, and on the borders of the Ohio river. PIabiamelis Virginica. Witch-hazel. The bark. This singular shrub does not commonly bloom until its leaves are destroyed by frost, when its numerous blossoms make a gay and agreeable appearance ; and continue until the weather be- comes very cold, often until snow falls. The germen endures the severity of our winters uninjured ; for the fruit does not ripen until the next September, the time of its blossoming again, when ripe fruits and blossoms will be found on the same tree. The Indians considered this tree as a valuable article in their Materia Medica. They applied the bark, which is sedative and discutient, to painful tumors and . external inflammations. A cataplasm of the inner rind of the bark, is found to be very efficacious in re- moving painful inflammations of the eyes. The bark chewed in the mouth is, at first, somewhat bitter, verysensibly astringent;, and then leaves a pungent, sweetish taste, which will remain for a considerable time. The specific qualities of this tree seem, by no means to be accurately ascertained. It is probably possessed of very valuable properties. Cutler. Helenium autumnale. This is an extremely common plant in many parts of the Un- ion, growing generally along the margins of rivers, and flowering 43ft MATERIA MEDlCA from the latter part of tlic summer through the autumn. The leaves and flowers of this plant possess the sternutative quality in an eminent degree: Gut it is strongest in the flowers, and espe- ci.-illv in the florets of the disk. A very small quantity of florets reduced to a powder between the fingers, or otherwise, gives a strong and durable impression, when applied to the nose. .Such, indeed, is the degree and durability of impression, without at the same time, any of the violent and dangerous stimulus, which is tiie consequence of the application of thejuices and oth- er preparations of certain species of Euphorbia, of Veratrum al- bum, &c, that I do not hesitate to consider the Helenium autum- nale (or Sneeze-weed, as it is called in some parts of Virginia, &c.) as a valuable addition to the list of our useful medicines. It may be employed either by itself, or combined with other table matters; or along with sulphat of mercury, as a mercurial errhine, The good and important effects of these mercurial erv- bines, and even of the simple vegetable errhines, are frequently so obvious, that it is to be regretted that they are not more fre- quently resorted to by physicians, in cases of amaurosis, or gutta serena ; in cases of deafness, especially perhaps when the aflect- ion depends upon a morbid state of the eustachian tube ; in cases of rheumatic congestions of the jaws, &c. In all these cases the errhine medicines have often been employed with much advan- tage by physicians : and it is a fact that they sometimes give re- lief when other measures, more generally applied, have been ap- plied in vain. Helleborus trifolius. Golden-thread. Mouth Root. The root. Golden-thread is a very small plant found in wet swampy situa- tions. The stems are erect and naked. The leaves grow by threes at the termination of the stems and are circular and scol- loped. The white solitary blossoms appear in May. The roots appear singular, being thread shaped, running, and of a bright yellow colour. They possess a considerable degree of astrin- gency and bitterness, and have long been employed by the peo- ple in the country as a remedy in apthas and cankerous sores ia the mouths of children with considerable benefit. From the bitter property possessed by these roots they are supposed by some to be useful as a stomachic bitter. IIetjchera Americana. The Heuchera Americana is the next astringent. This is sometimes called American Sanicle. It is more commonly call- ed Alum-root. The root is a very intense astringent. It is the .MATERIA MEDICA. 43£ basis of a powder, which nas lately acquired some reputation in the cure of a cancer. I suppose all its virtue, in this case, depends iipon its astringency. I may here observe, that the disease of cancer is not confined to civilized nations. It is known among ©ur Indians. I am informed that the Cheerake cure it with a plant, which is thought to he the Hydrastis Canadensis, one of our fine native dyes. I do not believe that Heuchera has cured, genuine cancer ; but it seems certain, that it has proved very beneficial in some obstinate ulcers, which have been mistaken for cancer. In such cases, the astringent medicines are too much neglected. Humulus Lupulus. The common hop. The flowers. This perennial plant is a very strong bitter accompanied with a degree of aromatic flavour and some astringency 5 these are ex- tracted by water by infusion 5 by decoction the aromatic flavour is lost. Along with its bitterness it has a narcotic power : of this the popular remedy, sometimes successful, of a pillow of hops to procure sleep in the delirium of fever and in mania, is a proof. It accordingly, when given internally in a full dose, reduces the fre- quency of the pulse and procures sleep. It has been employed as an anodyne, either in substance, in the dose of three grains, or under the form of infusion or tincture. A cataplasm or ointment, prepared from it, has been also used as an anodyne application to cancerous sores. Hydrastis Canadensis.. This is a very common vegetable in various parts of the Uni- ted States ; particularly in the rich soil adjacent to the Ohio and its branches, in the western parts of Pennsylvania and Virginia ; and in Kentucky. The root of this plant is a very powerful bitter : perhaps not less so than that of the Zanthor- hiza. To the taste, however, it is unquestionably more pungent than the Zanthorhiza. When held between the lips, it even ex- cites a very considerable sense of pungent heat. The dried root has a strong and virose smell, very similar to that of the Zanthorhiza, but stronger. The infusion in hot water, smells very like the infusion of Zanthorhiza. The two infusions taste a good deal alike. Hyssopus officinalis. Hyssop. The herb- The leaves of hyssop have an aromatic smell, and a warm pungent taste ; they are particularly recommended 111 humoral asthmas, coughs, and other disorders of the breast and lungs j being supposed wonderfully to promote expectoration. Accor- 438 MATERIA MEDICi^ ding to Kay, these leaves are of grear service when applied in cataplasms to bruises, the pain of which they speedily mitigate, and at the same time disperse every mark or spot from the part affected. Inula Helenium. Elecampane. The root. This is a very large downy perennial plant, sometimes found wild in moist rich soils. The root, especially when dry, has an agreeable aromatic smell ; its taste, on first chewing, is glutinous and somewhat rancid, quickly succeeded by an aromatic bitter- ness and pungency. The ancients entertained a high opinion of elecampane, which is recommended for promoting expectoration in humoral asthma and coughs; liberally taken, it is said to ex- cite urine, and loosen the belly. In some parts of Germany, large quantities of this root are candied, and used as a stomachic, for strengthening the tone of the viscera in general, and for attenuating viscid humors. Its dose is from twenty to sixty grains powdered ; and in this form, it has been found, by experience, to possess considerable efficacy. Juglans Cinerea. Butternut. IVhite Walnut. The unripe fruit, and the inner bark. This tree is generally known throughout the United States, and is now introduced into the Materia Medica of the Massa- chusetts Pharmacopoeia. During the American war, the ex- tract made from the inner bark of this tree, attracted the at- tention of Dr. Rush, and other medical men in our military hospital ; and, being frequently administered to patients under the operation of inoculated small pox, it was proved to be an excellent substitute for jalap or other cathartics. It is now es- teemed as a valuable purgative, in doses from ten to thirty grains, not occasioning heat or irritation ; and is greatly com- mended in cases of dysentery. Conjoined with calomel it is rendered more active and efficacious, especially in bilious hab- its. As this extract is often very carelessly prepared by the country people, it ought to be prepared by the apothecaries, or practitioners themselves ; and as a domestic medicine of consid- erable importance, it should he, adopted by every physician. — The bark of the root of this tree will excite a blister ; and the bark and shells of the nuts dye a good brown colour. A de- coction of the inner bark is advantageously employed as a ca- thartic in the disease of horses, called the yellow water. The e tract shoud be made from the bark in the month of May or June. MATERIA MEDICA. 430 Jotjiperus communis. Juniper. The berries and leaves. This is an evergreen shrub growing on dry barren commons and hilly grounds in different parts of the United States as in Europe. If planted in a good soil it will attain the height of fifteen or sixteen feet, and produce numerous branches . It is remarkable that no grass will grow beneath this shrub. This tree has three spreading pointed leaves coming out together, that are longer than the berry. The wood is of a reddish ceiour, very hard and durable. Gum sandarach, more commonly cal- led pounce, is the product of this tree. The flowers are borne upon a conical catkin, the scales of of which serve the purpose of a calyx. The berries of the Juniper require two years be- fore they ripen, when they change from a green, or a blackish purple, to a bluish black colour. Juniper berries possess a strong not disagreeable smell, and a warm pungent sweet taste, which if they be long chewed, or previously bruised, is follow- ed by a bitterish one. Their predominant constituents are, an essential oil, and a sweet mucilaginous matter. To the oil, they are indebted for their stimulating,carminative, diaphoretic, and diuretic properties. They are most commonly used in the form of infusion, to which a little gin is added, as a diuretic drink in dropsy. The essential oil may be separated by distillation. It possesses the same properties in a higher degree, and imparts them to ardent spirits. The peculiar flavour, and well-known diuretic effects of Hol- land gin, are owing to the oil of juniper. Juniperus Virginiana. Common Red Cedar Tree. The leaves. The red cedar tree is a native of the United States, and grows to the height of fifteen or twenty feet. Its berries are smaller than those of the true juniper. In Virginia and Carolina the berries are distilled into brandy. The leaves of this tree are now brought into notice by the investigation of Dr. Aaron Dexter., Professor of Chemistry, and Materia Medica, in the University at Cambridge. He has found this to be the only species of ju- niper in the United States, whose leaves agree in their proper- ties with those of the savine, directed by Dr. Crowther, as the basis of the savine ointment. Lactuca sativa. Common Garden Lettuce. The herb. This plant, so valuable as an article of diet, abounds with a milky juice, which possesses all the characteristic properties of the opium of the shops, and may be procured from it in sufficient 440 MATERIA MEDICA. quantity, to repay any labour bestowed on it for this purp«se. The laudanum made from the opium of the lettuce increases the pulse in force and frequency, and produces generally the same effects as result from similar doses of common laudanum. It has been used with advantage in allaying the pain of chronic rheumatism, and colic ; in checking the frequent stools accom- panying diarrhoea; in allaying cough, &c. &c; and doubtless the plant may be advantageously cultivated for medical pur- pose.?, especially as the opium is procured after the period in which the plant is usefid for the table. Laurus Benzoin. During the late American war, necessity drove the inhabit- ants, in many parts of the United States, to seek for a substi- tute for some of the spices to which they had been accustom- ed. They used the dried and powdered berries of the Laurus Benzoin, which we call Spicewood, and Wild-Alspice-bush, and found them a tolerable substitute for alspice*. A watery infusion of the twigs and leaves of the Laurus Ben- zoin, is often given to children, with a view to destroy and dis- lodge worms, and is deemed an efficacious medicine in this case. Laurus Sassafras. Sassafras. The wood, root, and its bark. This tree is a native of North America, and is cultivated in Jamaica. The wood, root, and its bark are used ; they have a moderately fragrant smell, and a sweetish aromatic taste. Sas- safras is a warm aperient and strengthening medicine ; it has often been successfully given in the form of infusion and decoc- tion, for improving the tone of the stomach and bowels, in per- sons whose humors were in a vitiated state. The essential oil is highly stimulating and heating, and must be given only in very small doses, being a sudorific and diuretic remedy. The bark ie useful in intermittents ; and the oil is said to be efficacious, appli- ed externally to wens. Lavandula Spica. Lavender. The flowering spikes. Lavender is a well known small, shrubby, perennial plant, a native of the south of Europe, but frequently cultivated in our • " A decoction of the small twig's rrutkrs an agreeable drink in slow •• fevers, and is much used by the covin try people. I' is said the In- " dians esteemed it highly for its medicinal virtues." Reverend Dr. M Cutler MATERIA MEDICA. 441 gardens for the sake of its perfume. There are two varieties. Tlie flowers of both have a fragrant, agreeable smell, and a warm pungent, bitterish taste ; the broad leaved sort is the strongest in both respects, and yields in distillation thrice as much essential oil as the other ; it is also hotter and specifically heavier ; hence in the southern parts of France, where both kinds grow wilu, this only is used for tlie distillation of what is called oil- of spike. The narrow leaved, is the sort commonly met with in our gar- dens. Lavender is considered as a warm stimulating aromatic. It is principally used as a perfume. Leontodon Taraxacum. Dandelion. The root and leaves. An indigenous, perennial plant, growing in meadows and pas- tures, on road sides, ditch banks, &c. It produces a yellow flow- er, which blows from April to September, and has the remarka- ble quality of expanding early in the morning, and closing in the evening. The root, leaves, and stalk, contain a large proportion, of bitter milky juice, which possesses considerable activity. Its more immediate operation is, to remove visceral obstructions, and promote the urinary discharge : the dose prescribed by Boerhaave for this purpose, is four ounces, to be taken three or four times in a day ; and later experience has corroborated its great efficacy in dropsical and other complaints connected with a disordered state of the first passages. By modern writers dandelion is highly extolled in the treat- ment of chronic inflammation of the liver, or incipient scirrhus of that organ, and also in several chronic derangements of the stomach, in a dose of half a drachm of the extract twice a. day. Either a strong decoction or the fresh expressed juice, in doses from two ounces to four, two or three times within the twenty- four hours, will, however, be found more active preparations. Leonurus Cardiaca. Motherwort. The leaves. This is a very common indigenous plant, growing in waste places, and flowering in July and August. The stalk is square, the leaves are spear shaped and three lobed. The flowers are in thorny whorls, purplish within and white on the outside. — The leaves are opposite, two to each whorl. They have a Strong, disagreeable odour, and bitter taste. Motherwort was formerly supposed to be useful in some ner- vous and hysterical complaints, and as a strengthener of the stomach. Its medicinal virtues are not undeserving of notice. — Though rejected from pharmacopoeias, it will not readily be abandoned by the female class, being peculiarly adapted to some 86 -14si MATERIA MEDICA. constitutions when affected with nervous and hysterical agita- tions. An infusion of this plant is a common domestic medi- cine, taken at bed time, it composes and procures refreshing sleep in a manner similar to valerian, when it could not be ob- tained by the operation of opium. Linum csitatissimu-M. Common Flax. The seeds and their fixed oil. Linseed contains about one fifth of mucilage, and one sixth of fixed oil. It is therefore considered as emollient and demul- cent. The entire seeds are only used in cataplasms. The mu- cilage resides wholly in the skin, and is separated by infusion or decoction. The infusion is used as a pectoral drink, and in ardor urime, nephritic pains, and during the exhibition of cor- rosive sublimate. Flaxseed syrup is made by adding to two pints of the mueilage one pint of honey ; while simmering away Dy a gentle heat observe to take off the scum as it rises. This is highly useful in all kinds of coughs, and other diseases of the breast and lungs. The oil is separated by expression. It is one of the cheapest fixed oils; but is generally rancid or nau- seous, and unfit for internal use. These seeds, when reduced to powder and properly blended with hot water, form one of the most convenient and useful of cataplasms. The cake which remains after expression of the oil, contains the farinaceous and mucilaginous part of the seed, and is used in fattening cattle, under the name of oil cake. LlQUlDAMBAK ASPLENIFOLIUM. The Liquidambar asplenifolium* of Linna?us is well known bv the name of Sweet-Fern. It lias often been found useful in diar- rhoea. Other virtues have been ascribed to it.t Colden was informed, that the Indians chew the root of this vegetable, with a view to stop haemorrhages in recent wounds. Tins effect of the Sweet-Fern may, perhaps, meet with some credit from those who have witnessed the wonderful powers of small doses of the preparations of lead, in diminishing and stop- ping, almost immediately after their reception into the stomach, haemorrhages from the uterus, intestines, &c. • Comptonui asplenifolia of Aiton. t See Schoepf's Materia Medica, &c. p. 142. MATERIA MEDICA. 443 Liriodendron Tulipifera. Tulip bearing Poplar' Tulip tree. The bark of the root. A native and well known tree in the United States, called al- so American poplar, white wood, and in some parts of New- England improperly called cypress tree. It attains to a very large size, rising as high as any forest tree, and makes a noble and beautiful appearance when in flower, about the middle of May. This tree is remarkable for the shape of its leaves, hav- ing the middle lobe of the three truncate, or cut transversely at the end. The flowers are large and beli shaped ; calyx of three leaves, six petals to the corolla, marked with green, yellow, and red spots ; and many lance shaped seeds, lying one over anoth- er, and forming a sort of cone. The bark of the root has long been employed by medical men in the United States, as a to- nic, and when joined with various proportions of prinos virticil- latus, and cornus Jlorida, has afforded a remedy of equal effica- cy with Peruvian bark. It is a strong bitter, and considerably aromatic and antiseptic, and has been found particularly bene- ficial in the last stage of dysentery. The powdered root com- bined with steel dust is an excellent remedy in relation to the stomach. According to Dr. Barton, the bark is used in some parts in gout and rheumatism. A decoction of it is said to be a common remedy in Virginia for botts in horses. Lobelia cardinalis. The Cheerake use a decoction of the root of the beautiful Lo- belia Cardinalis, or Cardinal-Flower, as a remedy against worms. I have already mentioned the diuretic quality of another spe- cies of this genus, the Lobelia siphilitica. Malva sylvestris. Common Mallow* The leaves and flowers. This is an annual plant, growing in hedges, foot paths, and among rubbish. The whole plant abounds with mucilage. — The leaves were formerly often used in food, to prevent costive- ness. At present, decoctions of the plant are sometimes pre- scribed in dysenteries and urinary complaints ; though it is chief- ly employed in emollient cataplasms, clysters, and fomentations. Marrubium vulgare. Wliite Horelwunct The leaves. This is a perennial plant, which grows wild on road sides, and among rubbish. The leaves have a very strong, not disagreea- ble smell, and a roughish, very bitter taste. It is reputed to be 444 MATERIA MEDIC A. both attendant and resolvent; an infusion of the leaves m water, sweetened with hone}', is recommended in asthamtic and phthisi- cal complaints, as well as in most other diseases of the breast and lungs. They promote the fluid secretions in general, and liberally taken, loosen the belly. Dr. Withering observes that it was a favourite medicine with the ancients in obstructions of the viscera. He says, that it is the principal ingredient in the negro Caesars remedy for veg- etable poisons. That a young man who had occasion to take mercurial medicines, was thrown into a salivation which con- tinued for more than a year. Every method that was tried to remove it, rather increased the complaint. At length Linnaeus prescribed an infusion of this plant, and the patient got well in a short time. Melissa officinalis. Balm. The leaves. Balm is much cultivated in our gardens on account of its pleas- ant aromatic smell, resembling that of the lemon, and its fra- grant though roughish taste. It is principally employed in tiie form of a watery infusion, which is drunk in the manner of tea ; and in acute fevers, when acidulated with the juice of lemon, it is an useful diluent. Mentha viridis. Spearmint. The herb- Spearmint is perennial and grows on the banks of rivers, and in watery situations ; and flowers in the months of July and Au- gust. The leaves have a warm, roughish, somewhat bitterish taste ; and a strong, not unpleasant, aromatic smell. Their virtues are stomachic and carminative. Mentha piperita. Peppermint. The herb. Of the different mints, this is the one which has the greatest degree of pungency. The leaves have a strong, rather disa- greeable smell, and an intensely pungent aromatic taste, resem- bling that of pepper ; and accompanied with a peculiar sensa- tion of coldness. They afford an essential oil, rich in the aro- matic quality of the herb- It also contains a small portion of camphor. Peppermint is used as a stimulant and carminative, to obviate nausea or griping, or to relieve the symptoms resulting from flatulence, and very frequently to cover the taste and odour of other medicines. It is also an excellent stomachic, of great use in flatulent colics, languors, and hysteric cases, and in vomiting. It is used under the forms of the watery infusion, the distilled MATERIA MEDICA. 445 water, and the essential oil. This last being dissolved in a due proportion of rectified spirit of wine, and coloured with green grass, forms the essence of peppermint of the shops ; a fashiona- ble and pleasant carminative, which, when taken on sugar, im- parts a glowing taste, sinking into the tongue, and extending its effects through the whole system, instantly communicating a glowing warmth. Myrica cerifera. Dwarf Candleberry Myrtle. Bayb&rry. The bark of the root. There are in the United States several species of this plant, from which myrtl-s wax is obtained in abundance. The dwarf candleberry myrtle, commonly called in the New England States, bayberry, is a plant which possesses considerable medi- cinal virtues. The bark of the root is much employed by com- mon people in jaundice, from obstructions to the flow of bile. — This medicine has been employed by the aborigines as a mild emetic. According to Dr. James Mann, of Wrentham, who has used the bark in powder, its strength is equal to ipecacuanha. — ■ A more particular acquaintance with its medicinal properties ought to be attempted by practical experiments. Orobanche Virginiana. The Orobanche Virginiana, or Virginian Broom-rape, is a very common plant in many parts of North-America. Michaux says that it grows from Canada to Georgia. It is generally, if not always, found under the shade of the American Beach-tree (Fagus ferruginea)*. Hence one of its names, in Pennsylvania, viz. " Beach-drops." But it is much more generally known by the name of Cancer-root.t Panax quinquefolium. The celebrated Ginseng, or Panax quinquefolium, may, with propriety, be thrown into the class of stimulants^ . I find it dif- ficult to speak of this plant with any degree of certainty. If it were not a native of our woods, it is probable that we should im- port it, as we do the teas of China and Japan, at a high price. * Michaux entirely restricts its habitation to the root of the Beach : " In radice Fagi nee alia: plants:." Flora, &c. Tom. II. p. 26. f See Elements of Botany, &c. Part Third, p. 80. t The Ginseng is by no means a powerful stimulant. It is not very happily arranged in the class of JWedicamenta Stimulantia, or Incitantia.- The Indians make use of a tea prepared of the leaves as well as the root of this plant. But I cannot learn, that they so highly esteem the Ginseng as their Tartar brethren in Asia do. 44G MATERIA MEDICA. Phttola* ca becandra. American Nightshade. Garget. The leaves, berries, and root. This is one of the most common North American plants, well known in New-England by the name of cunicum, skoke, or coakum. In the southern states it is called pokeweed. It has a t!;ick, fleshy, perennial root as large as parsnips. From this rise many purplish herbaceous stalks, about an inch thick, and six or seven feet long ; which break into many branches irregu- larly set with large, oval, sharp pointed leaves, supported on short foot stalks. These are, at first, of a fresh green colour, but as they grow old they turn reddish. At the joints and di- visions of the branches, come forth long bunches of small bluish coloured flowers, consisting of five concave petals each, sur- rounding ten stamina and ten stiles. These are succeeded by round depressed berries, having ten cells, each of which con- tains a single smooth seed. The young stems when boiled are as good as asparagus, but when old they are to be used with caution, being a plant of great activity, operating both as an emetic and cathartic. A tincture of the ripe berries in brandy or wine, is a popular remedy for rheumatism and similar affec- tions ; and it may be given with safety and advantage in all ca- ses where guaiacum is proper. The extract of the juice of the ripe berries has been employed in some cases of scrofula • and cancerous ulcers have been greatly benefitted by its application* The juice of the leaves, however, is said to be more effectual. Dr. Shultz in his ingenious inaugural dissertation on this sub- ject, observes, that « scabies and herpes have been often remov- ed by it. In these cases, a solution of the extract in water is generally substituted where the expressed juice cannot be had. In rheumatisms, the whole substance of this plant has at differ- ent times been of essential service ; although the berries have generally been preferred. In those rheumatic affections which sometimes occur to syphilitic patients, its virtue far exceeds that of opium : and it seems more valuable than guaiacum, especial- ly when combined with mercury. H For medicinal purposes, the leaves should be gathered about July, when the foot stalks begin to assume a reddish colour, dri- ed in the shade, and powdered for use. An extract may easily be obtained fpom the leaves when gathered at this period, by gently evaporating their expressed juice to a proper consis- tency." A tincture may be made by dissolving either the extract or the leaves, in their green or dry state, m common brandy, or m the spirit distilled from the berries. An ointment is also made by powdering the dried leaves, .and g them svell with hog's lard, or simple cerate j or by boil. MATERIA MEDICA. 447 ■ing some hog's lard and bees wax with fresh leaves, and strain- ing the mass. The proper time for gathering the berries in this climate is in October, when they become soft and ripe, and are of a blackish colour. The root is to be gathered about November or December, when the stalks of the plant are perfectly dead, and to facili- tate drying, it should previously be divided into small pieces. — An extract may be made from the root in the same manner as from the leaves or berries. It is affirmed by a physician of reputation and experience, that the leaves of phytolacca decandra have been found an ad- mirable remedy in hajmorrhois. A strong infusion is given in- ternally, and if it does not speedily relieve, the same infusion is to be injected into the rectum. This method will in general ef- fect a perfect cure. According to the experience of. Drs. Jones and Kollock, of Savannah, this plant may be relied on as an effectual remedy for syphilis in its various stages, even without the aid of mercu- ry ; and they employ it with much confidence, both internally and externally iu rheumatisms, and in cutaneous eruptions. — One ounce of the dried root infused in a pint of wine, and giv- en to the quantity of two spoonsful, operates kindly as an emet- ic. The roots are sometimes applied to the hands and feet of patients in ardent fevers. Many country people use the extract with great confidence in its efficacy in discussing indolent tu- mors, and in healing various kinds of ulcers. It is found to ope- rate as a mild vegitable caustic, cleansing and healing foul ulcers better than most other remedies of that class. In three cases of apparent Jistula lachrymalis, it is reputed to have performed cures, by being applied to the tumors twice a da^ for two or three weeks. This root has also been employed in compounds as an article of dying. Pimpinella Anisum. Anise. The seeds. Anise is an annual umbelliferous plant, growing naturally in Crete, Syria, and other places of the East. The seeds of anise have an aromatic odour, and a warm taste with a share of sweetness. They afford by distillation with wa- ter, a considerable quantity of an essential oil, having a strong flavour, and a sweet taste without pungency. Anise is used as a good carminative in dyspepsia, and in the flatulence to which children are subject. A drachm or two of the seeds may be taken, or a few drops of the oil rubbed with, sugar. tm MATERIA MEDICA. Plantago major. Plantain. The leaves. Great plantain is perennial, common in fields and by the road sides, flowering from June to August. The country people ap- ply the bruised leaves of this vegetable to slight wounds, and inflamed sores and swellings with a favourable effect. It has been recorded in a Virginia gazette, 1802, that a gentleman was bitten above the knee by a venomous spider. In a few min- utes be observed a pain shooting upwards from the spot, which presently reached h;s heart. A quantity of plantain leaf was immediately procure';, and the juice being bruised out was swal- lowed largely, by which the progress of the poison was stopt, and finally a cure was effected. Some oil was also swallowed, but the plantain leaf had the entire credit of his recovery, and but for this remedy, he said he could not have survived an hour longer. Podophyllum peltatum. May apple. Mandrake. The root. This plant is very common throughout North America. The fruit is esculent, and by many, thought delicious. The leaves are poisonous. The root is an excellent purgative in doses of twenty grains. It is most advantageously used in combination with calomel, or crystals of tartar. The root, also, often ope- rates as anthelmintic, and as such, it is used by the Cherokee and other Southern Indians. The best time of gathering the May apple, for medical pur- poses, is in autumn, when the leaves have turned yellow, and are about falling off. The Indians dry it in the shade, and powder it for use. Polygala Senega. Seneka. Rattle Snake Root. The root, Seneka is a perennial plant, which abounds in nearly all the United States, particularly in Virginia and Pennsylvania. This root is usually about the thickness of the little finger, variously bent, and contorted, and appears as if composed of joints^ whence it is supposed to resemble the tail of the animal whose name it bears ; a kind of membranous margin runs on each side, the whole length of the root. This root was first introduced into use in 1739, by Dr. Ten- nent, of Virginia, who wrote a pamphlet on the subject, and highly extolled 't as a remedy for many complaints, and par- ticularly, as a specific for the cure of the bite of the rattle-snake. It is an active stimulus, and increases the force of the circula- tion, especially of the pulmonary vessels. It has therefore been found useful in typhoid inflammation of the lungs, but it is apt te MATERIA MEDICA. 4# disorder the stomach, and to induce diarrhoea. Some have likewise employed this root in hydropic cases, and not without success. There are examples of its occasioning a plentiful discharge by stool, urine, and perspiration ; and by this means removing the disease, after the common diuretics and hydragogues had faded. It sometimes induces salivation, and it possesses diuretic, em- etic, cathartic, expectorant, and diaphoretic powers. Dr. Arch- er, of Maryland, discovered the great utility of seneka snake-root, as a remedy for that fatal disease, the croup, and speaks with confidence as to the general good effects produced by it. The decoction of the root is the manner in which he generally gives it; the strength must be determined by the physician; it must be so strong, as to act sensibly on his own mouth and throat, in exciting coughing, &c. for in this disease, the larynx (mouth of the wind pipe) in a manner loses its natural sensibility. Half an ounce of the root of seneka, bruised, and simmered in a close ves- sel, in half a pint of water, until reduced to four ounces, will, probably, in most cases be sufficiently strong. A tea spoonful of this to be given every hour or half hour, as the urgency of the symptoms shall demand ; and during these intervals, a few drops occasionally, to keep up a sensible action of the medicine, in the mouth and throat, until it act as an emetic and cathartic ; then repeated in small quantities, and so frequently as to keep up a constant stimulus in the same. By these means, in the course of two, four, six, or eight hours, a membrane is often times dis- charged by the mouth, one, two, and often three inches in length $ sometimes it is swallowed and voided by stool. Patients who use the medicine should not be permitted to drink any thing whatever, for some minutes after each dose. The reason must be obvious to all. The powder has lately been used by Drs. Archer and Son, in doses of four or five grains, mixed with a little water, with effects equally as pleasing as the decoc- tion, and more so, unless the latter have been carefully prepared. It should be remarked that this powerful stimulant cannot with safety be exhibited during the inflammatory stage of croup. It is in the third or last stage only, it has been found extremely use- ful in exciting the vessels of the trachea and lungs to a powerful' excretion. Seneka has been usefully employed in the decline of pleurisies and catarrhs, to promote expectoration. In suppressed coughs of aged persons, and in asthma, it is doubtless useful; a ge.itle and constant stimulus on the throat should be kept up in these diseases. It has also been exhibited as a powerful remedy in cases of female obstructions. Dr. Chapman of Philadelphia has found it of great utility in obstinate amenorrhea when given in decoction prepared by adding an ounce of the root to a pint of 57 450 MATERIA MEDIC A boiling water, which is slowly reduced by simmering to the quan- tity of one third. Four ounces of the decoction is to be taken during the day, increasing it when the menstrual effort is expect- ed, as far as the stomaeh will allow. If this excite nausea, he adds aroinatics. To prevent disgust, it is omitted a week or two in the intervals of the menstrual periods. The polygala san- guinea, a new species discovered at Savannah, has been used as a substitute for the polygala seneka. Prinos Yerticillatur. Winter Berry. Black Alder. The bark and berries. This is a very common shrub in many parts of the United States, and grows in the greatest perfection in swamps and mar- shy places. The bark is manifestly astringent. It is likewise considerably bitter, and pungent. The berries, which are of a fine red colour, greatly partake of the hitter quality ; and, if infused in wine or brandy, might be ad- vantageousiy employed in cases win re hitler tinctures are exhib- ited. The bark has been used as a substitute tor the Peruvian bark, in intermittents and other diseases, both in substance and decoction. It is supposed to be chiefly useful in cases of great debility unaccompanied with fever, as a corroborant in anasar- ca is and other dropsies, and as a tonic in cases of incipient spha- celus or gangrene. It is both given internally, and employed ex- ternally as a wash. On many occasions, it appears to be more useful than the Peruvian bark. Professor Barton says, it ought to have a place in the shops, and in the pharmacopoeia of this country, when such a desideratum shall be supplied. Dr. Mease observes, (Philadelphia Medical Museum, vol. 2.) it is useful in mortification, united with the root of sassafras, in decoction, &c. Care must be taken to distinguish our prinos from the swamp al- der or candle alder. Pruxus ViRGiSiANA. Wild Cherry Tree. The bark of the tree and root. The common wild cherry tree is often found in woods and and is associated with the trees of the forest, growing to ight of forty or more ieet and of a very large size. The g im which exudes from the tree is said to be equal to gum ara- ble. This tree produces in Autumn a small bitter cherry, black when quite ripe, which serves for food for birds who frequently become intoxicated from eating them. They also are infused in brandy by the country people on account of tbe pleasant aromatic flavour which they impart to the liquor. The bark of the wild tree is powerfully tonic, and has been frequently substi- MATERIA MEDICA. 451 tuted for the Peruvian bark, with great success. It is slightly- narcotic, and commonly produces a drowsiness in those who take it. From the experiments of Mr. C. Morris of Virginia, (Inaug. Diss. 1812, Phila.) it appeared that the bark of the root was more powerful than the bark of the trunk. It has been very useful in dyspepsia and in consumption of the lungs. The Indians it is said, use the bark in the cure of syphilis. Very excellent effects have been produced by washing ill conditioned ulcers with a de- coction of the bark, and the same has proved anthelmintic. The leaves of the tree are poisnoHS to certain animals. While this valuable tree abounds in the United States, we act unwisely, says Dr. Mease, in sending thousands of dollars out of the countxy for the Peruvian bark. Pyrola umbellata, Gf the Pyrola umbella.ta I have made no mention in the first part of this work. It is a very common North-American plant, and is sometimes called Ground-Holly, but is much better known (at least in New-Jersey and in Pennsylvania) by the name of Pippsisseva*, which is one of its Indian appellations. In the sex- ual system of Linnaeus, it belongs to the same class and order (Decandria monogynia) as the UvaUrsi. It also belongs to the same natural assemblage of plants as the last mentioned vegeta- ble, via. : the order Bicomes of Linnanis, and the order Ericce of Mr. de Jussieu. The two plants are, unquestionably, nearly allied to each other in respect to their botanical affinity, as well as in their medical properties. The pyrola is considerably astringent, and the quantity of as- tringency appears to be nearly the same in the leaves and in the stems. Hitherto, it has not greatly excited the attention of physicians. But I think it is worthy of their notice. A res- pectable physician, in East-Jersey, informed me, that he had employed this plant, with manifest advantage, in the same cases in which Uva Ursi has been found so useful. This looks very probable : for it would seem, from many facts, that the lithon- triptic powers of the Uva Ursi, are, in no small degree, owing to the astringent quality of this plant : and, " perhaps, upon the " whole (as an eminent practitioner!" has observed,) we shall u find it no better than other vegetable astringents : some of a which have long been used by the country people, in gravelly * Perhaps, Pkipsseatua. f Dr. Withering-. See A Systematic Arrangement of British Plants, &c, ■VW.II. p. 391. London: 1801. 45ii MATERIA MEDICA. " complaints, and with very great advantage : though hitherto " unnoticed by the regular practitioners.*'' The Pyrola, as I am informed by my pupil Dr. John S. Mitch- ell, has been used, with good effect, in some cases of intevniit- tents. In one case, its diuretic operation was evident. u The " urine discharged was almost black. It appeared as if a few K drops of a solution of the sulphat of iron had been put into an " astringent infusion." This was a solitary occurrence, and one which I am unable to explain. For more ample information concerning this vegetable, I beg leave to refer the reader to Dr. Mitchell's Inaugural Essay m the Arbutus Via Ursi, and the Pyrola umbellata and maeutata of Lirin'aeusf. Prefixed to this dissertation, there is a good figure of the Pyrola umbellata. Tiie bruised leaves of this plant, when externally applied, sometimes induce redness, vesication and desquamation of the skin. But this is by no means a constant operation of the veg- etable ; and therefore, it does not seem particular!} 7 - worthy oi our attention, in this point of view. Quercus alba. Oak. The bark. White oak bark exceeds in astringency the Peruvian bark and falls but little, if any short of it, in its tonic powers. Hence, we have a valuable domestic substitute for Peruvian bark, which is successfully employed in baemorrhagies, alvine fluxes, and other preternatural or immoderate secretions. On account of the great difficulty in reducing it to a sufficiently fine powder, it is most commonly given in decoction. Ranunculus bulbosus and sceleratus. The Ranunculus sceleratus, or Celery-leaved Crowfoot, is a very acrid plant. If it be bruised, and laid upon any part of the bod}-, it will, in a few hours time, raise a blister. This plant is a native of Europe and of America. The Ranuncu- lus bulbosus, called Bulbous Crowfoot, and Butter-cups, possesses the same properties. This plant grows very plentifully in our meadows and fields ; but I believe it is not a native. * I cannot forbear mentioning in this place (at the risk, perhaps, of exposing- myself to the ridicule of the mere theorist,) that the nuclei, or kernels, of the common American Hazlenut (Corylus Americana) have been found very useful in affording relief to several persons labouring under nephritic and perhaps calculous affections . 1 mention this fact on the respectable authority of my frind, Dr. Frederick Kuhn, of Lan caster, in Pennsylvania. Do these kernels act solely by virtue of then- astringent quality ? j Philadelphia : 1803. MATERIA MEDICA. 453 The Ranunculus bulbosus. Every part of tins species of Ra- nunculus is endued with an acrid quality. But it is especially the bulbous-like root which has frequently been used as a sub- stitute for cantharides. Where the foreign and native species of blistering-flies cannot readily be procured, this Ranunculus ought not to be neglected. I have employed it, and am dispos- ed to think, that it gives a more durable irritation to the part to which it is applied, than the anima 1 blisters which I have mentioned. If this suspicion be well founded, it will not be de- nied, that there are cases in which the Ranunculus ought even to be preferred to those blisters. Among other such cases, I may mention vertigo, and affections of the stomach, both originating in a misplaced or irregular gout. I must not omit to add, that the roots of the Ranunculus, that are collected in the fall, may be very well preserved through the winter, by burying them in some fine, siliceous sand. When thus preserved, they retain, with very little diminution, their active irritating quality. Rhus Copallinum. Narrow leaved Sumach. The berries. Narrow leaved Sumach, grows naturally in most parts of the United States j rising to the height of six feet in a slaty gravelly soil. The berries are very acid, and are sprinkled with a gray? ish pounce, of an agreeable acid taste. Rhus Glabeum. Pennsylvanian Sumach, The berries. Rhus glabrum, smooth Pennsylvanian sumach, common or upland sumach, rising to the height of eight or ten feet. The leaves are feathered, sawed 5 lanced, naked on both sides, and change to a beautiful red in autumn : it flowers in July. The seeds are arranged like the flowers, are red, and covered with a white powder of an agreeable acid taste. The two species above described are considerably astringent. An infusion of the berries sweetened with honey is sometimes used for a gargle in sore throats, and for cleansing the mouth in putrid fevers. They are also recommended as useful in several of the arts. The leaves or berries are found a valuable substi- tute for nut galls in dyeing or making ink, they give a deep and permanent black. The plants in all their parts may be us- ed as a succedaneum for oak bark in tanning, especially the white glove leather. Rhus Typhinum- Virginian Sumach. Stag's Horn. Vinegar Plant. The berries. This plant grows naturally in almost every part of the United Slates. In Virginia and Pennsylvania, it rises to the height of i54 MATERIA MEDICA. twelve or fifteen feet, with a trunk of six or eight inches in diam- eter. The young branches are covered with a soft velvet-like down, and from their resemblance to the horn of a stag, the common people have given it the appellation of stag's horn. The llowers are produced in close tufts at the end of the branch- es, and are succeeded by seeds inclosed in purple, coolly, succu- lent covers ; so that the branches are of a beautiful colour in autumn. This plant resembles in its properties the rhus copallinum and glabrum. Ribes rubrum. Currant tree. The fruit. The fruit of the red, and white currants of our gardens are greatly esteemed for their pleasant and nutritive qualities. In fevers, the juice of currants, when mixed with an equal quan- ity of sugar, and made into a jelly, is cooling and grateful to the stomach ; being in a slight degree astringent and antiseptic. Currant wine, with the addition of water, is an excellent beverage during the heat of summer. Various receipts are given for mak- ing this liquor in the Dom. Encyclopedia. Ribes nigrum. Black Currant is found growing, naturally, near Kennebeck river, and it is also cultivated in gardens. This fruit is reputed to be very wholesome, and their juice is frequently boiled down into an extract or syrup with sugar, in which state it is called rob, and much esteemed in sore throats of the inflammatory kind. — The fruit is often put into rum or brandy instead of black cherries. An infusion of the young roots is useful in fevers of the eruptive kind; and in the dysenteric fevers of cattle. Rosa Gallica. Red Rose. The petals. The Gallica, French or common red rose, has large, spreading, half double, deep red flowers. It has not the fragrance of the damask rose, but the beautiful colour of its petals, and their pleas- ant astringency, have rendered them officinal. It must however be remarked, that their odour is increased by drying, while that of the damask and moss roses is almost destroyed. Rosa Dajiascena. Damask Rose. The petals. This is justly termed the queen of flowers, and both its elegance and fragrance have rendered it the favourite ornament of ereiy MATERIA MEDIC A. 455 garden. It is sometimes called Dutch hundred leaved ro§e. The damask rose yields on distillation, a small portion of buty- rons oil, together with a water, which possesses the odour mid taste of the roses, and are generally esteemed for the agreeable flavour they impart to culinary preparations, and also to cordials, A valuable perfume is obtained from'the flowers by distillation,, called ottar or essence of roses. The true ottar of roses is sold in. the East Indies, at the exorbitant price of twenty guineas and upwards per ounce. It is doubtless the most elegant perfume m vegetable nature ; as a single drop imparts its fragrance through- out the room or dwelling, and suppresses other less agreeable odours. Rumex aquaticus. Water Dock. The root and leaves; It grows in peat marshes, wet ditches, pools, at the side of rivers, and in shallow water. It flowers in July and August, and is succeeded by large seeds. This plant affords a medicine of considerable efficacy, when applied externally, as awash for spongy, putrid gums ; its roots when pulverize^ have been found excellent for cleaning the teeth. These roots are of a bitter, astringent taste, and have often been employed for the cure of scorbutic and cutaneous disorders, whether administered inter- nally, or applied externally in ointments, cataplasms, lotions, or fomentations. Decoctions of the leaves are, likewise, an effica- cious laxative, and have been taken with advantage in rheumatic pains, and chronical diseases occasioned by costiveness, or by visceral obstructions. The dose usually given, is a decoction of half an ounce of the fresh roots, or from one to two drachms of them, in a dry state. The Indians, says Dr. Cutler, used the root of water dock with great success in cleansing foul ulcers- It is said, they endeav- oured to. keep it a secret from the Europeans. Dr. Withering says, he saw an ill conditioned ulcer in the mouth, which had destroyed the palate, cured by washing the mouth with a decoction of this root, and drinking a small quan- tity of the same decoction daily. Rumex acutus. Narrow Dock. ~) m, root<5 Rumex crispus. Curled Dock. 3 ? These grow about barn yards and in cultivated fields, flowering in July. The roots of both species are somewhat cathartic. The seeds are said to have been given with advantage in dysen- tery. The fresh roots bruised and made into an ointment or decoction cure the itch. Some instances have occurred among the eountry people, of ill conditioned ulcers, and hard tumors 456 MATERIA MEDICA. apparently of a cancerous nature, having been entirely removed by the application of the bruised roots of dock or a decoction of the same. RuTA grayeolens. Rue. The herb. This is a small shrubby plant met with in gardens, where it flowers in June and holds its green leaves through the winter. It has a strong ungrateful smell, and a bitterish, penetrating taste : the leaves when in full vigour, are extremely acrid, insomuch as to inflame and blister the skin if much handled. Former writers on Materia Medica have entertained a very high opinion of the medicinal virtues of this plant, and it is still retained in the Mas- sachusetts and other Pharmacopoeias. It has been considered as powerfully stimulating, attenuating, and detergent, and hence, in cold phlegmatic habits it quickens the circulations, dissolves tenacious juices, opens obstructions of the excretory glands, and promotes the fluid secretions. Boerhaave is extravagant in his praises of the essential oil and distilled water of rue, for their efficacy in promoting sweat and perspiration, and for the cure of the hysteric passion and of epilepsies, and for expelling poison. In modern practice, me is not regarded as possessing much power as a remedy. Salix alba. White Willow. The bark, and the bark of the root. The species or varieties of the willow, which have been noticed by botanical writers, are very numerous ; and it is probable that the bark of all of them possesses properties in many respects similar. In 1?63, Mr. Stone, an English clergyman, presented a paper to the Royal Society, on the beneficial effects of the salix alba, or white willow, in intermittent fevers ; and Dr. Cullen, on this authority, and from the sensible qualities it possesses, re- commends it, in his Materia Medica, as a substitute for the cinchona. Mr. Stone gathered the bark in summer, when it was full of sap ; dried it by a gentle heat, and gave a drachm of it powdered every four hours, betwixt the fits. In a few obstinate cases he mixed it with one-fifth part of the cinchona. Some judicious physicians here, says Dr. Cutler, made trial of the bark of white willow, and recommended it as a valuable substitute for the Peruvian bark. They have used principally the bark of the root. Salvia C'Ticinalis. Sage. The leaves. The leaves of the sage have a peculiar aromatic smell, and a worm aromatic taste, with some degree of bitterness and astrirt- jenev. MATERIA MEDIC A, 457 •In itseflects, sage agrees with other aromatics. It is stimulant, carminative, and tonic. In cold, phlegmatic habits, it ex- cites appetite, and proves serviceable in debilities of the ner- vous system. The best preparation for these purposes, is an infusion of the dry leaves, drank as tea ; or a tincture, or extract, made with rectified spirit, taken in proper doses ; these contain the whole virtues of the sage ; the distilled water and essential, oil, only its warmth and aromatic quality, without any of its roughness or bitterness. Aqueous infusions of the leaves, with the addition of a little lemon juice, prove an useful diluting drink in febrile disorders, feeing sufficiently agreeable to the palate. SlLENE VIRGINICA. The Silene Virginica, or Ground-Pink, as it is called in some parts of our country, is another native anthelmintic. A decoc- tion of the root is used, and is said to have been found a very efficacious remedy*. Scutellaria lateriflora. Blue Scull-cap. Hooded Willow Herb. The plant. The Scutellaria is perennial, of. which there are numerous species indigenous to the United States. The plant is found in great abundance on the banks of rivers and the borders of ponds ; flowering in July or August. The stem is square, branched, and attains the height of from one to three feet. The leaves are opposite, narrow pointed, on long foot stalks. The racemes are axillary and latent, bearing small violet coloured blossoms, intermixed with small leaves. The calyx is hooded, or helmet-formed, from whence originated the generic name of Scuil-cap or Scutellaria. It is now introduced here on account of its recently reputed efficacy as an antidote against the effects of canine madness. Should this plant ultimately prove a success- ful remedy for a disease so truly deplorable in its nature, and. destructive in its consequences, no encomflims can surpass its merits even if recorded in letters of gold. The remedy was tor many years a secret, in the possession^ a family by the name of Lewis, in West Chester county, and 'in 1809 it was promulga- ted by Mr. R. Bovvne, of New York. To the publication of Mr. B. [Med. Repos. Hexade 3. Vol. 2. No. 3.] was annexed an ac- * From the information of my friend, the late learned Dr. James Green- way, of Virginia. — This species of Silene, or Catch-fly, grows abundantly in many parts of the United States, as in Pennsylvania, Virginia, &c. &c. Some of our Indians have told me, that it is a poisonous plant. This is highly probable, if it be a fact, that it is a very efficacious anthelmintic. m 458 MATERIA MEDiCA. curate engraving of this species of Scutellaria, yet in his descrip tion he erroneously attached to it a specific name belonging to 1 a different species, the Scutellaria Galericulata. This last spe- cies is to be distinguished by its axillaiy flowers in pairs, on pe- dicles from the ake of the leaves, and pendulous. With regard to the anti-rabid virtues of Scutellaria, it is to be observed, that subsequent to its promulgation, it has been in- vestigated and tested by practical experiment, so far as oppor- tunity and the nature of the subject permit. A mass of evi- dence in favour of its efficacy may be found in a production entitled " Observations on Hydrophobia," lately published by the compiler of this work. As, however, it is still doubtful, and yet desirable to have the fact clearly ascertained how far this plant is entitled to the character of a specific preventive of hydro- phobia, every human person must consider himself warranted in resorting: to the use of it on any occasion which may offer, either of alleviating the misery and distress of mankind, or of arresting the devastation among the brute creation. This remedy is to be given in the form of strong infusion of the leaves every morning, fasting, and to be continued for sev- eral weeks. For cattle it may be mixed with their food oir drink. Sixapis ajlea» White Mustard. Sixapis nigra. Black or common Mustard. The root. These plants are both annual, both grow wild in England, and possess similar virtues. They produce small round compressed seeds, which have an acrid bitterish taste, and a pungent smell when reduced to powder. The common mustard has blackish seeds, and is more pungent than the white. They impart their taste and smell in perfection to aqueous liquors, while rectified spirit extracts extremely little of either. The whole of the pungency arises with water in distillation. Committed to the press, they yield a considerable quantity of a soft insipid oil, perfectly void of acrimony ; the cake left after the expression, is more pungent thaft the mustard itself. The imported mustard^ so common at tallies, and which is generally preferred to our^jwn, is the pulverized seed of the black species ; the difference insists only in the preparation of the powder. The seeds unbruised are frequently given in palsies and chro- nic rheumatisms, and are found beneficial. They may be tak- en in the quantity of a table spoonful or more, and will gently relax the bowels. Rheumatic pains in the stomach are often relieved by taking them in brandy. The powdered seeds, with crumbs of bread and vinegar, are made into cataplasms, and applied to the soles of the feet in £e\cvr>. when stimulants are MATERIA MEDICA. 459 wecessajfy. They are also topically applied in fixed rheumatic and sciatic pains. Dr. Withering says, wherever we want a strong stimulus, that acts upon the nervous system without ex- citing much heat, we know none preferable to the mustard seed. An infusion of the seed, given in large quantities, vomits ; but in smaller doses, operates as an aperient and diuretic. Mustard whey, with wine, is used as a drink in fevers. Its acrimony is said to consist in an essential oil. Mustard whey is made by boiling one and half ounce of the bruised seeds in a pint of milk, and as much water, till the curd be perfectly separated. This is perhaps the most elegant form in which mustard can be exhibited. A little sugar may be ad- ded, and an ordinary tea-cupful given four or five times a day in cases of low nervous fever, greatly warms and invigorates the habit, and promotes the different secretions. Solanum dulcamara. Bitter Sweet. Woody Night Shade. The twigs. This plant grows wild in moist hedges ; has wood)^, brittle stalks, and climbs on the bushes. But if there be no shrubs in their vicinity, the shoots creep along the ground, and frequently strike new roots. It flowers in the months of June and July. — The taste of the twigs and roots, as the name of the plant ex- presses it, is both bitter and sweet ; the bitterness being first perceived, and the sweetness afterwards. The dulcamara was formerly much esteemed as a powerful medicine. It is generally said to occasion some considerable evacuation by sweat, urine, or stool, particularly the latter. It has been recommended as a discutient and resolvent medicine ; and it has been said to have been attended with good effects in obstinate cutaneous diseases of the herpetic kind. It has also been used, and sometimes with advantage, in cases of rheu- matism, jaundice, and obstructed menstruation. i The twigs are principally employed under the form of wate- ry infusion, in doses of two teacupsful, morning and evening. Dr. Hill has found it very efficacious in the asthma. SophorA Tinctoria. Linn. ~) Wild Indigo. Indigo Weed*- Podalyria Tinctoria. Mick. 5 The root and plant. This vegetable is indigenous, and supposed to be exclusive^ American. It is perennial, growing in great abundance in al- most every barren pasture and in woods. The stalk rises to two feet or more, sending off numerous branches. The leaves are small, ternate, inversely heart shaped, and sessile. Iu July .and August all its branches display, butterfly shaped, golden 460 MATERIA MEDICA. coloured blossoms, which render the plant very conspicuous. — The seed vessels are inflated, containing numerous seeds. The root is ligneous, rough, and irregular in shape, of a dark brown colour externally, and sending off many long slender branches. Its taste is unpleasant, subacrid, and nauseous, very similar to that of ipecacuanha. I he pnrticular medical properties of indigo weed are yet to be ascertained ; that it possesses great activity is unquestionably true; those who in the spring season have made the young shoots a substitute for asparagus experienced its drastic evacuating powers. In the hands of some physicians it is found to operate in a laige dose, with much severity as an emetic and cathartic. But a weak decoction of the root has frequently been given with the effect only of a mild laxative. — A decoction of the bark of the root has, it is said, been made known by an empiric experienced in its use, as a remedy in scarlatina anginosa, and its employment has been extended in a few instances to typhus or putrid i'e\er with such good effect as to encourage farther trials. An experienced physician considers it as an excellent antiseptic and febrifuge, preferring it in some fevers to Peruvian bark. As an external application, its anti- septic qualities ought to be more extensively known. In the form of fomentation or cataplasm, it has proved eminently hene- f/cial when applied to phagedenic and gangrenous ulcers, espe- cially if the decoction be administered internally at the same time. A liniment prepared by simmering the cortical part of the root in cream, has been found an efficacious application to sore nipples and ulcerated breasts. A violet or pale blue colour has been prepared from the leaves and small branches of this plant and used as a substitute for indigo. The leaves turn black when dried. Spigelia Marilandica. Carolina Pink. The root. This plant is perennial, and grows wild in most of our south- ern states. The roots are celebrated as an anthelmintic, par- ticularly for the expulsion of lumbrici from the alimentary ca- nal. Every part is possessed of the anthelmintic property, though the root is most active. It is commonly administered in the form of infusion ; an emetic is generally premised, and its purgative effect assisted by some suitable addition, as senna or jalap. By some the powdered root is directed in doses of ten or fifteen grains ; while others prescribe it in drachm doses. But it should be observed that according to the late Dr. Lining, of Charleston, when exhibited in large doses, and without prop- er precautions, it sometimes produces very singular and dis- tressing effects upon the nervous system, such as vertigo, pains MATERIA MEDIGA. 461 over the eyes, and dilated pupil. As a vermifuge, spigelia has acquired a superior confidence, and it often *ftbrds relief and effects a cure, in cases where no worms are discharged. It is supposed by Dr. Barton, that it will be found highly useful in some febrile diseases of children, unaccompanied by worms, es- pecially in the insidious remittent which so frequently lays the foundation of dropsy of the brain. Spik^ia TKiFOLiATA, Indian Physic. Ipecacuan, Sfc. The root. This shrub grows plentifully in the United States, and is one of the few active plants of the class icosandria. The root, the part employed, consists; like that of the officinal Ipecacuan of a bark, and woody part. The active power seems to reside ex- clusively m the bark. It is a safe and efficacious emetic in do- ses of about thirty grains. It also seems to possess a tonic pow- er, and has accordingly been thought peculiarly beneficial in intermittent fevers. It is sometimes very injudiciously employ- ed by the country people, insomuch that they are obliged to apply for medical aid, to remove the debility induced by the large doses of the root which they employ. Another species, it is said, grows in Kentucky, which is still more valuable as an emetic, than the one under notice. Statice Limonium. Marsh Rosemary. Lavender Thrift. See Lavender. The root. This is well known in the New England States. It is indir genous and perennial, growing on the sea shore, in salt marsh- es ; and the fissures or clifts of rocks near the sea coast : it is in flower from July to September. The stem is naked, branched, and about a foot high. The radical leaves are long, pointed, and grow on foot stalks. The flowers are blue, and grow on long spikes on the tops of the branches. The roots of this plant are powerfully astringent. A decoction of them is given and used as a gargle with success in cankers and ulcerated sore throats. We learn from an authentic source, that the late Dr. Hews, of Providence, held the root of this plant in high estima- tion in cases of aphthous states of fever accompanying dysente- ry, ulcerous sore throats, or scarlatina anginosa. He valued it as the greatest antiseptic he was acquainted with, and said he could administer it in cases where the bark was inadmissible. Dr. William Baylies, of Dighton, in a communication to the Massachusetts Medical Society, makes favourable mention of this root from his experience in the ulcerated sore throat, as it appeared in that town in 1785 and 17S6. This in a large dose operates as a vomit ; in a smaller, proves ^powerful ex- MATERIA MEDICA. peetorawl ; and from its sensible qualities, one would suppose it to possess considerable antiseptic powers. I am well assured it was the basis of a medicine used by a physician in Providence, With very jrreat success in this complaint. It is undoubtedly of great efficacy, and deserves a more thorough investigation." Tanacetcm vulgare. Common Tansy. The leaves and seeds. Tansy is an idigenous perennial growing by road sides and the borders of fields, and is also cultivated in gardens. Its yel- low blossoms appear in August. This plant possesses a warm bitter taste ; it is deobstruent, not ungrateful to the palate, and some have had a favourable opinion of it in hysteric disorders. The leaves and seeds have been of considerable esteem as an- thelmintics, and are given in doses of from one scruple to one drachm. The leaves are frequently used to give colour and fla- vour to pudding. And if fresh meat be rubbed with the plant, it will be effectually preserved from the attacks of the flesh fly, Triosteum peefoliatum. Among the moFe mild, I may mention the Triosteum perfo- liatum, sometimes called Bastard-Ipecacuanha. This, when giv- en in very large doses, sometimes proves emetic ; hence the vulgar name. But I find it a good cathartic. Cortex, or bark, of the root is employed. I give it in doses of twenty and thirty grains. On some occasions, it has seemed to operate as a diu- retic. But this may have been only an accidental circumstance. Rhubarb sometimes produces the same effect, as has been ob- served by C. Pi so. Tussilago Farfara. Coltsfoot. The leaves and flowers. This grows wild in moist situations, producing yellow flowers in February and March : these soon fall off, and are succeeded by large, roundish leaves, hairy underneath ; their taste is her- baceous, somewhat glutinous and subacrid. It is recommended in coughs, phthisis, and other disorders of the breast and lungs, and some use it in scrofula. It is chiefly directed to be taken with milk, and upon this, probably, more than on the tussilago itself, any benefit derived from it in practice is to be explained. Ulmus pulva. American Elm. The inner bark. It rises to the height of thirty feet, with a pretty strong trunk, dividing into many branches, and covered with a light coloiraed MATERIA MEDICA. 45$ tough bark. The leaves are oblong, oval, and sharp pointed, unequally sawed on their edges, unequal at the base, very rough on their upper surface, and hairy underneath. The flowers are produced thick upon the branches, upon short, collected foot Stalks, and are succeeded by oval, compressed membraneous: Seed vessels, with entire margins, containing one oval compres- sed seed. The inner bark by infusion or gentle boiling in water affords a great quantity of insipid mucous substance, that is ap- plicable to a variety of important uses. Dr. Mitchell says it has been beneficially administered in catarrhs, pleurisies, and quinsies 5 it has been applied as a poultice to tumours, and as a liniment to chops and festers. [Letter to Dr. North, Amer. Museum, vol. 7th.] The surgeons of our revolutionary army, and also those of general Wayne's army, who defeated the Indians in August 1794, experienced the most happy effects from the application of poultices of the elm bark to gun shot wounds, which were soon brought to a good suppuration, and to a disposition to heal. It was applied as the first remedy. When tendency to mortifica- tion was evident, this bark bruised, and boiled in water, produ- ced the most suprising good effects. After repeated compara- tive experiments with other emollient applications, as milk and bread, and linseed poultice, its superiority was firmly established. In old ill-conditioned ulcers, and in fresh burns, equal benefit was derived from it. The infusion of the bark was used with ad- vantage as a diet drink, in pleurisy, and catarrh, and also in diarrhoea and dysentery. Many of the above facts relative to the medicinal qualities of the red elm, were communicated, says the editor of the Domestic Encyclopaedia, by Dr. Joseph Strong, ©f Philadelphia, who served as surgeon in the western army - and adds, as a proof of the nutriment which it affords, that a sol- dier who lost his way supported himself for ten days upon this mucilage and sassafras. The editor of the above mentioned work, (vol. 2d, p. 448) proceeds to observe, that the red elm tree may be considered as a highly valuable addition to our stock of medicines, exclusively American, and ought to be care- fully searched for by the medical gentlemen in the country, and preserved from the indiscriminate axe. The inner bark of the slippery elm, or its mucilage, has bee» found by recent experience to be singularly beneficial when applied to chilblains, cutaneous eruptions, and various kinds of sores and ulcers ; and there is much reason to believe, that its in- ternal use in dysentery, consumption, &c. may be attended with, greater advantage than is generally imagined. This tree cer-~ fctinly may be recommended to the particular regard of medical practitioners as a new, and domestic article of our Materia Medica, whose medicinal virtues, will probably be, found to merit a large share of confidence.- - 464 MATERIA MEDICA. Urtica dioica. Common Nettle. The plant. This is a well known perennial weed. The leaves of the fresh plant stimulate, inflame, and raise blisters on the part of the skin which they touch. Hence, when a powerful rubefacient is required, stinging with nettles has been recommended. It has been said, sometimes to have succeeded in restoring sense and motion to paralytic limbs. M. Zannetini, in Italy, asserts, that the flowers and seeds of the common nettle, may, with efficacy be substituted for the Peruvian bark, in all febrile affections, es- pecially in tertian and quartan agues. I operates more speedi- ly than the bark ; and in large doses, induces a lethargic sleep , the portion to be given should never exceed one drachm, and should be administered in wine, two or three times in twenty- fcur hours. The same cautions thst are necessary in the use of Peruvian bark, are likewise to be observed in taking the seeds and flowers of the nettle. Viola odorata. March Violet. The recent flower. This plant is perennial, and found wild under hedges, and in shady places ; but shops are generally supplied from gardens. Its flowers are so remarkable for their delightful odour, and their peculiar richness of colour, that they have given a name to both. They impart their colour and flavour to aqueous liquors ; a syrup made by this infusion has long maintained a place in the shops, and is said to be an agreeable and useful laxative for children ; but is chiefly valued as a delicate test of the presence of uncombined acids or alkalies, the former changing its blue to a red, and the latter to a green colour. Veratrum viride. A species of Veratrum, or Helonias, nearly allied to the Vera- trum album of the old continent, is a pretty common plant in many parts of the United States, and seems to possess the same sternutative and other active properties, that the foreign plant does. The American plant, to which I allude, is the Veratrum viride of Aiton ; the Helonias viridis of some later botanists. COMPLETE TREATISE ON THE ART /' * op / FARRIERY, WHEREIN ARE FULLY EXPLAINED THE NATURE AND STRUCTURE OP THAT USEFUL CREATURE, A HORSE ! WITH THE DISEASES AND ACCIDENT^ HE IS LIABLE TO $ AND THE METHODS OP CURE. LIKEWISE, RULES FOR BREEDING AND TRAINING OP COLTS : PRACTICAL RECEIPTS FOR THE CURE OP COMMON DISTEMPERS INCIDENT Td OXEN, COWS, CALVES, SHEEP, LAMBS, HOGS, &C. TO WHICH IS PREFIXED TEN MINUTES ADVICE TO THE PURCHASERS OF HORSES. NEW-HAVEN: PUBLISHED BY NATHAN WHITING. 1816. SETH ItlCHARDS, PRINTER MinDWTOTfT; PREFACE. THE following Treatise was compiled with intent to guard the unwary from deception in the purchase, as well as to refresh the memory of gentlemen better acquainted with the requisite qualifications, of that noble animal the Horse. The remarks are drawn from long, and, in some instances, dear-bought experience, in the snares which jockies and grooms in general lay before those who are under the necessity of deal- ing with them. Having premised thus much, it may not be thought improper, by way of introduction, to observe, That a large shin bone, that is long from the knee to the pastern, in a foal shews a tall horse. Double the space in a foal, newly foaled, betwixt his knee and withers, will in general, be the height of him when a complete horse. Foals that are of stirring spirits, wanton of disposition, active in leaping, running, and chasing, ever leading the way, and striving for mastery, always prove horses of excellent mettle : and those of the contrary disposition most commonly jades. Before I enter on my particular observations, it may not be unnecessary to give one general rule, which experience has proved to me a good one, that is, no foot, no horse. A horse's ability, and continuance in goodness, is known by his hoofs. jv PREFACE. If they are strong, smooth, hard, deep, tough, upright, and hollow, that horse cannot be a very bad one ; for they are the foundation of his building, and give a fortitude to all the rest j and if otherwise, he cannot be remarkably good or lasting. Without further preface, I shall therefore proceed to the fol- lowing particular remarks and observations. TAPLIN IMPROVED, ADVICE TO THE PURCHASERS OF HORSES. Nothing is more true than the common observation, that in the art of horsemanship, the most difficult part is that of giving proper directions for the purchasing a horse free of fault and blemish. The deceptions in this branch of traffic being looked on in a less fraudulent light* than they seem to deserve, and M consequence are more frequently practised. It shall, therefore be my business in the following brief remarks, to shew, in the best manner I am able, the imperfections which, from either na- ture or mischance, every horse is liable to. In the Stable.] See the horse you are about to purchase in the stable, without any person being in the stall with him ; and if he has any complaint in his legs he will soon show it, by altering the situation of them, taking up one and setting down the other : and this denotes his being foundered or overworked. On ordering him out let no one be the last in the stable but yourself ; you should also, if possible, be the first in, lest the owner, or some of his quick emissaries, take an opportunity to fig him ; a practice common .among dealers, in order to make the tail shew as if carried very high, when, in reality, the day after, he will in appearance be five pounds worse. The Eyes.] This is the proper time to examine his eyes, which may be done in a dark stable with a candle, or rather in the day time when he is led from the stall ; cause the man who leads him to stop at the stable door just as his head peeps out, and all his body is still within. If the white of the eye appears red- dish at the bottom, or of a colour like a withered leaf, I would not advise you to purchase him. A moon-eyed horse is known by his weeping and keeping his eyes almost shut at the begin- ning of the distemper : as the moon changes, he gradually re- cpvers his sight, and in a fortnight or three weeks sees as well 6 ADVICE TO THE as before he had the disorder. Dealers, when they have Such a horse to sell, at the time of his weeping, always tell you that he has got a bit of straw or hay in his eye, or that he has re- ceived some blow ; they also take care to wipe away the hu- mour, to prevent its being seen ; but a man should trust only himself in buying of horses, and above all be- very exact in ex- amining the eyes: in this he must have regard to time and place where he makes the examination. Bad eyes may appear good in winter, when snow is upon the ground ; and often good ones appear bad, according to the position of the horse. Nev- er examine a horse's eyes by the side of a white wall, where the dealers always choose to shew one that is moon-eyed. The moon-eyed horse has always one eye bigger than the other, and above his lids you may generally discover wrinkles or circles. If you observe a fleshy excrescence that proceeds from the corner of the eye, and covers a part of the pupil, and is in shape almost like the beard of an oyster, though seemingly a matter of no great consequence, yet it is what I call a Witlow in the eye, and if suffered to grow, it draws away apart of the nourishment of the eye, and sometimes occasions a total pri- vation of sight. On the contraiy, if the eyes are round, big, black, and shining ; if the black of the eye fill the pit, or out- ward circumference, so that in moving very little of the white appeareth, they are signs of goodness and mettle. The eye which in general is esteemed the best, is that which is neither small nor large ; but be sure to observe that the chrystaline be thoroughly transparent, for without that, no kind of eye can be said to be good. CoimtenwiceJ] After having carefully satisfied yourself as to his eyes, let him be brought out, and have him stand naked be- fore you 5 then take a strict view of his countenance ; particu- larly with regard to the cheerfulness of it, this being an excel- lent glass to observe his goodness and best perfections. Be careful you are not deceived by the marks in his face, as fre- quently a good looking star is made of cat's skin. If his ears be small, sharp, short, pricked, and moving ; or if they are long but yet well set on, and well carried, it is a mark of goodness ; if they are thick, laved, or lolling, wide set, and unmoving, they are signs of dulness, and of an evil nature. A lean forehead, swelling outward, the mark or feather hi his face set high, with a white star or catch of an indifferent size, and even placed, or a white snip on the nose or lip, they are all marks of beauty and goodness : on the contrary, a fat, cloudy or frowning countenance, the mark in his face standing low, as under his eyes, if liis star or ratch stand awry, and instead of a snip his nose be raw and unhairy, or his face generally haktj they are signs of deformity. PURCHASERS OP HORSES. ? Strangles.'] Handle his cheeks, or chaps, and if you find the 'frones lean and thin, the space wide between thein, the tlirap- ple or wind-pipe big as you can gripe, and the void place without knots or kernels, and the jaws so great that the neck seemeth to couch within them, they are all signs of great wind, courage, soundness of head and body: on the contrary, if the chaps are fat and thick, the space between them closed up with gross sub- stance, and the thrapple little, they are signs of short wind and much inward foulness. Should the void place be full of knots and kernels, beware of the strangles or glanders, the former of which may be easily discovered by a swelling between the two nether jawbones, which discharges a white matter. This disor- der usually appears about three, four, or five years old ; there .is no young horse but what is subject to it, either perfectly or imperfectly ; there is also a disorder which is called the Bas- tard strangles, which appears, sometimes like, and sometimes different, from the true strangles. The bastard strangles are what proves the horse has not thrown off his true strangles but that some foul humours are still left behind ; this disorder may come at four, five, six, or even seven years of age. A continual langour at work, and seemingly perpetually weary, without any visible ailment, is a certain sign that he is not clear of this dis* order, which sometimes will affect the foot, the leg, the ham, the haunch, the shoulder, the breast, or the eye, and without care in this latter case, may corrupt the pupil of the eye, as the small pox does in men. Morfoundering.] There is also another disorder, much like the strangles, which is called Morfoundering, and appears by a. running at the nose, but the swelling under the jaw is less. Glanders.] The glanders are discovered by a running at the nose, either on the one side or the other ; feel if he has any flat glands fastened to the nether jaw, which give him pain when you press them ; and remember that a running at one nostril is worse than at both. Fives.] When the jaws are strait, so that the neck swelleth above them, it is a sign of short wind ; but if the swelling be long, and close by his chaps, like a whetstone, then be sure he has the vives, which is a distemper most frequent in high moun- tainous countries, especially to horses that are not used to the crudities produced in the stomach by the spring and fountain waters that rise in hilly grounds: standing waters, or those of very little current, are the least dangerous, and seldom causes the vives ;. but very deep wells are bad. Nostrils.] If his nostrils be open, dry, wide, and large, so as upon any strakring the inward redness is discovered ; if his muz- jzle be small, his mouth deep, and his lips equally meeting, they a*re signs of health and wind: but should his nostrils be S ADVICE TO THE straight, his wind is then little. Should you find the muzzle to be gross, his spirit will be dull. If his mouth be shallow, lie will never carry the bit well : and if his upper will not reach his under lip, old age and infirmi- ty mark him for carrion. Age.'] Respecting the age of a horse that is fit for work, he should have forty teeth : twenty-four grinders, which teach us nothing ; and sixteen others, which have their names, and dis- cover his age. As mares usually have no tusks, their teeth are only thirty-six. A colt is foaled without teeth. In a few days he puts out four, which are called pincers, or nippers ; soon af- ter appear the four separators : next to the pincers, it is some- times three or four months before the next, called Corner-teeth, push forth. These twelve colt's teeth, in the front of the mouth, continue, without alteration, till the colt is two years, or two years and a half old, which makes it difficult, without great care, to avoid being imposed on during that interval, if the seller finds it is his interest to make the colt pass for either younger or old- er than he really is ; the only rule you have then to judge by is his coat, and the hairs of his main and tail. A colt of one year has a supple, rough coat, resembling that of a water span- iel, and the hair of his mane and tail feels like flax, and hangs like a rope untwisted ; whereas a colt of two years has a flat coat, and straight hairs, like a grown horse. At about two years and a half old, sometimes sooner, some- times later, according as he has been fed, a horse begins to change his teeth. The pincers, which come the first, are also the first that fall ; so that at three years he has four horse's and eight colt's teeth, which are easily known apart ; the former be- ing larger, flatter, and yellower than the others, and streaked from the end quite into the gums. The four horse pincers have, in the middle of their extremi- ties, a black hole, very deep ; whereas those of the colt are round and white. When the horse is coming four years old, he loses his four separators, or middle teeth, and puts forth four others, which follow the same rule as the pincers. He has now eight horse's teeth and four colt's. At five years old he sheds the four corner, which are his last colt's teeth, and is called a horse. During this year also, his four tusks (which are chiefly pe- culiar to^ horses) come behind the others ; the lower ones of- ten four 'months before the upper ; but whatever may be vul- garly thought, ahorse that has the two lower tusks, if he has not the upper, may be judged to be under five years old, unless the other teeth shew the contrary ; for some horses that live' to be very old never have any upper tusks at all. The two low- rr tusk- are one of the most certain rules that a horse is com- PURCHASERS OF HORSES. 9 ing five years old, notwithstanding his colt's teeth may not be all gone. Jockies and breeders, in order to make their colts seem five years old when they are but four, pull out their last colt's teeth ; but if all the colt's teeth are gone, and no tusks appear, you may be certain this trick has been played ; another artifice they use, is to beat the bars every day with a wooden mallet in the place where the tusks are to appear, in order to make them seem hard, as if the tusks were just ready to cut. When a horse is coming six years old, the two lower pincers fill up, and instead of the holes above mentioned, shew only a black spot. Betwixt six and seven the two middle teeth fill up in the same manner ; and between seven and eight the corner teeth do the like ; after which it is said to be impossible to know certainly the age of a horse, he having no longer any mark in the mouth. You can indeed only have recourse to the tusks, and the situa- tion of the teeth, of which I shall now speak. For the tusks you must with your finger feel the inside of them from the point quite to the gum. If the trunk be pointed flat, aud has two little channels within side, you may be certain the horse is not old, and at the utmost only coming ten. Be- tween eleven and twelve the two channels are reduced to one, which after twelve is quite gone, and the tusks are as round within as they are without ; you have no guide then but the situa- tion of the teeth. The longest teeth are not always the sign of the greatest age, but their hanging over and pushing forward j as their meeting perpendicularly is a certain token of youth. Many persons, whilst they see certain little holes in the mid- dle of the teeth, imagine that such horses are but in their sev- enth year, without regard to the situation the teeth take as they grow old. When horses are young, their teeth meet perpendicularly, but grow longer and push forward with age ; besides, the mouth of a young horse is very fleshy within the palate, and his lips are firm and hard : on the contrary, the inside of an old horse's mouth is lean both above and below, and seems to have only the skin upon the bones. The lips are soft and easy to turn up with the hand. All horses are marked in the same manner, but some natur- ally, and others artificially. The natural mark is called Begne ; and some ignorant persons imagine such horses are marked all their lives, because for many years they find a little hole, or a kind of void in the middle of the separators and corner teeth* but when the tusks are grown round, as well within as without^ and the teeth point forward, there is room to conjecture in pro- 1 ^ portion as they advance from year to year, what the horse's age may be, without regarding the cavity above mentioned. 3 0,0 ADVICE TO THE The artificial manner is made use of by dealers and joekies, who mark their horses after the age of being known, to make them appear only six or seven years old. They do it in this manner : They throw down the horse to have hiin more at com- mand, and with a steel graver, like what is used for ivory, hol- low the middle teeth a little, and the corner ones some what more 5 then fill the holes with a little rosin, pitch, sulphur, or some grains of wheat, which they burn in with a bit of hot wire, made in proportion to the hole. This operation they repeat from time to time, till they give the whole a lasting black, in imitation of nature ; but in spite of all they can do, the hot iron makes a little yellowish circle round these holes, like what it would leave upon ivory ; they have therefore another trick to prevent detection, which is to make the horse foam from time to time, after having rubbed his mouth, lips and gums with salt, and the crumbs of bread dried and powdered with salt. This foam hides the circle made by the iron. Another thing they cannot do, is to counterfeit young tusks, it being out of their power to make those two crannies above mentioned, which are given by nature : with files they may make them sharper or Hatter, but then they take away the shining natural enamel, so that one may always know, by these tusks, horses that are past seven, till they come to twelve or thirteen. As the defects of the mouth may destroy a horse without any distemper, I shall here just describe the barbs, the lampas, giggs upon the lips, and gagg-teeth. Barbs?] For the barbs, look under his tongue, and see if lie has not two fleshy excrescences on the under palate, like little bladders. It seems to be a mere trifle, but these however will hinder a horse from drinking as usual ; and if he does not drink freely, he eats the less, and languishes from day to day, perhaps without any one's taking notice of it. Lampas.] The lampas is known by opening the horse's mouth, and looking at his upper palate, to see if the flesh comes down below the inner teeth : this gives him pain in eating his oats, and even his hay, when it is too harsh : though he can very well manage bran, grass or kind hay. Giggs upon the lips.] When you have looked in the horse's mouth, without finding eiilu-r of the two disorders above, turn up his lips both upper and under, and perhaps you may find several small elevations, like little white blisters, which make the inside of the lips uneven. This defect may be felt with the finger, and is, what hinders horses from eating as usual ; and that is what is called giggs upon the lips. Gaggrteeth is a defect that rarely happens to young horgas, and is to be discovered by putting the colt's foot into the mouth,