Class Book. -T? SMITHSONIAN. DEPOSIT " THE MEDICAL COMPANION, OR FAMILY PHYSICIAN: TREATING OF THE DISEASES OF THE UNITED STATES, WITH THEIR SYMPTOMS, CAUSES, CURE, AND MEANS OF PREVENTION*. COMMON CASES IN SURGERY, AS FRACTURES, DISLOCATIONS, &c. THE MANAGEMENT AND DISEASES OF WOMEN AND CHILDREN. A DISPENSATORY FOR PREPARING FAMILY MEDICINES, AND A GLOSSARY EXPLAINING TECHNICAL TERMS. TO WHICH ARE ADDED, A BRIEF ANATOMY AND PHYSIOLOGY OF THE HUMAN BODY, SHOWING, ON RATIONAL PRINCIPLES, THE CAUSE AND CURE OF DISEASES : AN ESSAY ON HYGIEINE, OR THE ART OF PRESERVING HEALTH WITHOUT THE AID OF MEDICINE: AN AMERICAN MATERIA MEDICA, POINTING OUT THE VIRTUES AND DOSES OF OUR MEDICINAL PLANTS. ALSO, THE NURSE'S GUIDE. byTTmes^ewell, PHYSICIAN IN WASHINGTON, FORMERLY OF SAVANNAH. THE TENTH EDITION, REVISED, ENLARGED, AND VERY CONSIDERABLY IMPROVED ; EMBRACING A TREATISE ON HYDROPATHY, HOMOEOPATHY, AND THE CHRONOTHERMAL SYSTEM. PHILADELPHIA: PUBLISHED BY CRISSY St MARKLEY, FOR JACOB A. GEER. 1846. ^G -£ \* Entered, according to the act of Congress, in the year eighteen hundred and forty- eight, by E. KINGMAN, in the office of the Clerk of the District Court for the District of Columbia. STEREOTYPED BY F. LUCAS, JR. PRINTED BY SMITH & PETERS, Franklin Buildings, Sixth Street below Arch, Philadelphia. RECOMMENDATIONS In testimony of the merits of this work, the following commendations, by- some of the most distinguished medical characters of the United States, are inserted; together with the letters of their excellencies, Thomas Jeffer- son, and G. Hyde de Neuville — also, a review by Professor Mitchell, of New- York. Baltimore, Nov. 18, 1822. Dear Sir, I have been truly gratified in the perusal of the Sixth Edi- tion of your "Medical Companion, or Family Physician" The improvements made in this new impression of your work, com- pared with the former editions, are, indeed, extensive and important. Independent of your having enlarged considerably on diseases gene- rally, you have introduced additional matter, which greatly enhances its value. The introduction of the Nurse's Guide, as also the treatise you have given on the management of female complaints, will have the most happy effects, in correcting the gross errors daily committed by ignorant persons, and thereby save many, valuable lives. I do not hesitate to say, that this new edition of your Medical Com- panion, is decidedly the best popular treatise on medicine, that has ever been published ; and considering it, as I verily do, a safe and use- ful guide for heads of families, as well as for young practitioners of medicine, I take much pleasure in recommending it to the attention of our fellow citizens, both in town and country. I will only add, if your book meets with that encouragement, to which it is justly entitled, you will very soon be called upon, by the public, for another edition. I am, dear sir, with much respect, Your friend and servant, COLIN MACKENZIE, M.D Dr. James Ewell. IV RECOMMENDATIONS. m Baltimore, JVcra. 18th, 1822. Dear Sir, When the Medical Companion was first published, I con- sidered it greatly superior to every work of that character I had read. I have now read the Sixth Edition, and am much gratified in having it in my power to say, that in this Edition you have so enhanced the value of the work, as to claim my unqualified approbation. Doctor Rush, during my residence in his house, often spoke of his intention to publish a medical work for the use of families, adapted to the climate of the United States. As he reserved it for the last act of his labours, for the benefit of mankind, unhappily he did not live to accomplish his design. In the work now presented to the public, you have fulfilled the patriotic in- tentions of the great and good Rush, to the utmost extent, and I sin- cerely hope your reward may be, as it deserves, ample. I am, dear sir, very truly yours, ASHTON ALEXANDER, M.D. Dr. James Ewell. Philadelphia, August 13, 1816. Dear Sir, I have looked over, with some care, the copy of the Third Edition of the "Medical Companion," which you did me the favour to present to me. By the additions and revisions given to this new impression of the work, it is not only enlarged, but exceedingly improved. After stating so much, I need hardly repeat an opinion, which I publicly expressed on a former occasion, that I consider it, as indispu- tably, the most useful popular treatise on medicine with which I am acquainted. Compared with the European Books of the same nature, it has, es- pecially in relation to the treatment of the diseases of our own coun- try, a very decided superiority. I trust that the success of this literary enterprise may be equal to your very generous and benevolent disposition. With great respect, I am, dear sir, yours, &c. N. CHAPMAN, M.D. Professor of the Institutes and Practice of Medicine, and Clinical Practice, in the University of Pennsylvania. RECOMMENDATIONS. V Philadelphia, Aug. 13M, 1816. Dear Sir, I have derived much satisfaction from a perusal of a third edition of your "Medical Companion." The additions and improvements which it contains, as compared with the first two editions of the work, are extensive and important. To families in the country, remote, not only from medical aid, but from places where common medicinal articles are to be procured, your Materia Medica alone, disclosing to them the healing resources of their own farms and forests, will be of high value. Nor, provided they be true to their best interests, and avail themselves of the advantages placed at their disposal, will your rules and directions for the preserva- tion of health, be less useful to them. In addition to these two important branches, now introduced into the Medical Companion for the first time, it contains a large amount of new miscellaneous matter, which cannot fail to be interesting to the reader. On the whole, if I be not greatly mistaken in my estimation of the character of your work, it is well calculated to prove extensively use- ful, and to place you in the midst of the permanent benefactors of your country. That you may receive, in reputation and wealth, your full reward, is the sincere wish of, Dear sir, your very humble And obedient servant, CH. CALDWELL, M.D. Now Professor of Materia Medica and Physiology in the Transylvania University. Dr. James Ewell. Philadelphia, December 31, 1807. Dear Sir, I have read your book entitled " The Medical Companion," with pleasure, and think it worthy the attention of the citizens of the United States. W. SHIPPEN, M.D. Professor of Anatomy. Dr. James Ewell. VI RECOMMENDATIONS. Philadelphia, December 31, 1807. Dear Sir I have carefully perused your work, " The Medical Com- panion" and take much pleasure in expressing my entire approbation of the plan, and of the utility with which you have conducted your inquiries. Your book cannot fail to be a very acceptable present to the public in general, and especially to our own countrymen. I really am of opinion, that you are entitled to much praise for the pains which you have taken in furnishing us with a work, the want of which has long been experienced among us. Your friend, &c. B. S. BARTON, M.D. Professor of Materia Medica, Natural History and Botany. Dr. James Ewell. December 28, 1807. I have read " The Medical Companion" by Dr. James Ewell, with satisfaction. It is a book containing a variety of matter in a small compass. The practice which he recommends in diseases, is modern and judicious, and the work cannot fail of being useful in all families in the United States. JAMES WOODHOUSE, M.D. Professor of Chemistry in the University of Pennsylvania. * Dr. James Ewell. Dear Sir, I have looked over your " Medical Companion" with plea- sure. The arrangement of the various parts is judicious, the language plain and perspicuous, and the sentiments happily condensed ; the modes of treatment grow out of the most improved state of our sci- ence, and may serve as a safe and useful guide to every family cut off from the services of able physicians. Accept the homage of my regard, JOHN B. DAVIDGE, M.D. Professor of Anatomy, Surgery, &c. in the College of Medicine in Maryland. Baltimore, Feb. 19, 1808. Dr. James Ewell. RECOMMENDATIONS. Vll Dear Sir, We have perused your u Medical Companion'' with much satisfaction, and strongly recommend it to the attention of those fami- lies who cannot with convenience procure medical aid. We think it the best publication we have ever read on the domestic treatment of diseases, more especially as it regards those of our climate. We are, very respectfully, sir, Your most obedient servants, BROWN & MACKENZIE. Baltimore, March 4, 1808. Dr. James Ewell. Sir, T have read your book on Domestic Medicine with pleasure. The practice recommended in it is judicious, and, being from the pen of a native physician, has great advantage over the publications of Euro- pean authors.. JOHN SHAW, M.D. Professor of Chemistry in the College of Medicine in Maryland. Dr. James Ewell. Charleston, May 7, 1808. Dear Sir, Your "Medical Companion" contains much useful know- ledge in a small compass, and is particularly adapted to these States, Families remote from medical aid, will find their account in possessing a book which describes diseases so plainly, and prescribes for them so judiciously, as bid fair to save valuable lives, which otherwise might be lost. Your most obedient servant, DAVID RAMSAY, M.D. Dr. James Ewell. VU1 RECOMMENDATIONS. Charleston, S. C. May 12, 1808. Dear Sir, The perusal of your "Medical Companion" has given me the greatest satisfaction. Such a publication has been much wanted, and I think the plan and execution of your work must answer the most valuable purposes. Yours, very truly, ALEXANDER BARRON, M.D. Dr. James Ewell. Charleston, May 14, 1808. Dear Sir, + I have, with great pleasure, perused your "Family Physi- cian." I find it to be a well digested compend of the most modern and approved modes of treating diseases, especially those to which our country is most exposed. — You have subjoined a dispensatory, judi- ciously calculated to obviate those errors which too frequently ensue from the exhibition of medicine, where the aid of the practitioner can- not be obtained. Yours, &c. PHILIP G. PRIOLEAU. Dr. James Ewell. Washington, March 1, 1808. Sir: I return you my thanks for the copy of " The Medical Compa- nion," you have been so kind as to send me, and must particularly ex- press my sense of the favourable sentiments expressed towards me in the beginning of the work ; especially, too, where it recalls to my re- collection the memory of your respectable father, who was the friend and companion of my youth, and for whom I retained through life an affectionate attachment. The plan of your work is certainly excellent, and its execution, as far as I am a judge, worthy of the plan. It brings within a moderate compass whatever is useful, levels it to ordinary comprehension, and, as a manual, will be a valuable acquisition to every family. I pray you accept my salutations and assurances of esteem and- respect. TH. JEFFERSON. Dr. Ewell. RECOMMENDATIONS. IX Sir, Washington, July 3, 1819. I had the honour to thank you viva voce, after having received your book : I owe you new thanks after perusing it. Such a work would be useful, very useful, in every country, but it may be said it is necessary in the United States, and you have acquired true titles to the gratitude of your fellow-citizens, and specially that of families who happen to be distant from medical aid, by pointing out to them the surest and, at the same time, the simplest rules to be followed in case of sickness. I, above all, offer up my prayers, that your wise hints to ladies may not be laid aside, and that mothers of families may impress them into their minds. Consumption, that inexorable enemy of youth and beauty, is indeed, in most instances, but the mournful result of an imprudent fashion, and it cannot be too often repeated to young ladies who do not fear to show themselves at assemblies in winter, in light dresses, that which a great physician answered to one of his friends who told him, I am well, I have only got a cold : " Colds," said he, " take away more people than the plague P G. HYDE DE NEUVILLE. Dr. James Ewell. The following Review is from that celebrated Work, the New York Medical Repository. Manuals of health, or popular publications on medicine, have be- come so frequent as to have excited the censure of some grave and oracular members of the profession. They consider their publishing brethren as unnecessarily divulging the arcana of the art, as deprecia- ting its credit and estimation, and as teaching the common mass of readers to know as much as themselves. This communicative dispo- sition they conceive to be carried to a very faulty extreme. For when the secrets of the healing faculty are promulgated by its members with such consummate knowledge and success, what is left for distinguish- ing the regularly initiated from those who are without the pale? The propagation of the Esculapian mysteries is viewed to be faulty on an- other account; in as much as in diminishing the importance, it lessens the profits of the practisers, and thus, for the gratification and emolu- ment of one tell-tale author, the whole fraternity is disparaged. 2 X RECOMMENDATIONS. Let us, however, do justice to those sons of physic who are thus ac- cused of faithlessness, in uttering abroad those matters which ought to be viewed as under the restriction of closed doors. Contrast their conduct with that of another class of medical personages, who forever deal in nostrums, and are incessantly boasting of their wonder-work- ing powers; who assure the credulous world they can cure every pos- sible disease of mind and body ; but with a cunning equal to their effrontery, permit no mortal to become acquainted with their remedies. Compare the conduct of him who withholds nothing from his fellow- citizens, with that of him who keeps every thing to himself. There can scarcely be a stronger exhibition of generous communication on the one part, and of selfish concealment on the other. Whatever may be pleaded in behalf of the persons who refuse to make a magnani- mous publication for the good of mankind, of such valuable means of cure as they may possess, or who secure the profits of them under sta- tute of patents, there certainly is a character of greater disinterested- ness and philanthropy, and a temper of a brighter mould and finish in him, who, without fee or price, offers to his fellow creatures all he knows that will be beneficial to them. We know it has been said, that a smattering in the knowledge of the animal economy, and of diseases, multiplies the number of patients, and encourages the practice of physic. Books on such subjects, ad- dressed to the people at large, are peculiarly calculated to alarm their fears whenever they are unwell, and, therefore, impel them to seek as- sistance from those on whose skill they rely. It has been surmised too, that the disciples of Buchan, Willich, and their coadjutors, have often been led, from superficial and conceited knowledge, to become prescribers to others, and have, by their blunders, rendered the attend- ance of the regular physician more needful than ever. Hence it has been argued, that publications of this kind fail to promote the plausi- ble object of their composition, and in reality, produce a mischievous, and not a beneficial effect. It has even been urged against them, that they are of no service to any person but the writer, who may diffuse his fame and increase his wealth in proportion to the circulation of his book and the consequent disturbance it works in society. Whatever may be the merits of this controversy among those who are toiling night and day in the service of the infirm and disabled, or in the compilation of volumes, for our own parts, as reviewers, we feel favourable to the general distribution of knowledge. We are not attached to monopolies of any kind, and less than any, to that which confines to a particular order, the information which will teach man RECOMMENDATIONS. XI how to prevent sickness and- pain, and to remove these ills when they invade. He who publishes wholesome precepts and directions, cannot be denied the merit of good intention ; and it would be hard to refuse him the additional credit of having done substantial good to those who have followed his advice. Having indulged these prefatory reflections, we advance to the consideration of the work before us. The author has prefixed to it a dedication to the President of the United States, a preface explanatory of his design, and a number of recommendatory epistles from his friends. Then follows a chapter of preliminary observations, of which we were inclined to offer an extract for the gratification of our readers; but our limits forbade. The body of the work is devoted to the consideration of the princi- pal diseases which assail the human frame at different times of life. Thev begin with fevers, and end with rickets; without, however, ob- serving any strict method or nosological arrangement. Each section stands by itself, and has little or no connexion with the preceding or subsequent matter. — But a table of contents and index are two good keys to the subjects discussed. The diseases are severally considered in short and generally appro- priate terms. After a definition, the observations are mostly comprised under the head of symptoms, causes, treatment, regimen; to which, in some instances, are added paragraphs on prevention. And it is but justice to observe, that the author has manifested a careful and discri- minating mind in condensing so much valuable instruction into such a moderate compass. The sententious and, and at the same time intel- ligible manner of conveying his directions, is at once calculated to give the reader a clear idea of his meaning, and favourable opinion of his understanding. Besides the observations that are strictly medical, the work contains a variety of directions upon surgical subjects. To render his compilation more generally useful and acceptable, the author has annexed to it a dispensatory. This consists of two parts: the first comprehends a table of medicines for family use, with their doses and qualities annexed ; and the second contains a collection of recipes for the principal part of the compound medicines recom- mended in the course of the work. And this part of the publication is executed in a manner that justifies the opinion we hinted before, of Dr. Ewell's sagacity and skill. TO HIS EXCELLENCY THOMAS JEFFERSON, PRESIDENT OF THE UNITED STATES I beg leave to present this Book to Mr. Jefferson, not because he is President of 1807, but because he was the patriot of 1776; and still more, because, through the whole of a long and glorious life, he has been the philosopher and friend of his country : with all the ingenuity of the former, exposing the misrep- resentations of illiberal foreigners ; and, with all the ardour of the latter, fanning the fire of American science, and watering the roots of that sacred olive which sheds her peaceful blessings over our land. To whom, then, with equal propriety, could I dedicate a book, designed, at least, to promote health and longevity ? And to whom am I so bound by the tenderest ties of affection and gratitude, as to Mr. XIV DEDICATION. Jefferson ? The early classmate and constant friend of my deceased father, and instrumentally the author of my acquaintance with the first characters in the State of Georgia ; among whom, with peculiar plea- sure, I would mention the honourable names of Mil- ledge, Troup, Bullock, and Flournoy. That you may long direct the councils of a united and wise people, steadily pursuing health, peace, and competence, the main pillars of individual and national happiness, is the fervent prayer of your Excellency's Much obliged, and Very grateful servant, JAMES EWELL. THE MEDICAL COMPANION, AND ITS AUTHOR, JAMES EWELL, M.D In presenting to the public the Tenth Edition of the Medical Companion, and in claiming for it a continuance of that public favor which has ever been freely bestowed upon it, it is proper to give some account of the life of the author, and the history of the work. Dr. JAMES EWELL was born at his paternal mansion, Belle Air, in the county of Prince William, Va., the 16th day of February, A. D. 1773. His father, Colonel Jesse Ewell, was of Welch descent, and a man of distinction and liberal fortune. Colonel Jesse Ewell was educated at William and Mary College, at Wil- liamsburg, where he was the classmate of Thomas Jefferson, with whom he formed a lasting friendship. He married soon after he left college, and preferring the tranquil and domestic life of a plan- ter, to a professional or political career which his talents opened to him, he settled at Belle Air, which he left only at the call of his country, at the head of a regiment of Virginia militia, of which he was appointed Colonel, during the war of the Revolution. His wife bore to him nineteen children, of whom eleven were reared to maturity. Of this numerous and happy family, James was the third son, and every care was taken of his education. Every facility that paternal intelligence, and the literary institutions of the county could afford, was enjoyed by him. XVI MEMOIR OF DOCT. JAMES EWELL. Having completed his literary studies, he commenced the study of medicine, under the direction of his uncle, Dr. James Craik, of Alexandria, the family physician of General Washington. Sub- sequently, with a view to obtain greater facilities, he put himself under the instruction of Dr. Stevenson, an eminent physician, of Baltimore, and was by him introduced into a practical knowledge of the profession, visiting his patients in his company. From Balti- more his ardent pursuit of medical knowledge led him to Philadel- phia, where he attended the Lectures of the Medical Department of the University. Dr. Rush was then at the head of the Medical School as the Professor of the Theory and Practice of Medicine, and was succeeded by the celebrated Dr. Benjamin S. Barton, between whom and Doctor Ewell a friendship was formed that was severed only by death. Dr. Barton never ceased to take an interest in the professional career of his friend, and expressed strong appro- bation of the medical work, which Dr. Ewell subsequently pro- duced. The last time that they met was on board of a steam-boat between Baltimore and Philadelphia, in 1815, when Dr. Barton had just returned from Europe, in miserable health. Although there were a number of distinguished persons on board who felt a deep interest in Dr. Barton, he would receive no one in his state room but Dr. Ewell. Leaving Philadelphia, he returned to Virginia to fix upon a set- tlement, and, of course, to marry. A regard for the character and attainments of Doctor Andrew Robertson, of Lancaster county, Vir- ginia, had led him to visit his house, where he became acquainted with the Doctor's eldest daughter, Margaret Mcintosh Robertson, whom he married on the 2nd day of December, 1794. Doctor Robertson was a surgeon and physiciau of great eminence. He was born at Inverness, Scotland, in 1716, and graduated at Edinburg. Through the influence of his cousin, Dr. Thomas Munro, he was appointed a surgeon in the British army, and served three years in Flanders, in what was called the Pragmatic war, and was present at the disastrous action of Fontenoy, in 1 745. Ten years afterwards his regiment was sent to America, under General Braddock, and he accompanied it, in the spring of 1755, when the combined forces of royal and provincial troops marched against Fort Du Quesne. From the fearful slaughter of Braddock's defeat he escaped, with a small squad of twenty men, and living on MEMOIR OF DOCT. JAMES EWELL. xvii acorns alone made his way to Dunbar's camp, to which the rem- nants of the army, under Colonel Washington, had retreated. Forming a favorable opinion of the prospects of America, Doctor Robertson, soon after his return home, resigned his commission, and determined to emigrate, with his family, a wife and son, to Virginia, and devote himself to the practice of medicine and surgery. He landed at Indian Banks, Richmond county, Virginia, where he was hospitably received and entertained by a wealthy Scotch mer- chant, Mr. Glasscock. He was requested to prescribe for Mr. Glass- cock's daughter, an infant in the cradle, who was sick of the mea- sles, and this, his first patient, became his fourth wife, in the year 1771. Dr. Robertson settled in Lancaster county, and his sterling merit, and great skill, soon gave him the control of the practice of the northern neck of Virginia, then one of the richest and most prosperous portions of the State. He acquired wealth as well as fame, and continued in active practice till the day of his death, which occurred March 1st, 1795, at the age of seventy-seven. This distinguished physician bestowed his friendship and his daughter upon Dr. Ewell, for whose professional promise he entertained a high regard. Dr. Ewell purchased a farm in Lancaster county, and immedi- ately commenced a successful practice. But the country practice and the care of a plantation were soon exchanged hy him for a re- sidence in the town of Dumfries, in his native country. A still wider circle of city practice was desired by him, and he was strenu- ously advised by his friends to go to a Southern city. In 1801, he visited his father's friend, Mr. Jefferson, who had just become Presi- dent, at Washington, and stated to him his designs. " Will you," said Mr. Jefferson, "come and dine with me to-day ; some of my Georgia friends ?)]11 be here, and, perhaps, you may finally settle in Savannah." It was at this dinner party that Dr. Ewell met several distinguished Georgians, with whom he formed a pleasing and lasting acquaintance. His determination was soon formed, the city of Savannah would, henceforth, be his home. Mr. Jefferson was, at this time, receiving from Dr. Waterhouse, and others, the vaccine matter in quills, and he presented one of them to Dr. Ewell, and by this timely present, Dr. Ewell was enabled to be the first person who introduced vaccination into Savannah. Mr. Jefferson also gave the Doctor some very strong letters of introduction, and 3 XV111 MEMOIR OF DOCT. JAMES EWELL. recommendation, to a number of gentlemen in Georgia, securing for him, in that State, a hearty welcome, which his merit soon ri- pened into enduring esteem. During a residence of six or seven years in Savannah, he practised his profession with distinguished success. His fondness for social intercourse, in its best forms, found ample means of gratification, in the polished and intelligent circles of that opulent city. It was during professional visits to the neigh- boring plantations, that his attention became fixed upon the neces- sity of affording, through the means of a popular work on medicine, necessary information as a guide for nurses, and heads of families, in the absence of professional aid. A number of planters, indeed, who had experienced the benefit, of his medical skill, urged him to furnish them some directions for their guide in case of sickness, in their large families of whites and blacks, in the form of a medical work. Soon after this, his brother-in-law, the distinguished and popular clergyman, the Reverend Mason L. Weems, being on a visit to him in Savannah, strongly recommended to him to prepare a work of this sort, and pointed to it as a source of great emolu- ment, while, at the same time, it would not interfere with his pro- fessional practice. Motives of philanthropy were, however, more influential than any other in inducing Dr. Ewell to undertake the task, for there was nothing mercenary in his character. He accordingly prepared the first edition of his work, and circumstances rendered it absolutely necessary for him to go to Philadelphia to have it brought out in a proper manner. It so happened that one of his earliest and most valued Georgia friends, Col. George M. Troup, had just returned from Congress, of which he was a promi- nent member, and he described Washington City as a place of ra- pidly growing importance, and affording excellent society, and a wade field for the exertion of medical science. Dr. Ewell having published his first edition of the Medical Companion, and finding that there was a large and increasing demand for it, was induced to remove to, and settle in Washington, where he could combine his practice, with a due degree of attention, to the improvement and publication of successive editions of his work. His departure from Savannah was deeply regretted by a large circle of attached friends and patients. In 1S09, Dr. Ewell became a resident of Washington, and he published a number of editions of his work, accompanied by his MEMOIR OF DOCT. JAMES EWELL. XIX medicine chests, which were put up under his own direction for the convenience of families, and were eagerly sought for, in eveiy part of the country, especially at the South and West. A number of editions of the work were published in Philadelphia ; one in particular, of great beauty of mechanical execution, by Abra- ham Small. The work was dedicated by him to Thomas Jefferson, not as the President, but as a patriot and philanthropist. The reader will find among the recommendatory notices of the work, a letter from Mr. Jefferson to Dr. Ewell, wherein he says that the work will be " a valuable possession in every family." He also speaks of Col. Ewell, the Doctor's "respectable father," who, he adds, was the friend and companion of my youth, and for whom I entertained through life, an affectionate attachment. In 1812, Dr. Ewell was strongly recommended by all the leading men in Congress from the South, and by the most eminent medical men in the country, for the office of Surgeon General of the army. Mr. Madison was de- sirous of appointing him, but the office had been promised by General Armstrong to another person. A 2 The ,, 6>Bfe edition contained an account of the capture of Wash- ington, under the head of Camp Fever, the Doctor having had occasion to witness the ravages of that disease. Of this episode in his work, the best opinion is given by Dr. Cutbush, then Surgeon of the Marine Hospital at Washington, who says, in a letter on the subject to his friend Dr. Ewell, that it was the most interesting, and the most faithful account of the event, with all its attendent horrors of destruction and pestilence, that had ever been, or could be given, but he did not consider a medical work the exact place for it. It was omitted in subsequent editions ; but it was a most vivid picture of stirring and exciting scenes, into which the Doctor had been called as a citizen or as a physician. His influence was exerted successfully with General Ross and Admiral Cockburn, in behalf of the preservation of private property, which had been doomed to destruction, on the ground that it had been used for military or public purposes; and he was continually active, in affording medi- cal aid and provisions to our starving and pestilence striken militia, and to the wounded of both armies. Dr. EwelPs house fronted the Capitol on the east, and was on the south corner of the block. The enemy entered the city on the evening of the 24th of August, 1814, their troops dropping in numbers by the road side, from ex- XX MEMOIR OF DOCT. JAMES EWELL. haustion and heat. A company of sappers and miners, after setting fire to the Capitol, came up to Dr. Ewell's house to destroy it. He claimed it as private property, and also Colonel Caldwell's house, which had been consigned to destruction, from the circumstance of the contents of a baggage wagon having been emptied before the door, in the hurry and confusion of retreat. After some delay the order was countermanded, and the British General officers took pos- session of Dr. Ewell's house as their head-quarters, from its com- manding position. A terrific storm spent its fury on the devoted city about mid-day on the 25th, and when it had subsided, the sap- pers and miners were sent down to the arsenal to destroy it. Doc- tor Ewell was then in conversation with General Ross and Admiral Cockburn, having been requested by the neighbors to ask their in- tentions as to private property, when an explosion was heard that made the earth quake, and the strongest nerves tremble. Soon after, an officer rushed in, reporting that the Americans had sunk an immense quantity of powder in an old well at the arsenal, and a broken match thrown in by a careless artillerist, had produced the explosion, which had killed a number of officers and men. An or- der was issued for the wounded to be conveyed to a large unoccu- pied house in the immediate neighborhood ; and General Ross turned to Dr. Ewell and said : " Doctor, we must leave our wounded with you." The British left Washington during the night of the 25th, after kindling, with incendiary torch, a private dwelling that occupied a bold site on the brow of the Hill, and making therefrom, a long line of bonfires, with a view to conceal their retreat from our troops, who were on the other side of the river. Doctor Ewell took charge of the British wounded, and furnished them with provisions, from motives of humanity, without the least compensation, until the Government made other provision for them. The Doctor's hair becoming somewhat silvery at this time, he was accustomed to say that the " capture of Washington had turned his hair gray." Dr. Ewell published the sixth edition of the Medical Companion in Baltimore, in 1822. In 1826, he published an improved edition, the seventh, on his own account, in Washington. This edition, like all that had pre- ceded it, met with great favor, and a rapid sale. Having sustained repeated and heavy losses, from the unfaithful- MEMOIR OF DOCT. JAMES EWELL. XXI ness of agents employed in the distribution of his work, Doctor Ewell again turned his attention to the South, and determined to devote his yet unimpaired energies, to the practice of his profession in New- Orleans, and while there, to take more especial notice than ever, of the wants of the South and West in reference to a medical work for the use of families. He practised in New Orleans about two years with his usual suc- cess, and his society was courted by many old friends whom he found there, and new ones that he soon made. In the fall of 1832, while in the full career of prosperous practice, he was attacked with a nervous fever, from which he so far recov- ered as to be taken by his friend, Dr. Read, to his house at Coving- ton, on Lake Ponchartrain, where he met with unceasing kindness and attention. His friends were congratulating themselves on his recovery, when suddenly, without warning, he became, with many others at Covington, a victim to the malignant Cholera. He died in the full possession of his faculties, and expressing the most entire resignation to the Divine will, on the morning of the second of November, 1832, in the sixtieth year of his age. His widow survived him ten years, and died at the residence of her daughter, Mrs. Olivia P. Martindale, at Sandy Hill, New York, Aug. 26, 1842. They had four children, two of whom died in in- fancy. The other two were daughters, and still survive, — Mrs. Martindale, at Sandy Hill, and Mrs. Cordelia B. Kingman, now a resident of Washington City. As a skilful physician, Doctor Ewell had no superior among his cotemporaries. His success was the best proof of his mastery in the healing art. As a friend and social companion, he was cherished wherever known. He was ever dis- tinguished as a promoter of social harmony and innocent amuse- ment, and the tranquil and temperate enjoyment of life, and the bounties of Providence. His benevolence was unbounded ; and his hospitality and charity knew no limit, but his means. Though always industrious, he was never, in a mercantile sense, a business man. He was deficient in the management and care of his property and income. What Sidney Smith says of Sir James Mackintosh was true of Dr. Ewell. " He knew not the use of red tape, and would not learn to tie up his bills and papers; and was, therefore, unfit for the common business of life. Hence, in his career he was sometimes XX11 MEMOIR OF DOCT. JAMES EWELL an example of the ancient and melancholy struggle of genius with the difficulties of existence." With the most gifted and eminent men of the day in which he lived, Dr. Ewell was personally intimate, and his house and table were their constant resort. He received his friends with a hearti- ness of hospitality that " warms more than wine." To his many students he gave his instructions freely and zealously, and often without compensation. Among them have been some of the bright- est lights that have adorned the medical profession. In person, Dr. Ewell was of the medium height, his limbs were finely moulded, his hands and feet were remarkably small, and in the latter portion of his life he was somewhat inclined to corpulency. His complexion was florid, his eyes large, and of a deep blue color, and his countenance was animated, expressive and intellectual. In deportment he was mild, affable, and polite. In the sick room his presence gladdened patients and friends, and never failed to cheer the anxious and despondent. As it has been the lot of few indi- viduals to have been more eminently gifted with the means of being useful to mankind, so, perhaps, no one, in a greater degree, ever had the art of creating firm and durable friendships. The engraving accompanying this edition is copied from a portrait that was painted just before his departure from Washington for New Orleans, and is considered a faithful and striking resemblance. The eighth and ninth editions of the work was revised and great- ly improved by the nephew of Dr. Ewell, Mason L. Weems, M. D., formerly of Washington, now of Texas. These editions were pub- lished in Philadelphia, by Messrs. Carey, Lea and Blanchard, and the family of Dr. Ewell derived some benefit from them. This, the Tenth Edition, has been much enlarged and improved by the ad- dition of important matter, under the direction of two eminent phy- sicians ; and from the extensive sale which is anticipated for it, some emolument will result to the remaining portion of Dr. E well's family. PREFACE On the important subject of domestic medicine, many books have been written, which, though excellent in other respects, have great- ly failed of usefulness to Americans ; because they treat of diseases which, existing in very foreign climates and constitutions ', must widely differ from ours. The book now offered to the public, has, therefore, the great advantage of having been written by a native American, of long and successful practice in the southern states, and who, for years past, has turned much of his attention to the com- position of it. The professed object of this book is to treat in the most clear and concise manner, almost every disease to which the human body is subject, to give their common names and surest symptoms, to point out the causes whence they originate, and the most approved method of treatment — and, lastly, to prescribe the suitable regimen and means of prevention. A publication like this cannot but be exceedingly useful to all, but especially to those who live in the country, or who goto sea, where regular and timely assistance cannot always be obtained. Among the many and great services to be rendered by such a book, we may fairly state its tendency to prevent that dangerous officiousness of ignorant persons, and, that equally pernicious ne- glect of the patient, at the onset of the disease, whereby so many lives are lost. These, with many other evils resulting from the want of such a work, constituted the motives which first led the author to offer this publication to his countrymen. It is not for him to de- termine whether it be happily executed or not ; but, whatever may be the general opinion as to its merit, he has the high satisfaction to know, that it not only flows from the purest motives, but also con- tains a faithful relation of facts, collected principally from his own experience, and, in part, selected from authors of the greatest celebrity. XXIV PREFACE. He has not hesitated, occasionally, to use the language of his fa- vourite authors, where he found it sufficiently clear and familiar for his purpose ; and he hopes this acknowledgment will be received in place of frequent reference and quotation. The reader will find, in the latter part of the work, a table of such medicines most commonly called for in families, with an adap- tion of the doses to the age of the patient, together with directions to prepare and administer them. And, as it is impossible entirely to banish technical phrases when writing on medicine, the reader is presented with a Glossary, explaining the medical and scientific terms unavoidably employed in this work. The author, animated by the extraordinary success of the "Med- ical Companion," has greatly improved and enlarged it, by a synopsis of the anatomy and physiology of the human body; essays on air, food, exercise, sleep, evacuations, and passions ; and a Materia Medica. Thus improved, the Medical Companion not only treats of the art of preserving health, and curing disease, but also inculcates a familiar knowledge of the human system, in all its parts, and the laws that govern its economy It is obvious, that by due attention to the non-naturals, by which is to be understood the means of pre- serving health, we may go far to protect this fabric from injury or disease. To inculcate this truth more universally and sue cessfully , the disquisitions contained in this work, are enlivened with appro- priate illustrations, calculated to make impressions on the mind of the reader, as lasting as they are important. Not the least valuable portion of this work is the Materia Medica, pointing out those precious simples wherewith God has graciously stored our meadows, fields, and woods, for the healing of our diseases, and rendering us happily independent of foreign medicines, which, while they are sometimes hard to be obtained, are frequently adulterated, and always costly. To conclude — the author having added much new and important matter to this eighth edition, it will, unquestionably, be found much more valuable than any of the former ; because he has laboured to correct in this, all the errors and imperfections that have hitherto appeared, has enlarged upon the treatment of most diseases, and has introduced several others, particularly that scourge of the South and West, the malignant fever, sometimes denominated the Cold Plague, PREFACE. XXV which were not previously noticed, though highly important to be well known and understood. In the present state of the science of medicine, daily improving by experience, and adding rapidly to the number of valuable reme- dies, he felt it incumbent upon him to enlarge considerably on the treatment of the diseases generally, as well as to make other addi- tions, which a work of this nature required, in order to its increased usefulness. In a familiar style he has pointed out the modus operandi of the different remedies ; has given the prognostics of diseases ; has no- ticed more particularly the circumstance whence the disorders origi- nate, for the purpose of guarding against occurrences ; has distin- guished those cases which yield readily to the employment of simple means, from those which require the regular attendance of a medical practitioner ; and has detailed the means for checking or retarding the progress of such cases. On the management and diseases of women, he has endeavoured, with the aid of the most distinguished authors on this subject, to give such a description of the complaints to which they are liable, with instructions for their treatment, plain enough, to be understood by the attendants or the patients themselves ; and which he sincerely hopes will in a measure have the tendency to correct the errors and misconduct of unskilful midwives, and to prevent unnecessary in- terference in young practitioners. To all of which has been added a general sketch of the diseases of infancy and childhood. With a view of correcting the gross errors of nurses, whereby so many valuable lives have been lost, there is introduced the " Nurse's Guide," describing the preparations of such aliments as are most proper for the sick ; which, as a family assistant, will, unquestiona- bly, be a valuable acquisition. Desirous that nothing should be omitted, which would in the least add to the value of the work, he has greatly improved the Dispen- satory ; which is now arranged in a manner that will not in the least perplex the reader ; having endeavoured to render each formula or prescription, as concise and clear as possible, both as to the mode of preparing and the intention of employing it by short practical re- marks under each class or head. He has likewise given a detailed Index, so that in all cases of disease, the reader may be directed without trouble or embarrass- XXVI PREFACE. inent to the appropriate remedies. And, that the bulk of the volume might not be :■: : laige, he has expunged many of the illustrations under the head of Hygieine. being of little importance compared with the matter now introdi; : The author cannot but think a work of this nature- will be ex- ceedingly useful to the studen:. whose theoretical knowledge only prepared him to commence the arduous dudes of his profes- sion : for. it will not be denied, that the most experienced practit: : nei occasionally feels the want of a guide in his practice. I; is wor- thy to be noticed, when the first edition of the Medical Companion was presented to the public. Professoi Barton, with his usual liber- ality and philanthropy, enjoined npon his pupils to procure a copy of the work before they entered upon the duties of their profess observing, at the same time, that he himself had profited by it in practice, by refreshing his memory ;: what he had read in more voluminous works To every family, more especially those in remote situations, the possession of this book must, unquestionably, be of incalcub value : for, conducted by such a guide, it will not be presumptuous to say that any person of tolerable capacity, and reasonable atten- tion, may be enabled be practise with safety and advantage, in ohose cases of simple diseases most incident to our climate, H:~ :";,: the author has accomplished his wishes in these impor- tant respects, the madei is left to judge from the high :es:imouials prefixed to the work, from ~::„e of the most iistinguished ph] f& ::: ns in our country. He will only add. from the rime and attention he has devoted, in makiiir the improvements now introduced, he cannot but flatter himself, the u Medical Companion' 3 will not fail to be acceptable :: his fellow-citizens : and. under this pleasing impression, he submits it to their generous patronage. For the notes and additions herein containe: the I li :. :-. . gely indebted to the works of D:s. Mason. Good. Gregory. McL 7 [ inghson, Stokes and Ehotson; me London Lancet, Bos- ton Journal. Braithwa::.e's Retrospect &c ice. PRELIMINARY OBSERVATIONS. Contemplating the numberless diseases to which man is liable, and which may cause him to drag out a protracted life of distress, or suddenly cut him off in the bloom of his existence, and amidst his usefulness, we must adore the Divine excellence which has given us in medicine the means of counteracting their dreadful effects. As might have been expected, the attention to an art, rising in importance over all others, has ever kept pace with the general pro- gress of intellectual improvement, commanding for it the respect and encouragement of every enlightened people. With the Greeks, especially, the wisest and most polished of all the ancient nations, medicine was held in the highest estimation. Its votaries were cherished and revered by them while living, and in some instances, carrying their enthusiasm so far as to deify them af- ter death. It is not, indeed, easy to conceive a more noble charac- ter, than a great and amiable practitioner of medicine, who has ex- panded his mind to the utmost extent by the brilliant attainments of science, and mellowed the dispositions of his heart by the habit- ual exercise of benevolence towards the afflicted objects of his care. How exemplary are physicians of this description ! Such was Hip- pocrates, the father of medicine. Such was the pious, the enlight- ened Sydenham. Such was the benevolent Jones, of Savannah. Such was the enlightened Rush : and such are many others who have emulated their virtues and rivalled their fame ; among whom, I have the high satisfaction to enumerate of my particular friends, the late Drs. Craik, of Alexandria, Weems. of Georgetown, Ste- venson, of Baltimore, and Dr. Chapman, of Philadelphia. But unhappily, all those who profess our art do not resemble those bright examples. Medicine, more than any other good thing, is subject to abuse and debasement, by the sordid and mischievous " tricks and devices" of empericism. Like noxious weeds impos- tors rise up at first, from the rank soil of their own effrontery ; but they owe much of their subsequent growth to the protection which they derive from the want of that information widely diffused, which would at once detect, and "laugh into scorn" their idle claims, and arraign to conviction their dangerous tendencies. They live but by tolerance. The slightest examination of their pretensions would 28 PRELIMINARY OBSERVATIONS. drive the herd into their holes and hiding places, and consign their widely spread fame to utter oblivion. It is strange, that so little popular curiosity prevails with regard to medicine, particularly when the public mind is so actively alive to subjects certainly of less moment. Talk to the generality of mankind about property, and you would suppose they were all lawyers, they reason so sensibly on the various points of nieum et tuum : but touch them about that which is of more worth than all property, I mean health, and they are silent as mutes. Did not ex- perience evince the fact, we should think it impossible that in things of such high concern, men could be so preposterously deceived ! so careful of the dross, and yet so negligent of the gold. What can be more deeply interesting than the investigation of that beautiful organization which has, emphatically, been pronounced " God's master work ?" What more important than acquiring the knowledge of preserving this admirable mechanism ? And what more pleasant and useful than to investigate the medical plants of our extensive country, whereby we may remedy those painful ma- ladies which assail the human frame? Half the attention and the time devoted to the minor politics aris- ing out of our party dissensions, assisted by very little of that over- boiling zeal given to the acquisition of property, would, if appropri- ated to medical studies, enable any person of tolerable capacity to practise with safety and advantage in those cases of simple disease which are most common to our climate, and to determine between the "arrant quack" and the modest, well educated, and judicious physician. Assuredly, some care might be profitably directed to medicine. Why will not the intelligent citizens who are scattered throughout the country, dedicate a part of their " liberal leisure" to it? Of all the sciences it is the most inviting, and that which opens the largest treasures to its cultivators. No one can lend his mind to it without receiving "usurious interest." Medicine is the digest of human knowledge. It is the great reservoir into which every stream of science pours its tribute, which in return spreads its fertilizing water over eveiy field that brings forth its " ripe and abundant harvest." The want of a popular medical education, we have remarked, promotes the success of empirics. To what else can the amazing increase of these creatures be ascribed ? Would they dare to quit the shades of their native insignificance, if they thought they were to encounter the blaze of criticism, or to be inspected and scruti- nized by the torch of truth ? No : the terrors of such a process, were it practised, would exterminate the race, or leave to them only a " beg- garly account of empty boxes." We repeat, that empirics are nurtured and sustained exclusively by the prejudices of mankind in their favour, arising from their ina- bility to judge rightly of their merits. For, can it be presumed that any one acquainted with the subject, would repose the slightest con- fidence in the nostrums of the most stupid, illiterate, dishonest, and PRELIMINARY OBSERVATIONS. 29 vagrant of society, who are confessedly destitute of even the ele- ments, the mere alphabet of medicine. Who can believe, that these nostrums, as generally asserted by their proprietors, are applicable equally to a variety of diseases, op- posite to each other as the poles, and that too, under every differ- ence of age, constitution, temperament, habit, season, and climate ? Is it to be credited, that skill can be possessed in a profession the most complex, without any preparatory devotion to it ? Reason and experience combine, to assert the impossibility. The powers of eloquence or poetry may be an inheritance ; but medicine is not intuitive. Whoever acquires it, that is, that tho- rough knowledge of it, which confers " surpassing skill" must undergo a slow, toilsome, and arduous probation. Its temple is raised on the summit of the loftiest eminence, and the path which leads to it winds in tedious tortuosity, narrow, intri- cate, and perplexed ; but strewed at its different stages, with flowers to tempt, and hung at its termination with fruits to reward. Few, very few, have ever reached it. The majority of those who set out on the enterprise become soon discouraged, and either linger by the way, or are lost in its mazes. The energies of genius, assisted by unwearied diligence, can only hope to surmount the difficulties and to gain the prize. But candour must still allow that the empiric strengthens, in some degree, his credit with the public, by sometimes performing great and imposing cures. Such instances, however, of occasional suc- cess, bring with them no solid claims to confidence. They are, indeed, calculated to excite distrust when properly viewed. Their cures, which are admitted to be few, are alone registered and pro- mulgated. Nothing is ever said of the failures or the deaths pro- duced. No regular and impartial account is kept, nor any striking adjustment of balances : but what must be the fatality of a practice conducted in a way so rash and indiscriminate, without the guide of either principle or experience? The nostrums employed are uniformly composed of ingredients of the greatest activity, princi- pally of the mineral poisons, as arsenic, corrosive sublimate, calo- mel, &c, and which can never be neutral in their operations. Whenever administered, they assume a side in the pending contest, and exert all their might either for the patient or the disease, till one or the other yields. The preceding is a faithful picture of empiricism — of its swag- gering pretentions, of its danger, and its uncertainties ; a plain and unvarnished tale, in which naught is extenuate or set down in malice. But with the too prevalent inclination for nostrums, we regret the strange aversion that exists, and which proceeds from the same ne- glect of medicine, to* some of the most efficacious remedies. Tartar is denounced as a certain destroyer of the stomach ; mercury, be- cause it lodges in the bones ; arsenic, as rancorously poisonous, e But that which thou must give thyself grieves me." . Happy they ! the happiest of their kind, Whom gentler stars unite, and in one fate Their hearts, their fortunes, and their beings blend. 'Tis not the coarser tie of human laws Unnat'ral oft, and foreign to the mind, That binds their peace, but harmony itself Attuning all their passions into Love. — Thomson. " It is this, says Lavater, " which has sweetened every bitter of my life ; this has alone supported me, when the sorrows of a wounded heart wanted vent. When my best endeavours were rejected, when the sacred impulse of conscious truth was ridiculed, hissed at and despised, the tear of sorrow was ever wiped away by the gentle, tender, and affectionate address of a female mind, who has an aspect like that of unpractised virginity, which felt, and was enabled to efface each emotion, each passion in the most concealed feature of her husband's countenance, and by endearing means, without what the world would call beauty, always shone forth in countenance heavenly as an angel." Serene in virgin modesty she shines, And unobserv'd the glorious orb declines. Oh, blest with temper, whose unclouded ray Can make to-morrow cheerful as to day : She who ne'er answers till a husband cools, Or, if she rules him, never shows she rules ; Charms by accepting, by submitting sways, Yet has her humour most when she obeys. — Pope. How delightful that sentiment, which, even in advanced life, in- spires a passion, perhaps, more profound than it excites even in youth ; a passion which collects into the soul all that time has robbed from the senses, and stripping life, in its last stages, of all gloom, unsociability and indifference, secures us the happiness of meeting death in those arms which sustained our youth, and entwined us in the ardent embraces of love. O the sweet powerful influences of love ! It is this that unites the interests as well as the hearts of lovers, and gives to each the joys and felicities of the other. And it is this which induces the delicate lady to forget better days, and to smile in poverty, and toil with the husband whom she loves. What charm then under Heaven can excel this noble passion ? No pleasures are comparable to those that affect the heart, and there are none that affect it with such exquisite delight, as loving and being beloved by a worthy object. Ask the husband who is blest with an amiable wife, and he will tell you that the most delicious feeling his heart ever experienced were those of virtuous love. OP PRESERVING HEALTH. 99 Go, gentle gales, and bear my sighs along! The bird shall cease to tune their evening song; The winds to breathe, the waving woods to move, And streams to murmur, ere I cease to love. — Pope. Some angry poets spit all their venom against loving husbands ; but it in no way depreciates virtue. Virtue, the strength and beauty of the soul, It pleases and it lasts ; a happiness That even above the smiles and frowns of fate Exalts great nature's favourite ; — a wealth That ne'er encumbers, nor to baser hands Can be transferred ; it is the only good Man justly boasts of, or can call his own.— Armstrong. A Neapolitan, being at work in a field bordering upon the sea- side, his wife being some distance from him, was seized by some corsairs of Tunis, and carried on board their vessel. Missing his wife, and seeing a ship at anchor, he soon conjectured what the matter was, and throwing himself into the sea, swam to the ship, telling the captain, " He was come to take the same fate with his wife ; for though he understood the hardship and misery he must undergo in slavery, his love had conquered all difficulties, he neither could nor would live but with her." The Turks, admiring the man's unaccountable affection, at their return told it to the King of Tunis, who pleasing himself with so singular an example of love and constancy, gave them both their liberty. Bless'd is the maid, and worthy to be blessed, Whose soul, entire by him she loves possess'd. Feels every vanity in fondness lost ; And asks no power but that of pleasing most : Hers is the bliss, in just return, to prove The honest warmth of undissembled love ; For her inconstant man might cease to range, And gratitude forbid desire to change. Love is a vice only in vicious hearts. Fire, though the purest of all substances, will yet emit unwholesome and noxious vapours when it is fed by tainted matter ; so love, if it grow in a vicious mind, produces nothing but shameful desires and criminal designs, and is followed with pain, vexation, and misery. But let it rise in an upright heart, and be kindled by an object adorned with virtue ; it is safe from censure. Love, studious how to please, improves our parts With polished manners, and adorned with arts, It kindles all the soul with honour's fire ; Curbs and restrains extravagant desire, And to be chaste and kind does still conspire, A just heroic passion, that can find No room in any base degenerate mind. — Dryden. 100 ON HYGIEINE, OR THE ART In propitious love the heart beats with joy ; vivacity cheers the countenance, the eye is brilliant, society is courted, and all the be- nevolent affections are indulged. But disappointed love, on the other hand, is extremely detrimental. It depresses the spirits, en- feebles digestion, takes away the appetite, banishes sleep, and not unfrequently produces insanity. History affords many instances of mental derangement from disappointed love. — The following affect- ing cases deserve to be mentioned. A German lady, of great beauty and accomplishments, having married a Hessian officer ordered to America, and not being able to acquire any tidings of him in her own countiy, came over to England. Here, she could only learn the destiny of her husband from those ships which had either transported troops to the continent or were bringing back the wounded. Day after day she wandered on the beach at Portsmouth, and hour after hour she wearied her eyes, bedewed with tears, in the vain expectation of seeing him. She was observed at the same spot, ere it was light, and watched each motion of the waves until the setting sun. Then her haunted imagination presented him mangled with wounds, and the smallest gust of wind seemed to threaten her with an eternal separation. After eight months spent in this anxious manner, she learned that a vessel bringing some wounded Hessian officers had arrived : she kept at some distance, for fear of giving too great a shock to her husband's feelings, should he be among them. He was landed with others : she followed to the tavern. When she entered the room, he burst into a flood of tears. A lady was supporting him in her arms. What words or painter could represent the tragedy that fol- lowed ! He had married in America, and this person was also his wife. He entreated for "pardon" was past reproach, for in a few minutes after he sunk into the arms of death. The lady, whose melancholy history we are recording, rushed from the room, and leaving her clothes and money at her lodging, wandered, she knew not whither, vowing that she would " never enter house more, or trust man." She stopped at last near Bristol, and begged the re- freshment of a little milk. There was something so attractive in her whole appearance, as soon produced her whatever she requested. She was young, and extremely beautiful ; her manners graceful and elegant, and her countenance interesting to the last degree. She was alone, a stranger, and in extreme distress; she asked only for a little milk, but uttered no complaint, and used no art to excite compassion. Her dress and accent bore visible marks that she was a foreigner of superior birth. All the day she was seen wandering in search of a place to lay her wretched head ; she scooped towards night a lodging for herself in an old hay-stack. Multitudes soon nocked around her, in this new habitation, attracted by the novelty of the circumstance, her singular beauty, but, above all, the sudden- ness of her arrival. French and Italian were spoken to her, but she appeared not to understand these languages; however, when she OP PRESERVING HEALTH. 101 was accosted in German, she evidently appeared confused, the emo- tion was too great to be suppressed, she uttered some faint exclama- tions in that tongue, and then, as if she had been hurried into an imprudence, attempted to appear ignorant of this language also. Various conjectures were instantly formed, but what seemed passing strange, was, her acceptance of no food, except bread or milk, and that only from the hands of females. On the men she looked with anger and disdain, but sweetly smiled, as she accepted any present from the other sex. The neighbouring ladies remonstrated with her on the danger of so exposed a situation, but in vain; for neither prayers nor menaces could induce her to sleep in a house. Beneath the stack Louisa's dwelling rose, Here the fair maniac bore four winter's snows, Here long she shiver'd, stiff'ning in the blast, And lightnings round her head their horrors cast, Dishevell'd, lo! her beauteous tresses fly, And the wild glance now fills the staring eye, The balls fierce glaring in their orbits move, Bright spheres, where beam'd the sparkling fires of love. It may gratify the reader to learn, that it has been ascertained since her death, that this fair sufferer was the natural daughter of the Emperor Francis of Germany In W , a small village in Saxony, there lived a poor, but honest and upright curate, who for many years had enjoyed without alloy, the tranquil pleasure of domestic happiness. He had a wife, and an only child, a daughter. Content in the sphere wherein they were placed, and unacquainted with the turbulent passions of the fashionable world, their days flowed quietly on in a uniform course of undisturbed felicity. The mother and daughter took a joint care of all the domestic concerns, and strove by every act of attention and love, to diminish the burden which the duties of the good old man imposed on him. Harriet, this was the name of his daughter, was in the strict sense of the word, the child after his own heart. He was unhappy if she were absent even for a few hours; she was, therefore, his constant attendant. — She was about eighteen years old, but had not yet experienced the inquietudes of that passion, which often exhibits itself in very early life in the great world ; and her principles and mode of thinking were too noble and good to inspire her parents with even the slightest apprehensions as to the wanderings of her heart. But hear her history. Far different from the condition of the Americans, the Saxons are obliged in time of peace, to receive the king's cavalry, which are quartered in different villages, where it is maintained at the expense of the poor peasantry. Most of the soldiers are riotous young men, who, by virtue of their profession and uniform, obtain entrance into the houses of all the peasantry, and even to the curates, to the great corruption of the innocent and virtuous manners of the country people. One of them, a handsome, but giddy young man, was quartered at W , where 102 ON HYGIEINE, OR THE ART he soon made the acquaintance of the good old parson. The young- soldier had more culture of mind than is usually met with in such a class of men. He pleased the curate, who often invited him to the parsonage, and listened with pleasure to the histories of his battles and warlike achievements. The tender-hearted Harriet found great entertainment in the company of the young warrior, and, like Othello's mistress, the story of his life, the battles, seiges, fortunes that he had passed, the hair-breadth ''scapes, the moving accidents by flood and field, won her heart. — Love had taken possession of her bosom, before she was aware of its approach. She blushed when he took her by the hand, and was unhappy when he left her. The soldier could not resist the beautiful girl, for his heart was formed for love. They, there- fore, soon came to an explanation of their mutual passion, which, for the present, they agreed to conceal from their parents, for fear that prudential motives would cause them to oppose it. They bound themselves to each other, however, by an oath, which, at the same time that it showed the strength of their affection, exhibited the most romantic turn of mind. They promised to marry, as soon as he could attain the rank of sergeant-major, and agreed that the one should destroy the other ivho first failed, in the engagement. Thus matters stood, when, contrary to the wishes of the lovers, a lawyer from a neighbouring town applied to the father of Harriet for the hand of his daughter. He was well received, and his views promoted by the old people ; but when his intention was declared to the unfortunate girl, she fell into the arms of her father, as if struck with lightning, and, on her recovery, wept bitterly, entreating them not to encourage the addresses of this new lover. Her parents, being ignorant of the true cause of her aversion, thought that time would soon overcome it, and, therefore, gave their solemn promise to the lawyer to second his wishes. Harriet, however, resisted every argument, and remained true to her promise ; but her parents, at length growing tired of her opposition, determined to employ their authority, which at last prevailed. The young soldier soon received the intelligence, and instantly formed his desperate resolution, for without his lovely Harriet he could not live. A short time before the marriage day, a dance was given in W , in honour of the pair. To this he resorted, unable any longer to resist the desire of seeing once more his beloved. He concealed himself among the spectators until he saw her dance; which roused him to a state of fury. He ran home, took a pair of loaded pistols, and waited until the party broke up. It was a dark night, but he discerned the un- happy bride intended, and her bridegroom, walking hand in hand. He stepped up to her, and in a low voice, requested that she would indulge him with a moment's conversation. She disengaged her arm from that of the lawyer, entreated him to walk on, assuring him she would immediately return: but, alas! she was to return no more ! A pistol was heard, and when her trembling friends reached OF PRESERVING HEALTH. 103 the place, they found her weltering in blood, at the feet of her mur- derer. " Now art thou mine," cried the soldier, in tones of horrid joy, and fled, but not to escape. He delivered himself to the offi- cers of justice, and begged to be instantly executed, which event, indeed, soon followed. Learn, parents, from this story, the danger of interfering with your children's affections in so serious an affair as marriage : for as Shakspeare observes : Marriage is sure a matter of more worth. Than to be subject for attorneyship ; For what is wedlock,, forced, but a hell, An age of discord and continual strife ? Whereas the contrary bringeth forth bliss, And is a pattern of celestial peace. The most dangerous effect of love is jealousy. It is the most vain, idle, foolish, and turbulent disease that ever assaulted and oppressed the mind of mankind. Of all the diseases of the mind, it is that which most things serve for aliment and fewest for remedy. Bonaventur, sitting at a table, and looking earnestly upon a beau- tiful woman present, was asked by her husband, why he so gazed ? He answered : " That he admired the excellency of the Creator by contemplating the beauty of the creature ; and that if mortals were so amiable, how lovely should we be at the resurrection." This was an example, saith Boschier, that was rather to be admired than imitated ; suitable to the golden age, and not this present iron age of the world, wherein jealousy may be compared to the Indian arrows, so envenomed, that if they prick the skin it is very danger- ous; but if they draw blood, it is irrecoverably death: the first mo- tions that rise from this root of bitterness have their evil effects; but where the disease is improved, it impoisons all our comforts, and throws us headlong into the most tragical resolutions. The Marquis of Astorgas, of the family of Osorio, indulged him- self in an illicit intercourse with a most beautiful young woman. His wife on being informed of his intrigue, went immediately to the house where her husband's mistress lived, and murdered her in the most cruel manner. She tore her heart from her bosom, and took it home, ordering it to be hashed and served up to her husband for dinner. After he had eaten of it, she asked him if it were good ? and, on his answering yes, she said, she was not in the least surprised, for it was the heart of his mistress, whom he so dearly loved. At the same time, she drew from a cupboard the bleeding head of his murdered favourite, and rolled it on the table at which this unhappy lover was sitting with his friends. His wife immediately departed, and took refuge in a convent, where she soon afterwards went mad with rage and jealousy. Earth has no rage like love to hatred turn'd, Nor hell a fury like a woman scorn'd. — Dryden, 104 ON HTTGIEINE, OR THE ART The power of beauty is universally acknowledged, having been the object of love and admiration in all times and among all nations. But, alas! what is beauty without the graces of virtue ! In Italy there grows an herb called the Basilisco ; it is sweet- scented enough, but, withal, has this strange property, that being laid under a stone in a moist place, in a few days it produces a scor- pion. Thus, though the woman, in her first creation, was intended as a help for man, the partner of his joys and cares, the sweet per- fume and relish of his days throughout his whole pilgrimage : yet there are some so far degenerated from their primitive institution, though otherwise of exterior beauty and perfection enough, that they have proved more intolerable than scorpions, not only tormenting the life, but hastening the death of their too indulgent husbands. Not thai my verse would blemish all the fair, But yet if some be bad, 'tis wisdom to beware ; And better shun the bait, than struggle in the snare. — Drtden. Joan, grand-child to Robert, king of Naples, succeeded her grand- father in the kingdom of Naples, and Sicily ; a woman of beautiful person and rare endowments of nature. She was first married to her cousin Andrew, a prince of royal extraction and of sweet dispo- sition ; but being lasciviously disposed, she grew weary of him, and caused him to be strangled in the night, and then threw out his corpse into the garden, where it lay some days unburied. It is said her husband, on seeing her twisting a thick string of silk and silver, asked for what purpose she made it ; she answered, " to hang you in!" which he then little believed; the rather, because those who intend such mischief use not to speak of it before-hand ; but it seems she was as good as her word. O fairest of creation ! last and best Of all God's works! creature in whom excelled Whatever can to sight or thought be formed, Holy, divine, good, amiable, or sweet ! How art thou lost ! — Milton. Love is never more abused than by those men who do not design to marry. It will generally be found, that libertines will single out from among the herd of females, a raw, innocent, young creature, who thinks all the world as sincere as herself, to whom they design to make their addresses. They take every opportunity to be in their company, and pretend to zeal in love, when it is nothing but lust that fires them. When men's desires and lusts once sated are, For oaths and promises they little care. The female, who yields her virtue to the brutal desires of a false lover, degrades herself in his estimation by the infidelity she com- mits, and the surrender of so precious a jewel inspires a remorse OF PRESERVING HEALTH. 105 and shame, when she ceases to be beloved, that constitutes the bitterest wo of life. It is surely matter of wonder, that these destroyers of innocence, though dead to all the higher sentiments of virtue and honour, are not restrained by compassion and humanity. To bring sorrow, confusion, and infamy into a family ; to wound the heart of a tender parent, and stain the life of a poor deluded young woman, with a dishonour which never can be wiped off, are circumstances, one would think, sufficient to check the most violent passion, in a heart the least susceptible of feeling. OF HOPE. " Hope springs immortal in the human breast, Man never is, but always to be blest. O Happiness, our being's end and aim, Good, Pleasure, Ease, Content, whate'er thy name : That something still, which prompts the eternal sigh, For which we bear to live, or dare to die." — Pope. Hope is the anticipation of joy, or the presentiment of an expected good. It is attended with all the favourable effects of a fortunate event, without possessing any of its physical advantages ; because the expectation of happiness does not affect us so excessively as its enjoyment. Besides, it is not liable to those interruptions, from which no human pleasure is exempt ; it is employed principally with ideal or imaginary objects, and generally keeps within the bounds of moderation ; lastly, the sense of happiness contained in hope, far exceeds the satisfaction received from immediate enjoy- ment ; consequently, it has a more beneficial influence on health, than good fortune realized. Although hope is in itself only ideal, and presents its nattering images to the fancy in a borrowed light, yet it is, nevertheless, the only genuine source of human happiness. With thee, sweet Hope ! resides the heavenly light, That pours remotest rapture on the sight : Thine is the charm of life's bewilder'd way, That call's each slumb'ring passion into play. Wak'd by thy touch, I see the sister band, On tiptoe watching, start at thy command, And fly where'er thy mandate bids them steer, To pleasure's path, or Glory's bright career. — Campbell. The poet Hesiod tells us, that the miseries and calamities of man- kind were included in a great tun ; that Pandora took off the lid of it; sent them abroad, and they spread themselves in great quantities over all lands and seas ; but at this time, Hope only did remain behind, and flew not all abroad. But underneath the utmost brim and Ledge it still abode. 14 106 ON HYGIEINE, OR THE ART And this is that which is our principal antidote, which keeps our hearts from bursting under the pressure of evils ; and that flattering mirror that gives us a prospect of greater good. Hence some call it the manna from Heaven, that comforts us in all extremities ; others the pleasant and honest flatterer, that caresses the unhappy with expectation of happiness in the bosom of futurity. A very notable case of the influence of hope on the human body, and its maladies, is recorded in the history of the long siege of Breda, in 1625, by a physician, eye-witness of the fact. That city, from a long siege, suffered all the miseries that fatigue, bad provisions, and distress of mind could bring on its inhabitants. Among other misfortunes the scurvy made its appearance, and carried off great numbers. This, added to other calamities, induced the garrison to incline towards a surrender of the place; when the Prince of Orange, anxious to prevent its loss, and unable to relieve the garrison, contrived to introduce letters addressed to the men, promising them the most speedy assistance. These were accom- panied with newly discovered medicines against the scurvy, of a most extraordinary price, but still more extraordinary efficacy. To each physician were given three small vials, filled with drops of such sovereign power, that four drops were sufficient to impart a healing virtue to a gallon of liquor. We now, says the physician, who was one of the eye-witnesses of this curious, fact, began to display our wonder-working balsams. Nor were even the commanders let into the secret of the cheat upon the soldiers. Ail who had the scurvy crowded around us to take their doses. Cheerfulness again appears in every countenance, and the universal faith prevails in the sovereign virtues of the remedy. The effect of this delusion was truly astonishing. Many who had not moved their limbs for a month before, were seen walking the streets erect and perfectly cured. Many who declared they had been rendered worse by all former remedies, recovered in a few days, to their inexpressible joy, and the no less general surprise, by their taking, what we affirm to be, their gracious Prince's cure. " This curious relation," adds Dr. Lind, " would hardly perhaps gain credit, were it not, in every respect, consonant to the most ac- curate observations, and best attested description of that disease. It is given us by an eye-witness, an author of great candour and vera- city, who, as he informs us, wrote down every day the state of his patients, and seems more to be surprised with their unexpected re- covery, than he probably would have been, had he been acquainted with the nature of this surprising malady. An important lesson in physic," adds this excellent writer, " is hence to be learned ; the wonderful influence of the passions of the mind on the state and disorders of the body. This is too often overlooked in the cure of disorders, many of which are sometimes attempted by the sole mechanical operation of drugs, without calling in to our assistance the strong powers of the imagination, or the concurring influences OF PRESERVING HEALTH. 107 of the soul. Hence it is, that the same remedy will not always pro- duce the same effect, even in the same person ; aud that common remedies often prove wonderfully successful in the hands of men not of the faculty, which do not answer the purpose in a timorous and distrustful patient." Primeval Hope, the Aonian muses say, When Man and Nature mourned their first decay, When every form of death, and every wo, Shot from malignant stars to earth below ; When Murder bared her arm, and rampant War Yok'd the red dragons of her iron car ; When Peace and Mercy banish'd from the plain, Sprung on the viewless winds to Heav'n again j All, all forsook the friendless guilty mind, But hope, the charmer, linger'd still behind. — Campbell. A certain Rhodian, for his over freedom in speech, was cast, by a tyrant, into a cage, and there kept as a wild beast, to his great pain and shame : for his hands were cut off, his nostrils slit, and his face deformed by several wounds upon it. In this extremity, he was ad- vised, by some of his friends, to shorten his life by a voluntary ab- stinence from all food. But he rejected their counsel with great indignation ; and told them, u While a man is alive, all things are to be hoped for him." Cease, every joy, to glimmer on my mind, But leave — oh ! leave the light of Hope behind ! What though my winged hours of bliss have been, Like angel- visits, few and far between ! Her musing mood shall every pang appease, And charm when pleasures lose the power to please ! — Campbell. But hope ill-grounded does often trick and bubble the owner, as it did the Spanish woman that, coming with three of her sons a beg- ging to a French shoemaker that lived in Spain, he said to her one day, " Good woman, I will ease thee of some part of thy charge , for if thou leave one of thy sons with me I will breed him up in my trade, and make him capable of living like a man, and to be helpful to his parents also." " God forbid," said the woman, " that I should cast away my child to a stranger, and bring him up to so pitiful a mechanic trade as a shoemaker, since I live in hopes that the eldest will be Viceroy of Naples, the second of Mexico, and the youngest of Sardinia." Hope, Fortune's cheating lottery ! Where, for one prize, a hundred blanks there be. Fond archer, Hope ! who tak'st thy aim so far, That still, or short or wide, thy arrows are. Thin empty cloud ! which th' eye deceives With shapes that our own fancy gives : A cloud, which gilt and painted now appears, But must drop presently in tears. Brother of fear ! more gaily clad ! The merrier fools o' the two, but quite as mad. — Dryden. 108 ON HYGIEINE, OR THE ART OF JOY. Pleasures are ever in our hands or eyes ; And when, in act, they ease, in prospect, rise j Present to grasp, and future still to find, The whole employ of body and of mind. All spread their charms, but charms not all alike ; On different senses, diff'rent objects strike ; Hence different passions, more or less inflame, As strong or weak, the organs of the frame ; And hence one master passion in the breast, Like Aaron's serpent, swallows up the rest. — Pope. The consideration of some present good, and which particularly belongs to us, begets in the soul that delight which we call joy; for as soon as our understanding observes that we are possessed of the good we desired, the imagination presently makes some impression in the brain, from whence proceeds a motion of the sensitive soul, and of the spirits, that excites the passion of joy. By it, the activity of the whole machine is enlivened ; the action of the heart and arteries is increased ; the circulation of all the fluids is more vigorous and uniform, preventing the formation of disease, and facilitating the cure of such as are formed. There are several degrees of joy, as various circumstances may intervene; and so may we distinguish various differences of the passion itself; for there is no pleasure or good that may not be mixed with some ill or inconvenience. Our extremest pleasure has still some air of groaning and complaining in it, unless it be discreetly moderated it proves fatal to us when it grows into excess. Ptolemeus Philadelphus had received the sacred volumes of the law of God, newly brought out of Judea ; and while he held them with great reverence in his hands, praising God upon that account, all that were present made a joyful exclamation ; and the king him- self was so overjoyed, that he broke out into tears. Nature having so ordered it, that the expression of sorrow should also be the follower of extraordinary joys. Askew, a wealthy and facetious farmer of Cornwall, was afflicted with a most alarming imposthumation, of which he appeared to be on the very point of suffocation. Concluding, from his agonies, that he had but a few moments to live, his servants, an ungrateful crew to such a generous master, began to plunder. One seized his gold watch, another laid violent hands on his plate, and the third, more daring still, broke his bureau, and began to finger his gold. A monkey, who was present, seeing what they were about, and think- ing he might as well take a hand in the game, laid hold of his master's wig, and with his gold-headed cane, made him a low bow, and began to walk about the room as a man of great consequence. The stately steppings and self-assumed dignity of Jacko, so tickled OF PRESERVING HEALTH. 109 the fancy of Mr. Askew, as to excite a most immoderate fit of laughter. The imposthumation burst, the purulent matter was thrown up — and, to the eternal confusion of his servants, Mr. Askew perfectly recovered his health. Philemon, a comic poet, beholding an ass eating some figs that a boy had laid down; when the boy returned, "Go now," said he, " and fetch the ass some drink ;" the old man was so tickled with the fancy of his own jest, that he died laughing. In the same manner, and much upon the same occasion, died Crysippus. Diagoras, the Rhodian, when he saw his three sons all victorious in the Olympic games, and crowned the same day, was extremely pleased ; but when his sons came and embraced their aged father, and each put their triumphal wreath upon his head, he was so over- come with joy and delight, that he fell into their arms, and died. If we have anticipated any joyful event, the body is gradually prepared to undergo the emotions connected with it. For this rea- son we ought to fortify ourselves with the necessary share of firm- ness, to meet joyful as well as disastrous tidings. OF GRIEF. It is the great art of life to manage well The restless mind. For ever on pursuit Of knowledge bent, it starves the grosser powers Quite unemployed, against its own repose It turns its fatal edge, and sharper pangs Than what the body knows, imbitter life. Chiefly were solitude, the nurse of care, To sickly musing gives the pensive mind, There madness enters ; and the dim-eyed fiend, Sour melancholy, night and day provokes Her own eternal wound. ****** Armstrong. Grief, like a poison, corrodes the powers of the mind and body ; it enfeebles the whole nervous system ; the heart beats slower ; the circulation of the blood, and other fluids, becomes more inert ; the appetite and digestion become vitiated, and thus arise obstructions and other distressing complaints. Tears are the anodynes of grief, and ought, therefore, not to be restrained. They have a tendency to prevent the danger to be apprehended from grief, by diminishing the spasmodic motions in the breast and head ; and by restoring regularity in respiration, as well as in the circulation of the blood. A widow lady was left in narrow circumstances with a boy and girl, two beautiful and lovely children, the one six, and the other seven years of age. As her circumstances allowed her to keep but one maid servant, these two children were the sole attention, em 110 ON HYGIEINE, OR THE ART ployment, and consolation of her life. She fed them, dressed them, slept with them, and taught them herself. They were both snatched from her by the gangrenous sore throat, in one week; so that she lost at once all that employed her, as well as all that was dear to her. For the first three or four days after their death, when any friend visited her, she sat upright with her eyes wide open, without shedding tears, and affected to speak of indifferent things. After- wards she began to weep much, and for some weeks talked to her friends of nothing else but her dear children ; but did not for many years, even to her dying hour, get quite over a gloom which was left upon her countenance. When any cause of deep grief is presented to the mind, it fre- quently gains such a force as almost totally to exclude all thoughts, except those that are connected with it. Hence the whole imagi- nation is, by degrees, obscured, and the most usual consequences of it are the deepest melancholy, succeeded by insanity — and some- times, that speedier dissolution, " a broken heart." When the Turks came to raise the siege of Buda, there was amongst the German captains, a nobleman called Rayschachius, whose son, a valiant young gentleman, having got out of the army without his father's knowledge, he behaved so gallantly in fight against the enemy, in the sight of his father and the army, that he was highly commended of all men, and especially of his father, who did not know he was his son ; yet before he could clear himself, he was compassed in by the enemy, and, valiantly fighting, was slain. Rayschachius, exceedingly moved by the death of a brave man, ignorant how near it touched himself, turning about to the other captains, said, " This worthy gentleman, whosoever he be, deserves eternal commendation, and to be honourably buried by the whole army." As the rest of the captains were, with like compassion, approving his speech, the dead body of the unfortunate son was presented to the most miserable father, which caused all who were present to shed tears ; but such a sudden and inward grief surprised the aged father, and struck so to his heart, that, after he had stood awhile speechless, with his eyes fixed, he fell down dead. The melioration of grief by time, and its being at length even attended by pleasure, depends on our retaining any distinct idea of the last object, and forgetting for a time, the idea of the loss of it. This pleasure of grief is beautifully described by Akenside. * * * Ask the faithful youth Why the cold urn of her whom long he lov'd So often fills his arms : so often draws His lonely footsteps at the silent hour To pay the mournful tribute of his tears ? Oh ! he will tell thee, that the wealth of worlds Should ne'er seduce his bosom to forego That sacred hour ; when stealing from the noise Of care and envy, sweet remembrance sooths With virtue's kindest looks, his aching breast, And turns his tears to rapture. OF PRESERVING HEALTH. Ill Whilst the great genius of physic, Hippocrates, drove away mala- dies by his precepts, and almost snatched bodies out of the hands of death, one Antiphon arose in Greece, who, envious of his glory, promised to do upon souls what the other did on bodies ; and pro- posed the sublime invention, which Plutarch calls the art of curing grief, where we may truly say, he used more vanity, promises, and show of words, than he wrought effects. Certainly it were to be wished that all ages which are abundant in misery, should likewise produce great comforts to soften the calamities of human life. O ! canst thou minister to a mind diseased, Pluck from the memory a rooted sorrow, Rase out the written troubles of the brain ; And, with some sweet oblivious antidote, Cleanse the stuff 'd mind of that perilous stuff Which weighs upon the heart ? — Shakspeare In the Pagan religion, the power of dying was the great consola- tion in irredeemable distress. Seneca says, " No one need be unhappy, unless by his own fault." — And the author of Telemachus begins his work by saying, that Calypso could not console herself for the loss of Ulysses, and found herself unhappy in being immortal. But to the Christian this one suggestion, " I know that my Redeemer liveth," affords a richer cordial to the fainting soul, than all the volumes of heathen philosophy. Many are the sayings of the wise In ancient and in modern books enrolPd, Extolling patience as the truest fortitude : And to the bearing well of all calamities, All chances incident to man's frail life. Many are the consolatory writs form'd With studied argument and persuasion ; But with th' afflicted in his pangs such sounds Little prevail, or rather seem a tune Harsh, and of dissonant mood from his complaint : Unless he feel within Some source of consolation from above, Secret refreshings that repair his strength, And fainting spirits uphold. — Milton. In the midst of all distresses, there remains to every sincere Christian, that mixture of pure and genuine consolation, which springs from the promises and hopes of a future life. Consider what a singular distinction this makes in your situation, beyond the state of those who, under the various troubles of life, are left without hope; without anything to look up to, but a train of unknown causes and accidents, in which they see no ligbt or comfort. Thank the Father of Mercies, that into all the evil he sends, he infuses joyful hope, that the sufferings of the present time arc not worthy to be compared with the glory that shall be revealed in the end to the virtuous and good. Have we sustained the greatest of all losses ? It is his gain that he yet liveth, that this life is but the threshold, 112 ON HYGIEINE, OR THE ART the portal, the entrance to a better place, and that his happiness is as complete as our miseiy is great. Let us turn our eyes from earth to heaven, from the perishable body to that which endureth for ever; and even whilst we are heavy with affliction, let us smile with our eyes turned upwards, and say, " It is thy will : I submit. He is happy. I would not wish him back to a troublesome world. I soon shall follow after him. The mortal hath put on immortality — We shall then meet, never to be separated more." Think, then, ye mourning parents, nor complain For breathless children, as ye weep in vain. Why should you be in lamentations drown'd, While your young babes with victory are crown'd, Before the sword was drawn, or cruel strife Had shed its venom on the ills of life ? Perhaps, Almighty God foresaw some wile, Some tempting evil that should them beguile j Of sore adversity, a dreadful storm, Or of dire wickedness, a monstrous form. How then in words which nothing can avail, Against that kind precaution dare you rail ? Remember that of them you're not bereav'd, But from " the coming evil they are sav'd." — Anketell. of FEAR. Tim'rous self-love, with sick'ning fancy's aid, Presents the danger that you dread the most, And ever galls you in your tender part. Hence, some for love, and some for jealousy, Have lost their reason : some for fear of want, Want all their lives ; and others every day, For fear of dying suffer worse than death. Is there an evil worse than fear itself? And what avails in that indulgent Heaven From mortal eyes has wrapt the woes to come, If we, ingenious to torment ourselves. Grow pale at hideous fictions of our own? — Armstrong. Fear has its origin in the apprehension of danger, and is kindly placed in man as a sentinel for self-preservation. But, like every other passion, the excess of it is pernicious. O Fear ! I know thee by my throbbing heart ; Thy withering power inspired each mournful line : Though gentle Pity claim her mingled part, Yet all the thunders of the scene are thine. — Collins. Don Diego Osorius, a Spaniard of a noble family, being in love with a young lady of the court, had prevailed with her for a private conference under the shady boughs of a tree, that grew within the gardens of the king of Spain : but, by the unfortunate barking of a OF PRESERVING HEALTH. 113 little dog, their privacy was betrayed, and the young gentleman seized by some of the king's guard, was imprisoned. It was a capital crime to be found in that place, and, therefore, he was con- demned to die. He was so terrified at the hearing of his sentence, that one and the same night saw the same person young, and all turned gray as in age. The jailer, moved at the sight, related the accident to King Ferdinand, as a prodigy; who, thereupon, par- doned him ; saying, " He had been sufficiently punished for his fault, seeing he had exchanged the flower of his youth into the hoary hairs of age." " I knew a surgeon," says Dr. Darwin, "who was always rather of a parsimonious disposition, had a large house, with a fortune of forty thousand pounds left him ; and in a few weeks became insane from the fear of poverty ; lamenting that he would die in a jail or a work- house. He had left off a laborious country practice and the daily perception of profit in his books : he also now saw greater expenses going on in his new house than he had been accustomed to observe, and did not so distinctly see the source of supply ; which seems to have occasioned the maniacal hallucination. The fear of hell," continues he, " has also, in some instances, been attended with fatal effects. In this kind of madness, the poor patients frequently com- mit suicide ; although they believe they run headlong into the very hell which they dread !" It is said of Epicurus, a profane teacher, that never was a school boy more afraid of a rod, than he was of the thoughts of God and death. No man more feared the things which he taught should be despised, than himself. For whatever there is in the air, there is certainly an elastical power in the conscience, that will bear itself up, notwithstanding all the weight that is laid upon it. Conscience, the torturer of the soul, unseen, Does fiercely brandish a sharp scourge within. Severe deerees may keep our tongues in awe, But to our thoughts what edict can give law? Even you, yourself, to your own breast shall tell Your crimes, and your own conscience be your hell.— Dryden. The wretched state of Richard the Third, after he had murdered his nephew, is thus described by Sir Thomas More : " I have heard," saith he, " by credible reports, that after this abominable deed he never had quiet in his mind, and never thought himself safe. When he went abroad his eyes whirled about, his body was privily fenced, his hand ever on his dagger, his countenance and manner like one who was ever ready to strike; he took no rest in the night, lay long waking and musing, sore wearied with care and watching, and rather slumbered than slept, troubled with fearful dreams : he some- times started suddenly up, leaped out of his bed, and ran about his chamber: his restless heart was continually tossed and tumbled with the tedious impression and stormy remembrance of his horrid and abominable deeds." 15 114 ON HYGIEINE, OR THE ART Conscience, what art thou? thou mysterious pow'r, That dost inhabit us without our leave. And art within ourselves another self, A master self, that loves to domineer, And treat the monarch frankly as the slave ; How dost thou light a torch to distant deeds. Make the past, present, and the future frown ; How, ever and anon, wake the soul, As with a peal of thunder, to strange horrors! — Shakspeare. The rich Cardinal of Winchester, Henry Beaufort, who procured the death of the good Duke of Gloucester, was soon after struck with an incurable disease ; and, understanding by his physicians, that he could not live, he expressed himself thus : " Pie, will not death be hired ? Will money do nothing ? Must I die who have so great riches? If the whole realm of England would save my life, I am able, either by policy to get it, or by riches to buy it." But the king of terrors is not to be bribed by gold. It is a pleasure to him to mix the brains of princes and politicians with common dust; and how loath soever he was to depart, yet grim death would seize upon him. How shocking must thy summons be, O death! To him that is at ease in his possessions ; Who, counting on long years of pleasure here, Is quite unfurnish'd for the world to come? In that dread moment, how the frantic soul Raves round the walls of her clay tenement Rushes to each avenue, and shrieks for help, But shrieks in vain. ****** ########## The foe Like a stanch murderer, steady to his purpose, Pursues him close through every lane of life, Nor misses once the track, but presses on, Till forc'd at last to the tremendous verge, At once he sinks to everlasting ruin. — Blair. The best remedy against this torturing state of the mind is a good conscience, which is to the soul, what health is to the body. It preserves a constant ease and serenity within us, and more than countervails all the calamities and afflictions that can befall us. When the mind has been under the influence of sudden surprise, or vehement attention to some interesting object, it has frequently suspended, and even entirely cured, ague and fever, asthma, and other chronic diseases. An officer, of great courage, who had contracted the asthma by long service in India, declares, that during a most severe attack of that complaint, when he could scarcely breathe in an erect posture, and without power to move, as he thought, six yards to save his life, the alarm guns were fired for the whole line to turn out, be- cause the Mahrattas broke into the camp. Knowing that certain death would be his portion if he remained in his tent, he sprung out with an alacrity that amazed his attendants, instantly mounted OF PRESERVING HEALTH. 115 his horse , and with great ease drew his sword, which the day before he could not move from its scabbard, though he had used his whole strength in the attempt. From the instant of the alarm, the de- bility left him, together with the asthma, nor did the disorder return for some time after. " 1 have frequently observed," says the ingenious author of the Medical Extracts, " delicate hysterical women, who, for many months, had seldom enjoyed one day's health, suddenly relieved from every complaint, when a favourite child was attacked with a disease, in which danger was apprehended : and they continued in appearance, to be in perfect health during the whole course of the illness, and exhibited an unusual alertness in discharging their duty as nurses and parents. But when they understood that the danger was over, their former complaint gradually returned, to their great surprise ; for, from the health they had lately enjoyed, and from so considerable a time, they believed themselves perfectly cured." A very remarkable instance of the influence the mind has upon disorders of the body, occurred to the celebrated Boerhaave. A person fell down in an epileptic fit in the sight of other patients. The effect of this operated so strongly that great numbers of them became immediately affected in the same manner. The opinion of the great physician above mentioned was requested on this occa- sion. He judiciously reflected, that, as these fits were originally produced by an impression on the mind, that the most proper means of cure would be to eradicate these impressions by others still more powerful. He therefore, directed actual cauteries to be prepared, and kept hot, in readiness to be applied to the person who should next be affected. The consequence tvas, not one person ivas seized. Through a most criminal inattention to children in the nursery, a foundation is sometimes laid in their tender minds for those super- stitious terrors, from which not all their efforts in subsequent life can entirely relieve them. I allude to those dismal stories about witches, spirits, hobgoblins, raw-head find bloody-bones, wherewith silly nurses, especially poor blacks, are so fond of frightening infants. Considering the importance of deep impressions made during those tender years, parents cannot too strictly forbid every thing of this sort ; neither can they ever exceed in their generous labours to illu- minate the minds of their children with lofty ideas of their Creator, and that mighty power which he will never fail to exert in their favour, if they will but be good. Timorous persons are more readily infected by contagious disor- ders, than those possessed of fortitude. Hence it is we find nurses most frequently escape contagion, while persons of a fearful dispo- sition contract the disease on entering the chamber of the sick only once or twice. Persons under a violent fit of fear should be treated like those who suffer from any other spasmodic contraction. Tea, a little wine, or spirits and water may be given to them : vinegar, lavender- 116 ON HYGTEINE, OR THE ART drops, or spirits of hartshorn may be held to the nostrils; warm bathing of the feet, and emollient injections may be of advantage ; but above all, the mind ought to be duly composed. — Excessive bashfulness borders on fear; it may be corrected by social inter- course with persons of a cheerful disposition. OF ANGER. When reason, like a skilful charioteer, Can break the fiery passions to the bit, And, spite of their licentious sallies, keep The radiant track of glory ; passions, then, Are aids and ornaments. # * * Young. Resentment of wrong is a useful principle in human nature ; and for the wisest purposes was implanted in our frame. It is the neces- sary guard of private rights, and the great restraint on the insolence of the violent; w T ho, if no resistance were made, would trample on the gentle and peaceable. But, in the fulness of self-estimation, we are too apt to forget what we are. We are rigorous to offences, as if we did not daily entreat Heaven for mercy. It is a vice that few persons are able to conceal ; for, if it do not betray itself by external signs, such as sudden paleness of the countenance, and trembling of the joints, it is more impetuous within. Pale and trembling Anger rushes in, With falt'ring speech, and eyes that wildly stare ; Fierce as the tiger, madder than the seas, Desperate, and arm'd with more than human strength, He whom Anger stings, drops, if he dies. At once, and rushes apoplectic down; Or a fierce fever hurries him to hell. — Armstrong. Those who feel the approach of anger in the mind, should, as much as possible, divert their attention from the object of provoca- tion, and remain silent. They should never use loud oaths, violent upbraidings, or strong expressions of countenance, or gesticulations of the arms, or clenched fists ; as these, by their former associations with anger, will contribute to increase it. " I have been told," says Dr. Darwin, " of a sergeant or corporal, who began moderately to cane his soldiers, when they were awkward in their exercise ; but, being addicted to swearing and coarse language, he used soon to enrage himself by his own expressions of anger, till, towards the end, he w r as liable to beat the delinquents unmercifully." Is this not applicable to some of us, in the treatment of our slaves? A gentleman in New- Castle county, Delaware, w r as so enraged with a neighbouring slave, for persevering, contrary to his orders, to visit a female servant in his family, that he bought him of his master, OF PRESERVING HEALTH. 117 at a high price, for the express purpose of getting satisfaction ; that is, to give him a severe flogging ; and then to sell him to a negro- buyer. What with the bitter curses and blows he inflicted upon the poor fellow tied hands and feet, his anger rose at length to a flame he could not control, and, by the time the master had lost the power to inflict, the poor slave had lost the power to suffer — having literally expired under his cruel hands. A sea captain, hi Charleston, South Carolina, navigated his vessel with the help of three slaves. On some provocation from one of them, lie laid hold of the offender, who was so alarmed at his mas- ter's look, that he jerked away from him. * Roused to fuiy by such an act of treason, as this appeared to him, the master caught up a broad axe, and with the looks and voice of a demon, ordered his other slaves " to seize the d d villain." Frightened out of their wits, they seized their fellow-servant, and the master, black with rage, and regardless of his prayers and supplications, had him dragged to a block, and in a most barbarous manner struck off his head. Although the laws of the land did not sentence these inhuman masters to death, yet neither of them long survived their infernal acts. The gnawings of a blood-stained conscience soon brought them down to the grave* Cruelty is the extreme of all vices, an offence to God, abhorrence to nature, the grief of good men, and a pleasure only to devils and monsters divested of humanity. Justice may take away a man's life, to punish his offences, and to deter others by his example, from the commission of the same crimes ; but to do it by racks and other torments, savours little of humanity, less of Christianity. How many millions of men have the Spaniards butchered in South America. Bartholomew Casa affirms, that in forty-five years they destroyed about ten millions of human souls ; an unaccounta- ble way of converting these poor savages to Christianity. These millions were butchered outright, and if we add those who died la- bouring in the mines, doing the drudgery of asses, oxen, and mules, to what a vast number would they amount ? Some of them carry burdens upon their backs of a hundred and sixty pounds' weight, above three hundred miles. How many of these poor wretches have perished by water as well as by land, by diving fathoms deep, fishing for pearl, who stay there sometimes half an hour under water, panting and drawing the same breath all the while, and are fed on purpose with coarse biscuit and dry things, to make thorn long winded. And if what is reported be true, they hunt the poor Indians with dogs to make themselves sport. There is a story of Hathir Cacica, a stout Indian, who, being about to die, was persuaded by a Franciscan friar to turn Christian, and then he should go to heaven ; Cacica asked him whether there were " any Spaniards in heaven?" " Yes," says the friar, " it is full of them." "Slay, then," said the Indian, " I had rather go to hell than have any more of their company." 118 ON HYGIEINE, OR THE ART A young gentleman in Augusta, Georgia, going to a party in the neighbourhood, in a gig, had not got out of the street, before his horse balked. The youth, leaping from his gig, and angrily catch- ing his horse by the bridle, led him off. Having mounted his gig, he cracked his whip, for a second start; but his horse had not gone • many steps, before he unfortunately fell back again. — Leaping from the gig in a violent rage, he struck his horse over the head with a loaded whip, and then attempted to lead him off once more. Frighted by such violence, the animal, in place of moving forward, drew back. Enraged by such obstinacy, the young man repeated his blows with the whip until it broke, which rather increased the perturbation of his mind. By this time, finding himself surrounded by unwelcome spectators of his brutal conduct, he became more furious; and snatching a large club, continued his unmerciful blows, until he brought the horse to the ground ; when, after a few struggles, his blood and brains flowing copiously, the poor animal expired. As anger is a short madness, so patience is a recollection of all requisite virtues, that enables us to withstand the assaults of the for mer, and to behave ourselves like sober and prudent men. When Xenocrates came one time to the* house of Plato to visit him, he prayed him, "that he would beat his servant for him, in regard he himself was not at present so fit to do it, because he was in a passion." Another time he said to one of his servants, " that he would beat him sufficiently, but that he was angry." Forgiveness of injuries, and a merciful disposition towards those who have offended us, are not only infallible marks of a great and noble mind, but are our indispensable duties as reasonable creatures, and peculiarly so as Christians. Sir Walter Raleigh, a man of known courage and honour, being very injuriously treated by a hot-headed, rash youth, who next proceeded to challenge him, and, on his refusal to accept, spit upon him, and that too in public, the knight, taking out his handkerchief, with great calmness, made him only this reply: " Young man, if I could as easily wipe away your blood from my conscience, as I can this injury from my face, I would this moment take away your life." The consequence was, that the youth, struck with a sudden and strong sense of his misbehaviour, fell upon his knees, and begged forgiveness. Clinias, the Pythagorean, was a person very different both in his life and manners from other men. If it chanced at any time that he was influenced with anger, he would take his harp, play upon and sing to it ; saying, as oft as he was asked the cause of his so doing, "that by this means he found himself reduced to the temper of his former mildness." There is a charm, a power that sways the breast, Bids every passion revel or be still; Inspires with rage, or all your cares dissolves ; OF PRESERVING HEALTH. 119 Can sooth distraction and almost despair. That power is Music. * * * Armstrong. So great is the empire of music over all the faculties of human nature, and so loud have been the ingenious in celebrating its power and praises, that they have left nothing scarcely in heaven, not at all in the air, sea, or on the earth, but what, in excess of fancy or merit, they have subjected to its dominion for the better. Music exalts each joy, allays each grief, Expels diseases, softens every pain, Subdues the rage of poison, and the plague; And hence the wise of ancient days ador'd One power of Physic — Melody and Song. — Armstrong. While the physician prescribes draughts for curing bodily diseases, an able musician might prescribe an air for rooting out a vicious passion. When the tyrant Eugenius raised that perilous war in the East, and money grew short with the Emperor Theodosius, he determined to raise subsidies, and to gather from all parts more than before he had ever done. The citizens of Antioch bore this exaction with so ill a will, that, after they had uttered many outrageous words against the emperor, they pulled down his statues and those also of the empress his wife. Awhile afterwards, when the heat of their fury was past, they began to repent themselves of their folly, and considered into what danger they had cast themselves and their city. Then did they curse their rashness, confess their fault, implore the goodness of God, and with tears, " That it would please him to calm the emperor's heart." Their supplications and prayers were solemnly sung, with sorrowful tunes and lamenting voices. Their bishop, Flavianus, emyloyed himself valiantly, in this needful time, in be- half of the city ; made a journey to Theodosius, and did his utmost to appease him : but finding himself rejected, and knowing that the emperor was devising some grievous punishment; and on the other side, not having the boldness to speak again, and yet much troubled in his thoughts because of his people, then came this device into his head. At such time as the emperor sat at meat, certain young boys were wont to sing musically unto him. Flavianus wrought so, that he obtained of those who had charge of the boys, that they would suffer them to sing the supplications and prayer of the city of Antioch. Theodosius, listening to that grave music, was so moved with it, and so touched with compassion, that having then the cup in his hand, he with his warm tears watered the wine that was in it. and forgetting all his couceived displeasure against the Antiochans. freely pardoned them and their city. " Man may most justly tuneful strains admire, His soul is music, and his breast a lyre ; A lyre which, while its various notes agree, Enjoys the sweet of its own harmony. 120 ON HYGIEINE, OR THE ART What ravishes the soul? what charms the ear? 'Tis music, though a various dress it wear. Beauty is music too, though in disguise, Too fine to touch the ear, it strikes the eyes, And thro' 'em to the soul, the silent stroke conveys.' OF HATRED. Infernal Malice, only pining Hate, And envy grieving at another's state ; When these are in the human bosom nurst, Can peace reside in dwellings so accurst? — Hamilton. Hatred is a Fury that never sleeps ; ulcerates the soul ; and tor- tures it throughout. Hence it never fails to injure the body. As admiration, the first of the passions, rises in the soul before she has considered whether the thing represented to her be good, or con- venient to her, or not; so, after she has judged it to be good, there is raised in her the most agreeable and complacent of all passions, love ; and when she hath conceived the same to be evil, she is quickly moved to Hatred, which is nothing but the soul's aversion to that which threatens pain or grief, and may be defined to be " a commotion produced by the spirits, that incite the soul to be willing to be separated from objects represented to her as ungrateful and hurtful;" which definition only respects pure nature; but through the coiTuption of men and manners, it may be said to arise from an imbibed prejudice, or envy aggravated by continuance, and heightened by a malicious intention of malignancy, and injuring the person to whom we have a disaffection, and that too without any reason but what proceeds from a self-contracted wickedness. Anger is sometimes allowable, and, when excessive, is still called but the vice of men ; but hatred is said to be the sin of devils, being not confined at home, but roves abroad, seeking whom it may devour. " Cruel revenge, which still we find, The weakest frailty of a feeble mind : Degenerous passion, and for man too base, It seats its empire in the savage race." A certain Italian, having his enemy in his power, told him there was no possible way for him to save his life, unless he would imme- diately deny and renounce his Saviour. The timorous wretch, in hope of mercy, did it ; when the other, forthwith, stabbed him to the heart, saying, that now he had a full revenge, for he had killed at once both his body and soul. In the reign of Edward VI., upon the alteration of religion, there was an insurrection in Cornwall and divers other counties, wherein many were taken and executed by martial law. The chief leaders OF PRESERVING HEALTH. 121 were sent to London, and there executed. The sedition being thus suppressed, it is memorable what cruel revenge or sport Sir William Kingston, provost-martial, made by virtue of his office, upon men in misery. One Boyer, mayor of Bodmin in Cornwall, had been amongst the rebels, not willingly, but enforced. To him the provost sent word that he would come and dine with him, for whom the mayor made great provision. A little before dinner, the provost took the mayor aside, and whispered him in the ear, " That an execution must that day be done in the town, and therefore required that a gallows should be set up against dinner should be over." The mayor failed not of his charge. Presently after dinner, the provost, taking the mayor by the hand, desired him to lead him to the place where the gallows was ; which, when he beheld, he asked the mayoi " If he thought it to be strong enough ?" " Yes," said the mayor, "doubtless it is." "Well, then," said the provost, " get you up, speedily, for it is provided for you." " I hope," answered the mayor, "you mean not as you speak?" "In faith," said the provost, "there is no remedy, for you have been a busy rebel :" and so, without respite or defence, he was hanged. Near the said place, dwelt a miller who had been a busy actor in that rebellion, who, fearing the approach of the marshal, told a sturdy fellow, his ser- vant, that he had occasion to go from home, and, therefore, if any came to inquire for the miller, he should not speak of him, but say he was the miller, and had been so for three years before. So, the provost came, and called for the miller, when out comes the servant, and said, " I am the man. The provost demanded, how long he had kept the mill ? " These three years," answered the servant. Then the provost commanded his men to lay hold of him, and hang him on the next tree. At this the fellow cried out, " I am not the miller, but the miller's man." "Nay, sir," said the provost, " 1 will take you at your word. If thou beest the miller, thou art a busy knave, if thou art not, thou art a false lying knave ; and, howsoever, thou canst never do thy master better service than to hang for him;" and so, without more ado, he was despatched. Revenge is but a frailty, incident To crazM and sickly minds ; the poor content Of little souls, unable to surmount An injury, too weak to bear affront. — Dryden. Revenge is a great sign of cowardice, when an enemy is at one's mercy. There is more bravery and disdain in slighting a private enemy, and despising revenge, than in cutting his throat : not that a man should be insensible of an injury or affront, but that he should not carry his resentments too far, where a gentle revenge is sufficient Excellent was the advice that was given to the Romans by the am- bassadors of some cities in Etruria: — That since they were men, they should not resent any thing beyond human nature ; and that in mortal bodies they should not carry immortal feuds. Light inju- ries are made none by disregarding them; which, if we revenged, 16 122 ON HYGIEINE, OR THE ART grow grievous and burdensome, and live to hurt us, when they might die to secure us. It is princely to disdain a wrong; and they say, princes, when ambassadors have offered indecencies, used not to chide, but deny them audience ; as if silence were the royal way to revenge a wrong. When the Duke of Alva was in Brussels, about the beginning of the tumults in the Netherlands, he had sat down before Hulst, in Flanders; and there was a provost-marshal in the army who was a favourite of his, and this provost had put some to death by secret commission from the duke. There was one Captain Bolea in the army, who was an intimate friend of the provost's ; and one evening late he went to the captain's tent, and brought with him a confessor and an executioner, as it was his custom. He told the captain he was come to execute his excellency's commission and marshal law upon him. The captain started up suddenly, his hair standing up- right, and being struck with amazement, asked him, " Wherein have I offended the duke." The provost answered, " Sir, I am not to expostulate the business with you, but to execute my commission ; therefore, I pray prepare yourself, for there is your ghostly father and executioner." So he fell on his knees before the priest, and having done, and the hangman going to put the halter about his neck, the provost threw it away, and breaking into a laughter, told him " there was no such thing, and that he had done this to try his courage, how he would bear the terror of death." The captain, looking ghastly at him, said, " Then, sir, get you out of my tent, for you have done me a very ill office." The next morning, the said Captain Bolea, though a young man of about thirty, had his hair all turned gray, to the admiration of all the world, and the Duke of Alva himself, who questioned him about it; but he would confess nothing. The next year the duke was recalled, and in his journey to the court of Spain, he was to pass by Saragossa, and this Captain Bolea and the provost went along with him as his domestics. The duke being to repose some days in Saragossa, the young old Captain Bolea told him, " that there was a thing in that town worthy to be seen by his excellency, which was a casa de loco, a bedlam house, such a one as there was not the like in Christendom." " Well," said the duke, "go and tell the warden, I will be there to-morrow in the afternoon." The captain having obtained this, went to the warden, and told him the duke's intention ; and that the chief occa- sion that moved him to it was, that he had an unruly provost about him, who was often times subject to fits of frenzy; and, because he wished him well, he had tried divers means to cure him, but all would not do; therefore, he would try whether keeping him close in bedlam for some days would do him any good. The next day the duke came with a great train of captains after him, amongst whom was the said provost, very shining and fine. Being entered into the house about the duke's person, Captain Bolea told the war- den, pointing at the provost, " that's the man:" the warden took OF PRESERVING HEALTH. 123 him aside into a dark lobby, where he had placed some of his men, who muffled him in his cloak, seized upon his sword, and hurried him into a dungeon. The provost had lain there 'wo nights and a day; and afterwards it happened that a gentleman, coming out of curiosity to see the house, peeped into a small grate where the pro- vost was. The provost conjured him, as he was a Christian, to go and tell the Duke of Alva his provost was there confined, nor could he imagine why. The gentleman did his errand ; and the duke, being astonished, sent for the warden with his prisoner. The warden brought the provost in cuerpo, full of straws and feathers, madman- like, before the duke; who, at the sight of him, burst into laughter, asking the warden why he had made him prisoner? " Sir," said the warden, "it was by virtue of your excellency's commission, brought me by Captain Bolea." Bolea stepped forth, and told the duke, " Sir, you have asked me oft how these hairs of mine grew so suddenly gray ; I have not revealed it to any soul breathing ; but now I'll tell your excellency ;" and so related the passage in Flan- ders ; and added — " I have been ever since beating my brains to know how to get an equal revenge of him, for making me old be- fore my time." The duke was so well pleased with the story, and the witiness of the revenge, that he made them both friends. OF ENVY. ####### Malicious Envy rode Upon a ravenous wolf, and still did chew Between his canker'd teeth, a ven'mous toad, That all the poison ran about his jaw: But, inwardly, he chewed his own maw At neighbours' wealth, that made him ever sad : For death it was when any good he saw, And wept, that cause of weeping none he had, But when he heard of harm, he wax'd wondrous glad. He hated all good works, and virtuous deeds, And him no less than any like did use ; And who with gracious bread the hungry feeds, His alms for want of faith, he doth accuse, So every good to bad he doth abuse ; And eke the verse of famous poet's wit, He does backbite, and spiteful poison spews From leprous mouth on all that ever writ : Such one, vile Envy was. — Spencer. To repine at the superior happiness of others, is the nature of Envy. It arises from self-love or self-interest, particularly in such individuals whom nature has denied certain qualifications of body or mind, which they cannot avoid seeing in others. 124 OR THE ART It is almost the only vice which is practicable at all times, and in every place ; the only passion which can never lie quiet for want of irritation ; its effects are, therefore, every way discoverable, and its attempts always to be dreaded. Envy commands a secret band, With sword and poison in her hand, Around her haggard eye-balls roll, A thousand fiends possess her soul. The artful, unsuspected sprite, With fatal aim, attacks by night. Her troops advance with silent tread, And stab the hero in his bed ; Or shoot the wing'd malignant lie, And female honours pine or die. — Cotton. Solomon emphatically styles " Envy a rottenness of the bones," and we too often witness its baneful effects on those who cherish the fatal poison. It shows itself in horrors even on the face of young females, who, it might be supposed, could not possess so odious a passion. Observe an envious girl, while pleased with herself, appears quite, beautiful and pleasing in her manners ; but on the appearance of one of her sex, a school-mate , of superior beauty and endow- ments, her countenance becomes strangely altered. In like manner the spirits become depressed; and, as the body cannot remain un- disturbed, when the mind, to which it is so nearly attached, is in such misery, the person who is tormented with it cannot enjoy good health. For it is the passion of the damned; and, as it richly de- serves punishment, it never escapes it. A French lady of quality that was well married, and lived in plenty, hearing her husband's brother had married a very handsome lady with a great fortune, was mightily out of humour, insomuch that she perfectly hated all that spoke in commendation of her new sister-in-law, and hearing her husband also commend her as a very beautiful woman, she bribed a servant in that lady's family to poison her; but he, discovering the design, and the lady, being reproached for it by the husband, poisoned herself and died. Envy's the worst of fiends, procurer of sad events, And only good when she herself torments. — Cowley. Plutarch compares envious persons to cupping-glasses, which ever draw the worst humours of the body to them. Like flies, they resort only to the raw and corrupt parts of the body; or, if they light on a sound part, never leave blowing upon it till they have disposed it to putrefaction. When Momus could find no fault with the face in the picture of Venus, he picked a quarrel with her slippers ; and so malevolent persons, when they cannot blame the substance, will yet represent the circumstance of men's best actions with prejudice. The black shadow is still observed to wait upon those that have been the most illustrious for virtue, or remarkable OF PRESERVING HEALTH. 125 for some kind of perfection : and to excel in either has been an un- pardonable crime. "The man who envies, must behold with pain Another's joy, and sicken at his gain." When Aristides, so remarkable for his inviolable attachment to justice, was tried by the people at Athens, and condemned to ban- ishment, a peasant unacquainted with the person of Aristides, ap- plied to him to vote against Aristides. u Has he done you any wrong," said Aristides, " that you are for punishing him in this manner?" " No," replied the countryman, "I don't even know him ; but I am tired and angry with hearing every one call him the just" Mutius, a citizen of Rome, was noted to be of such an envious and malevolent disposition, that Publius, one day observing him to be very sad, said, " Either some great evil has happened to Mutius, or some great good to another." Medicine cannot cure a disease so odious. Education and im- provement of morals are its only antidotes. Envious persons com- monly give too much importance to trifles ; hence they ought to be instructed to employ themselves in more useful pursuits; to judge of things according to their true value, and to accustom themselves to a philosophic calmness, learn how to overcome or at least to moderate their selfishness ; to counterbalance their expectations with their deserts ; and to equal or surpass others in their merits, rather than in their pretensions. OF AVARICE. And, oh ! what man's condition can be worse Than his, whom plenty starves and blessings curse ? The beggars but a common fate deplore, The rich poor man's emphatically poor. If cares and troubles, envy, grief, and fear, The bitter fruits be what fair riches bear. If a new poverty grows out of store, The old plain way, ye gods! let me be poor. — Cowlev. This vile passion, which frowns at the approach of the stranger, clinches the hand against the poor, denies all encouragement of public good, and can pinch and starve wife and children, is hardly more detestable in a moral point of view, than it is pernicious in a physical. It is true, that by his unwillingness to part with his mo- ney, the miser is generally a temperate, and even an abstemious character, and so far his vice is beneficial to his health ; but, in many other respects, this detestable vice operates very hurtfully to 126 ON HYGIEINE, OR THE ART the health of him who is cursed with it. By the extreme eagerness to make money, by the distressing fears about keeping it, by the in- consolable grief for losing it; besides the heart-aches, the envies and jealousies, the sleepless nights, wearisome days, and numberless other ills which it inflicts on its slaves, it often ruins their health, and brings them down to the grave by some lingering disease, or more horrible suicide. History tells us of illustrious villains ; but there never was an illustrious miser in nature. Can wealth give happiness ? Look round, and see What gay distress ! what splendid misery ! Whatever Fortune lavishly can pour, The mind annihilates, and calls for more. — Young. To declaim against riches, is like a hungry man inveighing against wholesome food, and a naked man railing at warm clothing ; it is spending breath to no purpose, and one would sooner be stigmatized with the character of a fool or a madman, than gain belief that the harangue is more than a copy of one's countenance, or like the fox cursing the grapes that were out of his reach • for there are so many good uses to which riches may be employed, that to inveigh against them is to satirize upon acts of piety, beneficence, and charity. But to be poor in the midst of riches is the most insupportable kind of poverty. In vain our fields and flocks increase our store, If our abundance make us wish for more. — Rose. A rich cotton planter in Georgia, in consequence of losing two cents in the pound on a crop of cotton, was seized with such a sad- ness of heart, that he took to his bed, and refusing to be shaved, shirted, or to take suitable nourishment, died miserably. He was a bachelor, and his estate, on appraisement, amounted to nearly one hundred thousand dollars! In York county, Pennsylvania, a farmer so wealthy as to raise one hundred bushels of clover seed on his own lands, in consequence of losing five dollars per bushel on his clover seed, that is, only getting seven dollars in Baltimore, after he had been offered twelve for it at home, was struck with such a deadly heart anguish, that he went into a fit of despondence, and hung himself. After his death, silver to the amount of two hundred thousand dollars was found barrelled up in his cellar. Vain man! 'tis Heaven's prerogative To take, what it first deigned to give, Thy tributary breath : In awful expectation plac'd, Await thy doom, nor impious haste To pluck from God's right hand his instruments of death.— Warton. Hippocrates, in his espistle to Crateva, the herbalist, gives him this advice for the cure of some rich patients, that if it were possible OF PRESERVING HEALTH. 127 he should cut up that weed of Covetousness by the roots, that there might be no remainder left, then he might be certain, that, together with their bodies, he might cure all the diseases of their minds. The same great and learned philosopher wished a consultation of all the physicians in the world, that they might advise together upon the means how to cure covetousness. It is now above two thousand years ago since he had his desire ; and after him a thousand and a thousand philosophers have employed their endeavours to cure this insatiable dropsy. All of them have lost their labours. The evil rather increases than declines under the multitude of remedies. There have been a number, in former ages, sick of it ; and this wide hospital of the world is as full of patients as ever it was. OF INTEMPERANCE. We curse not wine — the vile excess we blame; More fruitful than the accumulated board, Of pain and misery, For the subtle draught Faster and surer swells the vital tide ; And with more active poison than the floods Of grosser crudity convey, pervades The far remote meanders of our frame. ###**## jr or know whate'er Beyond its natural fervour hurries on The sanguine tide ; whether the frequent bowl, High-seasoned fare, exercise to toil Protracted, spurs to its last stage tir'd life, And sows the temple with untimely snow. — Armstrong. Temperance, by fortifying the mind and body, leads to happi- ness. Intemperance, by enervating them, ends in misery. — And those who destroy a healthy constitution of body by intemperance, do as manifestly kill themselves, as those who hang, poison, or drown themselves. Virtue is no enemy to pleasure; but, on the contrary, is its most certain friend. Her office is to regulate our desires, that we may enjoy every pleasure with moderation ; and then our relish for them will continue. Pleasure, my friend, on this side folly lies ; It may be vig'rous, but it must be wise : And when our organs once that end attain, Each step beyond it is a step to pain. — Cawthorn. Anacharsis, the Scythian, in order to deter young men from that voluptuousness ever attended with ill effects, applied his discourse to them in a parable, telling them that the vine of youthful gratifi- cation had three branches, producing three clusters. " On the first," says he, "grows pleasure; on the second, sottishness; on the third, sadness." 123 ON HYGIEINE, OR THE ART Struck by the powerful charm the gloom dissolves In empty air : Elysium opens round A pleasing frenzy buoys the lightened soul, And sanguine hopes dispel your fleeting cares ; And what are difficult, and what was dire, Yield to your prowess and superior stars ; The happiest you of all that e'er were mad, Or are, or shall be, could this folly last. But soon your heaven is gone ; a heavier gloom, Shuts o'er your head ; and, as the thund'ring stream Swoln o'er its banks with sudden mountain rain, Sinks from its tumult to a silent brook ; So, when the frantic raptures in your breast Subside, you languish into mortal man : You sleep, — and waking, find yourself undone, For, prodigal of life, in one rash night You lavistid more than might support three days. A heavy morning comes ; your cares return With tenfold rage. — Armstrong. Drinking- is undoubtedly the most miserable refuge from misfor- tune. It is the most broken of all reeds. This solace is truly short- lived ; when over, the spirits commonly sinking as much belovi their usual tone, as they had been before raised above it. — Hence, a repe- tition of the dose becomes necessary, and every fresh dose makes way for another, till the miserable man is rendered a slave to the bottle; and at length falls a sacrifice to what at first, perhaps, was taken only as a medicine. Unhappy man, whom sorrow thus and rage, Two different ills, alternately engage. Whom drinks, alas ! hut to forget ; nor sees That melancholy, sloth, severe disease, Mem'ry confused, and interrupted thought, Death's harbingers, lie latent in the draught, And in the flowers that wreath the sparkling bowl, Fell Adders hiss, and poisonous serpents roll. — Prior. " Were the pleasure of the palate lasting," says Cornaro, " there would be some excuse for inebriety ; but it is so transitory, that there is scarce any distinguishing between the beginning and the ending; whereas the diseases it produces are very durable." O'er the dread feast malignant Chemia scowls, And mingles poison in the nectar'd bowls; Fell gout peeps grinning through the flimsy scene, And bloated dropsy pants behind unseen : Wrapp'd in his robe, white Lepra hides his stains, And silent Frenzy, writhing, bites his chains. — Darwin. The story of Prometheus seems to have been invented by physi- cians in those ancient times when all things were clothed in hiero- glyphic, or in fable. Prometheus was painted stealing fire from heaven, which might well represent the inflammable spirit produced by fermentation, that may be said to enliven and animate the ma?i of clay : whence the conquest of Bacchus, and the heedless mirth OF PRESERVING HEALTH. 129 and noise of his devotees. But the after punishment of those who steal his accursed fire, is a vulture gnawing the liver ; which well allegorizes the poor inebriate, labouring under painful hepatic diseases. Tt is thus beautifully described by Darwin : — So when Prometheus braved the Thunderer's ire, Stole from his blazing throne ethereal fire, And lantern'd in his breast, from realms of day, Bore the bright treasure to his man of clay : — High on old Caucasus, by Vulcan bound, The lean, impatient vulture flutt'ring round; His writhing limbs in vain he twists and strains, To break or loose the adamantine chains : The glutt'nous bird, exulting in his pangs, Tears his swoln liver with remorseless fangs. Let those who have been enticed frequently to taste spirituous liquors, till at length they begin to have a fondness for them, reflect a moment on the danger of their situation, and resolve to make a speedy and honourable retreat. Remember that custom soon changes into habit ; that habit is a second nature, more stubborn than the first ; and, of all things, most difficult to be subdued. Re- member, that it is by little unsuspecting beginnings, that the unfor- tunate vice is generally contracted ; and, when once confirmed ; scarcely terminates but with life! Learn, then, in time, to resist this bewitching spirit, whenever it tempts you. Then will you find yourself so perfectly easy without it, as at length never to regret its absence ; nay, peculiarly happy, in having escaped the allurements of such a dangerous and insidious enemy. Those who pride themselves on living fast, and are bent upon " a short and merry life," though, in truth, it is a short and misera- ble one, will, doubtless, spurn at these admonitions, and run head- long to their own destruction. Strange infatuation ! Can you sub- mit to such despicable bondage, and tamely give up your freedom without one generous struggle? The present conflict remember, is not for the fading laurel, or tinselled wreath, for which others so earnestly contend, but for those more blooming, more substantial honours, which Health, the daughter of Temperance , only can bestow. For it is thine, O Health] and thine alone, to diffuse through the human breast that genial warmth, that serene sunshine, which glow on the cheek, shine in the eye, and animate the whole frame ! But, if still you have no regard for this blessing, let me remind you of an hereafter I " To die — to sleep — to sleep ! perchance to dream — Ay, there's the rub /" If death were nothing, and naught after death ; If, when men died, at once, they ceas'd to be. Returning to the barren womb of Nothing, Whence they sprang — then might the wretch That's weary ol the world, and tired of life, At once give each inquietude the slip, IT 130 ON HYGIEINE, OR THE ART By stealing out of being when he pleased, And by what way, whether by hemp or steel, Death's thousand doors are open. Who could force The ill-pleased guest to sit out his full time, Or blame him if he goes ? Sure, he does well That helps himself as timely as he can, When able. But if there's an hereafter, And that there is, Conscience, uninfluenced, And suffer'd to speak out, tells every man ; Then must it be an awful thing to die : More horrid yet to die by one's own hand. Self-murder ! dreadful deed ! our island's shame, That makes her the reproach of neighb'ring states : Shall JYature, swerving from her earliest dictates, Self-preservation, fall by her own act? Forbid it Heaven ! Let not, upon disgust, The shameless hand be foully crimson'd o'er With blood of its own lord. Dreadful attempt! Just reeking from self-slaughter, in a rage, To rush into the presence of our Judge ; As if we challenged him to do his worst,. And heeded not his wrath. — Blair. It is an invariable law of our present condition, that every plea- sure, which is pursued to excess, converts itself into a poison. Could we expose to view the monuments of death, they would read a lecture on moderation much more powerful than any that the most eloquent writers can give. You would behold the graves, peopled with the victims of intemperance. You would behold those chambers of darkness, hung round, on every side, with the trophies of luxury, drunkenness, and sensuality. So numerous would you find those victims to iniquity, that it may be safely asserted, where war or pestilence have slain their thousands, intemperate pleasure has slain its ten thousands. By unhappy excesses, how many amiable dispositions have been corrupted or destroyed ! how many rising capacities and powers have been suppressed ! how many flattering hopes of parents and friends have been totally extinguished! Who, but must drop a tear over human nature, when he beholds that morning, which arose so bright, overcast with such untimely darkness ; that good humour, which once captivated all hearts ; that vivacity, which sparkled in every company; those abilities which were fitted for adorning the highest station, all sacrificed at the shrine of low sensuality ; and one who was formed for running the fair career of life in the midst of public esteem, cut off by his vices at the beginning of his course ; or sunk, for the whole of it, into insignificancy and contempt. Would you extend your narrow span, And make the most of life you can ; Would you, when med'cines cannot save, Descend with ease into the grave ; Calmly retire like evening light, And cheerful bid the world good night ? Let temperance constantly preside Our best physician, friend, and guide ! OP PRESERVING HEALTH. 131 One of the Fathers justly describes the nature of this beastly vice, when he saith of it, that " It is a flattering devil ; a sweet poison ; a delightful sin; which he that hath, possesseth not himself; and he that acts it, doth not only commit a sin, but is wholly converted into sin ; being deserted of his reason, which is at once his counsellor and guardian." A young gentleman of the most respectable parentage, being rather intemperate, was urged by his parents to marry, thinking that might produce a change in his habits. He paid his addresses to a most amiable young lady, of a fair estate, to whom he was soon united in wedlock. — It was not many months after marriage, before he resumed his former habits, and what with drinking and gambling he very soon exhausted the whole of her fortune. Executions being out against him, he was compelled to keep at home, where he did nothing but get drunk and abuse his amiable wife. One night, filled with rage, he resolved to destroy her, and going at a late hour into the kitchen, where she had been constrained to retire from his abuse, he continued his opprobrious language to her, and, notwith- standing she gave him only loving and kind words, yet he struck her over the head with a large stick, which she bore patiently, although it much injured her face. He still continuing to rage at her, wearied, and in great fear, she rose up and went to the door. Here he followed her with a chopping-knife in his hand, with which he struck at her wrist, and cut her very much ; no help being near but an old woman, who durst not interpose, fearing for her own life, who prayed her mistress to sta}^ and be quiet, hoping all would be well, and so getting a napkin, bound up her hand with it. After this, still railing and raging at his wife, he struck her on the forehead with an iron cleaver, whereupon she fell down bleeding; but recov- ering herself, upon her knees she prayed unto God for the pardon of her own and her husband's sins, praying God to forgive him, as she did. But as she was thus praying, the infernal demon, her husband, split her skull open with a cleaver, so that she died immediately : for which he was apprehended, condemned, and hanged. But so callous was the wretch, that even under the gallows he did not exhibit any marks of repentance. It is a lamentable fact, so great is the infatuation of this vice, that few, once deluded, have ever recovered their freedom. Some glo- rious instances, however, have occurred, which are surely fine encouragement to others. We also have the pleasure to find none are greater enemies to vice, than those who formerly were the slaves of it, and have been so fortunate as to break their chain and recover their liberty. A medical gentleman in Virginia, who was married to a most amiable lady, by associating with dissipated characters, became, at length, intemperate himself. As soon as he acquired habits of in- temperance, his disposition was altered, and from an affectionate husband he proved very turbulent, and treated his wife so ill that 132 ON HYGIEINE, OR THE ART she was constrained to separate from him. After living a disorderly life for some time, he was brought to a sense of reflection, and with an entire change of mind and manners, he renounced all vicious habits, pleaded guilty before his amiable wife, who was ready to forgive, and they have since lived in the utmost harmony. So sen- sible is he of the danger of using spirituous and vinous liquors to excess, that he will not taste them, lest he should be enticed to exceed the bounds of moderation ; and whenever he sees a person so inclined, never fails to caution him against so insidious an enemy. A gentleman of Maryland, addicted to drunkenness, hearing a considerable uproar in his kitchen one night, felt the curiosity to step without noise to the door, to know w T hat was the matter; when, behold, they were all indulging in the most unbounded roars of laugh- ter, at a couple of his negro boys, who were mimicking himself in his drunken fits ! — as, how he reeled and staggered ! how he looked and nodded, and hiccoughed and tumbled ! The pictures which these children of nature drew of him, and which had filled the rest with such inexhaustible merriment, struck him with so salutary a disgust, that from that night he became a perfectly sober man, to the inexpressible joy of his wife and children. A very respectable gentleman in Philadelphia had a wife, who, by her fondness for strong drink, had almost broken his heart. At length he was advised, "as a desperate remedy in a desperate dis- ease," to place a barrel of spirits in her closet, and let her kill herself as soon as possible, since every persuasive means had been used in vain to break her of this beastly vice. At the sight of so extraordi- nary a visitant in her closet, she was struck with such horror at the idea of the dreadful design on which it was placed there, that she was immediately reclaimed, and recovered all the purity and lustre of her former character, to the infinite joy of her husband, children, and numerous friends. O Temperance ! support and attendant of other virtues ! Preserver and restorer of health ! Maintainer of the dignity and liberty of ra- tional beings, from the wretched, inhuman slavery of Sensuality, Taste, Custom, and Example ! Brightener of the understanding and memory ! Sweetener of life and all its comforts ! Companion of reason, and guardian of the passions ! Bountiful rewarder of thy admirers and followers ! how do thine excellencies extort the un- willing commendation of thine enemies ! and with what rapturous delight can thy friends raise up a panegyric in.lhy praise ! OP PRESERVING HEALTH. 133 OF GAMING. The love of gaming is the worst of ills ; With ceaseless storms the blacken'd soul it fills; Inveighs at Heaven, neglects the ties of blood Destroys the power and will of doing good ; Kills health, pawns honour, plunges in disgrace, And, what is still more dreadful — spoils her face. — Young. While gaming keeps within the bounds of innocent diversion, to recreate the body, or compose the mind, and is not tainted with covetousness or passion, the most strait-laced casuist will not censure or condemn it as a crime ; but, when it breaks the limits of modera- tion, and transports men into heats, swearing, cursing, reproaching, and lying; or is taken up as a trade to live by, and pushed on by a covetous desire to enrich ourselves by the loss and ruin of one's neighbour, it is absolutely unlawful, carefully to be avoided, and utterly abominated, as the certain procurer of repentance, sorrow, grief, disease, derision, beggary, and contempt. To play sometimes to entertain company, says the Marquis of Halifax, or to divert your- self, is not to be disallowed ; but to do it so often as to be called a gamester, is to be avoided, next to the things that are most criminal. It has consequences of several kinds not to be endured ; it will en- gage you into a habit of idleness and ill hours, draw you into bad company, make you neglect your business, bring you to poverty and disgrace, and cause sleepless nights, and destroy health. What fool would trouble Fortune more, When she has been too kind before ; Or tempt her to take back again What she had thrown away in vain, By idly venturing her good graces To be dispos'd of by umes-aces ; Or settling it in trust, to uses Out of his power, on trays and deuces; To put it to the chance, and try, P th' ballot of a box and die, Whether his money be his own, And lose it, if he be o'erthrown ; As if he were betray'd, and set By his own stars to every cheat, Or wretchedly condemned by Fate To throw dice for his own estate. — Butler. It is true, as it is lamentable in the age in which we live, there are too many of all qualities and conditions excessively addicted to this abominable vice ; by which many respectable families have been reduced from affluence to extreme poverty. But the evil does not stop here : it must be fresh in every memory, of the most dia- bolical acts having been perpetrated by persons who enlisted under the banners of a gambler, and squandered away their estate. Let 134 ON HYGIEINE, OR THE ART the following melancholy catastrophe, which I have from the best authority not long since took place, prove a warning to others. Mr. A. S , who had a very comfortable support, was enticed to associate himself with gamblers, and in a short time lost all that he possessed, at cards and dice, which ought to have been treasured , up for the subsistence of his family. Reflecting on the foolish man- ner in which he had thrown away his money, and beholding his children cry about him for victuals, so diseased his mind, that taking advantage of his wife's absence, he cut the throats of his three children, and then hung himself. His wife, on returning home, being so much affrighted at the sight of so barbarous a tragedy, fell dead upon the spot. An old ruined gamester, in hopes to make a bubble or prey of a young gentleman that came to town with his pockets full of money, took him to a gaming-house, and there, to encourage him to play, showed him several topping sparks that were born to no fortune, who by play had purchased great estates, and lived in pomp and splendour, by success in shaking their elbows — " You show me," says the young gentleman, " the winners, but I pray what has be- come of the losers?" To which the old prig making no reply, a third person, overhearing their conversation, told the young gentle- man, that since the other was silent and confounded with shame at the question, he would oblige him with an answer — " Many of the losers," saith he, " taking the highway to repair their losses, have been hanged ; others have gone to sea to earn their bread ; some have taken up the trade of being bullies to bawdy-houses ; others that have not hid themselves as servants under a livery, are begging or mumping about the streets, or starving in jails for debt, where you will be ere long, if you follow that rascal's counsel." " The punish- ment," says the young gentleman, " is fit for the sin, when men possessed with great sums of their own money, will play the fool to make it another man's ; and, if this be the humour of the town, I will return again to the country, and spend my estate among my neighbours and tenants, where you, sir," speaking to the gentleman that dealt so plainly with him, " shall be very welcome." OF VANITY. So weak are human kind by Nature made Or to such weakness by their vice betrayed ; Almighty Vanity ! to thee they owe Their zest of pleasure, and their balm of wo. — Young. Yanity consists of an agreeable reverie ; and is well ridiculed in the story of Narcissus, who so long contemplated his own beautiful image in the water, that he died from neglect of taking sustenance. OF PRESERVING HEALTH. 135 On the green margin sits the youth, and laves His floating train of tresses in the waves ; Sees his fair features paint the streams that pass, And bends for ever o'er the watery glass. — Darwin. As the vain found their claims on qualities which they do not possess, they frequently meet with mortifications ; while their ex- treme solicitude for distinctions they are not entitled to, can never allow them any repose ; hence, vanity is an enemy to health. Observe a lady at a ball, anxious to be thought the finest woman in the assembly, and doubtful of success. The pleasure, which it is the purpose of the assembly to enjoy, is lost to her. She does not for a moment experience such a sensation; for it is totally absorbed by the prevailing sentiment, and the pains she takes to conceal it. She watches the looks, the most trivial marks of the opinion of the company, with the attention of a moralist, and the anxiety of a politician ; and wishing to conceal from every eye the torment she feels, her affection of gaiety at the triumph of a rival ; the turbulence of her conversation when that rival is applauded ; the over-acted regard which she expresses for her; and the unne- cessary efforts which she makes, betray her sufferings and constraint. Grace, that supreme charm of beauty, never displays itself but when the mind is perfectly at ease, and when confidence prevails. If we take the whole sex together, we shall find those who have the strongest possession of men's hearts, are not always eminent for their beauty. As pride destroys all symmetry and grace, so affecta- tion is a more terrible enemy to fine faces than the small-pox. And it will always be found, that the lady who has an humble opinion of herself, will have every body's applause, because she does not expect it; while the vain creature loses approbation through too great a sense of deserving it, by her own affectation. If a beautiful, proud, and gay woman, would but seriously reflect what a loathsome carcass she must ere long become in the grave, amidst worms and corruption, it would tend to mortify her pride, lessen her vanity, and teach her to be humble. Ye proud, ambitious, wealthy, young, and gay, Who drink the spirit of the golden day, And triumph in existence, come with me, And in the mould'ring corpse your picture see, What you, and all, must soon or later be. — Solitary Walks " Pride, well placed and rightly defined, is of ambiguous insignifi- cation," says the late incomparable Marquis of Halifax : " one kind being as much a virtue as the other a vice." But we are naturally so apt to choose the worst, that it has become dangerous to commend the best side of it. Pride is a sly, insidious enemy, that wounds the soul unseen, and many, who have resisted other formidable vices, have been ruined by this subtle invader ; for, though we smile to ourselves, at least ironically, when flatterers bedaub us with false encomiums; though we seem many times angry, and blush at our 136 ON HYGIEINE, OR THE ART praises; yet our souls inwardly rejoice; we are pleased with it, and forget ourselves. Some are proud of their quality, and despise all below it ; first, set it up for the idol of a vain imagination, and then their reason must fall down and worship it. They would have the world think, that no amends can be made for the want of a great title. They imagine, that with this advantage, they stand upon the higher ground, which makes them look down upon merit and virtue as things inferior to them. Some, and most commonly women, are proud of their fine clothes ; and when they have less wit and sense than the rest of their neighbours, comfort themselves with the reflec- tion that they have more lace. Some ladies put so much weight upon ornaments, that, if one could see into their hearts, it would be found that even the thought of death was made less heavy to them, by the contemplation of their being laid out in state, and honourably attended to the grave. The man of letters is proud of the esteem the world gives him for his knowledge ; but he might easily cure himself of that disease, by considering how much learning he wants. The military man is proud of some great action performed by him, when possibly it was more owing to fortune than his own valor or conduct: and some are proud of their ignorance, and have as much reason to be so as any of the rest ; for they being also compared with others in the same character and condition, will find their defects exceed their acquisitions. O, sons of earth ! attempt ye still to rise, By mountains piled on mountains to the skies ? Heaven still with laughter the vain toils surveys, And buries madmen in the heaps they raise. — Pope. A person of infinite wit, speaking of what might precisely be called a proud and vain man, once said, " When I see him, I feel something like the pleasure of seeing a happy couple ; his self-love and he live so happily together" " Pride was not made for men : a conscious sense Of guilt, and folly, and their consequence, Destroy the claim, and to beholders tell, Here nothing but the shape of manhood dwells." " I once saw," says Dr. Darwin, " a handsome young man, who had been so much flattered by his parents, that his vanity rose so near to insanity, that one might discern, by his perpetual attention to himself, and the difficulty with which he arranged his conversa- tion, that the idea of himself intruded itself at every comma, or pause of his discourse." I dreamt that, buried with my fellow clay, Close by a common beggar's side I lay ; And as so mean an object shock'd my pride, Thus, like a corpse of consequence, I cried : " Scoundrel, begone ! and henceforth touch me not, More manners learn, and at a distance rot." OF PRESERVING HEALTH. 137 " Scoundrel, thou," with haughtier tone, cried he, " Proud lump of earth, I scorn thy words and thee ; Here all are equal, now thy case is mine. This is my rotting place, and that is thine." — Dodd. The cure of vanity may be attempted by excess of flattery, which will at length appear ridiculous, or, by its familiarity, will cease to be desired. " I remember," says Dr. Darwin, " to have heard a story of a nobleman, in the court of France, who was so disagreea- bly vain in conversation, that the King was pleased to direct his cure, which was thus performed. Two gentlemen were directed always to attend him ; one was to stand behind his chair, and the other at a respectful distance before him : whenever his lordship be- gan to speak, one of them always pronounced, " Lord Gallimaufre is going to say the best thing in the world." And, as soon as his lordship had done speaking, the other attendant pronounced, " Lord Gallimaufre has spoken the best thing in the world." Till, in a few weeks, this noble lord was so disgusted with praise, that he ceased to be in vain, and his majesty dismissed his keepers. OF MODESTY Hail, Modesty ! fair female honour hails ! Beauty's chief ornament, without whose charms, Beauty disgusts, or gives but vulgar joys. Thou giv'st the smile its grace ; the heightened kiss Its balmy essence sweet! — Armstrong. Modesty is to virtue, what a fine veil is to beauty. It is one of the most distinguishing and attractive characteristics of the female sex. It comprises the beauties of the mind, as well as those of the body ; and it not only heightens the desire of the male, but deters him from rudeness and improper behaviour. It is, therefore, the interest of the men to cherish, and not to injure, by indelicacy, a quality from which they derive so much pleasure and advantage. Naked in nothing should a woman be, But veil her very wit and modesty ; Let man discover, let not her display, But yield her charms of mind without delay. — Young. " I remember," says a female author of great distinction, " the Count M , one of the most accomplished young men in Vienna, when I was there ; he was passionately in love with a girl of peer- less beauty. She was the daughter of a man of great rank and influence at court ; and, on these considerations, as well as in regard to her charms, she was followed by a multitude of suitors. She was 18 138 ON HYGIELXE, OR THE ART lively and amiable, and treated them all with an affability which still kept them in her train, although it was generally known that she had avowed a predilection for the count, and that preparations were making for their nuptials. The count was of a refined mind and delicate sensibility ; and loved her for herself alone ; for the virtues which he believed dwelt in her beautiful form ; and, like a lover of such perfections, he never approached her without timidity ; and when he touched her, a fire shot through his veins that warned him not to invade the vermilion sanctuary of her lips. Such were his feelings, when, one night, at his intended father-in-law's, a party of young people were met to celebrate a certain festival ; several of the young lady's rejected suitors being present. Forfeits were one of the pastimes, and all went on with a grateful merriment, till the count was commanded, by some witty mademoiselle, to redeem his glove by saluting the cheek of his intended bride. The count blushed, trembled, advanced to his mistress, retreated, advanced again — and at last, with a tremor that shook every fibre in his frame, with a modest grace, he put the soft ringlets, which played upon her cheek, to his lips, and retired to demand his redeemed pledge, in evident confusion. His mistress gaily smiled, and the game went on. One of her rejected suitors, but who was of a merry, unthink- ing disposition, was adjudged by the same indiscreet crier of the forfeits, to snatch a kiss from the lips of the object of his recent vows. A lively contest between the lady and gentleman lasted for a minute ! but the lady yielded, though in the midst of a convulsive laugh ; and the count had the mortification, the agony to see the lips, which his passionate and delicate love would not allow him to touch, kissed with roughness by another man, and one whom he despised. Without a word, he rose from his chair, and left the room, and the house — and never saw her more ! Thus, by that good-natured kiss, the fair boast of Vienna lost a husband and her lover. Although I consider this act of the count as ridiculously fasti- dious, yet I cannot but think it may prove a good hint to my fair readers. Certainly the sensitive plant cannot shrink more coyly, than should the lovely virgin from the slightest touch of the immodest. " Learn, then, ye fair, to keep the person sacred j ###### iik e the pure mine*, Be that array'd in modest dignity : For e'en its beauties flauntingly expose — Thus may ye keep the heart your charms have won." The attractive grace and powerful charm of Modesty cannot be better illustrated, than by relating the following interesting narrative : — Charlotte Cor day was tall and well-shaped, of the most graceful manners and modest demeanour. There was in her countenance, OF PRESERVING HEALTH. 139 which was beautiful and engaging, and in all her movements a mixture of softness and dignity, which were evident indications of a heavenly mind. She came to Paris, and, under a feigned pretext, gained admission to that republican tyrant, Marat, in whose breast. she plunged a dagger, acknowledged the deed, and justified it by asserting that it was a duty she owed to her country and mankind, to rid the world of such a monster. Her deportment during her trial was modest and dignified. — There was a softness so engaging in her countenance, that it was difficult to conceive how she could have armed herself with sufficient intrepidity to execute the deed. Her answers to the questions of the tribunal, were full of point and energy. She sometimes surprised the audience by her wit, and excited their admiration by her eloquence. Her face sometimes beamed with sublimity, and was sometimes covered with smiles. She retired while the jury deliberated on their verdict ; and when she again entered the tribunal, there was a majestic solemnity in her demeanour, which perfectly became her situation. She heard her sentence with attention and composure, and left the court with serenity, her mind being long before prepared even for the last scene. It is difficult to conceive the heroism which she displayed in the way to execution. There was such an air of chastened ex- ultation thrown over her countenance, that she inspired sentiments of love, rather than pity. The spectators, as she passed, uncovered their heads before her, and others gave loud tokens of applause. She ascended the scaffold with undaunted firmness. When the executioner informed her that her feet must be tied to the fatal plank, she submitted with a smile. When he took off her hand- kerchief, the moment before she bent under the fatal stroke, she blushed deeply ; and her head, which was held up to the multitude the moment after, exhibited the last impression of offended modesty. Such an instance of a young female, given up to destruction, and yet so tremblingly alive lo modesty, that even in her last moments she resents the slightest insult to that, more than she dreads the exe- cutioner's axe, is a display of the charm, as we]] as the force of virtue triumphant over death, that deserves to be preserved in ever- lasting remembrance. Its effects on the crowd beggared all descrip- tion. Admiration held the gazing thousands mute. And though, while gazing on her cheeks yet divinely enriched with the blush of deathless modesty, they shed their tears over her untimely fate, still their joy-glistening eyes seemed to thank her for such a proof of the divinity of virtue, and the birth-right to heaven. One of the spec- tators, a young man, by the name of Lux, had his feelings wrought to such an adoration of her virtues, that he proposed, in a pamphlet published the day after, to erect a monument to her honour, and to inscribe it with these words :— GREATER THAN BRUTIS He was instantly sentenced to the guillotine. He received the news with joy, and died exulting that he had the honour of being- offered up at the same altar with the immaculate Charlotte Corday. 140 ON HYGIEINE, OR THE APwT As lamps bum silent, with unconscious light, So modest ease, in beauty, shines most bright : Unarming charms with edge resistless fall, And she who means no mischief, does it all. — Hill. Plutarch observes, that as thistles, though noxious things in them- selves, are usually signs of an excellent ground wherein they grow, so bashfulness, though many times a weakness and betrayer of the mind, is yet generally an argument of a soul ingenuously and vir- tuously inclined. We read of many, who, through modesty and fear, when they were to speak publicly, have been so disappointed, that they were forced to hold their tongue. Thus, Cicero writes of Cario, that being to plead in a cause before the senate, he was not able to speak what he had premeditated. Also, Theophrastus being to speak before the people of Athens, was on a sudden so deprived of memory, that he remained silent. The same happened to the famous Demosthenes in the presence of King Philip. Nor are we ignorant that the like misfortunes have befallen many excellent persons in our times. Get that great gift and talent, Impudence, Accomplished mankind's highest excellence; 'Tis that alone prefers, alone makes great, Confers alone, wealth, titles, and estate ; Gains place at court, can make a fool a peer, An ass a bishop, can vil'st blockhead rear To wear red hats, and sit in porph'ry chair. — Oldham. When once men have bid adieu to modesty, there is nothing so unmanly, indecent, or reprehensible; but the brazen brow will venture upon; and nothing so high or great that his impudence does not pretend a title to. A gentleman being asked how it came to pass that he, being a man of extraordinary natural parts, and those improved by a uni- versity education, foreign travel, diligent study, and the knowledge of most European languages ; besides being well born, and having many friends to recommend him, missed a considerable employment in the government, at a time when there were so many vacancies ? The gentleman answered, a The reason is plain ; I have too much modesty, and too little impudence, to be preferred, where a higher value is put upon the latter than the former." For he that has but impudence, To all things has a fair pretence ; And put among his wants but shame, To all the world may lay his claim. — Hudibras. An Athenian, of decrepit age, came into the theatre at Athens, on a public night, when it was very much crowded. He went to that part of the house where his young countrymen were sitting ; but, instead of making room for him, they closed their ranks. By chance he came to a place where sat some young Lacedemonians OF PRESERVING HEALTH. 14.1 of the first distinction, who, moved with the age of the man, in reverence to his years and hoary hairs, rose up, and placed him in an honourable seat amongst them ; which, when the people beheld, with a loud applause, they approved the modesty of another city. At which one of the Lacedemonians said, " It appears that the Athe- nians do understand what ought to be done, but they neglect the practice of it." These young Lacedemonians were heathens. How devoutly were it to be wished, that all young Christians would copy so fair an example, and learn to treat seniority with a respect equally amiable and endearing. OF DRESS. If the rude verse that now detains your ear, Should to one female heart conviction bear ; Recall one gentler mind from Fashion's crew, To give to Nature what is Nature's due ; Whilst others mount the arduous heights of fame, To wake your feelings be my nobler aim : Nor you unblest, if, whilst I fail to move, The fond attempt my kind intention prove. — Roscoe. Pliny, one of the most celebrated naturalists of antiquity, pa- thetically laments, that, " whilst Nature has given various clothing to the brute creation, and even fenced plants and trees with bark against the injuries of the cold and heat, she should have cast man into this world naked, unprovided against the inclemency of different climates and seasons." But, instead of agreeing with that philoso- pher, that Nature has, in this particular, acted more like a cruel step-mother, than a kind and indulgent parent to man, we cannot sufficiently extol her providence and wisdom. It was no more than consistent with equity to provide the irrational part of her works with clothing suitable to their circumstances; but man, whom she e/idued with the transcendent faculty of reason, she hath very wisely left to accommodate himself to the difference of season and climate, and to clothe himself, accordingly, with the fleeces and skins of animals, and the products of various plants and trees. Nature knows no other use of clothes but to keep the body warm. The shape God has given, is too often attempted to be mended by dress; and those who know no better, believe that mankind would be frights without its assistance. The bones of growing persons are so cartilaginous, that they readily yield to the slightest pressure, and easily assume the mould in which they are confined. Hence it is, that so many girls, in proportion to boys, are misshapen. A lady, whose girls were all misshapen, though her family was numerous, consulted the celebrated anatomist, Mr. Cline, on the 142 OX HYGIEIXE, OR THE ART prevention. " To have no stays — and to let the next girl run about like the boys" was the excellent advice of this gentleman : which being complied with, none of the future children were afterwards maired by the ill-placed attention of the ignorant mother. " It has been said," observes a celebrated female author, " that the love of dress is natural to the sex;" and we see no reason why any female should be offended with the assertion. Dress, however, to be consistent with the graces and with nature, must be subject to certain rules. By attending to these particulars, is produced that agreeable exterior which pleases we know not why; which charms, even without that first and powerful attraction, beauty. also be occasioned by external injury. Treatment. — Unless the inflammation can be resolved in the very beginning, it rapidly terminates in a mortification. Therefore, a violent pain in the region of the stomach, with sick- ness and fever, should always be very seriously attended to. Copious and repeated bleedings, not regarding the smallness of the pulse, are absolutely necessary, and is almost the only thing that can be de- pended on. In no inflammation is the immediate use of the warm bath so necessary as in this, which attacks at once the " throne" of life. If a better bathing vessel cannot be had, a barrel or half hogs- head, filled with warm water, about blood heat, will do. Let the patient be instantly put in it, covering the top with a blanket. Keep him in as long as he can bear it, and when taken out and wiped dry with warm cloths, he should immediately have a large blister or ca- taplasm over the stomach. The bowels must be kept open by the mildest clysters, as water gruel, or weak broth, with the addition of a little saltpetre, and sweet oil or sugar. These injections answer the purpose of internal fomentations, and also nourish the patient, who is often unable to retain any food, or even drink, upon his stomach. The ery thematic inflammation of the stomach often arises in putrid diseases, and comes on insidiously. It is evident, by the inflamma- tion appearing on the internal surface of the mouth. When, there- fore, an inflammation of this kind affects the mouth and fauces in the bilious, typhus, or puerperal fevers, with a frequent vomiting, and an unusual sensibility in the stomach, we may suspect that the same affection extends downward. In such cases, or when the state of inflammation is approaching to gangrene, spirits of turpen- tine, in doses of a tea-spoonful, given alone or in a little water, upon the high authority of Professor Chapman, will arrest the disease. — This medicine is to be repeated, more or less frequently, according to the urgency of the symptoms. When the disease is a little alle- viated, the infusion of bark, with a few drops of any mineral acid, is borne with ease, and is highly beneficial. Regimen. — When the stomach will admit of nourishment, only that of the lightest kind should be allowed ; barley-water, and mu- cilage of gum Arabic, moderately warm, are the most suitable drinks. Every thing of a heating and irritating nature, must be carefully avoided for some time after the attack. INFLAMMATION OF THE INTESTINES. 247 INFLAMMATION OF THE INTESTINES. Symptoms. — Tension of the belly ; obstinate costiveness ; great internal pain ; external soreness, especially about the navel, and so severe as scarcely to bear the slightest touch ; great debility ; hard, small, and quick pulse. Causes. — The same, generally, that induce the preceding dis- ease. It may also be the sequel of other diseases, as rupture, colic r dysentery, worms, &c. Treatment. — Whatever may be the cause, we must endeavour to bring about, as quick as possible, resolution, lest mortification be the consequence. The treatment of inflammation of the stomach will also be proper here, as copious bleedings, emollient clysters, fre- quently repeated, the warm bath, and immediately afterwards, a blister on the belly. — Cupping on the belly is also useful. Such is the nature of this complaint, that we cannot be too cau- tious in the" administration of medicines or diluents by the mouth. But the frequent use of emollient injections will, in great measure, supersede their necessity, and at the same time, act as fomentations to the parts. Fresh olive oil, in the dose of a table-spoonful, is per- haps, the only medicine that can be admitted with safety. When the violence of the disease has considerably abated, we may venture to give some aperient medicine by the mouth, as castor oil, not rancid, calomel, or cathartic mixture. In this stage of the disease, laudanum may be employed with great advantage, particularly by way of injection. When the disease is combined with spasmodic colic, the applica- tion of cold to the abdomen, either by means of pounded ice, cloths wetted with very cold water, or cold water dashed from a pail imme- diately over the belly, has sometimes succeeded, when all other means have failed, in removing the obstruction ; producing an increased action of the intestines, from sympathy with the external parts. Regimen. — After the disease is subdued, the diet should be, for some time, of the lightest kind, and not flatulent. — The patient must be kept quiet, avoiding cold, severe exercise, and all irritating causes. 248 INFLAMMATION OF THE KIDNEYS. INFLAMMATION OF THE KIDNEYS. Acute pain and heat in the small of the back ; great numbness along the thigh, and not unfrequently, a retraction of one of the testicles ; retching to vomit ; voiding the urine in small quantities, sometimes very pale, and other times, of high red colour, attended with febrile affections. The patient generally feels great uneasiness when he endeavours to walk or sit upright, and lies with most ease on the affected side. Causes. — Excessive exertions, external injuries, violent strains, exposure to cold when heated, and calculous concretion in the kidneys. Treatment. — Bleed copiously, keep the bowels open with castor oil and emollient clysters, use the warm bath, or foment the part with a hot decoction of camomile or bitter herbs, or hot water alone ; give mucilaginous and diluting liquors, as flax-seed tea, bajley- water, and thin gruel, with the camphorated powders, (see Dispensatory,) or small portions of nitre. A decoction of peach leaves, (see Materia Medica,) is also beneficial in this complaint. Flannel wetted with spirits, and hartshorn, or tincture of Spanish flies, may be applied to the small of the back, for the purpose of exciting some degree of in- flammation of the external parts. After the inflammation has some- what abated, the exhibition of laudanum in its usual quantities, either by mouth or clysters, will add considerably to the cure. The disease is often removed by a moderate ptyalism. If the disease have been treated improperly, or neglected at the onset, and a suppuration take place, known by a discharge of matter with the urine, use uva ursi, (see Materia Medica,) or balsam co- paiva, twice or thrice a-day, for a week or two, and afterwards, take bark or steel. Regimen. — The diet should consist of the most mucilaginous substances, as arrow-root, sago, milk, buttermilk, custards, flax-seed tea, barley, or rice-water, &c. In the convalescent state, moderate exercise in the open air is of great service. INFLAMMATION OP THE BLADDER HEADACHE. 249 INFLAMMATION OF THE BLADDER. Symptoms. — Acute pain at the bottom of the belly, which is much increased by pressure ; a frequent desire for, and difficulty in making water, and frequent efforts to go to stool, attended with febrile affections. Causes. — Calculous concretions, suppression of urine from ob- struction in the urethra, Spanish flies taken internally, or applied to the skin, wounds, bruises, &c. Treatment. — It must be treated as the preceding disease, except- ing that, where there is an entire retention of urine, the jTatient should drink no more than absolutely necessary. Gum Arabic kept in the mouth will sheath the inflamed parts without adding to the quantity of urine. If necessary, the catheter must be introduced, though much care is required in the attempt, which often fails. After using the warm bath, a cataplasm of mustard and vinegar ap- plied to the perinseum or some rubefacient, to excite external inflam- mation, will be attended with good effects. The lovers of wine and cider should remember that those beve- rages, however pleasant and exhilarating, have a tendency to aggra- vate all diseases of the kidneys and bladder, especially when they originate from an acrid state of the fluids. HEADACHE If a foul stomach be the cause, give an emetic ; after which, take Columbo three times a-day. If from a plethoric habit, which is known by a heaviness of the head, and flushed face, bleed and give opening medicines. If from rheumatism, apply a blister to the back part of the neck, or between the shoulders ; and, at bed-time, bathe the feet in warm water, and take the anodyne sudorific draught. (See Dispensatory.) If from a weak habit, and where the pain returns at stated periods, as in cases of intermittents, and is confined to one side of the head, as over an eye, the cure will generally de- pend upon the free use of bark and snake-root, or the solution of arsenic, twice or thrice a-day ; which seldom fails, especially if pre- ceded by a brisk purge. In this, as well as other periodical pains, laudanum exhibited in a pretty large dose an hour or two before the expected fit, will often prevent its coming on. Edier externallv 32 250 HEADACHE. applied over the pain on a piece of linen, with a warm hand to con- fine it, will afford immediate relief in headaches attended with cold skin. Cayenne pepper mixed with snuff, by irritating the mem- branes of the nostrils, has also given much relief in cold or nervous headaches. It is not unfrequent that the partial or nervous headache, as it is termed, is produced from a decayed tooth, which, on discovery, should instantly be extracted. Symptomatic headache is a disease of so many organs, that it is difficult to ascertain the organ primarily affected. But when the real nature of the complaint is ascertained, the practice to be pur- sued, will, of course, be obvious. Where the causes are beyond our reach, the disease may be mitigated at least by some of the remedies we have pointed out, such as paying attention to the state %f the bowels, blistering, and keeping up a determination to the surface. The sympathy between the head and the stomach has been al- ready noticed. It is the subject of such constant experience, that to enlarge on it would be superfluous. Headache attends fever of almost every kind. Eveiy obstruction in the bowels; eveiy accu- mulation of sordes, or indigestible matter in the stomach, produces the same disease; every obstruction to the regular evacuation of any gland, particularly those of the surface; every nervous affection, either from excessive excitability or exhaustion, has a similar con- sequence. Repelled fluids from the surface produce very constantly a symp- tomatic headache. A cause of this kind is the repulsion of acrid matter from the surface, by the application of astringent washes to cutaneous affections ; by saturine or mercurial applications as cos- metics, from which the head generally suffers, though the mischief is often more extensive, and apoplexy or epileptic fits the frequent consequences. Repelled gout is a still more serious cause. We have not mentioned the mental causes, anxiety, fear, suspense, and grief; for these seldom produce the complaint until the body, or, in general, the stomach, is affected. The headache of students is often merely a nervous affection. — Whatever be the action of the nervous fibres in intellectual operations, its excess is often a cause of pain ; though, in many instances, the headache of students is con- nected with obstructions of the bowels, and very often with increased determination to the head. The hysteric headache partakes of this nervous cause, particularly when the pain feels as if a nail were fixed in the brain. Are we then to be surprised at its frequent oc- currence? Is it not wonderful that the head is ever free from pain? In the nervous headache, which occurs more frequently than is generally suspected, I have found no remedy so effectual as genuine wine. It may be given during the paroxysm, to persons unaccus- tomed to it, from a half pint to a quart, without producing any other than the pleasing effect of mitigating the pain. It is also the best EARACHE — DEAFNESS. 251 preventive of all nervous diseases, when used regularly and in mode- ration. (See Vine, Materia Medica.) When headache is accompanied with coldness of the extremities, bathing the feet in warm water, rubbing them with flour of mustard or tincture of Cayenne pepper, and keeping up a general circulation to the surface by flannel next the skin, will often afford immediate relief. And in cases of great determination to the forehead, as indi- cated by a flushed face and preternatural heat, the application of cloths wrung out of cold vinegar and water to the head and temples will be attended with good effects. Those subject to this complaint, should bathe their head every morning in cold water, avoid full meals, lie with their head high in bed; and always keep their feet warm, and the bowels in a regular state. EARACHE Is frequently produced by living insects getting into the ear. The most effectual way to destroy them, is to blow in the smoke of to- bacco, or pour in warm sweet oil. If occasioned by cold, inject warm milk and water in the ear, or drop in a little laudanum or vo- latile liniment. If this produce not the desired effect, foment the ear with steam of warm water, and apply a bag of camomile flowers, in- fused in boiling water, and laid on often, as warm as can be borne. When the inflammation cannot be removed, a poultice of bread and milk, or roasted onions may be applied to the ear, and frequently renewed till the abscess breaks ; after which, it must be syringed twice or thrice a-day, with Castile soap and water. In this com- plaint, a blister behind the ear is highly useful. DEAFNESS Is occasioned by any thing injurious to the ear, as loud, noise from the firing of cannons, violent colds, inflammation or ulceration of the membrane, hard wax, or by a debility or paralysis of the audi- tory nerves. It also frequently ensues in consequence of long pro- tracted fever. Treatment. — It is difficult to remove deafness, but when it is owing to a debility of some part of the organ, or arises in cons©- 252 TOOTHACHE. quence of any nervous affection, stimulants dropped into the ear, often prove salutary. Ether dropped into the ear, seems to possess a twofold effect, one of dissolving the indurated wax, and the other of stimulating the torpid organ ; but it is liable to excite some degree of pain, unless it be freed from the sulphuric acid. No prescription for deafness from indurated wax ever acted more surprisingly — none, I am sure, more agreeably, to my feelings, at least — than the following : — In consequence of a violent attack of bilious fever, which degen- erated into the nervous, my honourable friend, Colonel George M. Troup, of Georgia, was afflicted with a deafness for a year or two, so entire, that, in Congress, when the members were on the floor, he was obliged to place himself close to the orator, and even then, fre- quently failed of the pleasure and profit of hearing his reasonings. Suspecting indurated wax to be the cause of his deafness, I directed the cavities of both ears to be well syringed with warm and strong suds of Castile soap. This was done twice a-day, the ears con- stantly filled in the interim with pellets of wool dipped in strong camphorated liniment, and sometimes plugs of camphor. In a few weeks, the nerves of hearing recovered their sensibility, and, as the Colonel himself thought, more acutely, if possible, than before. Salt water is a better menstruum for the wax, and may be em- ployed, or some of the table salt finely powdered may be dropped in the ear. There is reason, however, for apprehending one bad effect from this remedy ; namely : giving such a susceptibility to the organ, that it is more liable in future to be affected by cold, and, therefore, this remedy must be employed with caution. Deafness, in old people, is sometimes attended with noise in the .ears, and is then generally owing to debility. Every evacuation increases it, and warm tonics, with a generous diet, are the best remedies. TOOTHACHE Is best removed by extracting the tooth ; but if this cannot be effected, fill the cavity with a little cotton dipped in the toothache drops, Turlington's balsam, or any of the essential oils, or with pills of camphor and opium. The nerve may sometimes be destroyed by a hot iron or knitting needle. A carious tooth is sometimes pained by accidental colds, and in such cases, it would not be prudent to have it extracted. If the external aperture be smaller than the carious cavity, after clear- ing away the carious matter, the access of air may be impeded by stuffing of gold or silver leaf. When the nerve is accustomed to the TOOTHACHE. 253 external air, it will continue carious for many years without pain, and be truly useful. When toothache is connected with rheumatism or gout, which sometimes happens, the remedies of either should be employed. This unpitied, though often excrutiating pain, is, in most cases, no more than the just punishment of our neglect of the teeth. Surely, then, we ought to take some care of them, though it were but for the pleasure of having them sound. But this care would be re- doubled, were we but daily to consider the advantage of good and clean teeth and sweet breath. Some women, indeed, are blessed with faces so nearly angelic, that not the blackest teeth can entirely defeat iaeir charms, nor the vilest breath drive away their lovers. But how different would be the effect of both, if, through their ruby lips, opened with a smile, we were to see teeth of ivory, white as snow, pure as the fair owner's fame, and accompanied with breath as sweet as that of infancy. The following tooth powder and wash will be found valuable. Tooth powder. Of the powder of red bark and armenian bole, of each one ounce. Powdered cinnamon half an ounce. Bicarb of soda half an ounce. Oil of cinnamon three drops. Tooth-wash. — Take of port wine one ounce. Carbonate of soda one drachm. Tincture of myrrh one drachm. Oil of horse- mint applied with a pellet of cotton or lint to the tooth has proved of the greatest benefit in putting an end to the pain of toothache. Prevention. — To prevent the toothache, and to preserve the teeth and breath perfectly sound and sweet, the tooth-brush dipped in warm water, and in the charcoal tooth-powder, (see Dispensatory,) should be used constantly every morning. The charcoal powder, an invention of the celebrated Darwin, is good for whitening the teeth, and admirable in correcting bad breath. The tooth-pick and tumbler of pure water should never be forgotten after every meal. If the calcarious crust or tartar upon the teeth adhere firmly, a fine powder of pumice stone may be used occasionally. When the gums are spongy, they should be frequently pricked with a lancet, aud gently rubbed with a powder composed of equal parts of Peru- vian bark and charcoal. Young persons who wish to carry their teeth with them through life, must take care never to sip their tea scalding hot, nor drink wa- ter freezing cold. Such extremes not only injure the tender coats of the stomach, but often ruin the teeth, and have caused many imprudent persons to pass a sleepless night, distracted with pains of the teeth and jaws. 254 RHEUMATISM. RHEUMATISM Symptoms. — Wandering pains in the larger joints, and in the course of the muscles connected with them, increased on motion, and generally worse towards night. When with fever, it is called acute or inflammatory rheumatism ; and, without chronic. Causes. — Sudden changes of weather; application of cold to the body when over-heated ; wearing of wet clothes. Treatment. In the inflammatory rheumatism, large and re- peated bleedings are necessary, as indicated by the fulnesf of the pulse, especially on the first days, and when there is much pain. With this should be combined a free use of diluent drinks, as flax- seed or balm tea, barley or rice-water, with a little nitre dissolved in each draught, or the antimonial powders, or mixture in small doses, to excite slight perspiration, which should be kept up with great care, as in this relaxed state of the skin, the disease is liable to recur upon the least application of cold. In this disease, a very essential discharge is the perspiration ; and if this be not produced, every medicine appears injurious. Of the diaphoretics, Dover's powder seems best adapted to this complaint ; and it should be observed, when sweating is once begun, should not be intermitted, and when it has relieved, should be suffered very gradually to decline. The foxglove, exhibited in doses from ten to twenty drops every four hours, will be found a remedy of considerable efficacy, particu- larly when an objection is made to the free use of the lancet. The blood root, (see Materia Medical) is also a useful auxiliary in this disease. Bleeding and blistering over the part affected, when the pain and inflammation continue violent, have likewise their good effects. After the inflammatory symptoms have in a great measure sub- sided, the anodyne sudorific draught or bolus, (see Dispensatory,) or laudanum alone, may be administered at bed-time, with great advantage. During this general treatment, attention must be paid to the state of the bowels, which should be kept open by emollient clysters or cooling medicines, as the cathartic mixture, or castor oil, exhibited in small and repeated doses. When the disease has fully attained its chronic state, it then forms a local affection, distinguished merely by stiffness, distension, and considerable immobility in the joint. In this species of the disease, a different plan of cure must be fol- lowed. Large evacuations are to be avoided, and external stimu- lants of the warmest kind should be applied, as the oil of sassafras, spirits of turpentine, opodeldoc, or the tincture of red pepper and mustard ; and, along with this, friction with a flesh brush or flannel RHEUMATISM. 256 over the afflicted joint is not to be omitted. If these means prove ineffectual to rouse the energy of the part, add to an ounce or two of either of the above articles, one or two drachms of the tincture of Spanish flies. In addition to these remedies, the internal use of the rheumatic tincture, (see Dispensatory ,) in doses of a table-spoonful, twice or thrice a-day in a cup of tea, is much to be depended upon. When these remedies prove ineffectual, we may suspect that some peculiar fault exists in the habit, which must be corrected before a cure can be expected. If the patient be much debilitated, or of a scorbutic habit, give him the nitric acid diluted, or bark freely. And if the disease be in consequence of venereal taint, or taking cold from the use of mercury, let him take calomel in small doses, or one of the mercurial pills night and morning until a ptyalism be produced. A strong decoction of sarsaparilla, (see Materia Medica,) is also a useful auxiliary, and sometimes a remedy of itself. In some cases of obstinate rheumatism, I have witnessed the hap- piest effects from taking, for some time, a tea-spoonful of flour of sulphur night and morning, in milk or spirits and water. In others, again, I found nothing equal to the pokeberry bounce, (see Materia Medical in doses of a wine glassful, morning, noon, and night. The cuckoo pint, or wake robin, (see Materia Medica,) in the form of a conserve, with an equal part of sugar, is often highly useful. The seneca root and mezereon in the form of decoction, has also been exhibited with most happy effects. Another valuable medicine in chronic rheumatism is the spirits of turpentine, in doses from twenty to sixty drops three times a-day, which may either be given on sugar, in a little water, or incorporated with double the quantity of honey, by melting them together over a gentle heat. But it should be observed that these active stimulants are never to be employed when there is the least febrile action prevailing in the system. The solution of arsenic has, in some instances, been exhibited with success in the chronic form of this complaint. Compressing the large arteries by means of a tourniquet or band- age, as mentioned under the head of intermittents, is another remedy which has been employed with advantage in severe rheumatic pains. In recent cases, when the pain wanders from one part to the other, or whenever the joints are stiffened and rigid, and the pain upon motion severe, or where the muscles have become contracted, by the length and violence of the disorder, immersing the whole body in a warm bath, strongly impregnated with salt, or applying it topically, by pouring warm water upon the limb from a kettle, or fomenting the part with a decoction of mullein two or three times a-day, will often sooth the pain, and prove a useful auxiliary to the other means we employ. Warm bathing, and warm pumping, are remedies of great utility in this disease; but as it requires painful muscular exertion to use the warm bath, it is not often resorted to. The vapour bath, from its superior temperature, is better adapted to its chronic form. 256 TIC DOULOUREUX. Two other forms of rheumatism ought here to be mentioned; namely, the lumbago, and the sciatic. The first attacks the loins or lumbar region, with a most acute pain shooting to the joints of the thigh. This affection is nearly related to the inflammatory rheu- matism, and must be treated in the same manner ; only, instead of applying blisters over the affected part, they should be applied on the inside of the thighs, and kept running for some time. The second, or sciatic, a violent, or fixed pain, attacking the hip joint, and partaking of the nature of the chronic rheumatism, is most successfully to be treated like that disease. Regimen. — In acute rheumatism, the patient must be kept on a cool spare diet; but no change whatever will be necessary in the patient's ordinary mode of living, in chronic rheumatism-. In this species, mustard and horse-radish, (see Materia Medica,) used freely in their natural state, or united with food, will be found very bene- ficial. In all cases of both diseases, flannel, or fleecy hosiery, should be worn next to the skin, a flesh brush be used morning and night, and every precaution be taken to guard against exposure to cold and wet, and also to a moist or damp atmosphere. If the appetite be im- paired, stomachic bitters, elixir vitriol or some of the tonic medicines may be taken with advantage. Exercise, either of the whole body or of particular limbs, will be highly important. The want of exer- cise is apt to produce stiffness in the limbs. Prevention. — Cold bathing, and the use of flannel next to the skin, are the most effectual means of preventing the recurrence of both acute and chronic rheumatism. TIC DOULOUREUX, OR PAINFUL AFFECTION OF THE FACE. Symptoms. — A painful affection of the nerves, which mostly at- tacks the face. The most frequent seat of the affection is in the nerves over the cheek bone, just below the orbit of the eye, the nos- trils, upper lip, and gums. The pain is often excited by opening and moving the mouth, attended with ptyalism and convulsive agi- tation of the adjacent muscles. The only diseases likely to be con- founded with this are, rheumatism occupying the face and jaws, and the toothache. It may, however, readily be distinguished from the former of them, by an attack of pain being readily excited, by the slightest touch, by the shortness of its continuance, and by its ex- treme severity and violence ; and from the latter, by the rapidity of its succession, and there being an entire freedom from pain at intervals. TIC DOULOUREUX. 257 Treatment. — A very great variety of medicines, given inter- nally, as well as remedies applied externally, have been tried for the alleviation and removal of this excruciating complaint, and even a division of the nerve has been resorted to ; but although this ope- ration has answered the purpose in a few cases, still it has failed in many others. Electricity, blisters, topical bleeding, by means of leeches, stimulant and anodyne embrocations, and frictions with mercurial ointment, have all been employed in rotation as external applications ; whilst the solution of arsenic, large doses of the extract, as also powder of Peruvian bark, preparations of iron, opium, and the extracts of hen- bane, hemlock, and nightshade, have been administered internally in considerable doses. It appears that the nightshade (bella donna) has, in many cases, proved a powerful and very efficacious medicine, and may, therefore, be given with confidence. From two to three grains of the extracts have been administered every five or six hours to adults during the great severity of the pain, or from twenty to forty drops of the tinc- ture, lessening the dose very considerably as soon as ease was pro- cured. It will always be most advisable to begin the use of this medicine in small doses, such as half a grain of the extract for an adult, repeated every four or six hours, increasing the quantity, by degrees, to about two grains ; and we may, at the same time, make trial of it as an outward application to the cheek, by laying over it a piece of fine linen rag, moistened in a solution of the extract in water, in the proportion of six grains of the former, to two ounces of the latter, or it may be wetted in the tincture of nightshade. The use of this medicine internally, is, however, often attended with distress- ing symptoms, when given in such doses as to produce a certain effect, as impaired vision, giddiness in the head, numbness, tightness at the chest, and a sense of suffocation, with dryness in the throat ; but these soon cease again, on greatly diminishing the dose, or wholly discontinuing the remedy. As persons unaccustomed to the use of so active a medicine, might be intimidated even by the probability of such unpleasant conse- quences, we would recommend them to make a previous trial of the carbonate of iron, in doses of one scruple, repeated three times a-day, gradually increasing each dose to the extent of one drachm, if no decided benefit be derived by taking it in smaller quantities. This remedy has been employed in several cases of the tic douloureux after a failure of very large doses of the extract of bark, the solution of arsenic, and most of the other means usually resorted to, with an exception of nightshade, in all of which the complaint soon ceased. and has not again returned in any of them. In the treatment of this very painful complaint, it has been advised to paralyze the nerve by the application of an ointment, consisting of two scruples of the superacetate of lead (sugar of lead") mixed with a little lard, every morning on the cheek affected about an 33 258 VACCINE DISEASE, OR COW-POX. hour before the paroxysm is expected. The experiment has been tried with success by Mr. Astley Cooper, in a case which had pre- viously resisted every other remedy, and even a division of the nerve by the knife. The following application has proved of signal benefit in this dis- tressing disorder. Laurel- water four ounces. Sulphuric ether one ounce. Extract of bella donna half a drachm to a drachm. To be applied to the part with cotton wadding wetted with it. A useful application will be found in the following ointment. Extract of bella donna half an ounce. Pulverized opium two scru- ples. Hog's lard half an ounce. Oil of thyme six drops. To be used with friction. Pills of bella donna and quinine have been very beneficial in a very distressing and protracted case in which many of the usual remedies had failed. Morphia has been applied by the skin to cure this complaint in the following manner. Two or three centigrammes of the sulphate of morphia were dissolved in a small quantity of water on a bit of glass. This solution was taken upon a vaccinating lancet, and forty punctures over the seat of pain were made. The operation was repeated several times and the patient completely cured. This disease has been successfully treated with tobacco. Take of the best shag tobacco four ounces. Distilled water two pints. Boil and let them simmer for two or three hours, and strain ; then wash the tobacco in two pints more of boiling distilled water ; strain and add it to the former liquor, and evaporate to an extract. One part of this extract to be mixed with seven parts of simple cerate to form an ointment. To make it more elegant, add a little neroly. Half a drachm night and morning to be rubbed in the part suffering. This has also cured toothache, used in the same manner by friction. It has been affirmed by some with great plausibility that this com- plaint arises from pressure produced by congestion of the blood ves- sels accompanying the nerve in its adit and exit from its bony canal. In this case, the application of cold would be of service, and such remedies as are likely to lessen such a state of aggravation. VACCINE DISEASE, OR COW-POX. The vaccine discovery may be justly considered as one of the most extraordinary blessings entailed on man ; since it is incontesta- bly a certain security against the small -pox, a disease distressing in its symptoms, formidable in its appearance, doubtful in event, and to which mankind are generally exposed. ■MBHM VACCINE DISEASE, OR COW-POX. 259 The comparative advantages which the kine-pox has over the small-pox, are very great and striking. First, it is neither conta- gious nor communicable by effluvia; secondly, it excites no disposi- tion to other complaints ; thirdly, it can be communicated, with safety, to children at the earliest age, and almost in every situation ; and fourthly ', it is never fatal. What more can be required to pro- duce a general conviction of its superior utility? The method of performing the inoculation is, to hold the lancet nearly at a right angle with the skin, in order that the infectious fluids may gravitate to the point of the instrument, which should be made to scratch the skin repeatedly, until it becomes slightly tinged with blood. The operator must be cautious not to make the wound deeper than ne- cessary, as the inoculated part will be more liable to inflammation, which may destroy the specific action of the virus. The most certain method of securing the infection is, to inoculate with fresh fluid from the pustule ; but as this is often impracticable, it is advisable to hold the infected lancet over the steam of boiling water to soften the hardened matter. Where the virus has been procured upon thread, make a small longitudinal incision in the arm, and insert in it the affected thread, and detain it there by court- plaster, until the disease be communicated. Matter may also be procured from the scab. The mode of inoculating from it is the same as from the fluid, taking care, however, previously to moisten it with tepid water, and to use the matter of the inner side of the scab. The scab will frequently retain its virus for months, provided it be kept in a close box. The first indication of the success of the operation is a small in- flamed spot where the puncture has been made, which is very dis- tinguishable about the third, fourth, or fifth day. This continues to increase in size, becomes hard, and a small circular tumour is formed, rising a little above the level of the skin. About the sixth or seventh day, the centre of the tumour shows a discoloured speck, owing to the formation of a small quantity of fluid, which continues to increase, and the pustule to fill, until about the tenth day. At this time it shows nrperfection the characteristic features which distinguish it from the variolous pustule. Its shape is circular, or somewhat oval, but the margin is always well defined, and never rough and jagged. The edges rise above the level of the skin, but the centre is depressed, and has not that plumpness which marks the small-pox pustule. As soon as the pustule contains any fluid, it may be opened for future inoculation. About two days before, and two after the eighth day, making a period of four days, is the season when the matter is found in its greatest activity. At the eighth day, when the pustule is fully formed, the efTects on the constitution begin to appear. The general indisposition is com- monly preceded by pain at the pustule and in the armpit, followed by headache, some shivering, loss of appetite, pain in the limbs, and a feverish increase of pulse. These continue with more or less vio- 260 VACCIXE OR COW-POX. lence for one or two days, and always subside spontaneously without leaving any unpleasant consequences. During the general indispo- sition, the pustule in the arm, which had been advancing to matu- rity in a regular, uniform manner, becomes surrounded with a cir- cular inflamed margin, about an inch or an inch and a half broad, and this blush is an indication that the whole system is affected ; for the general indisposition, if it occur at all, always appears on or before the time when the effloresence becomes visible. After this period, the fluid in the pustule gradually dries up, the surrounding blush becomes fainter, and in a day or two imperceptibly dies away, so that it is seldom to be distinguished after the thirteenth day from inoculation. The pustule now no longer increases in extent, but on its surface a hard thick scab, of a brown or mahogany colour is formed, which, if not removed, remains for nearly a fortnight, until it spontaneously falls, leaving the skin beneath perfectly sound and uninjured. The above is the progress of the vaccine inoculation in the greater number of cases, from the time of insertion to that of drying up of the pustule, with only the variation of a day or two in the periods of the different changes. The successive alterations, that take place in the local affection, appear to be more constant and more necessary to the success of the inoculation, than the general indisposition. With respect to the latter, the degree is very various : infants often pass through the disease without any perceptible illness ; with children it is extremely moderate ; and even with adults, its severity is but for a few hours, and then never dangerous. Very little medical care is necessary to conduct the patient through this disease with safety, especially when children are the patients. Adults may take a dose of salts on the eighth day, which will be particularly useful in plethoric habits. In general, no application to the inoculated part will be required, unless tbe inflammation in- crease, and the pustule become painful ; then the part should be kept moist with cold vinegar and water, or lead-water, till the pustule be dried up. To conclude, much attention and discrimination are necessary in the vaccine inoculation, to ascertain whether the infection have folly taken, and whether or not the disorder be complete and genuine. The regularity, with which the local disease at the place of inocula- tion runs through its several stages, seems to be the principal point to be attended to : for the presence of fever is certainly not necessary to constitute the disease, since the greater number of infants have no apparent indisposition. Therefore, when the vaccine inoculation is followed by no local disorder, or only a slight redness at the punctured part, for a day or or two, we can have no doubt that the operation has failed. When the pustule advances in veiy hasty and irregular progress, when the inoculated puncture, on the second or thud day after insertion, swells considerably, and is surrounded with an extensive redness, the pre- SMALL-POX. 261 mature inflammation very clearly indicates a failure in the operation, even when the inoculation has advanced for the first few days in a regular manner ; but when, about the sixth day, instead of exhibit- ing a well formed pustule and vesicle of fluid, the part runs into an irregular festering sore, the purpose of inoculation is equally defeated, and these varieties require it to be watched with an attentive and experienced eye ; since they might readily lead to a false, and per- haps fatal idea of security against any subsequent exposure to small- pox. The circumstance, however, which most strikingly distin- guishes the genuine from the spurious disease, is the appearance of the pustule. In the genuine, the pustule has a well-defined elevated margin, with an indentation in its centre, resembling a button mould. The spurious is either pointed like a small common abscess, or is rugged and irregularly formed, like an ordinary sore. Every other symptom, almost, occurs in each disease. SMA LL-POX It would seem unnecessar)^ to take any notice of the small-pox, after having treated so largely of its mild and merciful substitute, the cow-pox ; but as that dreadful disease does sometimes find its way on board of ships and into country neighbourhoods, sweeping whole families in its progress, it may be very proper to subjoin the follow- ing history of its symptoms and treatment. Symptoms. — A few days prior to the attack, the patient complains of languor and weariness, succeeded by cold shiverings and transient glows of heat, immediately before the fever, which is accompanied by violent pain of the head and loins, and, frequently, with a se- vere, oppressive pain at the pit of the stomach. The patient is very drowsy, and sometimes delirious. About the third day, the eruption appears like flea-bites, first on the face and limbs, and after- wards on the body. From this perid, the pustules gradnally in- crease, and on the fifth or sixth day, will begin to turn white on the tops. The throat, at this period, often becomes painful and in- flamed ; and sometimes on the seventh day, the face is considerably swelled. In the confluent, the spots assume a crimson colour, and instead of rising, like the distinct kind, they remain flat and run into clus- ters ; and, during the first days of the eruption, much resemble the measles, but are of a purple colour. The flow of saliva is constant in this form of the disease, and becomes so viscid as to be discharged with the greatest difficulty. Treatment. — The cure of small-pox depends on the general principle of the antiphlogistic plan, especially in a free admission of 262 SMALL-POX. cold air, which maybe carried much farther in this than in any other disease. Bleeding in the first stage of this disease, or when the pulse is full, may be allowed ; but the use of cooling purgatives, with acid and diluent drinks, are indispensable. When the eruption makes its appearance in clusters of a dark red^ colour, the disease is more of a putrid nature; and, consequently, in- stead of bleeding, requires a liberal use of bark and wine to invigo- rate the constitution, as directed in the nervous fever. (See Oak, Materia Medica.) But, besides this general treatment, there are some symptoms which require particular attention. Thus, when convulsions or great restlessness prevails, exposure to cold air, and a dose of lauda- num are enjoined. Where perspiration is much impeded, or deglu- tition difficult, blisters may be applied to the breast and neck ; and gargles, such as recommended for sore throats, frequently employed. If the perspiration be obstructed, the antimonial mixture may be used. When this disease finds its way aboard of a vessel, or into a family, all those who have not had it, should immediately be inoculated with the variolous matter, if the vaccine fluid cannot be procured. The benefits which result from inoculation are great, as we have an opportunity to prepare the system by abstinence from animal food, and by taking one or two purges of calomel and jalap before the eruption takes place. But if the subject be of a weak delicate habit, a restorative diet alone will be more proper. In every stage of the small-pox, the bowels should be kept open, either by mild purgatives or clysters. The following remarks of a writer in Queen Mary's time respect- ing the conduct or management of this disease have so much truth in them, I cannot refrain from giving them a place here. " Take away the blood in which the vital potency resides, and you mani- festly weaken the sick more and more, and diminish the spirits which ought to oppose, or encounter the disease. For nature, through bleeding, being weakened (not only by being robbed of her defence, but by introducing an enemy, who universally defiles her economy and quenches the vital flame) there immediately an universal weak- ness spreads over the whole human frame, and the contest of nature with the disease ceases, by nature's being overcome. This truth is so evident, that we cannot but speak it with grief, when we do but think of that late precious life, which by that means, we faithfully believe, was lost. In a thousand that have this disease and are let blood, at least, nine hundred and fifty of them die, and of this mine own eyes are witnesses. Whenever any of the blood-sucker's pa- tients die, the pustules seem to fall in again, grow flat and dead, or to dent in the middle; and sometimes to turn purple, livid, or black; with many livid or purple spots in the interspaces. Then to excuse themselves, they say it was a dangerous and malign disease, and complicated with an erysipelas, purples, spotted fever, or the like ; SMALL-POX. 263 by reason of which complication, 'twas impossible for the sick to escape death, what course soever had been taken." The best treatment consists in good nursing and a plenty of fresh air. HISTORY OF THE SMALL-POX. At what period of the world this scourge of mankind appeared, has never been determined. The ancient Greeks and Romans gave no evidence that they had a knowledge of it. The Arabian physi- cians were the first to give an account of it. Rhazes, an Arabian physician, described it about the beginning of the tenth century. It is supposed to have been conveyed about the middle of the sixth century by trading vessels from India to Arabia. And there is no question that the triumph of the Arabian or Saracenic arms, intro- duced it from Africa into the Levant, Spain and Italy. It spread its desolating ravages with great rapidity, during the 11th and 12th centuries, while Christian potentates arrayed their countless hosts in quest of the Holy Land. OF INOCULATION. This method of protection is derived from China, where it has been practised from time immemorial. From China it travelled into India and thence into Asia Minor — thence into Africa. They make (it is said) the incision when they inoculate, between the eye-brows. In 1721, Lady Mary Montague who had witnessed its triumphs in Turkey, and who had had a son inoculated there, submitted an in- fant daughter to the same process at this time, in London. The public and the profession viewed it with suspicion. An experiment was ordered to be made on six condemned criminals, all of whom were fortunate enough to recover, and who thus redeemed their lives. Yet such was the opposition to this innovation, that during a period of five years, not more than seven hundred and sixty four persons were inoculated all over England. OF VACCINATION. About fifty years ago it was known among those who kept dairies in Derbyshire and other counties in England, that cows are subject to a pustular disease, which, when communicated to milkers rendered them insusceptible of small-pox infection. Attempts were made to convey the small-pox to those who had been infected with the cow- pox, but all such attempts were fruitless. To Dr. Jenner is due the credit of taking up this subject and pursuing it with great ardour and judgment. He made many experiments, and ventured at length to publish his discovery in 1798, and to recommend inoculation with the virus of cow-pox as a substitute for smajl-pox. The result is well known, and vaccine inoculation has passed with rapid progress over every quarter of the world from the Arctic Circles to the" ex- tremes of Asia and Africa. 264 MEASLES. Regimen. — The diet is to consist of vegetable substances; as arrow-root, panado, milk, rice, &c, and when the eruption is com- pleted, a more nourishing diet may be allowed. If the disease be of a putrid kind, wine, cider, perry, porter, or milk toddy, may be given freely. In this, as in all diseases connected with putrescency, the advan- tages arising from cleanliness, as well as from frequent ventilation of the chambers, are so obvious, that to insist on them is unnecessary. (See Nervous Fever.) MEASLES. This disease is the effect of a specific contagion, and attacks pet- sons only once in life. Symptoms. — Alternate heat and chills, with the usual symptoms of cold. On the fourth day from the attack, eruptions like flea bites arise on the face aud body, and in about four days more, these erup- tions disappear with the fever. Treatment. — When the disease is very slight, little more is necessary than to keep the patient's body open with the cathartic mixture. But, should the febrile symptoms run high, with difficulty of breathing, bleed, blister the breast, and give Dover's or antimonial powders, the febrifuge mixture, or diaphoretic drops. (See Dispen- satory.) The cough being usually troublesome, it will be proper to take freely of flax-seed syrup, or some of the pectoral mixtures. Breathing the steams of warm water will also be useful, in relieving the cough as well as the eyes. The water should be put in a basin, and the head covered with a flannel large enough to hang over its edges. After the eruption is completed, the anodyne sudorific draught, paregoric, or laudanum, will be serviceable at bed- time, to allay the cough. If the spots suddenly disappear, immerse in warm water, or bathe the legs and feet, and give freely of warm wine whey, until the eruptions return. The consequences attendant on the measles, are often more to be dreaded than the immediate disease ; for although a person may get through it and appear for a time recovered, still pulmonary consump- tion frequently arises and destroys him. Another bad consequence of the measles is, that the bowels are often reduced to a very weak state, a diarrhoea remaining, which has sometimes proved fatal. An obstinate ophthalmia, or affection of the eyes, will also ensue, if pro- per attention be not paid in managing the disease. Most of these disagreeable symptoms may be prevented by blood-letting, and ad- ministering emetics, cathartics and diaphoretics, in the first stage of the disease. CHICKEN, OR SWINE-POX — MILIARY FEVER. 265 Should the symptoms manifest a malignant kind of the disease, and a putrid tendency prevail, we must then adopt a very different mode of treatment from what has been advised for the inflammatory. The cure must be conducted on the plan recommended for the ner-. ous fever, and putrid sore throat. Regimen. — The diet should be low and proportioned to the degree of fever. Barley or rice-water, flax-seed tea, or other cooling mu- cilaginous drinks, with jellies, as arrow-root, gruel, sago, &c, will, in general, be all that is necessary, until the feverish symptoms be evidently on the decline. Much caution is necessary, that the patient be not suddenly exposed to cold air, which might repel the eruption, and produce fatal effects. CHICKEN, OR SWINE-POX. In this disease, an eruption much resembling that of a very fa- vourable small-pox, appears after a very slight fever. This eruption soon proceeds to suppuration, in which state it remains but a little time, before the disease terminates by the drying up of the pustules, which seldom leave scars behind. As to the treatment, medicine is very seldom necessary, it being generally sufficient that the patient be kept moderately cool, and supplied with the diluent drinks and light food. — Should there be fever, a cooling purge, and afterwards, the antimonial powders, or mixtures, may be employed. MILIARY FEVER Is now considered to be symptomatic, only, because it never ap- pears contagious or epidemic. It sometimes attends febrile affections, as well those of an inflammatory as of a putrid nature ; but it sel- dom occurs in any, unless a hot regimen and sweat precede. The symptoms which attend, are restlessness, frequent sighing, fetid sweat, pricking of the skin, and an eruption of red small distinct spots, at first confined to the neck, breast, and arms, but soon spreads over the whole skin, except the face. When these eruptions make their appearance, they must be treated according to the rules laid down under their proper heads. 34 266 SCARLET FEVER. SCARLET FEVER. Symptoms. — Chilliness, followed by a burning dry heat; the pulse frequent, respiration irregular, a dejection of spirits, great pros- tration of strength, and often a stiffness of the neck. The face and neck are at first covered with red spots, which soon extend over the whole body. A sore throat generally comes on about the second or third day, but sometimes is wholly absent ; however, a redness of the fauces in every case is conspicuous. This fever is distinguished from the measles by the eruption being less distinct and more like a red-coloured effusion, and by not being accompanied by catarrhal symptoms. It is distinguished from Saint Anthony's fire by the fever being more considerable at night than the former, and the swelling being scarcely observable. It attacks more frequently young children ; whereas, Saint Anthony's fire is mostly confined to adults, and is not attended with a scarlet hue on the throat. This fever is evidently infectious, generally epidemic, and appears most frequently at the end of summer. Treatment. — Give an emetic on its attack, and on the following day administer some gentle cathartic medicine. The bowels should be kept in a soluble state, and nitre given in the patient's drink. The heat should be repelled rather than encouraged. And this is to be effected by cold affusions, which should be steadily applied. It is not enough to sponge the body once or again, but the cold water must be dashed against the patient repeatedly till the heat is subdued, and the process must be repeated as fast as it returns. In this disease, cold water is peculiarly applicable ; the heat being considerable, the determination to the head violent, and the debility alarming. We know no disorder which represses so powerfully the constitu- tional energy. Q,uinine and cordials would appear peculiarly useful in this complaint, from its tendency to putrefaction ; but if these be early employed, they will be found to increase both fever and de- lirium, to check the perspiration, and to impede sleep. Where this disease is attended with malignant symptoms, its ten- dency is to the putrid kind of fever, and must be treated accordingly. (See Nervous Fever, and Putrid Sore Throat.) Regtmen. — The diet should be light, the liquors cold, and acidu- lated with vegetable and mineral acids. The stools should be fre- quently removed, the linen frequently changed, and the room kept airy. The nurses should carefully wash themselves, and frequently change their linen. With these precautions, there is little danger of infection. st Anthony's fire — bleeding at the nose. 267 ST. ANTHONY'S FIRE. Symptoms. — An inflammation on some part of the skin, attended with pain and heat ; and when extensive, there is considerable fever, accompanied with drowsiness. Causes. — Imprudent exposure to cold when the body is heated ; hard drinking, and sudden stoppage of any natural evacuations. Treatment. — When slight, it requires only that the bowels be kept gently open, by an infusion of peach leaves, (see Materia Medica,) small doses of cream of tartar and sulphur, or the cathartic mixture, with small portions of nitre in the patient's common drink ; but when the attack is violent, and the head affected, then, in addi- tion to the above, bleed, bathe the feet in warm water, apply a large blister between the shoulders, sinapisms to the extremities, and give the saline or antimonial mixture, (see Dispensatory ,) with dilu- ent drinks. The best external applications are flour or starch, gently sprinkled by a puff on the part, or, in case of dryness and much heat, fresh leaves of the thorn apple, or cabbage leaves stripped of their stems and softened in boiling water, and renewed every two or three hours. Cold applications, as cloths wetted with vinegar and water, with the addition of a small quantity of camphorated spirits, have also been employed with great benefit and relief to the feelings of the patient. If, in spite of these means, ulceration should take place, apply bark poultices, frequently renewed, or cloths dipped in the cam- phorated spirits, with the usual means of preventing mortification. Should the inflammation assume a purple colour, or the swelling suddenly subside, attended with internal oppression, anxiety, and pulse, apply blisters or sinapisms to the extremities, and give wine or warm toddy freely, to throw out the eruptions to the skin; and then it is to be treated as the nervous fever. Regimen. — The diet should be low, and the drink chiefly of rice and barley-water, acidulated with tamarinds or the juice of lemons. Prevention. — Avoid the extremes of heat or cold, abstain from spirituous liquors, and keep the bowels regularly open. BLEEDING AT THE NOSE. In febrile diseases, accompanied with pain in the head, flushed countenance, and redness of the eyes, bleeding from the nose in general is salutary, and ought not to be checked, unless the patient is likely to be too much exhausted by it. — However, when this dis- 268 SPITTING OP BLOOD. charge is too profuse, the patient should have his head raised and exposed to the cool air. Beside which, cold acidulated drinks should be used, and the patient should rather immerse his head in very cold water, or have cloths dipped in cold vinegar and water frequently applied to the nostrils, face and back of the neck. A piece of metal, as a key for example, applied cold to the naked back, is a familiar remedy, and often succeeds. If these should not prove sufficient, a pledget of lint dipt in strong alum-water, or a powder composed of flour and alum of equal quantity, should be introduced into the nostrils, with sufficient force to compress the orifice of the ruptured vessels. In addition to these means, give a dose of Epsom or Glau- ber salts, to evacuate the bowels, and from ten to twenty grains of nitre every hour or two, in a glass of cold water. Immersing the feet in warm water while the cold applications are continued to the head, will also be found beneficial. One of the most powerful styptics which we can use, says Dr. Thomas, is powder of charcoal. It may be applied by means of tents, first moistened with water, and then dipped in this powder ; but in slight cases, it will answer by being taken like snuff. After the bleeding has ceased, the patient must be careful not to remove the tents of clotted blood, but should allow them to come away of themselves. SPITTING OF BLOOD. When there is a discharge from the mouth, of blood of a florid colour, brought up with more or less coughing, preceded by a sense of tightness, weight, and anxiety in the chest, and attended with a saltish taste of the spittle, it is in consequence of a ruptured vessel of the lungs. Causes. — Plethora; violent exercise of the lungs; and, frequently, mal-formation of the chest. Treatment. — The most important remedy in this alarming complaint, is blood-letting, which should be actively employed, paying, at the same time, attention to the state of the bowels. Spit- ting of blood, however, is sometimes owing to the contraction of the chest with debility ; and in this case, the lancet must not be so freely used. Sedatives, particularly those which repress the activity of the circulation, are highly useful. Of these, the chief are nitre and foxglove. Nitre, in doses of ten grains, given every hour, in the coldest water, and swallowed while dissolving, is much to be de- pended on in the early stage of this disorder. — The tincture of fox- CONSUMPTION. 269 glove exhibited in small doses every hour or two, by retarding the action of the pulse, will also prove a most useful auxiliary in suppressing pulmonic hemorrhages, particularly in those cases where an inflammatory diathesis prevails. Whenever there is fixed pain in the chest, a blister applied to the breast or back will do much service. According to Dr. Rush, two tea-spoonsful of common salt, dis- solved in a small quantity of water, and exhibited every two hours, or oftener, will check this disease, as well as hemorrhages from the stomach and uterus. Astringents are frequently resorted to, as alum, kino, and sugar of lead; but they are of little utility, except in the passive hsemoptyses, and even in these, nitre is often found preferable. If the cough be troublesome, it will be necessary to have recourse to demulcents and pectorals, as advised under the head of cold. Sometimes a spitting of blood is produced in consequence of sup- pressed evacuation; in this case, it is not dangerous, and only requires remedies to restore the customary discharge. A spitting of blood may readily be distinguished from a discharge of it from the stomach, as, in the latter, the quantity is usually more considerable, of a darker colour, and is generally unattended by coughing. Regimen. — A low diet should be strictly observed, and the body kept as quiet as possible. Nothing should be taken warm ; flax- seed tea, barley or rice-water, acidulated with the juice of lemons or elixir vitriol, ought to be used as common drinks, and taken as cold as possible. Prevention. — Carefully avoid all exertions which either detain or hurry the blood in its passage through the lungs, as singing, loud speaking, running, or lifting great weights. Obviate costiveness, by the occasional use of mild aperients, and use a spare diet. On ex- periencing any pain in the chest, blister, bleed, and constantly wear flannel next to the skin. Swinging, sailing, travelling in an easy carriage, and riding on horseback, will be the most appropriate exercise. CONSUMPTION. Symptoms. — Those which mark its first stage, are a slight fever, increased by the least exercise; a burning and dryness in the palms of the hands, more especially towards evening; rheumy eyes, upon waking from sleep ; increase of urine ; dryness of the skin, as also of the feet in the morning; occasional flushing in one and sometime* 270 CONSUMPTION. both cheeks; hoarseness; slight or acute pain in the breast; fixed, pain in one side, or shooting pains in both sides; headache; occa- sional sick and fainty fits ; a deficieney of appetite ; and a general indisposition to exercise, or motion of every kind. The first appearance of this disease will vary in different cases ; but the most constant symptoms which characterize it, are a cough and phlegm resembling matter, of which, at length, it becomes en- tirely composed. This disease often attacks insidiously, and is chiefly confined to the young, the fair, with light skin and blue eyes, florid complexions, contracted chest, and high shoulders. In constitutions disposed to hectic, the fingers are often long, and the nails bent ; they grow rapidly, but seldom expand in breadth and bulk. From the age of twelve or fourteen, to that of about thirty-five, is the hectic period ; more generally from sixteen to twenty-four; and the tendency seems to return about forty-five or fifty, especially in women at the period of the cessation of the catamenia. At the age of fourteen or sixteen in each sex, while the genital organs are evolving, there is often a considerable debility and irritability. The debility in females is often formidable, and a slight cough is no uncommon attendant. The cough is either quite dry, or accompanied with an expectoration of a small quantity of a thin frothy matter, which differs from that of true catarrh, in being easily diffusable in other fluids. Sooner or later, the general health becomes impaired, and at length, the fatal hectic makes its appearance with little suspicion ; all the symptoms being referred to the great change that then takes place. No diagno- sis can arise from the existence of fever, since in the chlorotic state coldness, with occasional flushing, are not unfrequent. In general, however, the fever of phthisis attacks more pointedly in the evening; that of chlorosis in the morning. The appetite of hectic patients is best in the forenoon ; of chlorotic at night ; and the latter can eat meat suppers frequently with impunity. It sometimes occurs that persons who have been improperly treated in the venereal disease, have symptoms which assume the form of consumption ; but, in general, the chest is free, while pains are more violent at night, and more frequently in the middle of the bones of either extremity, or deep-seated in the head, than in the trunk. It has also seldom proceeded so far as to mislead, without showing its nature by eruptions, or by an affection of the throat. From the state of mind, we may draw some distinction ; for cheerful hope illumines eveiy hour of the hectic; despair darkens each moment of the syphilitic patient. Strange as it may appear, amidst all the horrors of this disease, the patient's hopes are seldom abandoned, and even increase, as the fatal termination advances. Causes. — Obstructions and inflammation of the lungs, depending most frequently on the existence of small tubercles in the substance, which, coming to suppuration, burst and discharge a purulent mat- CONSUMPTION. 271 ter. Sometimes, it is induced by a general affection of the system, and sometimes it is a consequence of other diseases, as cold, measles, small-pox, pleurisy, &c. &c. Treatment. — This must be varied and adapted to each stage and case of the disease. In the first or inflammatory stage, moderate bleedings, twice or thrice a-week, according to the force of the pulse and habit of the patient, are essential, aided by blisters to the breast and back, and employing, at the same time, a cooling regimen. In almost every species of the disease, blisters or issues are often a means of relieving the cough ; for even when they have no ten- dency to remove the stimulating cause producing cough, as when it arises from a tubercle, yet they diminish the effect of the stimulus. They are particularly useful in that period of the disease, when a catarrhal has a disposition to degenerate into a phthisical affection; for in that modification of the disease, derivation from the lungs is of the utmost consequence. By this means, a change may often be effected in that state of suppuration which takes place from the in- ternal membranes of the lungs, and the purulent discharge may thus be converted into the natural mucus. Among other remedies in consumption, the use of emetics is strongly recommended. By the action of vomiting, the blood is propelled to the extreme vessels in every part of the body, particu- larly to the extreme vessels of the surface. Thus, there is produced a derivation from the lungs, and a consequent change in the state of suppuration at that part of the system ; but they are chiefly useful in consumption, as obviating symptoms, particularly cough and diffi- culty of breathing, and by promoting expectoration. A considerable variety of medicines of the refrigerating kinds have been strongly recommended for combating consumption in its in- cipient state. They tend to diminish the impetus of circulation, and although they do not immediately remove a plethoric state, yet they, perhaps, tend to diminish the inflammatory diathesis even more effectually than the repeated blood-lettings. The cooling neutrals, through the whole course of the disease, are useful ; par- ticularly nitre, which may be advantageously taken in any period of the complaint. Demulcents are always indicated, and usually employed in the manner we have recommended under the head of cold, to sheath the fauces, and lessen the violence of cough. Gum Arabic held constantly in the mouth, will also be found extremely useful in relieving this distressing symptom. Of all the remedies which have of late been fashionable in con- sumption is the foxglove, (see Materia Medical) but it does not seem to merit all the praises which have been given it. Under proper management, the foxglove produces a slowness of the pulse, not perhaps to be obtained from any other medicine yet discovered. And it has been the opinion of some, that, by reducing it to the natural standard, from the employment of digitalis, consumption may be overcome. But it should be observed, that the quickness 272 CONSUMPTION. of pulse in this disease is merely symptomatic, and that the reduction of it, even below the natural standard, can have no effect either in removing a tubercle, or in healing an ulcer in the lungs. Hence, on this ground, it is in vain to expect a radical cure from its use. However, as a diminution of the celerity of the pulse will somewhat alleviate the hectic fever, it may, in certain cases, be employed with advantage. The most eligible mode of using the foxglove is in a tincture, beginning with the dose of ten drops, and gradually in- creasing it to sixty to an adult, morning, noon, and night. In ex- hibiting this medicine, it should not, however, be given in such doses as to induce much sickness. Among other active medicines, recourse is frequently had to mer- cury, but unless consumption was excited by a venereal taint, we have never witnessed benefit from this medicine. On the contrary, when mercurial salivation is produced in the genuine consumption, it has uniformly hastened the death of the patient. The Iceland moss, or liverwort, has been, of late, highly extolled as a remedy in this complaint that readily allays cough, facilitates expectoration, abates hectic fever, and quiets the system without con- stipating the bowels. It is likewise said to strengthen the organs of digestion, without increasing the action of the heart and arteries. In- deed, the physicians of Europe have spoken so loudly in its praise, that eveiy patient ought certainly to give it a trial. The most ap- proved method of using it, is in the form of decoction ; an ounce of the herb to a quart of water, boiled for fifteen minutes over a slow fire, to which two drachms of sliced liquorice-root may be added about five minutes before it is taken off. A tea-cup full of this decoction should be taken four times a-day. Another form is by boiling two drachms of the herb in a pint of milk for ten minutes, and taking it for breakfast and supper. If choco- late be preferred, it may be blended with it, by making the choco- late with a decoction of the moss, without the liquorice, as above directed. Of all our indigenous plants, the Indian turnip, (see Materia Medica,) has the highest reputation as a remedy in consumption. It is evidently an active expectorant, and may be useful in the latter stage of the disease. In the treatment of this disease, balsamic medicines are frequently resorted to. They are totally unsuited to the inflammatory state of any one of the complaints of the lungs, whether acute or chronic. Action having been sufficiently subdued by depletory measures, they may be safely and advantageously administered in catarrhal con- sumptions and protracted coughs ; and will be found particularly useful when expectoration is checked from debility, and a want of irritability of the glands. So opposite are the states of the lungs in catarrhal affections, that it requires essentially different substances to produce expectoration. It may be depressed or imperfectly per- formed, by a constriction of the lungs ; by the removal of which, an CONSUMPTION. 273 infinite degree of relief is often afforded. It is also apparent that the lungs, occasionally from extreme debility, pour out an excessive dis- charge ; and that by direct stimulation of the exhalents, the effusion is abated and oppression removed. The advantages of the vegetable balsams, as they have been called, were supposed to consist in their power of promoting the healing of wounds and ulcers. At one time, many of them were highly extolled in pulmonary consumptions ; but each have had their day of fashion, and have each fallen into deserved neglect. According to the testimony of Drs. Duncan, Simmons, and other eminent physicians, gum-myrrh, exhibited in doses of twenty or thirty grains thrice a-day, united with an equal quantity of nitre, has, in many instances, been employed with the best effects in this intractable disease. While, for resolving tubercles or healing ulcerations in the lungs, many medicines have been taken internally, some modes of cure have been recommended with the view of acting topically on the diseased parts. In this way, different articles have been directed to be inhaled into the lungs, under the form of vapour. In an inflam- matory state of the bronchial glands, warm water vapour may be useful, and vinegar has occasionally been added ; but it seems often to irritate the cough, and the more stimulant vapours are evidently injurious, except where expectoration is difficult and deficient. In cases where the accumulations of the chest are owing to debility of the lungs, or are retained by the viscidity and tenacity of the matter, sulphuric ether is strongly recommended ; and, we are told, upon the high authority of Dr. Pearson, that its powers are improved by several substances which are soluble in it. Hemlock is particularly praised, half a drachm of which is to be digested in an ounce of ether, for several days, so as to form a saturated tincture ; of this, two or three tea-spoons full are to be put into a wine glass, to be held up to the mouth, and inspired till the whole is evaporated and repeated several times in the day. Similar in its effects to these inhalations, is the practice of smoking tobacco, the stramonium, and other substances. With the same views, tar fumigations, according to a distinguished Russian physician, Dr. Crichton, of St. Petersburg, have been em- ployed, and, it is said, with triumphant success. The mode he re- commends for doing this, is, to put the tar in an earthen vessel over a lamp, or heated iron, so as to cause a volatilization, till the air of the room is sufficiently impregnated, and this process is to be re- peated three or four times a-day. Having stated the remedies which have been most highly recom- mended in consumption, and from which, when properly adapted to the circumstances of the case, there is the best chance of recovery. we will conclude with a few remarks on the means of obviating urgent symptoms. It is a fortunate circumstance, that even in those diseases where 35 274 CONSUMPTION. the prospect of recovery is the most faint, and where there is next to certainty of an approaching dissolution in no long time, we still have it in our power to protract the period of life, and to alleviate the distress of the patient. In many cases of this terrible disease, it is all that we can reasonably expect to accomplish. Although colloquative sweats are not productive of pain, yet they tend very much to debilitate the patient, and by the loss of strength, the chance of recovery is very much diminished. Hence the ne- cessity, in such cases, of giving some tonic, as the elixir vitriol or in- fusion of bark. In every instance of consumption, it is of importance to prevent costiveness, and it is always a desirable circumstance to keep the bowels in a soluble state, which should be obtained rather by diet than medicines. But when diarhcea occurs spontaneously, this should in like manner be restrained by shunning the use of those articles which are observed to increase it, and by employing what are found to moderate it. Of all the symptoms which require to be mitigated, there is none which more frequently demands attention, than the cough. For this purpose an almost infinite variety of articles, either of the demul- cent or sedative kind, (see Cold,) may be employed with advantage. But of these substances, after the inflammatory symptoms have been subdued, none is so useful or so powerful as opium. This article, however, valuable as it is, cannot be considered free from inconve- nience. There are some individuals with whom, from peculiarity of constitution, it always disagrees, producing confusion in the head, vertigo, sickness at the stomach, and various other distressing symp- toms. In these cases the solution of sulphate or acetate of morphine might be given with advantage, as it is free from most of the objec- tions j ust mentioned. ( See Dispensatory.) Recourse has, however, been had to a variety of other sedatives, both with the view of allay- ing inordinate action, and of procuring sleep. Of all the substitutes for opium, none, according to the testimony of one of the most cele- brated and distinguished physicians in England, Dr. Duncan, equals the preparations formed from the common garden lettuce. (See Materia Medica.) It has been supposed, that by the continued use of opiates, we might allay irritation, and contribute to the great object, the healing of the ulcer. They have, however, failed in this view, though we cannot refuse their employment to lessen pain, and keep up the calm serenity, the pleasing delirium, in the midst of distress, and a state of hopeless of relief. From what has been said of the principal remedies recommended in consumption, the reader will find but little encouragement to in- dulge a hope of relief. He will probably exclaim, Is consumption, then, never cured ? Whence can arise the confident promises which every newspaper offers, and which the most respectable authorities confirm ? The deception arises from two sources. Catarrhal com- CONSUMPTION. 275 plaints are, in many instances, confounded with consumptive, and the most experienced eye is occasionally deceived. In some cases, also, vomicae are completely evacuated by expectoration, and the wound heals. So insidious is the attack of consumption, that it has often been taken for catarrh ; and, on the contrary, so violent is often a catarrh, that it has been pronounced to be truly phthisical, by practitioners of judgment and experience ; nor has the delusion been destroyed but by expectoration. From such errors it is not to be wondered that so many medicines should have gained credit in the cure of consumption. To say, however, that this disease is never cured would certainly appear rash; for instances have occurred in which a recovery has been perfected by nature ; but they are so few that they can scarcely inspire hope. Regimen. — Perhaps a greater number of cures in consumption have been effected by regimen than by medicine, especially if under this head be included, not merely diet, but air, exercise, and similar circumstances. It has been but too common to prescribe the same diet in every stage of the disease, which has been attended with the most perni- cious effects, and has often hastened the death of the patient. While the Brunonian fed his patients to avoid debility, the other practition- ers carried apparently their antiphlogistic system too far. In judging of that diet which is best suited to phthisical patients, due attention must always be paid to its effects upon the system. While a con- siderable discharge by blood-letting is requisite, it is certainly proper to avoid those articles which can furnish a large supply of rich chyle, even, although they should be, like milk, of the very mildest nature. But after the suppuration takes place, and there is a free discharge of purulent matter, the antiphlogistic plan should be pursued no far- ther; on the contrary, a more nutritious diet is essentially necessary. The healing of tuberculous ulcers in the lungs, as well as of scrofu- lous sores at other parts, is only to be expected from recruiting and giving vigour to the system. In this state of the disease, therefore, a nutritious diet is naturally indicated; and, indeed, the evident marks of exhaustion point out the propriety of a due supply. Be- sides these particulars, a liberal and nutritious diet is often mani- fested in this stage of the disease by the feelings of the patient ; for it is by no means uncommon to observe even a craving for animal food ; and it may be remarked, that in very rare instances only are such calls of nature entirely to be neglected. The diet in the inflammatory stage of consumption should be light, and composed of articles that tend to correct acrimony, and diminish inflammation, as milk, butter-milk, rice-milk, arrow-root, sago, fruits of every kind, and vegetables. In the advanced stage of the disease, and when the pulse is weak, a more cordial and stimulating- diet, and strengthening remedies are necessary. To prevent weakness, and other ill effects of an empty stomach, patients should partake frequently of meat, with wine, porter, or toddy ; raw oysters are 276 INCONTINENCE OF URINE. thought to be peculiarly proper. With this cordial diet, tar pills, bark, and elixir vitriol, or an infusion of the inner bark of the wild cherry tree, or hoarhound, and bitters of all kinds, have been ex- ceedingly useful in this state of consumption. Air and situation are apparently objects of considerable impor- tance, in a disease where medicine must confess the utility of her resources. Change of air is among the remedies constantly recom- mended ; and to change is often professedly the only object. Exercise, when not carried to fatigue, in a dry country air, often does more good than medicine ; and, consequently, should always be taken. Long journeys on horseback are the most effectual modes of exer- cise, carefully avoiding night air, and the extreme heat of the day in summer. That this exercise may not be carried to fatigue, pa- tients should, at first, travel only a few miles a- day, and gradually increase the distance as they increase their strength. When exercise on horseback cannot be supported, sailing and swinging should be substituted, and no efforts to cheer the spirits, or innocently to amuse the mind, should be neglected. Great care should be taken to regulate the dress according to the changes of the weather. The chest, in particular, should be de- fended from the cold, and the feet from the damp. In the various stages of this disorder, the bowels ought to be kept moderately open by emollient clysters, or the mildest laxatives, if the diet should not have the desired effects. INCONTINENCE OF URINE. Symptoms. — An involuntary evacuation of urine. Causes. — A relaxation of the sphincter of the bladder; injuries received about the neck of the bladder ; pressure of the womb in a state of pregnancy, &c. This sometimes proceeds from atony of the neck of the bladder : then a blister on the lower portion of the back with fifteen drops of the tincture of flies internally three times a-day will be of service with cold bathing. The sixteenth part of a grain of strychnine twice a-day has been attended with much benefit. When it arises from acrid urine diluent drinks should be used, together with the catheter. If there be a superabundance of lithic acid, alkalies should be em- ployed and tepid water injected into the bladder. When there is much irritation about the bladder and urethra, pills of camphor and hyoscyamus one grain each should be used. Fifteen drops of tur- pentine three times a-day have been given with decided benefit DIFFICULTY OF URINE. 277 ' Incontinence of urine (says Mr. Charles Bell,) never takes place but when the boy is asleep upon his back ; and the cure is a simple one. He is to accustom himself to sleep upon his face or side : the urine is not passed, nor is he excited to dream of making urine while he keeps this position. The circumstance is unaccountable, until we reflect on the position of this master-spring of the muscle of the bladder. When a person lies upon his belly , the urine gravitates to the fundus ; but when he lies upon his back, it presses upon this sensitive spot, and distends that part of the bladder which is towards the rectum." Treatment. — When the disease proceeds from a relaxation of the sphincter of the bladder, a large blister to the os sacrum, or lower- most part of the back-bone, will be found highly beneficial, and often effects a cure in one or two days. The cold bath, or dashing cold water upon the genitals, and tonic medicines, as the nitric acid, lime-water, bark, steel, and Columbo, are peculiarly proper in obstinate cases of this kind. The tincture of cantharides, in doses of ten or twelve drops, every three or four hours, is said, by Dr. Morton, to be a specific in this complaint. Others recommend alum whey, made as strong as the stomach will bear it, and direct half a pint to be taken night and morning. With others, the blue vitriol, in doses of half a grain, given twice a-day in any agreeable liquor, is most to be depended on. The occasional use of rhubarb, in small doses, to keep the bowels easy, tends greatly to alleviate the affection. When it is produced by an impregnated womb, little more can be done than observing a horizontal position as much as possible. DIFFICULTY OF URINE. When there are frequent uneasy urgings to void urine, and it is discharged with difficulty and pain, the disease is called a strangury ; and when it is totally retained, is called a suppression of urine. Causes. — It arises from a variety of causes, as calculous concre- tions ; obstructions in the urethra ; blisters ; or the tincture of can- tharides, taken internally too freely ; wounds, bruises, &c. Treatment. — The cure must greatly depend on the cause. If the pulse be full and feverish, bleed and procure stools by emollient clysters and cooling laxatives, such as castor oil, or the cathartic mixture. (See Dispensatory.) Much dependence is to be placed in the free use of demulcent drinks, as barley-water, flax-seed tea, mucilage of gum Arabic, decoction of marsh-mallows, of parsley roots, or of watermelon seeds, especially if the affection be owing to 278 DIFFICULTY OF URINE. the cantharides, or any injury of the bladder. One of the cam- phorated powders, (see Dispensatory,) given every three or four hours, in the patient's common drink, often effects a cure. — Great relief will be obtained from the warm bath, used oftener or seldomer as the case may require, or sitting in a tub of warm water, or from the frequent applications to the belly, of cloths wrung out of hot water, or bladders half filled with it. Opiates are very serviceable, but should never be used in the height of fever. A starch clyster, with laudanum, has very frequently given im- mediate relief. Cooling laxatives and diuretics, which operate without any stimulus, particularly the Epsom or Glauber salts, as in the form of the cathartic mixture, often relieve. As a diuretic, the following mixture is considered most salutary. Take, of sweet spirits of nitre, one ounce, laudanum and antimonial wine, each, two drachms, a table-spoonful of which may be given in some diluent drink, and half this quantity repeated every hour, if necessary. In the chronic strangury, after other means have failed, the use of calomel in small doses, or mercurial ointment rubbed into the thighs every night till a slight ptyalism ensues, has frequently ef- fected a permanent cure. In such cases an affection of the prostrate gland may be suspected to have been the cause. Walking on a cold wet floor, perhaps dashing water against the legs and thighs, would, in obstinate cases, succeed in procuring a discharge of urine, as it has done the faeces. When a suppression of urine arises from partial palsy, as frequently occurs in the old and debilitated consti- tutions, our best chance of success, in giving temporary relief, is to give the spirits of turpentine in pretty large doses, make use of general stimulants, and apply a large blister to the loins. When this complaint is in consequence of calculous concretions or gravel obstructing the urinary passages, which may be known by- pains in the loins, sickness at the stomach, and sometimes a dis- charge of bloody urine, an infusion of wild carrot-seed, sweetened with honey, as also the infusion of peach leaves, (see Materia Me- dica,) have been found exceedingly beneficial. The infusion of hops, which is considered a solvent of the stone, administered in doses of a wine-glass full, and taken to the quantity of a pint daily, is said to be an excellent remedy in calculous affections. The uva ursi is likewise celebrated as a remedy in cases of gravel, in doses of five grains with half a grain of opium, thrice a-day. A more power- ful medicine, however, for gravel complaints, is the caustic alkali, or soap-lees, (see Dispensatory,) but, being of an acrid nature, it ought always to be given in mucilaginous drinks, and commenced with small doses, which should be gradually increased as far as the stomach can bear, and continued for a long time, particularly if there should be an abatement in the symptoms. When great pain attends a suppression of urine, and the bladder is full, which can be ascertained by feeling it above the os pubis, and on pressure creating pain in the neck of the bladder, or at the end HEMORRHOIDS, OR PILES. 279 of the penis, it will be necessary to have recourse to the catheter, or a hollow bougie for drawing off the water. The larger sizes of each are more easily introduced than the smaller, as they are not so liable to stop in the corrugations and foldings of the urethra, which occur in elderly men. It is easy to introduce the catheter into the female bladder, since the direction of the urethra is nearly straight ; but in males there is greater difficulty. The celebrated Heister directs the man to lie on his back, and the operator to take the penis in his left hand as he stands on the patient's left side, reclining the penis to- wards the navel, then he is to introduce the catheter, thoroughly oiled, with its concave part to the belly, in the urethra, as far as the os pubis, and so thrusting it under the symphysis of those bones, and moving the hand gently outwards, forces it into the bladder. In the following cases, this instrument cannot be used : — When the neck of the bladder is greatly inflamed ; when a scirrhosity or preternatural tumour of the prostrate gland or stone obstructs the passage ; when the uterus is remarkably prominent and pendulous over the pubes; or when the uterus is retro verted; in which state it drags the bladder upwards and backwards. When the application of blisters causes a difficulty of urine, wash the blistered part frequently with warm milk and water, or apply sweet oil. In children, a suppression of urine is often relieved by a poultice of raw onions or radishes applied to the bottom of the belly. Regimen. — During the violence of this complaint, the lightest diet only should be used, and mucilaginous drinks taken freely. Those who are often afflicted with it, ought carefully to avoid aliment hard of digestion, flatulent, or of a heating nature. HEMORRHOIDS, OR PILES. When there is a discharge of blood from the hemorrhoidal veins, it is called the open or bleeding piles ; and when, instead of this hemorrhage, there are painful tumours at the lower part of the rectum, it is called the blind piles. Causes. — Costiveness; strong aloetic purges; much riding; or sedentary habits. Treatment. — If the patient be of a full habit, bleed, keep the bowels gently open with Epsom salts, the cathartic mixture, cream of tartar and sulphur or molasses and water; and avoid violent ex- ercise, high-seasoned dishes, and every thing of a stimulating nature. Topical applications, as cloths wrung out of cold vinegar and water, or lead- water, are also useful, and should not be omitted in either case. When the piles are of the bleeding sort, and will not readily 280 HEMORRHOIDS, OR PILES. yield to the above means, apply cloths dipped in charcoal powder, or in a strong solution of white vitriol or alum, frequently to the fundament, or anoint the part with the hemorrhoidal ointment, {see Dispensatory^) and endeavour to restore the tone of the vessels by the use of bark, elixir vitriol, nitric acid, or tincture of rust or steel. When the disorder assumes a chronic form in the more advanced periods of life, or when the piles do not bleed, they are generally at- tended with considerable pain ; in which case, dossils of lint dipped in olive oil may be applied, or olive oil with an equal portion of lau- danum, may be spread on soft rags and retained by the T bandage. In addition to this mode of treatment, when the tumours are very painful, it is necessary to sit over the steam of hot water, which sel- dom fails to produce immediate relief. The poke- weed (see Mate- ria Medica,) has, in some instances, been employed with good ef- fects. The balsam copaivi, in doses of a tea-spoonful night and morning is said to be useful in relieving the pain, and will sometimes effect a permanent cure. According to Dr. Thomas, the tincture of foxglove, given in pretty large and frequent doses, is a remedy both for the external and internal piles. When the tumours will not yield to the external applications above recommended, anoint them night and morning with the mercurial ointment, to which may be added one-fourth opium. If the blind piles encompass the anus so as to prevent the dis- charges by stool, and prove otherwise troublesome, the largest may be removed by a ligature. If the distend vein is high and inflamed, it may be opened with a lancet. When from long- continued piles a fistula is apprehended, Ward's paste is sometimes useful. It consists of a pound of elecampane root, with half as much black pepper, and a pound and a half of fennel seeds, made into a paste with honey. Perhaps the remedy of the honourable John Taliaferro, for whitlow, might be useful in this case. When the piles are apparently continued from relaxation, two. drachms of the tincture of steel, with nearly the same quantity of laudanum, and four ounces of Darley-water or thin starch may be injected as a clyster, morning and night. The following ointment has been found a valuable remedy. Sul- phate of zinc two scruples. Powdered opium one drachm. Pow- dered galls one drachm. Mercurial ointment, one ounce. In cases of blind piles, the following ointment has afforded instant relief. Oil of almonds an ounce. Extract of stramonium half an ounce. Sul- phate of morphia six grains. To be used as an ointment. The fol- lowing may also be employed. Opium one drachm. Galls two drachms. Simple cerate an ounce. In a very obstinate case of blind piles, the following powder has been of great service. Pow- dered oyster shells and burnt cork equal parts. Anoint the part with a little olive oil and dust the part with the powder. When every thing else has failed it must not be concealed that Hey's lini- ment has occasionally worked miracles. One tea-spoonful of Epsom 28i salts should be taken every morning to keep the bowels in a soluble state without operating enough to irritate. In all cases where debility attends, the sulphate of quinine should not be omitted. Prevention. — Those who are subject to this distressing com- plaint, may be assured of preventing its recurrence, by keeping the bowels in a soluble state, with the occasional use of sulphur at bed- time, by washing the fundament night and morning with the boldest water, and by making use of a sponge absorbed with cold water, af- ter obeying the calls of nature. DYSENTERY, OR BLOODY FLUX. Symptoms. — A discharge of mucus by stool, often bloody ; vio- lent gripings ; pain in the loins ; a constant inclination to go to stool, without being able to void any thing ; and sometimes fever. Causes. — Putrid air and aliment ; green fruit ; strong cathartics ; obstructed perspiration, and whatever increases the natural irritability of the intestines. Treatment. — To conduct the patient safely through this disease, the bowels should be evacuated by calomel, castor oil, or the cathar- tic mixture, and if the patient be of an inflammatory disposition, or there be febrile symptoms, blood-letting will also be required. After the acrid contents of the stomach and intestines have been evacuated, the anodyne sudorific bolus or draught, (see Dispensatory,) may be given at bed-time; and on the following day, if there be no evacua- tion of a natural appearance, one or other of the above aperient medicines must be exhibited in small doses, until the desired effect be obtained. To produce the natural evacuation daily, is a circumstance of the greatest importance in this disease, and should, at all times, be kept in view. To neglect this, as my good old friend, Doctor Henry Stevenson, of Baltimore, used often to say, would be like " Locking the thief in the house, to do all the mischief he could." It is some- times proper, instead of bleeding, to give an emetic in the beginning of the disease, to persons of weak habits ; but where there is a groat degree of irritability of the stomach, or obstructions of the liver, vo- miting will do more harm than good. It is my usual practice, at the commencement of this complaint, (o administer to adults about a scruple of calomel, conjoined with five or six grains of ipecacuanha, or a grain of tartar emetic, and a few hours afterwards, or if the medicine be taken at bed time, on the 36 282 DYSENTERY, OR BLOODY FLUX. next morning, to give a small dose of Epsom salts or castor oil. With children calomel, in large doses, united with a small portion of ipecacuanha, are the principal medicines I employ, as it is difficult to prevail on them to swallow either the salts or castor oil. This mode of practice, together with a plentiful exhibition of arrow-root, the occasional use of the warm bath, and after the inflammatory symptoms subside, an opiate at bed-time, has uniformly succeeded. When the febrile symptoms justified the use of the lancet, it was, of course, resorted to in the early stage of the disease. By conjoining the ipecacuanha with calomel or opium, a determination to the skin is produced, which is very desirable in this complaint. It should be remarked, however, though diaphoretics are indispensable, yet the patient should not be suffered to sweat profusely. The object is rather to produce a general relaxation, than to weaken by the dis- charge. A soft pulse, and moist skin, are the chief signs of the good effects of the remedies employed, and of a certain amendment. When the disease is epidemic, after having premised the necessary evacuations, calomel is most to be depended on, in doses of four or five grains, combined with Dover's powder, the anodyne sudorific bolus, or with one or two grains of opium alone, exhibited every night. And when the calomel does not produce a natural evacua- tion, it is always proper to give a small dose of Epsom salts, castor oil, or one or two wine glasses of the cathartic mixture, every morn- ing, until the disease begins to yield. If acidity prevails in the stomach and intestines, as marked by oppression, heat, sour belching, and vomiting, and excoriations about the fundament, besides a liberal use of mucilaginous and sheathing drinks, a wine-glass full of the absorbent mixture, (see Dispensatory ,) or a spoonful or two of new milk and lime-water, should be given every two or three hours. Frequent injections of cold water alone or flax-seed tea, or barley-water, with a table-spoonful of laudanum, are of infinite service when the pain in the bowels and tenesmus are distressing. In obstinate cases, or when there is the least apprehension of an inflammation of the bowels, the warm bath or local fomentation to the belly, and afterwards, a blister, are indispensable. At the close of the disease, or when it indicates symptoms of the putrid nature, the charcoal, Columbo, quinine, bark, and wine, are the appropriate remedies; and, as a purge, rhubarb maybe employed. Children that have been very much emaciated by this disease, have been most wonderfully restored to health, by bathing them night and morning in a strong decoction of oak bark, (see Materia Medica,) impreg- nated with whiskey or common spirits, and by putting on them bark jackets, as advised in the ague and fever. Doctor Mosely, a physician of great celebrity, states, that in chronic dysentery, unattended with fever, there is not a more efficacious medicine than the vitriolic solution, (see Dispensatory/,) in doses of a table-spoonful every morning, with an opiate at bed-time. DYSENTERY, OR BLOODY FLUX. 283 In preparing this solution, the proportion of either the vitriol or alum may be increased or diminished according to circumstances ; that is, when evacuations are required, the quantity of alum may be diminished, or entirely omitted*; and when great astringency is required, the quantity of alum is to be increased, and the vitriol diminished. A simple, though efficacious remedy in this disease, is a solution of common salt in vinegar or lemon juice, termed anti-dysenteric mixture. (See Dispensatory.) This medicine has also been strongly recommended in bilious fever, or putrid sore throat, when the bowels are in an irritable state. Dewberry is likewise a valua- ble medicine in this distressing disease. (See Materia Medica.) Regimen. — In the violence of this disease, the diet should consist only of arrow-root, sago, panado, or gruel, and the drinks of a cool- ing and sheathing nature, as barley or rice water, flax-seed tea, or mucilage of gum Arabic, or sassafras. (See Materia Medica.) But when the disease has existed some time, the diet should be more nourishing, particularly if the patient has been weakened by preced- ing disease, or is either of a tender or an advanced age. Oranges, and whatever ripe fruit the season affords, may be allowed. The room should be constantly fumigated with vinegar, and well ventilated. The clothing, as well as the bedding, ought to be often renewed, and all offensive odours, particularly the feeces, should be removed as speedily as possible. Prevention. — The same means of prevention are here to be used, as under the head of bilious; and, as this disease becomes infectious, by neglect of cleanliness, its farther progress, through the medium of bad air, may be checked by attending to the mode of purifying that element prescribed under the head of nervous fever.* * It was this disease, which carried from the honours of this, to the glories of a better world, the illustrious author of the Declaration of Independence, Thomas Jefferson. His disorder assumed a serious character on the 26th of June, 1826. The strength of his constitution and his freedom from pain, for a short time, encouraged the hope that his illness was merely temporary- He himself, however, felt the conviction, that his last hour was approaching. He had already lived beyond the limit ordinarily assigned to human existence, and, for some months past, he had looked forward to its termination, with a calmness and equanimity worthy of his past life, nunc dimittis domine, &c. "Lord, now lettest thou thy servant depart in peace," the beautiful ejacula- tion of the just and devout Hebrew, was his favourite quotation. On the 2d of July, the complaint left him ; but his physician expressed fears that his strength might not prove sufficient to restore him from the debilitated state to which he was reduced. Conscious that he should not recover, and free from pain, he calm]y gave directions relative to his coffin and interment, which he requested might be at Monticello, without pomp and parade. On Monday, the following day, he inquired with much solicitude, of those around him, what was the day of the month? On being told that it was the 3d day of July, he eagerly expressed his desire that he might be permitted to live vet a little while that he might breathe the air of the fiftieth anniversary. His de- sire was gratified. He was sustained up to the very moment when his wishes were complete, and was then borne to that world, where the pure in heart 284 APOPLECTIC FITS. APOPLECTIC FITS. Symptoms. — Sudden falling to the ground, with a deprivation of sense and motion, attended by deep sleep and noisy breathing, the circulation remaining unimpaired. Causes. — Plethora; hard drinking; too large doses of opium; blows ; tight neck-cloths, or whatever interrupts the return of the blood from the head. Treatment. — In the cure of a disease threatening such sudden fatality, remedies must be speedily employed. The patient's head should instantly be raised and supported, and he be placed in a situation where he can respire a cool air. He is to be bled most co- piously, to the amout of a quart or more, and this must be repeated after a short time, if he is not relieved, especially if the disease occur in a person of robust and plethoric habit. Cup also on the temples. Brisk purges are next to be administered, and when these cannot be swallowed, the most stimulating injections should be thrown up. The Croton oil, (see Dispensatory ,) will in these cases be valuable; for when the patient is unable to swallow, from one to two or three drops, dropped on the tongue, will soon find its way into the stomach, and produce the desired effect. Where the disease depends rather on a depletion of the blood vessels, than on too great fulness, which may be known by its at- tacking old people of debilitated habits, bleeding is sparingly to be resorted to, particularly if the countenance appear to be sunk and meet their God. Of Mr. Jefferson's public virtues and services, it were su- perfluous for the author to speak. History has taken charge of them. His excellent and amiable life, his warm and unvarying attachment to his friends, his liberal and unaffected hospitality, and his singular moderation and equa- nimity are also known to all, and by all, and are held in pleasing but mournful remembrance. None was ever more illustrious in life; none was ever more happy in death. On the same day died the venerable compatriot of Mr. Jefferson, the Ex- President, John Adams. Mr. Adams felt the gradual decay of age affecting his body rather by insensible degrees, than by any settled infirmity. He did not, till a few days before his death, show any indication of a more rapid de- cay of health than usual. The fourth of July found him unable to rise from his bed, on account of an unusual degree of debility. Roused by the sound of distant artillery, he said, " It is a glorious day." Being afterwards asked for a toast, to be drunk by his neighbours, he said, ** I will give them Indepen- dence for ever" These were his last intelligible words; about four o'clock, in the afternoon, this ancient patriot joined the throng of "just men made perfect." Great and glorious was the- consummation of these renowned founders of American liberty. They finished their course, when they reached the jubilee of that independence which they had, in so great a measure, con- tributed to establish. They departed, (to use the language of our present honoured Chief Magistrate, the distinguished son of John Adams,) cheered by the benedictions of their countrymen, to whom they left the inheritance of their fame, and the memory of their bright example. ■H EPILEPTIC FITS. 285 pallid. In these cases, the patient ought to be laid on a bed, with his head elevated, and turned every hour. Clysters are then to be given, and as soon as liquids can be swallowed, the contents of the stomach and bowels should be evacuated by a brisk purge. Sinapisms and blisters to the extremities, should not be neglected. But scalding or searing the soles of the feet with a hot iron, will more certainly and suddenly rouse the torpid system. Regimen. — The diet should be of the lowest kind, consisting principally, for several days after the attack, of diluent drinks, such as rice or barley-water, tamarind-water, or flax-seed tea, &c. Prevention. — In full habits, let the diet be light and sparing, and the bowels kept open. In debilitated habits, the diet should be more nourishing, and the strengthening medicines, as bark, steel, &c, employed to give tone to the vessels. EPILEPTIC FITS. Symptoms. — The patient falls suddenly with a deprivation of sense, while the muscles of the face and every part of the body are violently convulsed. Causes. — Excessive drinking ; sudden stoppage of the courses ; severe fright ; injuries of the head ; teething, in children ; and irri- tation from worms in the stomach and intestines. Treatment. — To prevent the patient from injuring himself b) the violence of his struggles, he ought immediately to be placed on a bed. The clothing should be every where loosened, and the head moderately elevated. A slip of wood should be placed between the jaws to prevent their closing on the tongue, and nothing adminis- tered in a glass vessel. Should it appear that the patient has beer drinking too freely of spirituous liquors, or has loaded his stomach with indigestible matter, a strong emetic should be immediately given ; which, by cleansing the stomach, will often terminate the paroxysm. If suppressed evacuations be the cause, they must be re-excited by such means as are calculated to restore the course of nature, h the patient complain of pain in the head, a seton in the nape of the neck should not be omitted. If worms be the fault, which may be known by an offensive breath and irregular appetite, they must be removed before a radical cure can be effected. The suppression of cutaneous affections has occasioned the dis- ease; the repulsion of the gout; and sometimes the deficiency of the constitutional strength, which prevents its formation, has had the 286 FAINTING FITS. same effect. In all these instances the knowledge of the cause will suggest the means of relief. When causes of debility and irritability, produce epilepsy; in other words, when the irritability is so great that the slightest irritation will induce the fits, the remedy is equally obvious. Warm, generous diet, which may appear at first indicated, must be used with caution ; since a fulness of the vessels is, alone, in tender habits, a cause of irritability. Tonic medicines, with some of the narcotic bitters, as hops, Iceland liverwort, and lettuce, are the best remedies in such cases, anxiously guarding, as usual, against any accumulations in the head ; but not by such medicines as will weaken. Sometimes an epileptic fit is preceded by an uneasy sensation in some of the limbs or trunk of the body, creeping upwards to the head. In this case, the fit will be prevented by applying a ligature above the part so affected. Many cases have occurred, in which this disease has been cured with the sugar of lead, particularly under the age of maturity. It should be commenced in small doses, beginning with one-fourth of a grain, for a half grown person, and gradually increased to two grains or more, thrice a-day, made into pills with the crumbs of bread. If from using this medicine the bowels be disordered, it should be laid aside until relief is obtained by the use of the bath, mild laxatives, and opium in more than usual doses. A small por- tion of opium, combined with the lead, (see Dispensatory^) will generally obviate or correct its unpleasant operation. The good effects of nitrate of silver, commonly called lunar caus- tic, have also been attested by eminent physicians, in doses from one fourth, very gradually increased to a grain, twice a-day, made into pills with bread. The flowers of zinc have likewise been highly spoken of, and are said to have performed permanent cures, in doses of six or eight grains, morning and night. As there is incontrovertible evidence, that these medicines have succeeded in certain cases, they are all deserving of a fair trial, par- ticularly in the treatment of a disease in which no plausible remedy should be left untried. FAINTING FITS Symptoms. — The pulse and respiration suddenly become exceed- ingly feeble, insomuch, at times, as to create a fear of the total ex- tinction of life. Causes.— Fright; long fasting; large evacuations; debility, &c. HYSTERIC FITS. 287 Treatment. — The patient should be placed in a reclining pos- ture, and every part of the clothing, which by its tightness is likely to interrupt the free circulation of blood, must be immediately loos- ened. The doors and windows of the room, especially if the weather be warm, should be kept open, and no more persons admitted than are necessary to give assistance ; and these should not prevent the free access of the air to the patient. Sprinkle the face with cold water or vinegar, and apply volatiles, burnt linen, or feathers, to the nostrils ; and, that the stimulus may with more certainty be inhaled, the patient should be kept from breathing through the mouth, by holding a handkerchief forcibly against it, taking care however, to leave the nostrils perfectly free. HYSTERIC FITS This disease more frequently occurs in unmarried or barren wo- men, and those who lead a sedentary life. It very seldom appears before the age of puberty, or after the age of thirty-five years. The time at which it most readily occurs, is that of the menstrual period. Symptoms.— Generally commences with universal languor and coldness of the extremities. The colour of the face is variable, being sometimes flushed and sometimes pale. The pulse becomes unequal and obscure. The stomach is sometimes affected with vomiting, the lungs with difficulty of breathing, and the heart with palpitations. A painful sensation is often felt, like that of a globe or a ball in the left side of the belly, advancing upwards, and producing the same uneasiness in the stomach, from which it rises to the throat, occa- sioning by its pressure, a sense of suffocation ; when a degree of fainting comes on, certain convulsive motions take place, agitating the trunk of the body and limbs in various ways ; after which, alter- nate fits of laughter and crying occur, and a remission then ensues. In some patients, a violent beating pain takes place in some part of the head, as if a nail were driving into it. Sharp pains, likewise, attack the loins, back, and bladder, and the patient makes an unu- sual quantity of urine as limpid as water ; which is one of the most characteristic signs of the disease. The appearances which take place in this affection, are consider- ably varied in different persons, and even in the same persons at dif- ferent times. It differs by having more or fewer of those circum- stances above mentioned ; by those circumstances being more or less violent, and by the different duration of the whole fit. Causes. — Excessive evacuations, particularly of the menses, de- 238 PALSY. pressing passions, continued anxiety, violent excitement, sudden sur- prise, grief, indigestion, &c. Treatment. — If the patient be young and of a plethoric habit, blood-letting will be required during the fit ; but in delicate consti- tutions, this operation is not advisable. Volatiles, singed feathers, and the like, should be applied to the nostrils : and if the patient can swallow, a tea-spoonful of ether, or tincture of assafcetida, or thirty or forty drops of laudanum, may be given, in a glass of cold water, and repeated in a couple of hours, or sooner, if necessary. Clysters of gruel, to which may be added a tea-spoonful or two of laudanum, will also have a good effect. The feet an 6! legs should, as soon as possible, be put in warm water, and well rubbed with the hand. Cold water sprinkled on the face, and the admission of the cool air in the room, are likewise proper auxiliaries. During the intermission of the fit, the nervous system should be strengthened to prevent a recureence, by the tonic powders, pills, or drops, {see Dispensatory ,) in their usual doses, after having admin- istered some purgative medicine. — Upon the approach of any lan- guor, the patient should instantly take a glass of wine, or a tea- spoonful of lavender, or ten or twelve drops of laudanum in a glass of cold water. When hysteric affections originate from a suppression or obstruc- tion of the menses, these must be promoted by adopting the means advised under those heads. Regimen. — An attention to diet is highly proper for the removal of this disease. A milk and vegetable diet duly persisted in, will have the most salutary effect, especially in sanguine constitutions ; but, should vegetables create flatulency and acidity in the stomach and bowels, in such cases animal food will be the most appropriate diet. The best drink after dinner is water with a little good wine, or a smaller quantity of old spirits. Tea should be prohibited altogether, or used sparingly. — Moderate exercise, particularly riding on horseback, is of the greatest service, as are likewise amusements and cheerful company. PALSY. Is a disease consisting in a loss of the power of voluntary motion, but affecting certain parts of the body only, and by this it is distin- guished from apoplexy. In the most violent degrees of palsy, the patient loses both the power of motion, and sense of feeling, either of one side or the lower half of the body. The first is termed hemi- plegia the latter paraplegia. When it affects particular parts only, as the tongue, the lip, eyelid, &c, it is termed a local palsy. PALSY. 289 Symptoms. — If this disease be not the effect of apoplexy, it is often preceded by universal torpor, giddiness, a sense of weight or uneasiness in the head, dulness of comprehension, loss of memory, and a sense of coldness in the part about to be affected ; there is also, sometimes tremour, creeping, and pain in the part. Causes. — Compression of the brain from any of the causes in- ducing apoplexy ; certain poisons received into the body, as lead, arsenic, (fee; injuries done the spinal marrow. It is also produced in consequence of extreme debility, and old age. Treatment. — If palsy arise from the causes producing apo- plexy ; it must necessarily be treated in the manner recommended for the cure of that disease, by bleeding copiously in full habits, and keeping the bowels in a laxative state for many days. It will also be requisite to apply a large blister to the back of the neck, and when the discharge is lessened, others should be applied behind each year. After congestion is removed by this mode of treatment, it will then be necessary to commence with the stimulat- ing plan, in order to rouse the torpid vessels into action. When stimulants are resorted to, they should be changed every eight or ten days, and sometimes alternated with gentle laxatives, to prevent re- turns of accumulation on the brain. In some instances this disease arises from diminished energy of the brain ; and in such cases we must have recourse to stimulants, both internally and externally, without delay. In this state the essential oils and balsams are frequently employed with good effects. One of the most active and useful medicines of this class is the spirit of turpentine in doses from twenty to sixty drops thrice a-day. A table- spoonful of horse-radish scraped, or the same quantity of mustard- seed, swallowed three or four times a day, will have a good effect. The volatile alkali is also of infinite service in large doses. At the same time, external stimulants must be duly attended to, such as dry frictions over the part affected, with a flesh brush or rough cloths, and the flour of mustard, or flannels impregnated with the tincture of Cayenne pepper, oil of turpentine, oil of sassafras, or volatile lini- ment, or some of the tincture of cantharides. Stimulating the part with nettles has produced good effects, as well as electricity, particu- larly in local palsies. A seton in the neck, particularly if the patient be affected with giddiness, will afford considerable relief, and should not be neglected. Cases of palsy have been cured by salivation. If the disease be in consequence of a curvature of the back bone, compressing the spinal marrow, a perpetual blister or issue over the part affected, or on each side of the diseased portion of the bone, is the only remedy. A local palsy, particularly when it is confined to one muscle, will generally yield to the application of a blister as near to the part affected as possible. This disease has been greatly relieved by the deul iodide of mer- cury combined with extract of aconite in the following combination. 37 290 HYPOCHONDRIAC DISEASE. Extract of aconite one grain. Deul iodide of mercury one grain. Pulverized opium three grains. Extract of gentian and mucilage Q,. S. to make sixteen pills. One, morning, noon and night. Col- chicum and Fowler's arsenical solution have also been taken with great benefit in this complaint. More recent experience has shown that blood-letting in this disease is not only unnecessary, but tends to aggravate and to fix the very symptoms it was designed to relieve. The cold shower-bath every morning and evening followed by fric- tion over the spine with a gently stimulating liniment has been very serviceable. Regimen. — In plethoric habits the diet should be of the lightest kind, but quite the contrary in debilitated habits. In such cases the diet should be warm and strengthening, seasoned with spices and aromatic ingredients, and the drink must be generous wine, mustard whey, ginger tea, or brandy and water. Flannel worn next the skin is peculiarly proper ; so is regular exercise, when not carried to fatigue or used in a cold damp air. HYPOCHONDRIAC DISEASE, (Commonly called Vapours, or Low Spirits.) This complaint chiefly occurs in the male, and that at advanced life; and it is confined, for the most part, to persons of a sedentary or studious disposition, especially such as have indulged grief or anxiety. Symptoms. — Languor, listlessness, or want of resolution and ac- tivity, with respect to all undertakings ; a disposition to seriousness, sadness, and timidity, as to all future events ; an apprehension of the worst or most unhappy state of them, and, therefore, often, on slight ground, a dread of great evil. Such persons are particularly attentive to the state of their own health, and to the smallest change of feeling in their bodies, from an unusual sensation, perhaps of the slightest kind, they apprehend great danger, and even death itself; and in respect to all their feelings and apprehensions, there are, for the most part, unfortunately, the most obstinate belief and persuasion. This diseased state of mind is sometimes attended with symptoms of indigestion, hysterical affections, and sometimes with melancholy; but these are merely effects. Causes. — Indolence; violent passions of the mind; suppression of customary evacuations ; obstructions of some of the viscera, &c. ; but its immediate cause appears to be a loss of energy in the brain, or torpid state of the nervous system. It would appear, however. HYPOCHONDRIAC DISEASE. 291 that these complaints proceed from an original affection of the stomach. Treatment. — The cure of this disease seems to depend on ex- citing the nervous energy which is depressed, and that particularly by attending to the state of the mind. A constant state of motion should, therefore, be advised, especially by riding on horseback, and making long journeys, which present new objects to the view. Nothing is more pernicious in this disease, than idleness; but in avoiding it, all application to former studies is to be prevented. The present emotions must be favoured and indulged : and though an attempt should be made to withdraw the attention of such patients from themselves, yet their confidence ought first to be gained ; and since the persuasion of their own opinion is strong, and the infalli- bility of their own fears and sensations rooted, however absurd these may be, they require a very nice management.* Raillery must * Some hypochondriacs have fancied themselves miserably afflicted in one way, and some in another — some have insisted that they were tea pots ; and some that they were town clocks, — this, that he had a big belly, and that, his legs were glass — one that he was extremely ill, and another that he was actually dying. But I have never heard of any of this blue-devil class, whose extravagance ever yet came up to the following, which was related to me by my noble-hearted old friend, the late Dr. Stevenson, of Baltimore, whose very name always sounds in my ears as the summary of every manly virtue. This hypochondriac, who, by the by, was a patient of Dr. Stevenson, after ringing the change on every mad conceit that ever tormented a crazy brain, would have it at last that he was dead, actually dead. Dr. Stevenson having been sent for one morning, in great haste, by the wife of his patient, hastened to his bed-side, where he found him stretched out at full length, his hands across his breast, his great toes in contact, his eyes and mouth closely shut, and his looks cadaverous. "Well, sir, how do you? how do you do this morning?" asked Dr. Ste- venson, in his blustering jocular way, approaching his bed. "How do I do," replied the hypochondriac, faintly — "a pretty question to ask a dead man." " Dead !" replied the Doctor. " Yes, sir, dead, quite dead. I died last night about twelve o'clock." Quick as lightning, Dr. Stevenson caught his cue, which was to strike him on the string of his character ; on which, the Doctor happily recollected he was very tender. Having gently put his hand on the forehead of the hypo- chondriac, as if to ascertain whether it was cold, and also felt his pulse, he exclaimed, in a doleful note, " Yes, the poor man is dead enough — it is all over with him, and now the sooner he can be buried the better." Then step- ping up to his wife, and whispering to her not to be frightened at the measures he was about to take, he called to the servant, " My boy, your poor master is dead, and the sooner he can be put in the ground the better. Run to Mr. C m, for I know he always keeps New England coffins by him, ready made; and, do you hear, bring a coffin of the largest size, for your master makes a stout corpse, and having died last night, and the weather warm, he will soon begin to smell." Away went the servant, and soon returned with a proper coffin. The wife and family having got their lesson from the Doctor, gathered around him. and howled no little, while they were putting the body in the coffin. Presemlv. the pall-bearers, who were quickly provided and let into the secret, started 292 HYPOCHONDRIAC DISEASE. never be attempted. From this supposed bodily affection, the mind should be diverted by employments suitable to the circumstances and situation in life, and unattended with much emotion, anxiety, and fatigue. Company which engages attention, and is at the same time of a cheerful kind, will always be found of great service. The occasional reading of entertaining books, or playing at any game, in which some skill is required, and where the stake is not an object of much anxiety, if not too long protracted, will farther assist in diverting the mind from itself. The symptoms of indigestion, and hysteric complaints, that so frequently attend this state of mind, although the effect, rather than the cause, are objects of practice ; inasmuch as they tend to aggravate and realize the false apprehensions of the patient. The secondary affections require the same mode of treatment recommended for in- digestion and hysteric disease. The warm bath is peculiarly bene- ficial in this complaint, and when the system becomes somewhat invigorated, the cold bath may be employed with advantage, provided there exist no obstructions in the bowels. From an acid acrimony generally prevailing in the stomach, the rust of steel, or filings of iron, in doses of ten grains thrice a-day,is the most salutary medicine of all the tonics. Magnesia and lime-water are useful on the same account. Regimen. — A proper diet constitutes an essential part in the treat- ment of this malady. In general, light animal food is what alone agrees with such patients ; for there are few, if any, vegetables which do not prove flatulent in their bowels. — Acids are particularly inju- with the hypochondriac for the church-yard. They had not gone far before they were met by one of the towns-people,, who, having been properly drilled by the facetious Stevenson, cried out, "Ah, Doctor, what poor soul have you got there V " Poor Mr. B ," sighed the Doctor, " left us last night." " Great pity he had not left us twenty years ago," replied the other, "for he was a bad man." Presently another of the towns-men met them with the same question. "And what poor soul have you got there, Doctor?" " Poor Mr. B ," answered the Doctor again, " is dead." " Ah ! indeed !" said the other. "And so the devil has got him at last." "Oh, villain!" exclaimed the man in the coffin, "if I were not dead, how I would pay you for that!" Soon after this, while the pall-bearers were resting themselves near the church-yard, another one stepped up with the old question again, " What poor soul have you got there, Doctor?" "Poor Mr. B " he replied, "is gone." " Yes, and to h— 11," said the other, " for if he is not gone there, I see not what use there is for such a place." Here the dead man bursting off the lid of the coffin, which had been purposely left loose, leaped out, exclaiming, "Oh, you villain! I am gone to h — 11, am I! Well, I have come back again to pay such ungrateful rascals as you are." A race was immediately com- menced between the dead man and the living, to the petrifying consternation of many of the spectators, at sight of a corpse bursting from the coffin, and in all the horrors of the winding sheet, racing through the streets. After having CRAMP. 293 rious. All malt liquors, except porter, are apt to excite too high a fermentation in the stomach ; and wines, for the most part, are liable to the same objection. If an exception can be made in favour of any, it is good old Madeira, when it can be obtained, which not only promotes digestion, and invigorates the concoctive powers, but acts, immediately, as a generous and wholesome cordial. The use of spirituous liquors is not to be recommended as an habitual resource, though they may be taken occasionally, in a moderate quantity, diluted with water. Tea and coffee, though hurtful to people with bad digestion, are often useful, however, to the hypochondriac. Moderate exercise, we have already observed, is indispensable in the cure of this complaint ; and it cannot be taken any way with so much advantage as in long journeys, when convenient, accompanied with such circumstances, as may convert them into an agreeable amusement. CRAMP. A painful spasm of the calf of the leg or muscles of the toes, and sometimes of the stomach. Causes. — Sudden stretching of the limbs; advanced pregnancy; acidity ; indigestion, irritation, and debility. Treatment. — A cramp of the calf of the leg is best relieved by standing up, which simple act, by throwing the weight of the body on the toes, forcibly extends the muscles, and thus takes off the spasm. If the cramp arise from acidity or indigestion, give every night a pill composed of half a grain of opium, with six grains each, of rhubarb and prepared chalk, and administer ten grains of the rust of steel, morning and noon. A cramp of the stomach is best treated by an infusion of red pepper, (see Materia Medica,) or a large dose of ether or laudanum, accom- exercised himself into a copious perspiration by this fantastic chase, the hypo - chondriac was brought home by Dr. Stevenson, freed of all his complaints. And by strengthening food, generous wine, cheerful company, and moderate exercise, was soon restored to perfect health. To demonstrate, farther, the happy effects of possessing quick wit, " to shoot folly as it flies," I will cite another case of hypochondriasm, which came under the care of that philanthropic and learned physician, the late Doctor Crawford, of Baltimore, who, in every thing amiable and good, was not unlike his intimate friend, Dr. Stevenson. A certain hypochondriac, who, for a long time, fancied himself dying o\' a liver complaint, was advised by Dr. Crawford, to make a journey to the State of Ohio. After an excursion of three months, he returned home apparently in good health: but upon receiving information of the death of a twin brother. who had actually died of a scirrhous liver, he immediately took the staggers* and falling down, roared out that he was dead, and had, as he always" ex- 294 TETANY, OR LOCK JAW. panied with friction on the part, either by a flesh brush or flanne' . When these fail, a very copious bleeding will sometimes remove the spasm, after which the patient must be purged. The chief remedies of spasm are those which remove the irritating cause. If this cannot be ascertained, we must endeavour to lessen irritability by anodynes. A sudden terror, the apprehension of a severe operation, on the return of the fit, and unexpected surprise, have succeeded. Dashing water in the face, touching a person with something cold, or throwing up a cold clyster, have, from the same principles, been effectual. Persons subject to the cramp in the leg may prevent it by wearing stockings in bed, and occasionally rubbing the part with camphorated oil. According to vulgar authority, sulphur grasped in the hand, is good to cure, and carried in the pocket, to prevent cramp. TETANY, OR LOCK JAW. Symptoms. — A rigid and painful contraction of all or several of the muscles. Its first symptoms are a stiffness in the back of the neck, increasing to pain, extending next to the root of the tongue, then shooting into the breast, and, lastly, seizing the back. Causes. — Wounds of the head or extremities, and punctures of the slightest kind, as running a splinter under the nail, or into the toe or finger. It is equally induced from cold or moisture, particularly when sudden vicissitudes prevail, or sleeping on damp ground. Treatment. — On the first appearance of this disease, give one oj two table-spoons full of laudanum, or six or eight grains of opium every two hours until the symptoms abate and then the dose should peeted, died of a liver complaint. Dr. Crawford being sent for,, immediately attended,, and asked the hypochondriac how he could be dead,, seeing he could talk. But still he would have it that he was actually dead. Whereupon, the sagacious Doctor exclaimed, tf O yes, the gentleman is certainly dead, and it is more than probable, his liver was the death of him. However, to ascertain the fact, I will hasten to cut him open before putrefaction takes place." And thereupon, getting a carving knife, and whetting it as a butcher would to open a dead calf, he stepped up to him and began to open his waistcoat, when the hypochondriac, horribly frightened, leaped up with the agility of a rabbit, and crying out, i: Murder ! murder! murder!" ran off with a speed that would have defied a score of doctors to catch him. After running a considerable dis- tance, until he was almost exhausted, he halted ; and not finding the Doctor at his heels, soon became composed. From that period, this gentleman was never known to complain of his liver; nor had he, for more than twenty years afterwards, any symptom of this disease. OR LOCK JAW. 295 be gradually lessened. Between the doses, wine or spirits should be given very freely. The use of the warm bath will also assist the efficacy of the opium. These remedies should be increased, and carried to the utmost extent, as the symptoms may indicate. If the opium cannot be swallowed, six times the quantity may be injected in clysters until the patient can swallow. This disease has oftentimes yielded to a salivation. And when there is time for the operation of mercury, it should be used both in- ternally and externally. At the same time it is advisable to give opium, in more moderate doses. Dr. Brown, who is now one of the principal professors in the Transylvania university, communicated some time since, through the medium of the New York Medical Repository, his success in the cure of tetanus with the tincture of cantharides. When recourse is had to this remed}^, give from twenty to thirty drops of the tincture every hour, until it produces strangury or a difficulty of urine. As soon as this occurs, it must be discontinued, and flax-seed or marsh- mallow tea or barley-water, or some mucilaginous liquid drunk freely, and some of it injected by way of clysters; to which may be occasionally added two tea-spoons full of laudanum. According to Dr. Nathaniel Miller, the solution of arsenic in doses of ten drops, with an equal quantity of laudanum, and a large spoonful of spirits every half hour, has, in several cases of tetanus, succeeded admirably in performing a cure. — When the symptoms abate, the dose must be diminished and the medicine gradually discontinued. Among the various remedies which have been recommended for the cure of tetanus, none has been employed with greater success than the cold bath. This is to be done by plunging the patient in the coldest water, or by pouring suddenly over his head and shoul- ders several tubs of cold water. The cold bath must be repeated every three or four hours, until a perfect cure be effected. On the decline of the spasm, bark with wine and opiates at bed- time should be given, until the patient's health be reinstated. Spirits of turpentine and infusion of tobacco (see Materia Medica,) have each been administered, by way of injection, with very happy effects in this alarming disease. In every stage of the disease, it is of importance to keep the bowels open, by the usual stimulating purgatives or clysters. When local injuries have been the cause of this disease, the wound should be dilated and filled with common salt, Spanish flies, or tur- pentine, and afterwards dressed with warm poultices until the wound be brought to a state of good digestion. If a wounded finger or toe be the cause of this horrible malady, it ought instantly to be cut off. 296 PALPITATION OF THE HEART — HICCOUGH. PALPITATION OF THE HEART. Symptoms. — In this disease, the motion of the heart is performed with more rapidity, and generally with greater force than usual, which may not only be felt by the hand, but often perceived by the eye, and even heard : there is frequently a difficulty of breathing, a purplish hue of the cheeks and lips, and a variety of anxious and painful sensations. It sometimes terminates in sudden death. Causes. — A morbid enlargement of the heart itself, and of the large vessels; organic affections ; an hereditary disposition ; plethora ; debility, or a morbid condition of the system ; mal-conformation of the chest, and many of the causes inducing fainting. Treatment. — This complaint is best relieved by keeping the mind and body at rest, avoiding every cause of irritation, and keep- ing up a proper equilibrium of the circulation. When the disease arises from plethora, and the action of the heart is violent, bleeding is indispensable, which should be followed by a cooling cathartic, and afterwards the exhibition of nitre every two or three hours, or the tincture of digitalis, in doses from ten to twenty drops thrice a-day, by lessening the action of the arterial system, will effect a cure. When there is reason to believe this affection is in consequence of debility, the solution of arsenic, in its usual doses, taken for some time, is a certain remedy. When the nervous system is affected, small doses of ether, laudanum, or some cordial will be found very serviceable. The feet should be kept dry and warm, frequently rubbed, and, if not otherwise warm, with powdered mustard seed, or tincture of Cayenne pepper. Those who are subject to a palpitation of the heart should care- fully avoid violent exercise, irregular passions, costiveness, and all circumstances that may tend to increase the action of the sanguife- rous system. HICCOUGH. A spasmodic affection of the diaphragm, and sometimes of the stomach, is a troublesome, but not often a dangerous complaint. Causes. — Debility, acidity, flatulence, cold drinks when the per- son is warm, repletion, worms, repelled gout, &c. NIGHTMARE. 297 Treatment. — When it arises, as is most frequently the case, from spasm induced by debilitating causes, the warm antispasmodics, as ether, laudanum, the camphorated mixture, hartshorn, tincture of assafoetida, or some of the essential oils, will be useful. A tea-spoon- ful of vinegar, slowly swallowed, has frequently afforded relief. Preserved damsons have likewise been found of excellent use in this complaint. When acidity is discovered to be the cause, give the absorbent mixture, or twenty drops of hartshorn, with a tea-spoonful of mag- nesia in a cup of mint tea, or a spoonful or two of milk and lime- water ; and, to prevent its recurrence, take ten grains of the rust of steel thrice a-day. When occasioned by poisons or improper food, an emetic will be proper. In weak stomachs, oppressed with indigestible food, a glass of good wine or spirits and water often relieves. Ether applied exter- nally to the stomach on a soft linen rag with a warm hand to con- fine it, is a good remedy; so is the application of an acrid cataplasm or blister in obstinate cases. Like other spasms, it is often stopped by strongly arresting the at- tention, whether by hope, fear, or terror. A sudden alarm has often succeeded in curing this affection after every other means had failed. On the same principle, a deep, continued inspiration will often re- move slighter degrees of this troublesome complaint. NIGHTMARE. Symptoms. — An alarming oppression of weight about the breast, with dread of suffocation. Causes. — Late and excessive suppers ; great fatigue ; drunken- ness, or sleeping on the back. Treatment. — If the patient be of a plethoric habit, bleed, purge, and use a spare diet. And when the disease is the consequence of debility and weak nerves, the tonic medicines, as steel, bark, or Co- lumbo in their usual doses, are proper. A glass of brandy, at bed-time will generally prevent the attack. Prevention. — The patient should sleep on a hard bed, which invites to frequent changes of sides, eat light suppers, which, with due exercise, and cheerfulness during the day, form the best preven- tive remedies. 38 29S ASTHMA. ASTHMA Is often hereditary. When attended with an expectoration of phlegm, it is termed moist or humeral ; and when with little or none, dry or nervous asthma. Symptoms. — It generally attacks at night with a sense of tightness across the breast, and impeded respiration. The person thus taken, if in a horizontal situation, is obliged immediately to get into an erect posture, and solicits a free and cold air. In violent paroxysms, speaking is difficult and uneasy. Treatment. — On i\\z first attack of asthma, bleeding is service- able, if the pain in the chest and difficulty of breathing be consider- able ; but less so afterwards, since the disease has a natural tendency to take off the plethoric state of the system. Emetics frequently repeated have been found of considerable utility in this disease. When there is reason to apprehend a paroxysm in the course of the night, an emetic exhibited in the evening will generally prevent it; and when the fit comes on in consequence of a loaded stomach, it will often afford immediate relief. As in other spasmodic affections, the most powerful antispasmodics, as laudanum, and ether, should be resorted to. These may be given conjointly or separately, but in large doses, to allay the violence of the fit, or to prevent its accession. Thus, half a tea-spoonful of laudanum, or one of ether, to be repeated in an hour, if necessary, in a glass of cold water, has frequently relieved the symptoms, or, when taken at the approach of the fit, have suppressed it altogether. A cup of strong colfee has sometimes afforded great relief; and when the disease proceeds from the irritation of mucus, a table-spoonful or two of vinegar in a glass of cold water is a good remedy. The skunk cabbage and stramonium, or thorn apple, are considered most valuable antispasmodics, and exceedingly beneficial in this complaint. According to Dr. Cutler, the emetic weed or Indian tobacco, {see Materia Medical) is a certain remedy. And Dr. Thomas speaks highly of the efficacy of the tincture of foxglove, in doses of fifteen drops twice a-day, conjoined with a few drops of laudanum. In every stage of this disease, the bowels must be attended to. The connexion of asthmatic paroxysm, with tlatulence and coslive- ness, plainly points out the importance of aperient medicines and those of the warm class, as aloes and rhubarb. Expectorants are frequently required in this disease. The powder, or syrup of squills, or gum-ammoniac exhibited in rather larger doses than usual, will often bring on expectoration, in cases apparently desperate. Blisters near the back are singularly useful, and should be often repeated. Cataplasms of garlic or onions to the feet are also valuable assistants. HEART-BURN 299 Regimen. — A light diet, easily digestible, and not flatulent, is always proper for asthmatic persons, and during the fit, cool drinks and fresh air are proper. It will always be found serviceable to wear a flannel shirt and to keep the feet warm. Prevention. — During the absence of the paroxysm, tonic medi- cines and the cold bath, together with moderate exercise, will be most efficacious in obviating its recurrence. HEART-BURN. Symptoms. — A burning sensation about the pit of the stomach, with acid eructations, flatulence, and sometimes retching to vomit. Causes. — A relaxed state of the stomach, generating acidities and acrimonies from food too long detained. As it is often a symptom of indigestion, the cause may be found under the head of the follow- ing chapter. Treatment. — The first indication is to remove the unpleasant sensations existing, which may be done by taking either a small tea- spoonful of salt of tartar, or a table- spoonful of magnesia in a glass of mint-water or tea ; or a tumbler of mucilage of gum Arabic or flax seed tea taken cold, with a small piece of liquorice ball dissolved in it. But, to cure the disease effectually, after an emetic, give the lime-water, or ten grains of the rust of steel, thrice a-day for some time, and keep the bowels moderately open with magnesia or the root of rhubarb chewed occasionally, or the tincture of it, taken in small doses; or the aloetic pill. If it should arise from bile, lemonade, or some of the vegetable acids, or a tea-spoonful of the spirits of nitre in a glass of the infusion of Columbo, will often afford immediate relief. When not arising from the contents of the stomach, general warmth, particularly of the feet, is essentially useful ; and even rub- bing them with flour of mustard, or tincture of Cayenne pepper, has produced good effects. Great benefit has also been experienced, and sometimes a complete cure effected, by the application of a blister to the pit of the stomach. To render it more efficacious, the blister should be kept running for at least a week. Regimen. — The diet of those who are subject to this complaint, should consist chiefly of animal food ; and all fermented or acid liquors and greasy aliment must be strictly avoided. A glass of brandy, or gin and water after dinner, is the best beverage* Moderate exercise is oarticularlv beneficial. 300 OR INDIGESTION. DYSPEPSIA, OR INDIGESTION Symptoms. — Want of appetite ; nausea ; sometimes vomiting ; heart-burn; costiveness; distentions of the stomach, particularly upon taking a small quantity of food ; frequent risings into the throat of a sharp acid liquor, and eructations of imperfectly digested matter. Causes. — Errors and irregularities in the mode of living; cola and moisture; intense study; depressing passions; and abuse of tobacco, opium, or spirits. Treatment. — To succeed in the cure of this disease, we must avoid the occasional causes, remove such symptoms as tend to aggra- vate or continue the disease, and invigorate the tone of the stomach. Crudities, acidity and costiveness, must be obviated, at least in their excess, as they tend both to aggravate and continue indigestion. The management of diet is also of considerable importance. The stomach should never be suffered to remain any time empty in dys- pepsia, as all the symptoms are aggravated by it. Persons afflicted with this complaint, should frequently eat a cracker or a piece of ship biscuit, as bread not subject to fermentation is one of the best sub- stances to be frequently taken. In some weak stomachs, a singular aggravation of the symptoms comes on in about an hour or two after a full meal, attended with a sense of sinking or weakness. This seems to be owing to a digestion unusually rapid, and consequently imperfect. In such cases, aliment of more difficult digestion, as eggs boiled hard, or the addition of condiments which retard digestion may be allowed; but, in general, a bit of biscuit and a glass of wine will remove the sense of weakness, which is owing to the sudden emptying of the stomach before too much distended. In order to the cure, recourse must be had to emetics, whenever the stomach is offended with mucus, bilious, or other humours. It is not unusual for a large quantity of very viscid mucus to be thrown up on the exhibition of an emetic. And this must occasionally be discharged, and its accumulation prevented by aromatics and tonics. The Columbo root is a medicine of great utility, when the stomach is languid, and the appetite defective. It may be given thrice a-day, in substance or infusion, with mint-water, or ginger tea, or infused in Madeira wine, or French brandy, now and then interposing small doses of the tincture of rhubarb. Taking a tea-spoonful of mustard seed with half the quantity of Columbo thrice a-day, will be found particularly useful, where acidity and flatulence prevail. A great variety of stomachics and tonics of the vegetable class, as camomile, gentian, quassia, Peruvian, and black oak bark, have been employed in the cure of this disease ; but scarcely any merits a preference to the Columbo, unless the Samson snake-root. (See Materia Medica.) However, it is not proper to continue the use of any tonic DYSPEPSIA, OR INDIGESTION. 301 longer than two weeks at a time. When acidity predominates, a wine-glass of lime-water, with an equal quantity of new milk, or ten grains of rust of steel, or filings of iron, will be found exceedingly beneficial. In some cases the digestion is injured by putrid matter, from decayed teeth, constantly mixed with the saliva, affecting the organs of taste, and destroying the appetite. In such cases, the charcoal tooth powder, (see Dispensatory^) or washing the mouth night and morning with the solution of alum, will correct this tendency. Even when the teeth could not be the cause of indigestion, I have seen the most happy effects result from the exhibition of char- coal powder, in doses of a table-spoonful, twice or thrice a-day, particularly when conjoined with a few grains of rhubarb, and double the quantity of powdered ginger, or by taking, after dinner, as much of the tincture of rhubarb as would keep the bowels in a regular state. Another medicine, apparently simple, though of con- siderable efficacy in this complaint, is the cob-web of the black spider, which generally inhabits the cellars, barns, and stables. Of this, from five to ten grains is to be given morning, noon, and night, in the form of pills. If the disease, as is too often the case, have been brought on by hard drinking, its only radical cure is to be found in temperance, cordial nourishment, exercise, and the use of elixir vitriol with bark, the nitric acid or the tonic powders or pills, (see Dispensatory.) When the patient complains of a pain in the stomach, resort to the remedies for heart-burn, and use friction with a flesh brush or flannel over the part. Should this fail, give a dose of ether or lau- danum ; and, in case of costiveness, administer an injection. This treatment will generally palliate the pain ; after which, endeavour to restore the tone of the stomach by tonic medicines, as the nitric acid, bark, Columbo, steel, &c. The costiveness peculiar to persons in this complaint, must be removed by medicines which gently solicit the intestines to a more regular discharge of their contents ; and this effect is best obtained by flour of sulphur, magnesia, or rhubarb chewed every day, and only the saliva swallowed. Strong purgatives are unfit to correct habits of costiveness, as they weaken the action of the intestines, and thereby increase the complaint when the evacuation is over. But nothing can so effectually obviate this affection, as the con- stant custom, most invariably observed, of going every morning to the privyj although you have not a natural inclination. Regimen. — The diet should consist chiefly of animal food well chewed, and taken in small quantities, followed with a glass of brandy and water, or good wine. Frequent friction with a flesh brush or flannel over the region of the stomach and belly will be found exceedingly beneficial. After taking an emetic, we have known a milk diet, persevered in for several weeks, effectually cure indigestion. This article, 502 COLIC. almost always offends the stomach at first ; but by continuance, be- comes agreeable to it, and effects a cure. The milk should be new, and free from acidity. Early rising, and moderate exercise in the morning air, can hardly be enough recommended, inasmuch as they contribute so happily to restore the tone of the stomach, as also the whole system. It is impossible to furnish a plan of regimen adapted to eveiy con- stitution and habit ; but if the patient will but pay due attention to what benefits, and what injures him, wisely regulating his mode of living by the information thus obtained, his present maladies will soon disappear, and their future recurrence for ever inhibited. COLIC. Symptoms. — A violent pain in the bowels originating from con- striction, attended with costiveness, and sometimes vomiting. The pain is commonly seated about the navel, and resembles various sensations, as of burning, twisting, boring, or a ligature drawn very tight across the intestines. It comes on without fever, which soon follows, especially if inflam- mation take place in the intestine affected, and then all the symp- toms become greatly aggravated. Causes. — Flatulency; indigestible aliment taken into the sto- mach ; acrid bile ; hardened faeces ; costiveness ; worms ; drinking too freely of acids; intermittents improperly cured; sudden check of perspiration ; and the application of poisons, such as lead, &c. (fee. Treatment. — When the disease evidently arises from wind, which may be known by a rumbling in the bowels, by pressure on the belly, or by the ease experienced from a discharge of it, or by the patient's lying on the belly, a glass of brandy, gin, strong mint-wa- ter, or tea made of ginger or calamus, will generally give relief : but it is only in colic from wind that these hot, spirituous and carmina- tive substances are to be used ; for in all other cases they do great harm, and often destroy life. The flatulent colic is frequently caused by wetting the feet, or otherwise checking the perspiration. — When this is the case, rubbing the legs and arms with warm cloths, and afterwards keeping the feet for some time in warm water, will be the most effectual remedy. As a spasm is the immediate cause, its resolution is the chief indi- cation of cure ; for this purpose relaxing and antispasmodic medicines with purges, which, while they solicit the internal discharge, will not greatly increase the morbid irritation, are the most proper means. colic. 3o3 Where the pain is fixed and acute, bleeding is advisable, particu- larly in full habits, to prevent inflammation. Next, the action of the intestines must be excited by brisk purgatives, such as castor oil, calomel and jalap, or salts, senna and manna, aided by stimulating clysters. The castor oil is often an invaluable medicine in this dis- ease. From one to two or three drops, will often succeed in purging the bowels, where all other remedies have failed. (See Dispensa- tory.) If these means prove inefficacious, immediate recourse must be had to the warm bath, in which the patient should remain as long as he can bear it. Where a bathing vessel cannot be procured, flan- nels wrung out of hot water, should be frequently applied over the belly as warm as can be endured. Besides which, tobacco clysters, (see Materia Medical) ought to be administered ; and when the pain continues obstinate, apply a large blister over the belly. If the above remedies prove ineffectual, opium and calomel, in large doses, should be employed. To their exceeding utility in ob- stinate colic, I can subscribe from numberless successful experiments made by myself. * Eminent modern physicians advise, that when all other means are despaired of, the patient should be placed erect on the floor, and a pail of cold water thrown on his feet and legs ; this, though appa- rently a droll remedy, yet certainly deserves to be tried in desperate cases, especially as we are assured, from the best authority, that it has often succeeded : it acts, as it is said, by occasioning an imme- diate evacuation of the bowels. For the vomiting which often occurs in this disease, common gar- den mint, peppermint, (see Materia Medica,) or any other spices * How I came in possession of this admirable secret, both justice and grati- tude require that I should explain. In the year 1801, I spent several weeks in Georgetown, Columbia District. While there, I was requested to visit a Mr. James Turner, who had long been indisposed with the ague and fever ; but then suffering under a severe attack of the colic, accompanied with most obstinate costiveness. For two or three days the best aperients, as calomel, castor oil, salts, senna and manna, and in- jections, with the warm bath, and blisters, were used but without effect. Being much alarmed about his situation, I stated the case to my very excellent friend, the ingenious and learned Doctor John Weems, who advised the imme- diate use of six grains of opium, with twenty of calomel, in a bolus, and one- third of that dose every two hours afterwards, if the first failed to operate. I expressed my fears that so large a dose of opium might do harm. " No, sir," replied he, " 'tis small doses that do harm ; give large doses, large enough to take off the spasms, and you save the patient." I still retained my repugnance ; however, recollecting his great medical at- tainments, and the desperate case of my patient, I acceded to his advice, and scarcely was the second dose swallowed, before it began to operate like a charm. The spasm was taken off the intestines; copious fetid evacuations succeeded, and our patient was presently restored. This is but one of many extraordinary cures performed by Doctor John Weems. The citizens of Georgetown and Washington, will long lament the early fate of this gentleman, of whom for ardent friendship, and medica] saga- city, I can truly say — his equal I have seldom seen, his superior never. 304 CHOLERA MORBUS. boiled in spirits, and flannels wrung out of it, and laid hot on the pit of the stomach, are excellent, especially if a little laudanum be added. If acrid bile be thrown up, the saline mixture, or infusion of Columbo should be given ; and when vomiting is attended with cold extremities, warm applications to the feet, and a blister to the back, often relieve the symptom. It is also frequently removed by a blister on the pit of the stomach. In violent colics, attended with vomiting, it is always advisable to administer an anodyne injection, and if it be speedily discharged, the clyster should be repeated till the vomiting ceases. A dose of calo- mel and jalap, castor oil, or infusion of salts, senna and manna, is then to be administered every two or three hours, until evacuations are procured. Regimen. — Evacuations being once procured, mucilaginous drinks and light diet should be strictly adhered to, and the bowels kept moderately open by mild purgatives, giving opiates at bed-time, if necessary, until the soreness and distention of the belly go off, and no hardened faeces appear in the stool. Prevention. — Those who are at times afflicted with pains in the belly should keep the feet dry and warm ; abstain from flatulent food, and attend carefully to the bowels, to prevent constipation. Those whose occupation subjects them to the fumes of lead, should breakfast on fat broth before they begin their work, and frequently interpose oily purgatives. CHOLERA MORBUS, OR VOMITING AND PURGING. Causes. — It is generally occasioned by a redundancy and acri- mony of the bile ; indigestible food, or such as becomes rancid or acid on the stomach ; poisons ; strong acrid purges or vomits ; pas- sions of the mind, or a sudden check of perspiration. Treatment. — Endeavour, as early as possible, to expel the acri- monious matter which affects the alimentary canal, by large and re- peated draughts of chicken-water, beef tea, barley or rice-water, or thin gruel, &c, which should also be given freely in clysters. It is said, upon high authority, that frequent small doses of cold water, not exceeding a gill at a time, will check the purging, cool the ar- dent heat of the stomach, and abate the thirst. Cold water is the more efficacious as the climate, season, and constitution of the pa- tient are warm ; for it cools, blunts acrimony, and restores the tone of the parts. It should be repeated as often as the patient throws up EPIDEMIC, OR MALIGNANT CHOLERA. 305 what he drinks ; and if fainting, with other symptoms of weakness come on, a little wine should be added to each draught of water. After having cleansed the stomach and intestines, give a tea-spoonful of ether, or thirty or forty drops of laudanum, in mint- water or tea, and repeat the dose every hour, or oftener, as the frequency of the evacuations or the urgency of the pain may require. If the laudanum be rejected from the stomach, give a tea-spoonful of paregoric, or opium in pills of half a grain, repeated every half hour at the farthest, until the disease be checked ; and at the same time, apply mint leaves stewed in spirits to the pit of the stomach. In general, this mode of treatment is sufficient ; but if the patient be of a plethoric habit, he ought to lose blood immediately ; and, in case the pain continue violent, be placed in the warm bath. Should the bathing vessel not be at hand, peppermint stewed in spirits, or cloths wrung out of hot spirits or decoction of camomile, hops or la- vender, ought to be applied to the stomach and belly, and often renewed. If acrid bile be the cause of this complaint, the Col umbo must be given every hour, or oftener, in large doses ; and, in case of great heat, a small quantity of nitre in the patient's drink, will be proper. In warm climates this remedy is considered almost a specific; it soon abates the violent evacuations, and, by continuing it a few days, a cure is effected. A tea-spoonful of the Columbo, finely powdered in a glass of mint-water or a gill of the infusion may be repeated every hour or two, according to the urgency of the symptoms. In preparing the infusion, it is better to add one-fourth vinegar, or some grateful aromatic, in cases unattended with fever. When the disease originates from food, either very acid or putrid, besides plentiful dilution with the above drinks, give castor oil, salts, or rhubarb; and if from poisons swallowed, the patient should drink largely of pure sweet oil, melted butter, or mucilaginous drinks, with small portions of salt of tartar. Regimen. — As no disease more suddenly weakens the patient, he should take freely of a light but cordial and nourishing diet, occa- sionally assisting his appetite, if deficient, with elixir vitriol, tincture of bark, or infusion of Columbo. If he cannot sleep well, an opiate at bed-time may be taken until his strength and spirits return. EPIDEMIC, OR MALIGNANT CHOLERA. Causes. — The general or remote causes of this, as of all other epidemics, is some atmospheric influence, the nature of which is veiled in darkness. The exciting causes are imprudence in diet, as 39 306 EPIDEMIC, OR MALIGNANT CHOLERA. eating unripe fruit, imperfectly cooked vegetables, tainted provisions, of any kind, gross animal food, shell-fish, or immoderate quantities of even the most innocent food. Intemperance in drink is a frequent, cause, and one which materially lessens the chance of recovery. Exposure to the night air, unusual fatigue of body or mind, the de- pressing influence of fear, any material deviation from accustomed modes of living, in fact, every thing that tends to depress the powers of life below the standard of health will, during the prevalence of the disease, act as an exciting cause. Tampering with medicines, particularly emetics and cathartics, to ward off the disease, has, in numberless cases, been the cause of an attack. Contagion has been alleged as a cause, but without the shadow of a solid foundation ; on the contrary, the strongest reasons can be given to prove, that the disease is not, under any circumstances, taken, by one person, from another. The attempt, therefore, to keep off the disease, by cutting off communication with an infected district, or by refusing aid to the unfortunate sufferers, is not only a shocking breach of moral law, but of common sense. No — the cause of the disease is in the air we breathe, and every act of inspi- ration, and every act of swallowing increases the quantity of the poison in our system. Our safety, therefore, depends on prudence, alone, which requires strict attention to the means of prevention and avoidance of the exciting causes. These views I conscientiously advance, with a firm conviction of their truth : and with feelings alive to the responsibility. The Symptoms vary very much in different cases, the variation being occasioned by the exciting causes and by the peculiar condition of the patient's system at the time of attack. In a vast majority of cases, however, the disease presents a uniformity of symptoms rarely to be met with in an epidemic. This disease is evidently a modified form of the common cholera morbus, of our country, being highly aggravated and rendered far more malignant, by the atmospheric influence mentioned above, which is the cause of its becoming epi- demic. In this, cholera agrees with dysentery, scarlet fever, and every other disease, that ever becomes epidemic; for it is a fact well known, that, those diseases are far more malignant when they prevail epidemically than when occasional cases only occur. In a majority of cases the individual is warned of approaching danger, by what are called the " premonitory symptoms." These are furred tongue, frequent pains in the stomach and head, and watery discharges from the bowels. During the prevalence of the epidemic, few persons in the infected district escape without ex- periencing some of these symptoms, particularly the pains in the stomach , which appear to be excited by food which had never, be- fore, disagreed with the individual. The duration of this stage of the disease is uncertain ; in many instances it will continue for days, and if the patient be prudent, it will in some cases go off even with- out medicine, the system, probably, gradually becoming accustomed EPIDEMIC, OR MALIGNANT CHOLERA. 307 to the atmospheric poison which is the cause of the disease. In other cases the disease advances, the discharges from the bowels become increased in frequency and in quantity, and the disease hurries with greater or less rapidity into the second stage, or what may be termed confirmed cholera, when some additional symptoms present them- selves. In addition to the copious and frequent discharges of a fluid resembling rice-water, in which are floating numerous white flakes, the patient now complains of oppression and sickness at the stomach, with heart-burn ; vomiting now takes place, at first of the common contents of the stomach, which are soon followed by the same kind of fluid which passes from the bowels ; cramps now come on, affect- ing at first the feet and hands, but rapidly extending, they, by turns, affect all the muscles of the body, and in some cases every joint, at the same instant, is rendered immoveable. The stomach, in some cases, is also violently cramped. The muscles of the face are some- times affected, producing great distortion of the countenance, which contributes not a little, to heighten a scene of horror, which it is as impossible to describe as to forget. The skin is now bathed in a cold sweat, which produces a wrinkled appearance of the fingers re- sembling those of a person whose hands have been long immersed in water; it is also, as cold or more so, than that of a corpse, particu- larly over the limbs. Respiration is laborious, and the air expired is cold or nearly so. The tongue is cold and moist ; notwithstanding which, the patient complains of an unquenchable thirst, and exces- sive burning in the stomach, which neither water nor ice can relieve. The countenance is indicative of the greatest distress and anxiety;— the mind is unimpaired ; — the blood, if now examined, is thick and black, and resembles tar more than any thing else to which it could be compared ; — the pulse, which at first was slow, contracted and somewhat tense, now becomes more hurried, smaller and weaker. If the disease be not now arrested, the patient soon sinks into the third stage, called " collapse." In this stage the disease continues to advance with the same train of symptoms, each moment making it more evident that the work of death is fast drawing to a close. The blood continues to recede from the surface, the eyes sink in their sockets and are surrounded by a blue or leaden hue — the skin over other parts of the body assumes the same colour, particularly about the hands and feet — the lips lose their colour, even the inner surface of the lips and cheeks and also the tongue are forsaken by the blood, and become pale and cold. The pulse continues to sink until it is no longer perceptible ; even the heart itself can scarcely make us sensible of its motion. The patient now appears indifferent about his situation — he seems to think or care, neither for himself nor for others, though his mind may retain its faculties to the last. The skin is now universally cold, and still bathed in perspiration, yet even under these circumstances its sensibility is sometimes so great, that the patient cannot bear the warm applications made use of to support him, nor can he even bear, patiently, the warmth of a 308 EPIDEMIC, OE MALIGNANT CHOLERA. single blanket. In other cases, the skin appears devoid of sensibility, the most stimulating articles produce no effect. In some cases, the vomiting and purging continue to the last, and the cramps have been known to continue for many minutes, and even hours, after every other appearance of life had ceased. In other cases, the primary and most important symptoms, as, vomiting, purging, and the cramps, now take their leave after having forced their victim beyond the reach of nature and of art. If the disease be not arrested, the pa- tient either sinks quietly into the anus of death without a struggle or a pang; or, as is often the case, he leaves the world in a paroxysm of agony, his limbs being distorted into every possible shape by the violence of the cramps. If, however, nature and art should triumph over this terrible min- ister of death, the first change we should look for, is the appearance of bile in the passages from the bowels. When we see this sign we may safely pronounce the patient out of danger ; for I never saw or heard of a death from this disease after the return of the secretion of bile. I hail the appearance of bile as a harbinger of returning health ; for, as if by magic, the symptoms of the disease disappear ; urine, the secretion of which, like that of the bile, had been entirely suppressed, now begins to flow ; the discharge from the skin ceases, the blood returns to the lately deserted surface, and with it, vital heat, and the patient, after copious discharges of bile for two or three days, rapidly returns to health. These are symptoms of a healthful reaction. There are some cases of reaction which would deceive the inex- perienced, and excite hopes of recovery which would never be rea- lized. In these cases, the patient, after remaining from a few hours to two or three days, will exhibit signs of amendment; he may be free from cramps, from vomiting, and from purging ; his pulse may rise, his skin become dry and warm, yet the secretions are not re- stored. These cas^s terminate fatally in a few hours after the ap- parent improvement, — nature, in her last effort, producing an ex- citement which may well be compared to the glare of an expiring taper. No reaction can be depended on which is not based on a re- storation of the secretions. The above are the symptoms of cholera as it generally appears. The varieties I will cursorily notice. In some cases the patient has no premonitory symptoms, but is taken suddenly, after eating some improper food, with a sense of weight and sickness at the stomach. Vomiting speedily supervenes, and is succeeded at first by discharges of the ordinary contents of the bowels, which are soon followed by the peculiar discharge; the other symptoms rapidly chime in, and the disease proceeds as above described. Some cases are not at- tended with cramps, the vomiting and purging being the principal symptoms. Other cases, again, are not attended with vomiting and purging, the cramps being the most striking symptoms. The cramps in these cases are more violent than in the cases which are attended with copious vomiting and purging. EPIDEMIC, OR MALIGNANT CHOLERA. 309 Treatment. — The first stage, commonly called " The premo- nitory symptoms," is, in a vast majority of cases, easily managed, and often goes off without any treatment. No one should, however, presume on this, for a slight cause may hurry on the disease, and before the remedies could produce their effects, he may be in eter- nity. Prudence, therefore, dictates that, immediately upon the ap- pearance of the diarrhoea, something should be done to remove it. To effect this, a variety of articles are extolled as specifics ; such as the spirits of camphor, essence or oil of peppermint, laudanum, and other articles possessing similar properties. That these articles some- times succeed we have no doubt ; that they often fail, almost every case of cholera proves ; for it is rarely we meet with a confirmed case of this disease, in which they had not previously received a fair trial. We should bear in mind that the discharge from the bowels is not the disease itself, but an effect of the disease, which is some consid- erable disturbance of the system. If, therefore, we should check the effect without removing the disease, we should, in many cases, act as unwisely as the man who would lock up a thief in his house and leave him to do what mischief he pleased. We should attack the disease itself, with our most powerful means. — Of these, we will always find calomel to be the most certain ; and should, therefore, give it immediately, either in a full dose of twenty grains at once, or in five grain doses every hour, until twenty grains have been taken ; and, in either case, follow it up with a full dose of rhubarb, or castor oil, to either of which three or four drops of the oil of cinnamon may be added. These medicines must be repeated until the discharges become natural. In some cases where there is much uneasiness in the stomach and head, and the pulse is slow andgfull, blood-letting is advisable, and may be necessary. These means will almost invariably remove the premonitory symptoms, or what we will call the first or forming stage of cholera, and the patient returns to health. In the second stage, or confirmed cholera, we have many indica- tions to fulfil, the leading one of which is to restore the secretions, and particularly that of the bile. This, possibly, we could not ac- complish without fulfilling another important indication, which, is to relieve the congestion of the internal organs, by bringing the blood to the surface. While directing all our energies to the accomplish- ment of these objects, we should not neglect two other important in- dications, which are, to check the discharges and relieve the spasms or cramps. The first step in the treatment of this stage is to relieve the stomach of any indigestible food, which it may contain. For this purpose various emetics have been extolled as possessing superior claims to confidence; as the white vitriol, ipecacuanha, tartar emetic, an infu- sion of mustard and salt in water. Of these, ipecacuanha is to be preferred, and should be given in a dose of twenty-five or thirty 310 EPIDEMIC, OR MALIGNANT CHOLERA. grains. If this cannot be obtained, the white vitriol may be taken to the same extent. The mustard or tartar emetic I could not re- commend. If the stomach have been evacuated by spontaneous vomiting, an emetic should not be given, for, to say the least, it would be a waste of time. The stomach being prepared, from twenty to thirty grains of calomel, to which may be added one or two drops of the oil of cinnamon, must be immediately given, and repeated every hour or oftener, if the symptoms be urgent, until bile appear in the discharges. The calomel had better be taken in syrup, that it may act without delay. As a means for relieving congestion and overcoming the cramps, blood-letting stands pre-eminent. It should be had recourse to, without delay, notwithstanding, the great apparent debility. The blood is now black, and in some instances so thick that it will not flow unless forced from the orifice by rubbing the vein : if, however, this be persevered in for a few minutes, it becomes thin, and soon runs in a free stream. The quantity of blood to be taken depends on the constitution, &c, of the patient. From a robust man from one to two pints may be taken with advantage. In more delicate patients the quantity must be less. The local detraction of blood, by cupping or leeching, has been recommended, but as it is less efficacious than general bleeding, it need not be resorted to, when the latter is practicable; — besides, the unavoidable delay is an insu- perable objection, for in this disease the loss of a few moments may be the loss of the patient. I cannot leave the consideration of this remedy, blood-letting, without insisting on its employment, and re- peating that it is one of the most powerful means we possess, for overcoming the spasms, removing congestion, and thereby contribu- ting, to arrest the morbid discharges and to promote the healthy se- cretions — thus powerfully aiding in the fulfilment of the four impor- tant indications mentioned above. In addition to the powerful re- medies just recommended, there are many others which we may have recourse to, not only with the view of aiding the former, but also to fulfil some other indication. Thus, to aid in bringing back the blood to the surface and to relieve the cramps, we must make use of external stimulants, of these, dry heat is the first that sug- gests itself. This may be applied, by means of jugs or bottles of hot water, to the extremities, and particularly to the muscles affected with cramps. Frictions, either with a stiff brush or with a warm coarse cloth, are valuable. They should be perseveringly used, and directed principally along the course of the contracted muscles. To increase the efficacy of the frictions, the brush or cloth may be dipped in some stimulating substance, such as spirits of turpentine, infusion of red pepper in whiskey, a strong ointment made of hog's lard and red pepper, or the powder of red pepper may be used in its dry state, and an ointment made of hog's lard and powdered cam- phor ; but, what is probably better than all, is a strong mercurial ointment, made irritating by the addition of powder of red pepper or camphor. EPIDEMIC, OR MALIGNANT CHOLERA. 311 The excessive thirst and burning at the stomach render some kind of drink absolutely necessary. The best drink is water, as cold as it can be obtained. It should, however, be taken in modera- tion. One or two table-spoons full every five or ten minutes will be sufficient, or a small piece of ice may be allowed to dissolve in the mouth. I have now, in as concise a manner as possible, given the practice, which I have found successful in a large majority of cases, and which will suit the various forms of the disease in this stage. There is, however, one form of the disease in which a modification of the treatment may be necessary. This is the form, noticed under the head of symptoms, in which there is little or no discharge from the bowels or stomach, but universal spasms of the whole muscular sys- tem, affecting also the stomach, and in some cases even the muscles of the tongue. In this form of the disease, if we suspect the sto- mach contains any kind of food, we should immediately exhibit twenty-five or thirty grains of ipecacuanha, in a tea-cup full of warm water; and, without waiting for its effects, tie up the arm and bleed until a decided effect is produced on the pulse. At the same time, frictions over the seat of the cramps, with some of the irritating arti- cles, advised above, should be diligently employed. Should these means fail to arrest the cramps, we should, after the operation of the emetic, give laudanum in a dose of from one to two or three tea- spoons full, according to the urgency of the spasms ; and if necessary, give a tea spoonful every half hour, continuing the frictions, until relief is obtained. If nothing occur to prevent it, the patient may be suffered to rest for some hours, after which he should take from twenty to forty grains of calomel, which should be followed by the same quantity of rhubarb, or by two or three drops of Croton oil. Before leaving the consideration of this, the second stage of cholera, it wilt be proper to notice some of the articles which have been ex- tolled in the treatment of the disease. Opium either in substance, or in the form of laudanum, has been extensively employed, and in every variety of dose, from the smallest to the most enormous. My opinion of this article is, that it is inadmissible in every form of this disease, with the exception of that variety of it, which has just been treated of. If taken in sufficient quantity to produce any effect, it retards the operation of the calomel, and thereby lessens the chance of the patient's recovery, for on the speedy operation of the calomel his safety depends. Another article, which has been highly spoken of, is the mustard emetic. Against this article, as an internal remedy, I protest: it has, however, been as extensively used as the opium, and I will say, with as little regard to consistency, for many physicians, who condemn the internal use of stimulants in this stage, make it a general rule to administer this article in every case, know- ing at the same time that it is so highly irritating, that it cannot he endured more than a few minutes on the most insensible parts of the skin. The indiscriminate use of emetics, of any kind, is improper. 312 EPIDEMIC, OR MALIGNANT CHOLERA. Where vomiting has not taken place, it will generally be advisable to give an emetic of the mildest kind, as ipecacuanha ; but where spontaneous vomiting has come on, an emetic will be of no use, but will cause the loss of precious time. Camphor is another article, which attracted much of the public attention. As it is a stimulant, its use cannot be justified in this stage. The limits and object of this work will not admit of a detail of reasons for the support of opinions: I shall therefore pass on to the treatment of the third or collapsed stage of cholera. If the disease be not arrested by the means which have been detailed, it gradually passes into the collapse, and we have a different state of symptoms, which have been de- scribed under the proper head. We must still continue the calomel, and aid it in its alterative effects by the steady use of the irritating mercurial ointment formerly advised. If nothing has been done for the patient until now, blood should be drawn, if possible, either in the common way or by cupping. Blood-letting, in this disease, is not employed to reduce the system, but to relieve congestion, and thereby prove an indirect stimulant. We are now obliged to make use of direct stimulants. The external stimulants, as heat, frictions, and irritating applications, must be continued. Large mustard plas- ters should be applied, and moved from place to place as the patient complains of their producing pain. Plasters of blistering ointment should be applied, and if they draw, the sore should be dressed with mercurial ointment. Internal stimulants must now be given. As spirituous liquors could not be borne, we must have recourse to the vegetable spices, as cloves, ginger, Cayenne pepper, or oil of cinna- mon. A table -spoonful of a strong infusion of cloves or ginger, or two or three drops of the oil of cinnamon, may be given every half hour. The following preparation is highly recommended : Take of Cayenne pepper three table-spoons full, of fine salt two tea-spoons full, beat them well together, and then pour, on the mixture, half a pint of boiling water ; when cold, strain off the infusion and add an equal quantity of strong vinegar. The dose is a table-spoon full every half hour. Having by these means succeeded in arresting the disease, which we are assured of by the reappearance of the secretions, and other changes mentioned under the head of symptoms, we must take care that the reaction does not exceed the bounds of health. In most cases nothing is necessary but a light and nourishing diet, warm clothing, an occasional use of small doses of rhubarb, either alone or combined with magnesia, and mild tonics, as infusions of Columbo or camomile. In some cases, however, reaction may be followed by fever. In this case, if the pulse be full or strong, we must bleed and resort again to cathartics. If, on the contrary, the pulse be small and weak and the symptoms resemble those of typhus fever, the remedies directed for that fever must be used. In some cases reac- tion is followed by determination of blood to the brain, or some other important organ. These cases must be treated by local bleeding, DIARRHCEA, OR LOOSENESS. 313 by cups or leeches, over the affected organ, by the use of calomel, unless the system be already affected by it, and other cathartics ; and by frictions, with irritating applications to the extremities. If it be (lie brain that is affected, cold applied to the head will be servicea- ble. The diet should be light. Prevention. — An old adage says, " An ounce of prevention is worth a pound of cure." In this disease it is worth tons. On the appearance of the epidemic in a neighbourhood, the strictest attention should be paid to cleanliness, not only of person, but of houses and lots. Every source of noxious exhalations should be cleansed and sprinkled with lime. The cabins of negroes, particularly, should be examined frequently, and cleansed and whitewashed. The negroes should be examined daily, and should any of them be affected with the premonitory symptoms, they should be promptly treated. They should be cautioned against the indulgence of their appetites, and informed of the articles they should avoid. The diet should be light and nourishing. Garden vegetables (Irish potatoes excepted,) should be avoided or sparingly used, and, if used, should be well seasoned. Rice is one of the safest articles of diet. Old habits should not now be altered. A man accustomed to strong drink should continue its use ; but the sooner he leaves it off, after the epidemic disappears, the better will it be for his health both of body and mind. The clothing should be warm ; the feet, espe- cially, should be warmly clad. Heavy suppers should be particularly avoided, as the disease generally makes its attack about midnight, or early in the morning. By attending to these directions, and avoiding the causes, the disease will certainly be prevented. The following articles should be kept in readiness ; namely : A lancet, calomel, mercurial ointment, rhubarb, castor oil, Croton oil, magnesia, ipecacuanha, laudanum, oil of cinnamon, cloves, camphor, mustard, and Cayenne pepper. DIARRHCEA, OR LOOSENESS. Symptoms. — A purging without sickness or pain, succeeded by loss of appetite. Causes. — Acid or putrid aliments ; obstructed perspiration ; acrid bile; drinking bad water; worms; violent passions; or a translation of morbid matter of other diseases to the bowels. 40 314 DIARRHCEA, Treatment. — If offending matter be lodged in the stomach, give an emetic, and an opiate at bed-time ; and on the succeeding day, if the disease be not removed, a dose of rhubarb or castor oil, followed by forty or fifty drops of laudanum at night. In every case where the diarrhoea continues obstinate, an emetic should be premised. It relieves the stomach from acrimony, checks the increased peristaltic motion downward, and determines to the skin. After the emetic, it is necessary to procure some respite, and with this view opiates may be employed with perfect safety. By lessening or stopping the peristaltic motion, we relax any spasmodic stricture which may prevent the discharge of offending matter, and the gentle laxatives afterwards required, will have a more salutary effect. By thus alternating the opiates and laxatives, we at last succeed in relieving the bowels from the irritation of offending matter, and moderately warm astringents will complete the cure. Opiates may sometimes be given in clysters, and in this way they affect the head in a less degree than when swallowed. If the disease be in consequence of cold, or the skin be dry, the antimonial mixture, or Dover's powder, exhibited in small doses during the day, and the anodyne sudorific bolus or draught, (see Dispensatory,) repeated at bed-time, with a flannel shirt, will gene- rally effect a cure. When bile is indicated to be the cause, the Columbo in decoction or powder, will be found admirable ; and if accompanied with sour and debilitated stomach, the tonic powders or pills, (see Dispensa- tory^) with exercise, are the best remedies. Where bad water is in fault, it should instantly be changed or corrected by wine, brandy, or porter; remembering, that in all cases of continued evacuation, laudanum may be given at night after the stomach and bowels have been cleared. When worms induce this disease, which may be known from the sliminess of the stools, and bad breath, such medicines as are calcu- lated to destroy them must be employed, afterwards a wine-glass full of lime-water with an equal quantity of new milk, will be proper three times a-day. In obstinate cases no medicine is superior to the continued use of the vitriolic solution, (see Dispensatory^) with an opiate at bed-time. The nausea which this medicine produces is very disgusting ; but from this circumstance much of its efficacy is derived. Should a common dose fail to nauseate, it should be increased until that symptom is effected. The jelly of slippery elm, and the blackberry, (see Materia Medi- cal) conjoined with a small portion of cinnamon, ginger, calamus, or some aromatic, are also valuable remedies. According to domestic practice, the efficacy of burnt cork is highly extolled in this troublesome complaint. A friend of mine, of Balti- more, informed me that he administered this medicine to three gentlemen who had their bowels very much disordered by a change DIARRHOEA, OR LOOSENESS. 315 of water, and that it afforded them immediate relief. He also stated of having given it to a child afflicted with the dysentery, in its chronic form, with the most happy effects. He directs a bottle cork to be burnt to a coal ; and after reducing it to a fine powder, it is to be moistened with spirits, and then mixed with a little milk and a lump of sugar. Half of this mixture is to be given to an adult, and about one-third to a child of two or three years of age, repeating the dose, if necessary, in an hour. From the astringent properties of this medicine it is proper to remark, it should never be employed in af- fections of the bowels, attended with fever. Regimen. — The diet should consist of arrow-root, sago, rice, milk, and the white meats. The drinks may be of the diluting kind, as already enumerated : genuine wine may also be allowed, if it do not turn sour on the stomach. Moderate exercise is peculiarly useful, and nothing facilitates the cure more than flannel next to the skin. # * This was the " Angel in disguise." That opened the prison doors of this uneasy life, and gave happy freedom to my ever-revered father, Colonel Jesse Ewell, of Virginia. My sister Charlotte celebrated his virtues in an Elegy, the following extracts from which I beg permission of the reader to insert, as a small tribute of gratitude to the best of parents, and but a faint portraiture of his worth. " Early he woo'd fair virtue for his guide, And rarely wandered from her guardian side; By him the needy never were denied, He sooth'd their sorrows, and their wants supplied. He mourn'd the contests of the neighbouring poor, And opened wide his peace-restoring door ; Where soon his wisdom taught their strifes to cease, Revived their loves, and sent them home in peace. The slaves whom Heaven to his care consigned, Ne'er felt the terrors of a slavish mind ; Well fed, warm-clad, to moderate labours prest, They loved their fetters, and their bondage blest. As friend — as father — who his praise can tell? Where first begin, or with due raptures swell ? To check our wrong, his frowns were ever light, And sweet his smiles whene'er we chose the right, And when at length the awful hour drew nigh, To waft his spirit to its native sky, Such in that moment, as in all the past, " O bless my children, Heaven ! " was still his last. Now 'scaped from earth, with God he dwells above, And shares with angels in their feasts of love. Then come, blest faith, come hasten to my aid, Lest grief profane disturb his happy shade ; Teach me to bow submissive — and adore The unerring counsels of eternal power, Which gives in love or still in love denies, And makes e'en " crosses blessings in disguise." And thou, fond memory, still my sire recall, Record his virtues, imitate them all — That joys like his my mortal life may prove, And peace eternal crown my state above." 316 DROPSY. DROPSY, A collection of water in some part of the body. Symptoms. — In common dropsies the legs usually swell, and a pit remains for some time after pressing the flesh ; the appetite abates ; the face is bloated ; urine little ; thirst great, with slow fever, short- ness of breath, and lassitude. Causes. — Excessive drinking ; poor diet; protracted intermittents ; scirrhous tumours of the abdominal viscera, but particularly of the liver, and in fine, whatever may occasion too free a secretion of the serous fluids in the cellular membrane, or any cavity of the body, and at the same time diminish the action of the absorbent vessels. Treatment. — Like other diseases, the treatment must vary ac- cording to circumstances. In every form of dropsy, if there be a hard, full, and quick pulse, blood-letting constitutes one of the prin- cipal remedies, and must be repeated once or twice a-week, until the action of the arterial system is considerably diminished. Brisk purges, as calomel and jalap, cream of tartar and jalap, or the Croton oil, (see Dispensatory,) in full doses, are indispensable, and ought always to succeed bleeding, and be given as often as the patient's strength will admit, followed by Dover's powder, or the anodyne sudorific bolus or draught, at bed- time. (See Dispensatory.) The discharge from the intestines is unquestionably of the greatest importance in dropsy; and when obstructed perspiration is the cause, sudorifics are much to be depended upon. However, this distinction must be made : If purgatives be accompanied by violent colics, and weakness be the consequence, without producing a considerable dis- charge, the remedy must be discontinued; but if they operate without pain and inconvenience, the stools watery, and weakness do not follow, whatever the number of evacuations may be, the remedy is good. And if, on the employment of sudorifics, they tend to weaken the system, in general, too much, they should not be persisted in. Another remark to be attended to is, that in every species of dropsy attempted to be cured by internal means, how- ever they may be relieved by different evacuations, unless the urinary organs continue their evacuating power, the cure will never be lasting. While feverish symptoms continue, nitre is extremely useful in this disease, in doses of ten grains four or five times a-day, or in such quantities as the stomach may bear ; but should not be continued longer than two weeks, if no good effects result from its use. An- other valuable medicine for lessening the action of the pulse, and thereby increasing absorption, is the foxglove, (see Materia Medica,) which may be given in powder, decoction, or tincture. The latter DROPSY. 317 is the most convenient form, and in doses of twenty or thirty drops in a wine glass of mint- water, may be taken twice or thrice a-day, until the water be removed, or the inflammatory disposition taken ofT. If this quantity do not induce sickness, or produce any evidently good effect, the dose must be gradually increased to forty or sixty drops, or more. Cream of tartar, from half an ounce to an ounce, dissolved in a pint or more of water, is a pleasant and useful drink; and this taken early in the morning has frequently succeeded in evacuating the water. As soon as the action of the pulse becomes lessened, it is necessary to strengthen the system and increase the digestive powers, by the nitric acid or the exhibition of steel alone, or the tonic powders, pills, or drops, (see Dispensatory^ thrice a-day during the intervals of purging. One of the most frequent causes of dropsy is obstructed liver; and when this is suspected, mercurial friction must be resorted to, or a grain or two of calomel, conjoined with a few grains of powdered squills, given night and morning, until ptyalism be produced, and afterwards the nitric acid, and other tonics, constitute the proper remedy. The squill in every form, is a valuable medicine, and suc- ceeds in the greater number of dropsical cases. United with cream of tartar and a small portion of jalap, it is highly useful as com- bining a diuretic and purgative effect ; and with the resin of jalap and gamboge, in pills, its utility is almost unrivalled. The efficacy of this medicine is also highly extolled in dropsies, in doses from five to ten grains, with double the quantity of nitre. It should be observed, however, the squill seldom increases the discharge of urine to any degree, till raised to a nauseating dose. The juice of leeks, in doses of a table-spoonful twice a-day, is said to have performed surprising cures ; at any rate, in this state of the disease the patient can hardly make too free a use of the acrid stimu- lating vegetables, as garlic, onions, horse-radish, &c. Tight bandages applied in the morning round the belly and limbs, have their good effects in preventing the increase or return of drop- sical swelling. Friction, with a flesh brush or flannel, every morning, from the extremities upwards, is of the greatest service, particularly if the skin be previously moistened with a liniment, composed of equal parts of soap, spirit, and vinegar; or with the volatile or camphorated liniment. Persons recovering from lingering diseases are very subject to anasarcous swellings, particularly if they replenish their weak vessels too fast by full diet. Scarifications with a knife are much commended when the legs and thighs are turbid with extravasated serum ; and, indeed, the water is speedily discharged this way; but the lips of the wound will close in two days, so as to admit of no discharge ; and from a defect of heat in the constitution, the part is apt to mortify. Dr. Fothergill 318 DROPSY. to obviate these difficulties, advises this operation to be performed with the common scarificator used in cupping, and the instrument to be placed so as to make the wounds transversely. If the skin be thick, the lancet may be so set as to make deeper, and, consequently, wider incisions ; thus, a large quantity of water will often drain from the legs or thighs, without risk of inflammation, or deterring the pa- tient from a repetition, if necessary. The punctures must be made in the most depending part of the leg ; and their number and repeti- tion depend on the circumstances of each individual case. The application of glasses, either before or after scarifying, is unnecessary; but the instrument must be gently pressed upon the skin, until a surface is formed sufficiently flat to admit the lancets in the scarifica- tor to act equally. In all cases where the skin is so stretched as to threaten inflammation, rupture, or a gangrene, and when the breath is greatly impeded, these openings should be made without delay. Blisters are often employed in the same circumstances instead of scarifications, and are equally useful. An oblong blister may be applied just above the inner ankle, and continued until a thick, white, or purulent discharge is produced. After this period but little water appears, and the sore should be healed. If necessary to be longer continued, blisters may be employed on the outside; and when these have acted sufficiently, we may return to the former surface, which will be now healed. Should a dark or black spot appear, bathe the leg in a strong decoction of oak, and sprinkle the spot with some of the bark, or myrrh powdered, or apply poul- tices of charcoal and bark, which will soon separate it, and arrest the mortification. When the difficulty of breathing is considerable, relief will very generally be obtained by expectoration ; and for this purpose, pretty large doses of gum ammoniac with the squill, or seneca infusion may be repeated as the occasion requires. The infusion of garlic is often useful, and assafoetida, in the form of pills or tincture, relieves the difficulty of breathing when it is connected, as is often the case, with wind in the stomach occasioning hysteric affections. Spasms often arise in particular parts, especially about the chest, frequently awaking the patient out of a sound refreshing sleep. In such cases, a grain of opium, with five of camphor, is the most ef- fectual remedy. When the duplication of the peritoneum is the seat of dropsy, tap- ping is alone the remedy. Regemen. — During the inflammatory disposition, or when there is a preternatural heat on the skin, or much action in the pulse, the diet should be light, and easy of digestion. In the other state, when the patient is weak and feeble, it should be of the most nourishing kind, with a liberal use of wine. The patient may, in general, drink in proportion to his inclination. Acid liquors, as lemonade, cider, the imperial drink, or wine, or gin and water may be allowed ; and thirst is often prevented by holding nitre in the mouth. GOUT. 319 Exercise is one of the greatest importance when not carried to fa- tigue. In the lowest stage of the disease, swinging or riding in a carriage are most proper ; but as soon as the patient's strength will admit of it, riding on horseback will be found most beneficial, GOUT Is often hereditary, but, generally, indolence and luxury, the hated parents of this disease, which righteous Heaven has marked with such severity, that, like the leprosy of Naaman, it is hardly ever curable.* But though art has not often succeeded to cure the gout, yet it has discovered a variety of means to shorten the fits, and to render them much more tolerable. Symptoms. — The gout mostly affects the joints, but the viscera are not exempt from its ravages. It sometimes comes on suddenly, passing from one part of the body to the other, in the twinkling of an eye ; but generally is preceded by indigestion, flatulency, loss of appetite, unusual coldness of the feet and legs, with frequent numb- ness, sense of pricking, and cramp. These symptoms take place several days before the paroxysm comes on, but commonly the day preceding it, the appetite becomes greater than usual. The next morning, the patient is roused from his sleep, by an excruciating pain in the great toe, or ball of the foot, resembling the gnawing of a little dog. Treatment.— No matter what part of the body this disease first seizes, the lancet will be required in every case where there is an increased action of the pulse, to take ofT the inflammatory disposition. The extent to which the blood-letting must be carried, can only be ascertained by the violence of the disease, and the sex and con- stitution of the patient. In this, as in all inflammatory fevers, the bowels ought to be kept open freely by laxative medicines, as castor * An English nobleman, after twenty years' riotous living, awoke one morn- ing in the torments of the gout. As he lay writhing with pain, his servant ran up stairs to him with great joy in his countenance : " O ! sir, good news ! good news ! there is a famous gout doctor below, who says he will venture his ears, he can cure your honour in less than a week." " Ah, that is good news indeed, Tom. Well, run, my good boy, and put up his carriage and horses, and treat the doctor like a prince." " O sir, the gentleman has no car- riage and horses; I believe he walked a foot!" "Walk a foot! what! cure the gout and walk a foot! go down, Tom, go down, and instantly drive the rascal out of the house; set the dogs upon him, do you hear? the lying varlet! why, if he could cure the gout, he might ride in a richer carriage than his majesty." 320 GOUT. oil, sulphur, cream of tartar, rhubarb, senna, jalap, or calomel. Indeed, a fit of the gout may be oftentimes entirely, and is almost instantaneously, removed by active purging-. Even drastic purges need not be dreaded in this disease. Nitre, with diluting liquors given in such quantities as to excite a gentle perspiration, are of great utility in the inflammatory stage of the disease. After the action of the pulse is somewhat reduced by evacuations, blisters over the pained parts are greatly to be relied on. As soon as the inflammatory state of the gout has subsided, stim- ulants and tonic medicines, as bark and steel, are the best remedies. Laudanum, ether, good French brandy, and aromatice, as calamus, ginger, Virginia snake-root, and red pepper, (see Materia Medica,) in the form of teas, are all exceedingly useful in this feeble state of the disease, especially when it affects the stomach or bowels. Be- sides these internal remedies, friction on the stomach and bowels, or the application of cloths wrung out of hot spirits or water, over the pained parts, and sinapisms to the feet, should be employed when- ever the gout attacks the head, lungs, bowels, or stomach. Gentlemen long in the habits of intimacy with this disease, should remember that it is of immense rudeness, and ready on the slightest provocation to quit the toes and knuckles, and seize on the very sto- mach and bowels of its best friends. They should, therefore, be constantly on their guard, and keep always by them a vial of ether or laudanum, or a case of good old French brandy ;* the latter of which is admirable for chasing the gout from the stomach. The white hellebore (see Materia Medica,) is highly extolled as a remedy in this distressing disease. Regimen. — The diet should be regulated according to the state of the patient. If feverish, and of a plethoric habit, the lightest diet ought to be used. If debilitated and of a relaxed habit, generous diet should be allowed. Exercise, although painful at first, must be freely taken. Prevention. — If the person be plethoric, and has been accus- tomed to drink freely of wine, and eat heartily, he should gradually diminish the quantity of the aliment ; particularly every spring and fall, as the disease is more liable to recur at those seasons than at any * For lack of this ammunition, the gallant Wayne was cut off long before " his eye was dim, or his natural force abated." Late in December, 1796, he embarked at Detroit for Presque Isle, but not without his usual supply of brandy, which, however, was all lost, through his servant's carelessness in upsetting his case. On the passage he caught cold, which brought on a violent attack of the gout in the stomach ; and, for want of his usual remedy, he suffered the most excruciating torture until he reached Presque Isle, where he died early in January, 1797. His body was deposited in the centre of the fort, to show the children of future days the grave of him who so bravely de- fended their liberties. Filial piety has since removed it to his native state, where it now sleeps with the dust of his fathers. I am happy to acknowledge, that for this anecdote, I am indebted to the po- liteness of my worthy friend, Captain Hugh M'Call, of Savannah. VENEREAL DISEASE. 321 other time. But in debilitating habits predisposed to the gout, a stimulating diet is most proper assisted with the use of the rust of steel, bitters, or bark in every case, costiveness should be avoided; and flannel worn next to the skin is peculiarly proper. Nothing, however, prevents this disease, more than temperance and exercise.* VENEREAL DISEASE. The venereal disease is of two species; the one a local affection of the genital organs, termed Gonorrhoea, or Clap ; and the other a general or a constitutional complaint, termed Syphilis or Pox. THE GONORRHOEA, Of which we shall first treat, is an inflammation of the mucous membrane, lining the urethra in men, and the vagina in women ; seated in the male about the freenum of the penis, and in the female a small distance up the vagina ; but in its progress communicating to all the surrounding parts, and producing a variety of painful sensations. Symptoms. — A discharge of mucus, at first white, but soon turn- ing of a yellow or greenish appearance, an acute or scalding pain in making water, with most, indecent erections of the penis, termed, chordee, very painful, and sometimes followed by a discharge of blood. At times the inflammation spreads to the contiguous parts, occasioning strangury, swelled testicles, swelling in the groin similar # The story of the wealthy Mr. Palmer, in the reign of George I., though well known to many, is yet so apropos to our subject, that I cannot deny my- self a wish to relate it. Young Mr. Palmer received from his father, what the London merchants call a plum (that is a round 100,0007.) of which he contrived to make such " good use," that by the time he was forty years of age, he was torn to pieces by the gout. His physicians advised him to try the virtues of a sea voyage with the soft balmy air of Montpelier. He set out, but on his passage up the Mediterranean, was captured by an Algerine corsair, who took him to Morocco, and sold him for a slave. He was bought by a farmer, who carried him into the country, and set him to hard labour, allow- ing him nothing better than brown bread and dates, and even of that hardly enough to support him. His only drink was water, and his only bed a plank. In a few weeks every gouty symptom disappeared, and he recovered his health, with an uncommon portion of activity. These first of blessings continued with him all the time he was in captivity. (two years;) at the expiration of which he was ransomed by his friends. On his return to England, he was hardly known by his acquaintances, so great was the change which temperance and exercise had wrought upon him. But alas ! for the lack of fortitude, he soon relapsed into his old passion for the rich dishes, flowing glasses, and soft couches of Epicurism. His system 5000 became bloated and relaxed, and his ancient foe, the gout, returned, and killed him in a short time. 41 322 VENEREAL DISEASE. to buboes, or a contraction and thickening of the fore-skin, which, when drawn over the head or nut of the yard, is termed phimosis, and paraphym,osis when retracted behind it. When these symptoms dance their attendance to the catastrophe, the clap may be said to flourish in its full bloom, and the patient finds himself fairly seated on the stool of repentance. The appearance of clap in the female is pretty much the same as in the male, allowing for the difference of the parts. The disease, in them, is always milder ; insomuch, that at times there is no other symptom but the discharge, which is often mistaken for the fluor albus. They are, however, more subject to excoriations of the parts than the men, and, indeed, when the inflammation is considerable, it often extends to the urethra, and occasions great pain. Treatment. — In the general treatment of gonorrhoea, rest, toge- ther with abstinence from strong food, and every thing of a heating nature, is of the greatest consequence ; and this alone, with little as- sistance from medicine, will complete the cure in a short period. As the disease is local, topical applications in the form of injec- tions become necessary. The patient should, therefore, without de- lay, employ one of the injections (see Dispensatory,) which, in irri- table habits, must be a little weakened, and the strength gradually increased as the inflammation abates. Indeed, when the inflamma- tion is very considerable, it is better, at first, to inject with sweet oil or mucilage of sassafras, (see Materia Medico,,) and in such cases the testicles ought to be suspended by a bandage, and the anti- phlogistic regimen strictly adhered to, particularly in taking freely of mucilaginous drinks, as flax-seed tea, barley water, or the muci- lage of gum Arabic, and obviating costiveness, by small and repeated doses of cream of tartar. Whichever of the injections is used, it must be thrown up the urethra six or eight times a-day, immedi- ately after making water, and with a syringe that works easily, that it may not hurt or inflame the parts. It should be observed, if as- tringent injections of full strength be used in the early period, they often prolong the disease, and occasion swelled testicles, strictures, and enlargement of the prostrate gland ; but after the inflammatory state is removed, they may be employed with safety, and will be found to facilitate the cure. Frequently bathing the part, and the greatest cleanliness, are too important to be neglected ; particularly washing under the glans, to prevent the accumulation of the fluids from the odoriferous glands, which produces irritation, inflammation, and often ulcers. For the chordee, which is more severe during the continuance of the inflammation, and occurs mostly in the night, while the patient is warm in bed ; take, on going to rest, a dose of laudanum, or souse the guilty member frequently in a vessel of cold water. Should a hemorrhage supervene, it may be removed by rest, and immersing the part often with cold vinegar and water, or lead-water, of the ordinary strength, of which the patient may throw a little up. VENEREAL DISEASE. 323 According to Professor Chapman, no remedy succeeds better in the cure of gonorrhoea than balsam copaivi. He commences with this medicine on the very accession of the disease, regardless of all the appearances of inflammation, such as scalding, chordee, &c. The proper dose is about forty drops, more or less according to cir- cumstances, to be repeated morning, noon, and night. He directs it to be taken in a little wine, or milk, or if it should act on the bowels, or be offensive to the stomach in this way, he advises it to be exhibited, agreeably to the following prescription: Take of balsam copaivi and sweet spirits of nitre, of each half an ounce, the white of an egg y or powdered gum Arabic and white sugar, each two drachms, mix, and then add laudanum, one drachm, and water three ounces : of this mixture, the dose is a table-spoonful three times a-day. One caution, he suggests, should always be en- joined on patients who are desirous of a speedy cure: An entire ab- stinence from every heating article of food or drink, and a state of complete repose. He says, contrasted with the ordinary mode of treating it by in- jections, his plan has several advantages. It is more convenient to the patient ; it produces no swelled testicles ; it occasions no stric- tures; it leaves no gleet; it is more prompt and certain in the cure. Of the efficacy of this remedy, coming from such unquestionable authority, there can be no doubt ; but candour compels me to ac- knowledge I have never resorted to it, having uniformly succeeded in the cure of gonorrhoea by injections, as above advised. When the inflammatory symptoms of gonorrhoea increase to a violent degree, a swelling or inflammation of one or both testicles sometimes supervenes. The same consequence is often produced by astringent injections imprudently exhibited. In such cases, the general remedies for allaying inflammation, as blood-letting, cooling cathartics, diluent drinks with small portions of nitre dissolved in them, become necessary. Besides which, the testicles must be sus- pended by a bandage, and kept constantly moistened with cloths wrung out of lead- water, or cold vinegar and water, often renewed. The swelling of the glands in the groin, and of the spermatic chord itself, require a similar treatment. In these affections, a horizontal posture, and spare diet, are particularly enjoined. In case of much pain, with little or no fever, an opiate may be given at bed-time. And if hardness remain after the pain, the patient should have mercurial ointment rubbed on the part, night and morning, and take freely of a strong decoction of sarsaparilla. But if the swell- ing without hardness follow, one or two vomits, succeeded by tonic medicines, with the use of the cold bath, will generally effect a cure. In case of phimosis, cold applications to the penis, as lead-water or cold vinegar and water, and topical bleeding with leeches, con- stitute the proper remedies. Besides which, soap-suds should be often injected with a syringe between the skin and the glans, to 324 VENEREAL DISEASE. prevent the stagnation of matter, the extreme acrimony of which might otherwise produce a mortification of the parts. When these means, assisted by opiates, fail, an operation becomes necessary ; it is simple, and by no means dangerous. A sharp-pointed knife, concealed, and defended by a grooved directory, which must be previously introduced betweeu the prepuce and glans, are the only instruments required. The point of the knife should pass through the prepuce at the bottom, and the section be made by drawing it towards the operator. Common dressings are sufficient ; but linen or lint should be interposed between the glans and the prepuce, to prevent adhesions. Paraphymosis is the opposite disease, where the prepuce cannot be drawn over the head of the penis; and in this case, bathing the part frequently in milk and water or soap-suds, and taking some cooling laxative medicine, will generally effect a cure. When the inflammation is considerable and long continued, a mixture of syphilitic infection may be suspected, requiring a mercurial course. Indeed, these affections frequently originate from chancres. Gonorrheal inflammation of the testicle and its appendages has been speedily and completely cured by purgatives, followed by the administration of opium. Hyoscyamus has been found to answer the same end as opium. The free and full operation of a previous purgative has been found essential in order to secure the advantage of the opiate. M. Velpeau uses balsam copaiva in the form of injection w T hen the stomach rejects it. He mixes one drachm of the balsam with four ounces of a viscid fluid and a little opium. This he injects up the rectum, and has been very successful with it. He also uses balsam combined with cubebs in the following pro- portions. Copaiva two drachms. Cubebs six drachms. Powdered opium two grains — and then adds enough of carbonate of magnesia to form a paste. This to be divided into six parts — one to be taken three times a-day for three days. Then omit one day and take again for three days. A favourite prescription of the same distin- guished individual is the nitrate of silver in the form of injection — one grain to the ounce of distilled water. Mr. Carmichael uses one- fourth grain to the ounce of water. Before using it care is to be taken, to make compression upon the bulb and membranous portions of the penis by a compress and retained by a bandage. Such are the principal symptoms which attend gonorrhoea. Its consequences, which induce a new state of disease, after the original affection is removed, are no less important. GLEET. This is known by a constant discharge of mucous matter, after the inflammatory symptoms have subsided, occasioned by a relaxation of the mucous glands, or stricture in the urethra. A discharge of VENEREAL DISEASE. 325 this kind may also be occasioned by hard drinking, violent exercise, or straining. A discharge of mucus, if not connected with venereal taint, even when accompanied with inflammation, which have been excited by high living, or violent exercise, is not infectious. Treatment. — Although this disease often yields with great facility to the common remedies, yet it is sometimes peculiarly dis- tressing and obstinate. The remedies generally employed are astringent injections ; the use of balsam copaiva, in doses of thirty or forty drops thrice a-day, and tonics of every kind, particularly cold bathing, both partial and general. In obstinate cases, the uva ursi, (see Materia Medica y ) as well as the tincture of cantharides, have often succeeded. None of the remedies should be continued longer than eight or ten days, if they produce no salutary effects. They often in this time remove the complaint which recurs on their being discontinued, so that they should be employed long after the discharge has ceased. The tinc- ture of cantharides may be given conjointly with balsam copaiva, or alone in common drink. This remedy must be cautiously employed, beginning with very small doses, about fifteen drops of the tincture, which may be gradually increased daily, as in the irritable state of these organs even a common dose may excite dangerous inflamma- tion. The application of a blister to the sacrum, or blistering the urethra, in its course, has sometimes succeeded. Upon high authority an obstinate gleet was cured by the injection of punch, a remedy suggested in a convivial moment; at another time by green tea; and again by a decoction of red oak bark. An astringent injection of considerable efficacy in obstinate gleets, is prepared by dissolving twenty or thirty grains of alum in a half pint of water, which should be injected up the urethra, twice or thrice a-day. When an ulcer in the urethra is the cause, which may be sus- pected, if on pressing the penis slightly erected, between the finger and thumb, one part be found more sensible to the touch than an- other, the best remedy which has come under my notice in practice, is an injection composed of one or two grains of corrosive sublimate in a half pint of water, or made of sufficient strength to excite some degree of inflammation in the part affected. If a stricture be the cause, the introduction of a bougie is the only remedy. While the use of a bougie is continued, the discharge usually proceeds, but after three weeks or a month, it should be omitted. If the running stops, the cure is usually effectual ; if it continues, the remedy should not be repeated. In women, gleets are equally obstinate, but they generally pass under the appellation oifiuor albus or ivhiles. SEMINAL WEAKNESS Is another consequence of clap, when there has been frequent returns of it, and is known bv an involuntary discharge of the semen. 326 pox. At the beginning of the disease there is a great inclination to erec- tions, and the emission of the semen is attended with pleasure ; but gradually the penis becomes lame, the testicles hang lower than usual, and unless they are otherwise suspended, become almost a burden to the possessor. Although veterans in the wars of Venus, are most liable to be complimented with this kind of gleet, yet it may originate from other causes, as self-pollution, a sudden lift or strain, hot clysters, straining to stool, or the imprudent use of strong diuretics. Let the cause, however, be what it will, there is no drain which steals away the quintessence of life and strength more rapidly. Treatment. — If the emission take place on the slightest irrita- tion, as heat, wine, ser, so as to keep the limb agreeably firm. The process is either slower or more imperfect in children and old people : their bones, therefore, are more apt to be broken again ; hence, with them, the splints should be kept longer applied. On particular occasions, also, particular precautions must be taken. Thus, with delirious patients, and those who are liable to sudden motion, as when at sea, the limb, after being set, must be laid be- tween two pillows, and the pillows fastened to the bed. It is, also, sometimes necessary to make the splints more secure, and this may be done by soaking a roller or bandage in whites of eggs, mixed with a little flour ; or by strewing a little powdered rosin on the bandage, and afterwards soaking it with spirits of wine ; or, finally, by soaking the bandage with fine glue, which makes a firm case, and is far from being offensive. Lastly, though splints and bandages, in general, are unnecessary during the cure ; yet, when a patient rises from bed, rests the weight of his body on a fractured bone, and begins to be exposed to acci- dents, the splints laid along the limb should be made firm by a ban- dage or roller as above described, to prevent those accidents which may be incurred by precipitation and rashness. In fractures of the arm, the parts hang naturally in the best pos- ture, and require but two splints of thin pasteboard, rolled gently with a linen roller: and, in fractures of the forearm, the limb pre- serves its natural length or form ; it requires merely to be laid upon a long splint of pasteboard, with a small splint laid above, the two splints being secured with light ribands or tapes, and the arm, from the elbow to the fingers' ends, supported by a sling or handkerchief round the neck, raising the palm of the hand to the breast, with the fingers moderately bent. When the arm is fractured between the elbow and shoulder, the forearm may be placed in the same position, as already described ; but the sling, instead of supporting the whole length of the arm, should only support the hand, which should be raised higher than in the former case, the elbow being allowed to sink; its motion, however, being prevented, by a handkerchief passed moderately tight round the trunk, including the fractured arm. When the small bones happen to be fractured, they must, be re- placed and retained in their situation, by splints and bandages fitted to the part. In using splints of pasteboard or untanned leather, it is always necessary they should be applied, in the first instance, wet, so as to assume the form of the fractured part. After the first fort- night, the dressings should be occasionally removed, to allow some motion of the joints ; and then replaced, and daily removed for the same purpose. 368 FRACTURES OF THE RIBS. When there is an external wound, communicating with the cavity of the fracture, it is termed a compound fracture. This sometimes occurs by the protrusion of the bone ; at other times by the same force which caused the fracture. In such cases, the bone is to be reduced by carefully attending to the posture of the limb, and by dilating the wound, when the bone becomes girded in it. The wound is then to be dressed with dry lint, in order to allow the blood to coagulate, which will form a kind of scab, and every effort should be made to unite the wound by the first intention, thereby convert- ing the accident to the state of a simple fracture. Almost all fractures are attended with contusion, and, conse quently, swelling ; the abating of which is the first step that should be taken towards the cure, and is to be effected by bleeding, if the patient be of a plethoric habit, by mild purges, a cooling regimen, and by the exhibition of the anodyne sudorific drops, as already described ; the application to the parts affected should be vinegar or lead-water, with crumbs of bread, or poultices made of stale beer, or vinegar and oatmeal, with a little oil to prevent their growing dry or stiff. The swelling of the limb being subsided, and the callus formed, cold water may be poured through the spout of a tea-kettle over the fractured limb, every morning, to restore the tone of the injured parts. FRACTURES OF THE RIBS. The ribs are broken, for the most part, near to the middle. The accident usually proceeds from blows or falls, and is known by an acute pain in breathing, and a crepitus or grating being per- ceived, on pressing the rib in different places. By carefully passing the hand over the rib, the inequality produced by the fracture may be sometimes distinctly felt. Coughing produces a crepitation, which is frequently perceptible to the patient himself as well as to the by- standers. The only treatment necessary, in simple fractures of the ribs, whether one or several be broken, is to keep the part, during the re- union, as much as possible in a state of rest. This is done by coun- teracting, to a considerable extent, their motion in respiration. To effect this, a bandage, six inches wide, is to be passed repeatedly round the chest, as tightly as the patient can suffer it to be drawn. Its slipping down may be prevented by means of a shoulder strap. Or, instead of a roller, a jacket, of strong linen, capable of being drawn very tight, by means of tapes, may be used. Until the re- union be completed, the patient should be kept as quiet as possible. BLOOD-LETTING. 369 If the lungs be wounded by a splinter of the rib, blood will be spit up, and high fever and inflammation will be likely to ensue. In this case, blood must be drawn copiously from the arm ; and the patient should be treated, in all respects, as if he were labouring under pleurisy. BLOOD-LETTING. The art of opening a vein, and the necessary cautions respecting the operation, should be learned by every one ; since cases of emer- gency may happen, when the necessity of its being performed is evi- dent, and where life may be lost before medical assistance can be obtained. Another qualification necessary to be possessed, is that of being able to stop the flow of blood from a vein thus opened. To bleed, you are to apply a riband or ligature with a degree of tightness, an inch or two above the elbow joint; and as soon as a vein is conspicuous, place the thumb of your left hand about an inch below the place of your puncture, and then with your right hand, holding the lancet firmly betwixt your thumb and fore finger, make an incision obliquely into the vein, without changing its direc- tion, or raising the handle, lest the point, being lowered in propor- tion, should cut the under part of the vein, or perhaps even wound an artery.* When the quantity of blood you wish is drawn, unite the ligature, and close the orifice. To accomplish this, let the thumb be placed on the orifice, so as to bring its sides together, and to press it with a moderate force. The flow of blood will now be stopped, and the operator with the hand, must apply a compress, made by twice doubling a piece of linen, about two inches square, between the ori- fice and his thumb ; over this, place another compress, three or four inches square, of a thickness sufficient to fill up the hollow of the bend of the arm, confining the whole with a riband or tape, passing over the compress, and above and below the elbow, in the form of a figure eight, finishing with a knot over the compress. If the bleeding continue obstinate, the sleeve of the gown or coat above the orifice, ought to be ripped or loosened ; and if this do not * To discriminate between an artery and vein, is a matter of the utmost im- portance. This is readily done if proper attention be paid. The chief mark of distinction is, that the artery has a pulsation, which the vein has not. But frequently it happens, that an artery lies so immediately under a vein, that its pulsation may be felt through the vein. In such cases, it will be pru- dent not to open the vein, unless the operator is skilful ; for it must be attended with danger. 4T 370 BLOOD-LETTING. succeed, the lips of the incision should be brought nicely together, and while they are compressed firmly by the thumb of the operator, the coldest water should be poured on the arm, or orifice washed with sharp vinegar. The placing of a piece of adhesive plaster over the orifice in the vein generally succeeds in checking the flow of blood. To bleed in the foot, a ligature must be applied above the ankle joint, and after opening the most conspicuous vein, if the flow of blood be not copious, it may be increased by immersion of the part in warm water. On removing the ligature, the blood will readily cease to discharge, and a piece of court-plaster is the best bandage. Topical blood-letting is executed by the application of leeches, as near as possible to the part affected, or by a scarificator, or an instru- ment with a number of lancets acted upon by a spring. When leeches are employed they must be previously prepared by drying them, or allowing them to creep over a dry cloth; and the part to attract them should be moistened with cream, sugar, or blood, and they confined on it by applying a wine-glass over them. When the scarificator is used, as soon as a wound is made, a cup exhausted of its atmospheric air, by burning over it, for a few se- conds, a bit of a soft paper dipped in the spirit of wine, and on the flame of which, being nearly exhausted, must instantly be applied over the scarified part ; when full, it is easily removed by raising one side of it to admit the air. When you have taken away, in this manner, a sufficient quantity of blood, the wounds are to be covered with some cream or mild ointment. In the operation of blood-letting, certain morbid consequences at times arise, which demand a special treatment. The most common of these, is a swelling of the part, termed ec- chymosis ; and when it occurs, shifting the position of the arm, so as to induce a free discharge, will lessen the tumour, if not entirely re- move it. Should this fail, compresses, dipped in the solution of sal- ammoniac or brandy, are to be applied. These also failing, and the swelling still continuing, without any diminution, the tumour must be opened, and after removing the coagulated blood, the sore should be treated as a common wound. The result, however, very rarely occurs. Another consequence, which sometimes follows blood-letting, is an acute pain immediately felt on the introduction of the lancet, and communicated from the part to the extremity of the member. The treatment of this complaint consists in the early use of cloths, wrung out of lead-water, applied to the part, and adopting, in every respect, the antiphlogistic plan, as blood-letting, cooling cathartics, and a low diet, to obviate inflammation. This treatment not succeeding, laudanum must be given in large doses, which, also failing, a free division of the nerve or tendon, which was pricked with the lancet, is the only remedy left. The last accident required to be noticed, is the wounding of an BLOOD-LETTING. 371 artery, which is known immediately after the operation, by strong compression of the vein, above and below the orifice, by the tremu- lous motion in which the blood flows, and by not being able to stop the discharge as usual. The cure of this affection may be attempted in the early stage by compressing, and observing the antiphlogistic regimen. On their failing, the tumour must be extirpated, and then the ends of the vessels secured by means of a ligature, until a re- union of the parts be effected, when the circulation is made to pur- sue a different channel. ISSUES. These are a kind of artificial ulcers, formed in different parts of the body, for the purpose of procuring a discharge of purulent matter, which is frequently of advantage in various disorders. Practitioners were formerly of opinion that issues served as drains to carry off noxious humours from the blood ; and, therefore, they placed them as near the affected part as possible. But as it is known that they prove useful, partly by the quantity of matter they produce, and partly by sympathy, they are generally placed where they will occa- sion the least inconvenience. The most proper parts for them are, the nape of the neck ; the middle, outer, and fore-parts of the shoul- der ; the hollow above the inner side of the knee ; or either side of the backbone : or betwixt two of the ribs ; or wherever there is a sufficiency of cellular substance for the protection of the parts be- neath. They ought never to be placed over the belly of a muscle ; nor over a tendon or thinly covered bone; nor near any large blood- vessel. The issues commonly used, are the blister-issue, the pea- issue, and the seton or cord. When a blister-issue is to be used, after the blister is removed, a discharge of matter may be kept up by dressing the parts daily with an ointment mixed with a little of the powder of cantharides, or Spanish flies. If the discharge be too little, more of the powder may be used; if too great, or if the part be much inflamed, the issue- ointment may be laid aside, and the part dressed with basilicon, or with common cerate, till the discharge be diminished, and the in- flammation abated. It is sometimes most proper to use the issue-ointment, and a mild one alternately. A pea-issue is formed either by making an incision with a lancet, or by caustic, large enough to admit one or more peas; though, sometimes, instead of peas, kidney-beans, a gentian-root, or orange- peel, are used. When the opening is made by an incision, the skin 372 MALIGNANT FEVER. should be pinched up and cut through, of a size sufficient to receive the substance to be put into it. But when it is to be done by caus- tic, (the common caustic,) or lapis infernal is of the shops answers best. It ought to be reduced to a paste with a little water or soft soap, to prevent it from spreading; and an adhesive plaster, with a small hole cut in the centre of it, should be previously placed, and the caustic paste spread upon the hole. Over the hole, an adhesive plaster should be placed to prevent any caustic from escaping, In ten or twelve hours the whole may be removed, and in three or four days the eschar will separate, when the opening may be filled with peas, or any of the other substances above mentioned. The seton is used when a large quantity of matter is wanted, and especially from deep-seated parts. It is frequently used in the back of the neck, for diseases of the head or eyes, or betwixt two of the ribs, in affections of the breast. When the cord, which ought to be made of threads of cotton or silk, is to be introduced, the parts at which it is to enter and pass out, should be previously marked with ink, and a small part of the cord being besmeared with some mild ointment, and passed through the eye of the seton-needle, the part is to be supported by an assist- ant, and the needle passed fairly through, leaving a few inches of the cord hanging out. The needle is then to be removed, and the part dressed. By this method, matter is produced in quantity pro- portioned to the degree of irritation applied; and this can be in- creased or diminished, by covering the cord daily before it is drawn, with an irritating or mild ointment. MALIGNANT FEVER.* In the year 1823, while the Epidemic Malignant Fever, some- times denominated the Cold Plague, was raging in the western and southern country, and when physicians were unsuccessful in its treatment, and divided about its nature and origin, the author re- ceived the following letterf from sundry respectable gentlemen, * This article, the author wished to place under the head of Fevers : but as it could not be conveniently prepared till the former portion of the volume was in type, and as the author has not aimed at a strict nosological arrangement, he thought it as well to introduce it at the end of diseases generally. Feliciana Parish, Louisiana, t Dr. James Ewell, September 24th, 1823. Dear Sir : — We have perused your Medical Companion, with pleasurable and profitable attention, and though professedly ignorant of the science of medicine, we deem that work a valuable addition to the libraries, and emi- nently deserving the grateful acknowledgments of your fellow-citizens, in MALIGNANT FEVER. 373 citizens of Louisiana, asking information from him, as to the man- agement of a disease, which had proved so fatal in their neighbour- hood. The author, having no personal knowledge of the disorder, being far removed from the scene of its devastation, and having no sources for information, on which he could rely, was constrained to decline giving the advice requested. He has since met with the elaborate and satisfactory essays on the subject, written by Samuel consequence of its peculiar excellence and utility. That portion of it dedicated to Materia Medica, the Dispensatory, and a table of Medicine, entitles the author to the gratitude and respect of many families. From observation, we have found that those physicians are the most successful in their practice who have followed the directions which you have offered to the public. Entertaining an exalted opinion of your professional talents, we have con- curred in addressing this epistle to you, in the confident expectation, that your popular benevolence will prompt you to favour us with your valued advice on a disease, generally acknowledged mortiferous in this section of the union, which of all others has most severely suffered from annual epidemic distem- pers, mostly of a febrile description. The Cold Plague is the ordinary denomination of the formidable malady to which we allude, and for which no adequate remedy has, as yet, been dis- covered. To afford you some idea of its prevalence and malignity, we state the fact, that, in the space of ten days, our neighbour, Mr. Waddle, lost six of his household who were attacked by this disease ; that he himself is now its vic- tim, and is hurrying to the threshold of eternity; while his sister is, at the same time, confined to her bed, with all the symptoms of the same complaint; and this, sir, is but one instance of many thousands of the fatality of that dis- ease, which annually desolates Louisiana and the bordering state of Mississippi. That distance precludes you from personal contemplation of the symptoms of the cold plague, is seriously lamented by us, as it subjects you to disadvan- tage in prescribing, and us to less certain benefit from your medical knowledge. We will, however, attempt to describe it. One of the undersigned was seized with the cold plague, about the conclusion of August, 1821. Symptoms. — Pain in the stomach extremely violent; a vibrating coldness; a fever, during which a profuse perspiration took place, of twenty-four hours' continuance. Will it be credited, that while it was obvious to the physicians, that the patient was in a high fever, the latter felt a death-like coldness, in all parts of his body, except the region of the heart ! He was continually thirsty ; and, for three days and nights, complained of extreme pain in the stomach. We earnestly request you, sir, to give your opinion relative to the best method of treating this enemy of Louisiana. Address to Mr. William George Dixon, St. Francisville, Feliciana Parish, Louisiana. (Signed,) Angus Umphraville,1 A. W. Draughan, Benj. O. Williams, I r , Francis Brian, Robert Dyer, f* 1 ^ *' Eli Rentz, David Pipes, Sen. J Joseph Drawdy, Jesse Knighten, Merchant. H. R. Harrell, N. M. K. Reid, U. S. Surveyor. Joseph Vick, Wm. G. Dixon, "| Micajah Courtney, Wm. Campbell, I Robt. Neyland, John Rowley, V Planters. M. Dikson, Stephen Shelton, B. Chance, fe 374 MALIGNANT FEVER. A. Cartwright, M. D. of Natchez, Mississippi, and published in the Medical Recorder, Vol. IX., year 1826. From these essays he has made copious extracts, which he presents to his very polite corres- pondents of Feliciana, and to the public, in general, as the best treatise on the cause, symptoms, and cure of malignant fevers, that has ever been published, and indeed the best which could be gath- ered from the whole stock of information on the subject, now pos- sessed by the profession. The thanks of the medical profession, and of the public, are due to Dr. Cartwright for his zeal and industry in investigating this subject, and for the ability with which he has communicated the results of his labours. Symptoms. — The disease was marked by three distinct stages, each of which had its peculiar symptoms. As it might, in its first and second stages, have been mistaken for some other malady, I will only describe the last stage, which presented features altogether pe- culiar, and could be confounded with no other disease whatever. In the last stage there was apparently no fever, and little or no pain. The patient often regained his strength so far as to be able, in the most of cases, to walk about his room. His eyes were of a yellowish red, sparkling appearance, and lent to a countenance, otherwise of apathy, a strange expression of wildness and horror. Black dissolved blood oozed from the mouth, the gums, and the nose; coffee ground vomit, or a dark brown flaky matter, with but little effort, was thrown from the stomach ; anxiety, restlessness, and great flatulency of the stomach, portended and accompanied its discharge, spasms seized the muscles ; the breathing became heavy, slow, and irregular, at- tended often by a hoarse, deep, sullen sound. The speech became incoherent ; yet, when the patient was spoken to, he appeared to be able to collect himself so far as to answer questions rationally, and although sensible of his situation, seemed resigned to his fate. These were the symptoms that characterized the third or last stage of the disease. Although all of them did not invariably occur in every patient, yet a sufficient number were generally present to point out the character of the disease to the medical attendant the moment he entered the sick room. The first stage consisted in a broken or irregular reaction ; and the second, or milder stage, in a general excitement diffused throughout the system. The duration of the first stage was generally from one to twenty-four hours ; and that of the second stage, from one to forty- eight hours. The first stage could readity be distinguished from the second period, by the partial evolution of heat in the one, and the uniformly hot surface of the other. The patient was found covered up with bed-clothes in the first stage, but in the second and third, he greatly preferred lying entirely naked. In a great many cases, the worst cases too, the state of the system which constitutes the second stage, never occurred ; but the disease passed immediately from the first to the last stage, without going MALIGNANT FEVER. 375 through the second stage of reaction. — These were called the cold cases of yellow fever, or yellow fever without reaction. The approach of the first stage of the disease was announced by an intoxicated appearance, and a remarkable exhilaration or depres- sion of spirits, and was soon ushered in by a contemporaneous sen- sation of heat and cold. The patient, although complaining of great internal heat, was often found under one or more blankets, which he would not permit to be removed. His skin, which to him felt excessively hot, was often actually cold to the touch. Yawning, stretching, soreness of the flesh, achings of the bones, and, at length, flatulency of the stomach, with great weight and oppression about the preecordia, took place, followed by pain in the head, stomach, and back. The pain, in this stage, was never so severe as in that of general reaction. Indeed, it was sometimes entirely absent. It was re- marked by a very intelligent and accurate observer of the disease, Dr. Gustine, that the most fatal cases were those which were at- tended with the least pain. A want of thirst also attended the disease in its first stage. The tongue was then seldom much furred ; its edges were often red ; sometimes, it presented no unusual appearance in the most malignant cases. The patient, in this and the second stage, was as anxious about living, as he was indifferent and careless of life in the last stage. Treatment. — Experience has long since proved that the same remedies produce very different effects in different diseases, and in different stages of the same disease. Stimulants, emetics, cathartics, &c, are the only relative terms; for, in many conditions of the sys- tem, stimulants impart no strength, tartar emetic will not puke, nor will calomel purge or salivate. I shall first point out the state of the system in which they were used, the effect they produced, and the manner in which they influenced the disease. In all important cases, I was in the habit of noting the state of the system when a remedy was given, and on my next visit, noting also the changes produced in the disease. When a remedy, in any particular state of the system, was found to be pernicious or useless, it was not con- cluded to be pernicious or useless in all states of the system, but only under those particular circumstances in which it had been proved to be so. When the disease terminated fatally, I looked back on the situation of the patient when the remedies had been used, their ef- fects on the disease, and immediately proceeded to make post mortem examinations, and to note down every morbid appearance. Having the charge of Natchez hospital, from the 6th of September, until the epidemic terminated in November, I had an excellent field for ob- servation. Patients of every description were admitted, and in every stage of the disease, — some who had been under the treatment of other physicians, and others who had taken no medicine. This hospital, with my private practice in the city, in which I resided during the epidemic, and the experience of the disease in my own 376 MALIGNANT FEVER. person, in the present, and also in a former epidemic, are the sources from which the following observations have been drawn. I have seen patients recover from yellow fever under very different, and apparently, opposite modes of treatment. The narrow view's which are too often formed of the action of medicines, and of the laws which regulate the system, aided by the dogmas of the schools, have, until within a few years past, shackled the science of medicine, and hindered its progress. Facts are yet too often overlooked or disregarded, when they do not support some slender-built theory, or favourite hypothesis. In the first stage of yellow fever, or that in which consists of an ataxic or crippled reaction, when the blood is unequally determined, the heat unequally-diffused, sensation impaired, and a secretion sus- pended, I found no other remedy, or combination of remedies, which produced such decided effects, as tartar emetic, in full doses. It, however, seemed sometimes inadequate to make a sufficient impres- sion on the torpid system. When given in this stage of the disease, its effects were not so soon apparent, as in the healthy state of the system, or in less violent diseases. Very often, it would be an hour or more, after a full dose had been taken, before the system appeared to feel it. At length the peculiar sensation of heat and cold , at the same time, would somewhat yield to a sensation of heat only ; the temperature of the skin would become more uniform, and as the ex- citement was brought out, great distress would ensue, and the sys- tem appeared to arouse from its torpor, and to regain, in some mea- sure, its organic sensibility. Some one or more of the great organs of secretion now took on a secretory action. The nausea, the retch- ing and anxiety, soon gave way to full vomiting, first of phlegm, and then of bile. This, to a spectator, was an alarming period in the disease, and most distressing to the patient. The powers of life would sometimes appear as if they were about to give way under it, but happily it was only in appearance. The vomiting at length subsided, and the patient enjoyed a little respite from his sufferings, and, bathed in a perspiration, he would fall into a slumber of short duration, for these were only the first effects which tartar emetic pro- duced on the system. Soon reaction took place, and the disease passed into the second stage ; but the reaction was general, and lost its ataxic or broken character ; it was accompanied with a hot skin, violent pain, and a full, strong, tense pulse. The patient would now complain of excessive misery. I delighted to see the disease come out thus openly, and show itself by fever and pain ; for, although the patient might fancy himself worse, yet he was far removed from the danger which attended on the ataxic fever from which his system had just emerged, and only required a bold use of the lancet, and other remedies hereafter to be mentioned, to restore him to health. But it was not always the tartar emetic, when given in the first stage, would produce vomiting. In those cases in the first stage, in which the skin was cold, and even when the reaction was ataxic MALIGNANT FEVER. 377 and scarcely perceptible, the organs as if palsied, secretion entirely suspended or strangely vitiated, the stomach irritable, and little or no pain complained of, tartar emetic, in full doses, might be given with- out producing vomiting. Strange as it may appear, tartar emetic, in such cases, was a most powerful stimulous ; it brought out the ex- citement, heated the skin, raised the pulse, allayed the irritability of the stomach, restored sensibility to the organs, and finally awakened one or more of them, the kidneys, skin, &c.,to active secretion. To have this effect, it should be given in doses of from three to ten grains every one, two, or three hours, dissolved in a small quantity of water, or what is better, as I have since learned, in similar states of the system, in pills. When secretion has been brought about by the remedy used in this way, and the excitement developed, it should not, at once, but gradually, be discontinued, by giving smaller por- tions at long intervals. Should a vomiting ensue before the skin has its heat and sensibility somewhat restored, bile will rarely be evacu- ated : in this event, another dose of the medicine should be imme- diately given, and repeated whenever great nausea ensues. I have rarely seen this practice fail, in such states of the system, to check the vomiting and heat the skin, when mustard and blisters had failed. It will be remembered, that those which are denominated cold cases, are the most hopeless. I have used the hot bath, fric- tions, sinapisms, blisters, besides various internal stimulants to bring on reaction ; but the combined influence of all these remedies has never had the same beneficial effect as tartar emetic alone. But in some cases of this kind, particularly in hard drinkers, it fails to pro- duce secretion, and to develop excitement. It may be imagined by men in their closets, that these are cases of congestion only, which congestion could readily be removed by small and repeated bleedings combined with internal and external stimulants. If the malignant nature of these cases depend entirely on congestion, it is a very dif- ferent congestion from that which takes place in many other diseases. In the latter, I have often succeeded in removing the congestion, by blood-letting, combined with internal and external stimulants ; but in the cold cases of yellow fever, never. In such cases, if blood be taken away, even should the patient not immediately sink under it, so far from the reaction being produced, the blood vessels lose more and more of their contractile power ; stimulants impart no strength ; the warm bath and rubefacients produce no more effect on the skin than if applied to so much leather ; the organs become more para- lyzed ; the sympathies more deranged ; and the whole system soon appears as if it were divided into two different parts, one not depend- ing on another, and each having the principle of life diminished in it. Instead, then, of using blood-letting in such cases, to remove congestion, I used tartar emetic to produce secretion, and to develop the excitement. Although tartar emetic was sometimes inadequate to produce these desirable effects in the cold cases, it scarcely ever failed to be eminently serviceable in the first stage of cases o( a less 378 MALIGNANT FEVER. malignant nature. The earlier it was given in the first stage of the disease, the better. When given freely, so as to produce secretion in the liver, kidneys, and skin, a general and equable reaction soon succeeded. It shortened the duration of the first stage, or that of ataxic reaction, and thereby converted a highly malignant into a mild case of yellow fever. For, in the mild cases, when left to na- ture, the first stage continues but a short time, and the disease soon passes into the second, or that of general reaction. These are the cases which bear bleeding and purging so well, and in which eme- tics are of no service, (unless given before the general reaction has taken place.) The good effects of emetics appear to depend on their ultimately producing a general and equable excitement throughout the system. In the more malignant forms of yellow fever, the stage of ataxic reaction, when left to nature, continues a longer time ; and should the second stage, or stage of general excitement ever occur, its duration is so limited, that a sufficient time is not given to subdue the disease, before it passes into the third and last stage. Tartar emetic, then, given in the first stage, shortens its duration, and places the system in a similar state to what we find it in the milder forms of the disease. And, in proportion as the ataxic stage is shortened, so is the stage of general excitement prolonged, and the chances of the patient's recovery greatly increased. On looking over my notes, I perceived, that when it had been given in the first stage, such patients not only bore bleeding better, and could be purged more easily, than those to whom it had not been given ; but whether they lived or died, the symptoms of the second stage, or that of reaction, continued longer than when tartar emetic had been omitted. — For in those cases in which it had not been given, should the stage of reaction ever occur, it continued but a short time, frequently not more than an hour ; then external reac- tion, like the blaze of recently ignited coals, would subside, not from the fire having been extinguished, but from the heat which supported it having become greater. My notes, likewise, showed me that tar- tar emetic, however well adapted to some states of the system, was not so to every one in yellow fever. For when it had been given in the stage of general reaction, its effects were extremely equivocal, and, in some cases, injurious ; and in the third stage, it appeared to accelerate the fatal black vomiting. I thus found that I had pushed a favourite remedy too far, by using it improperly ; and, at the same time, learned the particular states of the system to which it was peculiarly adapted ; namely, during the first stage of the disease, antecedently to the development of a general reaction. Tartar eme- tic used in this stage, restored sensibility to the torpid organs, pro- duced secretion, and destroyed the ataxic character of the disease, by establishing a general and equable excitement ; or, in other words, converted an irregular and intractable condition of the system, into an open, plain, and manageable case of fever. When I first treated yellow fever, in its first stage, by tartar emetic, and witnessed the MALIGNANT FEVER. 379 violent reaction that shortly succeeded its use, and heard the ago- nizing shrieks of my patients, from the pain that attended the increased sensibility and universal excitement that succeeded it, for a moment I thought I had done wrong, and would have ceased to use it, had I not found that this was the only state of the system in which the lancet could fearlessly and successfully be used. Even when the lancet was not used, the general reaction in- duced by tartar emetic, was nothing like so fatal, as when an ataxic state cloaked the violence of the disease. To illustrate this remark, Dr. McPheeters, lately from Missouri, was taken ill at the most peri- lous and alarming period of the epidemic. He found himself alone, and rendered helpless, by a violent disease that killed generally in three days. Being a man of great strength and energy of mind, he resolved to make use of efficient measures, and, accordingly, mixed up sixty grains of tartar emetic, and took a sixth part of it at once. It proouced copious secretion, and was soon followed by a vehement excitement of the whole system. Having no means to subdue the reaction thus brought about, it ran its course. But, every part being excited, the system was enabled to bear up against a power that oth- erwise would have caused it to succumb. Nine or ten days after- wards, I visited him. Reaction had nearly run itself down. He looked more like a patient in the advanced stage of a common syno- cha, than one in the yellow fever. Had not the ataxic reaction, with which the disease commenced, been removed, he would not, most probably, have survived. Blood-letting. — If blood-letting were resorted to before the development of general reaction, the reaction, which had yet only partially developed itself, abated ; the heat which had begun to spread itself over the surface, disappeared ; and the pain would sub- side ; and this, too, before the quantity of blood taken away was, in any degree, considerable. Medicines did not operate, and the dis- ease at once passed into the last stage. During the ataxic reaction, in vain may we be told to bleed to the relief of the symptoms ; foi they grow worse while the blood is flowing, and continue to become more alarming, and that in proportion to the quantity of blood taken away. When a feeble and broken reaction has taken place, to attack it by the lancet, is like attacking the first phalanx of an enemy, when he attempts to come out of his intrenchments, instead of waiting until the main body has appeared in the open field. But in the second stage, in which the heat of the whole surface is excessively increased, the pulse full and strong, the patient lying naked, and calling on the attendants to fan him, and to give him cold water, we may bleed fearlessly and successfully. The effects produced on the system by blood-letting in the reacting, so far from hastening the disease into the last stage, and bringing on fatal symptoms, prevented it from passing into that state, and robbed it of all its violence and danger. I will now give a case in which bloodletting was followed 380 MALIGNANT FEVER. by alarming consequences, from its being used a little too soon in the disease ; that is, before the second or reacting stage has fully deve- loped itself, yet so near the stage of general reaction, as to prevent blood-letting from proving fatal. Mr. McCauley, a printer, was attacked with yellow fever, on the 20th of August. The disease appeared at once to overpower the system. It seemed as if the vis- cera had absorbed nearly the whole of the circulating fluids, as the skin was cold and almost insensible ; the pulse small, slow, and weak, and no secretion appeared to be taking place from any organ whatever. He complained of no pain, yet was restless and uneasy, and seemed to be oppressed in his breathing, as if a heavy body were lying across him. In this situation, early in the morning of the 21st, about twelve hours after his attack, a full dose of tartar emetic was given him. In two hours afterwards, he began to com- plain of pain in his head and back ; his skin became sonjewhat warm, particularly about the head and breast ; frequent efforts were now made to vomit, but nothing except the drinks was evacuated : a clammy sweat bedewed his forehead and breast, which soon dried up, and again appeared. He continued in this state until noon, when full vomiting took place. At two o'clock, the vomiting ceased, and the irritability of the stomach was so much allayed, that it re- tained several doses of calomel and castor oil, senna, tea, &c, which were given at regular intervals, until seven o'clock ; and, although assisted by injections, had not operated. He now complained of excruciating pain. His skin, except his extremities, was hot to the touch ; his pulse at the wrist tense, but not full and strong. The ataxic reaction was verging on to general reaction ; but the latter had not, as yet, fully developed itself. Hoping that it would be the means of making the medicine operate, I opened a vein in the arm; as I never feared blood-letting in such states of the system, as, alone, it would either produce secretion, or cause medicines to do it. Being determined to bleed him until some sensible effect was produced, I took away upwards of sixty ounces of black dissolved blood, before the system seemed to feel its loss. The blood was stopped, in consequence of a slight sickness at the stomach. The patient answered several questions after I had tied up his arm. I went into an adjoining room, and, in about five minutes, was told the patient was dying. I took hold of his arm, but found no pulse. His face was sprinkled with water, washed with vinegar, and con- stant frictions applied to the skin during fifteen minutes, yet without effect. — Some laudanum was now procured, and one hundred and twenty drops poured down his throat. After waiting fifteen minutes longer, for a boy to return from the apothecaries, half an ounce of spirit of hartshorn was given, which he seemed not to feel. A stimu- lating injection was administered ; his face was washed with the aqua ammonia, and the frictions were kept up. All of his atten- dants, excepting one, left him, and reported him dead. I thought, myself, that animation had been suspended too long, in his present MALIGNANT FEVER. 381 condition, to be restored. After remaining in this situation for nearly an hour, signs of life again appeared. After several sighs, respira- tion took place, and a tremulous pulse was felt. But from the slightest exertion on the part of the patient, synocope would again ensue, and continue for several minutes. I ordered the spirits of turpentine to be freely given, stimulating injections to be used, and sinapisms to be applied to the extremities. On the morning of the 22d, I found that no perceptible secretion had taken place : he had neither sweated, urinated, or had an eva- cuation from his bowels. Suspecting that there might be a want of power in the bladder to evacuate the urine, I examined, but found no urine in the bladder. I continued to give the turpentine, in drachm doses, every hour through the day. His bowels, on the evening of the 22d, acted ; and, shortly afterwards, he discharged a little very turbid urine. On the morning of the 23d, the great organs of secretion were all awakened, and the patient, though much ex- hausted, was, in a few days, restored to perfect health. Had the reaction in this case been general, and not of the ataxic kind, I judge from what I have seen in other cases, that no alarming effects would have followed the use of the lancet ; but had not the ataxic ap- proached so nearly to general reaction, I am fully persuaded that the patient would not have borne half the quantity of blood to have been taken away, without producing death. I have dwelt the longer on this case, as the length of time which elapsed before the emetic operated, the changes that took place in the system in consequence of it, the great quantity of blood that was taken away before the system felt its loss, the alarming effects that followed it, and the length of time before the torpid organs assumed a secretory action, are well calculated to show the character of the most malignant form of yellow fever, and the manner in which they are influenced by remedial agents. I will now give one case, out of many, to show the effects of blood-letting after the excitement is fully evolved. Mr. Welch, a baker, was attacked with yellow fever on the 15th of September. On my visiting him, on the morning of the 16th, 1 found him wrapped in several blankets, and complaining both of heat and cold. I ordered five grains of tartar emetic every hour, till he vomited copiously. In the evening, I found him lying naked on the floor, as the bed was too warm ; he was raving like a madman from the excruciating pain in his head and back ; he begged the attendants to kill him at once, and put him out of his misery. His pulse was full and strong, and the whole surface of the body re- markably hot. — I took away, at one bleeding, six pints of blood, before the symptoms were relieved. He continued very sick at his stomach only for half an hour, but did not faint. Calomel and cas- tor oil, then given, operated freely on his bowels in six hours after- wards, and he speedily recovered. In my own case, I lost four pounds of blood at one time. It was taken away before general reaction had as fully developed itself as 382 MALIGNANT FEVER. I could have wished. A most distressing feeling of exhaustion en- sued, and continued for an hour or two. No healthy secretion took place for twenty- four hours afterwards; at the end of which time, by a judicious course of treatment pursued by my physician, and friend, Dr. Kenny, the skin, the liver, the kidneys, and salivary glands, all took on a secretory action ; and in less than a week from my attack, I was able to leave my room ; and in two or three days more, I resumed my practice. It was not until I had seen some of the most injurious effects from the loss of the smallest quantity of blood in the ataxic stage of the yellow fever, that I could be convinced of the propriety of waiting until the excitement had fully developed itself, before recourse should be had to the lancet. Purgatives.— If purgatives were given immediately on the ac- cession of the first stage, they sometimes produced secretion, which was followed by a reaction more or less general. But it was only in the milder forms of the disease, in which the organic sensibility was not greatly impaired by the first shock of the disease, that pur- gatives produced secretion. Drastic purgatives, in almost any state of the system, would, after so long a time, force away watery stools, which, like similar secretions in cholera morbus, soon exhausted the system, without producing any beneficial effects whatever, either immediately or remotely. When the system was placed in a proper state for the exhibition of purgatives, those of the milder class would be followed by bilious discharges, which were beneficial; but when it was not in this state, drastic purgatives would produce serous mucus, or sanguineo-serous discharges, which were extremely injurious. As the milder cathar- tics were found to have all the good of die drastic, and none of their evil effects, I preferred mild to drastic purgatives. Late in the epi- demic, I obtained some of the Croton oil. From the trials I gave it, I am induced to believe that it will be found to be a valuable remedy in many cases of yellow fever. Every time it was used, copious bilious dejections ensued. It was, however, only resorted to in those states of the system in which I would have used other purgatives. As this medicine is so pleasant to take, and can be retained on the stomach in cases in which almost any other purga- tive would be rejected, it promises to be of great utility in many forms of disease. Mercury. — Given in the first stage of the disease, mercurial pre- parations in, by far, the majority of cases, produced no evident effect on the system, and, consequently, none on the disease. Sometimes, however, even in this stage, they produced ptyalism, yet such ptyal- ism had little or no effect in arresting its progress. There is a state of the system which, however, occurs more often in bilious than in yellow fever, in which I have found the specific effects of mercury to be particularly serviceable. After reaction has subsided, and the skin, kidneys, and liver have been excited into a secretory action — owing to some organ having, from some cause or MALIGNANT FEVER, 383 other, sustained a great shock, a torpor will again take place in one or more of these organs, that produces great irritation in the system, preventing sleep, destroying the appetite, producing fever, and there- by exhausting, more and more, the already too much exhausted patient If the torpid organ be excited into action by any other remedy than mercury, as soon as it ceases to feel the impression of the remedy, it ceases to secrete : here, mercury, by keeping up an impression not transient, as the most of other medicines, but per- manent, will, by enabling the diseased organ to regain its powers, restore the patient to health. In the above state of the system, and in many others in which the specific effects of mercury are indicated, I had been taught to use Calomel in small and frequently repeated doses ; but experience has convinced me, that there is scarcely any state of the system, requiring the specific action of mercury, in which calomel, in large doses, is not the best means to effect it. Scruple doses of this medicine will not only induce the specific effects of mercury sooner, but will be followed by fewer disappointments, and less inconvenience and danger, than when smaller doses of that medicine, or any other form of mercury, have been resorted to. Diuretics. — As a copious secretion of urine was a favourable symptom, and a suppression of it alarming, and often fatal, diuretics were remedies, in many cases, of great importance. When purga- tives would not produce a secretion of bile, instead of trying by re- iterated doses of these medicines, more especially of a drastic nature, to force away alvine discharges, which, in such circumstances, would generally be of a serious kind, that tended only to weaken the pa- tient, I endeavoured to excite the kidneys to secretion by diuretics. I have often had the pleasure to find that the urinary secretion produced by them, was of equal advantage in arresting the progress of the disease, as the biliary, by purgatives. Soon after the secre- tion of urine was established, the skin and liver would both gene- rally begin to yield their peculiar secretions, and the disease would no longer be able to resist the efforts of these allied organs. Diaphoretics. — When neither the liver nor kidneys could be excited into action, diaphoretics were sometimes serviceable. But great irritability of the stomach, the distaste to all medicines, the want of nurses, and the rapid march of most cases, prevented me from encumbering my practice by such feeble medicines, in the treatment of a disease, which seemed to require only a few simple, efficient, and well timed medicines. Epispastics. — In every stage of the disease, I have used blisters, applied to the head, over the stomach and bowels, to the extremities and down the spine. The benefit, however, which I had reason to expect from my experience with them in bilious fevers and other diseases never followed their use. Sinapisms to the extremities, to assist tartar emetic, and the hot bath to produce reaction in the cold cases ; or after reaction had been reduced, to stimulate the prostrated 384 MALIGNANT FEVER. patient, were far more serviceable than blisters. The former acted much more quietly, and produced greater pain than the latter. Stimulants. — How the bark and wine in large doses would have answered in the first stage of this disease, to change the ataxic reaction of that stage into a general reaction, I cannot from expe- rience determine. The Spanish practice in the Andalusian fever, consisted in large and repeated doses of bark, given immediately when the patient began to complain. This practice, we are told by Dr. Johnson, was attended with extraordinary success. I very much suspect that the good effect of bark, in that fever, principally depended on its transforming the broken excitement, with which the disease com- menced, to a general reaction, or open case of fever. I lost one patient who drank a draught of ardent spirits, with pepper in it, immediately after the attack. The fever became developed, but great gastric distress attended throughout its course. Autopsic appearances proved the existence of unusually high inflammation in the stomach. Of the Bath. — The cold bath, if used in that state of the sys- tem, which I have called ataxic reaction, was evidently injurious. I cannot better describe its effects, than by the following case : — Mrs. Rice, in the first stage, used ablutions of cold water and vinegar. The efforts made by the system, towards general reaction, became immediately subdued; and, to use her own language, "the cold water drove the fever in upon her heart and stomach." Great cold- ness and shivering, with internal heat and oppression, succeeded its use. Reaction never took place, and the disease passed, at once, into the last stage ; and when I was called to see her, fatal symptoms had appeared. Had an emetic, instead of the cold ablutions, been tried, it is probable that reaction would have been general ; would have borne blood-letting, and have been attended with a different result. The only condition of the system, in which cold ablutions or affusions were advantageous, was when the surface was uniformly and pretematurally hot. In this epidemic I never found any dif- ficulty in reducing the reaction by the lancet and other remedies, consequently, I seldom found it necessary to call in the aid of cold affusions. In the yellow fever under review, when reaction was reduced, or on the wane, if secretion did not take place, the tepid bath, appa- rently by removing the remains of morbid heat, and by restoring the natural sensibility of the skin, enabled that important organ to take on a proper secretory action. But cold water, by carrying off too much heat, reduced the temperature of the skin below that degree which is compatible with natural sensibility; and, consequently, with healthy secretions. Pleased with the effect of the tepid bath, after the use of the lancet in the reacting stage of the disease, I re- sorted to the same remedy in the ataxic stage. The temperature of the bath was 96 degrees. The patient, as soon as immersed, com- MALIGNANT FEVER. 385 • plained of being disagreeably cold ; he was taken out in a shivering fit, and was shortly afterwards immersed in a bath so hot, as to be extremely painful to my own hands, yet he did not in the least com- plain of it. His skin soon became generally warm, and an emetic, which he had previously taken, began now to operate. He was removed from the bath, and in a few hours a fever so violent ensued, that copious blood-letting was employed to subdue it. The hot bath, whenever it could be procured, was employed in conjunction with emetics, in the cold cases of yellow fever, in order to bring about a general reaction. If emetics were not used in conjunction with the bath, the skin, it is true, would be heated : but its heat, like that of an inanimate substance would soon subside on being re- moved into a colder medium. Dr. Cartwright farther states, that he personally witnessed the yellow fever of 1825 in Natchez, " Under the Hill;" in Washing- ton, a village six miles from the river Mississippi ; at Haughton's, a tavern in the country; and, lastly, in Natchez, " On the Hill;" and he proceeds to give the following additional facts relative to the causes, nature, and treatment, of the disease, which its occurrence and prevalence in the above mentioned places afforded him an op- portunity of observing. Natchez Landing, (or Under the Hill, as it is called,) consists of a few rows of buildings, situated immediately on the brink of the Mississippi river, at the foot of a bluff about two hundred feet high, which forms the site of the principal part of the city, called Natchez " On the Hill." Although during high water, the buildings under the hill are immediately on the brink of the river, yet when the river falls, as it always does in summer, a surface of ground several rods in width, becomes uncovered between the buildings and the river. The surface thus exposed by the falling of the river, consists of mud recently deposited, and of the debris of various vegetable and animal substances, which, during the season of trade, had been thrown out by the flat boats that landed at this place. On the margin of this uncovered surface, there is a warehouse, which, in the months of July and August, 1825, contained a large quantity of spoiled porter and sour pork. The owner of the warehouse was constantly en- gaged in repacking the pork ; the brine from which, was permitted to run through the floor, into a kind of cellar, which had no outlet to it. Some of the porter barrels burst, and the spoiled porter, also, ran through the floor into the cellar, with the brine from the sour pork. Some few hundred yards above the warehouse, there was a boat containing a quantity of rotten corn, which had been sunk in the water, but became exposed in the summer by the falling of the river; and below the warehouse, but not so far from it, there were two or three houses that contained stagnant water, others, putrid sour krout, fish, oysters, &c, in their cellars. Leaving Natchez for the present, I proceed to Washington, to give 49 386 MALIGNANT FEVER. • a brief sketch of its topography, and an account of the epidemic yellow fever, which prevailed there in the autumn of 1825. Washington, a small village, containing about four hundred in- habitants, is situated six miles east of Natchez, and not less than the same distance from the nearest point of the Mississippi river. The town occupies a high and healthy situation, remote from any swampy ground, or from any water-course whatever, except a small stream of running water, a branch of the St. Catherine's, about a quarter of a mile north-east of it. The citizens of Natchez, prior to 1825, always found Washington to be a place to which they could retreat with safety, from the ravages of the malignant fever. The in- habitants of that town had hitherto opened their doors to the sick and the dying, and received no harm, as not a case of yellow fever ever occurred among those who had not breathed the Natchez atmosphere. A grocer, who had been living " Under the Hill," removed his grocery store to Washington in. the latter part of the summer. He rented an old wooden house on the north side of the main street, which, with the lot attached to it, is situated in the hollo w space of ground described above. The earth had been thrown up around the palings of the lot, except at one place, to serve as a drain in rainy weather. This drain was choked up with weeds and trash when I examined it, during the progress of the epidemic about to be described, and served but imperfectly the purpose for which it w r as intended. The grocer who removed his store to the house on this lot, removed also a quantity of bacon and mackerel, a great part of which had begun to putrefy at the time of its removal, or putrefied soon afterwards. These provisions the grocer was in the habit of selling to negroes. Mr. Alfred RadclirT informed me, that a few days before the yellow fever originated in Washington, he called on the grocer, in order to purchase some bacon for a friend in the country ; but on examining it carefully, the whole quantity which the grocer had on hand, was found to be in a putrescent state, and none of it fit to purchase. About two thousand pounds of bacon, he stated, was filled with large worms, and was in a putrid condition. The Rev. Mr. Burruss informed me, that in addition to the putri- dity within the house, the grocer was in the habit of receiving from the fishermen on the Mississippi river, supplies of fresh cat-fish, (a fish in this river weighing from ten to one hundred pounds,) the heads and entrails of which, besides what rotted on his hands, were thrown into the back yard of the lot above described. All I person- ally know with respect to the real situation of the grocery, is what every person knows, who either lived near, or came in its vicinity, that the stench from it was extremely disagreeable. The principal stores and boarding-houses in town, were situated a short distance from the grocery, both above and below it. Both of the town mar- kets were within twenty-five steps of it. Should it then be a matter of wonder, if a few persons living in the suburbs of Washington, in MALIGNANT FEVER. 3S7 the most healthy situations, should have been attacked with yellow fever, a little after the time it broke out around the grocery, when it is recollected that those who visited the stores, the taverns, and the markets, were exposed to the same atmosphere with those residing in the vicinity of the grocery ? The yellow fever of Washington, like that of Natchez, in 1823, had three stages. The first stage was generally preceded by, and at- tended with, catarrhal symptoms. It was known by the patient's sensations being no true evidence of the actual coldness or heat of his surface ; by the heat of the surface being unequally diffused, the head and breast hot, the extremities often cold ; by the patient pre- ferring to be wrapped up in* blankets, although, at the time, his skin may have been pungently hot to the touch, by the chilly feeling being greatly increased, if the patient merely reached out his arm to have his pulse felt, or if any of the bed-clothes were removed, al- though he might have complained of these making him disagreeably hot, by a copious perspiration occasionally taking place, and drying up without relieving the disagreeable chilly feeling, abating the pun- gent heat of the skin, equalizing its evolution, or establishing the lost relation between the patient's feeling of heat, and the real heat of his body. So different were the sensibilities, both organic and animal, in this fever, from a healthy condition of the system, that I have known patients to complain of their extremities being cold as ice, when they were actually burning hot. I was forcibly impressed with this fact, on seeing patients bear to their extremities, particularly their feet, applications sufficiently hot to corrode or blister the skin, and produce great pain, were not the organic and animal sensibility of the part very different from health. I recollect having affronted one person, from having him put in a tub of water, disagreeably hot to my hands, not because he found it too hot, but too cold. The second stage was known by the patient losing all his chilly feelings ; by his throwing off the bed-clothes, calling for cold drinks, being- tortured with the severest pain in his head and back, tossing himself from side to side in his bed, or going from one bed to another, by his uniformly hot surface, by a diminution in the secretory process, to wit : a paucity of bile and urine, great dryness and heat of the skin, and mucous membranes, and, lastly, by an increased energy of the whole arterial system. The third stage was pointed out, by the heat of the surface having diminished, but not the patient's sen- sation of heat having proportionally diminished, by a slow irregular respiration, or even when the number of respirations differed but little from the healthy state ; by the yellow skin, accession of strength, the black vomit, and hemorrhages from the mouth and nose. The first stage, in some cases, quickly passed into the second; in others, it continued twenty four, or even forty-eight hours, before the reacting stage ensued. This stage, in some, never occurred, the dis- ease passing at once from the first to the last stage, while in others badly managed, it lost many of its characteristic features ; namely : 388 MALIGNANT FEVER. there would be great heat, thirst, and pain, yet a quick irritable pulse, which would not bear the lancet ; a comatose state of the brain, similar to typhus fever, accompanied with extreme irritability of the stomach, and a strong disposition in the bowels to take on a watery purging. Such cases were very fatal. The disease, not only in Washington, but in Natchez, the present season, differed from that of the latter place in 1S23, in its very great liability, in many cases, to be attended with copious and vitiated secretions, not only in its first, but in all its stages. Treatment. — As in 1823, during the first stage, or that of ataxic reaction, tartar emetic was found to be the most useful remedy. I generally gave from six to ten grains at a dose, and repeated it in smaller doses, until it either produced bilious emesis, removed the chilly feeling, developed an excitement throughout the system, pro- duced secretion in the skin or kidneys, subdued the ataxic fever, or palsied the deranged organic actions. Vitiated secretions seemed to depend on the latter, as, in many cases, the first doses of tartar eme- tic put a stop to the vomiting of a vitiated fluid, which had taken place before its exhibition. Tartar emetic, however, used in small and repeated doses, often rendered the stomach more irritable, and even when used in effectual doses, it often did harm, unless properly managed. When the chilly sensation was very great, the warm or hot bath, if used a little before, or at the time, the emetic was given, enabled it to produce bilious reaction, much more readily, and with much less distress to the patient, than when the emetic had been trusted to alone. Case. — Mr. K., of Natchez, was violently attacked. He told me to give him any thing but tartar emetic; for it always cramped him, produced great coldness, and he had, every time he had taken it, come near losing his life. His life appeared to me to depend on a bold use of the remedy he so much dreaded, as I had no hope of subduing so violent an attack, unless some great change could be produced in his system by the remedy in question. As his kidneys were torpid, I gave him freely of gin sling, had him put into a hot bath, to remove the chilly sensation he complained of, and gave him, while in the bath, ten grains of tartar emetic in half a pint of strong seneca tea. He vomited bile copiously and easily ; and so far from requiring hartshorn, laudanum, &c, to remove the coldness and cramp, as formerly, he soon lost near two pounds of blood, to subdue the consequent arterial reaction. He soon recovered. From Dr. McPheeters, I learned the efficacy of black mustard in vinegar, both as an emetic itself, and as a powerful coadjutor of tartar emetic, in cases wherein the latter alone, from torpor of the stomach or some other cause, failed to awaken the energies of the system. Warm brandy-toddy, in some cases, prevented the tartar emetic from pro- ducing vitiated secretions, and at the same time enabled it to produce those of a proper kind, or at least enable it to prepare the system for their production. As cold feet and hands had a great effect in MALIGNANT FEVER. 389 opposing the beneficial action of tartar emetic, warm pediluvia, si- napisms, frictions, (fee, were found to be necessary to place the sys- tem in a proper condition for its reception. It was always necessary to subdue by the lancet, general arterial reaction or fever, whenever it came on, as it sometimes did, before bilious vomiting, had been produced. If it were a broken reaction or fever, however, tartar emetic was its best febrifuge. Great determination of blood to the head, in the ataxic stage, with a pulse at the wrist, which will not indicate blood-letting, while at the same time there is a very strong pulsation of the carotid arteries, so far from being a state of the sys- • tern that contra-indicates tartar emetic, is the very state of the system in which I have witnessed more beneficial effects from the remedy in question, than any other whatever. I am not the only one who can bear testimony of the beneficial effects of tartar emetic in such states of the system. Dr. McPheeters has kept a record of a great number of cases of this kind, wherein emetics were found to be no less useful than the bark in intermittent fevers. If the pulse, at the wrist, and other circumstances, do not forbid blood-letting, this, of course, should be premised, previously to the exhibition of the emetic ; but when this is not the case, the blood-letting should be deferred until after the remedy has produced a change on the de ranged organic sensibility of the system, broke up the irregular de- terminations of blood, and brought out a general reaction of the arte- rial system. The worst consequences sometimes occur from a timid use of tartar emetic, from giving it in too small doses, repeated at too long intervals, or from discontinuing its use on the first appearance of any unpleasant symptom, at a time when it may be most needed. Case. — Col. Marschalk, a very large, corpulent man, was attacked with the yellow fever of Washington : I gave him an emetic in the ataxic stage of his fever. In a few hours afterwards, I was called in great haste to see him. He was panting for breath, as if in a fit of asthma. No bilious vomiting had yet been produced. Great heat, pain, and inward distress, were complained of. I bled him about a pint, as his pulse would bear no more, and gave him three grains of tartar emetic every half hour in spirits eeth. nitr. The second or third dose brought on effectual vomiting, attended with no distress: the skin became moist ; the difficulty of breathing, internal heat, pain, and distress, were removed, and the patient recovered without farther difficulty. But it behooves rne to state, that the ivorst effects are sometimes produced by tarter emetic rashly persisted in, without regard to the condition of the patient, in order to bring about some particular ef- fect on the system; as, for instance, bilious vomiting. But who has not witnessed the worst effects from cathartics, or from mercury, rashly persisted in, without regard to the condition of the patient, in order to bring about some particular effect on the system ; as, for instance, dark bilious stools, or a discharge of saliva 9 390 MALIGNANT FEVER. By an emetic properly managed, if given early in the disease, not only the fever of Washington, but that of Natchez, was often cut short at once, and the patient recovered without farther trouble : while the mildest attacks, if left to nature, ultimately seldom failed to prove fatal. If the disease did not yield at once to emetics, gene- ral arterial reaction ensued in the most of cases, requiring the lancet for its reduction, together with purgative medicines, which brought on bilious evacuations, that soon relieved the patient. Sometimes, however, when emetics had not been used at a period of the disease sufficiently early, or, if used, had not been properly managed; or, if properly managed, owing to some peculiarity of the case, had not produced their general beneficial effects on the system ; but, most generally, when emetics had been entirely omitted, it was difficult to produce, by purgatives, the proper J$ind of evacuations from the bowels — I mean evacuations of a dark bilious matter of tolerable consistency. In such cases, it was very difficult to retain purgative medicines on the stomach, owing to its irritability; and, if retained, even calomel would often produce watery evacuations. In such cases, to continue the use of this or any other purgative remedy, without first altering that condition of the system on which the wa- tery evacuations depended, was to continue to use them to the de- struction of the patient. In as much as he became speedily exhaus- ted under such evacuations, I made it a rule to check them by an enema, of a tea-spoonful of laudanum in a little starch gruel, or by giving opium or its tincture. The next object was to alter that mor- bid condition of the system on which the watery or vitiated secretions depended. Tartar emetic, either with or without the addition of a little opium, in two or three grain doses, every one, two, or three hours, calomel with two or three grains of opium, or with ten or twenty grains of camphor, repeated according to circumstances, and assisted by the warm bath, blistering, (fee, were often found useful in preparing the system to be properly acted on by purgatives. A remedy, however, which appeared to suit some cases the best, w r as the sulphate of quinine, or, where the stomach would bear it, the Peruvian bark with cream of tartar and cloves ; either of which was given without regard to fever, if such fever would not admit of blood-letting. Even when the fever, (I mean heat of skin, &c.) was increased under this practice, the various organs of the system became more disposed to take on a proper secretory action, than be- fore such fever had been excited. I am confident that I used the sulphate of quinine in too small doses in our late epidemic. Dr. Perrine assured me, that in the bilious fever in the country, ten or fifteen miles from Natchez — to prevent a watery purging, which so often took place in that disease, he resorted, after having premised sufficient blood-letting, to the use of the sulphate of quinine in eight grain doses, every two hours through the day, notwithstanding the presence of fever, and at night gave aloes, scammony, and calomel in pills, still continuing the sulphate. He assured me that under MALIGNANT FEVER. 391 this free use of the sulphate, the fever would abate, and the cathartic would produce thick, copious evacuations of a dark colour, which would soon relieve the patient; whereas, to use the purgatives with- out the sulphate of quinine, if they operated at all, they only pro- duced watery stools, which soon robbed the patient of his strength, and aggravated his disease. Dr. McPheeters and myself have both used, with a similar intention, the sulphate of quinine, after the plan of that excellent physician, Dr. Perrine, and we have found it even to surpass our expectations. The purgatives which could be the most relied on, in the epidemic of 1825, to produce bilious secre- tions, were calomel, aloes, and scammony combined, the purified spirits of turpentine, and the Croton oil. When there was much pain in the bowels, accompanied with tenesmus, the charcoal was. of great service. The best plan of giving medicines in cases of great irritability of the stomach, which neither sulphuric ether, opium, ef- fervescing mixtures, &c, will allay, has heretofore been with me a desideratum in practice. The fate of a patient frequently depends on minutiae, too often unattended to in practice. It is an easy mat- ter to prescribe aloes, scammony, jalap, &c, in order to purge a pa- tient, who is constantly sick at his stomach. But the object of the prescription is often entirely defeated, in consequence of the patient refusing to take these remedies ; or, if he takes them, by the impos- sibility of his being able to retain them on his stomach. The best plan I ever tried, of giving these, and similar nauseous medicines, so as to obviate the inconvenience of their disagreeable taste, and to prevent them from being vomited, is to have the various purgative articles made into a soft mass with syrup. Any given quantity of this mass, is to be enclosed in a very thin wafer, made of flour, and softened by being soaked a few minutes in water or milk. The en- closed mass is then put into a spoon with a little water in it, out of which the patient is to swallow it. After this manner, a patient can take, at one dose, a mass sufficient to make a dozen pills, and he cannot, without the strongest efforts, throw it up from his stomach ; he tastes nothing but the flour wafer, and the nausea of his stomach is not increased, as it would be from his swallowing a quantity of bitter pills. In this way, a large quantity of Peruvian bark may be giving at a dose, without the patient's tasting it. One table- spoonful of flour, made into a batter with water, is sufficient to make sixty wafers. The plan of making them is, to have two smoothing irons heated, one of which is to be placed with its face upwards, on which a few drops of the batter is to be poured, and the other iron is then to be pressed upon it. The little cake or wafer, thus made, is, as I before observed, to be soaked in water, before using it, in order to make it sufficiently pliant to enclose the medicine. I venture to assert, that whoever tries this plan of giving nauseous drugs, as aloes, &c, in cases of great irritability of the stomach, will seldom proscribe them in pills, syrup, or solution : calomel, however, can be very conveniently given, floating on a table -spoonful of common cold wa- 392 MALIGNANT FEVER. ter. A table-spoonful of water will float two scruples, if the calomel be not in lumps, and if it be sifted down lightly on the water. Spi- rits of turpentine should be purified by mixing it with alcohol, as di- rected by Dr. Nemmo. With these remarks on the manner of ad- ministering remedies in cases of great irritability of the stomach, re- marks, though seemingly of little importance every where else, may not be entirely so at the bed-side of the sick, I close what I have to say on the Washington yellow fever, the history of which disease, if it does nothing else, will show that an epidemic yellow fever is not necessarily confined to water-courses. I now proceed to give an account of some cases of malignant fever which originated at Haughton's tavern, in the country, about a mile from Natchez. Nine or ten persons died in and about this place with yellow fever. The disease commenced at Haughton's, in September, a little prior to its appearance in Natchez, " On the Hill." If medical topography throw light on the origin of yellow fever in other places, it does not withhold its light in the present in- stance. Haughton's tavern, and Shears's, (the two houses where all the cases referred to originated,) are situated without the chartered limits of the city, on a small peninsula formed by a junction of two very long, deep, and winding bayous. One of the bayous commences on the eastern, the other on the western, side of Natchez; and, with the exception of two or three squares, the whole of Natchez is drained by them. The western bayou, after draining the western part of Natchez, passes by the butcheries, receives their offal, and pur- sues a serpentine course, to meet its fellow, the eastern bayou, at Haughton's. Between the eastern bayou and the foot of the little hill, on which the houses alluded to stand, there is a flat surface of about an acre, surrounded on all sides by hills. A gully, leading through the isthmus formed by the two bayous, conducts the water of an adja- cent field on this flat surface, over which it spreads, before it falls into the bayou. Haughton's tavern is within ten steps of this flat ground, which, besides what the gully brings on it, and besides its own vegetable productions, is the receptacle of the kitchen offal, and of a privy which has no well. When the eastern and western bayous meet, a distance from the tavern of about thirty rods, there is also a flat surface surrounded by hills. The eastern and western bayous, in their whole course from Natchez, are seldom less than ten feet wide, and ten feet deep. In many places they are more than fifty yards wide, and as many feet deep. Their banks, which are steep and abrupt, are almost constantly falling in, which obstructs the current of water from a light rain, but affords no obstructions to the torrents which roll down them during heavy rains. In 1822, the yellow fever prevailed at this place. I then supposed that the pol- luted atmosphere of the city had extended thus far. I was inclined to this opinion, as several persons, whom I attended, assured me that they had not been in town. I did not, at that time, suspect the MALIGNANT FEVER. 393 bayous of having any agency in the production of yellow fever ; but I have, since that time, in my practice through various parts of the adjacent country, which abounds with these bayous, found the re- mark verified, of an old practitioner of this place, the late Dr. Seip, that a "bayou was more sickly than a marsh." I again return to Natchez. The yellow fever " On the Hill," in 1825, differed but little from that of Washington. But " Under the Hill," it resembled more closely , in its symptoms and progress, that of 1S23. Nearly all the physicians who got much practice, adopted the emetic plan of treating the disease of the present year, and these seldom lost more than one in ten of their patients ; while, under the old plan of trusting to a few grains of calomel, frequently repeated, with inunction of mercurial ointment in order to bring on salivation, the disease was about as fatal as formerly. Dr. Hunt, who came to Natchez very much prejudiced, by education, against emetics in yellow fever, but who is too liberal to advocate the errors of theory, unsupported by facts, threw aside his prejudices, and not only pre- scribed emetics with great success to his patients, but when attacked with yellow fever himself, commenced the cure by an active emetic: so did Dr. Walker. Neither of these gentlemen ever had cause to repent of this first, yet all-important, step in the treatment of their disease. Prevention. — As respects the best method of preventing the disease, while usual health exists; and the best method of preventing the disease, when those who are exposed to its cause become indis- posed, Dr. Cartwright makes the following observations: Those persons in health, who, in order to avoid an attack of this epidemic, had recourse to medicines and ardent spirits to which they were un- accustomed, were among the first to be attacked. Fumigations and the smelling of volatile substances, were also found to be of no ser- vice. Those persons who escaped, regulated their diet and drinks, not by any fixed rule or standard, but by their former habits; and if they deviated from those habits, they approximated to simplicity and abstemiousness, not carried to the extent of debility ; for if the stomach were not sufficiently excited by food and drinks, the same effect was produced as if it had been too highly stimulated; namely, a derangement of action between it and the organs with which it is associated. Those who had been temperate and abstemious, con- tinued -to be so.- Two persons who had, for several years, kept up a strong excitement by ardent spirits, continued it during the preva- lence of the epidemic, and entirely escaped. But all who had not previously been habitual drunkards that imitated their example, be- came sick and died. Ardent spirits kept up the equilibrium of action in the systems of the former, but destroyed the equilibrium in the latter. Finally, those who escaped were such as preserved this equilibrium, by accommodating their diet, drinks, sleep, and exercise, to the existing state of the system, and to their former habits, avoid- ing all exciting causes, as heat, cold, fatigue, &C. 50 394 MALIGNANT FEVER. As to those who are indisposed ', it was found that the best means of warding off the attack, or rendering it milder, was to ascertain in what way the threat is made, and to apply the remedies accordingly. Persons of plethoric habit, whenever they felt a fulness and uneasi- ness about the head, or a disposition to fever, were relieved by bleed- ing, and escaped. Others, whose indisposition proceeded from a torpid state of the bowels to which they were subject, escaped by the occasional use of aperients. To those who complained of a bitter or mawkish taste in the mouth, sickness at the stomach, achings in the bones, soreness of the flesh, and sleeplessness, emetics were pre- scribed with success. A gentleman who complained of pain in his back, with restlessness and anxiety, and whose urine had, for several days, been small in quantity, was enabled, by a free use of diluent drinks and diuretics, entirely to .avoid the attack of the epidemic. From these facts it is plain, that though the poisonous atmosphere of yellow fever may long be breathed with impunity, while a due balance of action among the various organs is preserved, yet not so when it is broken; that living in such an atmosphere tends to break this balance ; the smallest disturbance of which is announced by symptoms that often point directly to the organ in which the distur- bance has commenced, and which, in many cases, may, by timely and appropriate measures, be restored to its healthy functions. ADMONITORY HINTS TO LADIES Light were my task, if every gentle breast, Owned the just laws of native truth imprest; For not by hopes of vain applause misled, In reason's injured cause alone I plead. 'Tis you to judge; nor I that judgment fear If truth be sacred, and if virtue dear. — Roscoe. If we consider but for a moment the wonderful power which superior beauty in woman exerts over the human breast ; how in- stantly, on the approach of its possessor, the hearts of the young are thrown into the most delightful palpitations, and the looks of the aged brightened with admiration and pleasure ; we can no longer wonder that it should be so highly prized by the sex. But it is to be lamented, that the most preposterous means should be employed to gain a property so desirable, and that real beauty should be so often abused. Thus, some girls fancy that beauty can onty exist in forms slen- der and delicate. At the very thought of being corpulent, they are alarmed, and to obviate grossness, as they call it, they drink such quantities of vinegar, that it not only destroys the tone of the sto- mach, but introduces a withered ghastly paleness. We knew a lady whose practice was to devour many pickles every day for the pur- pose (as she thought) of preventing obesity. The consequence was that she lost the healthy tone of the stomach to such a degree that at last she could retain scarcely any article of food. She wasted away to a shadow, and life itself became a burden. For the same purpose they continue the absurd practice of wearing jackets, or cor- sets, so oppressive, as, by compressing the ribs, to prevent the expan- sion of the lungs. Another imprudence, and still more detrimental, is that of appear- ing at assemblies, in winter, in light dresses, exposed to the baneful effects of cold, with the aggravating addition of extraordinary warmth, 396 ADMONITORY HINTS TO LADIES. by the fatigue of dancing; hence, consumptions, and a train of maladies, too long to be here particularly described, are produced. Motives of delicacy, as well as regard for health, have been re- peatedly urged in vain to enforce the necessity of relinquishing these destructive habits ; the arguments of the moralist and of the physician, having alike failed to convey conviction ; and hundreds, who would now have been shining forth among the loveliest of their sex, are dressed in shrouds, because, "in an evil hour," they laid aside those articles of their apparel which health, as well as decency, forbade them to relinquish. There are others, who, reading of the fair-skinned belles of Europe, foolishly conclude that the rose and the lilly are the only colors of beauty. Catching at this female passion for fair and unfreckled faces, the quacks have prepared a number of nostrums, called cosmetics or beautifiers, which, they vauntingly profess, are to heal the chaps on the lips ; to remove pimples and freckles ; and to give the counte- nance such a fair, smooth and charming appearance, as to render it impossible for any one to contemplate it without being enamoured. But, unfortunately, these boasted cosmetics, instead of heightening the polish and charm of beauty, too often contribute to tarnish and destroy them.* A fine lady of one of our large cities, one day after the use of one of these deleterious cosmetics had occasion to pass through one of the back streets on a damp, muggy day. On her return, she was amazed at the appearance of her skin, for since breakfast, she had turned quite black. A new compound had been formed by contact with a nauseous gas emanating from the portion of the city she had visited. Beauty ceases to be attractive when we know it to be artificial. Far from admiring, we turn away with disgust. We recently had occasion to admire the beautiful rose and lily of a handsome woman. It was of an evening. Calling the next morning on a professional visit to another branch of the family, and catching a glimpse of my fair lady, we shall never forget the sensation of disgust at the change in her complexion. A face naturally fair and of a sweet expression, had been awfully marred by the application of these poisonous cosmetics. The truth is, beauty is not the creature of a quack, but the gift of nature ; and to bring it to perfection, nothing more is necessary than exercise, cleanliness, temperance, and cheerfulness. These are the handmaids of health ; and health, to persons of certain symmetry and expression, is beauty. * To such of my readers as are partial to the use of cosmetics, an infusion of horse-radish in milk is recommended as one of the best and safest. Another innocent preparation for clearing the skin of pimples, and recent eruptions, is the expressed juice of house-leek, mixed with an equal quantity of sweet milk or cream. When these fail, blistering the face all over the eruptions will often succeed in removing them. ADMONITORY HINTS TO YOUNG LADIES. 397 The rural wilds Invite ; the mountains call you, and the vales, The woods, the streams, and each ambrosial breeze That fans the ever undulating sky ; A kindly sky ! whose fostering power regales Man, beast, and all the vegetable reign. — Armstrong. How much, then, is it to be deplored, that so many of our young females should think so meanly of exercise, which, alone, brings the female frame to perfection, paints it in the liveliest colours, and, by giving richness to the blood, and vigour to the nerves, disposes to habitual cheerfulness, and alike qualifies the mind for thought, and the heart for love. On the contrary, how different is the female who leads an inac- tive and sedentary life, too generally looked on as proofs of a fine modern lady, which seldom fails to relax the system, retard the cir- culation, vitiate the blood, and obstruct the secretions. Hence that chalky paleness of the face — that faintness of the eyes, indigestion, flatulence, weak nerves, low spirits, irregularities of nature, and con- stant complainings. The grand discharge, th 5 effusion of the skin Slowly impaired, the languid maladies Creep on, and through the sinking functions steal. Armstrong. Yes, many a girl by constant muffling and housing herself ; by dreading that the sun should ever kiss her cheeks, or the wind ruffle her tuckers ; by much indulgence in bed, and other imprudences, renders herself so exceedingly pale, delicate, and puny, that her ap- pearance is better fitted to damp love than to excite it. "The vigour sinks, the habit melts away; The cheerful, pure, and animated bloom Dies from the face, with squalid atrophy Devoured." MANAGEMENT OF FEMALE COMPLAINTS MENSTRUATION. One of the principal constitutional characteristics of the female, is menstruation, or the monthly evacuations peculiar to the sex. This important operation generally takes place about the age of twelve or thirteen ; but varies through the world, either in degree or frequency, both from constitution and climate. Women in the higher ranks of life, and those of a delicate nervous constitution, are subject to sickness, headache, and pains in the back and loins, during the periodical evacuation. Those of the lower rank, inured to exercise and labour, and strangers to those refine- ments which debilitate the system, and interrupt the functions essen- tial to the preservation of health, are seldom observed to suffer at these times, unless from general indisposition, or a diseased state of the womb. After the discharge has become established, it recurs periodically while in health ; and its recurrence is so regular that it can be cal- culated with great exactness. The usual period of its visitations is from twenty-seven to thirty days. As to the time of its continuance, this is various in different women ; but it seldom continues longer than six days, or less than three, and does not cease suddenly, but in a gradual manner. Its approach is generally preceded by certain feelings of oppres- sion or deviation from the ordinary state of health, which warn the individual of what is to happen. There is, in particular, a sensation of fulness about the lower part of the belly, and a relaxation about the uterine system, which can scarcely be overlooked by the most heedless. It must at the same time be admitted, that in some few constitutions these feelings are so inconsiderable as to be little at- tended to ; so that the woman mixes in society as usual, without any apparent inconvenience. MANAGEMENT OF FEMALE COMPLAINTS. 399 It is of importance for women to know that occasional irregulari- ties are not always the consequence of disease. Constitutions vary- as much in respect to the regular returns of this discharge, as they do with regard to its first appearance or its final cessation. Those in whom the change occurs very early from vigour of constitution, require little to be done for them ; but, in weak and delicate habits, the non-appearance of this evacuation is too often considered as the cause, whereas, it ought to be viewed as the effect, of the state of the habit unpropitious to its taking place. And, according to family practice, under this false impression, warm teas and forcing medi- cines are employed at the approach of this disease, which have often done much harm. Nature is not so defective in her own judgment as to require such auxiliaries. Care should be taken to improve the general state of their health, by attention to diet, moderate exercise, change of air, and cheerfulness ; which will be found to have the happiest influ- ence on the body and mind, and gives a salutary impulse to the circulation of the blood. With respect to the flow of the menses, women should remember, that what is to one woman a due propor- tion, wouid be to another, from the difference of constitution, and temperament, an immoderate flow ; and before they attempt to re- strain it, let them carefully consider, what may have been the exci- ting or occasional cause. They are too frequently told that such a situation arises from mere debility ; and under that belief will take cordials, and stimulating medicines. In general, this is not the case : and by such improper treatment, the flow is increased, and the habit rendered feverish. The quantity generally discharged in a healthy and regular woman, is from four to six ounces at each visitation. Those of a delicate constitution have, however, a more copious and longer con- tinued discharge than persons of a robust habit; thus, the full blooming country girl does not discharge half the quantity that the pale-faced lady of quality does. In some instances, the menstrual discharge does not make its appearance before the age of seventeen or eighteen, and, nevertheless, health is not in the least affected. The mere want of evacuation at the ordinary time, therefore, is not to be considered as morbid, unless the system be evidently deranged thereby. In many cases, however, symptoms of disease appear which are evidently connected with the defect of the menses, and go off upon its discharge. The treatment, in such cases, must be regulated by the particular circumstances and constitution of the in- dividual. There is no remedy adapted to every case of this kind ; byt an open state of the bowels, and a due regulation of the diet, to- gether Avith moderate exercise, are useful in every instance of this complaint. Warm clothing, too, particularly about the lower ex- tremities, is of most essential benefit. The occasional use o( the warm bath is pleasant and beneficial, especially if the skin be dry and warm. As the health improves, the cold bath will prove an 400 MANAGEMENT OF FEMALE COMPLAINTS. auxiliary, if, after using it, the patient feels a glow of heat, and a greater degree of liveliness. When the means ordinarily employed have failed, marriage, or a change of climate, has produced the wished-for effect. In some instances the evacuation is impeded by a mechanical cause, that is, an obstruction of the passage to the womb. This oc- casionally is met with, and the chief obstacle to its speedy removal is the difficulty of ascertaining its existence. The operation by which it is completely remedied, is not more painful nor formidable than blood-letting. Fortunately, in most cases, the evacuation takes place in due time, and the constitution sustains no material or permanent injury. It is, however, in every instance, proper to pay particular attention to the system during the continuance of the evacuation. The stomach and bowels, at this period, are very easily disordered, and, therefore, every thing which is heavy or indigestible, ought to be avoided. Some are hurt by eating fruit or vegetables; others by taking fermented liquor. In this respect experience must enable each individual to judge for herself. Exposure to cold, particularly getting the feet wet, is hurtful, as it tends suddenly to obstruct the discharge. The same effect is likewise produced by violent passions of the mind, which are also, at this time, peculiarly apt to excite spasmodic affections, or hysterical fits. It is, in general, a very proper rule not to administer any very active medicines, at this time, unless some violent symptom abso- lutely requires them. Opiates, for instance, are, in many cases, necessary to allay spasmodic affections, or abate pain; and they are, in such circumstances, uniformly safe. They give speedy relief to hysterical feeling or suffocation, or to spasms of the stomach and bowels. Blood-letting is also, in some instances, necessary, from particular circumstances, at this period, and in such cases it is safe, and does not obstruct the evacuation. Dancing, exposure to much heat, or making any great or fatiguing exertion, are improper. These causes may increase, to an improper degree, the quantity of the evacuation, and in certain circumstances may give a disposition to a falling down of the womb. To conclude, the period or time of life, when the monthly eva- cuation should disappear altogether, is considered as critical. It is really so in two cases. The first is, when the woman has suffered considerably at each period, from sickness, pain, and disorder of the bowels. Such women, not unfrequently, when the constitution is freed from the monthly change, enjoy better health than formerly. The second is, when there is a tendency to disease, in some particu- lar organ, especially in the womb itself, in some of the abdominal viscera, or in either of the breasts. In such cases, the time of life may prove the period, at which the disease begins to make its progress. The time at which this evacuation ceases, varies from the forty- MANAGEMENT OF FEMALE COMPLAINTS. 401 fourth to the fiftieth year. It is usual, for some time before it dis- appears, that it should become irregular. It not only is sometimes greatly less, and again much more in quantity than usual ; but it is also occasionally obstructed for some months ; and then, perhaps, comes oftener than it ought to do. The occasional obstruction, be- fore the final cessation of the discharge, is frequently accompanied with sickness and swelling of the belly, from the wind in the bowels. These circumstances, sometimes incline married women, for some weeks, to consider themselves with child. Others again, averse to be thought old, flatter themselves that the irregularity is occasioned by cold, or some accidental circumstances, and therefore very improperly employ their utmost endeavours to recall it. The complaints which, in many women, occur at this period of life, are to be ascribed rather to a general change in the habit, than merely to the absence or total cessation of the sexual evacuation. Women who have never had children, or good regular health, or those who have been weakened by frequent miscarriage, are most apt to suffer at the decline of life. It frequently happens, that women who were formerly much pained when out of order, or who were troubled with nervous and hysteric complaints, begin at the cessation of the periodical discharge to enjoy a good state of health, to which they had formerly been strangers. When no particular complaint occurs in consequence of the de- cline of life, it would be exceedingly absurd to reduce the strength by an abstemious diet and low living. If, on the contrary, headache, flushings of the face, or an increased degree of heat, restlessness in the night, and violent pains in the belly and loins, swellings of the feet, or eruptions on different parts of the body, take place at this period, there is reason to believe that a general fulness exists, in consequence of the stoppage of the ac- customed discharge. Under such circumstances, spare living with increased exercise, occasional blood-letting, and frequent gentle pur- gatives are enjoined. If ulcers break out in the legs, or in any other part of the body, on a total cessation of the menses, they ought to be regarded as criti- cal discharges, and should by no means be healed up without, sub- stituting some other drains by an issue. PAINFUL MENSTRUATION. In some instances, menstruation is attended with great pain in the back, thighs, and lower part of the belly. This state is sometimes 402 MANAGEMENT OF FEMALE COMPLAINTS. accompanied with suppression of urine, or violent colic pain and spasms of the stomach. The discharge generally takes place slowly, and is deficient in quantity, and not unfrequently attended with the expulsion of a skinny looking substance. Causes. — This disease is supposed to be owing to a weak action of the vessels of the uterus, or spasm of the extreme vessels. Pain sometimes attends copious menstruation ; but whenever it does, there is much reason to apprehend some local disorder of the womb. Treatment. — As soon as the symptoms that denote its approach are apparent, recourse should be had to the warm bath ; when this is not convenient, the patient should sit fifteen or twenty minutes in a tub of warm water, or cloths wrung out of warm water, or a bladder two-thirds filled with it, should be applied to the low T er part of the belly. After this the back and abdomen should be well rubbed with the camphorated, or volatile anodyne liniment, and if the pain continue, the anodyne clysters should be administered. If, notwith- standing these means, the pain become violent, it will be proper to give a tea-spoonful of the diaphoretic drops, or four or five grains of Dover's powders, or one of the camphorated powders, (see Dispen- satory,) every hour or two until a gentle, but general perspiration be induced. This is also to be encouraged by drinking warm penny- royal or ginger tea. When this complaint arises from general ful- ness and irritation, it may require repeated bleeding and purging. If there be pain in the stomach without fever, give a tea-spoonful of laudanum, with twenty drops of essence of peppermint; or should costiveness prevail, give a dose of castor oil in conjunction with the anodyne. For the cure of this distressing complaint, Dr. Fothergill recom- mends a pill of opium, of one grain, to be taken the moment the pain comes on, and to be repeated every hour until it be suppressed ; to keep the patient in bed ; and to let her dilute freely with herb teas, until the discharge be fully established, after which the pain seldom returns ; and when the period has passed, chalybeate bitters until within a few days of the next period. Dr. Denman proposed small doses of calomel every night at bed-time, for several weeks to- gether, and twice in the course of the day, a dose of the volatile tincture of the Peruvian bark. Dr. Dewees, of Philadelphia, re- commends the volatile tincture of gum guaiacum, to be continued for a considerable length of time, and says it acts almost as a specific. And Dr. Robertson, of Edinburgh, is as sanguine in praise of the tincture of cantharides given in pretty large doses, thrice a day, until it excites some degree of pain in voiding the urine. Preventiox. — In order to prevent this painful state, in those who are subject to it, the warm bath should be used, three or four nights preceding the menstrual period, and on going to bed, two tea-spoons full of the diaphoretic drops, or ten grains of Dover's powder should be given in some warm tea. The bowels are to be kept uniformly MANAGEMENT OF FEMALE COMPLAINTS. 403 regular ; and exposure to cold, especially near the time of the ap- pearance of the discharge, is to be carefully avoided. The constitution is to be improved, and strengthened by such means, as its particular condition requires ; and in general, by the use of tonic medicines, and the shower bath, provided these do not disagree with the patient. OBSTRUCTED MENSES. Many women have the menstrual evacuation postponed for a week or two, beyond the usual time, or miss one or two periods without any very evident cause, and without inconvenience. But when it is suddenly suppressed very troublesome symptoms occur ; and when it is retained for any considerable length of time, it is generally ac- companied by bad health. Symptoms. — When suddenly checked, it is usually attended with considerable pain in the back, bowels, or stomach, and sometimes in the chest. In persons of a full habit the face is generally flushed, the pulse hard and frequent, flying pains in the chest, perhaps, spit- ting of blood, cough, palpitation, difficulty of breathing, and a com- plication of nervous affection. Persons of a delicate frame and a melancholic temperament, and especially those who have suffered from some debilitating cause, have different symptoms, constituting what has been called chlorosis, or green sickness, a disease always connected with, and depending on, some derangement of the sexual organs. In chlorosis, every symptom of feebleness prevails, a pale skin, and even a greenish complexion, succeeds to the rosy hue of health; the skin under the eyes puffy and of a leaden colour ; the whole body lax, cedematous and doughy ; the judgment, memory, and natural cheerfulness impaired ; the pulse is generally slow and feeble, but easily excited ; and it is then accompanied with shortness of breath, a palpitation of the heart, and an almost unconquerable disinclina- tion to motion ; the appetite is destroyed, and the stomach so de- ranged, that the food, instead of being digested, undergoes the fo- mentation peculiar to its nature. Hence, the patient rinds gratifica- tion in chalk, lime, pieces of old wall, and other improper sub- stances ; and the bowels are commonly costive. It not unfrequently happens that the blood which should have passed off by the uterus, being determined more copiously and for- cibly to other parts, gives rise to hemorrhages; hence, it is fre- quently poured from the nose, stomach, lungs, and other parts, in such cases. When women (says Denman) are deprived of the common ute- rine discharge, they are sometimes liable to periodical emissions of 404 MANAGEMENT OF FEMALE COMPLAINTS. blood from the nose, lungs, ears, eyes, breasts, navel, and almost every other part of the body. To constitute the menses it is not necessary that the discharge should take place from the uterine or even genital organs, for some women have them by other passages, manifested by periodical vomit- ing, coughing of blood from the lungs, bleeding from the hemorr- hoidal veins, nose, and so on. — Edinburgh Medical and Surgical Journal. Causes. — A constriction of the extremities of the vessels of the womb, arising from accidental circumstances, such as exposure to cold, anxiety of the mind, fear, excessive evacuations, inactivity of the body, poor blood, the frequent use of acids, and other sedatives, &c. In some constitutions, particularly in those where pain attends the discharge, very slight occurrences suddenly interrupt the flow, and prevent its usual return, such as passions of the mind, fright, fa- tigue, irregularities of diet, putting on damp clothes, &c. This fact shows the necessity for certain cautions and attention during the dis- charge. Obstructions, too, are sometimes the effect of disease of the general habit. Treatment.— When the evacuation has been suddenly checked, it is proper to have immediate recourse to the warm bath, or sitting up to the hips in warm water, or fomentations to the lower part of the abdomen, and bathing the feet in warm water. It is also advis- able to put the patient to bed and give a tea-spoonful of the diapho- retic drops, or five or six grains of Dover's powders, in a cup of warm herb tea, such as sage, hyssop, penny-royal, every two hours, until a gentle perspiration is produced. Should there be fever, or pain in the head, or discharge of blood from other organs, bleed, give the cathartic mixture, or an infusion of salts, senna and manna, and afterwards endeavour to determine to the surface by the exhibi- tion of diaphoretic medicines. In every case where there are febrile symptoms, an amendment cannot take place until the antiphlogistic plan, such as bleeding, nitrous medicines, cooling cathartics, and a low diet, with rest, are adopted. After the febrile symptoms are removed, strengthening medicines, if necessary, may be employed, and in no instance suffer the bowels to remain in a constipated state. It is necessary to observe, in endeavouring to restore the monthly evacuation, we shall more likely succeed, if the usual remedies for removing the constriction which affects the extremities of the vessels in the womb are directed at the time of its expected return, or when some natural efforts for that purpose are observable ; which may be known by a sense of fulness in the organs of generation, a weight in the back and loins, and slight spasmodic pains in the uterus. At this period, bladders two-thirds filled with warm water, applied to the lower part of the abdomen, or sitting over a vessel filled with hot water, will have a most happy effect. And, to increase the re- laxing powers of these topical applications, we may, at the same MANAGEMENT OP FEMALE COMPLAINTS. 405 time, give an opiate, particularly in the form of clyster, when there is pain. Sometimes an emetic administered about the time when the evacution should appear, and the patient during- the operation to sit in a warm bath, has been of infinite service. In some instances an obstruction may continue in a young and healthy woman, for many months, without any inconvenience. This is chiefly the case in those who are very corpulent, or who have been in the pernicious practice of employing vinegar and strong purges to reduce their size. By the regular use of exercise, rising early in the morning, avoiding supper, keeping the bowels correct, and living, upon the whole, rather abstemiously, the health will be preserved, and, in course of time, the desired alteration will take place. Obstruction of the menses may also occur in young women with florid complexions, but, at the same time, of very delicate constitu- tions, and subject to a slight cough, with pain in the breast, and a predisposition to consumption. Such cases require the utmost cau- tion; and in them, small bleedings, an antiphlogistic diet, mild laxa- tives, a temperate climate, warm dress, and moderate exercise, are essential: and when it can be procured, a sea-voyage, or change of air, will probably prove the most useful remedy- In the chlorotic species of obstruction, the treatment is much the same, as advised under the head of menstruation, for the manage- ment of those who are long having this evacuation. It will be found, almost in every instance, the complaint is occasioned by general de- bility, consequently, the cure must be regulated on the plan of in- creasing the tone of the system and exciting the action of the uterine vessels in particular. This is to be effected by a nourishing diet, moderate use of wine, change of air, gentle exercise, particularly riding on horseback, with strengthening medicines, as bark and elixir vitriol, the rust or tincture of steel, or the tonic powders or pills in their usual doses, together with the occasional use of calomel or the stimulating purgative pills, (see Dispensatory ,) to keep the bowels in a regular state. The nitric acid, diluted in doses of a wine glass full three or four times a-day, will be found a valuable medicine to improve the habit of body. And if the obstruction be attended with cough, it should be given in the form of the nitric lac-ammoniac (See Dispensatory.) Previously to the use of tonic medicines, it is advisable to give an emetic, and afterwards a dose of calomel and rhubarb, or the aperient and diaphoretic pills, for the purpose of cleansing the stomach and freeing it from acidities and inactive fluids. Costiveness being a constant attendant on this disease, it is of the greatest importance, that purgatives be repeated, until all the sordes which have been collecting, most probably, for a considerable length of time, shall be removed. After this, and not before, the happiest effects may be ex- pected from the use of tonic medicines. Besides the above remedies, many others may be employed with 406 MANAGEMENT OF FEMALE COMPLAINTS. the same view, as an infusion of camomile, wild cherry, or dog- wood bark, tansy, penny-royal, hyssop, rue, &c. A table- spoonful of mustard seed, morning and evening, or a tea cup full of a weak infusion of horse-radish, on some occasions have produced very good effects. Two ounces of the rust of steel, or filings of iron, steeped in a bottle of wine or cider for a week, and given in doses of a small wine- glassful, morning, noon, and night, has also been found beneficial. With the view of exciting into action the uterine vessels, the sur- face of the body should be kept warm by means of a flannel shift and drawers, by frequent friction of the lower part of the abdomen and limbs with a flesh brush or flannel, and by the exercise of walk- ing, dancing, and jumping. By marriage, or a change in the mode of life, the disorder has frequently been removed, after having resisted all the ordinary remedies. In those instances where the evacuation has become suppressed in consequence of previous bad health, it is evident that no attempt to restore it can either be effectual or useful till the cause be re- moved. Some have obstruction caused by very slight weakness, or very early in chronic diseases, others continue regular, till even the last stage of consumption. From the great variety of causes of sex- ual obstruction, it is certain that many medicines, which possess very opposite powers, may, in different cases, produce the same effects. For the same reason, a remedy which, in one case, may prove mild, inoffensive, and successful, will, in another apparently similar, occa- sion a most violent disorder. No remedy applicable to every case can possibly be discovered, therefore, medicines, with a view to re- store the periodical evacuation, ought to be employed with the greatest caution. IMMODERATE FLOW OF THE MENSES. This alarming complaint may occur under two different states of the constitution. In the one, the woman is of a full habit, and often of a ruddy countenance. In the other, she is pale, delicate, and easily fatigued. Symptoms. — In plethoric habits it is often preceded by headache, giddiness, or difficult breathing, and is afterwards attended with pain in the back and loins, universal heat, and a frequent, strong, and hard pulse. But, when it arises from general debility, or in conse- quence of a laxity of the organ, paleness of the face, chilliness, las- situde of the whole body, oppressed breathing on the slightest effort, pains in the back on remaining any length of time in an erect pos- MANAGEMENT OP FEMALE COMPLAINTS. 407 ture, and coldness of the extremities, together with a long train of nervous complaints. Causes. — A variety of causes may produce this troublesome dis- ease. Some of these are general, such as a state of great weakness, or of too much blood ; others are local, such as debility of the ute- rus, occasioned by tedious labour or frequent miscarriages. It may also be produced by accidental circumstances determining the blood more copiously and forcibly into the uterine vessels, as violent exer- cise in dancing, much straining at stool from great costiveness, con- tusion on the belly, excess in venery, or strong passions of the mind, particularly at the menstrual period. Treatment. — In the management of this disease we have two objects : first, to moderate the discharge and procure present secu- rity ; and, secondly, to prevent a return. The first thing to be done when the hemorrhage is sudden or pro- fuse, is instantly to remove the clothing which may occasion the least interruption to the free circulation of the blood, and to put the patient to bed, lightly covered with clothes. So long as the dis- charge continues, it is of importance to keep her in a recumbent posture, as cool as possible, and perfectly at rest, both in body and mind. Cloths, dipped in cold vinegar and water, and renewed as often as they become warm. These cold applications have a pow- erful effect in restraining uterine hemorrhage, and ought never to be omitted where the discharge of blood is profuse. If the patient be of a full habit, attended with severe pain in the head or back, and febrile symptoms, it will be proper to bleed, and to give the antimonial, or febrifuge powders or mixture. (See Dis- pensatory.) The state of the belly must also be attended to. It can be kept gently open by the cathartic mixture, sulphur, or any mild laxative medicine. Stimulating purgatives, or clysters, under such circum- stances, are improper, from their tendency to increase the discharge. When no symptoms indicating an increased action in the vessels of the womb are present, astringent medicines should be employed. And, in cases where the discharges have not continued long, and the strength not much impaired, it is often sufficient to arrest the disease by giving fifteen or twenty drops of elixir vitriol, or six or eight grains of alum dissolved in a glass of cold water every hour ; or, what is preferable, alum whey, sweetened to the taste, in doses of a small cup full, as often as the stomach will receive it. But, if the dis- charge be obstinate, we should have recourse to pills of sugar of lead and opium. (See Dispensatory.) In no instance which has come under my knowledge, where the hemorrhage was in consequence of a laxity of the uterine vessels, have these pills failed in producing the desired effect In those cases where the hemorrhage is profuse, or o( long con- tinuance, and resists the means already pointed out, it will bo proper to inject into the uterus from a gill to half a pint o( a strong decoo 408 MANAGEMENT OF FEMALE COMPLAINTS. tion of oak bark, in which one or two drachms of alum have been dissolved, or as much of the saturated solution of alum in water, in order to constringe and strengthen the vessels of the womb. This may be repeated twice or thrice a-day, according to circumstances. When symptoms of an increased action in the vessels of the womb are observable, the tincture of foxglove, in doses of twenty drops every four hours, constitutes the best remedy. When there is reason to suppose the hemorrhage proceeds from a scirrhous or ulcerated state of the womb, all that can be done, is to afford temporary relief by giving opium in large doses. Indeed, opiates may be given with advantage in every case where there is considerable pain or anxiety, and the patient much exhausted. Under these circumstances, from one to two tea-spoons full of lauda- num, or from two to four grains of opium, according to the urgency of the case, will be useful not only in giving a check to the dis- charge, but also in preserving the strength, and abating nervous irri- tation. In most cases it is preferable to give opium in the form of injections to allay the spasmodic pains of the womb ; and, when administered in this way, clysters of thin starch or gruel, in each of which two tea-spoons full of laudanum are added, should be given every two hours until relief be obtained. (See Abortion and Flood- ing.) In a female greatly reduced in strength and much emaciated, with an excessive menstrual flow, Dr. Dewees gave half a tea-spoon full of laudanum and the same quantity of Hoffman's anodyne liquor, and two grains of sugar of lead with one-third of a grain of opium, every hour till the discharge should be moderated. These remedies proved of great service, but early next morning, the flow Avas much increased. He now ordered twenty grains of sugar of lead, a tea- spoonful of laudanum and a gill of lukewarm water, as an injection. This quickly arrested the discharge, which did not return. Exer- cise and sea-bathing soon confirmed her health. Regimen. — The diet, at the time of excessive discharge, must be light and cool. The drink must always be cold, as ice-water, lemo- nade, or tamarind beverage. Port wine, in such cases, is too fre- quently resorted to, which uniformly does harm by increasing the circulation. Prevention — To prevent a recurrence of the attack in those who are subject to it, the patient must necessarily avoid the causes by which it has been produced. When it is evident that the discharge is in consequence of a full habit, it will be proper to reduce the system by living sparingly, by keeping the bowels rather in a laxative state, and by rising early, and taking through the day regular but frequent exercise ; and, after the plethora is removed, by strengthening the vessels, which have been over-distended, by the use of the cold bath. In a greater number of cases, however, we meet with a delicate constitution and spare habit, with pale countenance : this state re- MANAGEMENT OF FEMALE COMPLAINTS. 409 quires the use of sea bathing or the shower bath, and the vessels of the womb are particularly strengthened by pouring cold water daily on the back and loins. It will be advisable to use a generous nutritive diet, with wine, and to have recourse to some of the tonic medicines, as advised un- der the head of obstructed menses, to strengthen the system gene- rally. At the same time the bowels must be attended to, and invi- gorating exercise taken daily; whilst, on the other hand, fatigue, and especially exposure to relaxing heat, must be carefully avoided, SEXUAL WEAKNESS. This complaint, commonly called Jluor albus, or whites, to which women are peculiarly subject, must form an important object of attention, since it is always attended with disagreeable symptoms; and, when aggravated, soon spoils the beauty of a fine face, weak- ens the digestive powers, produces a general bad habit, and occasions sterility. Symptoms. — An irregular discharge from the passage leading to the womb, of a fluid, which, in different women, varies much in colour, being of a white, green, yellow, or brown hue. In the be- ginning it is, however, most usually white and pellucid, and, in pro- gress of the complaint, acquires the various discolorations and diffe- rent degrees of acrimony, whence proceed a slight smarting in making water. Besides the discharge, the patient is frequently afflicted with severe and constant pains in the back and loins, indigestion, pale- ness of the face, chilliness, and languor. In process of time, every symptom becomes highly aggravated, the feet and ankles swell, pal- pitations, and a difficulty of respiration are experienced, the men- strual discharge is rendered irregular, the urine is turbid, the mind is dejected, and either consumption or dropsy supervenes and termi nates a miserable existence. In some languid habits, the fluor albus returns periodically, instead of the proper menstrual evacuation, until the patient's constitution is duly invigorated. Causes. — It may be produced by any cause which either weak- ens or irritates the womb and its appendages. It may arise from general debility of the constitution, but it is especially caused by cir- cumstances impairing the power of the womb itself, as, for instance, a severe labour, a miscarriage, or profuse menstruation. In some instances it appears to depend on a full and irritable habit of body, and, in other cases, of local irritation, such as disorders oi the womb, or of the urinary organs, or a collection in the gut, of the small thready worms called ascarides. 52 410 MANAGEMENT OF FEMALE COMPLAINTS. Upon the high authority of Dr. Hamilton, this disease is most fre- quently first brought on by some imprudence in respect to diet and clothing, or exposure to cold or fatigue, or neglect of the bowels about the time when menstruation begins. Treatment. — In the treatment of this complaint regard must be had to the apparent cause, and to the state of the patient. The discharge is too often considered by the sex as the effects of general weakness in their habit, and, therefore, are led to the indiscriminate use of heating medicines, as port wine, balsam copaivi, &c, without paying attention to the habit of the body, or cause of the disease. A milk diet, change of air, and the partial cold bath, as sponging the loins and thighs with cold water every morning, with attention to cleanliness and proper exercise, are often sufficient to arrest the disease, if early adopted. In addition to this plan of treatment, if the patient be of a full habit, a disposition to fever from slight causes, attended with a sense of heat about the passage to the womb, it will be necessary to have recourse to the lancet, cooling cathartics, and febrifuge medicines, and to inject, several times a-day, flax-seed tea or milk and water, into the passage of the womb. In the great majority of cases, the complaint arises from general debility or laxity of the vessels of the parts, and in such cases the indications of cure are to increase the vital heat, promote the digestion, and restrain the preternatural dis- charge. In order to which, recourse must be had to such of the tonic medicines as will be found to agree best with the patient. Of these, the bark and elixir vitriol, the tonic powders or pills, the rust or tincture of steel, and lime-water have usually been employed, and often with good effects. In some instances, however, I have known these medicines to fail, when the nitric acid, diluted, (see Dispensatory ,) in doses of a wine-glassful, three or four times a-day, wonderfully succeeded. Previously to the exhibition of tonic medicines, it is advisable to give a dose of ipecacuanha or antimonial wine. Gentle emetics are supposed to be of singular utility in this complaint, not only by cleaning the stomach and bowels, and making a revulsion of the humours from the inferior part of the body, but likewise by their exciting all the powers of the constitution to a more vigorous action. The bowels must be kept in a regular state by conjoining a few grains of rhubarb with some of the tonic medicines, or by taking occasionally, at bed-time, one of the aloetic, or aperient or diaphoretic pills ; or, in the morning, a tea-spoonful of Epsom salts dissolved in a tumbler of water. If there be a fulness of the stomach after eating, the tincture of rhubarb in small doses will excite digestion. In obstinate cases, it is often expedient to produce a change in the system, by giving a grain or two of calomel, or one of the mercurial pills at bed- time, until the gums become slightly affected, and then the cure may be completed by strengthening medicines, together with the shower bath. MANAGEMENT OF FEMALE COMPLAINTS. 411 Besides tonics, stimulating medicines, such as commonly deter- mine to the urinary passages, have very frequently been employed with great benefit. Of these, rosin in doses of ten grains in the yolk of an egg, or a spoonful of molasses, or balsam copaivi in doses of a tea-spoonful, or tincture of cantharides in doses of twenty or thirty drops in some mucilaginous drink, and taken three or four times a-day, will be found most salutary. These means strike at the cause of the complaint; but if it do not remove the effect very soon, we are not to trust to them alone. For once a morbid secretion being excited, it is very apt to continue, although the exciting cause cease to operate. On this account, we ought, without delay, to have recourse to astringent injections, such as a strong decoction of red oak bark, with the addition of a little alum or a solution of alum in water. Half an ounce of the former to be dissolved in a bottle of water; which should be thrown into the vagina by means of a female syringe, two or three times a-day. The celebrated Dr. Burns, says, after many trials, he satisfied himself, that although assistance may be derived from internal medicines and the cold bath, yet the chief dependence is to be placed on astringent applications to the seat of the discharge ; and these, where there is no fulness of the general system, nor any affection of the womb itself, are perfectly safe, and seldom fail in producing a cure. It will be prudent, when this disease occurs as an early symptom of pregnancy, not to check the discharge suddenly, lest miscarriage be the consequence; but it may be moderated by injections of water, with the addition of a little vinegar, or an infusion of green tea. Neither should the discharge be suddenly suppressed when it has been of long standing, and acquired a considerable degree of acrimo- ny, with an offensive smell. For if it be unseasonably checked, the belly swells, and a train of the most disagreeable symptoms occurs. In such cases, soap-suds, or an infusion of camomile flowers or hops, should be frequently thrown up the vagina ; and as soon as the blood is freed of its impurities, by suitable medicines, and has recovered, in some measure, its soft and balmy quality of which it has been deprived, the astringent injections may be employed with perfect safety. The application of a blister to the sacrum, has, in some obstinate cases, been attended with advantage. When the fluor albus proceeds from worms, purgatives and bitter clysters are the proper remedies. Pain in the back and loins is often mitigated by the application of a large adhesive or strengthening plaster, and by avoiding a standing posture of long continuance, much walking, dancing, or any other violent exertion. Women should carefully avoid all the remote causes of the disease : they should pay diligent attention to cleanliness, by washing the 412 MANAGEMENT OF FEMALE COMPLAINTS. parts frequently with cold water ; add when there are excoriations, milk and water, or lead-water, may be employed as a wash. Dr. Dewees on this subject is very high authority. His plan of treatment consists in washing the parts with warm water three or four times a-day — in gentle aperients — and a milk and vegetable diet, with tincture of cantharides till strangury is produced. And when the discharge has become thin and more abundant (and not till then) he uses injections of acetate of zinc six grains to the ounce of water — or of sulphate of copper, three grains to the ounce of water, three times a-day, always carefully washing out first the vagina with soap and water. Without strict attention to cleanliness, the best plan of treatment will be productive of but little benefit. Regimen. — The diet should be light, cordial, and nourishing, consisting of isinglass dissolved in milk by boiling it, jellies, custards, rice, milk, soft-boiled eggs, gelatinous broths, and light meats, together with a prudent use of genuine wine, particularly claret or port. Women, affected with this disease, should by no means indulge in the use of tea and other warm slops of a relaxing nature; but should lie on a mattress in preference to a feather bed ; and they should rise early, and take such daily exercise as their strength will admit, par- ticularly on horseback. When there is much languor, with chilli- ness, friction with the flesh brush, and wearing flannel next the skin must not be omitted. PREGNANCY. The great varieties of the female constitution occasion pregnancy to be, to some of the sex, of no trouble or distress, through the whole period of child-bearing ; but it is to others often a continual disease, being, perhaps, from the very first week to the last of their pregnancy, more or less disturbed in their frame from the peculiar irritability of their habits. Some feel, very soon after conception, such an alteration in the state of the stomach, or in their sensations in general, as apprizes them of their situation. The woman is troubled with heart-burn, acidity, want of appetite, or disgust at her usual food, and sometimes has a craving for things she formerly did not desire. She is usually sick in the morning, and generally vomits after she gets up, though some have no sickness till the afternoon. Sudden qualms and feel- ing of faintness, with or without an inclination to reach, occur at different times in the day. The bowels also generally become bound. Some, instead of being sick, or in addition to the fits of sickness, are troubled with a constant desire to spit, with toothache, MANAGEMENT OF FEMALE COMPLAINTS. 413 water-brash, cough, nettle-rash, or other affections. But the time to which these extend, varies, as well as the period at which they take place. In the young and healthy constitution, one of the most early symptoms of the incipient stage of pregnancy, is an uneasiness in the breasts, somewhat differing from what she may have been ac- customed to on the eve of menstruation, and soon attended with some sensible addition to the natural fulness and weight, as well as with a particular change in the appearance of the areola, or dark circle round each nipple. The nipples also soon become more pro- minent, the bulbous or glandular eminences around them enlarge, and a milky fluid will stain the linen, which had not been observed before. These occurrences may justly excite in the mind, the first appre- hension of pregnancy; after which, the interrupted course of the menstruation generally establishes the certainty of the situation. Obstruction, however, it must be recollected, may take place from other causes : hence, though we conclude, that she who is regular is not pregnant, we cannot infer, to a certainty, that she who is ob- structed has conceived. A woman in good health may accidently be obstructed for one or two periods ; but, in this case, the other signs of conception are usually absent, and, at all events, prudence will dictate the necessity of patience till the fourth month. In bad health, the courses are often stopped ; but, in such circumstances, the appearances of pregnancy are absent, whilst the symptoms of the accompanying disease point out the nature of the case. There is a situation in which there may, for a time, be some ambiguity, and that is where the woman has actually conceived, but the embryo has almost immediately perished, yet has not come away, but, together with some blood in the womb, is converted into a pretty firm, but shapeless mass, called a mole or false conception. About the end of the fourth month, or a little sooner or later, in difficult cases the motion of the child is perceived, and this is the most satisfactory of all the signs ; but those who are anxious to think themselves pregnant, when they really are not, are apt to mistake wind, passing along the bowels, for the motion of the child. The motion is at first gentle, it is felt pretty low, and resembles a gentle fluttering. The sensation is peculiar, and not imfrequently is, at first, accompanied with sickness, faintishness, or hysterical af- fections. It may be felt by night or day, and may either be repeated pretty regularly, or may not be again observed for two or three days. It is called quickening, not because the child at this time begins to live, for it is alive from the first, but because it can now move, or its motion is not till this time perceptible. Nature would seem, by these early notices, to put the mother im- mediately upon her guard, that she might not disturb the tender embryo, by avoiding the occasions of either sudden alarm, fatigue, fever, or whatever might derange the equitable state o( her health 414 MANAGEMENT OF FEMALE COMPLAINTS. and by attending to those means for its preservation, which are best suited to her particular constitution. At the end of five months, the infant's size is nearly double what it was at the completion of four months, and the size is again nearly doubled by the commencement of the eighth month. At the full time, or nine calendar months after conception, the ordinary size of the child is twenty inches in length, and seven pounds avoirdupois weight. But there are deviations from this standard. Some do not exceed sixteen or seventeen inches in length, and five pounds in weight ; while others weigh nearly fourteen pounds, and measure above twenty-four inches. This difference in size and weight ren- ders it extremely difficult, and it may be said impossible, to deter- mine, in many cases, whether the infant have attained to its matu- rity or not. The ordinary marks of hair on the head, nails on the fingers and toes, usually depended upon by those unaccustomed to consider this subject, are quite fallacious ; and although there be cer- tainly marks by which it can be unequivocally determined when the infant has not exceeded the sixth month and a half, it would be an imposition on the credulity of mankind to allege, after the seventh month, the exact age of the infant could be ascertained by its general appearance, or its size and weight. To protect the child, while in the womb, from the numerous acci- dents to which it might be exposed from the exertions or imprudences of the mother, a most simple and effectual apparatus is provided. Not only is it enclosed in a bag, and surrounded by a quantity of water; but it is also nourished by means of a substance similar to a sponge, by which the blood of the mother does not run directly into its system. The infant lies generally with its head down-most, that is, to- wards the mouth of the womb, and with its limbs so bent and folded together, as to occupy wonderfully little room, like the chick in the egg just before it breaks the shell. When there are twins in the womb, each infant is included in a separate bag, and attached to its own after-birth. The head of the one infant lies towards the breach of the other. By means of the apparatus thus imperfectly described, it may be understood that the infant, while in the womb, is admirably defended from external injuries ; but it may not be very obvious how it is nourished, and by what contrivance its increase of bulk is accom- plished. There is every reason to believe, that the after-birth serves the purpose ; and, accordingly, the quantity of blood sent to it al- ways keep pace with the size of the child. Thus, in the early weeks, the vessels which run from the womb to the after-birth are not larger than the hairs of the head ; while, in the latter months, many of them are as large as an ordinary writing quill, and the number of vessels always corresponds with the extent of its surface ; for at every period of pregnancy, it is found, that a separation of the MANAGEMENT OP FEMALE COMPLAINTS. 415 slightest portion of the after-birth is productive of the bursting of nu- merous blood vessels. That the derangement of the general system during pregnancy is produced by the new actions which take place, for the purpose of supplying the infant with the principles of life, is rendered probable, by the fact, that the breeding symptoms cease from the moment the infant dies, and by the additional fact, that they most commonly are less and less severe the more children a woman has. Accordingly, the ordinary complaints during pregnancy seem to be the immediate effects either of a disturbed action of the stomach and bowels, or of the formation of too much blood. The most important circumstances to be attended to in the inci- pient months of pregnancy, is the costive habit of the bowels. Its prevention will subdue, if not wholly keep off, some of the trouble- some complaints of the stomach, and will often guard most securely against some of th« exciting causes of early abortion. Blood-letting, cautiously used, either to reduce a too plethoric state of the general habit, or to alleviate some morbid affection, is a salu- tary agent ; but it is, in general, more frequently had recourse to in pregnancy than it should be, upon very erroneous principles. Be- cause a pregnant woman, though by one of the established laws of nature, is now obstructed, they conceive it proper to draw blood, that the constitution may be freed of an imaginary redundancy, not re- collecting the process of pregnancy is going on, to employ the inter- rupted menstrual fluid, to the now essential purpose of affording growth and support to the increasing womb itself, as well as to its contents. All the temporary benefits to be derived from blood-letting may be most safely and permanently attained by a due attention to the diet, and to the state of the bowels. Nothing can be of greater importance to a pregnant woman, than cheerfulness. They should, therefore, not be depressed by the re- lation of any unpleasant intelligence. Some women are often greatly disturbed by the account of misfortunes which have happened to others in the same situation. The impression made on a timid mind, may remain during the whole state of pregnancy. The general health may be thus impaired, and the approach of labour too much dreaded, so that both body and mind are in a less favourable state than they would otherwise have been. It should be considered, that though difficult and dangerous cases now and then occur, they most commonly terminate well, if properly treated, and their number is exceedingly small, when compared with the multitude of women who are delivered ; and it is probable it would be still smaller, if the cautions above laid down were properly observed. We would farther caution women against having recourse to cor- dials, to raise their spirits when low. Their good effects are, at best, but temporary, while they are ultimately baneful to their constitu- tion; and the use of a small quantity too frequently produces the necessity for a larger, until the mother and the unborn infant are in 416 MANAGEMENT OF FEMALE COMPLAINTS. jured by this pernicious practice. The best cordials for lowness of the spirits in pregnancy, are pure air, moderate exercise, and a light and cautious diet. There is another affection of the mind of a different character, from which lowness and hysterical indispositions often arise; namely, the force of a pregnant woman's imagination. This is often sup- posed to reach the infant in the womb, and to occasion marks and other deformities. But every mother may feel confident, that Pro- vidence has better guarded the unborn innocent, than to have ex- posed it to injury, from every variation in the feelings of a parent. Even admitting the possibility of such an influence, it could only take place at a very early period after conception, while the embryo is in its most tender state ; and even then it seems in a manner se- cured by nature against the above accidents, by the peculiar provi- sion made for its defence in the womb ; but it soon attains a sufficient degree of firmness to overcome any sudden or irregular impulse of the blood, from which alone such deformities or other blemishes could happen. The mother should, as much as possible, avoid every occasion of terror, on her own account, when any thing alarming occurs ; but let her not fear that her child will be marked from thence, or, still less, from some hidden operation of a disappointed longing, which most generally does not take place until the above-mentioned period is past. Numberless examples could be produced to convince women, that the notion which most of them have, that figures of animals, or other extraordinary marks, are stamped on the face or the body of the fetus in the womb, by the mere force of the woman's imagination, is a gross error. In every instance, it will be found, where a child is marked, the supposed cause of it has never been mentioned by the mother until after its birth ; and when a woman has really been alarmed during her pregnancy, and ventured to foretell her child would be marked, she has as uniformly been delivered of her fears and her child together, for her prediction has never been verified.* * Dr. Moore,, in his " Medical Sketches/' relates a case so strongly in point, attended with such singular circumstances, that it is worth mentioning here. "A lady who had a great aversion to monkeys, happened, unfortunately, during the course of her pregnancy, to visit in a family where one of these animals was the chief favourite. On heing showed into a room, she seated herself on a chair which stood before a table upon which this favourite was already placed. Not naturally of a reserved disposition, and rendered more petulant and wanton by long indulgence, he suddenly jumped on the lady's shoulders. She was terrified and screamed ; but on perceiving who had treated her with such indecent familiarity, she actually fainted ; and though the re- maining course of her pregnancy, she had the most painful conviction that her child would be deformed by some shocking feature, or perhaps the whole countenance of this odious monkey. "The pangs of labour did not overcome this impression, for in the midst of her pains she often lamented the fate of her unfortunate child, who was doomed through life, to carry about a human soul in the body of an ape. MANAGEMENT OF FEMALE COMPLAINTS. 417 DISEASES OF PREGNANCY. When we reflect on the several changes in the system which are produced by pregnancy, we cannot be surprised that it should be the source of disagreeable sensations, and of the cause of many dis- eases. No part of the human body is possessed of greater irritability than the womb; nor any part the increased irritability of which is more readily communicated to the system in general. The breasts are so connected with the uterus by their office, that every affection of the womb is immediately accompanied by some change in the breasts. — Next to the breasts, the stomach most readily sympathizes with the womb ; and through the stomach, the head and the heart are very soon brought to participate in its changes and complaints. Breeding Sickness — When it does not materially impair the general health, is to be regarded as a favourable symptom , because it certainly tends to prevent the formation of too much blood in the early months, which is one of the chief causes of abortion. It is generally sufficient to keep the bowels open. But when it becomes troublesome, it is necessary to interfere in time, otherwise alarming nervous complaints may be induced. The most effectual means of affording relief in those cases are blood-letting, and gentle laxatives regularly administered. The ap- plication of mint, (see Materia Medica,) or laudanum rubbed on the pit of the stomach, or administered in the form of an injection, has sometimes been of service. When sickness arises immediately upon first getting out of bed, a cup of tea or coffee often affords relief. Costiveness — Is a common attendant on pregnancy, and, if neglected, may produce serious consequences. Women in this situation should never allow more than one day to pass. without having a motion. (See Dyspepsia.) Heartburn — Is commonly confined to the early months, but sometimes accompanies every stage of pregnancy. A table-spoonful of a fluid, prepared by mixing the white of an egg with a little sugar and water, so as to make it of the consistence of thin syrup, taken occasionally, has, in many cases, afforded relief. When the heart- burn is attended with a constant desire to hawk up phlegm, the sto mach should be emptied by a gentle emetic. (See this disease.) Longings. — Pregnant women have often unnatural cravings, or what are termed longings, which, however absurd they may appear When the child was born, she called to the midwife with lamentable voice, for a sight of her unfortunate offspring, and was equally pleased and surprised when she received a fine boy in her arms. — After having enjoyed, for a few minutes, all the rapture from this change from pain and misery, to ease and happiness, her pains returned, and the midwife informed her that there was still another child. "Another," exclaimed she, "then it is as I have dreaded, and this must be the monkey after all!" She was, however, once more hap- pily undeceived, the second was as fine a boy as the first. 418 MANAGEMENT OF FEMALE COMPLAINTS. on some occasions, are frequently involuntary. They should be gratified, if possible, as women are apt to miscarry from the anxiety these occasion, when they are not indulged. It will be found, when the appetite is feeble, and the powers of digestion impaired, the sto- mach often rejects particular substances, and retains others, which, though seemingly whimsical, are found to agree with it. Fainting Fits. — Hysterical and fainting fits are apt to occur about the period of quickening, and, though sometimes attended with alarming appearances, are, in general, slight and of short dura- tion. A repetition is to be prevented, if the patient be of full habit, by keeping the bowels open, taking some blood occasionally, and putting her on a spare diet. But, if she be thin, and there be an appearance of nervous delicacy, strengthening means, as the cold bath, nourishing diet, cheerful society, regular exercise in the open air, with attention to the state of the bowels, are the best preventives, (See this disease.) Palpitations — Is another distressing affection to which some women are liable during the whole of pregnancy. The treatment of these nervous complaints must be varied accord- ing to the constitution and situation of the individual ; but, in gene- ral, invigorating diet, moderate exercise in the open air, keeping the bowels regular, avoiding every thing that disagrees with the stomach, and whatever can agitate the mind, will render the attack less fre- quent. (See Palpitation of the Heart.) Looseness. — This may occur during pregnancy, and is to be treated just as at any other time. (>S*ee Diarrhoea.) However, it may be necessary to observe, that women of full habit, especially in the early stage of pregnancy, should be very cautious in checking it suddenly, as an immediate overflow of blood to the womb may be the consequence ; and because such discharges are sometimes the effects of an effort of the constitution to throw off some oppressive load. Difficulty of Urine. — In some cases, during pregnancy, there is great pain or heat in making water. This is often accompanied by a most troublesome itching at the neck of the bladder, and neigh- bouring parts, with fever. In this case, it will be proper to bleed, to keep the bowels open with some cooling laxative, to drink freely of some diluent liquors, and to wash the parts three or four times a-day with lead water, or apply a sponge, wet with cold water, to be frequently renewed. Another more serious affection is a suppression of urine, at the same time that the stools are also obstructed. It chiefly takes place between the third and fourth month, and is attended with much pain in the lower part of the belly, owing to the distension of the bladder, and a feeling of bearing down, like the latter end of labour, with a desire of going to stool. This complaint consists in a change of the position of the womb, which is turned nearly upside down, and is sometimes brought on MANAGEMENT OF FEMALE COMPLAINTS. 419 suddenly by a fall, sudden exertion, or straining at stool, but much oftener by retaining the water too long. Pregnant women, therefore, should, on no account, place them- selves in situations which may lay them under restraint in this re- spect, and carefully attending to every call is essential to their safety. When the womb has descended very low, the os tincee will be found to protrude the external orifice. In this case, the complaint may generally be removed by pushing the womb up into the pelvis, and and supporting it there while the woman discharges her water. The reduction may be effected by the patient placing herself on her hands and knees, and then passing two fingers of one hand into the vagina, and a finger of the other into the rectum, by which means it is pos- sible sometimes to succeed. But even this assistance may be ren- dered unnecessary, by trying the effect of different postures, by lying on her back, with her hips raised, or kneeling on the floor, with her elbows resting on a pillow ; or by lying on either side, either of which attitudes may relieve the pressure on the urethra. In all cases of strangury, especially if the woman be of a full and plethoric habit, flushed and heated, she should lose blood according to the urgency of the symptoms. The bowels should be fully opened by copious injections, or mild laxatives* She should take mucilaginous drinks, and apply warm fomentations externally, or sit over warm water. These remedies, when the suppression is only partial, will generally afford relief; but whenever total suppression takes place, the patient should keep gum Arabic in her mouth, and avoid, as much as possible, drink of any kind, until she has been relieved ; and, if she do not soon succeed in her endeavours, recourse must be had to the catheter without delay. When the womb in- creases in size so large as to rise out of the pelvis, these distressing symptoms are relieved. Too much caution cannot be given to pregnant women on the subject of the retention of their urine. Every moment's delay in- creases the difficulty, and an hour's neglect may lay the foundation of the most painful and distressing complaint. Incontinence of Urine.— In the end of pregnancy there is sometimes an incontinence of urine, or the woman is obliged to void it frequently, but has no pain. This often proceeds from the pres- sure of the child's head on the bladder, and is considered as a favour- able sign of a natural labour. It can only be moderated by frequent horizontal posture, and its bad effects prevented by attention to cleanliness, and the use of a thick compress of linen or sponge. Swelling of the Feet. — It is usual, during pregnancy, espe- cially in the latter end of it, for the feet to swell. It is the effect of the enlarged womb preventing the ready return of the fluids from the lower extremities. But, when the swelling extends over the knees, and more especially when it appears on the upper parts of the body, and where it does not entirely subside after having boon a low hours in bed, it is to be regarded as a very serious complaint. 420 MANAGEMENT OF FEMALE COMPLAINTS. In the slight degrees, which happen chiefly during a first preg- nancy, or when the womb seems much distended, or when the woman is rather relaxed, the occasional horizontal posture, when the swelling is troublesome, with spare diet and an open state of the bowels, are all that seems necessary. But, in the serious degrees of the complaint, it is generally found that blood-letting, to a pretty considerable extent, and repeated purgatives, can only prevent the dangers which might ensue either during labour or after delivery. A different kind of swelling of the legs proceeds from an enlarge- ment of the veins. The feet are not necessarily swelled ; but along the inside of the legs, towards the knees, is a chain of knots of a blue color, disappearing by using friction after lying down. This is re- lieved by applying a roller, with a moderate degree of firmness, but not so tight as to give uneasiness, or affect the circulation. Inability to Sleep.— Inquietude and inability to sleep prove troublesome complaints towards the latter period of a pregnancy : the patient being obliged to rise frequently through the course of the night, in order to expose herself to the influence of cool air. Nothing affords so great relief, in cases of this nature, as bleeding in small quantities, with the occasional use of some cooling laxative medicine. Opiates are never attended with advantage in such con- ditions. Pains — Often occur about the back and tops of the thighs in the early part of pregnancy, and frequently are brought on by walking rather more than is proper. This requires a state of strict rest for some da}rs, and the part to be rubbed with the anodyne liniment y .{see Dispensatory^) or, if the pulse be full, and the patient strong, some blood should be taken away. Another kind of pain affects the back alone, and is of an aching nature, with a feeling of weakness. This is often relieved by the shower-bath, and the application of a strengthening plaster. Towards the latter end of pregnancy, colic pains are often so severe as to resemble the throes of labour. If they be not preceded by, nor attended with, costiveness, they may be easily remedied by opi ates, and a proper regulation of the diet. In consequence of the stretching of the muscles, some of the fibres may separate, so as to allow part of the intestines to be pushed out beneath the skin ; or this may take place at the time of delivery, and a pretty large swelling arise on some part of the belly. If the opening be large, the bowel is easily pressed back, but starts out and renews the swelling whenever the woman walks or even attempts to rise. This is called a rupture, and it may also take place at the navel, &c. The bowel is to be reduced, and kept in by a well adapted but easy bandage, and costiveness is to be prevented. When the woman is in labour, and has forcing pains, it is often necessary to apply the hand to the part, to keep the bowels from being strongly forced out, and after delivery, pressure must be immediately made otherwise faintishness may be produced. MANAGEMENT OF FEMALE COMPLAINTS. 421 When the integuments of the belly become cracked and sore from over-distention, nothing is so effectual as a frequent use of warm sweet oil, by friction. Cramps. — Women near the end of pregnancy are subject to cramps in the legs, the thighs, &c, which occur most frequently when lying in bed. They are occasioned by the pressure of the womb ; and, therefore, like the other complaints depending on the same cause, they do not entirely cease till after delivery. In slight cases, change of posture affords almost immediate relief: when this fails, rubbing with a flesh brush or flannel, or the application of cold vinegar, opodeldoc, or anodyne liniment, to the affected parts, are the best modes of procuring relief. When the stomach is affected, the same remedies as advised in cramps of that organ are to be employed. False Pains. — Many women are afflicted, long before their con finement, with pains so nearly resembling those of labour, that they often are mistaken for them. They are known by the name of false pains. They may affect the back, and come on with regular inter- missions, and are peculiarly apt to occur during the night. ' They may be distinguished by being rather more irregular and shifting than those of labour, or being more early attended with a pressing • down. They are also usually accompanied with griping or wind in the bowels, or some difficulty in making water. In such cases, con- finement in a horizontal position ; bleeding, if plethoric ; laxative medicines, if costive ; and administering small and frequent doses of some opiate, until the patient finds ease, will be necessary. They are sometimes produced by worms, which are removed by giving an injection of strong decoction of camomile flowers, with salt, and using laxatives. Occasionally they affect the side chiefly, and are accom- panied with a great motion of the child. Rubbing the part with anodyne liniment sometimes does good. Shivering not unfrequently occurs in the end of pregnancy, espe- cially in the night time ; and as labour sometimes begins with this, it creates an unfounded belief that delivery is approaching. It is either unattended with pain, or the pain is irregular, affecting chiefly the bowels or sides. It goes off by taking twenty to forty drops of laudanum, in a glass of warm tea or thin gruel. Convulsions — Are usually preceded by some symptoms which indicate their approach, such as a sense of fulness or heaviness in the head, severe or even excruciating headache, dimness of sight, or the appearance of substances floating before the eyes, sometimes dark, sometimes of a fiery brightness. They may also be preceded by cramp in the stomach, attended with dreadful sickness. They are likewise to be apprehended, if the face and arms be swelled in the same way as feet are in ordinary pregnancy. At whatever period of pregnancy convulsions take place, we uni- formly find, that if they are repeated, and do not prove fatal, they bring on labour, or at least open the mouth of the womb. But there 422 MANAGEMENT OP FEMALE COMPLAINTS* are many instances where, by proper measures, the repetition of the fits have been prevented, and the patient has safely gone to the full time. A knowledge of the causes of convulsions cannot be too widely diffused, as their occurrence may, in more than the majority of cases, be prevented. The formation of too large a quantity of blood, and an increased susceptibility of impression of the nervous system, occa- sion the tendency of this disease. 9 When these exist in any conside- rable degree, circumstances suddenly bring on the fits, which in any other condition of the body have little influence, such as over fatigue, fright, distress of mind, irritations of the stomach or bowels, over- distention of the urinary bladder, or obstruction to the passage of the blood through the belly and lower extremities, in consequence of the pressure of the enlarged womb. The immediate cause of the fits is an overflow, or too great determination of blood to the vessels within the head. These facts explain the necessity for so regulating the diet and exercise during the latter months of pregnancy, as shall prevent both too great fulness of the habit, and also impaired energy of the ner- vous system. # Under proper and active management, convulsions are found to be, in general, more alarming than really dangerous. The frightful appearances which attend such cases having paralyzed the exertions of practitioner's, may perhaps account for the unfortunate event in many cases. The practice consists chiefly in evacuation. The patient must be instantly bled, and the bleeding must be repeated once and again, if it do not prove at first efficacious. A prodigious quantity of blood has been taken away with advantage, and has been the means of saving life. Two quarts of blood have been drawn off in the course of twenty- four hours under these circumstances, and with a happy effect. The bowels are also to be opened immediately by an injection of soft soap dissolved in warm water, and then giving a strong solution of Epsom salts, or an infusion of salts, senna and manna, every hour or two, until copious evacuations are produced. After the first bleed- ing the head should be immediately shaved, and a blister of conside- rable size should be applied to it. When convulsions are dependent on an irritable or excitable state of the nervous system, it is not necessary to use the lancet so freely* It will be best, after moderate bleeding, to apply leeches to the temples, at the same time not to neglect the bowels, which should be kept perfectly open. If by these means the disease be checked, the camphorated mixture in its usual doses may be given to allay the nervous irritation. Por this purpose, opium in the form of a clyster has also been recommended. Dr. Denman proposed that a clyster, containing six or seven grains of opium, should be administered, un- der the supposition that, by putting a stop to the contractions of the MANAGEMENT OF FEMALE COMPLAINTS. 423 uterus, the convulsive contractions in the other parts of the body may also cease. The warm bath is strongly recommended by Dr. Denman among the means of preventing convulsions in women previously to, or during their confinement. He also recommends the warm bath in labours rendered complex by convulsions, and this upon a long and extensive experience. He says, that when convulsions have con- tinued or increased, notwithstanding copious bleeding and the use of all other rational means, the patient may be put into the warm bath, in which she may remain a considerable time, if the convul- sions are suspended while she is in it. In instances where a warm bath could not be procured, or while it was preparing, he has directed flannels, wrung out of warm water, to be applied over the whole of the abdomen. Dr. D. also observes, that he has seen the patient relieved from that state of irritation immediately preceding the convulsion, by dip- ping feathers in cold water and dashing it with force on the woman's face, as this roused her, and interrupted the progress of the fit. Where the farther application of cold water is deemed necessary, and appears advisable, we may throw water over the patient's head, bringing this over the side of the bed, and holding an empty pail underneath to receive it. It should be done on the approach of the fit, which may be ascertained by attending to the vibrations of the intercostal muscles. Discharge of Water — May take place at different times during pregnancy, especially in the last two months. The quantity is va- riable, and sometimes the discharge is accompanied or succeeded by irregular pains. When this is the case, give a dose of laudanum, and afterwards some gentle laxative, to prevent costiveness. At the same time, the woman should remain quiet in bed. By these means, she may go to the full time. If the water continue several days but trifling in quantity, a solution of alum or decoction of oak bark, should be injected up the vagina two or three times a-day. Discharge of Blood — May proceed either from the passage to the womb, or from that organ itself. In the former case, no bad effects can be dreaded ; but in the latter one, the most serious conse- quences may ensue. The immediate cause of a discharge of blood from the womb, during pregnancy, is the rupture of blood vessels, by the partial or total separation of those parts which connect the child with the mother. This circumstance explains the difference of danger in the early and latter months ; for in the former, the blood vessels of the womb being small, are incapable of pouring out. much blood ; but in the latter, they are very large, and may discharge, in a short time, a great quantity. The management of these cases must be varied according to a number of circumstances. Tranquillity of mind, and confinement to bed in an airy room, lightly covered with clothe-, are of great im- 424 MANAGEMENT OF FEMALE COMPLAINTS. portance. A bladder two-thirds filled with cold water, or cloths wrung out of cold vinegar and water, should be immediately applied to the lower part of the belly. If the discharge continue in small quantities, accompanied with irregular pains, a dose of laudanum, or the anodyne clyster, should be administered. When it has sud- denly been brought on by a fall, blow, or any great exertion, it is necessary to draw blood from the arm ; but when the symptoms which threaten miscarriage have come on, it is improper either to bleed, or to give laudanum. The languor or faintness, usually induced by loss of blood, fre- quently lead officious attendants to exhibit spirits of wine, as neces- sary cordials. As these generally increase the action of the blood vessels, they serve to promote and increase the discharge, and should, therefore, be strictly prohibited. In the latter stage of pregnancy, if the attacks be severe or repeated, nothing can save the mother and the child but delivery, which must not be too long delayed in ex- pectation of pains coming on, or of their becoming brisk, if they have already taken place. ABORTION. By abortion or miscarriage is meant the expulsion of the child at a period of gestation so early that it cannot live. It is always accompanied with two circumstances, separation of the membranous bag, expulsive efforts, or contraction of the womb itself. The first is productive of discharge, the second of pains like those of labour. Sometimes the separation or detachment of part of the conception takes place before any pain is felt ; on other occa- sions, the pain, or contraction of the womb, takes place first, and produces a separation. In the first of these cases, the symptoms of abortion take place suddenly, and are usually occasioned by fatigue, sudden exertion, or fright. In the second, the child is frequently dead a short time before the pains come on, and there are particular feelings, and changes, which indicate that a miscarriage is likely to take place ; as, for instance, the cessation of the morning sickness, the subsidence of the breasts, absence of motion of the child, a feel- ing of weight, or heaviness in the lower part of the belly, &c. Causes. — Violent exertions of strength, severe exercise, sudden frights, violent fits of passion, over-fulness of blood, profuse evacua- tions, excessive venery, former miscarriages, a diseased state of the uterus, general debility of the system, external injuries, and strong acrid and stimulating medicines, which are often taken for the ex- press purpose of exciting abortion, and the death of the child. Such criminal intentions to destroy the fostus by artificial means MANAGEMENT OF FEMALE COMPLAINTS. 425 can never succeed, unless the most violent effects are produced on the organs contiguous to the womb, which seldom fail to produce inflammation of these delicate parts, and occasion the death of the mother. Whenever, therefore, women commit such unjustifiable crimes to conceal the indulgence of irregular passions, their life is exposed to the greatest danger. Treatment. — When a woman is threatened with a miscarriage, there are two objects to attend to : the first is, to prevent it if we can ; the second is, to manage it so that as little blood as possible be lost ; and both these are obtained by the same means. With this view, the patient should immediately, on the first alarm, undress and go to bed, lightly covered, with a firm determination not to rise till the pro- cess be either checked or completely over. There should be little fire in the room, though it be winter; and, in summer, the windows must be opened. Cloths, wet with cold water, should instantly be applied to the lower part of the belly and back: the drink must be cold, and every thing stimulating should carefully be avoided. In robust habits, or when the symptoms have been brought on suddenly by some such cause as a fall or exertion, it is proper to bleed, and, in cases of sickness or great feebleness, to give a dose of laudanum ; or, what is better, to administer the anodyne clysters. (See Dispensatory.) Opiates are useful in every case where we hope to prevent abortion, and must be repeated more often or seldom, according to the effect they produce. They are, however, improper in those cases where miscarriages must decidedly take place. Their tendency to occasion costiveness, when employed, must be obviated by clysters, or some gentle laxative medicine, such as calcined mag- nesia, Epsom salts, or a little castor oil. If there be a continued but trifling discharge, great advantage may be derived from injecting, three or four times a-day, up the vagina, a solution of alum. In- deed, in all protracted cases, this is of much benefit. The solution ought, to be thrown up pretty high, that it may reach the womb. When these means produce not the desired effect, and along with the discharge of blood large clots come off attended with bearing down or pains in the back and loins, especially if the symptoms which precede abortion have appeared, there must be every proba- bility that the threatening event cannot be avoided ; and then we must endeavour to conduct the patient safely through the process. In all cases during the last stage of pregnancy, where our endea- vours to stop or repress the hemorrhage prove abortive, and the life of the woman becomes endangered by its severity, it will be advisa- ble to deliver her as soon as possible. If the ovum be still entire, and the pregnancy considerably advanced, the expulsive action is to be excited by rupturing the membranes. When the whole conception come away at once, the pain and dis charge usually go off; but, if only the child come away, all the symptoms either continue and increase till the after-birth come away. or, if they be for a time suspended, they are sure to return. 54 426 MANAGEMENT OF FEMALE COMPLAINTS. After the process is over, if the discharge be profuse, and do not stop on the application of cold water to the lower part of the belly, it will be proper to plug up the vagina, and this is best done by tak- ing a pretty large piece of soft cloth, dipping it in oil, and then wringing it gently. This is to be introduced with the finger, portion after portion, until the lower part of the vagina be well filled. The remainder is then to be firmly pressed on the orifice, and held there some time for the effused blood to coagulate. In obstinate cases, previously to the introduction of the plug, we may insert a little pounded ice, or snow tied up in a rag, if to be procured ; but neither of these should be continued so long as to produce pain or much shivering. In addition to this mode of treatment, it will be advisable to have recourse to the astringent medicines, as advised under the head of Immoderate Flow of Menses. Regimen. — Arrow root, tapioca, sago, panado, or rice milk, con stitute a proper regimen. If the process be protracted, and the strength much impaired, the diet may be more liberal. In every case, ripe fruit is safe and useful. The bowels are to be kept regu- lar, and sleep, if necessary, is to be procured by an anodyne. Prevention. — It requires great attention to prevent abortion in subsequent pregnancies, whenever it has happened. In all such cases, it will be highly necessary to attend to the usual habitudes and constitution of the women, and to remove that condi- tion which is found to dispose to abortion. A woman that is subject to miscarriage, and who is of a full ple- thoric habit, ought to be bled just before the usual time of her mis- carriage, and she should take the tincture of foxglove, twice or thrice a-day for two or three weeks. In robust habits, blood-letting may be repeated every fortnight during the second, third, or fourth months ; but the blood should be taken from a small opening, and not much at a time, lest fainting be produced. The quantity and the repetition must depend on the constitution of the patient, on the particular symptoms in the individual, and on the effect produced by the evacuation. She should likewise keep her body perfectly open with gentle ape- rient medicines, use a spare diet, and avoid all agitations of the mind. The sleep should be abridged in quantity, and taken on a mattress, instead of a feather bed. Regular and moderate exercise should be taken daily, being cautious, at the same time, not to carry it to the length of exciting fatigue. In women of a weak, lax habit, bleeding would be highly impro- per; for such, a nutritive and generous diet, moderate exercise, and tonic medicines, will be required. And, along with nourishing diet, a moderate use of wine should be allowed, if it do not heat the pa- tient, or otherwise disagree. The cold bath is of signal service in every instance where it is not followed by chilliness. Until gestation be far advanced, it would be advisable for the wo- MANAGEMENT OF FEMALE COMPLAINTS. 427 man to sleep alone, and strictly avoid every cause which is ascer- tained to be capable of producing abortion. Women more frequently miscarry in the second or third month than at any other time ; but some have a certain period at which they usually go wrong, and do not vary a week from it. In such cases, the woman should confine herself to the house, avoid the least exercise, and frequently recline on the sofa or bed, till that period be past. When women miscarry repeatedly about the fifth or sixth month, and feel, previously to that accident, the symptom's of the child's death, and at the same time, the child, when expelled, is putrid, some latent poison, which will probably yield to a mercurial course of medicine, may be suspected. OF LABOUR. f Labour generally happens in about nine calendar months, that is, from thirty-nine to forty weeks. In some cases, this time is consid- erably shortened, and, in others, is certainly protracted. There are two methods of reckoning ; namely : from the time obstruction takes place, and from the sensation of quickening. If the former be de- pended on, the date of conception should be taken at a fortnight be- fore the obstruction ; if the latter be preferred, five calandar months may be allowed from the time that the movement of the infant was distinctly perceived. There are three different steps in the delivery of a child : First, the mouth of the womb must be gradually opened; secondly, the child must be expelled ; and, thirdly, the after-birth must be thrown off. The first of these effects must be accomplished by the repeated contractions of the womb, which produce sharp or grinding pains. The second is fulfilled by more forcible efforts, productive of bearing down pains, which at last, increase to great severity. The third takes place a short time after the child is born, and is attended with very slight pain. These pains proceed from the attempt made by nature to dilate the mouth of the womb, and they must continue until this be accom- plished. The complete dilatation is assisted and rendered both easier and frequently more speed}', by the protrusion, through the mouth of the womb, of part of the membranous bag, which contains the child and the water. The degree to which it is pushed out of the womb, during a pain, varies much in different cases. Sometimes it forms a very slight projection, at other times is very bulky, being little less than the child's head. When the membranes begin (o be pushed, the water is said to " gather." 428 MANAGEMENT OF FEMALE COMPLAINTS. The mouth of the womb being considerably opened, efforts are next made to press down the child, or to empty the womb. These produce a change in the pains, which are attended with a little incli- nation to press down. This gradually increases, and at last, the sensation of bearing down becomes very strong and irresistible ; and it is observed, that, though the pains are strong and forcing, they are productive of less complaint than those which, in the beginning of labour, appeared to be less severe. There is a great variety in the duration of this part of the process. It is sometimes gradual and slow, in other cases sudden and rapid. The pains may be strong and forcing, and have very little interruption, or they may come on at very regular periods, with complete intervals of ease. During this period the membraneous bag, in which the child lies, usually bursts, and the water which it contained is discharged. This event is followed by an increase of the pain, which becomes more forcing, and the spirits of the woman rise in proportion. At length the head of the child comes to the birth, and, by repeated efforts, is at last expelled. This is followed by the gradual delivery of the body. After an interval of ease, one or two slight pains are felt, which serve to throw off and expel the after-birth. The duration of this process is various, but it is generally longer in a first child than afterwards. This is particularly the case with regard to the second stage. Some women are uniformly expeditious, others al- ways tedious. Some have the first stage slow and the second quick ; some have the water discharged early, others not until the child is born. Some have much sickness, or retching, or shaking, others none at all. In short, there is great variety in these respects with different women, or even with the same woman in different labours. In a natural labour, the whole process is concluded within twenty- four hours after its commencement, often in a much shorter period PROGRESS OF LABOUR. When a woman, after a preceding day of ease, an unusual acti- vity, about the period of her reckoning, begins to feel some restless- ness about her, with occasional pains in her loins and side ; if she farther perceive that the bulk of her belly has fallen, that the motion of the child has not been for some time so sensibly or frequently felt, and that she has a nervous hurry of spirits upon her, with a feverish glow of heat, she may then conclude that nature feels an inclination to prepare her for the termination of her pregnancy. When labour has actually commenced, the bed on which the patient is to be delivered, should be properly prepared, that it may not remain wet and disagreeable after the delivery. It should be MANAGEMENT OF FEMALE COMPLAINTS. 429 placed in such a situation that the room may be ventilated, without the patient being exposed to a current of air. The mattress is to be put uppermost, as being more comfortable than a feather bed when it is not daily made up. A folded blanket, or dressed sheep-skin is put next to this, in order to prevent it from being wet and soiled. Over this the undermost bed sheet is thrown, and the bed made up as usual. Afterwards, a sheet, in five or six folds, is laid across the bed ; and these being removed when the child is delivered, and the woman is laid up, she finds herself clean and dry, without farther trouble. Every thing ought to be in readiness before it can possibly be needed, particularly the baby-linen, and such articles of dress as the mother may require. The dress of the woman, during labour, ought to be as light and as simple as possible, and so prepared, that it may not be necessary to disturb them soon after delivery by a change of apparel. When this is properly managed, they avoid an unreasona- ble fatigue, and the hazard arising from linen which may not have been cautiously aired. Little things are often of great importance, and are sometimes found so when it is too late. Premature labour is sometimes threatened by pains, which pro- duce, for awhile, some real change in the womb sufficient even to give the practitioner just reason to expect that they will terminate in the delivery. But things again recover their pristine state, the alarm of nature subsides, and the woman proceeds in her pregnancy, for several days longer, and sometimes for weeks. As the change in the womb above mentioned does certainly occur, even on a false alarm, it should put young and female practitioners on their guard, lest they promote labour too hastily, either by gene- ral treatment, or any manual operation ; for these would only fruit- lessly tease the patient, when the judicious exhibition of an anodyne would do every thing that can be wished for. When, in consequence of irregular premature pains, the mem- branes containing the water with which the child is surrounded have been broken before labour has really commenced, it must be ex- pected soon to take place ; though if the pains should have entirely ceased, on the discharge of the waters, it may be delayed for some days : but it most frequently happens within twenty-four hours. There is nothing in this circumstance alarming. It may occasion the first part of labour to be more slow, but not in any degree less safe in the end. It arises wholly from the fineness of the mem- branes, which contain the waters, and which must rupture in every labour, at some period or other, and hence the waters are unexpect- edly discharged, in a sudden manner, without the least preceding pain. In a slow labour, especially if it be the commencement, the time commonly spent in the lying-in apartment, might, with more pro- priety, be passed in the usual domestic habits. It would serve to lessen the too anxious expectation of a speedy delivery, as well as to 430 MANAGEMENT OP FEMALE COMPLAINTS. prevent the impatience of the attendants, both of which are often improperly indulged. A sensible woman should always consider that, in a slow labour, she may be afflicted with many distressing, or what have been called false or spurious pains, but there are very few by which nature does not mean some good in the end. She must, therefore, give her mind to patience, as all unnecessary interference would rather retard than assist the labour, and will only be employed by the designing or unskilful. In the first stage of labour, the bowels should, if necessary, be emptied by means of a clyster, or a dose of some gentle aperient medicine. This is attended with several advantages : it renders delivery easier, and sometimes promotes it sooner. All heating drinks and stimulants are carefully to be avoided, as they increase the natural tendency to fever which women have at that time, and the temporary vigour they induce is soon followed by a great degree of languor, that retards the delivery. Violent agitations of the body must be carefully guarded against, that the waters may not be discharged prematurely, which might be productive of the worst consequences. For these reasons, the fre- quent interference of the practitioner in the beginning of labour, except where there is some unusual resistance to the opening of the womb, or the water has drained off too early, might do much harm, and could be attended with no good effects. At that period, no medicine, or rather expedient for increasing the force of the pains, should be prescribed, as the more slowly the passages are enlarged the less injury will the patient suffer. In every instance she should be kept quiet and cool, though she ought not to be confined to one position. She may be allowed to stand, walk, or sit, or remain in bed, as may be most agreeable to her feelings ; but she ought, by no means, to stand so long, or walk so much, by way of forwarding the labour, as is productive of fatigue, and, after the pains become very frequent and pressing, it will be, in general, most prudent not to come out of bed. Second Stage. — When the first stage is nearly completed, the woman should be placed on her left side in bed, with a folded pil- low between her knees. The bearing down pains, by which the child is forced through the passage, should be the effort of nature alone, and ought not to assisted by the exertions of the mother : for, in that event, either the delivery might be hurried on before the passages are sufficiently prepared, or the woman would be much worn out that she could not undergo the necessary fatigue that attends the complete expulsion of the infant. This important caution cannot be too strongly inculcated ; for in- attention to such conduct, and the impatience w T hich women in such situations cannot perhaps avoid, often make a labour difficult and painful, that would otherwise have been natural and easy. MANAGEMENT OF FEMALE COMPLAINTS. 431 Voluntary bearing down must be particularly guarded against at the time when the head of the child is only prevented from being born by the soft parts at the outlet of the basin ; for, if the delivery (lien be hastened, these parts may be readily torn. The utmost at- tention of the practitioner is indispensably necessary to prevent so unfortunate an accident, in every case where, from the acute feel- ings of the patient, violent bearing down at that period cannot be resisted. When the child's head presses against the perineum, it should be supported by gently pressing with the hollow of the hand during the pain, to prevent its tearing. After the head of the child is excluded, the woman should be allowed to enjoy, for a little time, the temporary relief she feels, and therefore, the body ought not to be immediately taken out with force, as is often done ; for, besides the injuries which may be occa- sioned by not allowing the patient a little rest, the extraction of the after-birth will be thereby rendered difficult. Two or three minutes may therefore be allowed to elapse before the body be drawn forward. If the patient have a rapid labour, and the midwife be at a dis- tance, she ought to keep constantly in bed, and refrain, as much as possible, from bearing down. If the child should be born before assistance be procured, the most experienced woman present should take the navel-string between the finger and thumb, and as soon as she finds the pulsation in the cord stopped, tie a string firmly near the navel, and apply another ligature about three inches from the first, and cut the cord between these ; or, if she be afraid to do this, the child must lie beside the mother till the midwife come, taking care that the face be uncovered, to permit of breathing. We will now suppose the woman is just safely delivered of her child, and that a complete cessation of the regular pains has followed. She must now endeavour to calm that disturbance of the whole frame, which, added to her anxiety of mind before the delivery, had excited a great degree of heat and perspiration, especially if it should have been her first labour, or one attended with some unusual diffi- culty. In this state she must not let herself chill or cool too fast. It may, perhaps, have been necessary to throw off the bed-clothes, during the last hour or two ; if so, they should immediately, on the birth of the child, be lightly placed over her again. She may now moisten her mouth with a cup of tea, grit gruel, or barley water, for either of which she will feel desirous, if she have not been fre- quently taking one or the other during the latter part of her labour ; but they must be given to her without wine or brandy. If she feel herself disposed to sleep, she should indulge it : at all events, she should keep herself quiet, and not encourage conversation. For it may be observed, that, in general, the mind of a woman newly de- livered of her first child, is so occupied with the novelty, as well as the anxiety of her situation, that her attention is long kept alive, and, therefore, she can scarcely sleep, though exhausted by the fatigue of her labour. 432 MANAGEMENT OF FEMALE COMPLAINTS. In the third Stage — The midwife must carefully attend to the degree and force of contraction, which the womb is disposed to take on immediately, or soon after, the birth of the infant. The experi- enced practitioner will, indeed, have a presentiment, even while it is coming into the world, of what is likely to take place afterwards, from the manner in which the expulsion of the infant is completed. This should be effected slowly, as we have already observed, because sucli a practice favours that kind of action of the womb necessary to detach the placenta. Premature or active endeavours to loosen it, must, however, be avoided, if its separation should not readily take place, by the seasonable contraction of the womb. Let the opera- tions of nature be watched, and she will prove the surest guide, though in this part of the delivery, she ought never to be wholly depended on. We generally find, when there has not been any sudden or hurried delivery of the infant, the after-birth is soon expelled without any assistance. The vessels which passed from the womb to the after-birth would, when this was separated, pour an increased quantity of blood, did not the womb contract so much as to diminish their size and compress their orifices. This contraction both expels the after-birth and pre- vents flooding. When, therefore, the after-birth is expelled, we have an evidence of the existence of that state of the womb which ensures the safety of the mother. A woman should, however, avoid expressing any impatience about this, as it might induce some practitioners to use that despatch which many have done, that the patient or her friends might not insinuate that they were a long while in bringing away the after burden. This kind of censure is too frequently passed upon the just conduct of the midwife, from the improper prejudice too often indulged in favour of a speedy delivery of the placenta. Women are apt to deem that practitioner most skilful who is the shortest time in finishing that part, of her labour. Fatal, therefore, have sometimes been the con- sequences of this ill-judged management, particularly among the female practitioners. It is a mistaken idea, that, in general, some external mechanical force is necessary in order to expel the placenta. We cannot, there- fore, approve of the modes occasionally recommended, of coughing, sneezing, blowing on the back of the hand, or making general pres- sure over the belly, with a view of helping its descent, by any kind of tight bandage applied to the abdomen, immediately after the birth of the child. There is a general action of the hand on the abdomen, which the patient herself may perform, and by which the uterus is tenderly excited to contract, and the placenta of course detached in the most favourable manner, that will be found more useful than a bandage, or any extraordinary exertions of the patient, for this purpose. But as this may not be necessary in every case, it must be left to the MANAGEMENT OF FEMALE COMPLAINTS. 433 judgment of the practitioner to direct, with the proper caution to be observed in the applications. We would farther observe, that there can hardly ever be occasion for a woman to bear down during the delivery of the placenta. In- deed, on many occasions, it must be carefully avoided, lest it should produce, or increase, a disposition to the prolapsus uteri. The throes, which take place naturally, are caused by the contractions of the womb ; and with them alone the practitioner can, generally, in due season, safely bring it away. When the effects of nature do not tend to disengage the secundine within an hour after the birth of the infant, the interference of art ought to be submitted to. For if it be not thrown off within a short time after the infant is bom, it becomes putrid, and induces an alarm- ing fever, from which few women have recovered. In assisting the expulsion of the after-birth, unless the practitioner wait for the con- traction of the womb, that part may be turned inside out. This cir- cumstance should be properly understood by all those who happen to be out of reach of regular assistance ; for the patient's life, after an easy labour, may be destroyed by the rashness of an ignorant practitioner. By explaining, however, the case of danger, those who are prevented from being under the care of persons of skill, may thereby escape those hazards to which they might otherwise be exposed. The after-birth is generally fixed to the bottom of the womb, and as the greater portion of the womb, at the full period of pregnancy, is not attached to the adjoining parts, if the navel-string be violently pulled before the after-birth be separated, the womb must be turned inside out, the ordinary consequence of which is fatal. When the grinding pains are felt by which the contraction of the womb is distinguished, the practitioner should assist by pulling gently the navel-string during a pain, and by endeavouring to bring down the after-birth through the basin, in such a manner that its progress may not be interrupted by any of the neighbouring parts. Until the after-birth is expelled, the patient and midwife should be attentive lest there be a great discharge, and if this occur, no time is to be lost in checking it. This is done by exciting the con- traction of the womb, by the application of cloths wet with cold water, to the lower part of the belly and to the passage, or by pour- ing cold water out of a pitcher from a height on the abdomen ; and also by the introduction of the hand of the midwife to stimulate the womb. Some do this with the sole object of extracting the placenta or after-birth, considering the retention of this as the cause of the flooding. But this opinion is wrong, and the mere extraction of the placenta can only do good, so far as the introduction of the hand and the means used to effect this, serve to excite the action of the womb itself. We do not approve of a free and indiscriminate use of greasy ap- plication, in the progress of labour. They are wholly unnecessary 55 434 MANAGEMENT OF FEMALE COMPLAINTS. in the first stage of it, and in the latter part they interfere with the changes which then take place naturally, and produce that mucous secretion by which the parts are most favourably lubricated, for the easy termination of the labour. But after the complete removal of the placenta, it will be proper to apply a small quantity of pomatum or fresh lard, to defend the parts from the acrimony of the ensuing discharges. LABORIOUS LABOUR. When the delivery is not completed within twenty-four hours from its real commencement, though the head of the child be forced fore- most, it is styled laborious labour. It may occur under three different circumstances. First, the pains may be, from the commencement, few and weak, and the labour may, if left to itself, be long becoming brisk. Secondly, the pains during the first stage may be sharp and frequent, but not effective, in consequence of which, the power of the womb is worn out before the child has advanced far, or come into a situation permitting it to be expelled. Thirdly, the pains, during the whole process, may be strong and brisk, but for some obstacle the delivery may be either greatly protracted, or rendered altogether impossible, without assistance. Different causes may produce these states; such as general weak- ness of the constitution, particularly the action of the womb itself, premature discharge of the water, fear, impatience and strong passions of the mind. When the first stage of labour is protracted, and the pains do but little good, a clyster has often had the happiest effect in exciting more brisk and productive action. In like manner, a change of posture, or walking a little in the room, has sometimes rendered the pains brisker. But whenever sitting or walking produces fatigue, or is felt to be disagreeable, they certainly do harm. The most powerful means we can employ for remedying some of those conditions, which give rise to tedious and severe labour, are blood-letting and the use of laudanum, either in the form of a draught or clyster. The states requiring or admitting of these it is impossible to explain here ; but it may be a service to do away a prejudice which may exist against their employment, when they are necessary. Opiates are serviceable sometimes, as cordials or general stimulants ; at other times they are beneficial by suspending the use- less, but painful action, of the womb, and thus allowing time for the strength to recruit, and these effects they produce more safely and effectually than any other means could do. They are also of effi- cacy in checking that irregular spasmodic action of the uterus, which MANAGEMENT OP FEMALE COMPLAINTS. 435 gives much pain, and rather retards than forwards the expulsion of the infant. With regard to blood-letting, there is only one objection of any weight, namely, that it will weaken the patient ; but, in reply to this, we observe, that if it have the effect of rendering the delivery more speedy and safe than it otherwise would be, it will rather save the strength by preventing unnecessary fatigue. It is also well known, that a much greater quantity of blood is often lost after delivery than would have been taken from the arm, and yet no bad effect what- ever follows from it. When convulsions occur during labour, or in the end of pregnancy, six times the quantity of blood that would be taken in any other situation, are often extracted with present relief and future advantage. Last of all, the experience of different ages and various countries proves the safety of the practice. It is not a remedy newly introduced, the effects of which we are ignorant of, for it is even the habit of some to bleed women in natural labour in order to render it still more easy and expeditious. Blood-letting is also a powerful means of preventing local inflammation, which may be excited by protracted labour. In difficult labour we must always pay due attention to the state of the bowels, and we should also be very attentive that the urine be voided regularly. There are some unfavourable positions of the head, which may be rectified by the finger without giving pain. If, notwithstanding all our care, the labour be protracted until the strength be impaired, and the pains are ceasing ; or, if the obstacle be so great as, during the course of labour, to make the head be £xed within the bones of the pelvis, and produce suppression of urine, or a tender state of the soft parts, with a sense of tightness within the pelvis, restlessness, giddiness, or pain in the head, severe pain, or feeling of pinching, even in the absence of the labour pain, about the share bone, or other symptoms indicating that the powers of nature cannot any longer be safely trusted to, it will be necessary to have recourse to the use of instruments. These are never to be resorted to except in cases of absolute necessity ; but it cannot be too strongly enforced on the mind of the patient who requires them, that, if she delay, after they have been advised by a practitioner of judgment and integrity, her own life, as well as that of her child, may be lost. PRETERNATURAL LABOUR. When any other part of the infant than the head is forced fore- most during labour, the case is styled preternatural, or, in common language, a cross-birth. Where neither the head nor lower parts 436 MANAGEMENT OF FEMALE COMPLAINTS. are placed next the passage, nature cannot, in general, accomplish the delivery ; and, therefore, the life of the woman must depend on the position of the infant being changed. The operation by which this is performed, is called, in the language of midwifery, turnings and consists in bringing the feet into the passage. When the case is discovered before the water is drained off, the operation of turning may be had recourse to with perfect safety, pro- vided the woman be in good health, and without occasioning much pain to the patient or trouble to the practitioner. But when, either from the restlessness of the patient, or from the improper interference of the practitioner, the water has been evacuated at an early period of the labour, the life both of the woman and infant must be exposed to considerable hazard. In this case the turning is not to be at- tempted till, by the administration of sixty or eighty drops of lauda- num, the pains are suspended. A neglect of this rule may be fol- lowed by very serious consequences. Dr. Denman relates three cases of the upper extremities present- ing, and the delivery being partly effected by the spontaneous evo- lutions of the child. In the first case, the woman had been in labour during the whole night, and one of the child's arms was the pre- senting part ; on attempting to turn the child, the pains were too violent to admit the introduction of the hand into the uterus. Ima- gining that the child was small, so that it might pass, doubled, through the pelvis, farther endeavours to turn were omitted, and, on waiting a little, the breech presented, and the head was the last part that was delivered. In the second case, the presentation was the same as in the first, and it was agreed on to turn the child ; but the pains were strong and frequent, so that the action of the uterus was such as to forbid all endeavours that way. It was then agreed to wait for the effect which a continuance of the pains might produce, or till they were abated, when the child might be turned with less difficulty. The pains continued and propelled the child lower in the pelvis, and in little more than an hour it was born, the breech being expelled, as in the first case. In the third case, the arm pre- senting, and labour gone on for some time, after which attempts were made during several hours to turn the child, whose shoulder strongly pressed upon the perinseum. At length, by the action of the uterus, the child was doubled and the breech expelled ; after which the shoulders and head were extracted. In all these cases, the Doctor observes, that the women were at the full period of utero- gestation, and the children were of the usual size. More cases might be related, but these sufficiently prove the fact, that, in cases in which children present with the arm, women will not necessarily die undelivered, though they are not assisted by art. With respect to the benefit we can in practice derive from the knowledge of this fact, it may be observed, that the custom of turning and delivering by the feet in presentations of the arm, will remain necessary and proper in all cases in which the operation can be performed with MANAGEMENT OF FEMALE COMPLAINTS. 437 safety to the mother, or give a chance of preserving the life of the child. But, when the child is dead, and when we have no other view but merely to extract the child, to remove the danger thence arising to the mother, it is of great importance to know that the child may be turned spontaneously by the action of the uterus. If we avail ourselves of that knowledge, the pain and danger which some- times attend the operation of turning a child, may be avoided. Some propose bleeding ad deliquum for abating the too strong contraction of the uterus, and, at the moment of fainting, to attempt delivery. PLURALITY OF CHILDREN. It has been supposed when women have conceived twins, there are certain symptoms before delivery by which that circumstance can be ascertained ; but there are no sure indications of the existence of a plurality of children till after the birth of one child, when this takes place, it is very easy to determine when any other remains. This may commonly be done without having recourse to the painful and indelicate means that have been proposed and practised : for, by feeling the state of the belly alone, a judicious practitioner can be very seldom mistaken on such occasions. When only one child has been originally contained in the womb, that organ, soon after delivery, diminishes very much in size, while the bowels, which are kept out of their natural situation, in the lat- ter months of pregnancy, immediately get forward to the fore part of the belly, and render it soft and yielding. But, when a second child remains, the womb does not apparently diminish in size. The intestines, therefore, remain behind and at the sides, and the fore part of the belly has the same hardness as before delivery. It some- times happens that the pains advance rapidly, and the second infant comes very soon after the birth of the first. In such cases, all that the practitioner has to do is to be assured that the second infant is in a proper position, and to take care so to conduct the extraction of the after-births that no alarming discharge may follow their expulsion. But, when the labour-throes cease, or become trifling on the birth of the first infant, the object of the practitioner should be neither to interfere before the woman has recruited sufficiently from her fatigue, nor to delay extracting the second child so long that the passages should become contracted, or the after-birth of the first-born be separated. Inattention to this important rule has been the cause of the loss of many lives. In more than the majority of cases, do more than an hour should be allowed to intervene between the birtii of both children. 43S MANAGEMENT OP FEMALE COMPLAINTS. If the delivery be conducted on this simple and obvious principle, although in many instances it becomes necessary to alter the posi- tion of the second infant, and in that way the woman must be put to a little pain, yet all hazard, both to mother and child, may be almost certainly avoided. It requires, indeed, considerable attention after delivery, to guard against loss of blood, which is a very com- mon occurrence, where there had been a plurality of children in the womb. FALLING DOWN OF THE NAVEL-STRING. A portion of the umbilical cord may be forced down, either natu- rally or in consequence of mismanagement. In the former case, it will be felt through the membranes at the beginning of labour; in the latter, it does not come down till after the waters are drained off. When the cord is felt originally through the membranes, the pa- tient should be kept very quiet, and in one posture, till the circum- stances preparatory to delivery are completely accomplished ; when the practitioner, by turning the infant, may probably be able to save its life. But when the early discharge of the water has occasioned the pro- trusion of the cord, it is not always in the power of a practitioner to obviate the threatening danger without exposing the life of the patient to much hazard, which is a risk that ought never to be incurred for the precarious chance of saving the infant CONVULSIONS DURING LABOUR. The precautions by which convulsions, during labour, may, in many cases, be prevented, have already been mentioned under the head of pregnancy, and the dangers to which pregnant women are exposed, when attacked with this frightful disease, have also been pointed out. But when it does happen in time of labour, the safety of the woman commonly depends on expeditious delivery; and, therefore, the proper means for accomplishing so important an object must be employed without delay. If the mouth of the womb be in any way opened or distended, the midwife should introduce the hand in a gradual manner, finger by finger, assist the dilatation, and bring the infant into the world. Should the convulsions continue after the birth of the child, and the MANAGEMENT OF FEMALE COMPLAINTS. 439 coming away of the after-burden, all that can be done is to keep the brain unloaded by topical bleeding, the bowels open by laxative medicines, and the irritability of the system counteracted by camphor and opium. A large blister may also be applied to the head, and small ones to the inside of each leg. FLOODING, DURING LABOUR, Arises in labour either from an accidental separation of the whole, or more commonly from a part of the after- birth, or from the unusual place of attachment of that substance. When the discharge is con- siderable, there cannot be a question that the patient must be deliv- ered either by turning the child or by the forceps, according to the stage of labour and situation of the child. After the birth of the child, if the natural powers do not separate the secundines within an hour, the practitioner should also perform that duty. When necessity obliges the practitioner to introduce a hand into the uterus, the back of the hand should be towards the uterus, and the hollow of the hand kept as close to the placenta or after-birth as possible in separating it, that the womb may not be injured. In some rare cases, the adhesion is so strong that it is impracticable to separate the whole of the cake without tearing the womb. The portion that is left generally becomes detached in three or four days, and its expulsion may be promoted by the use of a stimulating injec- tion. Such cases require the most serious attention, lest any putrid portion may be absorbed. After these stages of labour are safely completed, flooding some- times takes place. This is the effect of the womb not having become sufficiently contracted, and it requires different management in dif- ferent cases. If the discharge be profuse, cloths soaked in cold water and vinegar, applied to the naked belly, or even cold water poured on the part from a height, should be had recourse to. But some- times the flooding is not observable by the attendants, as the blood congeals as soon as discharged, and is collected within the womb and passages. This circumstance may be feared, if the woman be- come sick or faintish, or complain of ringing in her ears, or dimness of sight. In such cases, the womb must be forced into contraction by manual assistance. In all cases of considerable loss of blood, large doses oi' opium, frequently repeated, are found of the greatest service iti supporting the living powers. (See Immoderate Flow of the Menses — Pro- gress of Labour, and Abortion.) 440 MANAGEMENT OF FEMALE COMPLAINTS. MANAGEMENT OF CHILD-BED. A child- bed woman, as soon as all the circumstances of her labour have been adjusted, may, with propriety, consider herself as still in a state of health, and as requiring little more than the common cautions, and good management, on all occasions necessary to pre- serve it. The first hours after the delivery, provided some light nourishment have been taken, should be dedicated to quiet and sleep, and no person should be allowed to enter the patient's chamber, except such as are absolutely necessary. The chamber door, and even the win- dows, if the weather be warm, should be opened ; and the room, in every respect, kept as clean and as free from any disagreeable smelly as any other part of the house. The patient should often be supplied with clean linen, well aired ; for cleanliness and free pure air, are essential in this situation ; and upon the strictest examination, it appears that there never was miliary eruption produced without a sweat, nor puerperal fever without foul air. The heat of the room ought to be so tempered, that the pa- tient may neither be chilled with cold, nor yet suffer from sweat or burning. The strictest attention should be observed to have an evacuation daily by the use, if necessary, of mild laxatives, or by the exhibition of clysters composed of milk, oil, and sugar, or of soap-suds. It is a security against fever and inflammation, and even forms one princi- pal mode of relief when they occur. An equal regard should also be paid to get out of the bed, as soon as they can with propriety, and to sit up as long as possible without fatiguing themselves. If the lochia do not flow so plentifully as may be expected, or if they entirely stop, no regard need be paid to this circumstance, if the patient be otherwise as well as can be wished. We not only find this evacuation different in different women, but even in the same women in different lyings-in, from which she recovers equally well. Much mischief is often done by binding the belly too tightly. If there be any occasion for support, a thin napkin pinned very slightly round the waist, is all that is absolutely necessary, and the sooner this is disused the better. But little change takes place in the breasts, after the first months of pregnancy, until about the second day after delivery. Then it is usual to feel a great sensation of fulness in them, accompanied with a febrile irritation, which varies in different women, according to con- stitution and management ; but in all is favoured by temperance, a cool regimen, and composure of mind. The child should always be put to the breast early, before the milk can have stagnated in them, or they can have acquired any MANAGEMENT OP FEMALE COMPLAINTS. 441 great degree of hardness. It will be beneficial, both to mother and child, if this be done a few hours after delivery ; and this is most consistent with the operations of nature. If the patient have not nursed any former child, the infant will probably meet with difficulties in fastening on the nipples. In this case some older infant should be applied, or it will be proper to have them drawn by some other means without giving pain. Thick rings made of bees- wax, and fitted very exactly to the nip- ples, are often preventives of sores, by keeping the nipples elongated. They should be applied immediately after the child has finished its suction, and be put on so that the ends of the nipples may protrude themselves through them. These rings, however, ought not to be used when the milk runs out in too great quantities. If the woman do not suckle her child, no method should be used either to repel the milk, or invite it into the breasts. Nature will be certain to do her part. She is soon made sensible, that the blood determined to them is not wanted, and there will, therefore, be little farther effort made on her part to continue it, and it will in the course of a short time cease of itself. A cooling cathartic, with a suitable regimen, will entirely supersede the necessity of any local treatment, and is all that can be required, even when a mother has suckled before. No degree of fever in child-bed should be passed over unattended to, or be thought lightly of. Even the most serious are often slight at their beginning. Neither should any local pain, or tenderness, or fulness of the bowels, be neglected, lest they should arise from the incipient stage of some inflammation; which, if not checked at first by proper medicines or suitable regimen, might, in a short time, put on some alarming appearance. Let it be remembered, that it is much easier to prevent diseases than to cure them. The diet of lying-in women should be particularly attended to. All gross meats which might overload the stomach, or, by heating the woman, prove a cause of fever, should be strictly prohibited. But every patient, after child-bearing, ought not to be half starved, as some recommend. Proper regard in this respect should be paid to her habit, former manner of living, and present state. Too great indulgence, it must be remembered, is more to be dreaded than too much abstinence, though both extremes should be equally avoided. The bad effects of confined or impure air are now most univer- sally knoAvn ; consequently, the propriety and necessity of having the bed curtains always open, of preventing many visiters from crowding the room, of removing as speedily as possible every thing which can contaminate the air, and of admitting occasionally the fresh air, by opening the windows and doors, must be obvious. Women were formerly obliged to remain in bed for a certain num- ber of days after delivery, by which they were much weakened and fatigued. In modern times the practice has passed from one ex- treme to another. 56 4.42 MANAGEMENT OF FEMALE COMPLAINTS. This circumstance should surely be regulated according to the strength of the patient. When the woman feels that she can easily undergo the fatigue of rising, which, in ordinary cases, happens about the second, third, or fourth day, she ought to be taken out of bed that it may be properly adjusted. If she be made to sit upright, she will suffer considerable uneasiness; and, at the same time, by the bulky womb, (for that organ does not resume its natural state till two or three weeks after delivery,) pressing forcibly on the soft parts at the bottom of the basin, the foundation for a very troublesome and disagreeable complaint, namely, the falling down of the womb, must unavoidably be laid. She ought, therefore, to be placed in a po- sition half sitting and half lying, when out of bed, as long as the womb continues enlarged, by which means these inconveniences will be avoided. For the same reason, walking, even from one room to another, at least as long as the lochial discharge continues, and the womb is bulky, is highly improper. Many women boast that they have been able to go through the whole house within a few days after delivery ; but they often find, at a subsequent period of life, by the complaints which they suffer, that they had little cause to be satisfied with their own prudence, or the attention of the practitioner who indulged them in such liberties. DISEASES OF CHILD-BED. As there are certain natural causes of disease during lying-in, so there are certain disorders to which women of every description are liable, for some time after delivery. The most usual complaints which occur in child-bed are as follow ; namely : — Faintings. — The languid state in which many women are, im- mediately after delivery, is sometimes succeeded by faintings. This is not dangerous whilst the pulse and breathing continue good, and there is no unusual discharge. In this case the complaint may be attributed to the peculiar state of the body and mind of the patient at that time, and will be readily removed by the exhibition of a little wine, toddy, or any cordial. But when the faintings are attended with quick irregular pulse and cold extremities, the greatest danger is to be apprehended ; for it will generally be found that they are the consequences of some violent injury, or of great loss of blood. In this alarming case, if there be a considerable discharge from the womb, a soft cloth is to be pressed firmly on the external opening, and pressure should be made at the same time on the lower part of the belly with the hand, to prevent the womb from distending with MANAGEMENT OF FEMALE COMPLAINTS. 443 blood, and to excite its action. A large dose of laudanum or opium is also to be administered without delay. And the heat is to be pre- served by the application of warm flannels to the stomach, hands and feet. SHIVERINGS Occur from similar causes to f^intings, and sometimes in conse- quence of rash and sudden exposure to cold, after being heated with the exertion of labour. Nothing, in general, affords more speedy relief, than a tea-spoonful of spirits of hartshorn or laudanum in wa- ter. At the same time the ordinary means for restoring warmth, by the application of heated flannel, as recommended in case of fainting, ought to be had recourse to. If it should continue, the camphorated mixture, (see Dispensatory,) in doses of a table-spoonful every two hours, will be of service. This medicine, given as soon as the child is born, commonly prevents both shiverings and faintings in those who have been formerly liable to such symptoms. AFTER-PAINS. For some time after delivery, the contractions of the womb fre- quently continue, and occasion pain, which in some cases is so vio- lent as to resemble throes of labour. This complaint, termed after- pains, though productive of considerable uneasiness, is never to be considered dangerous. In general, they are most effectually relieved by a full dose of laudanum. When the pains continue after the exhibition of this medicine, warm flannels, or bladders, two-thirds filled with hot wa- ter, should be applied to the lower part of the belly. The campho- rated julep, in obstinate cases, will be beneficial, as well as clysters to open the bowels, and afterwards an opiate pill, or an injection of camomile tea, with two tea-spoons full of laudanum, should be administered. 444 MANAGEMENT OP FEMALE COMPLAINTS. LOCHIAL DISCHARGE. An increased and sometimes a continual discharge, after delivery, is often the consequence of getting up too soon, or making some early exertion. When this evacuation continues beyond the ordi- nary time, it occasions weakness, and requires the early employ- ment of means to prevent the train of nervous disorders, which com- monly succeeds a profuse discharge of the menses. With this view, tonic medicines, as bark and elixir vitriol, &c, must be employed along with nourishing diet, a liberal use of claret wine, and such other means as may support the strength. The importance of cleanliness, as long as the lochia! discharge continues, does not require being pointed out: but when the evacu- ation has a bad smell, common attention in that respect is not alone sufficient; for unless the most scrupulous regard be paid to prevent its stagnation in the passage of the womb, excoriations or inflamma- tion, with all their formidable consequences, will ensue. The nurse should, therefore, on such occasions, be directed to wash that organ by means of a syringe, twice or thrice a-day, with warm milk and water, or with an infusion of camomile flowers, or decoction of oak bark. The lochial discharge is in some women very trifling, and may even stop very soon without any bad effect. But when it is sud- denly checked by exposure to cold, or other causes, most painful consequences may follow, such as swelling of the belly, great pain, sickness, and fever. In such cases the evacuation ought to be pro- moted by sitting in a tub of warm water, or by the application of warm fomentations to the parts, and the exhibition of some gentle evacuating medicine, and afterwards endeavour to determine to the surface by the use of Dover's powder, with warm diluent drinks. MILK-FEVER. The breasts are greatly distended for the first two or three days after delivery, and in some cases a considerable degree of pain and fever are occasioned. The best management in these cases consists in gently rubbing the breasts with a little sweet oil morning and evening, covering them with flannel, and keeping the bowels open with some gentle laxative medicine. When the mother's health will not admit of suckling the child, she should have her breasts occasionally drawn, and every circum- stance which can contribute to the secretion of the milk, should be MANAGEMENT OF FEMALE COMPLAINTS, 445 carefully avoided. Great abstinence should, therefore, be enjoined, her body should be kept perfectly open with laxative medicine, and as little milk as possible taken. Ripe acid fruits ought to be used, which will assuage thirst, and by proving laxative, will assist to carry off milk and prevent its secretion. LACERATION OF THE PARTS. The excessive dilatation sometimes required for the exit of the in- fant, and the contraction which follows delivery, occasion a degree of soreness and of uneasy feelings that not unfrequently lead the wo- man to suppose herself torn. These feelings are removed by bath- ing, at first with warm milk and water and afterwards with warm spirits. But where the swelling is considerable, attended with throbbing pain, emollient poultices ought to be applied, and renewed every four hours, until suppuration takes place, and then treated in the ordinary way. (See Abscess.) Women are sometimes really torn during the birth of the infant ; which, in most instances, is the effect of mismanagement. Where the laceration is inconsiderable, little more than the ordinary manage- ment is required, as the process by which the passages are restored to their former state tends to reunite any slight separation of parts. INVERSION OF THE WOMB. There are two degrees of the inversion of the womb, namely, the partial and complete. The former, which is the more ordinary one, appears in the shape of a swelling as large as a child's head, pro- truded without the passages immediately after expulsion of the after- birth, accompanied with violent forcing and bearing-down pains, and followed by flooding, faintings, and urgent fruitless attempts to make water. This arises from a part, more or less, of that portion of the. womb, which had extended, previously to delivery, above the bones of the basin, being turned inside out. The other degree is so complete an inversion of the womb, that it is torn away from its attachments to the sides of the basin, the im- mediate consequence of which is instant death. Such accidents can only arise from rash and ill-directed endea- vours to extract the after-birth, by drawing down the navel-string before it can be completely separated. But whatever be the cause, 446 MANAGEMENT OP FEMALE COMPLAINTS. the part must be immediately restored, or the consequence will soon prove fatal; for its orifice will contract in its unnatural state, and so prevent the needful relief. Therefore, without delay, place the pa- tient on her back, with her hips raised, and gently return the uterus into the vagina with three fingers, and then with the whole hand place it in its natural position; after which, clench the first, and re- tain it there until the uterus contract upon it; lastly, apply the ban- dages as advised in the case of falling down of the womb, and direct the patient to remain in bed some days. SEPARATION OF THE SHARE-BONES. Is the effect of severe labour or of some former accident, or inflam- mation within the joint which connects these bones. This affection is distinguished from every other, by the pain being uniformly in- creased or excited upon the slightest motion of the lower part of the body, and by feeling the share-bones rasp against each other when either leg is moved. The treatment must depend upon the cause. Where these bones have been separated by a blow or fall, at a former period of life, they only require being held together by means of a broad belt, till the patient have regained strength. The cold bath, whenever it can be used with propriety, should be had recourse to, morning and evening, as it tends greatly to the accomplishment of that object. SWELLED LEG. This disease takes place at different periods after delivery, from the fourth or fifth day to the seventh week. It is ushered in with pain in the back, smart fever, and painful stiffness in the groin. Soon after these symptoms, the thigh begins to swell at the upper part, and gradually the swelling is extended to the whole limb, so that in a short time it is double the size of the sound one. It is rather pale-coloured than red ; and is called by some the white leg. It is hot, shining, very painful on being touched or moved, and at first it does not pit when pressed upon by the finger, and may be distinguished by the above marks. By active treatment at the beginning of the complaint, its progress may be certainly stopped. MANAGEMENT OF FEMALE COMPLAINTS. 447 The bowels should be kept open by salts or cream of tartar, and a determination to the skin produced by Dover's powders or some of the diaphoretic medicines. (See Dispensatory.) Should these not have the desired effect in arresting the disease, a grain or two of calomel, given morning and night, until a slight affection of the salivary glands are excited, and afterwards the nitric acid, will gene- rally succeed. Topical applications are also to be employed, as flannels wrung out in hot vinegar, and renewed as often as they become cold. Good effects have also been derived from the application of a strong solution of crude sal-ammoniac and sugar of lead in vinegar. When these fail to produce any good effects, surrounding the limb with a portion of English bran and sweet oil, with the addition of half an ounce of laudanum, or soft-boiled turnips, and renewing it night and morning, will afford considerable relief. The best application, how- ever, in such cases, when they can be procured, are the leaves of the thorn apple, scalded in vinegar ; with which the limb must be thickly covered, and then confined by a flannel bandage. Friction, with the anodyne or camphorated liniment, has pro- duced some good effects, but the mercurial ointment, united with camphor, has been externally employed with more permanent advantage. When the acute symptoms are over, and the limb remains weak, friction with the flesh brush is proper, and a roller should be applied with moderate firmness from the toe to the groin. The cold -bath is useful to re-establish the health. The diet, after the inflammatory symptoms have abated, ought to be nourishing; and sleep, when re- quired, should be procured by opiates INFLAMMATION OF THE BREASTS. This disease is easily known by the pain, hardness, and swelling which accompany it. In some cases, the whole breast appears to be affected, in others, only one side, and in some the affection is small and superficial. When the breast inflames, it is evident that the retention of the milk must, for a time at least, increase the pain. The first object then should be to have the breast drawn, either by the child or some other means ; but, should the milta not come away readily, and the pain be increased thereby, farther attempts must not be made; otherwise both the disease and the sufferings of the woman may be aggravated. A cooling diet and an open "state of the bowels are necessary while the swelling continues. And it 448 MANAGEMENT OF FEMALE COMPLAINTS. is better for the patient to remain in bed, as the weight of the breast, while in the erect posture, often increases the inflammation. The breast should be gently rubbed with a small quantity of sw T eet oil or unsalted butter, and poultices of crumb of bread and lead water ap- plied. If the pain and hardness do not very soon go off by this ap- plication, warm emollient poultices, as milk and bread, with a little oil, or united with the leaves of the thorn apple, must be had re- course to. These poultices will not promote suppuration unless the inflammation has proceeded so far, that that process has already be- gun, and in this case the sooner it is produced the better. If the abscess do not point and break soon, no good can be gained by delay : an opening should therefore be made, so as to evacuate the matter freely. This not only gives immediate relief, but pre- vents a farther extension of the mischief. The milk and bread or flax-seed poultices must be continued for a few days, in order to re- move the hardness, and then the part must be dressed, as in ordinary cases. (See Abscess.) Indurations remaining after an abscess, may be frequently reme- died by the application of a mercurial plaster, or cloths wet with the camphorated spirit, or rubbing the part, night and morning, with mercurial ointment, united with a little camphor. Sometimes after the abscess heals, and the breast seems to be cured, it swells a little, especially towards night. This is from weak- ness, and is cured by strengthening the constitution. In the early stage of this complaint, the best application made by the most experienced physicians, is warm vinegar. When the breast seems likely to suppurate, the following applications have been made with the greatest advantage. Olive oil two ounces. Sugar of lead one drachm. Sulphuric ether two drachms. Laudanum one drachm. The following has been highly spoken of. Carbonate of lead one drachm. Vinegar two ounces. Add spirits of wine one ounce. Distilled water, five ounces. To be applied to the breast, cold, with a piece of linen. The patient to be restricted to the lightest diet. Bowels to be kept open w T ith salts, magnesia, or senna and manna, The patient to be made to lie on her back and the breast to be lightly covered. Temperature of the air to be moderate and drinks cool. • SORENESS OF THE NIPPLES. The nipples, from the delicacy of their structure, are very liable to be injured by the action of the child's mouth in sucking, along with the irritation which the stagnant milk occasions, unless they be MANAGEMENT OF FEMALE COMPLAINTS. 449 kept very dry. Women are subject to this complaint more frequently while nursing their first or second child than afterwards; for the nip- ples lose much of their sensibility by use. In the treatment of this disease, the great object to be attended to is, to remove, as much as possible, every circumstance which can tend to irritate these parts. It is important to keep the nipple dry and cool, for which purpose rings of lead are generally worn. The nipple ought to be washed frequently with some gentle stimulating liquor, as brandy and water, or port wine, or a solution of alum or white vitriol, in the proportion of fifteen or twenty grains to four ounces of water : these must be frequently varied, for the same lotion soon loses its effects. A saturated solution of borax, in vinegar or water, with the addition of a little honey, has been very beneficial to sore nipples. In obstinate cases, the sores should be touched by means of a fine hair pencil, with a solution of blue vitriol, or the following liniment, which is highly extolled by Dr. Hamilton. Take of litharge and vinegar, each, two drachms, olive oil, six drachms, to be made into a liniment by rubbing the whole together in a mortar until it be- comes of a flesh colour, and the consistence of cream. Washing the sore nipples with a decoction of the roots of wild indigo, (see Ma- teria Medica,) is also celebrated as a valuable remedy in these affections. As long as we are under the necessity of applying any medicines to the nipples of the mother, it will be prudent not to suffer the child to suck her. Where this cannot, however, be dispensed with, the part should be well washed with a little warm water, each time, pre- viously to giving the child the breast. To prevent the sore from being aggravated by sticking to the woman's clothes, a little cup made of wax may be laid over the nip- ple, which is the part most apt to suffer. If only one nipple be affected, the child may be confined to the other ; but if both be af- fected, and the pain occasioned by its sucking i& too great to be borne, the woman must then desist from the duties of a mother until the excoriations are somewnat healed, taking care, however, to have the breasts drawn regularly twice or thrice a-day. In many cases where the woman has never nursed before, the nipples at first are not sufficiently prominent to afford a proper hold for the child. In such cases the breasts should be fomented by flan- nels dipped in warm water, and then, by gentle pressure on the sides of the breasts with the hands, the milk is pushed forward. At the same time the pressure is made, the nipple should be drawn out by a breast-pipe, and the instant the glass is removed, the child being put to the breast, will keep it out by sucking until satis- fied. After the operation has been repeated two or three times, the child, except in extraordinary cases, will find no difficulty in Bucking. Those who have been subject to sore nipples, should endeavour to diminish the sensibility of these parts, by applying to them for 57 450 MANAGEMENT OF FEMALE COMPLAINTS. several weeks previously to delivery, cloths dipped in alum water, in strong spirits, or in the pickle of salted meat boiled, which latter has been recommended as an infallible specific for that purpose. When little sores appear in the brown circle surrounding the nip- ple, and correspond with similar appearances in the child's mouth, or other parts of the body, there is just cause to suspect some latent poison lurks within the system, which, it is more than probable, it will require a mercurial course of medicine to subdue. INFLAMMATION OF THE WOMB Commonly occurs about the second or third day after delivery though in some instances later. The existence of it may be ascer- tained by pains in the lower part of the belly, which are greatly in- creased, by pressure, a constant fever, with a quick hard pulse, and a great prostration of strength. The lochial discharge is very early suppressed, and the secretion of milk very much diminished. It is commonly attended with sickness. It often happens that the woman can only lie on her back, and on turning to either side, she feels a painful heavy mass fall to that side, and at the same time an excessive pain in the loin, kidney, and groin, of the opposite side. Many causes tend to induce inflammation of the womb, such as abortion, difficult or tedious labour, the exhibition of heating and stimulating drinks, exposure to cold after delivery, ivo? time — £?/"* heat or temperature. The principle upon which the above mentioned articles cure and cause disease is one and the same, namely, their power of electrically altering the motive state of cer- tain parts of the body, and of changing at the same time their ther- mal conditions. These remedies are all of great efficacy ; but some of them more so than others, less with reference to the disorder, and its cause, than to the constitution, or peculiarity of system of indi- vidual patients. How conflicting (says the author of this system) are the views expressed by practitioners in reference to the effects of various medicines. By some, a particular remedy is extolled — by others it is denounced. These conflicting opinions are easily ex- plained. The difference of action of the same remedy at different times, depends upon certain electrical conditions of the brain. Remedies are valuable or not in proportion as they are capable of electrically or galvanically affecting temperature or motion — change in one never taking place without the other. The causes of disease can only affect the oody through the nervous system. No disease CHRONO-THERMAL SYSTEM. 515 can arise independent of this — no disease can be cured without it. Let the nerves of a part be paralysed and the most potent agents cease to exert their wonted influence over the parts supplied by such nerves. Divide the pneumo-gastric nerves of a living dog, and arsenic loses its accustomed effect on the lungs and stomach. Is not this one of many proofs that an external agent can only influence internal parts, by means of its electric power over the nerves con- nected with, or leading to those parts? Through the same medium and in the same manner, do the greater number of the chrono-thermal remedies exert their salutary influence on the human frame. All these forces act by attraction or repulsion. The brain and spinal column are the nervous centres through which, every medicine tells, and many are the avenues through which, these centres may be approached. Assimilation, secretion, absorption, the change of the matter of one organ into another, of the fluids and solids, and of solids into fluids, are (says Dickson) operatives of vital chemistry, and the brain and nervous system are electric apparatus by which these operations are effected. Let a bone or tendon be fractured, and they are reunited by the result of secretion under the influence of this electricity through the nerves supplying those parts. If, during childhood, the great nerve of a limb be paralysed, the growth of that limb is arrested in breadth and length. Nerves are the moving powers, destroy them, and all vital action ceases. The following is a summary of all the chrono-thermal doctrines : 1st. The phenomena of perfect health consists in a regular series of alternate motions, or events, each embracing a special period of time. | 2d. Disease under all its modifications is in the first place, a sim- ple exaggeration or diminution of the amount of the same motions and being universally alternative with a period of comparative health, strictly speaking resolves itself into fever — remittent, or intermittent, chronic or acute — -every kind of structural disorganization, from tooth decay to pulmonary consumption. 3d. The tendency to disorganization usually denominated acute or inflammatory, differs from the chronic or scrophulous in the mere amount of motion and temperature ; acute diseases being more re- markably distinguished by excess of both, exhibit a more rapid pro- gress to decomposition or cure ; while chronic diseases approach then srminations by less obvious alternations of the same action and temperature. The principles of the chrono-thermal system are few and simple : First. Fever remittent or intermittent comprehends every shade which disorder can assume. Secondly. That the treatment of every disease is to be conformed to that of intermittent fever. Thirdly. That attention to temperature is the end to all medicine. 516 CHRONO-THERMAL SYSTEM. Fourthly. That blood-letting may be dispensed with in nearly all diseases, even in apoplexy. The sum of this system appears to be this : that the movements of all animal bodies — the greater and the less — the atomic, the func- tional, and the organic — whether in health or disease — disease how- ever caused, like all the movements of all the systems, minor and major of the universe at large — are equally intermittent and periodic ; and that there can no more be a continuous disease (that is a disease without an intermission) than there can be an eternal earthquake, or an eternal tempest. It was Samuel Dickson who first established the periodicity of all animal movement — that look when you will — above — below — beneath — around — in the tempest and whirlwind — on sea or land — in heaven above or on earth beneath — in animals and in man — in health and in disease — the face of all things bears the impression of this same great, uniform, universal characteristic of periodicity — that life in health is really a " fitful fever " — a thing of alternate motion and rest — alternate chill and heat, depression and excitement — and that intermittent fever is the model or type of all the movements of life, called disease — that all medicinal agents in nature cause, and cure by their electric influence solely — in one case electrically producing — in another electrically reversing every mor- bid, motive condition of the body — that whether opium produce sleep or wakefulness — whether copaivi relieve or aggravate discharges — that whether prussic acid or strychnine cause or relieve paralysis and spasms depends upon the positive or negative electrical state of the brain of the individual patient. Samuel Dickson was the man who waived his magic wand over the chaotic mass, and brought harmony and beauty out of disorder and confusion ! 'Twas he that first breathed upon the irregular and jumbled materials, and part came to his part — portion to kindred portion, till a beautiful array of facts is presented in all the symmetry and proportions of truth ! He it was who first touched and retouched the shapeless marble, till forth appeared one by one, the glowing features of the perfect statue ! # * In giving the above brief summary we have as much as possible confined ourselves to Dickson's own language. MATERIA MEDICA Life's lowest, but far greatest, sphere I sing, Of all things that adorn the gaudy spring ; Such as in deserts live, whom, unconfined, None but the simple laws of nature bind ; And those who, growing tame by human care, The well-bred citizens of gardens are ; Those that aspire to Sol, their sire's bright face, Or stoop into their mother Earth's embrace ; Such as drink streams, or wells, or those dry fed Who have Jove only for their Ganymede ; And all that Solomon's lost work of old (Ah! fatal loss!) so wisely did unfold. Though I the oak's vivacious age should live, I ne'er to all their names in verse could give. — Cowley. " How wonderful are thy works, O Lord ! in wisdom hast thou made them all : the earth is full of thy riches." In all parts of these his Glorious Works, in their admirable fitness to one another, and their constant subserviency to the good of all, we behold the Wisdom and Goodness of the Great Creator. But in no department of his works do mingled wisdom and good- ness shine with greater lustre than in the vegetable kingdom. There is scarcely a plant that greens the fields, a flower that gems the pas- ture, a shrub that tufts the garden, or a tree that shades the earth, which does not contain certain medicinal virtues, to remove our pains and to heal our diseases. The American continent, though the last found, is not the least favoured of God in this respect. Embracing almost every clime and soil of the globe, it richly abounds with drugs of every healing quality. The common saying, that every country contains the best cures for its own diseases, seems fully verified in America. Here, above all countries, is the ague, and here, exclusively, is the grand cure, the Peruvian bark tree, or dogwood. And here too, exclusively, is found the Spanish fly, the tobacco, the Jamestown weed, the pink and snake roots, besides those other valuable plants, equal to the ipecacuanha, rhubarb, jalap, &c. &c, which have hitherto been im- 518 MATERIA MEDICA. ported at a great, expense, though not always genuine ; but which may now be obtained in our own fields and woods, both unadulte- rated and cheap. Worthy of the high character of Americans, many gentlemen of the finest genius among us have explored the medical treasures of our country, and have shown an eagerness to make known the pre- cious means to preserve the health and lives of our citizens. First on the list of this noble band of philanthropists stood that bright lite- rary and professional genius, the late Professor Barton, from whose " Collections towards a Materia Medica of the United States," much valuable matter has been selected. If by the laws of Rome, " a civic crown was adjudged to the man who saved the life of a citizen," what eulogy is sufficiently great to be attached to the memory of him who, besides illuminating several other walks of ornamental and useful knowledge, has by investigating the virtues of our native vegetables, laid the foundation whereby millions of our worthy citizens may be rescued from an untimely death. Professor Chapman, succeeding the lamented Barton as teacher of Materia Medica, gave additional interest to the studies connected with his department, and by the application of his powerful talents to the acquisition of appropriate learning and discovery, has made a handsome accession to the stock of knowledge before extant. In the chair of Materia Medica, this accomplished teacher displayed advantageously those happy qualities which have since secured to him the post he now enjoys, professor of the theory and practice of physic, &c. Professor Bigelow of Harvard University, and Elliott of South Carolina, have since communicated to the world the results of their valuable scientific labours in a series of interesting lectures and ela- borate publications. Much is due also to Professors Dexter, Mitchell, Hosack, Cox, Baker, Caldwell, and to Doctors Mease, Cutler, Thatcher, &c. Prom the valuable discoveries, and communications of these gen- tlemen, I have, with great industry and care, compiled an Ameri- can Materia Medica, exhibiting, in alphabetical order, the names y characters, and qualities of our best medicinal plants hitherto dis- covered, together with the diseases they suit, and their proper doses, and forms of administration ; the whole stripped of technical terms, and making, as I humbly hope, one of the most complete systems for family use now extant. AGARIC. See Touchwood. AGRIMONY, Agrimonia — Grows two or three feet high, in hedges and the margins of fields — blossoms in July on long spikes, MATERIA MEDIC A. 519 yellow. It is known by the vulgar name of cuckold, from the seeds sticking to the clothes in the fall of the year. In whey or tea it forms a good drink in fevers. The juice of this plant, or a strong infusion of the roots, two hands full to a quart of boiling water, and sweetened with honey, is an excellent medicine in the jaundice, scurvy, and habitual diarrhoea or looseness. Dose of the infusion half a pint ; of the juice a wine-glass full three times a-day. The herb has been applied externally to fresh wounds. ALDER, BLACK, Alnus Nigra — Sometimes called Virginia winterberry, grows in most places, generally sending up several slen- der stalks to the height of ten feet, and bears a red berry. The bark is tonic, and accordingly is used in substance, or in strong decoction, like the Peruvian bark, in intermittents, and other cases of debility, as dropsy, gangrene, &c. The inner bark in the shape of poultice externally, with the decoction internally, a handful or two boiled slowly in three pints of water to a quart, is celebrated both by Professor Barton and Dr. Mease, as of admirable use in arresting the progress of mortification. A strong decoction of the berries formed into a syrup with molasses in doses of a wine-glass full, or two tea-spoons full of the powder of the inner bark, is said to be a good purge. Dr. Thatcher recommends a decoction or infusion of the bark taken internally in doses of a tea-cupful, and employed also as a wash, for the cure of cutaneous eruptions, particularly of the her petic kind. ALEXANDER. See Parsley, Wild. ALUM ROOT, Heuchera Americana — Called also American Sanicle. The root is a very intense astringent. It is the basis of a powder which has lately acquired some reputation in the cure of cancer. Professor Barton observes that he does not believe that the alum root has cured genuine cancer; but that it has proved very beneficial in obstinate ulcers which have been mistaken for cancers. He says it is one of the articles in the Materia Medica of our In- dians, the powdered root of which they apply to wounds, ulcers, and cancers. ANGELICA, Angelica — Grows in marshy woods and hedges, flowering in June and July. It is frequently cultivated in our gardens. Every part of this useful vegetable partakes of its aromatic virtues, but especially the root, which, in the form -of powder, tincture or tea, is useful in flatulent colics. Conjoined with dogwood bark, or any other tonic, it may, like the Peruvian bark, be employed with advantage in intermittents and low stages of fever. The dose, one tea-spoonful, in substance, of the former to two of the latter. It 520 MATERIA MEDICA. may also be employed in the form of strong- decoction, in doses of a gill, or in cold phlegmatic habits, in tincture, either alone, or with dogwood berries, centaury, lemon peel, or any other articles of the bitter and tonic class. A strong decoction of the root, combined with red oak bark, a large handful of each to a pint of boiling water, makes an admirable gargle for relaxed and spongy gums, and ulce- rated sore throat. APPLE, PERU. See Thorn Apple. ARBUTUS. See Bearberry. ARROW ROOT, Maranta Arundinacea — Is cultivated in the southern states. A table-spoonful makes a pint of the finest jelly in nature, which affords the most nutritious food in acute diseases for children. To persons labouring under bowel complaints, as diarrhoea and dysentery, it is of itself a remedy. The jelly is made in the following manner : — To a table-spoonful of the pow T dered root, add as much cold water as will make it into a thin paste, and then pour on boiling w T ater through the spout, of a kettle, stirring it at the same time briskly, till it becomes a clear jelly ; after which, season it w T ith sugar and nutmeg, and, to render it still more palatable, a little wine or lemon juice may be added. But, to children, blending it with new milk is best. AS ARAB AC C A SWAMP, Asarum— Grows in low lands. It has but two leaves, which rise immediately from the root, and divide from one stem. The flowers are purple and bell-shaped, and pro- ceed from between the leaves. The whole of this plant has a nauseous bitter taste. — The root, from a half to a table-spoonful in powder, operates both upwards and downwards. In the form of infusion, a half-handful to a quart of boiling water, is said to be serviceable in the whooping-cough, in doses of a table -spoonful to children every half hour, or oftener, un- til it vomits; and in doses of a tea-cupful three times a-day, it has been used with success to promote the menses, or courses. AYENS COMMON, Geum Urbanum— Grows a foot high by fences and borders of fields. The blossoms are w T hite or yellowish in July. Its smell resembles that of cloves. A strong tincture of the root, two hands full, steeped in a quart of spirits, given to the quantity of a half wine-glassful or the powder, in doses of a tea-spoonful, several times a-day, has afforded an ex- cellent remedy in intermittents and other disorders where strength- ening medicines are requisite. It is said to be equal to the Peruvian bark. There is another variety of this plant, called water avens, throat root, cure all, which is to be found in boggy meadows. The bios- MATERIA MEDICA. 521 soms are purplish, and appear in May. Its properties are the same as the preceding. A decoction of it has been found beneficial as a gargle in ulcerated sore throats, which probably gave rise to the name of throat root, or throat wort. BACK-ACHE BRAKE. See Fern Female. BALM, Melissa Officinilas — Makes an excellent tea in fevers, and when sweetened, and acidulated with the juice of lemons or cream of tartar, forms a most grateful beverage. BARBERRY, Berberis Vulgaris — Grows along the sides of roads in hedges; — leaves oblong, tender, and subject to the rust; the flowers are in clusters: the fruit oblong, and acid, the stem is de- fended by three thorns. A double handful of the berries boiled in three quarts of water to two, and given in doses of a tea-cupful four or five times a-day, sweetened with white sugar, is extolled as a remedy in diarrhoea, dysentery, and jaundice. BASTARD IPECACUANHA. See Ipecacuanha American. BAYBERRY, Myrica Cerifera Humilis — Called also Dwarf- Candleberry Myrtle, grows in swamps to the height of two or three feet, and bears numerous green berries, of which tallow is made. The bark of the root has been considered a good remedy for the jaundice. The powder of it, in doses of twenty or thirty grains, has been employed as a mild emetic. The inner bark, in poultice, ap- plied morning and evening to scrofulous swellings, and drinking a tea-cupful of a strong infusion of the leaves, is said to have wrought surprising cures in a few weeks. BEARBERRY, Arbutas Uva Ursi — Bears whortleberry — wild cranberry. Is a low evergreen shrub, somewhat resembling the myrtle. The leaves have a bitter astringent taste, and unquestionably pos- sess great medical virtues, especially in relieving the irritation of the stone, gravel, and old cases of gonorrhoea, menstrual discharges, also catarrhs and consumptions. The dose — half a pint, twice or thrice a-day, of a decoction made of the leaves, a handful to a pint, or a tea-spoonful in substance, two or three times a-day. BEECH DROPS. See Broomrape Virginia. BENNE, Se Samum Orientate — Is now cultivated in South Carolina and Georgia. The leaves by infusion afford an excellent 66 522 MATERIA MEDTCA. mucilaginous drink, which is used with manifest advantage in dys- entery, diarrhoea, and cholera infantum. The seeds yield a pure and pleasant oil, which in doses from one to two wine-glasses full, acts well on the bowels. It is now gene- rally used at the tables of the wealthy, and from the specimen I had of it at the table of my honourable friend Governor Milledge, near Augusta, I consider it equal to the best Florence or salad oil. BETH ROOT, Trillium Rhumboydum — Grows in meadows, about a foot high — the leaves oval, three at the top of each stalk, one flower of a purple colour, bell-shaped, producing a small berry, that contains the seed — the root of a brown colour externally, bul- bous and full of small fibres. The powder of the root, in doses, of one tea-spoonful three or four times a-day, is said to be exceedingly useful in spitting of blood, im- moderate discbarge of the menses, or in cases of discharging bloody urine. It is also said to be a good application, in the form of poul- tice, to putrid ulcers, and to obviate gangrene or mortification. BIND WEED. See Potato, Wild. BITTER-SWEET. See Nightshade, Woody. BLACKBERRY, or DEWBERRY.— These, though different in name, are nearly, if not entirely, the same in nature. They both bear the same kind of berry, which, when ripe, is pleasant and wholesome. The roots of these vines, but especially of the dewberry, are fa- mous as astringents. From my own observation in practice, two hands full of the clear root in three pints of milk or water boiled to a quart, and given in doses of a tea-cupful every two or three hours, has often cured obstinate diarrhoea and dysentery, when the best medicines of the shop have failed. BLACK SNAKE ROOT. See Virginia Snake Root. BLAZING STAR. See Devil's Bit. BLOOD ROOT, Sanguinaria Canadensis — Has a variety of names, as Red Root, Puccoon, Indian Paint, Turmeric. It grows about a foot high in rich woodlands, and flowers in April. The leaves are roundish and deep indented; somewhat like the white oak leaves — stems naked, supporting single flowers ; blossoms white. When the fresh root, which is about the size of the little finger, and blood red, is broken, a juice issues in large drops resembling blood. According to Dr. Downie, the root in powder, from twenty to thirty grains, is strongly emetic. Professor Barton considers it nearly MATERIA ME DIC A. 523 equal to the Seneca or rattle-snake root in cases of ulcerous sore throat, croup and hives, and other similar affections. Professor Dexter celebrates it in doses of one grain of the powdered root, or ten drops of the tincture, every two or three hours, as an excellent diaphoretic in colds, or pleurisies, rheumatism, and other inflamma- tory complaints. A tincture may be prepared by steeping a handful of the root sliced in half a pint of spirits. It may also be exhibited in the form of decoction, a handful to a quart of boiling water, and a table-spoon- ful for a dose every two or three hours. The blood root is considered the chief ingredient of the quack medicine known by the name of Rawson's bitters ; recommended as a remedy for the jaundice. The juice of the root is said to be good for destroying warts. To Professor Smith, of Hanover, N H., the world is indebted for the discovery that this plant, used as a powder and snuffed up the nose, is a certain cure for the polypus. Professor Smith also found it of great use in the incipient stages of pulmonary consumption, given in large and repeated doses, and in cases of great irritation it was combined with opium. Professor Ives, of New Haven, considers the Blood Root as a remedy in many diseases of the lungs and liver. He observes, that in typhoid pneumonia, " in plethoric constitutions, when respiration is very difficult, and the cheeks and hands become livid, the pulse full, soft, vibrating and easily compressed, the Blood Root has done more to obviate the symptoms and remove the disease," than any remedy which has been used. He infuses from a scruple to half a drachm of the powdered root in half a gill of hot water, and gives one or two tea-spoonsful every half hour, in urgent cases. This treatment has often removed the symptoms in a few hours. Dr. Ives thinks highly of its use in influenza, in consumption, and particularly in whooping-cough. He also states that, given in large doses, sufficient to produce vomiting, it often removes the croup, if administered in the first stages. "It has been given," he remarks, " for many years, in the country ; some physicians relying wholly on this remedy for the cure of the croup." Dr. Macbride of Charleston, S. C, has found the Blood Root use- ful in Hydrothorax, given in doses of sixty drops, thrice a-day, and increased till nausea followed each dose. He also used it with ad- vantage, in torpor of the liver, attended with colic and yellowness of the skin, a disease common in southern climates. BLOOD WORT STRIPED, Lapatkum Sanguineum Bu- brum — Grows six or seven inches high, on the sides of banks and in upland woods. Out of the top of the stalk, which is small and bare of leaves, grow small purple flowers, which turn into husks that contain the seed. The leaves, three or four in number, lie flat upon the ground, are hairy, and full of red winding veins; the root small, tough, and fibrous. 524 MATERIA MEDICA. An infusion of this plant, a handful to a quart of boiling water, in doses of a tea-cupful every three hours, is said to be useful in re- straining immoderate flowing of the menses, and all other hemorr- hages. A strong decoction of the roots with half the quantity of sugar or honey, and formed into a syrup in doses of a table spoonful every hour or two, is beneficial in consumptions or violent coughs. The expressed juice, in doses of a wine glassful, and the leaves bruised, and frequently applied to the wound from a snake, or any venomous insect, is said to eradicate the poison. BLUE CARDINAL FLOWERS. See Lobelia. BONE-SET. See Thoroughwort. BOWMAN'S ROOT. See Indian Physic. BOXWOOD. See Dogwood. BROOMRAPE VIRGINIA, Orobanche Virginiana— Grows from Canada to Georgia, and rises six or eight inches high, of a brown colour, brittle sprigs, but no leaves ; the root is bulbous. It is generally found under the shade of the American beech tree, hence it is sometimes called beech drops, but more generally cancer root. Every part of this plant is considerably astringent, and along with the astringency, especially in the recent plant, there is combined a peculiar and extremely nauseous bitterness. It has been celebrated as a remedy in dysentery, but its principal reputation is in cancerous affections. It is supposed this formed part of the celebrated cancer powder of Dr. Hugh Martin, whose success in the management of many cases of this dreadful disease, has been acknowledged by the regular practitioners of Philadelphia. It is certain, says Professor Barton, that the powder of cancer root has been of great service, externally applied to obstinate ulcers, some of which had resisted all the ordinary applications. The fresh-bruised root has also been applied with good effects to cancerous sores. In the form of decoction it has been found useful as a wash to gallings in warm weather, or excoriation of the skin. It is also esteemed a good application in cases of St. Anthony's Fire. BUCK THORN, Spina Cervina — Grows in hedges. It is a prickly bush; which flowers in June, and produces in the fall a round black berry containing four seeds. Equal parts of the expressed juice of the berries and molasses, 01 half the quantity of sugar, with a little calamus or ginger, formed into a syrup by a gentle fire, is said to be a good purgative medicine in doses of a large wine glassful, and is much used in the cure of dropsies. MATERIA MEDICA. 525 BURDOCK, Arctium Lappa — Grows on the road-side, on rub- bish and ditch banks, bearing purplish blossoms in July and August, The juice of the fresh leaves, or an infusion or decoction of the roots, operates gently on the bowels, sweetens the blood, promotes sweat and urine, and is esteemed serviceable in scorbutic, rheumatic, and venereal disorders. The juice is given in doses of a wine glass- ful, and the decoction half a pint three times a day. BURNET SAXIFRAGE, Pimpinella— Grows about a foot high. The leaves are variously shaped, flowers in September ; the seeds are furred and egg-shaped. The root, in the form of decoction, a handful to a quart of water, is esteemed by some a useful medicine in asthma, coughs, and ob- structions of the menses, in doses of a wine glassful twice or thrice a-day, sweetened. BUTTERFLY WEED. See Pleurisy Root. BUTTER-NUT. See Walnut, White. BUTTON SNAKE ROOT.—" The button snake root grows in South Carolina and Georgia, in poor pine land, the root bulbous, with numerous fibres, of a pungent nitrous taste ; the leaves or blades long, narrow, pointed, and saw-edged. A stalk shoots up in autumn, to the height of three feet, bearing globular prickly flowers, of an ash colour, which, from a fancied resemblance to buttons of an old fashion, gives it its name. " This root is a powerful sudorific ; but, in cases of gangrene and foul ulcers, is, perhaps, superior to any thing yet discovered. The mode of applying it, is in the form of poultice, by boiling it soft."* * For the above I am indebted to my honest, but unfortunately too credulous friend, Paul Hamilton, Esq., formerly Secretary of the Navy, whose zeal and success in exploring the virtues of our indigenous plants can never be suffi- ciently applauded. For these and many other patriotic virtues, a kind Provi- dence was pleased to raise him up a son as disinterested and public spirited as nimself; I mean that extraordinary youth, Lieutenant Archibald Hamilton, who, in defence of his country, went forth in the early period of life to meet the veteran tars of Great Britain. He was a midshipman on board the United States frigate, when after a short action she captured the British frigate, Macedonian. His activity and valour in that brilliant affair were so conspicuous, that the gallant Decatur assigned to him the honourable and pleasing duty of bearing the British co- lours to the seat of government. With uncommonly good fortune he had ar- rived at Washington on the very evening that the President and his lady, with me heads of departments, at a splendid ball, were celebrating this glorious victory. I had the pleasure to be one of the party, and never shall I forget the looks of his venerable father, his most amiable mother, and charming sisters, when this blooming young warrior was ushered into the crowded ball room, with the trophies of American valour. The joy manifested on this occasion was not confined to his relations alone; for it was to be seen in the counte- nance of every one present, but more especially in the young females, who. 526 materia medica. CALICO TKEF^^Kalmia Latifolia — Broad-leafed laurel; called also winter green ; grows seven or eight feet high in swamps and moist rocky pastures ; blossoms are white, tinged with red in June or July. There is another species, Kalmia Augustifolia, narrow- leafed or dwarf laurel, called also ivy, lambkill ; blossoms reddish, variegated. A decoction of the plant externally applied has often cured the itch ; but, like all other poisons, it should be used with great caution. An ointment, made by simmering the leaves in hog's lard, is good for the scald head and obstinate sores. According to Dr. George G. Thomas, an obstinate diarrhoea has been cured, by the decoction made from an ounce of the leaves in half a pint of water, boiled to half, and thirty drops three or four times a-day. In this form it has also been used internally with great success in the scald head. CALAMUS, OR SWEET FLAG, Acorus Calamus— Grows in marshy situations, and in shallow water, and may be known by the long sword-shaped leaves, resembling those of the blue and yellow flags, but narrower, and of a brighter green. The root is like that of the blue flag in appearance, but has a strong aromatic smell, and a warm pungent taste. The flavour is greatly improved by drying. The root possesses stomach virtues, and is frequently grated into water, and given to children for flatulent colics, free of fever. It is sometimes used as an ingredient with dogwood, cherry bark, cen- taury, &c, in morning bitters, as a preventive of the ague in low marshy situations. CAMOMILE, Chamcsmelum — Grows well in our gardens. An infusion, or tea, made of the flowers, is excellent to warm and strengthen the stomach in cases of indigestion, loss of appetite, and other complaints arising from debility. It is also of great use in doses of a tea-cupful three times a-day, as a preventive to ague and fever, and bilious fever in sickly situations. In the form of fomen- tation and poultice it is serviceable in discussing hard tumours. as was very natural to suppose, from his unassuming and graceful deportment, could not conceal the tender emotions of their hearts. To the honour of the President,, this modest and amiable youth was soon after promoted to a lieutenancy. He followed the fortunes of Commodore Decatur, when he shifted his flag from the United States to the President; and was with this intrepid officer when in that single frigate he endeavoured to fight his way through a British squadron. In this most unequal conflict the President was overpowered, hut not until she had completely silenced one of the hostile frigates. By the last shot that was fired from the enemy, the gal- lant young Hamilton was killed. To say he was brave to the height of that heroism which has raised the in- fant navy of his country to be the admiration of the world, is to say but half his praise. The far nobler praise was his, of having rendered himself the idol of his brother officers, and his numerous relations and friends — to all of whom he has bequeathed the inexpressible pleasure of attaching to his memory every thing that was amiable and good. MATERIA MEDICA. 527 CAMOMILE, WILD. See Mayweed. CANCER ROOT. See Broomrape Virginia. CANDLE-BERRY MYRTLE. See Bayberry. CARAWAY, Carum Carui — A choice aromatic ; grows kindly in our gardens. The seeds assist digestion, strengthen the stomach, and are serviceable in flatulent colics. The dose of the seeds in powder, from one to two tea-spoons full to adults. CARROT, WILD, Daucus Carato. — The wild carrot grows two or three feet high in meadows and swamps, and flowers in July. The seeds have an agreeable aromatic smell, and in a slight degree, a warm pungent taste. An ounce or half a handful of the seeds infused in a pint of water, and taken in doses of a tea-cupful every hour or two, is said to give immediate relief in suppression of urine, and is also serviceable in promoting the menses. The roots of the carrot cultivated in our gardens, beaten to a pulp, form an excellent application to cancerous and other ill-conditioned ulcers, allaying the pain, checking the suppuration and fetid smell, and softening the callous edges. A marmalade of carrots, on ac- count of their strong and antiseptic qualities, has been successfully used for preventing and curing the sea scurvy. An infusion of these roots has also been found useful in gravel complaints. CASTOR OIL, Ricinus Communis — Flourishes well among us. The kernels yield almost a fourth part of their weight in oil, which is obtained from them either by expression or decoction. Expression is the best method of preparing; but the common mode is to shell the seeds and boil them in water, and as the oil rises, to skim it off. Castor oil is a gentle and useful purgative, and is a most efficacious remedy for the colic or dry belly-ache, and also dysenteries, in doses of a wine-glassful every two or three hours until it operates. In doses of a tea-spoonful, it is the most suitable purge, when not ran- cid, to expel the meconium from new-born infants. CAT-GUT, or GOAT'S RUE, Galega Virginiana.—li is vul- garly called cat-gut, from the resemblance of some of its roots to the article of that name. A decoction of the roots is reputed to be an excellent medicine for destroying worms. CELANDINE, THE GREATER, Chelidonium Major— Grows about two feet high, in meadows and by running brooks, has many stalks, with larger joints than is common in other plants, very easily broken ; the leaves large and saw-edged ; the flowers, consist- 528 MATERIA MEDICA. ing of four leaves, are yellow ; after which come long pods enclosing black seeds ; the roots long, reddish externally, and yellow within and full of yellow juice. Twenty or thirty drops of the juice, or half a tea- spoonful of the dried root in powder, in a cup of new milk, morning and night, is said to be beneficial in dropsy, green sickness, and cutaneous erup- tions. The juice rubbed on warts, ring and tetter worms, effectually cures them. A poultice made of this plant boiled in milk, or the roots roasted, and mashed in vinegar, is extolled by some as an ex- cellent application to disperse scrofulous tumours on the neck. CENTAURY, Centaurium, minor — Is a fine stomach bitter, and either in a simple infusion, or united with calamus or angelica root, is excellent in relaxations of the stomach and general debility. CHERRY TREE, WILD, Prunus Cerasus Virginiana.— The bark of this tree is an excellent substitute for the Peruvian bark. I have myself frequently employed it in the cure of ague and fever, bilious fever, and other diseases where tonic medicines were proper. In intermittents of long standing, I have found it more efficacious when united with the Virginia snake root, in the proportion of one part of the latter to four of the former. It may be employed, either in powder, or decoction in the same doses as the Peruvian bark. A strong infusion of it in sound cider, is said to be useful in the jaun- dice. A decoction of the bark will be found a good wash to ill-con- ditioned ulcers. The cherry of the tree, when ripe in autumn, is much used in the southern states, for making bounce and cordial. — The gum of the common cherry tree is a good substitute for the gum Arabic. CHICK-WEED, RED, Annagallis Phenicea— Called also red pimpernel, guach-hul — is cultivated in many gardens, and grows spontaneously near Baltimore and Havre de Grace. According to the deposition of Valentine Kettiring to the Legisla- ture of Pennsylvania, and report made by their committee, the red chick-weed is a specific in that most dreadful of all diseases the hydrophobia, or bite of a mad dog. The dose for an adult is a small table-spoonful of the dried leaves in powder. For beasts the dose is much larger. CINQJJEFOIL, Potentilla Reptans — Grows on pasture grounds, and is something similar to strawberry. The stalks trail along the ground, and have but five leaves on each stalk, placed together, of an equal size, and bear a yellow flower. The whole of the plant, particularly the root, in the form of de- coction, a handful to a quart of water, or milk, boiled slowly, and sweetened with loaf sugar, is recommended as a remedy for the dysentery and bowel complaints. The dose for adults is a tea cup- MATERIA MEDIC A. 529 ful three or four times a-day, and one third or half the quantity for children. CLEAYERS. See Goose Grass. COCUM. See Pokeweed. COCK-UP-HAT, OR YAU WEED, Stillingia—Giows on the high dry lands of the southern states, and is much used there as a cathartic medicine. It is employed in the cure of that hideous disease, the yaws, and is said to be a specific in the venereal disease. COHUSH, OR PAPOOSE ROOT, Caulophyllum Thalictro- ides — Grows about two feet high, in low, moist, rich grounds, near running streams, and on islands that have been overflowed. The leaves grow on small stalks near the top of the stem, which resem- bles the hand and fingers. The flowers are of a pale blue colour, which yield a berry something like grapes. The root is composed of many fibres, and is crooked, resembling the rattle snake root. An infusion of the root, a handful to a quart of boiling water, in doses of a tea-cupful three or four times a-day, or the same quantity steeped in a quart of spirits, in doses of a wine glassful twice or thrice a-day is highly extolled by the country people as a remedy for the rheumatism, and serviceable in cases of obstruction of the menses and dropsical complaints. COLT'S FOOT, Tussilago Farfara— Grows about eight inches high, in moist situations, producing yellow flowers, early in the spring, which appear before the leaves. These are soon succeeded by large roundish leaves, which have a bitter mucilaginous taste. It is said a decoction of the leaves and flowers, two hands full to a quart of water, with or without milk, taken freely, is serviceable in coughs, consumptions, diarrhoea, and dropsical complaints. The leaves, finely powdered, and used as snufT removes giddiness and obstructions of the head. COLUMBO AMERICAN, Columba Americana— Grows plenti- fully in the western country, in the vicinity of the Ohio river ; and, from abundant experiments, is found fully equal to the imported. It has long been esteemed a powerful antiseptic and tonic ; and as such, has been employed with manifest advantage in gangrene, cholera morbus, bilious vomiting, or purging, bilious fever, indiges- tion, want of appetite, &c. It may be given in powder, in doses of a small tea-spoonful every three or four hours, or in decoction, in doses of a tea-cupful. Two or three ounces or the root, steeped in a quart of spirit, forms an excellent bitter; which, when taken in mint water, or infusion of orange peel, in doses of a table-spoonful, is excellent for moderating the retching in pregnant woman. 67 530 MATERIA MEDICA. COMFREY, Consolida — Grows about two feet high in moist situations near springs, but is cultivated in our gardens. The leaves are large, similar to water dock, flowers of a pale blue colour ; the roots long, rather thicker than a man's finger, mucilaginous, and black externally, but white within. A handful of the roots boiled in milk, and given in doses of a tea- cupful three or four times a-day, is a popular remedy in dysentery, bowel complaints, and the fluor albus, or whites. It is also bene- ficial as a diet drink in the clap, or in other cases attended with a burning heat in making water. CORIANDER, Coriandrum — Is cultivated in our gardens. The seeds are warm, and of a pleasant flavour, and in doses of a tea to a table-spoonful, have been found useful in cases of indiges- tion and flatulence. When mixed with senna, they more effectually correct the odour and taste of the infusion, than any other aromatic. They also form an excellent addition to ingredients for bitters. COW PARSNIP, Heracleum Spondylium — Is found in hedges, meadows, and pastures ; but should be carefully distinguished from the hemlock or wild parsnip that grows in hedges, and is poisonous. According to Dr. Orne of Salem, it has been often used with success in epilepsy, especially in cases of indigestion with flatulence. The dose is three drachms of the powdered root, taken daily, and a strong infusion of the leaves and tops drank at bed-time. CRANE'S BILL, Geranium Maculatum — Improperly called by some crow foot. It grows five or six inches high in meadows and woods ; has long slender stalks, with seven long narrow leaves at a joint. The root is generally crooked and knotted, blackish on the outside, and reddish, has a rough taste, with an aromatic flavour. When applied externally, it is highly extolled for its styptic power, in stopping hemorrhages of wounded vessels. The powdered root, in doses of a tea-spoonful thrice or four times a-day, or a decoction in milk, used as a common drink, is said to be excellent in checking immoderate menstrual discharges, also the whites and gleets, and ob- stinate diarrhoea. The following account of the efficacy of crane's bill, as stated by Dr. Mease, in the Medical Museum, deserves the attention of the reader. The son of Mr, David Cooper, near Woodbury, partially divided the artery at the wrist with the point of a hatchet in trimming a tree ; the wound bled profusely, and an aneurismatic tumour of the size of a pullet's egg was quickly formed. Dr. Hendry, who was imme- diately called, applied a tourniquet, and also a piece of flat lead to the tumour ; and apprehending that the usual operation would be necessaiy, requested the assistance of Dr. William Shippen from Philadelphia. On the arrival of that gentleman, the operation was MATERIA MEDICA. 531 resolved on ; when the father of the young man insisted upon the trial of a vegetable remedy, which he said he had learned the use of from one of the aborigines of our country. He immediately repaired to the woods, and returned with some of the specific, which was pounded in a mortar with a little cold water, and applied to the part, and in a short time, to the great satisfaction of the sufferer and his friends, checked the bleeding. The tourniquet was left on as a pre- cautionary measure, but fortunately no occasion offered for using it. In the course of a few days the wound healed, and the young man had no farther trouble. A man in pruning a tree, divided the stout muscles of the forearm in an oblique direction ; the wound was full four inches in length, and bled profusely from a large artery, and numerous smaller ves- sels. His shirt sleeves was filled with blood ; for being made tight round his wrist and forearm, it prevented the blood from escaping, and forming a coagulum round the bleeding orifice, checked for a short time farther effusion. The powerful effects produced by the geranium in the former case, induced Dr. Hendry to apply it in the present ; accordingly, he pro- cured some of the roots, and after washing and pounding them, filled the wound therewith : the effect upon the smaller vessels, was almost instantaneous in checking the profusion of their contents, and the bleeding in a short time entirely ceased ; and although, as in the former case, the tourniquet was \ery properly suffered to remain, yet no occasion offered for using it. Another case occurred of a wound in the ankle from a scythe, which had bled so profusely as to cause the man to faint ; but on the application of the geranium by Dr. Hendry, as above, it ceased in a short time. In the instance of a violent vomiting of blood, which had resisted a variety of remedies, an infusion of the plant in water, produced the desired effect in a few minutes. Another instance mentioned to me by Dr. H., of the astringent effect of the geranium, was that of a young man who had a most obstinate hemorrhage from the socket of a jaw-tooth, which had been extracted. An attempt was made by a physician from Philadelphia to close the bleeding orifice by burning it with a red hot needle, but without effect; on the application, however, of the geranium, the bleeding soon ceased. In consequence of the virtues of the gera- nium having been so often experienced about Woodbury in cases of hemorrhage, the inhabitants have been induced to cultivate the plant in their gardens; and it would be Avell if their example were followed by every one in the country; for though Providence has diffused the valuable plant over every part of our country, yet as it grows princi- pally in the woods, and the accident it is intended to relieve may admit of no delay, and often happens in winter, when the plant can- not be found, it should be transferred to every garden, that it may be at hand when wanted. 532 MATERIA MEDICA. CROSSWORT. See Thoroughwort. CROW FOOT, Ranunculus Bulbosus — A very acrid plant, growing in meadows and fields. The leaves or roots bruised and applied to any part of the body, will soon raise a blister, and ought to be used when the Spanish flies cannot be obtained. The roots, collected in the fall, may be very well preserved through the winter by burying them in some fine dry sand. CUCKOLD. See Agrimony. CUCKOW BREAD. Set the following. CUCKOW PINT, Arum Maculatam— Also called lords and ladies, wake robin, dragon root. The leaves are generally bespan- gled with black and white spots, striped in gaudy style ; whence the country people have given it the name of lords and ladies. The root is bulbous, resembling a small turnip. Both this and the leaves, in a fresh state, are extremely acrid, and have been used with advantage externally for blistering, and inter- nally in cachexies, rheumatisms, and all other complaints of cold phlegmatic habits. Of the fresh root, from ten to thirty grains may be taken thrice a-day, in the form of emulsion, which gum Arabic, or cherry tree gum. The root, which should be used fresh, may be kept so for a year, by burying it in a cellar in sand. CUCUMBER ROOT, Medeola Virginica— According to Pro- fessor Barton, is a very common plant. The root is white, and tastes a good deal like the cucumber. It possesses diuretic proper ties, and has cured dropsies. CURE-ALL. See Averts. CURRANTS, Ribes— The white, red, and black currants, all grow luxuriantly in our gardens; and when perfectly ripe, and made with sugar and water, into the form of lemonade, serve as a most grateful and cooling drink in fevers. An infusion of the bark, sweetened with currant jelly, or honey, is an excellent gargle in sore throat, and an infusion of the young shoots is said to be beneficial in eruptive fevers. Currants afford an excellent wine; for making which, the following is an admirable recipe : — Of red or white currants, ripe, take fourteen pounds, broken into three gallons of water, and let it stand for two days, when the stalks, &c, will be at the top. Press off all the stalks, and, while straining the mixture, add twelve pounds of sugar; turn it into a cask, and keep it full enough to let the feculent matter work out — repeatedly removing it, and filling it up, until no more rise, which will be in MATERIA MEDICA. 533 about fourteen days ; add to it one quart of spirits nearly tasteless, or else brandy, and bung up close, keeping it at least six months before it is bottled. Let the currants be gathered free from dew or rain; and if they be spread a day or two before they are used, they will be none the worse. Fourteen pounds will make one gallon of juice, twelve pounds of sugar another gallon; therefore, the above ingredients should be equal to five gallons, and enough to fill up with. CUSTARD APPLE, Annona Triloba— -It is said to be a good purgative medicine. DANDELION, Leontodon Teraxacum — Vulgarly called piss-a- beds, grows in meadows, pastures, and road-sides and ditch-banks, with yellow flowers; which blow from April to September, and pos- sess the remarkable quality of expanding early in the morning, and closing in the evening. The root, leaves, and stalk, contain a large proportion of bittei milky juice, which, in doses of a wine-glass full twice or thrice a-day, is good in chronic inflammations of the liver, dropsies, diffi- culty of making water, and other complaints arising from obstruc- tions of the viscera. It may also be taken in the form of a strong decoction, from a gill to a half-pint, twice or thrice a-day. DEADLY NIGHTSHADE. See Nightshade, deadly. DEERBERRY. See Mountain Tea. DEVIL'S BIT, Veratrum Luteum — The root of this plant is a very pungent bitter, and is employed as a tonic, either in the form of tincture or infusion. In this last form it has been employed as a vermifuge. DEWBERRY. See Blackberry. DILL, Anetheum Graveolens — Flourishes in our gardens, pro- ducing seed delightfully aromatic, which, in doses of one or two tea-spoons full, is excellent to remove flatulent colics, and assist digestion. DOCK WATER, OR WATER DOCK, Rumex Aquaticus— Grows in wet ditches, mill-ponds, sides of rivers, and in shallow water, flowering in July and August. Half a pint of a decoction of the leaves or roots, two hands full to a quart of boiling water, or two or three tea-spoons full of (he dried roots in powder, taken two or three times a-day, is an admirable medicine to sweeten and purify the blood in scurvy, scald head, tetter-worm, and other cutaneous diseases. The fresh roots bruised, and mixed with vinegar, or in strong decoction, are a good cure of 534 MATERIA MEDICA. the ring-worm, and have often subdued that filthy complaint the itch, when quack medicines, and even sulphur, had failed. They are also worth trying in the form of a poultice to tumours, and cancerous ulcers. The curled dock, narrow and broad-leafed dock, which grow in yards and cultivated fields, are all varieties of this useful plant, and possess similar virtues. It is said the narrow-leafed dock, applied in the form of fomentation and poultice, to a cancerous sore, and from a pint to a quart of the decoction taken daily, makes a perfect cure. DOGWOOD, Cornus Florida.— The bark of this famous tree, which may well be termed the chinchona or Peruvian bark of North America, possesses, like that, all those tonic powers, which give it such admirable control over intermittents, gangrene, and all diseases proceeding from debility. From my own observation in practice I am abundantly warranted in pronouncing it generally preferable to the imported bark, which is often injured by adulteration. Like the Peruvian bark, but in somewhat larger doses, it may be used in substance or decoction, in- fusion or tincture, either alone or conjoined with snake-root, or some of the aromatics. But the shape in which it will be found most agreeable, is that of an extract ; which is easily prepared by boiling the bark, straining it, and then evaporating it very slowly to the consistence of honey. To prevent the fatal effects of burning it, the vessel in which it is evaporated should be of the wide-mouth sort, placed in a large pot of boiling water, and often stirred towards the close of the operation. The dose is from a half to a whole tea-spoonful, three or four times a-day. The beautiful red berries of dogwood, combined with lemon-peel, snake-root, calamus, or any other warm aromatic seeds, form a fine bitter against the common fall complaints. DRAGON'S CLAW. See Fever Root. DRAGON ROOT. See Cuckoo Pint. ELDER COMMON, OR BLACK, Sambucus Niger— Grows to the height of a small tree, in hedges, and along the border of meadows : the young shoots are full of pith ; and the old stalks empty ; flowers in July, and the berry of a blackish purple colour when ripe. The expressed juice of elder berries put into a plate, or wide- mouth vessel, and evaporated in the sun to the state of an extract, in doses from a tea to a table-spoonful, acts as a good aperient medi- cine. A tea made of the leaves, a large handful to a quart of boiling water, and taken freely, removes a costive habit, promotes perspira- tion, and thus proves useful in eruptions of the skin, St. Anthony's MATERIA MEDICA. 535 fire, colds, dropsies, and all obstructions of the viscera. The inner green bark, steeped in wine, a large handful to a pint, or made into a strong decoction, purges gently, in doses of a gill. The flowers stewed with lard, form a good ointment for burns. Elder berries also make an excellent wine, according to the fol- lowing recipe : Elder wine is made by mixing twelve gallons and a half of ripe elder berry juice, and forty- two pounds of sugar, with thirty-seven gallons and a half of water, that previously has had boiling in it six ounces of ginger, and nine ounces of pimento, bruised and strained ofT; and when it has nearly cooled, rather less than milk warm, add a pint of thin brewer's yeast, and let it foment for fourteen days, in the barrel, then bung up close, and bottle in six months. ELECAMPANE, Inula Helineum — Grows three or four feet high, in stony pastures, and by the road-side : flowers large and yellow, in July and August ; and the root, when dry, has an agree- ble aromatic smell, and in a decoction sweetened with honey, or in the form of syrup, or a tea-spoonful of the powdered root in mo- lasses, is recommended for promoting expectoration in asthma and coughs. The fresh root in ointment or strong decoction, is said to cure the itch. ELM, AMERICAN, OR SLIPPERY, TJlrnus Americana— My very learned friend, Professor Mitchell, has witnessed its good effects internally in catarrhs, pleurisies, and quinsies, and externally as a poultice for gun-shot wounds, tumours, and all ulcers and sores accompanied with irritation. A tea- spoonful of the inner bark in powder, to a quart of boiling water, or a simple infusion of the bark in boiling water, forms an astonishingly rich jelly, which I have often tried with the happiest effects in diarrhoea and dysentery. With the addition of a little sugar, lemon juice, citron, or nutmeg, it might be made an excellent substitute for sago, or arrow root. I am indebted for this improvement to the reverend and very amiable Dr. Gant, many years chaplain to Congress, and physician to Mr. Jefferson. This learned gentleman, universally celebrated for his successful treatment of dysentery, declared to me with great candour, that he ascribed much of his reputation in that dangerous disease to this fine jelly. EMETIC WEED, OR INDIAN TOBACCO, Lobelia Infla- te* — Grows in dry fields, and rises to the height of one or two feet, with branched stems, flowering in July and August, with blown cups, filled with numerous small seeds. The blossoms are solitary, in a kind of spike, of a pale blue colour. The leaves are oblong, and have a very acrid and pungent taste, similar to that of tobacco. The leaves collected in August, while the plant is in blossom, and carefully dried and preserved, act as a speedy and excellent emetic, 536 MATERIA MEDICA. in doses from ten to twenty grains ; or it may be exhibited in the form of a saturated tincture, in doses from a tea to a table-spoonful. As it is a medicine of considerable activity, it should be given in small quantities ; and the dose repeated every ten or fifteen minutes, until it excites vomiting. From its speedy operation as an emetic, there is no doubt it would be an effectual remedy for the croup and whooping-cough. In small doses it must be of great utility in con- sumptive and other coughs, by exciting expectoration. It is, how- ever, valued on account of its approaching nearer to a specific in that most distressing disease, the asthma, than any other that has been yet discovered. The following highly interesting observations from the Rev. Dr. M. Cutler, an eminent botanist, who first noticed the virtues of this plant, is related in Dr. Thatcher's American New Dispensatory. " By chewing a small portion of it, commonly not more than one of the capsules, it proves a gentle emetic. If the quantity be a little increased, it operates as an emetic, and then as cathartic, its effects being much the same as those of the common emetics and cathartics. " It has been my misfortune to be an asthmatic for about ten years. I have made trial of a great variety of the usual remedies, with very little benefit. In several paroxysms, I had found relief more fre- quently than from any thing else, from the skunk cabbage. The last summer I had the severest attack I ever experienced. It com- menced early in August, and continued about eight weeks. Dr. Drury, of Marblehead, also an asthmatic, had made use of a tincture of the Indian tobacco, by the advice of a friend, in a severe paroxysm early in the spring. It gave him immediate relief, and he has been entirely free from the complaint from that time. I had the tincture made of the fresh plant, and took care to have the spirit fully satu- rated, which, I think, is important. In a paroxysm, which was, perhaps, as severe as I ever experienced, the difficulty of breathing was extreme, and after it had continued a considerable time, I took a table-spoonful. In three or four minutes my breathing was as free as it ever was, but I felt no nausea at the stomach. In ten minutes I took another spoonful, which occasioned sickness. After ten minutes I took a third, which produced sensible effects upon the coats of the stomach, with moderate puking, and a kind of prickly sensation through the whole system, even to the extremities of the fingers and toes. The urinary passage was perceptibly affected with a smarting sensation in passing urine, which was probably provoked by stimulus on the bladder. But all these sensations very soon sub- sided, and a vigour seemed to be restored to the constitution; which I had not experienced for years. I have not since had a paroxysm, and only a few times some small symptoms of asthma. Besides the violent attacks, I had scarcely passed a night without more or less of it, and often so as not to be able to lie in bed. Since that time I have enjoyed as good health as perhaps before the first attack. Dr. MATERIA MEDICA. 537 Cutler states a particular case has been related to him, of an effectual cure of the hydrophobia, or bite of a mad dog in the last stage of the disease, by this plant. In a disease so formidable as this, it is cer- tainly worthy of trial." Dr. Bradstreet, of Newburyport, has given the saturated tincture in cases of dyspepsia, also in some cases of a rheumatic nature, with beneficial consequences. He considers its sensible effects to be very like those of common tobacco, but its medicinal action more speedy and diffusible, and of shorter duration. He thinks that it affects those accustomed to the use of tobacco as readily as others. The active properties of the Lobelia are readily extracted both by water and alcohol. The tinc- ture, however, is most easily kept, and is the most convenient form for exhibition. The tincture is prepared by digesting two ounces of the dried plant in a pint of diluted alcohol. A tea-spoonful given to an adult will generally produce nausea and sometimes vomiting. In certain instances, however, much larger doses have been given, without producing any other effect than a flow of saliva. ERGOT, OR SPURRED RYE, Secale Cornutum.—Rye is subject to a disease, in low wet situations, or when a hot summer succeeds a rainy spring. The spurious substance called ergot, is found projecting from among the leaves of the spike or ear; it is a long crooked excrescence resembling the spur of a cock, pointed at the extremity, of a dark brown colour externally, and white within. Some spikes are occupied wholly by spurs, while others have two or three only, interspersed with genuine seeds of rye. This extraordinary substance possesses considerable medicinal pro- perties. In lingering and laborious cases in child-bed, it acts as an invaluable medicine, speedily inducing forcible pains, and expediting delivery. It is given in the form of powder, in doses of from five to fifteen grains ; but it has sometimes been found more active in the form of decoction, prepared by gently boiling thirty grains of the powder in half a pint of water, of which one-third may be taken every twenty minutes, until proper pains shall have commenced. It is proper, however, to caution the domestic practitioner against employing this powerful medicine in cases of preternatural presenta- tion, or even in every case of natural presentation. The powerful and continued efforts of the uterus, from the effects of the ergot, pre- vent the retreat of the child's head after being advanced, and (lie unceasing pressure, in some instances, occasioned the death of the child. Let this circumstance, therefore, have its due effect, and induce the utmost precaution in the administration of this powerful article. This medicine has also been successfully employed in cases of obstructed menses, or monthly evacuations. (See Thatcher's Dis- pensatory.) 68 538 MATERIA MEDICA. EVERGREEN CASSINE. See South Sea Tea. FEATHERFEW, OR FEVERFEW, Matricaria Vulgaris.— It is frequently cultivated in gardens. A handful of the leaves and tops infused in a quart of water, and given in doses of a tea-cupful three or four times a-day, is used by country people to promote the menses, to strengthen the stomach, to raise the spirits, and promote perspiration in colds and fevers. FENNEL, SWEET, Famiculum Dulce— Grows kindly in our gardens. A tea-spoonful of the seeds, with a little sugar and spirits, is a common remedy among the country people in flatulent colic. To children afflicted with the above complaint, an infusion of the seeds, sweetened, is highly serviceable. The seeds yield an aro- matic oil, which, in doses from two to twelve drops, removes flatu ience, promotes expectoration, and is serviceable in coughs. FERN FEMALE, OR BACKACHE BRAKE— Grows near ponds, and iu moist pastures, about twelve inches high. The leaves are single, winged, and about a hand's length ; the root is about the size of a goose-quill, of a brown colour, very sweet, and of a muci- laginous taste. A quart of a strong decoction of the roots, and a pint of honey, formed into a syrup, by gentle simmering, and given in doses of a table-spoonful every hour or two, is esteemed highly beneficial, in all violent coughs. It is said that three parts of the roots of this plant, and one part of sumach root, boiled slowly in any kind of spirits, until it becomes slimy, and then applied warm to the spine, has frequently relieved the backache ; hence the vulgar name back- ache brake. It has also been employed as a remedy for the rickets in children. FERN MALE, Polypodium — Called also sweet fern, male poly- pody. It grows in woods and stony places, flowering from June to October. The root, when chewed, is somewhat mucilaginous and sweet, and afterwards astringent and bitter. Sweet fern in powder, in doses from one to two tea-spoons full, or a decoction, a pint a-day, followed on the fifth day with a dose of castor oil, or some purgative medicine, is esteemed a powerful medicine against worms, and particularly the tape worm. FEVER BUSH, OR WILD ALLSPICE, Demus Febris— Grows in meadows and swamps, and generally rises five or six feet nigh, leaves numerous and somewhat spear-shaped ; the blossoms rather of a reddish colour ; the berries are blood red, and of a plea- sant smell. A handful of the twigs of this bush, infused in a quart of boiling MATERIA MEDICA. 539 water, and given in doses of a tea-cupful every hour or two, is said to be extremely cooling and beneficial in fevers. A handful or two of the berries infused in a quart of spirits, forms a pleasant bitter. FEYER ROOT, OR DRAGON'S CLAW— Grows upon moun- tains and the sides of hills ; about six or seven inches high ; the J eaves grow in a cluster from the top of the root; spear-shaped ; blossoms yellow ; the root black, about the size of cloves, very ten- der, resembling the claws of the animal whose name it bears. When it is pulverised and exposed to the air, it will liquify. The root in the form of powder in doses of a tea-spoonful or in the form of decoction, a handful to a quart of water, in doses of a tea-cupful every hour, is esteemed an excellent medicine in bilious fever, pleurisy, colds, St. Anthony's Fire, and other febrile diseases. FIG TREE, Ficus. — This tree ought more generally to be cul- tivated in our gardens, as it affords a fruit both grateful to the sto- mach, and easy of digestion, possessing also medicinal properties. A decoction of figs makes an excellent gargle for cleansing the throat and mouth ; and the fruit, externally applied to tumours, or gum biles, is good to promote suppuration. When unripe, figs, as well as the whole tree, yield an acrid milky juice, which, if taken, proves both emetic and purgative, but externally is a mild caustic : hence it is frequently used to remove warts, ring and tetter worms. FLAG, BLUE, OR WATER FLAG, Iris Pseudacoris— Grows by the brink of rivers, in swamps and meadows, blossoming in July ; flowers blue, variegated with white, yellow, and purple. The juice, in doses of a tea-spoonful, diluted with water, is said to be an active cathartic medicine, and to produce copious evacua- tions from the bowels, and to be useful in dropsy and dysentery. It produces similar effects in powder, from thirty to sixty grains, and has been employed as a vermifuge. In the form of decoction, used as a diet drink, it is greatly extolled in venereal cases. The root of the yellow flag, mixed with the food of hogs that have been bitten by a mad dog, has been known to save, when without it others have run mad. FLAG, SWEET. See Calamus. FLAX-SEED, Linum — Possesses great medicinal virtues. An infusion, or tea, is the most suitable drink for patients labouring un- der violent colds, coughs, difficulty or burning in making water. The flax-seed syrup, which is prepared by adding a pint of honey to a quart of strong tea, and simmering it away slowly by a gentle tire for an hour, observing to take off the scum as it rises, I have found to be a most valuable medicine in diseases of the breast and lungs, 540 MATERIA MEDICA. in doses from a tea to a table-spoonful every hour or two, or often er, when the cough is troublesome. The flax-seed bruised, also forms one of the best emollient poultices with which we are acquainted. FLEA-BANE, PHILADELPHIA, Erigeron Philadelphicum — Called, by some, skerish. It is said, by Professor Barton, to be a very common plant in many parts of the United States, and that in the form of infusion or decoction, it operates powerfully as a diuretic, and also as a sudorific. It is likewise reputed to be a good remedy for promoting the menstrual discharge. In Virginia there is a plant called pisswort, which is esteemed a powerful medicine in cases of strangury, or difficulty of urine. FLOWER DE LUCE. See Flag, Blue. FLUX ROOT. See Pleurisy Root. FOXGLOVE, Digitalis Purpurea — Has lately been cultivated in our gardens. It rises to the height of two or more feet, and its leaves are large, egg-shaped, notched like a saw, and covered with hairs. Blossoms of a beautiful purple colour, hanging downwards in a row along one side, which are compared to the fingers of a glove, and in the inside are elegantly mottled with spots like little eyes. The foxglove has been employed with advantage in those disor- ders where the frequency of the pulse requires to be abated. In the incipient stage of consumption, it has, b} r diminishing the circulation through the lungs, frequently succeeded in arresting the progress of the disease. It has also been advantageously employed in the second stage, but here it should be exhibited with the greatest pre- caution. The treatment of consumption with foxglove, cannot be more satisfactorily shown, than in the following practical remarks of my learned friend, Dr. John Spence, of Dumfries, Virginia, commu- nicated in that useful work, the New York Medical Repository : — " In the incipient stage of consumption, where there is considera- ble vigour of constitution, particularly if attended with active hemor- rhage from the lungs, I push the use of the digitalis cautiously, but freely ; that is, I try to reduce the pulse under sixty strokes in a minute, and maintain this depression for two or three weeks, not- withstanding there be occasionally considerable and distressing nau- sea. At the same time, I advise a milk and vegetable diet, with gentle exercise on horseback, or in a carriage, when the weather will admit, and the use of the swing-chair for an hour at a time, or twice or thrice a-day. When the pains about the chest are wandering, I also advise the repeated application of a blister, and other stimulating plasters, to the breast, and between the shoulders ; but if the pain be fixed, I prefer the introduction of a seton, as near the part affected as possible. My patient is also directed to drink moderately of emol- MATERIA MEDICA. 511 lient teas, or tar- water, to be warmly clothed, to avoid cold and wet feet, and setting up late at night. All great exertions of the body, but particularly of the lungs, as singing, or speaking loudly, must also be carefully avoided. In the second or more advanced stage of this disease, accompanied with a quick pulse and great general debility, the treatment is very different. The foxglove must be so managed, as to lower the pulse, and moderate the fever, but never pushed to such an extent, as to excite nausea or sickness at the stomach. A little experience will soon enable a judicious and attentive practitioner to ascertain the dose adapted to his patient's constitution ; and as soon as he has attained this knowledge, he must be persevering in the use of the medicine. At this period of the disease, the patient's strength must never be suffered to languish. He must be supported by nutritious diet. Agreeably to the present manners of society, two or three meals are taken in the course of the day ; but this mode of eating is very improper with delicate constitutions, more food being generally eaten at such stated periods, than is necessary ; thereby causing great heat, accelerating the pulse, and throwing the whole system into commotion. The diet should be nourishing, and of easy digestion, such as jellies, broths, eggs boiled soft, oysters, raw or moderately roasted ; indeed, a bit of fowl, beef, mutton, or venison, dressed rare, may be taken in small quantities every two or three hours through- out the day. This deviation from the present fashion of eating is indispensable, ample nourishment being thereby thrown into the system without exciting irritation. At the same time I recommend solid food in this way, I forbid the use of spices, wine, or spirits. The same directions respecting topical applications and exercise, are equally applicable to this as the incipient stage, and particularly the exercise of swinging ; and care must be taken that the swing-chair be so constructed, that the patient may be perfectly at ease without being afflicted with fatigue or bodily exertion." Many other respectable physicians bear testimony in favour of this medicine in consumptive cases. Dr. Beddoes of London, considers the foxglove almost as infallible a remedy in consumption, as the Peruvian bark in intermittents. From its power of reducing the force of the circulation, it is esteemed likewise a valuable remedy in bleeding of the nose, spitting of blood, and excessive discharge of the menses, and also palpitation in the heart, from the passions of the mind, or intemperance. Dr. Rand, of Boston, has experienced the most decidedly good effects of this medicine in most of the preceding complaints. In one instance, haemoptoe, or spitting of blood, in a very athletic young man, where the discharge eluded the force of every other medicine, it reduced the pulse in eight hours, from one hundred to fifty pulsa- tions in a minute, and stopped the hemorrhage. He has also given the medicine with complete success in cases of mental derangement Foxglove possesses also diuretic power ; and has long been em- &42 MATERIA MEDIC A. })]oyed in dropsy. It unquestionably acts powerfully as a diuretic, or in evacuating the water in dropsy, and will be found of the great- est utility in every species of this disease, but more especially the dropsy of the breast, where there exists an increased action in the system. However, from the respectable authority of Dr. Withering, and the celebrated Dr. Darwin, we are assured it had been exhibited with the most happy effects, in cases of extreme debility, where the pulse was feeble, intermitting, and the countenance pale. It should not be given in such doses as to excite much sickness or purge, otherwise it will not produce its diuretic effect. The best rule for its administration, is to commence with the smaller doses, twice or thrice a-day, and gradually increase the quantity daily, until the medicine either act on the kidneys, the stomach or the bowels ; and on the first appearance of any of these effects, it is to be suspended. After evacuating the water, tonic or strengthening medicines should be employed. Dr. Currie, another physician of great emi- nence in England, has employed this medicine with signal advan- tage in inflammation of the brain, heart, and lungs, and found it also an excellent remedy in the inflammatory rheumatism. The leaves of this plant are the part in use, of which from one to three grains in powder, may be given to an adult twice or thrice a-day, alone, or united with some aromatic, or the powder may be formed into pills with soap, or the crumbs of bread, or it may be given in the form of infusion, by infusing a drachm of the dried leaves in half a pint of boiling water, for four hours, adding to the strained liquor one ounce of any spiritous water; from one to two table- spoons full to be given twice or thrice a-day, as a medium dose for an adult. Another more convenient way of ascertaining the dose of foxglove, is by making a saturated tincture of it in proof spirits, which has the twofold advantage of being invariable in its original strength, and of keeping a long time without losing any of its virtues. Put two of the leaves nicely dried, and coarsely powdered, into a half pint of spirits ; let it stand by the fire-side twenty-four hours or longer, frequently shaking the bottle, and thus making a saturated tincture of foxglove, which must be poured from the sediment, or passed through filtering paper. From twenty to sixty drops of the tincture may be taken in a little mint-water, or tea, two or three times a-day. This medicine has also been externally applied with good effects. An infusion of it is recommended as a good wash for painful cutaneous eruptions, or ulcerations. An ointment prepared by simmering the leaves in lard or fresh butter, has been found suc- cessful in scrofulous ulcers and scald head. FRENCH APPLE. See Thorn Apple, FROSTWORT, Sijstis Canadensis — Grows in woods, about two feet high, leaves small and numerous, of a whitish colour, like frost; MATERIA MEDICA. 543 the stalk purple; flowers of a pale colour, producing a small pod with veiy small seed. It is said, in cases of scrofula, or king's evil, an infusion of the leaves, a handful to a quart of boiling water, in doses of a tea-cupful three times a-day, and the leaves in the form of a poultice, applied to the swelling twice a-day, has performed cures. FUMITORY, Fumaria Officinalis — Grows in corn-fields, and by fences, and rises a foot high ; leaves pale green, and the flowers of a reddish purple. The leaves, in the form of infusion, a handful to a quart of boiling water, and taken in doses of a tea-cupful thrice a-day, are esteemed a good medicine in scabby eruptions, and all cutaneous diseases, particularly if the eruptions be washed with the infusion. GARGET. See Poke Weed. GARLIC, COMMON, Allium Sativum — Is highly stimulating, and, therefore, useful to persons of cold, phlegmatic constitutions. It provokes the appetite, assists digestion, removes flatulence, pro- motes expectoration and urine ; and hence has long been used in scurvy, asthma, and dropsy. Where it cannot be taken in substance, the best form is either in syrup or pills. Externally applied, it blisters the skin. A poultice or cataplasm of equal parts of bruised garlic and crumbs of bread, mixed with sharp vinegar, applied to the soles of the feet, in the low stage, of acute disorders, or nervous fever, is good to raise the pulse, and relieve the head. Sydenham says it exceeds all other applica- tions for occasioning a revulsion from the head, and that the efficacy of garlic, thus applied every night, until slight inflammation be pro- duced, is superior to Spanish flies. It is an excellent remedy in cases of croup, or violent sore throat. (See Onions.) It will also be found a good application to the pubes in producing a discharge of urine, when its retention has arisen from want of due action of the bladder. When made into an ointment, it is said to disperse cold and indolent tumours, and has been esteemed for its efficacy in cutaneous eruptions. In deafness, a small clove of the root, wrapped in gauze, cotton, or wool, moistened with the juice, and introduced into the ear, has frequently proved an efficacious re- medy, if repeated twice or thrice a-day. GENTIAN, Gentiana — Grows on the sides of roads, and in waste pastures, two or three feet high. The stem is strong, smooth, and erect ; the leaves, which rise from the lower part of the stem, are spear-shaped, large, ribbed, and rough : flowers yellow, in whorls, terminating in yellow bitter berries. Its virtues are equal to the imported. It has long occupied the first place in all recipes for bitters, whether used to provoke the ap- 544 MATERIA MEDICA. petite, or give tone to the system. It may also be taken in the form of infusion, a small handful of the root to a quart of boiling water, in doses of a tea-cupful three or four times a-day. In the form of a decoction, it is used with decided advantage in pneumonia cases, where the fever is nervous, and it acts as a tonic and sudorific; a tincture of it is esteemed as a remedy in dyspepsia, given in doses of one-fourth or half an ounce. It is said to increase the appetite, prevent the acidification of the food, and to enable the stomach to bear and digest articles of diet, which before produced oppression and dejection of spirits. GILLENIA, COMMON, Gillenia Trifoliata— Grows in woods, in light soil ; flowers in June and July ; and has commonly a num- ber of stems from the same root which are a foot or two in height, erect, slender, smooth, of a reddish tinge, and considerably branched. The leaves are alternate, and slightly toothed ; the flowers few in number and scattered; and the root branched and knotty. The root, when boiled in water, imparts to it a beautiful, deep red colour and an intensely bitter taste. This plant has long been known to practitioners as an emetic. Professor Bigelow adds his testimony of its possessing properties in a certain degree analogous to those of ipe- cacuanha. Dr. de la Motta, of Charleston, S. C, testifies to its effi- cacy, as an emetic both upon an empty stomach and a full one. Twenty or twenty -five grains, divided into four equal parts, each taken every fifteen minutes, are the proper dose. GINSENG, Panax Quinquefolium — Is thinly scattered through- out the mountainous regions of the northern, middle, and western states, between the 38th and 47th degrees of north latitude. It in- habits rich, shady woods, the declivities of mountains, and the banks of torrents. The stem is smooth, round, and green, regularly divided at the top into three branches, with a flower stalk in the centre. It flowers in July, and has red berries. The root consists of one or more fleshy, oblong portions, of a whitish colour transversely wrinkled. This plant is precisely the same with the Asiatic, the roots of which are so highly valued in China. The Chinese consider the ginseng as possessing unequalled medicinal powers, and their phy- sicians have written many volumes upon the qualities of the plant. It is made an ingredient in almost all remedies which they give to the nobility, its price being too expensive for the common people. The sick take it to recover health, and the healthy to make them- selves stronger and more vigorous. They affirm that it removes all fatigue, either of body or mind, dissolves humours, cures pulmonary diseases, strengthens the stomach, increases the vital spirits, and pro- longs life to old age. Its price at Pekin, according to travellers, has been eight or nine times its weight in silver, and even more. The report of the high value of the ginseng in China led to an MATERIA MEDICA. 545 inquiry among Europeans, whether the plant was not to be found in parallel latitudes in the forests of America. Father Lafiteau, a Jesuit, after much search in Canada, found the plant in the year 1717. The French and the Anglo-Americans commenced the col- lection of the root, and large quantities were exported. The first shipments to China proved extremely profitable. In a short time, however, the supply overstocked the market, the Chinese began to think the American ginseng inferior to the Tartarian, and its value depreciated, so that it ceased to be an object of profitable commerce. Its demand has not materially risen at any subsequent period, though it is still occasionally exported. The Chinese most readily purchase the forked or branching root ; and those exporters have been most successful who have prepared their ginseng by clarifying it after the Chinese manner. They dip it in scalding water, and scour it with a brush. The roots are then prepared with the fumes of a species of millet, to give them a yellow colour. The millet is put in a ves- sel with a little water, and boiled over a gentle fire. The roots are placed over the vessel upon transverse pieces of wood, being first co- vered with a linen cloth or another vessel. When treated in this way, they assume, upon drying, a horny or semi-transparent ap- pearance. The roots may also be dried in the sun, or by the fire, and retain their qualities perfectly. In this case, however, they have not that yellow colour which the Chinese so much admire. As far as ginseng has been tried in this country, and in Europe, its virtues do not appear, by any means, to justify the high estimate of it by the Chinese. That it is not a very active substance, is proved by the fact, that a whole root may be eaten without incon- venience. Its place in the Materia Medica is among demulcents. It has an agreeable taste, consisting of a mixture of sweet and bitter, with some aromatic pungency. Dr. Fothergill tells us that " in tedious chronic coughs, incident to people in years, a decoction of it has been of service. It consists of a lubricating mucilage, com- bined with some degree cf aromatic warmth." Ginseng is princi- cipally used as a cordial ; many persons chewing it or taking it steeped in wine or spirits, in doses of a wine glassful twice a-day. As a masticatory, ginseng is innocent and refreshing. It forms an excellent substitute for tobacco. I have repeatedly prescribed it to those whose constitutions have been injured by the immoderate use of tobacco, and, in every case, have witnessed the most beneficial consequences from its use. It is necessary, however, that the saliva should be swallowed. GOLDEN ROD, OR THREAD. See Mouth Root. GOOSE GRASS, Galium Aparine — Called by some Poor Ro- bin's plaintain, from its efficacy in curing the gravel. Grows in hedges, low grounds, and near brooks, to the height of 69 546 MATERIA MEDTCA. five or six feet, climbing on the bushes near it. The upper side of the leaves is white, with sharp prickles ; the flowers small, and di- vided into four segments: these change into a fruit rather large, composed of two berries slightly adhering together and covered with hooked prickles, containing two seeds. The leaves in the form of decoction, a handful to a quart of water, are highly celebrated as a remedy in gravel complaints, and suppres- sion of urine, in doses of a tea cup full every hour or two, until relieved. It has also been recommended in the cure of scurvy, spit- ting of blood, and epilepsy or fits. GROUND HOLLY, Pyrola Umbellata — It is sometimes called Pipsissewa, which is its Indian appellation. It possesses, in an eminent degree, the same properties as Bear's Whortleberry, which see. GROUND PINE, Arthetica — Grows plentifully in stony lands, about six inches high, sending forth many small branches, with small narrow grayish leaves, somewhat hairy; flowers of a pale colour, growing from the joint of the stalk, among the leaves, after which come small round husks. A large handful of the leaves and flowers steeped in a pint of wine, and taken in doses of a wine glassful twice or thrice a-day, is said to be beneficial in rheumatism and uterine obstructions. GROUND PINK, Silene Virginica— Called also catch-fly. A decoction of the roots is said to have been found a very efficacious remedy for worms. GUINEA PEPPER. See Pepper, Red. HART'S TONGUE — Grows among rocks and shady places, the leaves being of a shining black colour, long, pointed, and tongue shaped. This herb, in the form of infusion, a handful to a quart of boiling water, in doses of a tea cupful two or three times a-day, is said to be a good remedy in diarrhoea and dysentery ; and in the form of oint- ment, prepared by simmering a handful of the leaves in half a pint or more of lard, is a good application to scalds and burns. HEART'S EASE, OR HERB TRINITY, Viola Tricolor— Grows generally in corn-fields, producing white and yellow blossoms, intermixed with purple, which flower from May to September. A decoction of a handful of the fresh leaves, or half the quantity of the dried, in a pint of milk, used daily for some weeks, is said to be a certain remedy for that disorder in children, called milk scab, or that species of scald head which affects the faces of children. MATERIA MEDICA. 547 HEART SNAKE ROOT— Flourishes in Carolina and Georgia, in rich and high lands, never exceeding the height of six inches. The root is of a very aromatic taste, and the smell somewhat resem- bling the sassafras. The leaf shaped like a heart, dark green, and very glossy on the upper surface. The juice of the root and leaf pounded together, in doses of a table-spoonful for an adult, is an active and safe emetic ; and a decoction in as large quantities, and as frequent as the stomach will bear, is of excellent service in the jail, camp, and nervous fever. HELEBORE, WHITE, Veratrum Album— Grows in wet mea- dows and swampy places. The stalk is thick, strong, hairy, upright, and usually rises from two to four feet. The leaves are large, oval, ribbed, plated, of a yellowish colour, and surround the stem at its base. The flowers are of a greenish colour, and appear from June to August, followed each by three flat pods, containing whitish tri- angular seed. The root is short, commonly near an inch thick, with numerous fibres hanging from it, of a brown colour externally : it has, when fresh, a nauseous bitter taste burning the mouth and fauces; and, snuffed up the nostrils in very small quanties, excites most violent sneezing. Every part of this plant is extremely acrid and poisonous. By the hand of skill, it has been employed internally, with beneficial effects, in several obstinate diseases, as those of the melancholic and maniacal kind, and epilepsy, king's evil, herpetic, and other cutane- ous affections. In these complaints, the bark of the root, collected in the spring, has been given in the form of powder, beginning with half a grain at a dose, and gradually increasing the quantity daily, according to its effects. The American species, says Dr. Thatcher, very probably possesses all the properties of the foreign officinal root. It is undoubtedly a plant of highly active powers, meriting a particular investigation as an article of our Materia Medica. In fact, a new interest has lately been excited both in Europe and the United States, relative to the properties of white helebore. It is even supposed to be the basis of the French specific remedy, called Eau Medicinale d'Husson, so highly famed for its almost infallible powers in the cure of the gout, as to command the enormous price of from one to two crowns a dose. This remedy was discovered about forty years ago by M. Husson, a French officer, who affirms it to be prepared from a plant whose vir- tues were before unknown in medicine ; and it has long been cele- brated in France, and other parts of the European continent. The importance and popularity of the subject were incitements to various attempts for that purpose, and to the ingenuity of Mr. I. Moore, member of the royal college of surgeons, London, the public are indebted for a composition, which if not identically the same bears a strong resemblance to the Eau Medicinale, in smell, taste, and dose ; and also in all its effects, as far as it has been tried in the 548 MATERIA MEDICA. cure of gout. The composition of Mr. Moore consists of wine of opium Sydenham, one part, wine of white helebore, three parts, made by infusing for ten days, eight ounces of the sliced root of that plant, in two and a half pints of white wine, and strained through paper. This compound, when exhibited in doses from one to two drachms, has, in a variety of instances, effected a speedy cure of gouty paroxysms. There are, indeed, well attested facts, where the most painful gouty affections have yielded to a single dose of about one drachm ; and the instances of its failure have hitherto, it is be- lieved, been more rare than can be said of any other remedy. The employment of the composition of Mr. Moore, has also, in the hands of respectable physicians, been extended to acute rheumatism, and to some comatose affections, with the most decided advantage ; and a perseverance in similar trials is strongly recommended. Its opera- tion may be promoted by some aromatic, or peppermint, pennyroyal, or ginger tea. It in general occasions some nausea and vomiting, followed by bilious stools. Externally applied in the form of oint- ment or decoction, it cures the itch, and other cutaneous affections. An ointment is prepared by simmering the root slowty in hog's lard. The decoction is made by boiling two ounces or a handful of the root bruised, in a quart of water, to a pint and a half, and then strained. The addition of a few ounces of lavender, rose, or lemon water, may be made, if convenient. With this the parts affected should be washed twice or thrice a-day. HEMLOCK, Conium Maculatum — Grows to the height of six or seven feet in rich land, near ditches, and in moist shady places. It is an umbelliferous plant, with large leaves, of a dark green colour on the upper side, and a whitish green underneath ; much resem- bling parsley, especially the leaves of the smaller sorts, whose poison- ous quality is the most violent. The stalk is round, smooth, hollow, and marked with brown or red spots; the flowers are white; the seeds greenish; flat on one side, very convex, and marked with five fuiTows on the other. The root is long, yellowish without, white and fungous within, and somewhat resembling a carrot. It changes its form according to the season; and the leaves have a rank smell resembling the urine of a cat, but do not much affect the taste. This poisonous plant possesses great medicinal virtue when judi- ciously employed. It has been used with considerable advantage in painful cancerous ulcers, venereal ulcerations, cutaneous affections, gleets, painful discharges from the vagina, and in a variety of cases of scrofulous affections. It has also been of great efficacy in epi- lepsy, chronic rheumatism, and jaundice. Externally applied, it has been useful in discussing scirrhous tumours, particularly those of a scrofulous nature. The proper method of administering hemlock, inwardly, is to begin with a grain or two of the powder of the leaves, or the inspissated juice, and gradually to increase the dose until the head is affected MATERIA MEDICA. 549 with slight giddiness, as it occasions some sickness, and trembling agitations of the body, or produces one or two evacuations the morn- ing after the dose. One or more of these symptoms are the evidences of a full dose, and here continue until none of these effects are ob- served ; and then, after a few days, increase the dose ; for little advantage can be expected, but by a continuance of full doses. The dried leaves are less liable to injury from keeping than the inspissated juice. The leaves should be collected in June, when the plant is in flower, and its peculiar smell strong. The drying of the leaves should be performed quickly before a fire, on tin plates. The proof of the drying having been well performed, is the pow- der's retaining the odour of the leaves, and the deepness and fresh- ness of the colour. It should be kept in close vials, and secluded from the light. HENBANE, BLACK, Hyosciamus Niger — Grows at the sides of fences, about old ruins, and on dung-hills, and with the dung is sometimes carried into gardens, where, from its similitude to parsnips, it is mistaken for them ; and w r hen eaten produces stupor and apo- plectic symptoms terminating in death. It rises from one to two feet in height; the stalks are thick, w r oody, irregularly branched, and co- vered with a hairy down, the leaves surrounding the stalk at their base, stand irregularly ; they are large, soft, and downy, pointed at the ends, and very deeply indented at the edges ; their colour is a grayish green, and they have a disagreeable smell ; the flowers are large, egg-shaped, and of a dirty yellowish colour, with purple streaks. The root is long, tough, white, and when recently cut through, smells like liquorice. According to Dr. Stork, the juice of this poisonous plant inspis- sated, and exhibited in doses of from one grain to twenty, every twenty-four hours, has relieved many from palpitation of the heart, a tendency to melancholy, coughs, and other spasmodic disorders and convulsions, and this after other means had failed. HERB BENNET. See Avens. HERB TRINITY. See Heart's Ease. HOGBED, OR HOGWEED, Ambrosia— Grows near farm yards, and on stony soils, like moss, about three inches high. The leaves are of a deep green colour, small and curly. The hogs de- light to make their bed on it, from whence it derives its name. A handful of this plant infused in a quart of water, and given in doses of a tea-cupful three or four times a-day, is a popular remedy among women to promote the menses or courses. HOLY THISTLE. See Thistle, Holy. HOODED WIDOW HERB, Scutellaria Lateriflora— Is found 550 MATERIA MEDICA. in abundance on the banks of rivers, and the borders of ponds, flow- ering in July and August. The stem is square, branched, and at- tains the height of from one to three feet. The leaves opposite, nar- row pointed, on long foot stalks; the blossoms small, of a violet colour, intermixed with small leaves. Dr. Thatcher has introduced this plant in his American Dispensa- tory on account of its recently reputed efficacy as an antidote to ca- nine madness. It is directed to be given in the form of a strong in- fusion of the leaves every morning fasting, and to be continued for several weeks. For cattle, it may be mixed with their food or drink. HOPS, Humuli — Are an agreeable strong bitter, principally used in making malt liquors. They also induce sleep ; hence the popu- lar remedy of a pillow of hops to procure sleep in the delirium of fever and insanity, which not unfrequently succeeds. They give out their virtues to spirits or water. In the form of fomentation and poultice, hops serve as a most valuable application to ill-conditioned ulcers, or painful cancerous sores. Mr. Stephen Hammock, assistant surgeon to the royal hospital at Plymouth, gives the following account of the benefit obtained from the external use of hops. I have seen (says Mr. H.) very good ef- fects from hops in poultices and fomentations applied to ulcers of the worst kind, in more than sixty patients received into the hospital from ships of war. Some of the ulcers proceeded from scurvy, and some from other causes. But though all of them have been sordid, fetid, and extensive, yet the foetor has soon been corrected by these applications, and the ulcers have ceased to spread. A large handful of hops is to be well boiled with a quart of water, to which should be added meal or bran, forming a poultice, applied to the ulcer, without any intervening lint. But, previously to this application of the poultice, the ulcers are directed to be well fomen- ted with the decoction. The pain proceeding from the ulcers is soon alleviated, and the ulcers soon cease to spread. They become clean, and in a state to be dressed with lint, or any soft ointment. (See Duncan's Annals of Medicine , also Medical Repository.) Hops form the bases of beer and yeast, of which the following are the most simple, and among the most approved. Beer. — Take fifteen gallons of water, and boil one half of it, or as much as can conveniently be managed ; put the part of the water thus boiled, while it is yet of its full heat, to the cold part, contained in a barrel or cask, and then add one gallon of molasses, commonly called treacle, stirring them well together ; add a little yeast, if the vessel be new, but if it has been used for the same purpose, the yeast is unnecessary. Keep the bung-hole open, till the fermentation ap- pears to be abated, and then close it up. The beer will in a day or MATERIA MEDICA. 551 two afterwards be fit to drink. A few hands full of hops, boiled in the water, either with a little orange peel, or without, give a whole- some and pleasant bitter to this beer, and assist in keeping it from turning sour. If tops of the spruce-fir be added to the water which is boiled for making this beer, it is then called spruce beer. Extemporaneous Small Beer. — To two quarts of common por- ter, add cf molasses half a pint, of ginger two drachms, water just warm, four quarts : let the whole ferment in a warm place, then rack off. Another. — Lemon peel one ounce, cream of tartar, four ounces, hops one ounce, molasses one quart, ginger one drachm, bruised cloves four in number, boiling water four gallons, ferment with yeast. To make Yeast. — Boil a pint bowl full of hops in two quarts of water to one quart ; put eight table-spoons full of flour into a pan, and su-ain the hop water boiling on it ; when mixed, it should be thick batter, and when milk warm, stir in it a breakfast cup of good yeast ; put it in three porter bottles, stopping them with paper ; put them into a milk-pan near the fire, and as soon as the mixture rises to the top of the bottle, remove them to the cellar until it subsides, then cork the bottles, and set them on a cool cellar floor, or in an ice-house. In very warm weather, the corks ought to be taken out every day, to let out the carbonic acid air, and the bottles again stopped. Another valuable recipe. — Boil twelve clean-washed, middle sized potatoes, and at the same time, boil in another vessel, a handful of hops in a quart of water ; peel and mash the potatoes in a mortar or bowl ; pour part of the hop water, while hot, upon the potatoes, mix them well, and pass them through a sieve, then add the remainder of the hop water, and half a tea-cupful of honey, beat all well, and add a small portion of leaven to bring on the fermentation. Put the whole in a stone jug, and set by the fire, in the winter ; all the utensils must be scalded every time they are used, and washed per- fectly clean. One tea-cupful of the above potato yeast, will answer for two quarts of flour. In summer the yeast ought to be made every second day. HOREHOUND, Marrubeum Vulgare — Grows among rubbish, flowering from July to September. The leaves have a very bitter taste. An infusion or tea of the leaves sweetened, is a very common remedy for colds. A syrup prepared by simmering slowly for an hour, a pint of honey in a quart of a strong decoction of the plant, is, from my own experience, an excellent medicine in coughs, or any breast complaint, in doses of a small table-spoonful every tv 552 MATERIA MEDIC A. three hours, or oftener, when the cough is very troublesome. In like manner a candy prepared by simmering slowly half a pint of the juice with a pouud of sugar, will be found equally serviceable. In the southern states there is a plant, called wild horehound, growing to the height of one or two feet, of which a tea, prepared by adding one or two hands full of the fresh leaves, or half the quantity of the dried, to a quart of water, in doses of a gill or more ? every two or three hours, acts gently on the skin and bowels, and ks used like the Peruvian bark, as a tonic in the cure of ague, and bilious fever. HORSE-RADISH, Cochlearia Aimoracia — Grows on the sides of ditches and damp places, but is cultivated in our gardens for culi- nary and medicinal purposes. It has long been known as a most powerful antiscorbutic, and when taken freely, it stimulates the ner- vous system, promotes urine and perspiration, and is, therefore, use- fully employed in palsy, dropsy, scurvy, and chronic rheumatism. The root should be cut into small pieces, without bruising, and swal- lowed in the dose of a table-spoonful, without chewing, once or twice a-day, or it may be steeped in wine, and taken in doses of a small wine-glassful. Upon the authority of the celebrated Dr. Cullen, it is, in the form of syrup, excellent in hoarseness, or in the decline of violent colds and pleurisies. Whether externally or internally employed, horse- radish proves a stimulant ; hence it has been found serviceable by chewing it in palsy of the tongue, and applied in paralytic com- plaints to the affected parts. The root, scraped, and applied in the form of poultice, to the feet, until some inflammation is produced, in low stages of fever, attended with delirium, has also produced good effects. It is said, the root steeped in vinegar, will remove freckles of the face ; if so, it deserves to be tried in cases of ring or tetter worm. HOUSELEEK, Sempermvum — Grows on the roofs of houses and old walls, flowering in July. The juice of this plant, mixed with honey, is said to be of con- siderable service in the thrush of children. Stewed with cream, il is a great favourite with the country people for the cure of corns., fresh burns, stings of wasps, bees, and other external inflammations. An infusion of the leaves is also said to be cooling and laxative. HYSSOP, Hyssopus — Is cultivated in our gardens. An infusion of the leaves, sweetened with honey, or in the form of syrup, is use- ful in humoral asthma, coughs, and other disorders of the breast and lungs, accompanied with inflammatory symptoms. ICE-PLANT, Me&embryanthemum— Grows in woods te, the MATERIA MEDICA. 553 height of six inches, and becomes white in September; the stalks and leaves are like frozen jelly, and when handled, dissolves as ice. The root pulverised, in doses of a half or tea-spoonful, in the morning, is said to be a good remedy for children troubled with fits ; hence it is called by the country people, Fit root. Adults may take it in much larger doses. INDIAN HEMP — Grows in woods, and on the borders of mea- dows, three feet high ; the stalk is bare for a root, then spring many branches, leaves numerous, flowers whitish, similar to buckwheat, which terminate in seed pods resembling a cucumber. The bark of the root, in the form of powder, in doses of from twen- ty to thirty grains, or half a tea-spoonful, will generally operate as an emetic and cathartic. In doses of five or six grains, or a wine- glassful of the infusion, every two hours, it promotes perspiration. It has been found beneficial in rheumatism, dropsies, and asthmatic complaints. A table-spoonful of the infusion, half a handful of the bark to a pint of boiling water, given occasionally to children in the whooping-cough, throws off the phlegm, and prevents straining. INDIAN PHYSIC, OR AMERICAN IPECACUANHA, Spircea Trifoleata — Grows about two or three feet high, in low woods and meadows. Professor Barton says, the root, which is the part made use of, is a safe and efficacious emetic. The celebrated Colonel Bird, of Virginia, was so enamoured of this plant, that he wrote a pamphlet on its virtues, which he found, from great and successful practice in his own very numerous family, to be at least equal if not superior to those of the imported ipecacu- anha. In the dose of thirty to forty grains in powder, for an adult, it is one of the most safe and certain emetics. In broken doses of five or six grains, every two hours, it is equally valuable as a sudo- rific. It may also be given in infusion, a handful to a pint of boil- ing water, of which a small tea-cupful may be taken every fifteen or twenty minutes until it promotes vomiting. INDIAN TOBACCO. See Emetic Weed. INDIAN TURNIP, Arum Triphyllum — Grows in meadows and sw r amps, six or eight inches high, purple stalks, leaves three in number, roundish, and berries of a bright scarlet colour. It is a very acrid plant. As ointment prepared by simmering the fresh root in hog's lard, and one eighth part of wax, is said to be a good application in the scald head. From the authority of Professor Barton, we learn that the recent root, boiled in milk, has been ad- vantageously employed in cases of consumption. He even cites a very striking instance. It is also recommended in the asthma, and whooping-cough, in the form of conserve, made of a pound of the 70 554 MATERIA MEDIC A. peeled root pounded finely in a mortar, with three pounds of loaf sugar ; dose, a tea-spoonful twice or thrice a- day. INDIGO WEED, OR WILD INDIGO Sophora Tinctoria— Grows in great abundance on the road-sides, and in the woods, and is used by travellers in the middle states to drive away the flies. A decoction of this plant in large doses, is said to operate power- fully on the stomach and bowels, but in smaller doses of a wine- glass full, proves a mild laxative. An infusion, or tea, is said to he cooling and good in fevers ; and, in the form of fomentation and poultice, to arrest the progress of mortification, especially if a little of the infusion be taken internally at the same time. An ointment prepared by simmering the bark of the root in cream, fresh butter, or lard, has been recommended as a good application to sore nipples or ulcers of the breast. IPECACUANHA, AMERICAN. See Indian Physic. IYY. See Calico Tree. JAMESTOWN, OR JIMSON WEED. See Thorn Apple. JERUSALEM OAK, OR WORM SEED, Chenopodium An- thelmenticum — Has long been employed to expel worms. One or two tea-spoons full of the seed with molasses or honey, are generally given to a child two or three years old, in the morning, on an empty stomach, and the dose is sometimes repeated at bed-time. It ought to be continued for several days. When there is an aversion to using it in this form, the seed may be boiled in milk, and taken in doses of one or two wine-glasses full, or the expressed juice of the plant sweetened, may be exhibited in doses of a table-spoonful. The oil, which is prepared from the seed, possesses the same virtue, and is found a more convenient form of giving the medicine. JUNIPER, COMMON, Juniperus Communis — An evergreen shrub, growing on dry barren commons, and hilly ground. A strong decoction, made of a handful of the tops and berries to a quart of boiling water, in doses of a tea-cupful three or four times a-day, has long been employed in dropsy, scurvy, and gravel, or dif- ficulty of urine. The oil of juniper possesses the same properties in a high degree, and imparts them to ardent spirits. The peculiar flavour, and well known diuretic effect of Holland gin, are owing to this oil. Hoffman found it of great use in debility of the stomach and in- testines, particularly in old people. The stronger preparations have been found useful in uterine obstructions, and in paralytic affections of the bladder. MATERIA MEDICA. 555 LAMBKILL. See Calico Tree. LAUREL. See Calico Tree. LAVENDER THRIFT, Statice Ldmonium— Grows on the sea-shore, on salt marshes, flowering from July to September. The stem is naked, branched, and about a foot high ; the leaves long and pointed ; the flowers blue, and growing on long spikes on the tops of the branches. According to Dr. Hughes of Providence, and Dr. Baylies of Dighton, a decoction of the root has been tried with success in ap- thous state of fever, and ulcerous sore throat, as a most powerful an- tiseptic. In large doses it operates as an active emetic, and in smal- ler, as a strong expectorant. LEMON TREE, Citrus Medica— Is now cultivated in the southern states, and holds the first place among the cooling and an- tiseptic vegetables, to correct the putrid tendency of animal food in summer. The acid of lemons, from its antiseptic properties, has long been employed as a remedy in the scurvy. Dr. Cutbush says, from the commencement of our navy, it has been used on board the ships of war with very great success, in preventing, as well as curing, this disease. The fresh fruit is preferred. Lemon, or lime juice, diluted with water, and the addition of a little sugar, forming lemonade, serve as one of the most grateful be- verages in bilious and nervous fevers. When saturated with com- mon table salt, it proves a valuable medicine in dysentery, putrid sore throat, and remittent fever. In diarrhoea and diabetes, where the aliments are apt to run off in their crude state, this mixture is said to be a most efficacious remedy. A table-spoonful of lemon juice, fifteen or twenty grains of salt of tartar, or salt of wormwood, with the addition of a little water, swallowed in a state of efferves- ence, is excellent to stop nausea, and allay febrile heat. The acid of lemons is a common remedy against narcotic vegetable poisons, such as opium. Either of the following methods is recommended for preserving the juice of lemon or limes. Boil the juice after straining, and bot- tle it, or squeeze the fruit, put the juice and pulp into a bottle, cover the top with an inch of oil, cork and rosin the bottle. The juice is supposed to feed on the pulp. Before using the juice, the pulp and oil must be carefully taken out. The dried peel of lemons is a grate- ful aromatic, and as a stomachic generally constitutes one of the in- gredients of bitters. LETTUCE, Latuca Stativa — From the fortunate discovery and perseverance of the celebrated Dr. Duncan, the inspissated juice of the common garden lettuce is found to be but little inferior in sopo- 556 MATERIA MEDICA. rifle power to opium. In those constitutions in which opium cannot be employed without producing very disagreeable consequences, we may with safety employ, as a sedative, the lettuce opium or tincture. Many eminent physicians bear testimony of the good effects of this medicine in procuring sleep, in alleviating pain, and in allaying inordinate action, particularly a troublesome cough. And in no in- stance has it been found to produce nausea, costiveness, or irritation of the skin, which generally follows the use of opium or laudanum. The best method of obtaining the inspissated juice of lettuce in abundance is as follows : Let the ice-lettuce, which is considered best for this purpose, be planted in rows; and when the top of the stem is about a foot above the ground, cut off about an inch from the top of each plant. The milky juice immediately rises above the wounded surface. But it is better to cut off the tops of all the plants before you begin to collect. After having done this, begin to collect the milky juice by means of a wet sponge where the incision was first made, and as you go along cut off a thin cross slice from the stem of each plant, leaving fresh wounds. After going round the plants about five or six times in the way mentioned, they will cease to yield any more milky juice at that time. But this process may be repeated two or three times in a day. The milky juice collected in this way is to be expressed into a tea-cup, or any similar vessel. It soon acquires a dark brown colour, like opium obtained from the poppy; has all its other sensible qualities; and hence it may justly be distinguished by the title of lettuce opium. It may be administered in the form of pills, in doses from one to two grains. The tincture is prepared by adding one ounce of the extract to a pint of spirits, which may be given in doses of a tea- spoonful. Another mode of preparing the tincture is by steeping two or three ounces of the dried leaves and stalks in a pint of spirits, for eight or ten days, in a warm place, frequently shaking the vessel, j.nd then let it be strained through paper. LETTUCE, WILD, Lactuca Virosa— Grows abc ,1 four feet high, about hedges and the borders of meadows. It 1 as three dif- ferent kinds of leaves : those proceeding from the roo* are slightly toothed ; and those attached to the flower stalks are arrow-shaped, pointed, and minute ; the flowers are yellow, and small ; the leaves are milky, and smell like opium. An extract prepared from the expressed juice of the leaves, ga- thered when in flower, and given in doses of from five to ten grains, twice or thrice a-day, is said to be a powerful diuretic, and of great efficacy in the cure of dropsy. LICHEN, OR LUNGWORT, Lichen— Is a thin shell, or skin, which grows on the bark of the white oak tree, resembling the lungs, from whence it is called lungwort. MATERIA MEDICA. 557 It is said to possess the same qualities as the Iceland moss, or lichen, so celebrated in the cure of consumption. An infusion, a handful to a quart of boiling water, used as a com- mon drink, or a strong decoction formed into syrup, with honey or sugar, may be taken in doses of a wine glassful three or four times a-day. It is also said to be a useful medicine in the whooping- cough. LIFE ROOT — Grows on the borders of meadows; about two feet high ; leaves large and saw-edged ; flowers yellow, and the roots small and fibrous. An infusion of this plant, a handful to a quart of boiling water, taken in doses of a tea cupful five or six times a-day, is said to be an excellent remedy for the gravel. LOBELIA, OR BLUE CARDINAL FLOWERS, Lobelia Syphilitica — Grows abundantly in the middle and southern states in moist grounds, and near springs; has an erect stalk three or four feet high ; blue flowers; a milky juice and a rank smell. Professor Barton says this plant was purchased from the northern Indians by the late Sir Wm. Johnson, as a remedy in the venereal disease : hence, its specific name syphilitica, He doubts, however, its power to cure the pox ; though, from its diuretic quality, it cer- tainly has been found useful in gonorrhoea or clap. He states that many persons in the western country, from their ignorance of botany, have made use of a plant which they call obelia, in the venereal complaint. But from the specimen he has received, he believes the plant to be the seratula spicata or spiked sawwort. It is a powerful diuretic, and there is good reason to believe that it has been found useful, not only in venereal complaints, but also in cases of gravel. Thus, ignorance sometimes leads to knowledge. The lobelia is generally administered in the form of a decoction, a handful of the root and leaves boiled slowly in three pints of water to a quart, of which a gill or more may be taken three times a-day. MADDER, WILD, Rubia Tinctorum— Is cultivated in Penn- sylvania and South Carolina for dyeing a fine red colour, but also possesses great medical powers. It has been highly recommended in visceral obstructions, particu- larly of the uterus, in coagulations of the blood induced either by falls or bruises, in dropsical complaints, and especially in the rickets. It may be given in powder from five to fifteen grains to children, and from half to a whole drachm three or four times a-day to adults. When taken internally, it possesses the remarkable quality of tinging the urine of a red colour, and produces similar, effects on the bones of animals, when eaten with their food. MAGNOLIA — Goes by several names, as beaver tree, swamp sas 558 MATERIA MEDICA. safras, elk bark, Indian bark. It is an agreeable aromatic tonic bit- ter medicine. An infusion or decoction of the bark has been used in the ague and fever, and is much celebrated among the western Indians as a remedy in rheumatism. I am informed, from a respectable source, that John Dickinson, Esq., author of the celebrated Pennsylvania Farmer's Letters, was completely cured of a violent attack of the chronic rheumatism by a strong decoction of the twigs of the magnolia. The species Magnolia Grandiflora, evergreen laurel, sometimes called tulip tree, grows to the height of eighty feet near Savannah. The bark of the root of this tree is also used as a substitute for the Peruvian bark in intermittent fevers. The cones or seed-vessels of the magnolia, which is commonly called cucumber tres, has been advantageously used in Virginia in the form of tincture, in rheuma- tic complaints. MAIDEN HAIR, Asplenium Trichomanes — Called also milk waste, spleenwort — Grows on old walls, rocks, and shady stony places, generally to the height of seven or eight inches; leaves very fine and soft, and spotted underneath ; stalks of a dark purple colour ; flowers from May to October. Its leaves have a mucilaginous sweetish taste, without any peculiar odour. An infusion, by pouring a quart of boiling water on a handful of the dry herb, sweetened with honey, and taken in the quantity of a tea cupful every hour or two, or a spoonful in the form of syrup, is said to be good in tickling coughs, hoarseness, and disorders of the breast, proceeding from acrid humours in irregularities of the menses, and obstructions of the viscera. MALE FERN. See Fern, Male. MALLOW, COMMON, Malva Sijlvestris— Grows in hedges, footpaths, and among rubbish ; flowering from June to August. The leaves possess a mucilaginous sourish taste. A decoction of this plant is said to be useful in dysenteries and gravel complaints, though it is chiefly employed as an emollient poultice to produce suppuration. MANDRAKE, OR MAY APPLE, Podophyllum Peltatum— Grows on lows grounds, two or three feet high, leaves generally three, broad at the base, and terminating in a sharp point ; flowers yellow; the fruit resembling a lime, or small yellow apple, which is much admired by some. The root is an excellent purgative, and may be taken in doses from ten to thirty grains in substance, or double the quantity infused in a gill of water. Dr. Little, of Pennsylvania, esteems it preferable to jalap. The honourable Paul Hamilton, who often used it, directs MATERIA MEDICA. 559 equal parts of the juice and molasses to be mixed, and a table spoon- ful taken every hour or two until it operates. The best time of gathering the mandrake, for medicinal purposes, 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. MARSH TREFOIL, OR BUCK BEAN, Menyanthes Trifo- Uata — Is a native of Europe and of America. Spongy and boggy soils which are inundated at certain seasons of the year, and are never wholly destitute of water, are the favourite situations of this plant The root penetrates horizontally into the bog earth to a great distance, and is regularly intersected with joints at the distance of about half an inch from each other. The stalks are long, and from each of them proceed three leaves. Flowers white, tinged with red. The root is intensely bitter, and has long held a place in the Euro- pean Materia Medica, as a powerful tonic. When given in small doses, of about ten grains, it imparts vigour to the stomach, and strengthens digestion. We are told by authors that it has been em- ployed with advantage in intermittent and remittent fevers. Boer- haave, in his own case of gout, was relieved by drinking the juice of the plant mixed with whey. Other physicians have found it useful in keeping off the paroxysms of that complaint. Taken by infusion, it also has good effects in some cutaneous diseases of the herpatic or seemingly cancerous kind. We may regard this plant as one of our numerous vegetable bit- ters, which are fully equal in strength to imported articles of their class. MARSH MALLOW, Althcea Officinalis — Grows in marshes and wet places. The leaves have a soft woolly surface, feeling like velvet. The flowers are of a white pale flesh colour, and appear in August. Every part of the marsh mallow, and especially the root, when boiled, yields a copious mucilage, on account of which it is employed in emollient cataplasms or poultices, for softening and maturing hard tumours. It is likewise of eminent service, in the form of infusion, in asthma, hoarseness, dysentery, and gravel. MARSH ROSEMARY. See Lavender Thrift. MASTERWORT, Imperatoria — Grows in meadows and rich soils, two feet high ; leaves, three together, saw-edged, and spear- shaped ; flowers in June. The root of this plant is a warm and grateful medicine in flatu- lency, weakness of the stomach and bowels, and dropsical affections. It may be taken in the form of powder, decoction, or tincture. One drachm, or a tea-spoonful of the powder, in a glass of wine or spirits. and taken an hour before the fit, has frequently prevented the ague. 560 MATERIA MEDICA. The decoction or infusion is made of one handful in a quart of boil- ing water, and the dose is a tea cupful three times a-day. MAY APPLE. See Mandrake. MAY WEED, OR WILD CAMOMILE, Cotula Fcetida— Grows about two feet high, in pastures near fences ; the flowers are yellow, resembling camomile flowers, and are frequently used as a substitute for them. ME Z ERE ON, Daphne Mezereum — Called also spurge laurel, dwarf bay. Grows plentifully in woods and shady places near the Ohio, and flowers in the month of February or March. The fruit is a berry, in which is found a single seed. The leaves are spear- shaped, and the flowers grow of a beautiful red or rose colour. The bark of the root of this plant is the part used in medicine, and has an extremely acrid burning taste in the mouth and fauces. Dr. Withering asserts that a patient who lived under extreme diffi- culty of swallowing for three years, was effectually cured in two months, by chewing the root as often as she could support its irrita- ting effects. The fresh root scraped, and applied to the surface of the skin, affords an efficacious blister — when taken internally, it determines to the surface, and has been found greatly serviceable in rheumatism and obstinate cutaneous diseases. Its principal use, however, is in the venereal disease, in the last stage, or when mer- cury has failed. It is particularly efficacious in relieving noctural pains, and removing venereal nodes. One gill to a half pint of the decoction, made of two drachms, or a handful of the bark, with an equal quantity of liquorice root, boiled in three pints of water to a quart may be taken three or four times a-day. MILK, OR SILK WEED, Vincetoxicum— Grows by the road- sides, and on sandy ground, about three feet high; the stalk square; leaves oval and milky ; flowers yellow, which terminate in a pod resembling a cucumber, filled with down, which, when ripe, is blown away. A handful of the root, boiled slowly in a quart of water for half an hour, and given in doses of a gill or more three or four times a-day, is reputed to be an effectual remedy in the cure of dropsy, and serviceable in catarrhs, scrofulous and rheumatic disorders, and gravel complaints. MILKWORT, COMMON, Polygala Vulgaris— Thrives in dry pastures, and flowers in June and July. Its roots possess an ex- tremely bitter taste, together with all the virtues of the American rattlesnake root. A table-spoonful of a strong decoction of the root, two hands full boiled slowly in three pints of water, to a quart, and taken every MATERIA MEDICA. 5f)l nour or two, promotes perspiration as well as expectoration, and has, therefore, been used with advantage in colds, pleurisies, and other disorders of the breast. MILTWASTE. See Maiden Hair. MINT. See Peppermint. MISLETOE OF THE OAK, Viscum— Is to be found on several kinds of trees. That which grows upon the oak is said to have cured epilepsy or fits. It is directed that the misletoe be sepa- rated from the oak, about the last of November, gradually dried, and when pulverised, confined in a bottle well corked ; to be given in doses of a tea-spoonful three or four times a-day, gradually increasing the dose according to its effects. MOORWORT, BROAD-LEAFED, Andromeda Mariana— Called wicke at the southward. A strong decoction of this plant is extremely useful as a wash in that disagreeable ulceration of the feet, which is called toe-itch, and ground itch, a very common complaint among the negroes and lower class of people in South Carolina and Georgia. MOTHERWORT, Leonurus Cardiaca — Grows in waste places, and flowers in July and August. 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. An infusion of this plant is a common domestic medicine in faint- ing, and disorders of the stomach. It is said to be peculiarly adapted to some constitutions affected with nervous and hysterical agitations; . and that, if taken at bed-time, procures refreshing sleep, when opium and laudanum had failed. MOUNTAIN TEA, OR DEERBERRY, Gaultheria Procum- bens. — It spreads very extensively over the more barren mountainous parts of the United States. A strong infusion of this plant, a large handful to a quart of boil- ing water, in doses of a tea-cupful three or four times a-day, is es- teemed useful in asthma, and for promoting the menstrual discharge. MOUTH ROOT, OR GOLDEN THREAD, Nigelia— Is found in swamps ; the stems erect and naked ; the leaves grow by threes at the termination of the stems ; the white solitary blossoms appear in May; the roots are thread-shaped, and of a bright yellow colour. This plant has been supposed to be efficacious, as a local applica- tion, in ulcerations of the mouth. Its reputation in this case is, 71 562 MATERIA MEDI-CA. however, wholly unmerited, since it possesses no astringent or stim- ulating quality, by which it can act on the ulcerated spots. As a pure tonic bitter, capable of strengthening the viscerse and promoting digestion, it is entitled to rank with most articles of that kind now in use. MUGWORT, OR COMMON WORMWOOD, Artemisia Ab- sinthium. — Grows two or three feet high, on road sides and among rubbish ; leaves deeply divided, pointed ; on the upper side of a deep green, and on the under, soft or downy; flowers small and purplish. An infusion, a handful of the tops to a quart of boiling water, in doses of a tea-cupful, or a tea-spoonful of the powdered leaves three or fonr times a day, is an admirable stomachic in weakness of the stomach, lowness of spirits, and hysterical affections. It is also said to be a useful medicine in difficult menstruation, in intermittents, jaundice, and dropsical affections. Externally it is applied in the form of fomentation and poultice to resist putrefaction and relieve the pains of bruises, as well as prevent the swelling and discoloration of the part. MULBERRY TREE, Morus, Nigra et Alba.— Its fruit has the common qualit)^ of all other sweet fruits, quenching thirst, abating heat, and proving laxative in its effects. A syrup made of the juice of the fruit, serves as an excellent gar- gle for mitigating inflammations of the throat and ulcers of the mouth. The bark of the root of the black mulberry tree, in doses of thirty grains, or half a tea-spoonful of the powder, or double the quantity infused in a gill or half a pint of boiling water, or equal parts of a strong decoction and molasses, formed into a syrup, in doses of a wine glassful, is an excellent purgative, and has been used with suc- cess as a vermifuge, particularly for the tapeworm. The fruit of the common mulberry tree, when properly fermented and prepared, yields a pleasant vinous liquor, known under the name of mulberry wine. Considerable quantities of these berries are likewise consumed in the cider countries, where they are mixed with the apples, in making a delicious beverage called mulberry ci- der. For this purpose, the ripest and blackest mulberries are select- ed, and the expressed juice is added to the cider, in such a propor- tion as to impart a perceptible flavour. The liquor thus acquires a very pleasant taste, as well as a deep red colour similar to that of the finest port wine, both of which continue undiminished by age. MULLEIN, Verbascum — The leaves, a handful to the quart of milk, is a common remedy in bowel complaints. In the form of fomentation or poultice, it is employed to relieve the piles, and other painful swellings ; and in a dry and pulverised state, to destroy fungous or proud flesh. MATERIA MEDICA. 563 MUSTARD, BLACK AND WHITE, Sinapis, Nigra et Alba — Mustard used with our food, provokes the appetite, assists diges- tion, and promotes the fluid secretions, and is especially adapted to persons of weak stomachs, or where much acid prevails, as it acts upon the system generally without producing much heat. A table-spoonful of prepared mustard in a pint of warm water, on an empty stomach, operates as an emetic in nervous disorders. A table-spoonful of the unbruised seed, taken twice or thrice a-day, proves a gentle laxative, increases the urinary discharges, and is useful in chronic rheumatism, asthma, palsy, and dropsy. In obsti- nate intermittents, or ague and fever, or with persons who find the Peruvian bark oppressive at the stomach, a tea-spoonful of the whole seeds, or the flower of mustard, united with the bark or any of its substitutes, will very frequently succeed in the cure, when a pound of bark alone would not produce the desired effect. In languid con- stitutions, or low stages of fevers, a gill of the seeds mixed with a small handful of horse-radish, and infused in a quart of wine, in doses of a wine glassful, occasionally, is a most cordial stimulant. Another excellent form in which mustard may be taken, is that of whey. It is prepared by boiling two or three table-spoons full of the seeds bruised, in half a pint of milk, and as much water, till the curd be perfectly separated, to which a little sugar may be added, and of this drink, a tea-cupful may be taken three or four times a-day, in nervous fevers. The powder of the seeds, mixed with the crumbs of bread or flour, and formed into a poultice with sharp vinegar, is an excellent appli- cation to the parts affected with rheumatism, and to the soles of the feet, and palms of the hands, in fevers, where there is a languid cir- culation, or cold extremities, or in cases of delirium. NETTLE, STINGING, Urtica— The expressed juice of a wine glassful, or a decoction, one handful to a quart of boiling water, in doses of a tea-cupful three or four times a-day, is said to be useful in jaundice, asthma, consumption, and gravel complaints. It is also said that the flower and seeds, in doses of a drachm thrice a-day, may be substituted for the Peruvian bark in ague and fever. Externally, it has been employed in restoring excitement to paralytic limbs, and other cases of torpor and lethargy. It may be applied by stinging the part with the nettles; or the fresh leaves may be applied to the arms or legs. NIGHTSHADE, AMERICAN. See Pokeweed. NIGHTSHADE, DEADLY, Atropa Belladonna— Grows two or three feet high in hedges, among rubbish, and uncultivated places ; flowers dusky brown on the outside, and a dull purple within, ap- pearing single among the leaves in June or July ; the berries round, green, changing to red, and, when ripe, of a shining black. The 564 MATERIA MEDICA. whole of this plant is poisonous, and children allured by its beautiful berries, have too often experienced their fatal effects. Like all other strong poisons, in the hands of skill it performs won- derful cures in palsy, epilepsy, melancholy, jaundice, dropsy, and cancer. " I have," says the great Professor Cullen, " had a cancer of the lip entirely cured by it." A scinhosity in a woman's breast, of such a kind as frequently proceed to cancer, I have found entirely discussed by the use of it. In the employment of this dangerous medicine, it is necessary to begin with very small doses. Half a grain of the powdered leaves or root, or two table-spoonsful of the infusion, prepared by infusing twenty grains in half a pint of boiling water, and strained after cooling, is a sufficient dose for adults to commence with. The dose is to be gradually increased, and repeat- ed daily : but as soon as any dangerous symptoms occur, its use ought to be suspended for some days, and afterwards resumed in smaller doses. Externally, the powdered leaves are applied to miti- gate the pain in cancerous and other ill-conditioned ulcers, and the leaves, in the form of poultice, to discuss scirrhous and cancerous tumours. The garden nightshade, growing also on dung-hills, with white flowers, odour of musk, and the berries, when ripe, of a shining black, possesses virtues similar to those of the deadly nightshade. From one to three grains of dried leaves infused in boiling water, and taken at bed-time, will generally induce a copious perspiration, increase the discharge of urine, and operate as a mild laxative on the following day. If after increasing the dose some visible effect be not produced, its farther use will not avail much. The dose is to be repeated every night, or every other night. In the form of poultice, it has abated the inflammation of the eyes, painful swellings, and inflammation of the venereal kind, and scrofulous and cancerous tumours. The woody nightshade, called also bitter sioeet, because it is first sweet, and then bitter, grows on the sides of ditches, and in moist hedges, climbing upon the bushes with winding, woody, but brittle stalks. The flowers are in clusters of a blue purple colour, appear- ing in June or July, and always turning against the sun. The ber- ries are red. This species is not so deleterous as the above two, and it acts more uniformly. Its sensible operation as a medicine, is also by sweat, urine, and stool, and in the form of infusion, is said to be eminently serviceable in acute rheumatism. It has also been found efficacious in jaundice, scurvy, obstruction of the menses, and in obstinate cu- taneous disorders. An infusion, prepared by adding a pint of boiling water to an ounce or half a handful of the twigs or stalks, either in a fresh or dried state, of which a tea-cupful or more may be taken morning and evening. Another form is made by steeping four ounces of the twigs in a pint of wine. The dose a wine glassful. In the form of poultice or cataplasm, it is also said to be a powerful dis- MATERIA MEDICA. 565 cutient of hard tumours. For this purpose boil two or three hands full of the leaves in wine or vinegar, to which may be added a little flax-seed, and this to be applied warm to indurated or hard tumours. The application of the juice and leaves to cancerous sores, in some instances, has performed a cure. OAK, Quercus. — The bark of the oak possesses, in a considerable degree, astringent, tonic, and antiseptic properties. Hence, we can never be at a loss for a remedy in those diseases in which the Peru- vian bark has been recommended. In intermittents and low stages of fever, in the advanced stage of dysentery, diarrhoea, indigestion, and other diseases of weakness, or loss of tone in the system, I have myself employed internally the black and red oak bark with equal effects, though in rather larger doses than the Peruvian bark. Many cases have come under my knowledge in practice, of persons, espe- cially children, reduced to mere skeletons, by protracted disease, of bilious, nervous fever, and bowel complaints, whose stomachs would not retain medicine, being most wonderfully restored to the blessing of health by bathing in a strong decoction of oak bark not more than milk warm, twice a-day. In the year 1809, I was requested by my brother, Dr. Thomas Ewell, who had the superintendence of the Marine Hospital in Washington, to visit some of his patients in the confluent small-pox, which had proved fatal in several instances. The first case presented to my view was that of a poor sailor, in the last stage of this dreadful disease, and so far gone, that it was thought utterly useless to prescribe for him, his coffin being actually ordered. Reflecting, however, on the virtues of the oak bark, I did not myself entirely despair of his case ; and instead of passing him by, I ordered a bath of a strong decoction of oak bark to be prepared with all possible despatch, setting, at the same time, some of the soldiers to boil the water, while others hastened to the woods for the bark. When we came to immerse him in it, we found his whole body such a mass of corruption, from the top of his head to the soles of his feet, so filled with vermin, that there was no other way to bathe him but in a sheet. I directed him to be supplied liberally with milk toddy, and to repeat the bath every two or three hours. By persevering in this treatment for two or three weeks, gradually diminishing the toddy and oak bath, as his strength increased, to the astonishment of all the spectators, he was miraculously snatched from the jaws of death. When his sight was restored, he was much surprised to see that the astringent waters of the bath, had made him look, as he said, u as black as a negro" I am happy to add, that of several others in the hospital, who were treated in a similar mode, not one died. In farther proof of the tonic and antiseptic virtues of the oak bark. I beg leave to cite the following case from Professor Hart on. " In a case of gangrene of the foot," says this learned professor. 566 MATERIA MEDICA. "from the puncture of a nail, which came under my notice in the course of last summer, I gave to the patient very large quantities of the decoction of oak bark, at the same time that the affected pait was constantly kept wet with the same decoction, or with a poultice made of bread and milk and the bark. I cannot but ascribe the recovery of my patient to the use of these means, and I am imbold- ened to recommend the use of this cheap remedy, as one highly worth attention in similar cases." OAK POISON. See Poison, Oak. ONIONS, Allium Cepa — Possess similar virtues with the garlic, only in a less degree. The disagreeable smell which they impart to the breath, may be effectually obviated by eating a few leaves of parsley immediately after the onions. Onions are justly reputed an efficacious remedy in suppression of urine, in dropsies, and in abscess of the liver. The following ex- ejnplification of the virtue of onions in liver complaints, deserves the attention of the reader. Captain B. Burch, of the District of Columbia, was afflicted with an abscess of the liver, deemed incurable by his physicians, and see- ing some onions in the room, expressed a wish to eat one. Thinking his case desperate and no longer a matter of any consequence what he ate, his wife immediately gratified his appetite. After eating one or two onions he found himself much better, which induced him farther to indulge his appetite. He subsisted for several weeks en- tirely on onions, with only the addition of a little salt and bread ; and from using this diet he was restored to perfect health, and is now a very hearty man in his fifty-third year. This, with innumerable instances of a similar sort, ought to convince the young practitioner, that in the cure of this disease nature ought always to be consulted, as she seldom or never errs. Upon the high authority of our virtuous and able statesman, the honourable William H. Crawford, onions externally applied is an invaluable remedy in violent sore throat. This worthy patriot in- formed me, that one of his children being violently attacked with the croup, at his mansion in Georgia, a physician was sent for ; but before he arrived, the disease became so alarming as to threaten the child with immediate death, if something for its relief were not speedily done. Having heard that an ointment of garlic had been, employed with beneficial effects in sore throats, he instantly had some onions beaten, not having any garlic at hand, to which was added a small portion of hog's lard ; and with this mixture, the neck, breast, and back of the child were well rubbed, which, in the short space of one hour, relieved all the distressing symptoms. Another case of croup, cured by this application, came under the notice of Mr. Crawford last fall, as he was travelling from Georgia to the seat of government. A little girl, daughter of the gentleman at whose MATERIA MEDICA. 567 house he tarried one night, was seized with this alarming malady , and on his recommending the above remedy, it was employed with the same happy effects. He also stated to me, that, while in Paris, he was afflicted with a very sore throat, which did not yield to the usual remedies ; he di- rected some onions to be beaten, and had them applied to the soles of his feet and legs, over which his stockings were drawn. The happy result was, that he had a good night's rest, and in the morn- ing found his throat entirely cured. He communicated the cure wrought on himself to a French lady who was greatly distressed with a sore throat, which induced her to make the experiment, and the fortunate result was very remarkable. ORANGE TREE, Citrus Aurantium — Is now cultivated in the southern states, and deservedly esteemed for its grateful acid juice, which, by quenching thirst, and diminishing heat, is of considerable use in febrile disorders. From its virtues to resist putrescency, it has always, and most deservedly, held the first place on the list of antiscorbutics. The following is a recipe for making orange wine: — Take the ex pressed juice of forty sour oranges, five gallons of water, and fifteen pounds of sugar ; boil the water and sugar for twenty minutes, skim constantly, and when cooled to a proper heat for fermentation, add the juice and outer rinds of the fruit, rasped or sheered off, putting all in a proper keg ; leave it open for two or three days and then bung it close for six months. PAPAW. See Custard Apple. PAPOOSE ROOT. See Cohush. PARSLEY-LEAFED YELLOW ROOT, Zanthoriza Apii- folia^-ls a native of the southern states. The stems reach the height of three feet, and are somewhat thicker than the barrel of a goose-quill. The root is from three to twelve inches long, and about the diameter of a man's little finger, sending off numerous scions, sometimes two feet in length, by which means it spreads considera- bly. The flowers appear before the leaves, very early in the spring. Both the stem and the root are of a bright yellow colour, and possess a strong and bitter taste. In medicinal virtues, it is nearly allied to the celebrated Columbo root. The powdered stem anil root, in the dose of two scruples, are highly recommended in all cases requiring bitter and tonic medicines.* * The above is the character of this plant, as given by my excellent friend, the late Professor Woodhouse. Friendship is often partial; but eulogy, to be just, must employ bright colours to paint the character of such a man as Dr. Woodhouse. With that rare benevolence which imparts its noblest ardour to friendship, he combined a genius which threw a solar radiance over the 568 MATERIA MEDICA. According to Professor Barton, we have a very common plant in various parts of the United States, particularly- in the rich soil adja- cent to the Ohio and its branches, in the western parts of Virginia, Pennsylvania, and Kentucky, which is commonly called Yellow Root. He describes the root of this plant as being a very powerful bitter, perhaps not less so than the preceding, and very popular as a tonic medicine. The usual forms of administering it are powder, tincture, and infusion. This latter has been employed as a wash in inflammation of the eyes. It is supposed this is the plant which some of the Indians make use of to cure cancers. PARSLEY, WILD, Petrosellinum — Grows in meadows, and among rocks near the sea; stems firm, near six feet high; long, thick root, strong smell, acrid taste ; flowers in July, and kidney-shaped seed, which alone are used in medicine, as a powerful diuretic. A small handful of the seed, boiled in a quart of water and sweet- ened with honey, in doses of a tea-cupful every hour or two, is cele- brated as a remedy in suppression of urine, or gravel complaints. PEACH TREE, Amygdalus Persica — Both the flowers and leaves are excellent cathartics, and ought to be preserved by every family. A tea-spoonful of a strong infusion, sweetened, and taken every hour or two, will operate mildly on the bowels, without griping as senna does. Of the syrup, prepared by boiling slowly the juice of the leaves, with nearly an equal quantity of molasses, honey, or sugar, a table-spoonful to children, and a wine glassful to adults, will also prove a mild laxative medicine. I have myself witnessed its good effects in St. Anthony's Fire and measles, and have no doubt of its utility in other diseases requiring gentle laxatives. Two of my most intimate friends, on a visit to one of their cotton plantations just settled in the interior part of Georgia, and where there was neither medicine nor physician, were taken dangerously ill of the bilious fever. A good neighbour hearing they were ill, went to see them, and prescribed what he called " an excellent phy- sic" which was simply a strong infusion of peach leaves, to be taken in doses from a gill to a half pint every two or three hours. It ope- rated on the stomach, bowels, and skin ; and by persevering in the use of it for a few days, they were happily restored to health. A decoction, prepared by boiling a handful of the dried leaves in a quart of water to a pint and a half, and taken in doses of a tea- dark abyss of chemical science, besides illuminating other walks of useful knowledge. To darken the gloom of so awful a dispensation, it pleased the great FA- THER of LIGHTS to take into his presence another star of equal lustre with Dr. Woodhouse. I mean that refulgent genius, Dr. Shaw, late Professor ot Chemistry in the University of Maryland. The friends of an art so impor- tant as Chemistry, will have cause to mourn the early extinction of those bright luminaries. MATERIA MEDICA. 569 cupful every two or three hours, is reputed, upon respectable au- thority, to have proved an effectual remedy in many cases of affec- tions of the kidneys or gravel complaints, as also in cases of voiding blood by urine, which had resisted the usual remedies. PENNYROYxlL, Mentha Pulegium — An infusion, a handful to a quart of boiling water, the dose a tea-cupful three times a-day, has long been esteemed in hysteric complaints and obstructions of the menses. Dr. Withering says, that the expressed juice of penny- royal, with a little sugar or honey, a tea-cupful every two or three hours, is a useful medicine in the whooping-cough. PEPPERMINT, Mentha Piperita— Is an excellent stomachic in flatulent colics, languors, hysteric cases, and vomiting. The usual modes of administering it, are infusion, the distilled water, and the essential oil. The last, united with rectified spirits of wine, forms the essence of peppermint, so highly esteemed. In nausea, cholera morbus, obstinate vomiting, and griping, pep- permint, infused in spirits, and applied, as hot as can be endured, to the stomach and bowels, will be a most valuable remedy. A lady of Alexandria was seized with a violent fit of the colic, bringing on a weakness and irritability of the stomach, with nausea and vomiting incessantly. Two eminent physicians sent for could prescribe nothing that did any service. Dr. Craik being called in, immediately ordered a large cataplasm of stewed mint in spirits, to be applied as warm as it could be borne, to the pit of the stomach and abdomen. It operated like a charm. The distressing nausea and vomiting left her, the aperient medicines were then retained, and the obstinate constipated state of the bowels was speedily removed.* PEPPER, RED OR CAYENNE, Capsicum Annum— Is culti- vated in our gardens; it is a powerful stimulant, and has been found beneficial in chronic rheumatism. Those who are subject to flatu- * To heighten my satisfaction in this cure, it was wrought by a man, of whom I can never think without feeling the most tender sentiments of grati- rude; I mean my uncle, Dr. James Craik, with whom I was then a student in Alexandria. From the double motive of •pleasure to myself and profit to others, I beg to sketch a short outline of Dr. Craik. Habits of temperance, early adopted and steadily adhered to, imparted to nis constitution, though naturally delicate, a degree of vigour and vivacity that carried him through life very pleasurably, till his eightieth year. After he retired from practice, he continued daily to take considerable exercise ; and such was his activity, that, but a short time before his death, he walked from his country-seat to Alexandria, a distance of eight miles! The virtues which adorn the husband, the parent, the friend, and the mas- ter, have seldom been seen to shine with more durable lustre than in Dr. Craik. In reward of his virtues, Heaven was pleased to distinguish him with un- common favours. For upwards of forty years he was honoured in an extra- 72 570 MATERIA MEDICA. lence will find benefit in using it with vegetables and soup. In cases of violent pain or cramp in the stomach, no medicine is supe- rior to a strong infusion of red pepper, one or two pods to a half pint of spirits, in dose of from a half to a wine glassful. It is also useful, both as a medicine and gargle, in putrid sore throat, when infused in water. Steeped in spirits and applied warm to the extremities in chronic rheumatism, or low stages of nervous fever, when the circu- lation is languid, it has produced the most happy effects. PINK ROOT, CAROLINA, Spigelia Maralandica— Grows abundantly in the southern states, and is deservedly esteemed a ver- mifuge, or destroyer of worms. An infusion, a handful to a quart of boiling water, and one or two tea-cupsful night and morning, is the usual form and dose. With the addition of milk and sugar, children will take it almost as readily as their tea. It sometimes oc- casions disagreeable affections of the eyes ; when this occurs, suspend the use of the medicine until these symptoms disappear, and then select from another parcel, or make tea of the tops only, as it is sup- posed the deleterious effects are in consequence of some other root being attached to it. Pink root is also considered a valuable medicine in fevers, as is verified daily, when given to children in a febrile state for a vermi- fuge, when no other effect has been produced than a removal of the fever. PISS WORT. See Flea Bane. PLANTAIN, Plantago — Has long been employed as an anti- dote against the bites of snakes, spiders, and other venomous insects. The juice, extracted from the whole of the plant, is generally given in doses of two table-spoonsful every hour, or oftener, until the pa- tient be relieved. It is sometimes given in conjunction with hore- hound or rue. The leaves, bruised,' are considered, by some, a good application to fresh wounds. ordinary degree, with the friendship of the great Washington, being all that time his companion and physician. This, however, was nothing compared to the happiness he enjoyed in marriage with a lady, who, for all the charms " of a mind-illumined face, and all the graces of truth, goodness, and harmony of love," never had her superior among the fairest daughters of Eve. " So like an angel did she spend her days, So like a blessed saint's, were all her ways ; So bland, so gentle, all her actions were, One would have thought her an immortal here." After more than fifty years of the happiest life, Dr. Craik was removed to those scenes where bliss immortal reigns. But their separation was short. He first deceased, she for a few months tried To live without him — liked it not, and died. — Heath. MATERIA MEDICA. 571 PLEURISY ROOT, Asclejpias Decumbens — Has a variety of names, as butterfly weed, flux root, decumbent swallow wort. It is a beautiful plant, growing two or three feet high, under fences and upland pastures. The flowers are of a bright orange colour, and ap- pear in July and August. These are succeeded by long slender pods containing the seed, which have a delicate kind of silk attached to them. The root is spindle or carrot-shaped, of a light brownish colour on the outside, white within. This plant possesses great medicinal virtues, and ought, therefore, to be cultivated in our gardens. It has long been employed as a remedy in the treatment of violent cold and pleurisies. No medi- cine is better calculated than this to produce general and plentiful perspiration without heating the body, and hence its well merited fame in curing the disease, which name it bears. Mr. Thompson Mason of Virginia, was among the first who noticed the virtues of this plant, and from his long experience of its utility in pleurisy, re- commended it as a specific. He states, that after the use of an eme- tic, and the loss of some blood, in the incipient stage, he adminis- tered, of the pleurisy root, finely powdered, as much as would lie upon the point of a case-knife, in a cup of warm water, and repeated the dose every two hours until the patient recovered, which happened frequently in a very few days. By these simple means Mr. M. cured great numbers. We have, also, many of the most respectable physicians celebra- ting its virtues in pleurisy, and other recent affections of the breast. A tea-cupful of a strong infusion, a handful to a quart of boiling wa- ter, is given every two or three hours. Professor Barton says the root of this plant in powder possesses a purgative quality, and that he has used it with advantage in dysentery. In Virginia also it has been used with great effect in this complaint. This root is fre- quently resorted to by country people for the relief of pains of the stomach from flatulence and indigestion ; hence it is called, by some, wind-root. The late Paul Hamilton, Esq., ascribed the same virtues of curing pleurisies and dysentery to a plant that grows in South Carolina, and which is also called Pleurisy Root, Asclepias Erectas. He thus describes it : — It grows in rich high lands. The root has the appearance and taste of a small, long, sweet potato ; the stalk erect ; the leaves re- sembling the persimmon leaf, is situated transversely, and when bro- ken, it throws out a viscid milk; blossoms in May and June. The blossoms are a cream colour, with purple centres. Twenty grains of this root in powder, he says, given in warm water or tea, is excel- lent in flatulent colic; and the same quantity repeated every two hours, in pleurisy, will seldom fail to bring on a perspiration, while the pectoral effects are admirable. POISON OAK, Rhus Toxicodendron — Embraces several spe- 572 MATERIA MEDICA. cies, the most dangerous of which is the swamp sumac. The poi- son may be communicated, not only by the touch, but also by the smoke, smell, or steam producing an eruption on the skin, with pain and itching, and sometimes attended with swollen head and fever. One of the best remedies which has come under my notice, is a wash of crude sal ammoniac and corrosive sublimate, two drachms of the former to one of the latter, in a quart of water ; used exter- nally twice or thrice a-day; with a dose or two of salts, or an infu- sion of senna and salts. — I have lately been informed, from a source which can be relied on, that lime-water excels any other applica- tion as a wash in this distressing affection of the skin. The species called sometimes poison wood, has a low shrubby stalk, the leaves somewhat heart-shaped, the flowers small, the berries round, and of a yellow gray colour when ripe. Dr. Anderson, of Hull, has em- ployed the leaves of this species in doses from half a grain to four grains, three times a-day, with success in paralytic cases. Poison vine, called also poison creeper, has a slender stem, and frequently climbs to the top of our tallest trees. The flowers, which appear in June, are small, of a light yellow colour, and have a de- lightful odour. An extract of the leaves, two grains to a dose, and increased, has been successfully employed in paralytic affections, as w T ell as an infusion in tetter- worm and scald head. Professor Barton says, that a decoction has been used with seem- ing advantage in cases of consumption; and others say, that a decoc- tion of the root is serviceable in asthma. POKE WEED, Phytolacca Decandra — Is known by a variety of names, as American nightshade, coacum, garget, skoke. The berries, steeped in spirits, have long been employed in the chronic rheumatism. It has, however, sometimes failed, which may have been owing to the peculiarity of constitution, or to the inertness of the bounce or tincture from age, an effect often observed by Professor Barton, as also by myself. From the authority of this learned pro- fessor, the juice of the ripe berries, inspissated to the state of an extract, and spread upon a rag, or upon the leaf of the plant, is an excellent application to scrofulous or indolent tumours. The juice of the leaves has been applied in the same manner with equal ad- vantage. An ointment of the leaves with lard is good, in various kinds of ulcers. The roots, bruised, are sometimes applied to the hands and feet of the patients in ardent fevers. To make an extract, expose to moderate and continued heat, the juice of the berries or leaves, until by evaporation, it thickens to the consistence of honey. It may also be made from the root, which is equally efficacious. Boil the roots for some time, strain the decoction, and then reboil it to a thick consistence. Other virtues have been recently ascribed to this plant by respectable physicians. An infusion of the leaves is recommended externally as an admi- rable remedy for the piles. One ounce of the root steeped in a pint MATERIA MEDICA. 573 of wine, and given to the quantity of two table spoonsful, is said to operate mildly as an emetic. — It is also said that this plant may be relied on as an efficacious remedy for the venereal disease, in its various stages, even without the aid of mercury. From my own experience of the virtues of poke-weed, I can re- commend it as a most valuable medicine in rheumatic and gouty affections, as also in nocturnal pains, and obstinate ulcerations in the venereal disease, brought on by the excessive use of mercury. The usual form of exhibition is the bounce, a wine glassful three times a-day. The bounce is prepared by filling a jug with the whole berries when ripe, and then pouring as much spirits to them as the vessel will contain. An ointment, prepared by simmering slowly the leaves or a hand- ful of the root scraped in a pint of hog's lard, with a small portion of bees-wax, has been used with great success in cancers, and various kinds of ulcers. POLYGONUM — An infusion of it, as a diet drink, is a powerful promoter of urine, and very useful in gravel complaints. POLYPODY, COMMON, Polypodium— Grows on old walls, shady places, and at the roots of trees, flowering from June to Octo- ber. The root has a sweetish taste, but by long boiling becomes bitter. An infusion of half an ounce of the fresh root in half a pint of boiling water, in doses of a wine glassful every hour or two, operates as a mild laxative. POMEGRANATE, Punica— Is cultivated in the southern gar- dens. The fruit is agreeable to the palate, and possesses the proper- ties of subacid fruits. — Its rind, boiled in milk, and drunk freely, or in powder, a tea-spoonful for a dose three times a-day, has been used with success, in diarrhoeas, dysenteries, and other diseases requiring astringent medicines. The flowers possess the virtues of the rind, only in a less degree. POPLAR TREE, OR WHITE WOOD, Liriodendrum Ttt lipifera — The bark of this noble tree, as well as the root, is a very strong bitter, and considerably aromatic. In intermittents, in the last stage of dysentery, and other disorders requiring tonic medicines, it is considered but little inferior to the Peruvian bark, and is generally employed in similar doses and forms. Professor Bigelow states that the bark is acceptable and apparently useful to patients who have derived occasional benefit from " Hux- ham's tincture," " Stoughton's elixir," and similar compositions of bitter and aromatic drugs. There is another species of poplar, the aspen tree, populus trcinula, the bark of which, according to Professor Barton, is also an excellent tonic and stomachic. 574 MATERIA MEDICA. POPPY, TVTIITE, Papaver Somniferum — Grows in our gar- dens, and yields a juice, which, when inspissated, to a proper consis- tence, is called opium. According to the experiments of Dr. S. Ricketson, of Dutchess county, New York, the opium obtained from our poppies, is equal, if not superior to the imported. With respect to the method of cultivating the plant, and preserving the opium, we shall insert the directions given by Dr. Ricketson. " The poppy seeds should be planted about the middle of May, in rich moist ground, an inch deep, and ten or twelve inches apart, and kept clean. When the plants are arrived to the state of flower- ing, on a sun-shining day, cut off the stalks, at about an inch dis- tance from the flowers, and as soon as the juice appears, which it does at first equally well on the part of the stalks cut off with the flowers, as on the standing part, collect it with a small scoop, or pen- knife. After the juice ceases to appear on the standing stalk, it should be cut off about an inch lower, when it will be found to yield almost as freely as before, and repeated as long as any juice appears. The juice, when collected, should be put into an evaporating pan, placed in the sun's heat, and frequently stirred, till it becomes of a consistence to be formed into pills, or to be made into rolls for keep- ing and exportation. The quantity of opium that may be preserved, depends very much on the largeness of our plants, and the care used in collecting it. From one poppy plant, I have obtained seven grains of opium. If any would choose to have the opium freed from its impurities, it may be easily done, by pressing the juice, before it is inspissated, through a linen strainer; but if pains be taken, accord- ing to the foregoing directions, I believe there will be little or no occasion for it." A strong decoction of the dried heads mixed with half the quantity of sugar, or honey, and formed into a syrup, by simmering slowly by a gentle fire for an hour, is occasionally used in doses of a table- spoonful in coughs and breast complaints, on account of its anodyne effects. — Poppy heads are also used externally in fomentations and poultices, either alone or conjoined with the leaves of southern wood, camomile flowers, or other ingredients. POTATO, SWEET, Convolvulus Batata— From _ this root Bowen's patent sago is prepared, which forms a veiy nutritious jelty, like arrow root, and is prepared in the same manner ; to which the reader is referred. The process generally used for procuring the powder of the sweet potato, is to grate the clean roots, wash the mass through brass sieves of different sizes, and collect the flour at the bottom of the vessel which receives the fluid ; finally, dry it in pans either by the fire or in the sun. The vine of the sweet potato, supports the famous insect called the potato fly, which, from repeated experiments, is found fully equal MATERIA MEDICA. 575 in all respects to the best Spanish flies. The potato flies general] v make their appearance about the last of July or first of August, and may be collected in great abundance morning and evening, by shaking them from the leaves in a vessel of hot water, and after- wards drying them in the sun. These insects will also feed upon the vine of the Irish potato. As they can be procured in immense quantities annually, with but little trouble, every family should care- fully collect them. POTATO, WILD, Convolvulus Panduratus — Grows in low grounds and sandy soils, near running water. — It trails along the ground several feet, much like a grape vine, the root very large, hard, and white, running very deep in the earth ; the leaves triangular, the flowers are whitish, with a purple tinge, and bell-shaped. It is called wild rhubarb, and from the article whose name it bears, is employed as a purgative in doses from a tea to a table-spoonful of the powdered root. Professor Barton says, the root in powder or decoction has been much recommended in Virginia, and other parts of the United States, in cases of gravel. The decoction is prepared by boiling slowly a handful of the root sliced or bruised in three pints of water to a quart, of which, in gravel complaints, a tea cupful may be taken four or five times a-day. PRICKLY ASH, AND PRICKLY YELLOW WOOD, Zan- thoxylum — Possess the same virtues. Both species are covered with numerous prickles, whence the name. — Both the bark and berry are of a hot acrid taste, and when chewed, powerfully promote spittle. It is used in this way to cure the toothache, as well as putting some within the hollow, also to cure the palsy of the tongue. The prickly ash has a great deal of reputation in the United States as a remedy in chronic rheumatism. In that disease its operation seems analogous to that of Mezereon and Guaiacum, which it nearly resembles in its sensible properties. It is not only a popular remedy in the country, but many physicians place great reliance on its pow- ers in rheumatic complaints, so that apothecaries generally give it a place in their shops. It is most frequently given in decoction ; an ounce being boiled in about a quart of water. Dr. G. Hay ward, of Boston, states that he took this decoction in his own case of chronic rheumatism, with evident relief. It was prepared as above stated, and about a pint taken in the course of the day, diluted with water sufficient to render it palatable by lessening the pungency. It was warm and grateful to the stomach, produced no nausea nor effect upon the bowels, and excited little, if any, perspiration. There is no medicine which I have found so effectual in relieving nocturnal pains, and disposing venereal ulcers to heal, as the prickly ash in the above form and doses. A tincture prepared by steeping half a pint of (he berries, or a handful of the bark, in a bottle of spirits, is much esteemed as a re- 576 MATERIA MEDICA. medy in doses of a wine-glassful, in flatulent colics. It is sometimes employed in this form, in cold phlegmatic habits, afflicted with the rheumatism. PRICKLY PEAR — Grows on sandy lands and rocky places. A large handful of the pear cut in slices, boiled in a quart of milk, and taken in doses of a gill every morning, is reputed to be of great ben- efit in scurvy, dropsy, cancers, and cutaneous eruptions; and that the inner soft mucilage of the pear, while green, on a rag, to ulcers, morning and night, is very efficacious. It is also said that a fresh piece of the inner side of the pear, applied twice a-day to corns, af- ter soaking the feet in warm water, and paring off the horny part, will, in a few days, perform a cure. PRIDE OF INDIA, OR CHINA, Melia Azedarach— Is now completely naturalized to the southern states. The public walk and streets of Savannah and Augusta, are ornamented by rows of this tree, a mile long, which furnish a most delighful shade against the scorching sun, and add not less to the healthiness than to the beauty of these cities. Independently of its luxuriant verdure, and cooling shade, it is highly valuable for its medicinal properties, being now ascertained to be one of the best vermifuges in nature. Many physicians in the southern states have witnessed its re- markable effects in destroying and dislodging worms. It has been even found a remedy against the tape- worm. I have not myself made use of this medicine, possibly because of the deleterious effects of the berries on some pigs and a parrot. In the fall of the year 1795, at a country seat which I then owned, in Lancaster county, Virginia, a sow with eight or ten pigs came into the yard where I had several trees of the Pride of China, and ob- serving the pigs to eat with avidity of the berries, which were drop- ped on the ground, I had many of them thrown from the tree, and in a few hours all the pigs were seized with the common symptoms of inebriation, and died. The sow did not appear to be the least affected, although she also ate of them. The death of the pigs would not have operated so strongly on my mind had it not been for a parrot, which not long after fell a victim to these berries. This enchanting bird, which spoke many words as plainly as a human person, and w T hich for several years had been a pet in the family of Dr. Andrew Robertson, the father of Mrs. E #### , had not long ar- rived at its new home, before it was tempted to eat of the fruit of this tree. A gentleman who was not apprized of the deleterious properties of this berry, presented the much admired Poll with one of them, which she soon ate, and relished it so well, as loudly to call out, "give me some more! give me some more !" After consum- ing several, she, in a short time, fell into a state of stupefaction, fol- lowed by a violent purging, which soon terminated her existence. The common modes of using this medicine, are the infusion or tea, MATERIA MEDIC A. 577 and saturated decoction. Of the former, a handful of the bark to a quart of boiling water, is given in doses of a small tea-cupful morn- ing and night. The decoction is made by boiling a large handful of the fresh bark of the root in three pints of water, to a quart, which is given to children in doses from a half to a whole wine-glassful. Dr. Kollock, of Savannah, observes, when exhibited in the latter form, every three hours, until it operates, he has found it beneficial as a febrifuge in those affections usually denominated worm fevers, but where no worms are voided. The pulp which invests the stone of the fruit, pounded with tallow, has been successfully employed in cases of scald head. Would not an ointment prepared by slowly simmering the root in hog's lard, be found also an excellent applica- tion to that loathsome disease; also the tetter worms and ulcers? PUCCOON. See Blood Root. QUEEN OF THE MEADOWS— Grows in hedges, and on the sides of meadows, about four feet high ; the stalk reddish, leaves long, spear-shaped, and opposite each other, flowers purple. A large handful of the roots boiled in three pints of water to a quart, and given in doses of a tea cupful every two hours, is said to be an excellent remedy in suppression of urine, and for carrying off the water in dropsy. QUINCE TREE, Pyrus Cydonia — The liquor expressed from the ripe quince, also the syrup, has frequently been given with great success in nausea, vomiting, and fluxes. The juice of the quince with sugar, a gallon of one to two pounds of the other is said to make a most delightful wine. The ripe fruit, sliced and steeped in French brandy or spirits, with a little sugar, or equal parts of the juice and spirits sweetened, forms an admirable cordial and stomachic. The quince makes also a nice preserve, and the seeds a fine mucilage, which, with sugar and nutmeg, is an ex- cellent drink in dysentery. RADISH, Raphanus — Is esteemed as an antiscorbutic, particu- larly if eaten with the skin. When old, or after having been kept some time, they ought to be avoided, especially by persons of weak stomachs, as apt to create indigestion and colic, and to render the breath disagreeable. RASPBERRY, Idaus — Like the rest of the rich subacid fruit. when ripe, are wholesome and nourishing. Raspberries, as well as strawberries, held in the mouth, will dissolve tartarous concretions formed on the teeth. RATTLE, OR SENECA SNAKE ROOT, Polygok* Senega — Grows nearly a foot high, the leaves pointed, and somewhat oval: 73 578 MATERIA MEDIC A. the stalks upright and branched, the flowers white, the root variously bent and jointed, whence it is supposed to resemble the tail of the animal whose name it bears. The first reputation of the Seneca root was one which it divides with a multitude of other plants, that of curing the bite of the rattle snake. A reward was given by the legislature of Pennsylvania, to Dr. Tenant, for the promulgation of this supposed property. When, however, we consider the number of cases of recovery from the bite of this serpent, under every variety of treatment, we cannot avoid the conclusion, that these injuries are not necessarily dangerous, and that spontaneous recoveries are, perhaps, as frequent as those which are promoted by medicine. In violent colds, croup, pleurisy, acute rheumatism, and all in- flammatory complaints, I can recommend it as an admirable medi- cine to promote perspiration. The best form of using it is in decoc- tion, a handful to a quart of boiling water, a wine glassful to adults, every two or three hours, increasing or lessening the quantity to avoid vomiting and purging. Professor Chapman recommends it very highly in obstructions of the menses ; four ounces of the decoction to be taken in the course of the day, increasing the quantity when the menstrual effort is ex- pected, as far as the stomach will allow. If this excite nausea, aro- matics are to be added, as cinnamon, calamus and angelica. Dr. Archer, of Harford county, Maryland, was among the first who noticed the efficacy of this medicine in cases of croup or hives. He directs a tea-spoonful of the strong decoction to be given to a child every hour or half hour, as the urgency of the symptoms may demand, and, during the intervals, a few drops occasionally, until it acts as an emetic or cathartic ; then repeated in small quantities, to keep up a constant stimulus in the mouth and throat. Patients who use this medicine, should not be permitted to drink any thing what- ever for some time after each dose. He employed it in the form of a powder in doses of four or five grains, mixed with a little water. Professor Barton, with his usual candour and liberality, observes, " I am persuaded that the Seneca is a very important medicine in the treatment of this common, and too frequently unmanageable dis- ease; and praise is, in my opinion, due to Dr. Archer for his impor- tant discovery, for such I cannot but deem it. That the Seneca is a specific or certain remedy for the cure of croup, I do not believe ; but from my own experience I am led to repose more confidence in the use of this medicine than in any other. I have made use of a very strong decoction of the root. I have always given it in large quantities. It appears to be chiefly beneficial when it occasions an expectoration of mucus, and when it proves emetic. It is also very useful by virtue of its purgative quality. But I have known it oc- casion very plentiful stools, without benefiting the patient. Indeed, m the exhibition of Seneca, I would rather wish to guard against large purgings. I have sometimes treated my patients almost entirely MATERIA MEDIC A. 0/\J with Seneca. Even in such cases I have perceived most un equi- vocal good effects from it : but, have more generally given along with the Seneca, calomel, and sometimes calomel combined with ipecacuanha. I have not omitted the employment of the lancet, though this in many cases of croup is not absolutely necessary, and the use of blisters or sinapisms applied near the seat of the disease. I am happy to close this short notice by observing, that several re- spectable physicians in Philadelphia inform me that they have used the Seneca with much advantage in the disease in question. In various forms of dropsy, the Seneca root has been resorted to with advantage, and has received the commendations of Percival, Millman, and some others. Its cathartic and diuretic effects are very considerable, when persevered in, in large quantities; and have, in many instances, effected the dissipation of dropsical swellings. In the prevailing epidemic I have found a decoction of this vegeta- ble, taken freely at the commencement of the disease, a medicine of great utility. RATTLESNAKE YIOLET. See Violet. RED CEDAR, Juniperus Virginiana — Is found from Lake Ghamplain to the Cape of Florida. The leaves have a strong disa- greeable taste, with some pungency and bitterness. Its most fre- quent use is in the composition of the cerate employed for keeping up the irritation and discharge of blisters. This preparation is the same with the Savin cerate, used in Europe, the leaves of the red cedar being substituted for the Savin. When properly prepared by boiling the fresh leaves for a short time in about twice their weight of lard, with the addition of a little wax, a cerate is formed, of pecu- liar efficacy as a perpetual epispastic. When applied as a dressing to a newly vesicated surface, and afterwards repeated twice a-day, it rarely fails to keep up the discharge for an indefinite length of time. Under its operation, the discharge usually changes from a serous to a puriform appearance, and concretes upon the surface ; so that it re- quires to be removed from time to time, to admit the full action of the cerate. Internally, the leaves have been found to exert effects very similar to those of the Savin. They have proved useful as an emenagogue, and as a general stimulant and diaphoretic in rheumatism. They have also had some reputation as a diuretic in dropsy. RHUBARB, WILD. See Potato, Wild. ROSE, Rosa. — The hundred-leafed, or damask rose, is justly termed the queen of flowers. Otto, or essence of roses, is obtained from these by distillation, and is doubtless the most elagant perfume in vegetable nature. Independently of their use in this manner, a decoction of its leaves will be found a mild laxative, and, when 580 MATERIA MEDICA. formed into a syrup, may be given with advantage to children. The conserve of roses is also prepared from them for medicinal purposes. ROSE WILLOW, Salix — Grows near brooks, along the banks of rivers, and on the borders of meadows. It is about the size of an apple tree, and covered with a grayish -coloured bark, and very red within, with a bunch in the top resembling a bunch of roses. Four ounces, or a large handful of the bark, boiled in three pints of water to a quart, and taken in doses of a tea-cupful three or four times a-day, is said to be an excellent remedy in cases of gleet, the whites, immoderate flowing of the menses, and in cutaneous eruptions. RUE, Ruta — Has an ungrateful smell, and a pungent bitter taste. The leaves are acrid, and when applied to the skin are apt to produce blisters. Employed in the form of tea, they are reputed to be of great service to persons of cold phlegmatic habits. According to Boerhaave, an infusion of the leaves powerfully promotes perspi- ration, quickens the circulation, removes obstructions, and is particu- larly adapted to weak and hysterical constitutions, suffering from re- tarded, or obstructed secretions. SAGE, Salvia — An infusion of the leaves or tea, is considered serviceable to persons of cold phlegmatic habits, labouring under nervous debility. Sweetened with the addition of a little lemon juice, it forms an exceedingly grateful and useful drink, in febrile disorders. Sage was supposed by the ancients to possess the virtue of pro- longing human life; hence the following verse : "Cur moriatur homo, cui salvia crescit in horto?" How can a man die, in whose garden there grows sage? in allusion to its many virtues. What a shameful abuse of this pretended property was made by the late Sir John Hill, in his patent tincture of sage, for the prolonging of human life, and warding off old age, is known to every one. This conduct could not fail to draw upon him the pen of the wits of the age; and Garrick, with Thomson, conjointly, published the following epigram : — "Thou essence of dock, valerian, and sage,, At once the disgrace and pest of the age, The worst that we wish thee, for all thy bad crimes, Is to take thy own physic, and read thy own rhymes." Dr. Hill made the following reply : — "Ye desperate junto, ye great or ye small, Who combat dukes, doctors, the deuce, and them all, Whether gentlemen, scribblers, or poets in jail, Your impertinent curses shall never prevail : I'll take neither sage, dock, nor balsam of honey ; Do you take the physic, and I'll take the money." MATERIA MEDICA. 581 Such shameless imposition on common sense, deserves something worse than ridicule ; for deceiving the sick and helpless, they merit the execrations of every man who has one spark of humanity. SAMSON SNAKE ROOT— Grows from six to twelve inches on diy land, and bears on the top two or three pale blue flowers ; leaves opposite, sword-shaped; the root matted, variously bent, and has an agreeable bitter taste Upon the respectable authority of the honourable William May- rant, of South Carolina, the root of this plant possesses in a very great degree tonic powers. He stated to me, that being himself re- duced to a mere skeleton by dyspepsia, or indigestion, and having tried the usual remedies employed in such cases, without receiving any benefit, he was at length induced, as his last hope, to try the virtue of this plant, which had been recommended to him by a negro man. He was directed to steep a handful of the root in a bottle of spirits, of which he was to take half a wine glassful diluted with wa- ter three times a-day ; and such was the astonishing effect wrought by this medicine, that in a few weeks his health was perfectly rein- stated. He discovered the plant to grow near Fredericksburg, Vir- ginia, and collected some of it to exhibit in Washington. Several persons in delicate health, and troubled with dyspepsia, were readily persuaded, from the recommendations of Col. Mayrant, to make use of his favourite remedy, and not without receiving considerable benefit It may be taken in the form of powder, tincture, or de- coction. SANICLE, AMERICAN. See Alum Root. SARSAPARILLA, Smilax Sarsaparilla — Grows in several parts of the United States. It is a small vine resembling a bramble. A decoction of sarsaparilla, prepared by boiling a large handful of the root in a quart of w T ater, till the third part be evaporated, has long been employed as an auxiliary to mercury, in the treatment of venereal complaints. It promotes perspiration, attenuates viscid humours, relieves venereal headache, nocturnal pains, and disposes venereal ulcers to heal. In rheumatic affections, cutaneous disor- ders, and scrofula, it is a very useful medicine. It may also be ex- hibited in the form of powder in doses of two drachms, or extract in doses of one drachm, three or four times a-day. SASSAFRAS, Laurus Sassafras. — An infusion or tea of the flowers, or bark of the root, has often been successfully given as a sweetener or purifier of the blood, in scorbutic, venereal, and cuta- neous disorders, or where an acrimony of the fluids prevails. Con- joined with bark of dogwood, cherry tree or oak, it is very useful in obstinate intermittents. The oil, externally applied, in die chronic rheumatism, and also in wens, has oftentimes proved salutary. The 582 MATERIA MEDIC A. pith of the small twigs, in water, forms a mucilage of excellent use for sore eyes, and as an injection in the incipient stage of gonorrhoea. It also affords, when sweetened, with the addition of nutmeg, a palatable jelly, useful in dysentery and febrile diseases. SCULL CAP, BLUE. See Hooded Widow Herb. SCURVY GRASS, Cochleara Officinalis — Is a pungent stimu- lating plant, and in the simple state of a salad, or, in the form of ex- pressed juice, a wine-glassful three times a-day, has long been es- teemed one of the best of all the antiscorbutic plants. SENNA, AMERICAN, Cassia Marilandica— Is easily cultiva- ted from the seeds, and ought to be more generally introduced in our gardens. It has long been employed as a purgative. To increase its effects on the bowels, manna, salts, or tamarinds, are generally added. To correct its ill flavour, and prevent griping, it should be joined with some aromatics, as coriander or fennel seed, ginger, &c. In the form of decoction, a handful to a pint of boiling water, the dose is a tea-cupful every hour or two until it operates. It may also be ex- hibited in the form of tincture, to relieve flatulent colics, four ounces of senna to a quart of spirits, with an ounce of coriander seed, or ginger, and a wine-glassful the dose. SKOKE. See Thorn Apple. SKUNK CABBAGE, DraconituF&tidum — Abounds in swamps and meadows, and emits a disagreeable smell, nearly resembling that of a skunk or polecat, and from this, and its leaves resembling those of a cabbage, it has acquired its name. The roots dried and powdered, have proved of excellent use in asthmatic cases, and often afforded relief in this distressing disease, when other means were ineffectual. It should be exhibited during the paroxysm, and repeated as circumstances may require, in doses of thirty or forty grains. It will be proper to persevere in the use of it for some time after the paroxysm has gone off, until the patient has perfectly recovered. Dr. Cutler has celebrated its efficacy in his own case of asthma, after other medicines had failed. In one of the most violent asth- matic cases, two tea-spoonsful of the powdered root, in spirits, pro- cured immediate relief; and, on repeating the trials with the same patient, it afforded more lasting benefit than any other medicine. In childbed it produces the desired effect, in doses of a tea-spoonful re- peated occasionally. In numerous other instances of spasm, and also in chronic and acute rheumatism and dropsy, in powder or decoc- tion, it has performed important cures. The seeds possess the same virtues as the root. MATERIA MEDICA. 583 Dr. Cutler vehemently cautions, that, in collecting the roots, the white hellebore, or poke root, which some people call skunk weed, be not mistaken for this plant, as the consequence might be fatal. There is an obvious difference ; the hellebore has a stalk, but the skunk cabbage has none ; and the roots of the latter are much larger than those of the former. SNAKE ROOT. See Virginia Snake Root. SOAPWORT, Saponaria Officinalis — Grows in moist swamps and meadows, particularly on the Ohio river, where it is used as a substitute for soap. It rises about a foot high, the leaves are pointed, and furnished with three ribs, the flowers numerous, large, and of a pale pink colour. A handful of this plant boiled in three pints of water to a quart, in doses of half a pint, three or four times a-day, has been found useful in the jaundice, obstructions of the liver, and the venereal disease. SORREL, Oralis Acetosella — Called also sour trefoil, or cuckow bread, yields, on expression, a grateful acid juice, which has been beneficially used in the scurvy and scorbutic eruptions. An infusion of the leaves makes a palatable diet drink in fevers, and on being boiled in milk, forms an agreeable whey. A conserve made of the leaves, with double their weight of loaf sugar, forms an excellent substitute for lemons, and may be given with advantage, in all pu- trid and other fevers, where antiseptics are indicated. The leaves bruised, and externally applied to scrofulous ulcers, have produced excellent effects, by promoting suppuration and granulation. SOUTHERN WOOD. See Mugwort. SOUTH-TEA, OR YAUPON, Alex Vomotoria— Grows abun- dantly in the southern states. It rises about twelve feet high, shoot- ing into many upright, slender, stiff branches, covered with whitish smooth bark; the leaves small, evergreen, and saw-edged; the flow- ers small and white, and grow promiscuously among the leaves, succeeded by small berries, which become red in October, and re- main so all the winter. It is held in great esteem among the southern Indians. They toast the leaves, and make a decoction of them, which is called black drink. An infusion, or tea of the leaves, is considered as palatable as Bo- hea tea, and when used freely, is a powerful diuretic, and hence of service in the cure of dropsy and suppression of urine. SPIKENARD, Aralia Racemosa — Grows in low rich grounds and among rocks, to the height of three or four feet; the leaves are 584 MATERIA MEDICA. many, on long branches, from a thick purplish stalk, flowers very small, of a bluish colour, producing berries much resembling those of the elder, of a sweetish pleasant aromatic taste. The roots are very long, and about the thickness of a linger. A pint, of berries steeped in a quart of spirits, in doses of a wine- glassful, is said to be a speedy cure for the gout in the stomach. The roots in the form of infusion, a handful to a quart of water, and given in doses of a tea cupful three or four times a-day, have been found efficacious in gouty complaints. The fresh root applied in the form of poultice, is said to be excellent for wounds and ulcers. SPLEENWORT. See Maiden Hair. SPRUCE LAUREL. See Mezereon. SQUIRREL EAR, OR EDGE LEAF— According to the late Paul Hamilton, Esq., is produced on barren pine land, in Carolina and Georgia. It is a species of sage, and very efficacious as an anti- dote to the poison of the snake bite. It is known by the remarkable characteristic which forms its name; the leaf, instead of the surface, presents its edge to the sun, and is in colour and shape, very much like the ear of the squirrel, although larger. The stalk never rises beyond three feet, and its leaves are alternate and transverse. A wine-glassful of the juice of this plant has been known to rescue from death persons bitten by the rattlesnake, who were so far gone, as to be incapable of speaking. The flower of this plant is white and fuzzy, and appears in every warm month in the year; the smell that of mellilot, with a slight tincture of the aromatic. STAR GRASS, Aletris Farinosa — Grows in fields and about the edges of woods, and flowers in June and July. The leaves are grass-like, but smooth and stiff, of a willow-green colour, and spread like a star upon the ground. " No plant," says Dr. Bigelow, ''sur- passes this in genuine, intense, and permanent bitterness." Hitherto, it has been chiefly used as a tonic, exhibited in small doses. STINK WEED. See Thorn Apple. STRAWBERRY, Fragaria— The fruit of this plant is delicious, and being of a cooling and laxative nature, may be considered as medicinal. If freely eaten, they impart their peculiar fragrance to the urine, and when retained in the mouth for some time, dissolve tartareous concretions on teeth. They are of great service in cases of scurvy, and, according to Linnseus, a copious use of them has proved a certain preventive of the stone in the kidneys. An infusion of strawberry leaves, while young and tender, makes excellent tea ; but for such purpose they ought to be dried in the shade, being slightly bitter and styptic. They have been used with advantage m MATERIA MEDICA. 585 laxity and debility of the intestines, as likewise in hemorrhages and other fluxes. Lastly, they are of considerable service as aperients in suppression of urine, visceral obstructions, and jaundice. SUMACH, COMMON, Rhus Copallinum.— The berries or seeds, when ripe, are red and very acid. An infusion of them, sweetened with honey, is a good gargle for the sore throat, and for cleansing the mouth in putrid fevers. Mr. Jesse Torrey considers the bark of the root of sumach to be one of the best antiseptics produced by vegetation. Corroding ul- cers, defying every common application, immediately began to heal by washing them with a strong decoction, and applying the boiled bark as a poultice. He says it is a very important material in decoc- tions for hectic and scrofulous diseases. Sumach constitutes one of the ingredients of the following recipe, which was handed to me by a gentleman of the first respectability and veracity, as a remedy for the venereal disease. Of the inner bark of pine and swamp elm, and the bark of the root of sumach, take each one pound ; boil them in a gallon of water to three quarts, drink half a pint three times a-day: if costiveness be produced, a dose of salts may be used. If there be ulcers, they are to be washed with a decoction made warm. The detergent effects will appear in a very short time. Abstinence from too much stimulants will accelerate the cure. This remedy is one of Heaven's best mercies to offending man ; and instances can be produced of the effects of it, which would stagger credulity. Mercury, and nitric acid have failed, but this has never been known to fail when properly applied. It is, moreover, a fine application in dysenteric affections. SUNDEW, Ros Solis— Called also red root, or youthwort. Grows in mossy bogs, flowering in July and August. The whole of this singular plant is acrid, and its juice sufficiently caustic to corrode corns and warts. It is said, the juice, properly mixed with milk, and applied to the skin, will remove freckles and sun-burns SWALLO WWORT. See Pleurisy Root. TANSY, Tanacetum Vulgare. — This -plant possesses a warm taste, and may be used as a substitute for hops. An infusion of the leaves is recommended for a weak stomach, hysteric complaints, and obstructed menses. According to Dr. Withering, its seeds are an excellent vermifuge, in doses from a scruple to a drachm, and that if animal substance be rubbed with the herb, it will be effectually preserved from the attack of the flesh fly. 74 586 MATERIA MEDICA. THORN APPLE, Datura Stramonium — Has a variety of names, as James-town, or jimson weed, French apple, stink w r eed, &c. Its common name, James-town weed, is said to have arisen from the circumstance of a number of sailors being violently diseased by ignorantly eating the boiled plant at Jamestown, in Virginia, at its first settlement. It grows among rubbish, and on dunghills, to the height of two or three feet, flowers in July and August. The corolla is funnel-shaped and plated white with a tinge of purple. The capsule is large, egg-shaped, and covered with thorns, which have four divisions, and contain numerous kidney-shaped seeds. The leaves are large, egg-shaped, and deeply indented, of a disa- greeable smell, and nauseous taste. Every part of this plant is a strong narcotic poison ; nevertheless, when judiciously administered, it is unquestionably one of the most valuable medicines in our possession. Professor Barton considers it a medicine of great and invaluable powers, especially in cases of mania, attended with little or no fever, or with a cold skin and lan- guid circulation. The form in which he exhibited it, w T as that of an extract prepared from the fresh leaves, beginning with a few grains, and gradually increasing the dose to fifteen or twenty grains. In one case of mania, in a woman, he increased it to sixty grains. In a few weeks it brought on an eruption in various parts of the body, " and she was dismissed," he observes, " from the hospital, per- fectly cured." Dr. Fisher recommends it highly in those cases of mania in young persons, where fits occur daily, or monthly, at regu- lar periods, especially if assisted by chalybeates, or such other medi- cines as particular symptoms require ; but advises the free and regu- lar use of it, one or two doses every day. The most convenient form, especially for children, he thinks, is the saturated tincture: the requisite dose may be known by the dilatation of the pupils. Dr. Alexander King, of Connecticut, has employed this medicine, in the form of decoction, one drachm of the seed bruised, boiled in half a pint of water to a gill, in several cases of inflammation of the brain, attended with delirium. The following is one of the cases re- cited by the doctor. A man of robust constitution, and sanguine habit, about twenty- six years of age, after drinking pretty freely, w T as seized with a slight paroxysm of the apoplexy, which was followed by a cold fit of fever, attended w T ith a violent pain of the head, and delirium. On the second day, I found him delirious, with an inflammation of the brain, or rather the meninges. I bled him largely, so that he even fainted in a recumbent posture, which was succeeded by another partial paroxysm, similar to the first. I put him on a course of medicine, nearly the same as prescribed in a former case. The next day I found no abatement of the symptoms ; he had slept none for two nights past, and was quite outrageous. I then prescribed for him a decoction of the seeds of the datura stramonium, and directed the nurse to give him a tea-spoonful every quarter of an hour. I MATERIA MEDICA. 587 found, on visiting him the next morning, that soon after taking the decoction, he became calm and composed, and went to sleep. I continued the same medicine through the course of the fever, which lasted about seven days, except one day in which I purposely omit- ted the use of it, in order fully to satisfy myself as to the operation of the medicine. On that day the delirium returned, and he slept none the night following. The next morning I had recourse to the decoction as usual, and it produced the same salutary effects as before. In this case, I had a fair opportunity to observe the action of the medicine, in an early stage of the disease, which was cooling, ano- dyne, and sedative. As a remedy in epilepsy, Professor Barton thinks it may be relied on even in the most deplorable cases. A lady, aged fifty-five, having for some months been afflicted with alarming attacks of epilepsy, by which her powers of intellect and of articulation were impaired, hap- pily experienced a restoration, by taking one grain of the extract once in twenty-four hours. Although she did not suffer another at- tack, after commencing the course, she found it necessary to continue it for several months, to remove all apprehensions of a recurrence. A single grain seldom failed to excite unpleasant vertiginous sensa- tions, accompanied with efflorescence of her face, and some degree of sleepiness. In asthma and spasmodic cough, stramonium is said to have proved essentially beneficial. It is also said to have pro- duced salutary effects in cases of chronic rheumatism, and difficult menstruation. As this medicine is indued with most active powers, it ought to be administered in very small doses at first, and the quantity gradually increased daily, until it produce, in a slight degree, vertigo or dilata- tion of the pupil. In the course of my practice, I witnessed the deleterious effects of this plant in a child, who was attacked with convulsions similar to those which attend persons afflicted with the disease termed St. Vi- tus's dance, accompanied with delirium, tremour, thirst, glaring eyes, dilated pupil, and considerable efflorescence of the skin. The parents were perfectly ignorant of the cause of the child's sudden indisposition; but from the symptoms, I was convinced it had taken some of the stramonium, and on making the necessary inquiries, learned that it had been playing with some of the seeds a few hours before. Immediately on visiting the child, I directed the warm bath, and gave it six or eight grains of blue vitriol, which was re- peated at the interval of fifteen minutes, before it excited vomiting-. when some of the seeds were thrown up. After the operation of the emetic, I administered a large dose of castor oil, which, assisted by stimulating injections, produced in a few hours some evacuations, and the child was entirely relieved from all those distressing- symp- toms. Domestic practitioners will recollect, that two or three grains of blue vitriol is a full dose for adults; and the large dose given in 58S MATERIA MEDICA. this case, was from persuasion that the child's stomach had been de- prived of its sensibility, through the narcotic effects of the poisonous seeds. The extract may be made by exposing the juice of the plant to the heat of the sun, or by boiling the bruised seed or leaves in water for the space of four hours; then strain off the liquor, evaporate over a gentle fire, without taking off the scum, until it has acquired the thickness of syrup : then place it in a warm oven, in an earthen ves- sel, until it becomes of a proper consistence for use. The dose is from one to two grains, or more, for an adult. The saturated tinc- ture is prepared by steeping one or two hands full of the leaves in a half pint of spirits for a few days. The stramonium has also been employed externally with the most happy effects. In recent wounds, inflammations, or bruises, the leaves, either alone, or united with bread and milk poultice, have been applied to the part with manifest advantage. In the form of ointment, which is prepared by simmering slowly the fresh leaves bruised in hog's lard, with about one-eighth part of bees-wax, for an hour, and then strained through a coarse cloth, it will be found ex- cellent for the piles, scalds, and burns. From my own observation it far excels all other applications I have made to obstinate cutaneous sores, ill-conditioned ulcers, and painful cancerous affections. THOROUGHWORT, Eupatorium Porfoliatum—ls known also by the following names : thoroughstem, crosswort, boneset, and Indian sage. The first of these names, thoroughstem, has been im- posed upon it from the peculiar structure of the leaves, which are opposite, and appear as though the stem were thrust through them. It has received the second name, of crosswort, by which it is known in many parts of Virginia, from the position of the leaves, each pair of which take their origin from opposite sides of the stem, so that they cross each other nearly at right angles. I am at a loss, says Professor Barton, to refer the word boneset to its real origin ; but I presume the plant received this name from the great relief which on many occasions, it has been found to afford to persons labouring under violent remitting and other fevers, in which the bones are greatly pained. The resemblance of the leaves of this plant to those of the common sage, was long ago remarked by the botanists. Hence the name Indian sage, by which the eupatorium is known in some parts of Pennsylvania. This plant flourishes in wet meadows, and other moist places. The stalk is hairy, and rises from two to four feet. The flowers are white, and appear in July and August. The leaves at each joint are horizontal, saw-edged, and rough, from three to four inches long, and about one inch broad at the base, gradually lessening to a very acute point, of a dark green, and covered with short hairs. This plant possesses very active powers, and has been exhibited with uncommon advantage in intermittents, remittents, and other MATERIA MEDICA. 589 diseases of debility. When exhibited m the form of a warm decoc- tion, a handful of the herb boiled in a quart of water, a wine-glassful every two hours, has proved peculiarly beneficial, says Professor Barton, in fevers, by exciting a copious perspiration. In larger doses it proves emetic ; with which view it is used in some parts of the United States, as an excellent remedy in intermittents. The dried leaves in powder, in doses of twelve or fifteen grains, are said to operate gently on the bowels. Every part of this plant may be ad- vantageously employed in practice. The flowers, as a tonic bitter, are deemed equal to the flowers of camomile, for which they might be substituted on many occasions. This medicine has also been found very efficacious in cutaneous diseases. In a peculiar and distressing affection of the herpetic kind, which was formerly very common in Virginia, and there known by the name of James River ring worm* Professor Barton states, from the respectable authority of Dr. Thomas Knox, of Cul- pepper county, Va., that a decoction of this plant drunk daily, for a considerable time, made a perfect cure. A wine-glassful of the ex- pressed juice of the green herb drunk every hour, is celebrated as a certain cure for the bite of a rattlesnake. The bruised leaves should be applied to the part. THROAT ROOT. See Avens. THYME, GARDEN, Thymus Vulgaris— Is one of the most powerful aromatic plants, and, as such, is frequently employed in the form of tea, in those complaints where medicines of this class are indicated. TOBACCO, Nicotiana Tabacum — This " obnoxious luxury," is a medicine of the most uncommon powers; being emetic, cathartic, sudorific, diuretic, expectorant, narcotic, and anti-spasmodic ; hence its utility in a variety of diseases. A table spoonful of an infusion, one ounce in a pint of boiling water, will excite vomiting ; however, as it has no peculiar property as an emetic, and its operation is attended with severe sickness, it is not often employed with this view. As a purgative, it is employed in the form of clysters, in all cases of obstinate costiveness. Ex- hibited in this form, in the quantity of two or three table-spoonsful of the infusion, mixed to half a pint of milk or thin gruel, it has fre- quently afforded almost instantaneous relief in violent, colics, after other medicines had proved ineffectual. If this quantity produce no relief, nor excite giddiness nor nausea, the injection may be repeated every half hour, with the gradual increase of the infusion, till one * This disgusting disease prevailed mostly among the inhabitants on James River. It attacked the thighs, the scrotum, and especially the parts immedi- ately adjacent to the arms. It extended its ravages into the rectum and per haps much farther. 590 MATERIA MEDICA. or other of the effects take place. By this mode of proceeding, the violent effects of tobacco may always be avoided. As a diuretic, it has on many occasions proved an invaluable remedy, as in ascites and other dropsical affections, also in gravel, or difficulty of making water. In those cases, according to Dr. Fowler, the dose for adults should be from sixty to one hundred drops of the infusion in a tea- cupful of water twice a-day, about two hours before dinner, and at bed- time ; it being observed to disagree most with the stomach in the morning fasting. And, such is the difference between the morning and night, that almost every patient will require to take one-fourth, and some one-third more in the forenoon than in the evening, in order to enable them to bear the dose with equal convenience. The common dose just mentioned, relates only to adults of an ordinary constitution ; for it deserves particular notice, that between constitu- tions which are nervous and irritable, and those which are very ro- bust or toipid, or long accustomed to the use of tobacco, the dose will admit of very great and surprising alterations. As an expectorant, in asthmatic cases, unattended with inflamma- tory symptoms, this medicine has frequently afforded relief. In cases of tetanus, or lock-jaw, injections of tobacco infusion, says Dr. Mease, have been used with success. They not only produce evacuations from the bowels, which are generally obstinately constipated, but tend to a relaxation of the violent spasms so peculiar to this disease. On this account he suggests the propriety of giving it in the dreadful disease produced by the bite of a mad dog. Besides the internal use of tobacco in the above diseases, it is like- wise commended for its virtues externally employed. In the tooth- ache, a piece of lint moistened with the expressed juice of tobacco, has often acted as a charm in mitigating the pain. In obstinate ulcers, an ointment, or the dried leaves of tobacco, steeped in water, and applied to the part affected, have been attended with beneficial effects, after the usual remedies had failed. In the itch, and obstinate cases of cutaneous eruptions, the tobacco infusion, as a wash, applied two or three times a-day, seldom fails of effecting a radical cure. In that detestable distemper, called lousy evil, to which many children are subject, though, from neglect of cleanli- ness, adults are sometimes afflicted with it, the infusion has effected a radical cure, in several instances, after preparations of mercury, and other applications, had failed. It will be found equally destruc- tive to crab-lice, if applied two or three times a-day to the parts which they infest. In cases of worms, tobacco, externally applied, is deserving the highest estimation. Professor Barton states, that the leaves pounded with vinegar, and applied in the shape of poultice to the region of the stomach and abdomen, have often discharged worms, after powerful anthelmintics had been exhibited internally in vain. " We ought not to be surprised," says he, " at this effect of the tobacco, since we know that the same vegetable, applied externally, is often MATERIA MEDICA. 591 efficacious in inducing vomiting. Accordingly," says he, " I have for some years been in the habit of applying tobacco leaves to the region of the stomach of persons who have swallowed large quanti- ties of opium, and other similar articles, with a view of destroying themselves." It is well known, that in these cases the stomach is often extremely irritable, insomuch that the most powerful emetics have little effect in rousing that organ into action. Here, as an auxiliary at least, the tobacco, in the manner I have mentioned, is certainly very useful, and in many instances ought not to be neglected. In farther testimony of the efficacy of tobacco, externally applied, in the most formidable diseases, I cannot forbear inserting at length, a letter addressed to the editors of the Medical Museum, by a gentle- man of distinguished medical attainments and surgical knowledge. Preceding this letter, is a minute detail of the case, related by an Italian physician, of a young woman, long afflicted with an ab- dominal swelling, producing violent convulsions, which, after having baffled the most efficacious means, was radically cured by Dr. Cut- bush, senior physician of the American Marine Hospital ; at Syracuse, in the year 1805. " Sir — In consequence of the earnest solicitations of the parents of the young woman, whose case is above stated by one of her phy- sicians, she was brought to my house in Syracuse to be examined. I received from herself and parents a history of her case, which cor- responded very nearly with the above statement. Her parents in- formed me they had consulted thirty-three physicians and surgeons of Naples, and different parts of Sicily, without receiving any ad- vantage. Some were of opinion that the swelling was owing to a collection of water in the uterus ; others in the ovaria ; others, that it was an enlarged liver; finally, two or three were strongly im pressed with the idea, that it was an extra-uterine foetus, which pro duced all the distressing symptoms above stated. On examination, I found a very large swelling, extending from the epigastrium in a diagonal direction to the anterior spinous process of the right ilium The tumour had a number of inequalities on its surface; no fluctua tions could be felt ; she could not bear it pressed without suffering great pain. I must confess I did not give any decisive opinion in the case, it being perfectly new to me, and especially after the nu- merous contradictory opinions and practice of the first physicians of Naples and Sicily had failed in giving relief. She had been twice under the liberal use of mercury in Naples and Syracuse ; in the latter place, by the direction of a surgeon belonging to Lord Nelson's squadron, when his lordship was there in 1798, without beneficial effect. From this history and examination, I entertained no hope of relieving her, but the solemn entreaties of her parents determined me to make trial of a remedy, which I had found useful in discuss- ing obstinate tumours, and which finally terminated a disease that had been the source of great distress to the unfortunate female, and 592 MATERIA MEDICA. • which, doubtless, proved the disease to have been an hydropic affec- tion of the uterus, or right Fallopian tube, though no undulation could be discovered. I directed the leaves of the nicotiana, recently collected, to be stewed in vinegar, and applied to the abdominal swelling. The first application produced nausea, vomiting, vertigo, great depression of muscular strength, copious perspiration, and a loose state of the bowels. Her pulse became very slow. In conse- quence of the violence of the above symptoms, it was not long con- tinued ; but on the succeeding day, it was repeated morning and evening, and produced all the above symptoms, but in a less degree, attended with an immoderate flow of water from the vagina. The application was continued twice a-day for one week, when its effects on the system were less powerful; but I was informed, with the most rapturous expressions, that the tumour had diminished very much. The day following, a priest was despatched to inform me, that the water was continually running from her as she walked her room. The remedy was continued about twenty days, but the swelling disappeared entirely before the fourteenth. No medicine was given, excepting a small quantity of opium or wine during the day. When the application of the tobacco was omitted, her abdomen was perfectly soft, and she could bear it pressed without pain. She was occasionally attacked with syncope, and complained of a want of appetite : I advised a bandage to be applied around her body, a course of tonic medicines, a generous diet to be gradually increased, equitation, (riding) and cheerful company. I saw her in October, 1805 ; she informed me that all the functions of the body were natural; her countenance w T as florid and cheerful. — April 1st, 1806, I was informed she remained in good health. " It is difficult to account for the modus operandi of tobacco in this case, unless the violent commotion, which it excited in the sys- tem, ruptured the cyst which probably contained the water. I con- ceive the external application of tobacco, as a remedy in many diseases, demands more attention from physicians, than it has gene- rally received. In obstinate constipation of the bowels, I have applied tobacco stewed in vinegar or water, with the greatest suc- cess; even after powerful cathartics, enemata of different kinds, injections of tobacco smoke, or the infusion of the plant have failed ; and conceive it preferable, in many cases of ascites, to the common mode of administering it internally in the form of tincture or infusion. " I am, sir, with esteem, yours, EDWARD CUTBUSH," Happy if this plant " of many virtues" could always be exerted to beneficent purposes, and for which, no doubt, it was intended by the all- wise and benevolent Creator : but, alas ! w T e are constrained to deplore not only the idle and expensive, but too often fatal abuse of it, by snuffing, chewing, and smoking practices, which cannot be MATERIA MEDICA. 593 loo severely censured, especially in young persons, and those of weak digestion, consumptive or delicate habits. When used in either of these forms, by persons unaccustomed to it3 use, it will in small quantities produce stupor, giddiness, and vomiting : but, like spirits, opium, and other narcotics, the use of it may be introduced by de- grees, so that its peculiar effects, even from large quantities employed, seldom appear. TOE ITCH. See Moonvort, Broad-leafed. TOOTHACHE TREE. See Prickly Ash. TOUCHWOOD, Boletus Igniarius — Called also spunk. It is a spongy substance, growing on the white oak, pine, and hickory trees, generally used for catching fire with flint and steel. The heart of that which grows on the oak reduced to powder, and ap- plied to violent hemorrhages from wounds, is said to be an excellent application to stop the bleeding. TREFOIL, WATER, Menianthes— Grows about twelve inches high, in marshes, swamps, and wet meadows. It bears many ele- gant flowers, in a spike, which are sometimes white, but are com- monly rose-coloured on the outside, and in the inside finely fringed ; the leaves are three together, resembling our garden beans. A drachm of the powdered leaves is said to operate up and down. An infusion of the leaves, two hands full to a quart of boiling wa- ter, in doses of a tea-cupful two or three times a-day, is esteemed a useful medicine in chronic rheumatism, in scorbutic complaints, and in all impurities of the blood. TULIP-BEARING POPLAR. See Poplar, White. TURMERIC. See Blood Root. UNICORN ROOT, Aletris Farinasa — Grows in meadows, and on the sides of mountains, about six or seven inches high ; leaves spear-shaped, lying on the ground, and are green all the winter. The flowers grow on the stalk from the ground, which hang clown at the top when fully blown ; the root is whitish, full of small fibres, about the thickness of the end of the little finger, and crooked at the end. The powdered root, in doses from half to a tea-spoonful, is said to afford relief in hysteric and flatulent or wind colic. A large handful of the root steeped in a quart of spirits, in doses of a wine-glassful three times a-day, is highly esteemed by some as a valuable remedy in chronic rheumatism. VALERIAN, WILD, Valeriana Officinalis — Grows abundantly in the vicinity of the Ohio river. It rises two or three feet high ; the 75 594 MATERIA MEDICA. leaves in pairs, large, hairy, and of a dusky green colour ; flowers stand in large tufts on the top of the branches, of a pale whitish-red colour. The root, which is the part used in medicine, consists of a num- ber of slender fibres, matted together, and attached to one head, of a brown colour, having a strong and unpleasant smell. Valerian has long been recommended by the most learned physicians as a medi- cine of great use in nervous disorders ; and is particularly serviceable in hysteric cases, as well as in epilepsy, proceeding from a debility of the nervous system. According to Dr. Withering, it is an excel- lent medicine in cases of habitual costiveness. It should be given in doses from one to two tea-cupsful or more, in powder, three times a-day. It seems most useful when given in substance, and in large doses. VINE, GRAPE, Vitis Vinifera. — Several species of this valuable shrub grow in the United States. The success which has attended the attempts to cultivate foreign and native grapes, sufficiently proves that our climate is perfectly congenial to the cultivation of the vine, and that, with very little attention, we might supply ourselves abun- dantly with cheap and wholesome wines. Wine certainly is most excellent to prevent, as well as to cure, diseases. A prudent use of it, when genuine, I can say, from my own experience and observation, admirably conduces to health. It will be found particularly beneficial to the weak and aged, and to those who are exposed to a warm and moist air, or to a corrupted one. It exhilarates the spirits, quickens the circulation, promotes di gestion, invigorates both the body and mental faculties, and thereby renders persons less susceptible to disease. As a medicine, wine is a most grateful and valuable cordial in languors and debility, in which it is found to raise the pulse, support the strength, promote perspiration, and resist putrefaction. Hence, we cannot appreciate too highly this reviving liquor, which justly merits the title of " donum Dei," gift of God. Were we to have less recourse to ardent spirits, and instead of continuing in those abomi- nable practices of drinking before dinner, to take a few glasses of wine after dinner, we should find " our account " in it. During my long residence in Savannah, and exposed as I was alternately by my professional pursuits, to the scorching sun and chilling night air, I was never attacked with the prevailing fever incident to that cli- mate, which I ascribe almost entirely to the daily use of the purest and best wine. In farther corroboration of this fact, I will with can- dour state, that, when from unforeseen reverses of fortune, I was in- duced to remove to the more healthy situation, as I thought, of Washington, not a season has elapsed, but some one or other of my family has suffered severely with the bilious or nervous fever, which I cannot but ascribe, in a great measure, to our not drinking such good wine as we were accustomed to at the southward. MATERIA MEDICA. 595 There are many persons in good circumstances, who ohject to the daily use of wine, as being too expensive. To such I would recom- mend it as economy. Besides the very great satisfaction which would naturally flow from having a healthy family, money is often saved by a prudent use of it. To illustrate this, it is only necessary to state, that several families at the southward, who were in the habit of paying annually large accounts for medical attendance, inquired of me how it was, that myself and family enjoyed such perfect health, while they were sickly. I remarked, that it was principally owing to drinking good wine, and assured them, though against my interest, if they would but pursue my plan, they also would enjoy good health. Some of them adopted my plan, which carried con- viction with it; for on the following year, and afterwards, they enjoyed much better health, were enabled to attend to their busi- ness, and found the expense of the wine saved in their physcian's bill. Others again, object to the habitual use of wine, as not congenial to their constitution, observing that whenever they entertained, or dined with, their friends, they were induced, either from politeness or persuasion, to drink as the rest of the company,* from which their heads were uniformly affected, and they always felt disagreeable on the following day. This objection is at once refuted, by simply stating, it is my wish to impress on my readers the use but not the abuse of wine, which no man more heartily than myself abhors, es- pecially in young persons, whose readiness to take glass for glass with their elders, is to me one of the most lamentable spectacles in nature. The excessive use of this stimulant, as well as every other, is most certainly injurious to the system, and ought, therefore, to be carefully guarded against by every rational person. It deserves also to be noticed, that the same quantity of wine which would produce intoxication in one person, would have little or no effect on another; and there is also a wide difference between taking it on an empty stomach and a full one. One glass, taken an hour or two before dinner, will affect the head, in most cases, more than a pint after dinner. In like manner, a half pint of adul- terated or impure wine, will produce unpleasant sensations, when a pint of genuine Madeira will have no other than the pleasing effect of invigorating the constitution. The apprehension which some per- sons entertain, that children, early accustomed to wine, will be apr to become drunkards, is without the smallest foundation whatever. * The following anecdote will at once show the absurdity of pressing out friends to drink more wine than their appetites crave. A foreigner was invi- ted to a party, consisting, as he was told, of English philosophers, of whom he conceived a great deal. After a very plenteous dinner, the cloth was cleared, and the bottles were placed on the table. He was pressed after rive glasses to drink on, but the the stranger persisted in assuring the company, he felt no drought. These philosophers began to be angry, and the foreignei rang the bell, and insisted on another course, - r they ought as much to eat, as he to drink, against inclination. 596 MATERIA MEDICA. On the contrary, it is a lamentable truth, that we daily see per- sons, who were restrained in the early period of their lives, from drinking wine, toddy, or table drink, in the presence of their parents, become perfect sots after they arrive at the age of manhood. It is one of the greatest commendations of wine, that we never see those who daily indulge the use of it become drunkards. This is verified not only in France, but in many parts of our Union. In Charles- ton, Savannah, and Augusta, the inhabitants generally make use of wine; the consequence of which is, they are sober, discreet, and not- withstanding the climate, are healthy. It is a rare thing indeed to see a drunkard of any description in the streets of those cities. Whether it be owing to drinking less of ardent spirits, or a better po- lice, I will not pretend to say; but it is the fact, and would that I could, with equal propriety, make the same remarks of the metro- polis of the United States, where drunkenness, among the lower class and negroes, reigns triumphantly, throwing open, as it were, the gates of every species of vice. Vice is a monster of so frightful mien, As, to be hated, needs but to be seen; Yet seen too oft, familiar with her face, We first endure, then pity, then embrace. — Pope. It is also worthy ot remark, that among the genteel circles in Charleston, Savannah, and Augusta, you will hardly meet with an instance of a gentleman drinking any thing before dinner, or press- ing his friends to take more wine after dinner than they feel an in- clination for ; however, this is only what might be expected of those not excelled by any society on earth, either for polished manners or true hospitality. " Experientia docet," experience teaches, is my motto, and as I speak from this alone, I feel conscious of the recti- tude of my heart, in earnestly recommending to my fellow-citizens, both old and young, the daily and prudent use of genuine wine, at least during the sickly season, and in unhealthy situations, without any fear whatever of becoming sots. That the tenderest infant may be benefitted by it, I am convinced from my own practical observa- tions; but if higher authority be required, I will conclude with the following sentiment of the late Professor Rush : — " It is remarkable," says he, " that the children of persons in easy circumstances, who sip occasionally with their parents, the remains of a glass of wine after dinner, are much less subject to disease, than the children of poor people, who are without the benefit of that arti- cle of diet." Having said so much in praise of the generous juice of the grape, and considering it, as I sincerely do, one of the choicest medicines in the Materia Medica, I cannot do otherwise than present my readers with the following most approved method for making Ameri- can wines, taken from the Domestic Encyclopedia, as well as the mode of detecting adulterated wines. MATERIA MEDICA. 597 Grapes must be fully ripe before they are gathered ; gather them in a fair day, when they are perfectly dry ; and take away all the rotten and unripe grapes, for they spoil the wine. If your vintage be large, and you gather more grapes than you can mash and press out in one day, let them be gathered without bruising, for bruised grapes soon attract an unsavoury taste, and hurt the wine ; however, if they be mashed the same day they are gathered, the bruising will do no hurt. Chaptal advises to cut of the tails of grapes very short with a pair of scissors, and to choose none but sound grapes, and those clusters which are best exposed, rejecting those which have been sheltered, and near the ground, and to prefer those which ripen at the bottom of the vines. They are then to be put into small baskets to prevent the loss of juice, by the superincumbent weight ; and when full they ought to be put in carts, or on the backs of men or horses. I would advise the gathering of them to be directed by some grave discreet person ; for as this work is done generally by servants and children, it is made matter of pastime and frolic, and many grapes are torn off, and either bruised or scattered on the ground, to the no small damage of the owner, both in the loss of fruit and in hurting the wine. These things should be impressed on the minds of the gatherers before they begin, that every thing may be done regularly and in order, by which means more work will be done, and to much better purpose. If white frosts happen before some of your grapes are fully ripe, let them still hang on the vines, and they will grow ripe, rich, and high-flavoured ; but they must be gathered before the weather be so hard as to freeze the grapes, for that will spoil them : the light frosts that only kill the leaves do not hurt the fruit, unless it be such as are late ripe ; these should be carefully covered from all frosts, they should grow against walls or board fences fronting the south or south-east, and at night be covered with mats or frames thatched with straw, which should be so contrived as to be set up to cover the fruit or let down at pleasure. As the wine made from black grapes has a different management from that made of w T hite grapes, I shall begin with the white ; these then must be gathered, as I mentioned before, in a fair day, when the grapes are perfectly dry ; and both the rotten and the unripe grapes carefully plucked off from every bunch ; the clusters are then thrown into the mash vat, and two or three men, according to the quantity, having Avashed their feet and legs very clean in bran and water, get into the vat and trample and mash the grapes thoroughly, so that none escape. Chaptal says, as a general rule, that the grapes must be equally pressed, to ensure a uniform fermentation: and the vat filled in twenty-four hours, to avoid the inconvenience and imperfections arising from a successive series of fermentations, and when unex- 598 MATERIA MEDICA. pected rain suspends the collection of the grapes, the juice of those already collected and placed iu the vat, must ferment separately. The first and second pressing being mixed together, is put into hogsheads, and filled within four inches of the bung, that it may have room to work and ferment, the casks placed in some warm room or dry cellar. Then having a small spile fixed in the middle of the head of the cask, the third or fourth day, draw a little of the wine in a glass, and if it be pretty fine, draw it off immediately into a clean, dry, well-scented cask, the larger the better, so you have wine enough to fill it, which you must, do within two inches of the bung, and stop it closely, leaving only the vent hole open for a se- cond fermentation ; after a few days it will work a second time, but not so much as at the first; if your wine be strong and good, which you ma}^ know by the age of your vineyard, and by the goodness of the seasons, it will be best to leave the bung-hole open for this se- cond working ; the wine will be the better, for strong wines require a greater fermentation than weak wines; and the stopping of the bung-hole checks the working, and prevents weak wines from spend- ing themselves too much ; on the contrary,, if strong wines have not a thorough working, they are apt to grow thick and ropy ; by this you may form a proper judgment what degree of fermentation is proper for the wine that is under working, and govern yourself ac- cordingly. Three or four days after the second fermentation begins, carefully watch your wines every day, again try them in a glass, and if they be pretty fine, prepare a cask sweet and good, burn a good large brimstone match in it, and as soon as the match is burnt out, whilst the cask is full of smoke draw off the wine into it; now fill up your cask to the brim, and bung it up tightly, and stop the vent-hole ; the smoke of the brimstone will hinder any farther fer- mentation ; and this is called stunning or sulphuring; then make a mortar of clay, and horse dung, mixed up with strong flax-seed jelly, covering the bung and vent-hole close with it, let it stand till it is fit for use. When you first rack off, if you have any old wine that is rich and good, of the same kind or colour, put four or six gallons of it and two gallons of good brandy, into your cask ; this quantity is sufficient for an English hogshead, and then rack off your wine into it for the first time ; this will greatly strengthen and preserve it. When wine is in fermentation, all the gross parts are thrown up to the top of the cask or vessel that it ferments in, and there meet- ing the air thej^ contract a harshness. If then they be suffered to pass down through the body of the wine, which they certainly will do as soon as the fermentation is over, they will communicate those evil qualities to the wine. For this reason, draw off your wine both times before the fermentation be quite over. — These general rules are of great consequence. I now pass on to the making of red wine from the black grapes. Red wines have a different management from the white ; the whole MATERIA MEDICA. 599 of one or even two days' treading or mashing, where the vintage is great, is thrown into a large vat, the must, stalks, skins and all, and stands in some warm dry place or cellar. The vat is covered close with sheets or blankets, or both, and thus it remains according to custom, from four to seven or even ten days, according to the cold- ness or heat of the weather. This is done to obtain a strong fermen- tation, in order to give a deeper colour to the wine ; and this is the only end proposed by it ; the manager of this work visits the vat twice a-day, and in a glass views the colour of the wine, and tastes it ; if the tincture be not deep enough to his mind, he knows by the taste of the wine, whether it will stand a longer fermentation ; if it will not, he contents himself with the colour it has, and draws and presses it off, and fills it into casks leaving about two inches from the bung, for a second fermentation. When the second fermentation is over, which generally happens in four or five days, he draws it off into clean well-scented casks, and adds to it six gallons of good old wine and two gallons of brandy to an English hogshead, which con- tains from sixty to sixty-three gallons. Where the same kind of wine is not to be had, he makes use of port wine. He then fills the cask quite full, and bungs it up tightly, leaving only the vent hole open to let out the generated air. Note : when I say, where the same kind of wine is not to be had, he makes use of Portugal wines, it is mentioned for our practice, not that the French make use of such wines, for they always have wines enough of their own of the same kind. Besides the main pulp or core of the grape, which is white in black grapes as well as others, there sticks to the inside of the skin, a considerable body of rich pulp, of a deeper dye in some than in others. This pulp gives the colour to the grape: this same pulp also gives the colour to the wine, for the same grape is capable of making white wine as well as red toine ; if the main core which is first trod out, be only used, the wine will be white ; but if the red pulp be mixed with it, it makes it of a rich purple colour : as this is a clear case, the great point of improvement is, to dissolve or extract, this rich pulp without injuring the wine. — That the present method is the best and most effectual to that purpose, I can by no means think ; the violent fermentation through which the wine is made to pass, in order to procure the tincture, must exhaust the spirits in a very great degree, and leave the body in a weak and languid state, and subject it to harshness, to turn meagre or vapid in a short time ; I think I have reason to conclude, that if the husks or skins, after four days lying in the murk, were taken out, and thrown into the mash vat, and trod over again, and especially if some of the must, or rather wine, be now and then thrown over the husks, in order to wash away the pulp, that a full tincture may be obtained, without torturing the wine, as the present manner is, and without running so great a risk of spoiling it. 600 MATERIA MEDICA. Another method, by Joseph Cooper, Esq. of Gloucester county, New Jersey. — I put a quantity of the comb from which the honey had been drained, into a tub, and added a barrel of cider, immedi- ately from the press : this mixture was well stirred, and left for one night. It was then strained before a fermentation took place ; and honey was added till the strength of the liquor was sufficient to bear an egg. It was then put into a barrel ; and after the fermentation commenced, the cask was filled every day, for three or four days, that the filth might work out at the bung hole. When the fermen- tation moderated, I put the bung in loosely, lest stopping it tightly might cause the cask to burst. At the end of five or six weeks, the liquor was drawn off into a tub, and the whites of eight eggs, well beaten up, with a pint of clean sand, were put into it : I then added a gallon of cider spirit; and after mixing the whole well together, I returned it into the cask, which was well cleansed, bunged it tightly, and placed it in a proper situation for racking off, when fine. In the month of April following, I drew it off into kegs, for use, and found it equal, in my opinion, to almost any foreign wine: in the opinion of many judges, it was superior. This success has induced me to repeat the experiment for three years ; and I am persuaded, that by using clean honey instead of the comb, as above described, such an improvement might be made, as would enable the citizens of the United States to supply them- selves with a truly federal and wholesome wine, which would not cost a quarter of a dollar per gallon, were all the ingredients pro- cured at the market price ; and would have this peculiar advantage over every other wine, hitherto attempted in this country, that it contains no foreign mixture, but is made from ingredients produced on our own /arms. Adulterated Wines. — Wines may be adulterated by a variety of substances. The object proposed to be accomplished by this fraud, is to mask some of their defects, and to give them colour, odour, or strength. Among the substances employed, there are some, the use of which is attended with no danger ; others on the contrary are more or less poisonous, and cannot be swallowed without giving rise to serious accidents, which may often be followed by death. This consideration has induced us to state the method whereby it may be determined, whether the wine has been adulterated. Sugar of lead, cerusse, and still more frequently litharge, are mixed with acid or sharp-tasted wines, in order to render them less so, and these substances do, in fact, give them a sweet taste. Of all frauds this is the most dangerous. White ivines, adulterated by preparations of lead, offer, indepen- dently of their saccharine astringent taste, many properties by which we may detect them. They redden but slightly the tincture of litmus, because the acid they naturally contain is saturated by the oxide of lead. Sulphuric acid (oil of vitriol) and the sulphates, (or salts formed by the union of sulphuric acid,) such as the sulphate of MATERIA MEDICA. 601 soda, (Glauber's salts,) sulphate of magnesia, (Epsom salts,) dis- solved in pure water, and mixed with these wines, render them thick and muddy; in a short time a white precipitate is found at the bottom of the vessel in which the experiment is made. The de- posite does not disappear upon the addition of water. Muriatic acid and the muriates, as the muriate of soda, (common salt,) when dissolved in pure water, and added to adulterated wine, also occasion a heavy white precipitate, which may be dissolved in twenty-five or thirty times its weight of water. The sub-carbonates of soda, potash and ammonia, act in the same manner. The white pre- cipitate they throw down is insoluble in water, but is dissolved in a very singular manner by pure nitric acid. The chronic acid, and the cromate of potash, occasion a precipitate of a very fine Canary yellow colour. Sulphuretted hydrogen, and the hydro- sulphates, as liver of sulphur, turn white wines sophisticated with lead of a black colour, and at the end of a few minutes throw down a black deposite. — If we collect upon a filter, and dry the precipi- tates obtained by the means just indicated ; and if, after having mixed them with powdered charcoal and caustic potash, we expose them in a crucible to a red heat, during half an hour, we obtain a metallic button easy to be known ; first, by its deep blue colour ; secondly, by the facility of marking it with the nail ; thirdly, by the quickness with which it is dissolved in aqua-fords, forming thereby a liquid salt of a sweetish taste, and having the property of being precipitated of a white colour by the sulphates, the hydro-chlorates, and the carbonates. Pure potash, soda, and the volatile alkali mixed with these wines, cause a white precipitate. Evaporated in a cap- sule at a boiling heat, they leave a deposite, which, being heated to redness with powdered charcoal, furnishes, at the end of thirty or forty minutes, metallic lead. This property is sufficient to prove the presence of lead in wines. Red icines, when adulterated with the preparations of lead, are never of so deep a colour as before the adulteration ; they are of a pale red. We may prove the existence of lead in red wines, by the aid of the substances directed to be used for white wines. It is, however, necessary to observe, that ammonia causes a dirty green- coloured precipitate, when mixed with red wines which contain lead ; on the contrary, in white w r ines the precipitate is white. That the hydro-sulphates may lead us into error, if we confine ourselves to the superficial examination of their action. That these substances detect the presence of lead in red wines, by throwing down a black precipitate, is true, but the same substances, when mixed with the greater parts of red wines, produce the same effect ; they become dark, and finish, by depositing flakes of a deep violet colour. It is necessary then, when we wish to decide upon the test furnished by the hydro-sulphates, to add that, the black precipitate they form, when mixed with red wines, indicates the presence of lead, if, after 7(3 602 MATERIA MEDIC A. having been dried upon a filter, and calcined with potash and char- coal, it leave a button of metallic lead. Wines adulterated by Alum. — The object of this adulteration is to render the wines redder and less changeable ; and to give them an astringent taste. The danger of this fraud is generally known, digestion becomes painful, vomiting from time to time, obstruction of the bowels, and piles, are the result of drinking wines thus adul- terated. Of all the methods proposed to discover the presence of alum in wine, the following appears to merit the preference. By evaporating several pints of wine we observe a reddish mass, com- posed of alum, and the colouring matter and tartar, which make a part of the wine. This mass being dissolved in a large quantity of water, and made to boil with some charcoal of the linden tree*, a liquid almost without colour is obtained. If the liquid be filtered, and then evaporated by a gentle heat, until a thin crust be formed upon the surface, and set in a cool place, the tartar will crystallize and the supernatant fluid will hold the alum in solution. This fluid ought to have a sweetish astringent taste, and throw down a white precipitate, upon the addition of ammonia, or caustic potash ; that formed by this last body ought to be soluble by an excess of potash. A solution of barytes, its acetate or muriate, ought to render it thick and occasion a white precipitate, insoluble in water and nitric acid. Wines adulterated by Chalk. — Some persons are in the habit of adding chalk or lime to red or white wine, having a disagreeable acidity, with a view of saturating the acetic, or tartaric acid, and thus by the combination of the chalk or lime with the acid, destroy their sharp taste. Wines treated in this manner are really much safer, but they may give rise to disagreeable symptoms if they con- tain too great a quantity of the acetate of lime. This fraud may be discovered by the following means : — Evaporate a quantity of the wine in an open vessel, or if the spirit be desired, let it be distilled : when the fluid is reduced to the consistence of a syrup, add a few ounces of distilled water, agitate the mixture for ten or twelve min- utes and filter the liquid, which will be found to contain acetate of lime, formed by the acetic acid of the wine, and the lime or chalk which has been added. The tartar which the wine contained will not be dissolved, but will remain upon the filter. VIOLET, RATTLESNAKE— Grows about four inches high, on the banks of rivers, and in pine woods ; leaves grow in a cluster from a stalk, oval-shaped, fleshy, and full of small veins; flowers of a pale blue colour. An infusion of this plant, a handful to a quart of boiling water, taken in doses of a tea-cupful three or four times a-day, and some of * Or any fresh-made charcoal. MATERIA MEDICA. 603 the green leaves bruised, and applied twice or thrice a-day to scrofu- lous tumours, or king's evil, is said to be an infallible remedy. YIOLET, SWEET, Viola Odorata— Is cultivated in our gar- dens ; leaves heart-shaped, notched, flowers deep purple, odoriferous. A tea-spoonful of the powdered herb is celebrated as a mild laxa- tive. To children, a strong infusion or decoction formed into syrup with molasses, honey, or sugar, in doses of a wine glassful, will be more acceptable. YIRGIN'S BOWER— Grows about two feet high, near ponds and low pastures; leaves opposite in pairs, and terminated by an odd one; the flowers somewhat resemble the appearance of feather tails. A small handful of the leaves infused in a quart of boiling water, and given in doses of a gill three times a-day, is said to be very bene- ficial in venereal sores, or cutaneous eruptions of long standing, particularly if the sores be washed with the same. The bruised green leaves have been applied to ulcers, as an escharotic, to destroy fungous or proud flesh. VIRGINIA, OR BLACK SNAKE ROOT, Serpentaria Vir- giniana — Grows in rich woodlands, from seven to nine inches high, leaves heart-shaped, flowers of a purplish brown colour. The root is composed of a number of strings, or fibres, issuing from one head, and matted together, of a brownish colour on the outside, and pale or yellowish within. It has an aromatic smell, and a warm, bitterish, pungent taste. It promotes perspiration, raises the pulse, and resists putrefaction. Hence it is especially adapted to the low and advanced stage of typhus or nervous fever. It may be given in the form of infusion or tea, a handful to a quart of boiling water, in doses of a tea-cupful, or in powder, from ten to thirty grains every two or three hours. Conjoined with the Peruvian bark, or any of its substitutes, it is an admirable remedy in obstinate cases of the ague and fever, and other disorders of general weakness. In cold phlegmatic habits, it has also been exhibited in the form of tincture, and. when united with double the quantity of dogwood bark, or berries, it affords a good bitter. Professor Barton observes, that a strong decoction of the root was used with great benefit as a gargle in a putrid sore throat, which prevailed in New Jersey. In that species of pleurisy, which is properly enough designated by the epithet bilious, Professor Chapman states, he has repeatedly had occasion to recur to the serpentaria, and always with more or less utility. This bilious pleurisy he considers as having all the characteristics of pneumonic inflammation, with the addition of some of the symptoms incident to autumnal fever, such as headache, great gastric distress, and almost always violent vomitings of bile. It dif- fers, also, from ordinary pleurisy, in having less activity of inllam- 604 MATERIA MEDICA. mation, and consequently in not bearing the same extent of deple- tion. The system, indeed, will often be very evidently depressed by one or two bleedings. In this case, the practice which has been commonly pursued is, after the removal of a comparatively small portion of blood, and the thorough evacuation of the alimentary ca- nal, to administer very freely draughts of the infusion of the serpen- taria, in order to excite perspiration. Externally applied, the decoction has been found to cure the itch. WAKE ROBIN. See Cuckow Pint. WALNUT, WHITE, Juglans Alba— Affor&s one of the finest cathartic medicines in the whole American Materia Medica. The inner bark, boiled for several hours, then strained and reboiled to the consistence of thick honey, forms the best preparation of this invalu- able medicine. A common-sized pill or two, at going to bed, is ad- mirable to remove those costive habits, which occasion headaches, loaded stomachs, colics, &c. And, in increased doses, saj^ double quantities, it will be found a sovereign medicine in dysentery, bilious fever, and all other complaints requiring aperient medicines, more especially if combined with equal quantities of calomel. I cannot quit this extract without most heartily recommending it to every American family to keep it constantly by them. The bark of the root is excellent to raise a blister, therefore, may be substituted for Spanish flies. WATER CRESSES. — Grow in running brooks and wet ditches. The green herb, eaten as a vegetable, and the expressed juice in doses of a table-spoonful two or three times a-day, is an effectual re- medy for the scurvy. WATER TREFOIL. See Trefoil, Water. WHITE BRYONY — Grows in low meadows and swamps ; the stems twist about bushes, and shoot out to a great extent ; the leaves pointed, irregularly toothed, very large, diminishing gradually to the top ; flowers of a yellow green, which produce a red berry ; the root is white and large. A very strong decoction of the root strained, and then simmered slowly by the fire, until it become of the consistence of honey, is said to be a good purgative medicine in doses from one to three tea- spoonsful. WHITE WOOD. See Poplar. WILLOW, Salix — Professor Barton thinks that our willows pos- sess nearly the same virtues that have been ascribed to those of Eu- rope, and that they might be substituted for the Peruvian bark. The MATERIA MEDICA. 605 bark of the white willow, smooth willow, and crack willow, so called from the remarkable brittleness of its branches, collected when it abounds with sap, has been successfully employed in intermittent or ague and fever, in doses of one or two drachms. The broad-leafed willow is said to possess greater virtues than either of the above. This species may be distinguished by the shape of its leaves from all others, except the bay-leafed willow. The leaves of the latter are smooth and shining, of a deeper green, and have not the downy ap- pearance on the under surface, which is so remarkable in this. It is found in woods and hedges, on hilly situations, and delights in cold clayey moist grounds. A strong decoction of this bark resembles port wine in colour. It is astringent to the taste, and somewhat bitter. According to Dr. Wilkinson, it is a remedy of great efficacy in most cases where the Peruvian bark is indicated. He directs one ounce and a half (a handful) of the bark to be infused in one quart of water for six hours, then boil it over a gentle fire for a quarter of an hour, and strain for use. Of this the ordinary dose is a wine-glassful three or four times a-day. But in ague and fever, the dose may be repeated every third hour in the interval of the fit. WINTERBERRY. See Alder, Black. WINTERGREEN. See Calico Tree. WOOD BETONY— Grows about a foot high in upland woods, and old pastures ; the stem square and hairy; the leaves opposite, and hairy, the flowers in spikes, of a purple colour. An infusion of the herb, a handful to a quart of boiling water, in doses of a tea-cupful every two hours, is said to be serviceable in rheumatic or gouty affections. WORMSEED. See Jerusalem Oak. WORMWOOD. See Mugwort. YARROW — Grows in dry pastures and along the sides of fences, about a foot high ; leaves pointed ; flowers white, tinged with a little purple beneath. A handful of the tops of yarrow, infused in a quart of boiling wa- ter, in doses of a tea-cupful three or four times a-day, is reputed to be a valuable medicine in the dysentery, bleeding piles, and re- straining immoderate flow of the menses. A table-spoonful of the expressed juice taken twice a-day, and the herb bruised; or in the form of a poultice, is said to have cured a cancer of the breast. The green leaves pounded, and applied over a bruise, dissipates it in a few days. 606 MATERIA MEDICA. DIRECTIONS RESPECTING THE. COLLECTION AND PRESERVATION OF VEGETABLE SUBSTANCES. Herbs and leaves are to be gathered in dry weather, after the dew is off them, and are to be freed from decayed, withered, or for- eign leaves. They are usually tied in bundles, and hung up in a shady, warm, and airy place, or spread upon the floor, and frequently turned. If very juicy, they are laid upon a sieve and dried by a gentle degree of artificial warmth. They should be dried in such quantities at a time that the process may be finished as quickly as possible; for by these means their powers are best preserved ; the test of which is, the perfect preservation of their natural colour. Flowers ought also to be collected in clear dry weather, after the dew is off, immediately after they have opened. They should also be dried nearly as leaves, but more quickly, and with more atten tion. As they must not be exposed to the sun, it is best done by a slight degree of artificial warmth. Barks and woods should be collected when the most active part of the vegetables are concentrated in them, which happens in spring and in autumn. Spring is preferred for resinous barks, and autumn for those that are gummy. Barks should be taken from young trees, and freed from decayed parts, and all impurities. Seeds and fruits are to be gathered when ripe, but before they fall spontaneously. Roots which are annual, should be collected before they shoot out their stalks or flowers. Those which are worm-eaten or decayed are to be rejected. The others are immediately to be cleaned with a brush and cold water, letting them lie in it as short a time as possi- ble; and the fibres and little roots, w T hen not essential, are to be cut away. Roots which consist principally of fibres, and have but a small top, may be immediately dried. If they be juicy and not aro- matic, this may be done by a moderate heat; but if aromatic, by simply exposing them, and frequently turning them in a current of cold dry air. If very thick and strong, they are to be split or cut into slices, and strung upon threads ; if covered with a tough bark, they may be peeled fresh, and then dried. Such as lose their virtues by drying, or are directed to be preserved in a fresh state, are to be kept buried in dry sand. MATERIA MEDICA. 607 The proper drying of vegetable substances is of the greatest im- portance. It is often directed to be done in the shade, and slowly, that the volatile and active particles may not be dissipated by too great heat ; but this is an error, for they always lose infinitely more by slow than by quick drying. When, on account of the colour, they cannot be exposed to the sun, and the warmth of the atmos- phere is insufficient, they should be dried by an artificial warmth less than 100 degrees of Fahrenheit, and well exposed to a current of air. When perfectly dry and friable, they have little smell ; but af- ter being kept some time, they attract moisture from the air, and re- gain their proper odour. THE NURSE'S GUIDE No radiant pearl, which crested fortune wears, No gem, that twinkling hangs from beauty's ears, Not the bright stars, which night's blue arch adorn, Nor rising sun, that gilds the vernal mom, Shine with such lustre as the tear that breaks For other's wo, down virtue's manly cheeks. — Darwin. Indigent Sick. — Having in my professional duties so often witnessed the most grievous sufferings of the sick for want of suitable nourishment, and this occurring too, not unfrequently in re- spectable families who have been reduced in circumstances, I feel it my duty, since it is not foreign to the subject, to call the attention of those in affluence, throughout our numerous cities and extensive country, to extend the arm of charity to the indigent sick, in their respective neighbourhoods. While feasting in their own houses, let them listen to the voice of humanity, and not forget the " house of mourning," where the lone widow and her orphans pine in sick and starving solitude. It is not easy to estimate the good which may be done to suffering humanity by beneficent acts of this kind. What a treat to the sick, instead of coarse food, to have a com- fortable bowl of soup, arrow root, sago, panado, or custard ! — And what a cordial, to a person labouring under protracted disease, in- stead of simple water to have a glass of good porter, ale, cider, or wine, which nature craves in this exhausted state. It is a well known fact, that a rarity sent unexpectedly has often been the means of recalling long lost appetite, and thereby rescuing from an untimely grave a valuable life. Indeed, there cannot be a greater object of charitable commiseration than a person confined to the bed of sickness, without the means of obtaining suitable nourishment. Nor are the indigent alone the grateful receivers ; for in the houses of the wealthy a real good sick cook is rarely met with ; and many who possess all the goods of fortune have attributed the first return of health to an appetite excited by what is called good kitchen physic. How important an advantage in overcoming disease is a nutritious diet ! Nor is this the only good to be derived from acts of charity THE NURSE'S GUIDE. 609 for we have frequently seen a fond mother denying herself the ne- cessary quantity of food that she might the better provide for her sick children, reduce that strength upon which the welfare of her family essentially depends. In faith and hope the world will disagree, But all mankind's concern is charity ; All must be false that thwart this one great end, And all of God, that bless mankind, or mend. — Milton. In the preliminary observations of this work {Seepages 32 and 33) we stated facts illustrative of the important advantages resulting from good nursing and dieting. The frequent occurrence of fatal effects when this is neglected, imperiously demands that I should present to my readers the most approved rules which ought to be understood by every nurse, as well as to exhibit the mode of preparing such aliments as are most proper for the sick; in order that the tram- mels of ignorance in nurses, if possible, may be broken, and sim- plicity of diet and general management become an increased object of our attention. But trust me, when you have done all this, Much will be missing still, and much will "Be amiss." — Milton. Duty of a Nurse. — Before we proceed farther on this subject, it may be necessary to observe, that none should be nurses unless they possess honesty, sobriety, and fidelity. The more equal and cheerful they are in their disposition, the better, provided they keep at their proper distance, and never incommode the patient with idle chit chat, or any thing that can occasion sudden alarm. The)^ ought to be expert in the execution of their office, yet without bustle or noise ; the track being easily kept when once got into, and the objects to be attended to but few. " To watch the " afflicted" with anxious care,, The lurking symptoms of disease detect, And with the aid of sweet nutritious food. Or potent herb, or kindly drug, to aid Oppressed nature in her arduous task Be thine ! and thine the grateful rich reward Of conscious duty done — a meed more fair Than all the laurels which bedeck the brow Of modern Caesar." The office of a nurse, however trifling it may appear, if well known and rightly performed, is unquestionably of great benefit to mankind. To prove this fact it is only necessary to appeal to every skilful physician, whether, when the plan prescribed by him lias been punctually observed, he has not commonly seen the disease either yielding readily to the remedies, or terminating in its usual period, without any mysterious or difficult symptoms arising through 77 610 the course of it. Whereas, on the contrary, when his plan has been altered, as for instance, when the medicine has not been taken at the appointed time ; when improper diet has been given instead of that directed, when the air in the rooms and many other circum- stances have been improperly attended to, whether he has not then known the disease to be either aggravated, or diverted from its course, often terminating fatally ; when, if no such errors had been commit- ted, there was the highest probability of the patient's recovery. Air and Temperature. — It being a well known fact that the life of every animal depends as much on air as on diet; and its health also as much on the goodness of the former, as on that of the latter, care should be taken what sort of rooms we sleep in, but more espe- cially so when confined by sickness. It is a misfortune that the poor as well as the slaves are constrained from necessity to sleep in low dwellings, and many of them in the same room, by which due attention is not generally paid to cleanli- ness; hence the air becomes impure and extremely offensive. Others again accustom themselves, sick or well, to the curtains drawn. This is equally detrimental to health, for the air being thus confined, be- comes contaminated, and so offensive as to be disagreeable to any one entering the room from the fresh air. How much more so then must this be the case in sickness, which tends greatly to destroy its purity. In warm weather it is necessary to keep a window open day and night, during the whole course of the disease ; but in this case the nurse must take care that the patient is not exposed to either a damp or violent current of air. Whenever a fire is required, it should be kept up, and regulated according to the nature of the disease, and state of the weather. The room being brought to a due heat, should never be suffered to cool suddenly ; for the air ought to be kept as temperate as possible. When the general exhaustion is great, the temperature of the apartment should not by any means be permitted to be so low as to endanger an attack of chilliness; as in this case a rapid reduction of the animal heat may speedily be fatal, by sinking the heart's action. In some instances an exposure to the cold air, in getting up to the night-chair, has been the cause of a shivering fit, under which the patient died in a few hours; but death will rarely happen, if some Avarrn stimulant be immediately administered internally, and suffi- cient warmth applied to the extreme parts of the body. Chills and Fevers. — It is too prevailing a custom in the cold fit of an ague, or when the patient complains of chilliness, for the attendants to heap great loads of bed clothes, which never fail to produce difficult or oppressed perspiration. In such cases, warmth should be restored by applying warm flannels to the stomach and abdomen, and the same or warm bricks to the feet. Recourse THE NURSE'S GUIDE. 611 should also be had to friction with a flesh brush or flannel on the extremities. It is vulgarly imagined that it is absolutely necessary to promote perspiration, and under this absurd idea, heating and stimulating drinks are given by way of cordials which readily induce delirium or a more obstinate fever. The fact is this, when the pulse is quick and the body hot, sweat can only be induced by lessening the action of the pulse, and heat of the body. And this can only be accom- plished by strict observation of a cooling regimen. In some cases, it is necessary, that the sick person should be kept out of bed as much as possible; and placed so, as to face the current of air ; the body being defended sufficiently by the clothing, to pre- vent any inconvenience being experienced. It should be recollected, however, as we have already noticed, that in the stage of collapse, or when the exhaustion is great, this practice is not admissible. But there is much less reason to fear this practice will be too frequently adopted, than it will be neglected, in those cases in which it is re- commended. For, too often, in this point, are the wishes of the physician opposed, and his directions disobeyed ; the languor of the patient, and the unwillingness to be removed, with the prejudices against a practice so novel, forming, very often, almost insuperable obstacles. Indeed, it is very difficult to persuade those, who have not witnessed the effects resulting from this mode of practice, that it is not necessary, for every person in a fever to be kept closely con- lined to his bed under a load of bed-clothes and supplied with heat- ing drinks. It frequently happens, therefore, that no sooner has a physician left the room, than the patient is supplied with warm li- quors, the windows and curtains are closed, and the bed-clothes, which had been removed, are replaced. Such opposition to the di- rections of a physician, viewed in the most favourable light, is highly censurable ; being, in a great measure, the effect of ignorance, it is all that prevents it from being really criminal. Nurses should, therefore, be on their guard, and neither deviate themselves from the rules laid down, nor permit any person at the expense of the patient's life to interfere with what might be consi- dered their duty, otherwise their conscience will upbraid them as murderers. It is to be hoped, by means of this treatise, ignorance will no lon- ger be a cloak for omissions, and that one uniform method will be attained in the management of the sick, which will unquestionably be of vast importance to mankind. Cleanliness. — It is certainly of great moment to the sick to have their bed and bedding kept clean as possible, and their linen frequently changed that it may not become foul or offensive. — Such of the bed-clothes, as are not changed, should, in diseases of a putrid nature, be exposed to a current of air, since, by their known capacity for retaining effluvia, they may become so loaded with contagious 612 the nurse's guide. and putrid matter, as to prove infectious to the attendants, and, per- haps, to impede the recovery of the patient. In summer it is much more healthy to sleep on mattresses than feather beds, which are apt to make persons become faint and lan- guid. The best materials for making mattresses are, clean horse- hair, Carolina moss properly cured, corn husks split, or straw. When a bed is unsettled, or a patient's head uncomfortably low, or when his feet are pushed from under the bed-clothes, he should be raised in bed, and the bed, bolster, and covering shook up and smoothed. The patient's face and hands are to be washed every morning. And when he is no longer able to assist himself, his face, breast, hands, and arms, must be frequently sponged with vinegar and wa- ter. The floor should be kept clean and occasionally sprinkled with vinegar, particularly before it is swept, and on no account should any thing the least offensive be suffered to remain in the room. It is also the duty of the nurse to pay great attention to the state of the patient's mouth. When his tongue and gums are covered with a brown or dark crust, she must wipe them with a bit of flannel moistened with salt and water, two or three times a-day ; or, if this cannot be accomplished, she must put a thin slice of lemon, without the rind, in his mouth. The patient is often unable to swallow, from the dry and shrivelled state of his tongue; in such cases, the nurse, before offering him drink, should put a tea-spoonful of lemon juice and water, or vinegar sweetened, into his mouth ; after which, the scum upon his tongue will become softened in a minute or two, and then he will drink with ease. Delirium. — When, during great derangement of mind, a patient insists upon leaving his bed, the nurse must endeavour to calm him ; or, if that should fail, she may speak with authority, but she is not on any account to use forcible restraint. The nurse must wrap his legs in a blanket, put on his bed gown or cover his shoulders, and permit him to sit on his bed, or even to go to the fire, till the vio- lence of his derangement shall abate. When indulged in this way, he will, in general, soon return to the bed of his own accord. In the putrid fever, delirium is one of the most constant and alarming symptoms, and the removal of it depends much upon the nurse or attendants. We have seen a temporary stop put to the patient's raving, by making him drink, or upon his discharging his urine or faeces : for being then unconscious of thirst and other natural wants, he is, therefore, ignorant of the means of satisfying them : and when he does so, he fancies he is about something else, which is the sub- ject of his delirious thoughts. This observation leads to a material practical purpose ; for it follows from it, that unremitting attention should be given to the patient's feelings, and all his possible wants, as those natural notices, and instinctive cravings, which occur in the nurse's guide. 613 health, are now wanting, in consequence of the depraved state of sensation. The following excellent passage will be found in Levant's Chap- ter on the Synochus Putris (Nervous Fever.) As soon as the deli- rium comes on, the pain subsides, or at least the patient does not complain of pain, nor seem to feel any; but replies in a hurried manner, when asked how he does, that he is very well ; according to the observation of a French physician " Q,uand ie malade repond, je me porte bien, ce seui mot suffit, il n'est pas plus a' lui." " When the patient answers that he is very well, this alone convinces me," says Dr. Cheyne of Dublih, " that he is no longer himself. In all these cases, the patient endeavours to get out of bed, to sit up, or even to walk about from one room to another ; but, unhappily, the attendants are solicitous to confine him to bed, and to load him with bed-clothes; nay, he is frequently kept struggling for two or three days together, with two strong people lying upon him continually. Now, to prevent all this misery, I know no method equal to what is here recommended; namely, let the patient have his clothes put on, and be placed in an easy chair; let his head be shaven, washed with vinegar, and covered with a linen cap. When he is tired of the erect posture, let him lie along on a couch, or upon the bed, with his head high. Let his diet be cooling, and his body be kept open by clysters, repeated occasionally. Let this method be persisted in till his delirium goes ofT; or till the pulse subsides, and he seems ex- hausted ; then, perhaps, he will begin to doze, or slumber on his chair, which will do him no harm, and when he is inclined to go into bed, let him lie down. By this method," adds Dr. C, " I have recovered great numbers of persons, when I was suffered to conduct them in the hospital; and I do believe some have perished by an op- posite treatment, who "might have been saved." Medicine. — Although it be admitted, the cure of diseases de- pends very much upon the right choice of medicines ; yet, it cannot reasonably be expected that these will produce the desired effect un- less they be punctually taken, agreeably to the directions given. It has oftentimes occurred, that when aperient powders containing calomel have been prescribed, and directions given that they should be administered in syrup or molasses, the physician, on making the necessary inquiry on the following day, has been told by the nurse that they had no effect upon the bowels. " How was the medicine given?" "In tea, sir." " Why was it not administered agreeably to instructions?" " Because the patient preferred taking it in a liquid, and I thought it would answer as well." By thus changing the vehicle, the calomel being heavier than the tea, was left at the bottom of the spoon, and, as it was not swallowed, could not, of course, have any purgative effect. In like manner, the patient or nurse frequently thwarts the intention of the physician by making use of the medicines prescribed, irregularly ; so that if there be any 614 particular action to be kept up on the system, it is rendered abortive, 'and blame cast where it should not rest. It is not unusual for medi- cines, though ever so well adapted to the case, to excite nausea and retchings immediately after each dose has been taken. Hence, a prejudice arises directly against the medicine, which being taken for the cause, it is condemned and set aside. The consequence is, the disease becomes more aggravated. Cases may happen, wherein if but one medicine be neglected, it can never be administered again properly; and, consequently, the patient may either be lost, or greatly injured. It is, therefore, the duty of the nurse, when a physician prescribes in whom confidence can be placed, strictly to adhere to the curative process he selects, as without such attention iEsculapius himself might fail. It commonly occurs, through the course of many diseases, particu- larly fevers, that the patient has little or no inclination to eat, till na- ture has gained the victory. But this not being rightly understood by either him or his attendants, an outcry is made that he will never have an appetite whilst he takes medicine. Hence the remedies are discontinued ; yet the appetite does not recover, nor does the case grow better, but rather worse. The reason is obvious, if they would but only observe, that as the disease is cured, the appetite in conse- quence will revive. Again, it not unfrequently happens in diseases which are obsti- nate, requiring a long course of medicines, that the patient becomes impatient and discontinues the use of the remedies. And in such cases, it is too common, that the patient becomes prejudiced against his physician and mistrusts his ability wholly, though perhaps he has been conducted by him through the most difficult stages of his illness, and not uncommonly sends for another, who, if not so honest as to undeceive him, enjoys the honour that was due to the former. By these observations we do not mean to screen any unskilful or improper use that maybe made of medicine, or to raise it into higher esteem than what it deserves ; on the contrary, it will ever be found I hat he who knows his business best, will make his constant care to heal with fewest medicines ; and will always be most ready to re- sign his patient to diet alone , as soon as he knows it can be done with safety. During a long spell of sickness it not unfrequently occurs, that good-natured friends are in the habit of recommending nostrums, each on the supposition that his own is infallible. When the pa- tients are credulous, as is too often the case in lingering diseases, they readily grasp at any relief, however monstrous the proposition may appear : the consequence is, that in nineteen cases out of twenty, the medicaments of which they are composed are utterly unfit for the disease, and, consequently, prove deleterious in their effects. It too frequently occurs that insuperable difficulties of another kind arise. For a there are some persons bred up with strong preju- the nurse's guide. 615 dices, and an excessive like or dislike of certain things, and cannot easily be persuaded to comply with what is thought the most proper method of cure ; namely, a particular regimen, bleeding, vomiting, &c. And thus their lives are often lost, or if they survive, the fu- ture period of their existence is rendered very miserable by some consequent disease remaining fixed in the constitution. Again, we often find, with respect to children who have been much indulged, when the physician ascertains the nature of the disease, and pre- scribes suitably to the case, he will very likely be told by the parents, if he expect any medicine to be gotten down, it must either be nicely flavoured, or absolutely without taste. Or, should he advise topical bleeding by leeches, he will more than probably be told, however necessary their application may be, it is a remedy which must be de- clined, for the very sight of them would throw the child into convul- sions. — And, as to a blister, the infliction of this torture on such deli- cate skin could not be endured ; for as soon as any pain from its ac- tion was produced, it would be directly torn off. Placed under such limitations, it cannot be expected, however capable and anxious the physician may be to procure relief to his patient, that much advan- tage can be obtained from his prescriptions. He, therefore, either declines his attendance, or acting within the bounds to which he is limited, he does little more than alleviate some of the more distress- ing symptoms, whilst he has the mortification to witness the almost uninterrupted progress of the disease. Leeches. — As these little animals are depended on for the remo- val of very dangerous diseases, and as they often seem capriciously determined to resist the endeavours made to cause them to adhere, it will be proper to give a few directions, by which their assistance may, with more certainty, be obtained. This useful ally to the physician, it may be remarked, is as little fond of the taste of physic as the physician can be himself. The introducing of a hand, to which any ill-flavoured medicine, adheres, into the water they are kept, will be often sufficient to deprive them of life ; the application of a small quantity of any saline matter to iheir skin, immediately occasions the expulsion of the contents of their stomach ; and, what is most to our present purpose, the least medicament that has been applied, remaining on the skin, or even the accumulation of the matter of perspiration, will prevent them from fastening. The skin should, therefore, previously to their ap- plication, be very carefully cleansed from any foulness, and mois- tened with a little milk. The best mode of applying them is by retaining them to the skin in a small wine-glass, or the bottom of a large pill box, when they will, in general, in a little time, fasten themselves to the skin. On their removal, the rejection of the blood they have drawn mav be obtained by the application of salt externally; but bore, for the sake of those to whom we are so much indebted, it may be necessary to 616 the nurse's guide. remark, that a few grains of salt are sufficient for this purpose ; and that covering them with it, as is sometimes done by nurses, generally destroys them. It sometimes happens, that the blood will continue to flow from the orifice made by a leech longer than is desirable ; and, sometimes, children have been nearly lost from the inability of the attendants to suppress the discharge. In such cases, the blood should be washed off clean, and the point of the finger pressed moderately hard on the orifice, when the blood will cease to flow. A small compress may then be applied to the wound, w^hich may be retained by the point of the finger as long as the blood appears upon withdrawing the pressure ; remembering that no more blood need be suffered to flow, than is thought necessary ; since all that is required to prevent it, is patiently to persevere in the necessary pressure. It sometimes occurs, on the application of leeches to the funda- ment, in order to relieve the piles, that they get into the rectum. If that accident should happen, an injection of a solution of common salt is the proper remedy ; but the animal is soon gorged, and then may be destroyed. Clysters. — As the use of clysters is also of great importance in the cure of many diseases, and as nurses are not always conversant, even in this part of their office, it may be proper to give some direc- tions relative to the administration of them, which may be done in the following manner : The bed being prepared with a sufficiency of clothing to keep it dry, the patient must be placed on the side across it, with the knees forward, and then covered decently ; the clyster being likewise prepared, and brought to that moderate heat called milk warm, must be poured into the bladder and secured by tying the opening; which being done and the pipe anointed, the whole must be placed in the bed near to the patient. The nurse must now pass the point of her left forefinger, the nail being cut short, close to the anus, or a little within it, and then slide the pipe along this finger, till the greatest part of it be entirely introduced. In doing this, the pipe must be directed a little backwards, taking care not to push it against any part so as to cause pain. When thus introduced, its outer end must be held fast with one hand, whilst with the other she takes hold of the string, and pulls out the cork -, which done, the bladder must be grasped with both hands, and the contents forced up, keeping the pipe in its place at the same time. When the clyster has been pressed out of the bladder, the pipe must be instantly withdrawn. A large pewter syringe is more convenient to administer an injec- tion ; and some of them are so constructed that the patient may use it himself. Diet. — In the cure of diseases, experience proves how much de- pends upon the choice and administration of diet. We see one the nurse's guide. 61 7 series of disorders, wherein the appetite, either from a bad habit or some morbid effect, craves such thing's chiefly as have a tendency to heighten the disease. Another series, in which the whole fabric- being fully engaged and struggling with the disease in order to con- quer it, the stomach, till in that conflict nature gets the better, loathes every kind of aliment, except such as is fluid. And we see in the third class, the stomach not affected, but dispensing with all kinds of food. Yet these being taken indiscriminately, the disease is not only nursed, but the medicines usually the most efficacious in curing it, are rendered entirely ineffectual. The nurse should, therefore, be extremely cautious how she devi- ates from the diet which has been prescribed, as fatal consequences may arise from what may seem to have been but a trifling variation. The stomach must never be oppressed with much at a time, about half a pint being enough, and that should be repeated only as nature indicates. This will, generally, be known by the patient's desire or dislike of it. We say generally, for in some cases where there is great weakness, insensibility, or both, the patient may not be able to give such indication. And there are cases, especially fever that ter- minates badly, where the patient's thirst is insatiable. In either of these exigencies, the nurse must proceed with discretion ; that is, in the former she must rouse the patient every hour or two, and give a cupful or half a pint of such drink as directed ; and, in the latter, she must give drink more frequently, but small quantities at a time. But it should be observed that, whenever patients fall into tranquil slumber, they should hardly ever be disturbed to give them drink or food until five or six hours shall have elapsed. Such a repose is most desirable, and will, sometimes, renovate nature, when her fa- culties had before seemed prostrate, beyond the power of recovery. It is a vulgar error, and a very common one too, that a sick person is to be supported by rich broths, by pastry, or by solids. The out- cry is, that the doctor will starve him. Hence a variety of dishes is prepared to tempt the stomach to take food, and, in order to provoke the appetite, pickles are frequently given. The patient, from the extreme kindness of friends or offi- ciousness of the nurse, is teazed with repeated urging, to try to take a little more, until the stomach has received so much as to produce effects directly opposite to those intended. Even after the disease is conquered, and the appetite begins to crave, it is always advisable to feed the patient sparingly for several days. Unlimited indulgence in the article of food, is a source from which a multitude of diseases arises in health ; then how much more deleterious in its effects, must this be the case in a state of convalescence. At this crisis, it is, indeed, a nice point to avoid giving the patient too much or too little nutriment ; but even here, perhaps, excess is the most dangerous extreme. Great anxiety to prevent the sick from sinking, often induces their attendants and friends to give much more food than can possibly be digested, and it often lies as an offensive 78 618 load upon the stomach, or induces an exhausting vomiting or diarr- hoea. When the weakened condition of the digestion or assimilative organs are considered, it cannot but appear, even from that reason, that small portions of plain, simple food, given at stated intervals, will best support the remaining strength of the system, and this is really confirmed by experience. In preparing all kinds of aliment, it is essentially necessary to be very cleanly, but more especially in that for sick people, the stomach being often so greatly weakened and disordered by the disease, as to render it difficult to find out by way of diet, what is agreeable to the natural powers, and suitable to the case. The nurse, who ought to be the cook, with respect to this part of diet, may select, from the articles enumerated for the sick, such ali- ments as are suitable to the case. It is advisable that a choice be made of the things most likely to agree with the patient, that a change be provided, as invalids require variety; and that they should succeed each other in different forms. Conclusion. — I believe I have now completed the task that was allotted me, and sincerely hope, notwithstanding its imperfections, the improvements I have made to the seventh edition of the "Medi- cal Companion," will greatly enhance its value, and be productive of much comfort and good. So long as sickness is a concomitant of humanity, so long will a work of this kind retain its estimation. By persons in health, the possession of such a book may not be suf- ficientty prized; but when sickness finds access to a beloved wife or child, it will doubtless be read with pleasure, and considered in reality a valuable and acceptable companion for the sick chamber. It is not to one description of persons alone that the " Medical Companion," will prove useful, but to every class of society. — Many families are ignorant even of the mode to prepare the various articles of diet suitable for the sick, and, with such, this part of the work, as a Family Assistant, must be of incalculable value. To the in- quisitive mind, the attentive perusal of this book, from the begin- ning to the end, will be found to contain so many interesting facts, as will not fail to prove a source of rational and instructive enter- tainment. To diffuse medical knowledge, is the most effectual mode of checking the career of empiricism ; and, indeed, so obvious is this, that it is surprising to find heads of families pay so little attention to the perusal of books of this kind, wherein they might obtain such in- formation as would enable them to detect ignorant pretenders in the healing art, as well as afford them the very great satisfaction of ren- dering that assistance in the management of the sick, for which hu- manity often loudly calls.— Such knowledge is also highly useful, on the one hand, in preventing unnecessary apprehension respecting symptoms by no means dangerous ; and, on the other, in giving the alarm, where delay might be injurious or fatal. And, again, there DIET FOR THE SICK. 619 are situations in which a little medical knowledge may be of essen- tial consequence to the comfort, or even the life of the patient, before regular assistance could be procured. DIET FOR THE SICK. Sage Tea. — Take of the leaves of green sage, plucked from the stalks and washed clean, half an ounce, (a handful,) loaf sugar an ounce, outer rind of lemon peel, undried, a quarter of an ounce, or a little lemon or lime juice, boiling water, two pints. Infuse them in a mug or pitcher, covered, for half an hour, and then pour ofT the tea. When the sage is dried, it must be used in a less proportion than that above. In the same manner teas may be made of balm, ground ivy, cat- mint, rosemary, southern wood, &c. The lemon peel, or lemon juice, being omitted or not, and the sugar lessened or increased, as occasion requires. Lemons, or apples cut in slices, tamarinds, currants, fresh or in jelly, cranberries, dried whortleberries infused in boiling water, sweetened with sugar or syrup : these may be so prepared and varied in form, as to suit every taste, and to answer the purpose of pleasant, cooling, and salutary drinks, in all febrile complaints. Such drinks should always be kept in a covered vessel. Bran Tea. — Take of bran, fresh ground, two hands full ; mo- lasses or honey one spoonful ; boiling water, six pints. Mix them well, and when they have stood covered about three or four hours, strain off the tea. ' Flax-seed Tea. — Take of flax-seed, one ounce ; white sugar, one ounce and a half; lemon juice, two table-spoons full ; boiling water, two pints. Infuse them in a pitcher some hours, and then strain off the liquor. An ounce of liquorice shaved, may sometimes be used instead of sugar. Camomile Tea. — Take of camomile flowers, one handful ; boil- ing water, one gallon. When they have stood covered about half an hour, strain off the tea. If the drinking this tea be to strengthen the stomach, it must be made stronger, as for instance, about a quar- ter of an ounce to a pint. Lemonade. — Take of the outer rind of fresh lemon peel, about one drachm; lemon juice, one ounce; double refined sugar, two 620 DIET FOR THE SICK. ounces ; boiling water, a pint and a half. When they have stood in a vessel about ten minutes, strain off the liquor. Orangeade. — Take of the fresh outer rind of Seville orange, one drachm ; orange juice, two or three table-spoons full ; white sugar, one or two ounces, or enough to make it of an agreeable sweetness ; boiling water, one quart. When they have stood in a pitcher about ten minutes, strain off the liquor. Imperial Drink. — Take of cream of tartar, one drachm ; the outer rind of fresh lemon or orange peel, half a drachm ; loaf sugar, one ounce ; boiling water, two pints. When they have stood in a pitcher about ten minutes, strain off the liquor. Barley Water. — Take a handful of either pearl barley, or the common sort, wash it clean, first in cold, and afterwards in boiling water, then simmer it in a quart of water for an hour ; when half done, put into it a bit of fresh lemon peel and a little sugar. — Rice water may be prepared as above. Toast Water. — Toast slowly a thin piece of white bread till extremety brown and hard, but not the least black, then plunge it into a jug of cold water, and cover it over an hour before used. Pectoral Drink. — Take of common barley and raisins stoned, each two ounces ; liquorice root, half an ounce; water, two quarts. Boil the water first with the barley, then add the raisins, and after- wards, near the latter end of the boiling, the liquorice. The decoc- tion then will be fully completed, when one quart only of the liquor will be left after straining. Arrow-root Jelly. — Mix a large spoonful of the powder with a tea-cupful of cold water, by degrees, then pour this into a pint of boiling water, stirring it well, and when it boils it is finished. A little sugar and nutmeg may be added. Or prepare it as directed under the head of Arrow-root. — (See Materia Meclica.) Sago Jelly. — Take of sago, washed well, one large spoonful ; water, nearly a pint. Boil them gently, stirring often, till the mix ture is smooth and thick; then add two spoons full of wine, a little nutmeg, and sweeten it to the taste. A bit of lemon peel added to it when boiling, gives it a pleasant taste and flavour, and with some patients it agrees better when boiled in milk. Tapioca Jelly. — Choose the largest sort, pour cold water on to wash it two or three times, then soak it in fresh water five or six hours, and simmer it in the same until it becomes quite clear, then DIET FOR THE SICK. 621 put lemon juice, wine, and sugar. The peel should be boiled in it. It thickens very much. Calves' Feet Jelly. — Boil two calves' feet in one gallon of water till it comes to a quart, then strain it, and when it is cold, skim the fat entirely off, and take the jelly up clean ; if there be any set- tling at the bottom, leave it. Put the jelly into a saucepan, with a pint of mountain wine, half a pound of loaf sugar, the juice of four large lemons, and the white of six or eight eggs, beat up the whisk ; mix all well together, set the saucepan upon a clear fire, and stir the jelly till it boils. When it has boiled a few minutes, pour it through a flannel bag till it runs clear. — Have now ready a large china basin, with some lemon peel in it, cut as thin as possible, let the clear jelly run upon them while warm, and from these it will acquire both an amber colour, and an agreeable flavour. Afterwards it may be poured into glasses. Boiled Flour. — Take a pound or two of fine flour, tie it up as light as possible in a linen rag, dip it repeatedly in cold water, and dredge the outside with flour till a crust is formed around it, which will prevent the water soaking into it while boiling. It is then to be boiled till it becomes a hard dry mass. Two or three table- spoons full of this may be grated down and boiled in milk and water to a proper thickness, and sweetened to the patient's taste, and a little nutmeg or other spice may be added. This forms an excellent food in dysentery, and in bowel complaints in children. Water Gruel. — Take of the coarse part of com meal or grist, two hands full; water, three quarts; boil it till only two quarts re- main, then strain off the liquor, and season it to the palate with salt, sugar and nutmeg, to whicli may be added a spoonful or two of wine. Or, take of oatmeal, two large spoons full; water, one quart ; mix them well, and boil them about ten or fifteen minutes, stirring often; then strain the gruel through a sieve, and add sugar and salt enough to make it agreeable to the taste. When it is designed as a meal, dissolve it in a little butter, and then add bread and nutmeg, as oc- casion requires. Rice Milk. — Take a large tea-cupful of rice, washed nicely ; water, one pint; boil it for about half an hour, then add a quart of new milk; let it simmer over a slow fire till it is sufficiently done, and then add to it a little susrar and nutmeg. *&' Treacle Posset. — Take of milk one pint, put it on the coals till it just begins to boil, then add two or three table-spoons full or iicacle or molasses, stirring the milk as it is poured in. When mixed : t is lit for use. 622 DIET FOR THE SICK. Panado. — Take of bread one ounce ; mace, one blade ; water, one pint — Boil them without stirring, till they mix and turn smooth, then add a little grated nutmeg; a small piece of butter, and sugar enough to make the mixture agreeable. When butter is not ap- proved of, two spoons full of wine may be used in its stead. Or, set a little water on the fire, with a glass of white wine, some sugar, and a scrape of nutmeg and lemon peel ; mean while, grate some crumbs of bread. The moment the mixture boils up, keeping it still on the fire, put the crumbs in, and let it boil as fast as it can. When of a proper thickness just to drink, take it off. White Caudle. — Take of oatmeal two table-spoonsful ; water, one quart ; mace, two or three blades ; three or four cloves. Mix them well together, boil them about fifteen minutes, stirring often, then add a few slices of the outer rind of a lemon ; when the mix- ture has boiled about fifteen minutes, strain it through a sieve. As it is used, add to it white wine, grated nutmeg, white sugar enough to make it agreeable to the patient. Toasted bread is to be added likewise, as the appetite may require. Or, put into a pint of fine gruel, made of coarse corn meal, or grits, while it is boiling hot, the yolk of an egg beaten with sugar, and mixed with a large spoonful of cold water, a glass of wine, and nutmeg. Mix by degrees. Some like gruel, with a glass of table beer, sugar, &c, with or without a tea-spoonful of brandy. Flour Caudle. — Into five large spoonsful of the purest water, rub smooth one dessert spoonful of fine flour. Set over the fire five spoonsful of new milk, and put two bits of sugar into it ; the moment it boils, pour into it the flour and water, and stir it under a slow fire twenty minutes. It is a nourishing and gently astringent food. Rice Caudle. — When the water boils, pour into it some grated rice, mixed with a little cold water; when of a proper consistence, add sugar, lemon peel, and cinnamon, and a glass of brandy to a quart. Boil all smooth. Bread Soup. — Take the upper crust of a roll, the drier the bet- ter ; or two or three crackers, cut or break them into pieces, and put it into a saucepan, with a pint of water, and a piece of butter about half as big as a walnut; boil them well, every now and then stirring and beating them, till the bread is mixed ; then season the soup with a very little salt, and pour it into a basin. Egg Soup. — Take of water one pint; the yolk of an egg; butter the bigness of a small walnut; sugar enough to make it agreeably sweet. Beat up the yolk with the water, and then add the butter and sugar. Stir it all the time it is upon the fire; when it begins to DIET FOR THE SICK. 623 boil, pour it to and fro between the saucepan and mug till it be smooth and well frothed, and then it will be fit to drink. Beef Tea. — Cut one pound of lean beef into thin slices or shreds, and boil it in a quart of water for twenty minutes, taking off the scum as it rises. After it grows cold, the liquor should be strained, in which state it resembles a light infusion of green tea, has a very grateful flavour, and is more strengthening than other broths. Chicken Broth. — Take a middling-sized chicken, divide it into two parts, put one half into a saucepan, with a quart of water, sea- soned with a little salt; as the scum rises take it off; then may be added a small. bundle of parsley, and a crust of bread; when they have boiled about three-quarters of an hour, the parsley may be ta- ken out, and the broth will be fit for use, or it may be used seasoned only with salt. Mutton Broth. — Take of mutton one pound ; water three pints. Put them into a saucepan, and set it upon a clear fire, throw in a little salt, and as the scum rises take it carefully off with a spoon ; then add a small onion, if there be no objection to it, and a little parsley. Boil till the meat is very tender, then take it out, pour the broth into a basin, and when cold, skim the fat part which is con- gealed on the surface, entirely off; after which, a part of the broth may be warmed and given to the patient as often as needful. A little boiled rice or barley may be added here occasionally. Calves' Feet Broth. — Boil two feet in three quarts of water, to half, strain and set it by; when to be used, take off the fat, put a large tea-cupful of the jelly into a saucepan, with half a glass of sweet wine, a little sugar and nutmeg, and beat it up till it be ready to boil, then take a little of it, and beat by degrees to the yolk of an egg, adding a bit of butter, the size of a nutmeg, stir all together, but do not let it boil. Grate a bit of fresh lemon peel into it. Boiled Pigeon. — Take one pigeon, drawn and washed very clean ; boil it in a sufficient quantity of milk and water; that is, about half a pint of each, for fifteen minutes. When thus prepared, it may be taken out and eaten with the following sauce : — Take the liver parboiled, bruise it fine, with a little parsley boiled, and finely chop- ped ; melt some butter, and mix a little of it first with the liver and parsley, and then add the rest, and pour the whole upon the pigeon. To broil Pigeons. — After cleaning, split the backs, pepper and salt them, and broil them very nicely; baste with butter, and serve as hot as possible. 624 DIET FOR THE SICK. Roasted Pigeons — Should be stuffed with parsley, either cut or whole, and seasoned within. Serve with parsley and butter. Partridges and other birds may be dressed as above. Bread Pudding. — Take of crumbs of bread about half a pound ; new milk, about three-quarters of a pint. Pour the milk boiling hot upon the bread, and let it stand about an hour covered close up ; then add the yolks of two eggs, well beaten; a little grated nutmeg; about a spoonful of rose water ; a little salt, and sugar also if agree- able ; beat the bread well, and mix the whole together with a spoon. Tie it then close up in a clean linen cloth, and when the water boils, put it in ; boil about three-quarters of an hour, then take it out, lay it upon a plate, pour over it some melted butter mixed with a little mountain wine, if there be no objection, and sprinkle a little sugar over all. Batter Pudding. — Rub three spoonsful of fine flour extremely smooth, by degrees, into a pint of milk ; simmer till it thickens, stir into it two ounces of butter, set it to cool, then add the yolks of three eggs ; flour a cloth that has been wet, or butter a basin, and put the batter into it ; tie it tight, and plunge it into boiling water, the bottom upwards. Boil it an hour and a half, and serve with sweet sauce. If approved, a little ginger, nutmeg, and lemon peel, may be added. Rice Pudding. — Wash and pick some rice, throw among it some pimento finely pounded, but not much ; tie the rice in a cloth, and leave room for it to swell. Boil it in a quantity of water for an hour or two. When done, eat it with butter and sugar, or milk. Put lemon peel if you please. It is very good without spice, and eaten with salt and butter. Or, swell the rice with a very little milk over the fire, then add some more milk, an egg, sugar, allspice, and lemon peel. Bake in a deep dish. Potato Pudding. — Take eight ounces of boiled potatoes, two ounces of butter, the yolks and whites of two eggs, a half pint of new milk, one spoonful of white wine, a morsel of salt, the juice and rind of a lemon beat all to froth ; sugar to taste. — A crust or not, as you like. Bake it. Custard Pudding. — Mix by degrees a pint of good milk with a large spoonful of flour, the yolks of four eggs, and a little pounded cinnamon. Butter a basin that will exactly hold it, pour the batter in, and tie a floured cloth over. Put in boiling water over the fire, and turn it about a few minutes, to prevent the egg going to one side. Half an hour will boil it. DIET FOR THE SICK. 625 Wine Whey. — Take of new milk two pints ; water one pint ; white wine one gill. Put the milk and water into a saucepan, well tinned, and set them upon a clear fire, and when they begin to boil, throw in the wine. Boil them about fifteen minutes, during which time, as the curd, or cheesy part collects, take it off with a spoon, and if the whey be not clarified enough with this quantity of wine, add a spoonful or two more ; then boil it a little longer and skim it, by which means it will become sufficiently fine, and then it may be poured into a basin for use. Or, put half a pint of new milk on the fire ; the moment it boils up, pour in as much sound raisin wine as will completely turn it, and it looks clear; let it boil up, then set the saucepan aside till the curd subsides, and do not stir it. Pour the whey off, and add to it half a pint of boiling water, and a bit of white sugar. Thus you will have whey perfectly cleared of milky particles, and as weak as you choose to make it. Mustard Whey. — Boil one ounce and a half of mustard in powder, in a pint of milk, and an equal portion of water, till the curd be entirely separated, after which the liquid is strained through a cloth. This preparation is one of the most pleasant and effica- cious forms in which mustard can be given. A tea-cupful sweetened with sugar, taken three or four times in a day, is exceedingly bene- ficial in low fevers as a diaphoretic cordial. Vinegar and lemon whey may be formed in the same manner as wine whey. Alum Whey. — Boil two drachms of powdered alum in a pint of milk till it be curdled ; then strain out the whey. This astringent preparation is often employed with advantage in uterine hemorrhage, and in diabetes. The dose is two or three ounces, or as much as the stomach will bear, several times in the day. To mull Port Wine. — Boil some spice in a little water till the flavour be gained, then add an equal quantity of wine, some sugar and nutmeg; boil it together, and serve with toast. Another way. Boil some allspice, or a bit of cinnamon, and some grated nutmeg a few minutes, in half a pint of water; then pour to it a pint of wine, add sugar to your taste, beat it up, and it will be ready. To mull White Wine. — Boil a pint of good wine with a table- spoonful of allspice ; beat up the yolk of an egg with a little sugar, and add it to the wine while boiling. Refreshing Drinks in Fevers. — Boil two quarts of water with two ounces of tamarinds, an equal quantity of currants and raisins, till near a fourth be consumed. Strain it on a piece of 79 626 DIET FOR THE SICK. lemon peel, which remove in an hour, as it gives a bitter taste if left long. Tamarinds, currants, fresh or in jelly, or scalded currants, or cran- berries, with cold water, make excellent drinks ; a little sugar may be added, if agreeable. Lemon Water. — Put two slices of lemon, thinly pared, into a tea-pot, a small piece of the peel and some white sugar, pour in a pint of boiling water, and stop it close two hours. Apple Water. — Cut two large apples in slices, and pour a quart of boiling water on them, or on roasted apples, strain in two or three hours, and sweeten lightly. DISPENSATORY Having finished, as far as the limits of this work will permit, a general detail of the practice of domestic medicine, adapted to the climate of our country, it now only remains to notice the medicines requisite for family use, and to point out the best forms of prescribing them, in the treatment of the different diseases, described in the pre- ceding parts of this work. The following tables of medicines will be found sufficient to answer every purpose of practice, and the expense will be found nothing, compared to the great advantages which must result from being constantly supplied with them. To render the work still more complete, I have, in these tables, annexed to the medicines, their doses, according to the age of the patient ; observing, however, that whatever general rule may be given, it can only be applied with reference to the habit and state of the patient. The judgment of the person who administers the medicine must, therefore, be exercised in this respect. It will be found that the constitution is often at- tended with certain peculiarities, both in relation to medicine in general, and also to certain substances, particularly, which knowledge is only to be obtained by experience. EXPLANATION OF WEIGHTS AND MEASURES. 20 grains make 1 scruple, 3 scruples 1 drachm, 8 drachms • . I ounce, 1 2 ounces 1 pound. A tea-spoonful is equal to 60 drops, or . . 1 drachm. A table-spoonful is the measure of ... |- an ounce. 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Ph m TTl CQ XII > DISPENSATORY. 635 EMETICS, Are medicines which excite vomiting, and are usually employed in fevers of almost every species, especially when accompanied in the commencement with nausea, vomiting, and other symptoms indi- cating a disordered state of the stomach. They cleanse the stomach of its noxious contents, and prepare the way for the reception of other remedies. As a general rule, emetics should always be given on an empty stomach, and in the morning. They act with greater certainty, and with less distress to the patient. They will, however, answer very well in the evening. In ordinary cases, administer the medicine in divided quantities, so as to guard against too violent an effect, and encourage its operation by drinking freely of warm water. To check inordinary vomiting from too large a dose of emetic medicince, give laudanum, combined with some cordial, apply fo- mentations to the pit of the stomach, and sinapisms to the extremi- ties. Chicken water, copiously drunk, is sometimes useful by turning the action downwards. When these fail, anodyne injections may be resorted to, and a large blister should be put on over the region of the stomach. Of the emetics, the mildest are ipecacuanha, the antimonial solu- tion, and antimonial wine, in broken doses. The most active and expeditious, are the white and blue vitriol. Where poisons have been swallowed, one or other of these should be given in very large doses, and repeated every fifteen minutes until the desired effect be obtained. — (See Thorn Apple, and Poisons.) Antimonial Solution. — Take of tartar emetic, six grains, water half a pint; spirits of lavender thirty drops; sugar, one lump. — Mix. Dose for adults a wine-glassful every fifteen minutes, which should be encouraged by drinking freely of warm water, and afterwards turned downwards by taking a bowl of thin gruel made very salt. CATHARTICS, Are medicines which, by quickening the peristaltic motion, in- crease the evacuations of the intestines, or as may happen, induce purging. Cathartics differ very materially in their degree of activity ; some operating mildly, while others are more violent in their effects. The former is usually distinguished by the title of laxatives, and the latter by that of purgatives, the harshest of which, are called drastic purgatives. The primary and most obvious effect of cathartics, is the evacua- tion of the bowels. These are liable to various accumulations of a 636 DISPENSATORY. morbid nature, which, remaining, disturb health, and frequently ex- cite or confirm disease. Cathartics, in relieving the bowels, under such circumstances, extend also their operation upwards, and bring down, in many instances, the contents of the stomach. To this may be added, that the strong impression which they impart to the liver and pancreas, excites these glands to invigorated efforts, and the result is a vast increase of their respective secretions. It is in this way, that congestions are removed, biliary calculi dislodged, and jaundice and other affections, from organic obstruction, cured. They also subdue the pulse, equalize excitement, and render important service in the management of the febrile and inflammatory cases. Exhibited in the commencement of almost any febrile affection, they will often arrest its progress, and, during the subsequent or more ad- vanced periods, they are sometimes daily repeated, and, so far from weakening, add to the strength of the patient. As in the case of emetics, give the medicine on an empty stomach, and either in the morning or at bed-time. By doing this, we prevent its being rejected, and secure a much more easy and effectual opera- tion. And it should be recollected, as cathartics are of very different properties and modes of operation, they should carefully be selected according to the circumstances of the case. Laxatives. — Of this description are castor oil, sweet oil, magnesia, calomel, neutral salts, sulphur, cream of tartar; as also the cathartic mixture, and the aperient and diaphoretic pills, in broken doses. Cathartic Mixture. — Take of Glauber salts, one ounce and a half; lemon juice or sharp vinegar, one ounce; water, half a pint; sugar, a sufficient quantity to sweeten it. — Mix. Or, take of cream of tartar finely powdered, and manna, each one ounce; water, half a pint; sugar, a sufficient quantity to sweeten it. -Mix. Dose for adults, a wine-glassful every hour till it operates. A?itibilious, or Aperient and Diaphoretic Pills. — Take of calo- mel, jalap, each twenty grains ; tartar emetic, two grains ; syrup or mucilage of gum Arabic, sufficient to form a mass ; make eight pills. Dose for adults, two at bed-time, and the dose repeated every hour in the morning until it operates sufficiently. — Or take four in the morning, and one every hour until the desired effect be obtained. Purgatives. — The drastics are the Croton oil, gamboge, aloes, calomel, jalap, rhubarb, and senna, the purgative infusion, purgative powder, stimulant purgative pills, and purgative electuary. The distinction, however, between laxatives and purgatives, is by no means easy, since by diminishing or increasing the dose of the former, they may, with some propriety, be considered as belonging to the first or second class. DISPENSATORY. 637 Croton Oil. — This oil is obtained from the seeds of the Croton Tiglium ; a native of the East Indies. It is one of the greatest and most powerful cathartics, with which we are acquainted: Like all other active cathartics, it sometimes gripes the bowels. This effect may be relieved by drinking freely of chicken water, gruel, or flax- seed tea ; or, if necessary, by a little laudanum. The usual dose, for an adult, is one drop, but four or five drops are sometimes given. It may be given in syrup, or made into the form of pill with crumbs of bread — the latter form is preferable. Purgative Infusion. — Take of senna and manna, each, half an ounce ; salts, one ounce; ginger, one drachm ; boiling water, one pint. Dose for adults, one gill every hour or two, until it operates. Purgative Poivder. — Take of calomel and jalap, each, twenty grains, to be taken in the morning in syrup or molasses, by adults. Or, take of rhubarb and vitriolated tartar in fine powder, each one drachm; mix well together, and divide into four powders. — One taken going to bed, and another in the morning, will be found an efficacious remedy, whenever it is required to cleanse the stomach and bowels of bilious and other offensive matter. Stimulant Purgative Pills. — Take of calomel and gamboge each one drachm; syrup sufficient to form a mass. Beat them together, and then make twenty-four pills. Dose for adults, from three to six. Or, take of calomel, aloes, rhubarb, and soap, each, one drachm, syrup or mucilage of gum Arabic, sufficient to form a mass. — Beat them well together, and make forty-eight pills. Dose for adults from four to eight. Or, take of calomel and jalap, each, one drachm ; powdered gin- ger and soap, each, half a drachm ; mucilage or syrup sufficient to form a mass — divide into thirty pills. Dose for adults from four to eight. Aloetic Pills. — Take of Socotorine aloes, in the finest powder, one drachm and a half; Castile soap, one drachm; ginger, half a drachm. Beat them well together, and then add mucilage or syrup sufficient to form a mass — which is to be made into forty-eight pills. Dose for adults, two at bed-time, or a sufficient number to keep the bowels in a regular state. Purgative Electuary. — Take of jalap, one drachm ; cream of tartar, one ounce ; syrup or molasses as much as will give the whole a proper consistence. Dose for adults, from one to two tea-spoons full in the morning, to keep the bowels in a soluble state. 633 DISPENSATORY. DIAPHORETICS. In the common language of the schools, the term diaphoretic, is restricted to those articles only which promote the insensible perspi- ration ; and such as occasion sweating, are distinguished by the ap- pellation of sudorifics. But, as in the medicines arranged under these titles we can discern no difference, except in the degree of force, or what arises from the manner of administration, we shall comprehend the whole under the head of diaphoretics. To promote perspiration it is essentially necessary that the patient should be confined to his bed. Let his pulse, and the temperature of the body, be carefully watched. It is a principle settled and fully recognised, never to resort to diaphoretics in fevers of an inflamma- tory species, till arterial action and general excitement are consider- ably reduced by previous venesection and evacuations by puking or purging. After this direct depletion, diaphoretics then come in with great advantage, and will commonly either mitigate or completely arrest the progress of the disease. In the exhibition of diaphoretics give diluent drinks, unless the stomach be irritable. This remark particularly applies to the anti- monial preparations, and some of the combinations of ipecacuanha. The temperature of the drinks must be regulated by that of the skin. The latter not being high, they should be warm, or even hot; but if the contrary prevail, they must be given cold. In the low stages of disease, while pursuing the diaphoretic plan, studiously avoid purging, unless circumstances imperiously require this remedy. It is very apt, in this state of the system, to check sweating, and to bring on an aggravation of the complaint. It does this by diverting action from the surface of the intestines, and by ex- posing the patient to cold. Diaphoretic Drops. — Take of sweet spirits of nitre and antimonial wine, each, one ounce. — Mix. Dose for adults, a tea-spoonful every two hours. If the stomach is in an irritable state, add only half the quantity of antimonial wine. Antimonial Wine. — Dose for adults, twenty drops every hour or two, till the proper effect be produced. Saline Julep or Mixture. — Take of lemon juice, one ounce ; vol- atile sal ammoniac, one drachm, or salt of tartar four scruples. After the effervescence, add syrup, two tea-spoons full ; simple cin- namon water, or tea, half an ounce, or spirits of lavender, thirty drops ; spring water, six ounces. — Mix. Dose for adults, two table- spoons full every three hours. Effervescing Draught. — Take fifteen grains of salt of wormwood, DISPENSATORY. 639 or volatile sal ammoniac, dissolved in a table-spoonful of water, in one cup ; in another, two large tea-spoons full of lime juice, lemon juice, or one table-spoonful of very good vinegar, with one or two table-spoons full of water sweetened ; Dpur one to the other, and let the patient drink immediately while tSey effervesce. When made with fresh lime or lemon juice, this is an elegant, pleasant, and use- ful medicine in all fevers, and peculiarly effectual in removing nau- sea and vomiting ; it may be repeated every two or three hours. Spirit of Mindererus. — Take of volatile sal ammoniac, two drachms ; lemon juice or vinegar, half a pint, or as much as may be sufficient to saturate the volatile alkali. — Mix. A dose to be taken every two hours. Antimonial Solution. — Dose for adults, a table-spoonful every two hours as a diaphoretic. (See Emetics.) Antimonial Powders. — Take of tartar emetic, three grains ; nitre, two drachms. — Mix, and divide into twelve doses. One dose to be taken every two or three hours by adults. In obstinate cases, the addition of ten or twelve grains of calomel to the above recipe, will render the medicine more salutary. Febrifuge Powders. — Take of ipecacuanha, two scruples ; nitre two drachms. — Mix, and divide into twelve doses. One dose to be taken every two or three hours by adults. Febrifuge Mixture. — Take of nitre, two drachms ; lemon juice or vinegar, one ounce ; water, half a pint ; sugar, a sufficient quan- tity to sweeten it. — Mix. A wine-glassful to be taken by adults every two hours. It will be rendered more active by the addition of two drachms of antimonial wine, Dover'' s Powders. — Ipecacuanha, powdered, and opium, each, one drachm ; vitriolated tartar, in powder, one ounce. — The greatest possible pains should be taken to grind the mass to a completely fine powder. Nitre may be substituted for the vitriolated tartar, when that is not at hand. This powder is the most efficacious sudorific we possess. It is an admirable remedy for quieting the bowels, when affected by the exhibition of mercury, or any other cause. Dose for adults from ten to twenty grains every three or four hours. Camphorated Powders. — Take of camphor, two scruples; nitre, powdered, two drachms. Moisten the camphor with spirits, and after reducing it to a fine powder, add the nitre. Divide it into twelve doseS. One to be taken every two or three hours by adults. Infusion of Virginia S?iake Boot. — Snake root, half an ounce ; 640 DISPENSATORY. boiling water, half a pint ; infuse for two hours in a covered vessel and strain. — Dose. A table-spoonful occasionally, taken warm. It is used to aid other diaphoretics, and in its effects, resembles camphor. Anodyne Sudorific DropW. — Take of laudanum half an ounce ; antimonial wine, one ounce. — Mix. Dose for adults, two tea-spoons full at bed-time. Anodyne Sudorific Bolus. — Take of opium, one grain and a half; ipecacuanha, ten grains : syrup or mucilage, sufficient to form a bolus. Or, take of opium, one grain and a half; tartar emetic one grain; or golden sulphur of antimony, two grains; mucilage sufficient to form a pill. To be taken by adults at bed-time. For children, the best means of procuring a perspiration is the tepid bath, succeeded by the use of a table-spoonful of saline julep, or the diaphoretic drops, every two or three hours. Besides the warm bath, the external stimulating diaphoretics are, friction, rubefacients, and blisters, which excite copious partial per- spiration, previously to their vesicat on. There are many vegetable substances which belong to this class of medicines, particularly the Virginia and seneca snake roots, sarsa- parilla, thoroughwort, &c. (See Materia Medica.) DEMULCENTS. Demulcent Drinks — Are those which sheath the acrimony of the humours, and render them mild, such as flax-seed tea, marsh-mallow tea ; mucilage of quince seeds, pith of sassafras, slippery elm, (see Materia Medica,) and gum Arabic. A solution of gum Arabic is made by boiling an ounce of picked gum Arabic, in a little more than a quart of water, until it be dissolved. All these are useful to sheath and defend very sensible parts from the irritation of acrid humours, as is the case in tickling cough, and common lax, or bloody flux, heat of urine, &c, in all which, the natural mucus of the parts is defective. ABSORBENTS. Absorbent Medicines — Are such as correct acidity in the stomach. Calcined Magnesia — One or two tea-spoons full to be taken oc- casionally mixed in milk or mucilage of gum Arabic, by adults. Prepared Chalk. — A tea-spoonful to be given in the same manner as magnesia. DISPENSATORY. 641 I Ante Water. — A wine-glassful, with an equal quantity of new milk, to be taken occasionally by adults. Absorbent Mixture. — Take of chalk prepared, half an ounce ; gum Arabic, powdered, and white sugar, each, two drachms ; water, four ounces. Dose for adults, a table-spoonful every two or three hours. Absorbent and Aperient Mixture — Is made by adding one drachm of rhubarb in powder, or half an ounce of the tincture of rhubarb, to the above recipe. • Or, take of prepared chalk and magnesia, each, half an ounce ; sugar, two drachms ; rub them well together, then add mucilage of gum Arabic, two ounces ; weak cinnamon tea, four ounces. — Mix. Dose for children, from one to two tea-spoonsful. DIURETICS, Are remedies to promote the urinary discharge, which may take place, either by stimulating the kidneys, or by an invigoration of the powers of absorption, and especially in cases of dropsical effusion. It hence appears, that diuretics are of two species, though in which- ever mode they operate, it is by an action primarily on the stomach, extended to the absorbents or kidneys, according to the affinity of the article to the one or other of these parts. Mild Diuretics. — Of this class of medicines, nitre, by reducing the force of circulation, will be found eminently useful in febrile cases. Dose, ten or fifteen grains, for adults, every two or three hours. Conjoined with camphor, as in the camphorated powders, its diuretic effects, in some cases, is increased. Dulcified Spirits of Nitre. — Dose for adults, half an ounce every three or four hours. Unless this medicine be given in large doses, it will excite perspiration, rather than act as a diuretic. It is chiefly valuable in the cases of children. There is, indeed, scarcely any medicine which, in their complaints, we can substitute in its place, and it may be given to them, in the same proportion even in the earliest periods of life. Cream of Tartar. — Dose for adults, half an ounce, dissolved in a pint and a half of water, to be taken throughout the course of the day. It must be gradually increased, as the stomach becomes ac- customed to it. Of all the diuretic medicines, this is perhaps most fitted to those cases of dropsy which are accompanied with increased or febrile ac- tion of the pulse, though it here sometimes operates more effectually 81 G42 DISPENSATORY. when combined with jalap, as in the form of laxative electuary. (See Cathartics.) Dose for adults two tea-spoonsful every three or four hours, where we wish to evacuate large accumulations of fluid, and here an abstinence from drink must be enjoined. Salt of Tartar — Is considered, by some practitioners, a valuable diuretic, in doses of half a drachm, dissolved in water, three or four times a-day. By combining it with the infusion of Colurnbo, or some of the bitter tonics, its efficacy is very much improved. Thus exhibited, it is said to increase the diuretic effect, while at the same time it invigorates the system generally. Parsley. — The common parsley of our gardens is another valuable diuretic. A strong infusion of the roots in doses of a tea-cupful every two or three hours, is well adapted to relieve the ordinary sup- pression of urine. It is customary to unite with the parsley the seeds of the water melon. Diuretic Infusion. — Pound a handful of the kernels of pumpkin seeds or melon seeds, with a small quantity of hard white sugar, to a smooth paste; then add a quart of boiling water, and a quarter of an ounce of saltpetre, or half an ounce of sweet spirits of nitre, and rub them well together. This is a pleasant and mild diuretic, particularly useful where the discharge of urine is attended with heat and pain. A tea cupful may be taken every hour or two by adults. Diuretic Pills. — Take dried squills in fine powder and calomel, each, half a drachm ; mucilage of gum Arabic, sufficient to form a mass, and then make twenty pills, two of which are to be taken at bed time. The pills powerfully promote urine, and are very effi- cacious in carrying off cold, phlegmatic humours, in all dropsical swellings. When the squill alone is given, it may be taken in doses of two or three grains, three or four times a-day, in the form of pills, by adults. Oil of Juniper. — Dose for adults, ten drops in gruel. — (See Ma- teria Medica. See also, under this head, wild parsley, wild carrot, foxglove, and tobacco.) Stimulating Diuretics. — The Spanish fly promotes, as well as restrains, the urinary discharge. Exhibited in a state of excitement, or at any time in small doses, it most^ commonly occasions strangury. But taken in a reverse state of the 'system, or in large doses, it as constantly proves diuretic. Thus, in the weaker forms of dropsy, two, three, or four drachms of the tincture, given in divided doses during the twenty -four hours, will produce the most copious evacu- ations of urine. DISPENSATORY. - 643 EXPECTORANTS. Expectorants have been denned those medicines which facilitate or promote the excretion of mucus or other fluids, from the pulmo- nary system or lungs. Expectorants are employed when the mucus is too thin and acrid, when too viscid, or when the excretories are not sufficiently irritable to propel their contents. Where the mucus is thin and acrid, inflammation generally exists, and in such cases mucilaginous drinks, as flax-seed tea, mucilage of gum Arabic, or slippery elm, Iceland moss, or syrup, liquorice, antimonials, and nauseating medi- cines are employed. Oils differently prepared, and jellies, are also useful. Independently of inflammation, the mucus is sometimes too thin and acrid, from too great irritability of the vessels of the bron- chial glands, and we then employ opiates and stimulating medicines, as mustard, horse-radish, seneca, squills, garlic, Indian turnip, mea- dow saffron, and tobacco, (See Materia Medica.) When the ex- pectoration is too viscid, or the vessels not sufficiently irritable to assist the excretion, expectorants, strictly so called, are useful. These are the more stimulating medicines just mentioned ; to which may be added all the variety of fetid gums, and the turpentines, including the balsams. Steams of warm water, impregnated with vinegar, aromatic herbs, and ether, are adapted to the same purpose. Nitric Lac Ammoniac. — Pour very gradually two drachms of ni- tric acid, diluted in eight ounces of water, on two drachms of ammo- niac, and triturate them in a glass mortar till the gum is dissolved , forming a milky fluid. Of this a table-spoonful may be taken every two or three hours in sweetened water. Laudanum, in some cases may be usefully added. Pectoral Mixture. — Gum ammoniac, two drachms; syrup oi squills, half an ounce ; laudanum, fifty drops ; spring water, six ounces. Reduce the gum to powder in a marble mortar, and gra- dually add the water, and triturate till the gum is dissolved, then strain from the impurities and add the other articles. Dose, a table- spoonful every two or three hours, for adults. Or, take of sweet oil, one ounce ; rain or soft water, half a pint ; salt of tartar, five grains ; white sugar, half an ounce. Dissolve the salt of tartar and the sugar in the water, and afterwards add the oil, when, by agitating the phial, a mixture will be formed of cream-like appearance. To this add paregoric elixir, half an ounce. Dose, a table-spoonful every hour or two. Pectoral Emulsion. — Take of oil of almonds, or pure sweet oil, one ounce; barley-water, six ounces; best white sugar and gum 644 DISPENSATORY. Arabic, powdered, of each half an ounce; laudanum, forty drops, Incorporate the sugar and gum Arabic together in a mortal- with a small quantity of the barley-water, then gradually mix the oil, and afterwards add, by little at a time, the remainder of the water with the laudanum. One or two table-spoonsful of this emulsion may be taken frequently. Or, take of the best purified honey and pure sweet oil, each, two ounces ; fresh lemon juice, one ounce ; syrup and paregoric, each, half an ounce. Mix, to form an emulsion. Dose, a tea-spoonful whenever the cough is most troublesome. Cough Mixture. — Take of paregoric elixir, one ounce ; powdered gum Arabic, one ounce; simple water, two ounces; sweet spirit of nitre, two drachms; antimonial wine, one drachm. Mix and dis- solve. Dose, one tablespoonful to be taken whenever the cough is troublesome. But, in the first stage of catarrh, when inflammatory symptoms are present, this and all opiates, are improper. Or, take of elixir paregoric, one ounce and a half; antimonial wine and syrup of squills, each one ounce; lac ammoniac, four ounces; syrup bal. tolu, one ounce. Dose, half a table-spoonful every two or three hours for adults. Or, take of tincture of opium, one drachm ; wine of ipecacuanha, half a drachm ; oxymel of squills half an ounce. — Mix. Dose, for adults, a tea-spoonful every two hours while the cough is severe. Domestic Remedies for Whooping- Cough. — Dissolve thirty grains of salt of tartar in a gill of water, add to it ten grains of co- chineal finely powdered, sweeten this with fine sugar, and give an infant a tea-spoonful four times a-day. To a child of two or three years old, two tea-spoonsful ; from four years and upwards, a table- spoonful or more may be taken. The relief is said to be immediate, and in general within five or six days. Or, take equal portions of new milk, and the lie strained from hickory ashes, of which one table-spoonful maybe given every hour through the day to a child of seven or eight years old — This reme- dy is also strongly recommended. Pectoral Lozenges. — Take of purified opium, two scruples; tinc- ture of balsam of tolu, two drachms; syrup, composed of one part of water, and two parts of white sugar, four ounces ; refined Spanish liquorice, previously moistened with a little warm water, so as to make it soft ; gum Arabic, in fine powder, each, two ounces and a half; emetic tartar, eight grains. Rub the opium and the emetic tartar with the tincture and syrup until the former is perfectly dis- solved, then add the liquorice; softened with wann water, and whilst beating them together, gradually sprinkle in the gum Arabic. Di- vide the mass into lozenges or troches ; each weighing ten grains, and exsiccate them gradually in the air. One may be put in the DISPENSATORY. 645 mouth and gradually dissolved, every hour or two when the cough is troublesome. Nitrous Lozenges. — Take of purified nitre, two drachms ; re- fined sugar, reduced to a fine powder, six drachms ; pulverized gum tragacanth, three drachms. — Beat these together with a small por- tion of water, until they are intimately mixed, and form a coherent mass, which may be divided into moderated sized troches or lozenges, to be dried by means of a gentle heat. In cases of quinsy or sore throat, one of these lozenges frequently put in the mouth and suffer- ed gradually to dissolve, will be found very beneficial. ANODYNES. Anodynes are medicines which ease pain and procure sleep. Opium. — Of all the articles of the Materia Medica, this is, per- haps, the most extensively useful ; there being scarcely one morbid affection, or disordered condition of the system, in which, under certain circumstances, it is not exhibited either alone or in combina- tion. Opium, the product of the poppy, with some persons, leaves unpleasant effects, and with such, the lettuce opium, (See Materia Medica,) should be employed. Opiate Pills. — Take of pure opium, and powder of cinnamon, or ginger,. each, twelve grains; mucilage or syrup sufficient to make them into twelve pills. Dose, for adults, one or two at bed-time. Anodyne Draught. — Take of laudanum, a tea-spoonful ; syrup, two tea-spoons full ; cinnamon, or herb tea, one ounce. — Mix. This to be taken at bed-time by an adult. When laudanum disagrees in the ordinary quantity, it may often be given with much advantage in doses of five or six drops every hour till the proper effect be pro- duced ; or it may be given in vinegar, whey, or conjoined with the antimonial wine, as in the form of the anodyne sudorific draught (See Diaphoretics.) As laudanum is extremely prejudicial to children, it ought not to be administered to them, except under peculiar circumstances. In- stead of its internal use, a little of it should be rubbed on the back- bone ; or the same effects may be produced by rubbing on that part a tea-spoonful of anodyne balsam. When laudanum is prescribed by way of injection, the proportion must be more than double what can be given by the mouth. Paregoric. — Dose, for adults, one or two tea-spoons full, in a cup of tea or gruel. 646 DISPENSATORY. Morphine. — For this article, as well as for the quinine and most of the other improvements, in pharmacy and chemistry, we are in- debted to the skill and industry of the French chemists. It is an alkali obtained from opium, and is that principle in opium which quiets irritability and disposes to sleep, without producing those dis- agreeable effects, which sometimes arise, from any other preparation of that valuable medicine. Hence it is particularly valuable to those with whom opium generally disagrees. Morphine is used in medi- cine in combination with sulphuric, or acetic acid, forming the sul- phate, or the acetate of morphine, of which the sulphate is to be pre- pared. They are used in solution ; which, may be obtained from any apothecary, and is thus prepared : — Take of sulphate, or acetate of morphine, sixteen grains, water one ounce, acetic acid, or strong vinegar five to six drops, alcohol one draehm. — Mix. The dose for an adult is from six to twenty-four drops of the so- lution, or one-fourth to one-half grain of the morphine itself, in pills or syrup. ANTI-SPASMODICS As the causes of spasms differ essentially, the remedies must equally differ. Bleeding, mercury, warm bathing, blister, opiates, camphor, volatile alkali, musk, castor, assafoetida, garlic, ether, wine, and spirits, bark, steel, and other tonics, are the remedies usually re- sorted to. In the choice of these, we employ the sedatives and ftetids to shorten the fit ; and the stimulants and tonics to prevent returns. Gum Pills. — Take assafoetida, three parts ; gum ammonia, two parts \ camphor, one part \ beat them well together, and with as much syrup as is necessary, make into pills of the size of a common pea, from three to five may be taken at a dose, and repeated as often as shall be found necessary ; not, however, exceeding three or four doses in a day. This is a powerful antispasmodic, and very useful in all nervous and hysterical complaints. When it is wished to render the mass purgative, which is generally proper, add as much socotrine aloes as of camphor. CORDIALS. A glass of wine or a little brandy toddy. Compound Spirits of Lavender. — Dose, for adults, a tea-spoonful on a lump of sugar, to be dissolved in the mouth, and gradually swallowed. DISPENSATORY. 647 Cordial Mixture. — Take of aromatic spirit of hartshorn, two water, two ounces ; spring water, three ounces. — Mix. The dose, for adults, a table-spoonful now and then. Cordial Draught. — Take of volatile tincture of valerian, one drachm; simple syrup, water, of each four tea-spoons full. — Mix them together. To be taken at once by adults. Cordial Drops. — Take of paregoric elixir, volatile tincture of va- lerian, of each equal parts. Mix them well together. Dose, one tea-spoonful in a glass of water, for adults. For children the best cordial is white wine whey. STIMULANTS. In relation to general stimulants, there is a distinction too impor- tant to be overlooked. We have a set distinguished by great diffu- sibility, and which, nearly as soon as exhibited, occasion universal excitement over the body; and there is a second section, by which tone is imparted, though very slowly, and by a long administration. The diffusible are very transient in their effects, while such as are more gradual in their operation, produce permanent or enduring im- pressions, and are called tonics. As in the administration of stimulants, we hope to overcome an existing action, by exciting a new and stronger one, it is obvious that they can only be resorted to with any hope of advantage, in the feeble shapes of disease, or in more violent forms, reduced by pre- vious evacuations. But, in determining the exact point at which to commence the use of stimulants, we may also be aided by watching their operation. Being ill-timed, they commonly produce pain in the head, or delirious wanderings, or morbid vigilance, or stricture of the breast, restlessness and anxiety, with a hot dry skin, parched tongue, and a quick, small, and corded pulse. In the administration of stimuli, we should endeavour to graduate the article to the state of excitability. This is a point of infinitely greater importance than is commonly imagined. It is not always the most active article produces the greatest effects. In the low states of disease, we have witnessed, in some instances, more effects from wine whey, than strong toddy. This proceeds from the article being in unison with the condition of the system. Narcotics. — That the purer narcotics are endowed with a stimu- lant power, is very satisfactorily proved by the operation of opium. Exhibited in a moderate dose, the purer narcotics excite activity both of body and of mind. But to command their stimulant powei , they ought to be given in small doses, frequently repeated, and 648 DISPENSATORY. drachms; compound spirit of lavender, three drachms; cinnamon gradually increased, and the excitement which they enkindle is thus sustained. But when the design is to mitigate pain, or to procure sleep, or to relieve irritation, or deaden sensibility, they should be exhibited in a full dose, and at more distant intervals. It should be remembered that the indications, chiefly, which narcotics are capa- ble of fulfilling, are to excite and support the actions of the system, to assuage pain, and allay irritation, to relieve spasmodic affections and to induce sleep, and to check the morbidly increased secretions and excretions. Volatile Sal Ammoniac. — In a great variety of febrile affections this medicine has been prescribed, though it is in the low, or typhus fevers, that it is chiefly employed. In one respect the volatile alkali differs from every article of the class to which it is attached, and, it would seem, from all other me- dicines. The peculiarity to which we allude is this, that the excite- ment it raises approaches more nearly to that of healthy action, and hence it may be recurred to earlier than stimulants generally, in the inflammatory affections, and with greater safety in mixed cases so equivocal or obscure, as to render uncertain the propriety of stimu- lation. It may be given in the shape of a pill or julep, in the dose of five or ten grains, every hour or two, according to circumstances. The best form, however, is the latter, which maybe made agreeably to the annexed prescription. Take of volatile sal ammoniac, two scruples; gum Arabic, white sugar, each one drachm ; oil of cinnamon, five drops ; spring water, five ounces. — Mix. Dose, for adults, a table- spoonful every two hours. Camphor. — No medicine, perhaps, has been prescribed for a greater variety of purposes than camphor. In every modification of febrile action, when approaching to the typhoid state, camphor has been resorted to, and not without success. It excites perspira- tion, quiets nervous irritation, removes delirium, and abates the force of the disease. Camphor is best exhibited in the form of julep or mixture. Camphorated Julep, or Mixture. — Take of camphor, one drachm ; gum Arabic, two drachms; white sugar, half an ounce; water, half a pint. Moisten the camphor with spirits, and after reducing it to a powder, add the gum Arabic and sugar, and then, by degrees, pour on the water, while triturating them together in a mortar. Dose, for adults, a table-spoonful every two or three hours. Or, take camphor, one drachm ; myrrh, half a drachm ; white sugar, two drachms ; spring water, six ounces. — Dose, for adults, a table-spoonful. The mixture, thus made, is perfectly transparent and very palatable. Of late, however, the solution, or rather sus- DISPENSATORY. 649 pension of camphor in milk, has nearly superseded all other prepara- tions of the medicine in practice. It is made by simple trituration. The dose of camphor is from five to ten grains, to be repeated once in two or four hours, according to circumstances. Pills of Camphor and Assafoetida. — Take of camphor, assafoetida, each one drachm ; moisten the camphor with a few drops of alcohol, unite them together, and make thirty-six pills. It is sometimes ad- visable to add half a drachm of calomel to the above. This is an admirable combination, as well as camphor united with opium, for that species of mania, excited by frequent intoxication. Dose, for adults, two pills every three or four hours. Spirit of Turpentine. — This is one of the most active and diffu- sible of stimulants. In the typhus or low fevers, when other diffusible stimuli are given, much may be expected from turpentine. It promptly relieves gout in the stomach, and is particularly suited to periodical colics, arising from flatulence. The dose of the spirit of turpentine, in those cases, is about a drachm, to be repeated, more or less frequently, according to the nature of the disease, and the best mode of giving it is alone, or with a small portion of water. By at- tempting to blend it with mucilage, or any such vehicle, it seems in some degree to be volatilized, and is thereby rendered more pungent to the fauces, and difficult to swallow. Aromatics. — Ginger, cinnamon, cloves, nutmegs, allspice, and all the aromatics are more or less stimulant. Wines. — As a cordial and tonic, wine is often directed in various chronic cases, attended with debility, and also in the convalescence from acute diseases. Compared with ardent spirits, the action of wine is infinitely less injurious in a state of health, and as a remedy in disease, it evinces the same superiority. The effect it produces is slower, and more permanent, combining also qualities which, while they blunt the ardency of the stimulus, afford no inconsiderable por- tion of nutriment; by which the system is sustained and invigorated. In exhibiting wine we are cautiously to regulate its administration by the effects it manifests, since, urged too far, it might induce indi- rect debility, and thus cause irreparable mischief. Wine may always be considered as doing good, when it renders the pulse fuller, slower, and stronger, when it removes or lessens delirium, calms irritation, and composes to sleep. But if, on the contrary, it accelerate the pulse, flush the countenance, increase the temperature of the skin, excite thirst, aggravate delirium, or restlessness, and thus occasion an exacerbation of the disease, the evidence of its injurious tendency is no less decisive, and we should at once withdraw it altogether, or reduce the quantity. 82 650 DISPENSATORY. ASTRINGENTS. Astringent Medicines are employed for checking hemorrhages, and immoderate evacuations of every kind. Infusion of Roses. — Upon a large handful of dried red rose-leaves, pour a pint of boiling water ; let them infuse half an hour. Infusion of Oak Bark. — Upon a handful of white oak bark, shred fine, pour a quart of boiling water ; let it stand one hour, then boil a few minutes. Infusion of Galls. — Upon a quarter of an ounce of galls, pour a quart of boiling water; let them infuse one hour, then boil for a few minutes. A small quantity of cinnamon adds greatly to the flavour of this and the oak bark ; and acidulating any of them with the acid of vitriol, renders it more efficacious : they should be taken cold, to the quantity of half a gill, or a wine-glassful, every hour or two. Astringent Decoction. — Take of cinnamon, three drachms ; Pe- ruvian bark, one ounce; spring water, three pints. Boil these together till only one half remains; then strain oft the liquor after it has cooled, and add elixir vitriol, one drachm. Dose, for adults, two ounces thrice a-day. Astringent Mixture. — Take of the infusion of galls, four ounces ; prepared chalk, two drachms; laudanum, forty drops. — Mix. Dose, for adults, a table-spoonful every three or four hours. Or, take of tincture of kino and prepared chalk, each, half an ounce; laudanum, forty drops; boiling water, four ounces. — Mix. Dose, for adults, a table-spoonful eveiy two or three hours. Vitriolic Solution. — Take of white vitriol, three drachms; alum, two drachms; spirit of lavender, half an ounce; boiling water, one pint. — Mix. Dose, for adults, a large table-spoonful every morning, on an empty stomach, without diluting it, and in some cases to be repeated every six hours. When evacuations are required, the quantity of alum may be diminished, or even entirely omitted ; and when great astringency is required, the quantity of alum is to be increased, and the vitriol to be diminished. Pills of Sugar of Lead, fyc. — Take of sugar of lead and ipecacu- anha, each, six grains ; opium, one grain ; syrup sufficient to form a mass. Divide in four parts; one pill to be taken every three hours, until the hemorrhage cease. DISPENSATORY. 651 Anti-dysenteric Mixture. — Take of lemon juice or best vinegar, two ounces; common salt, as much as the acid will dissolve; strong mint tea, half a pint ; white sugar, sufficient to sweeten it. — Mix, Dose, for adults, a wine-glassful every two or four hours. TONICS. Tonic Medicines are those which increase the tone or strength of the body. In the widest acceptation of the term, this class of remedies is extremely extensive, since it includes every means which invigorates the powers of life. Among the means to over- come debility, or to invigorate the system, is properly regulated diet. The diet should always be accommodated to the state of the system ; and whatever may be the nature of the case, the patient should eat much more frequently than the common meals. The stomach has been pronounced, by a very sagacious observer, to be in one respect like a school-boy, who is always doing mischief when not employed. After recovery from acute diseases, it should at first consist of the lightest vegetable matter, and especially the farinaceous articles, such as rice, tapioca, arrow root, and sago. To these may succeed eggs, oysters, game, and the white poultry, and finally, ham, beef, and mutton. As a general rule, solid food is preferable to fluids. It is usually more comfortable to the stomach, and restores strength with greater rapidity. In selecting the articles of diet, the palate of the person himself should be consulted, since the pleasure which is received in eating, is of itself no ordinary stimulus, and particularly to a very debilitated system. Next to diet, in point of efficacy as a tonic, are the warm and cold baths. Though different in temperature, they produce effects not very dissimilar. Each, when judiciously managed, will very rapidly, in many instances, invigorate the body. — (Seepages 32 and 33.) As a tonic, exercise is undoubtedly among the most decisively useful, and has been divided into two parts, active and passive. — It is proper, in extreme debility, or in the first stage of convalescence from an acute disease, to begin with the second species. — This con- sists chiefly of frictions, which may be made with the naked hand, or with a brush, either alone, or with the addition of some stimulating matter. To rub at least once a-day for half an hour or more, the whole body with fine dry salt, creates a universal glow, renders the skin smooth and florid, imparts vigour to the muscles, improves ap- petite and the powers of digestion, and in all its tendencies is highly salutary. When the patient is able to take exercise, let the mode be adapted as much as possible to the seats of debility or disease ; but be careful of fatigue. Medicinal Tonics. — Of this class, nature has been lavish in her 652 DISPENSATORY. supplies. Two of her kingdoms, at least, are exuberant in articles possessed of such powers ; namely : the vegetable and mineral. Peruvian Bark — Is one of the best strengthening remedies ; it may be taken in powder alone, or conjoined with one-fourth of the Virginia snake root, in doses of a tea-spoonful, five or six times a-day. When the. doses are to be frequently repeated, as soon as one is taken, put another, with a small quantity of wine or water, into a glass, by which means it will become equally and universally moist, and may be mixed more easily and more smoothly. As many per- sons cannot take the bark in substance, it should be exhibited in infusion, or decoction. Cold Infusio?i of Bark. — Mix one ounce and a half of bark in powder in a quart of water; let it stand twenty-four hours, occasion- ally shaking the bottle, and then strain off the liquor. Dose, for adults, a wine-glassful every two hours. Decoction of Bark. — Put two ounces of coarsely powdered bark into a quart bottle of water, which, after being corked, is to be placed in a pot of water, and boiled for two or more hours. This is a very elegant preparation, and one of considerable efficacy. The dose of the decoction, for adults, is a wine-glassful every two or three hours. To correct some inconveniences occasionally produced by the bark, it is frequently combined with other remedies. When it excites vomiting, or oppresses the stomach, cinnamon, or some aro- matic, must be added ; when it purges, opium ; when it induces constipation, rhubarb; and where there is much acidity of the stomach, magnesia, or small portions of the mineral or vegetable alkali. As children cannot be induced to take the bark in sufficient quantities, it should be administered in the form of clysters, united with a little milk or flax-seed tea, to which may be added a little laudanum. Applied externally by means of a bark jacket, (See page 166,) it will be found to have as salutary an effect as when exhibited internally. Quinine. — For this article we are indebted to the French chemists. It is an alkali, obtained from the Peruvian bark, and is used in medicine in combination with sulphuric acid, forming the sulphate of quinine. It is the most powerful tonic with which we are acquainted, and so superior is it considered to the bark, that it has almost entirely driven that article out of use. Its dose being ex- tremely small, and its taste that of a simple bitter, it will not disagree with the stomach when any tonic would be proper, and it may be given to children of any age. Like every other tonic, it should not be given during active fever, nor until the bowels are thoroughly cleansed. Dose, one grain every hour or two, according to circum- DISPENSATORY. 653 stances. It may be taken mixed in syrup, or made into pills with crumbs of bread, or in solution. The solution is prepared as follows. Solution of Sulphate of Quinine. — Take of sulphate of quinine, eight grains; water, one ounce; mix, and then add sulphuric acid, or elixir vitriol, from twenty to thirty drops. Dose, for adults, a tea- spoonful every hour or two. Pills of Sulphate of Quinine. — Take of sulphate of quinine, twelve grains; crumbs of corn bread, or mucilage of gum Arabic, a sufficient quantity to make twelve pills. Dose, for adults, one every hour or two. It would sometimes be advantageous to add a little rhubarb to these pills, to prevent costiveness. Columbo. — Dose, for adults, in powder, a tea-spoonful ; to be given in mint tea or water. Infusion of Columbo. — Take of Columbo, bruised, one ounce ; boiling water, one pint. Dose, for adults, a large wine-glassful every two hours. This bitter is peculiarly serviceable in cases of weak stomachs and bowels, attended with lax, and abounding in bilious crudities. Infusion cf Gentian. — Put half an ounce of gentian, bruised, and two drachms of orange peel, in a pint of cold water for twelve hours, then strain ; when used in hot weather, add half a gill of brandy. Dose, for^adults, a wine-glassful three times a-day. Bitters are pro- perly considered strengthening remedies, when not continued too long ; they improve the appetite, and strengthen the stomach and bowels, but a constant and long-continued use of them, or any one tonic, is generally prejudicial. The black oak bark, the dogwood bark, the wild cherry tree, and thorough wort, (see Materia Medica,) claim our attention as tonics. Mineral Tonics. — Iron, in its operation on the system, evinces all the effects of a powerful and permanent tonic : no medicine, perhaps, leaving behind it such lasting impressions. The indications, there- fore, that it is calculated to fulfil, are numerous and important, most of which, however, are embraced within the sphere of chronic debility. ,. Iron Filings — If made with a fine file, will require no other pre- parations ; the dose, for adults, is six or eight grains, or about as much as a common pinch of snuff, with an equal quantity of pow- dered ginger, to be mixed in syrup or molasses, and taken two or three times in a day. In this simple form, iron acts as well as in any more laborious preparation. It is a most useful tonic in all pale and relaxed habits, subject to watery swellings; particularly for chil- 654 DISPENSATORY. dren of this description, with pale faces and distended bellies, whose complaints are frequently accompanied by worms. The doses for young and old, provided the filings be made with a fine file, may be much the same, as no more acts than what is dissolved. The rust and tincture of steel are employed with the same view. Tonic Powders. — Take of Columbo,in powder, and rust of steel, each, one ounce ; unite them well together in a mortar, and then di- vide into forty-eight doses— one to be taken by adults, thrice a-day. Tonic Pills. — Add to half an ounce of the tonic powder, a suffi- cient quantity of mucilage to form a mass, and make pills of an ordinary size. Three or four of them, or the number constituting a dose, to be taken thrice a-day. In cases of debilitated stomach, an equal quantity of powdered ginger may be added to the above. Chalybeate Wine. — Put rust of steel, one ounce and a half; orange peel and gentian root, each half an ounce, into a bottle of wine. The vessel containing these ingredients is to be exposed to the sun, or near the fire, for three days, and to be repeatedly shaken during this time. This preparation is an excellent stomachic, and agreeable tonic. Dose, for adults, two or three tea-spoonsful thrice a-day. Blue Vitriol, or Sulphate of Copper. — The fourth of a grain, united to a small portion of opium, given three or four times a-day, gradually increasing the dose, is celebrated as a valuable remedy for obstinate intermittents. White vitriol, in doses from three to five grains, for adults, in the form of pills, is also considered highly useful as a tonic. Solution of Arsenic. — This is a valuable tonic, and may be given with perfect safety, cautiously administered, to persons of every age. Pills of Sulphate of Quinine. — Take of sulphate of quinine, twelve grains; mucilage of gum Arabic, a sufficient quantity to make twelve pills. Dose for adults, one every hour. Solution of Sulphate of Quinine.— Take of sulphate of quinine, eight grains; powdered gum Arabic, thirty grains; cinnamon or ginger tea, one ounce. — Mix gradually. Dose, for adults, a tea- spoonful every hour, observing to shake the mixture just before using it. This is an excellent anti-febrifuge and tonic. Nitric Acid, as well as Elixir Vitriol, given in doses from ten to twenty drops, in a glass of sweetened water, thrice a-day, will be found very pleasant and useful tonics. They speedily quicken the appetite, and restore tone to the digestive organs. DISPENSATORY. 655 ALTERATIVES. Alteratives — Are those medicines supposed to correct the acrimony which appears on eruptions of the skin, and in removing venereal complaints. These are almost exclusively mercurials, assisted by the warm bath, sarsaparilla, mezereon, slippery elm, lobelia, (See Materia Medica^) nitric acid, tar water, &c. Mercurial Pills. — Take of calomel, one drachm ; opium and tartar emetic, each, ten grains ; crumbs of bread, a small quantity ; syrup, or mucilage of gum Arabic, sufficient to form a mass. Divide into forty parts ; one pill to be taken night and morning by adults. Mercurial Solution. — Take of corrosive sublimate, twenty-four grains; laudanum, half an ounce; spirits, one pint and a half. — Mix. Dose, for adults, one table-spoonful morning and night Calomel — In doses of one or two grains, given every night, or every other night, drinking with it the following diet drink. These, together, make a powerful alterative for blotches on the skin, foul eruptions, and all other cases, in which the object is to remove ob- structions, and sweeten the humours. An occasional warm bath greatly promotes their good effects, whilst, at the same time, it con- tributes to prevent the mercury attacking the mouth, and bringing on salivation, which, during the use of mercury, must be carefully watched and guarded against, by avoiding cold, and suspending the medicine, from time to time, for a few days. Alterative Diet Drink. — Boil one ounce of the borings of lig- numvitse, and two ounces of split sarsaparilla, in three pints of water until it comes to a quart ; then strain it through linen, to be drunk in one or two days, by divided doses. The sarsaparilla, which is the least efficacious, is by far the most expensive article in this diet drink; it may, therefore, be omitted, adding in its place half an ounce more of lignumvitae, or two ounces of parsley roots. In either case, a small handful of stoned raisins, or two or three sliced figs, or half an ounce of liquorice root, will render it more agreeable. Nitric Acid, diluted. — Take of nitric acid, two drachms ; water, one quart. — Mix. As this acid is not always to be got of equal strength, it would be best to make a quart of water as sour with it as can be drunk ; which quantity sweetened, may be taken daily by adults, in doses of a wine-glassful every hour or two. To prevent its injuring the teeth, it should be sucked through a quill, or its sharp- ness may be obtunded by washing the mouth with milk, or muci- lage of gum Arabic. Nitric acid is diffusible in its operations, pervading every part of 656 DISPENSATORY. the system, and imparting more or less vigour to all the functions. It is, hence, an exceedingly useful remedy in a great variety of af- fections. Of these, perhaps, the most striking are certain forms of inflammation of the liver; to most glandular diseases, it is, indeed, well adapted. Where there is too much debility to justify the use of mercury, or when it has already been used ineffectually, it is un- questionably the best medicine that can be administered, and, there- fore, should be uniformly employed in such cases. TINCTURES, ELIXIRS, &c. Laudanum. — Take of purified opium, two ounces ; brandy, two pints. Digest for eight or ten days, frequently shaking the bottle, then strain off the tincture. Tincture of Rhubarb. — Take of Rhubarb, three ounces ; lesset cardamom seeds, or ginger, bruised, half an ounce; brandy or rum, two pints. Digest for eight or ten days, and then strain. Tincture of Bark. — Take of Peruvian bark, powdered, two ounces ; orange peel and Virginia snake-root, each half an ounce ; brandy or rum, two pints. Digest for eight or ten days, and then strain. Tincture of Columbo. — Take of Columbo root, bruised, three ounces ; brandy, two pints. Digest for several days, and strain. Tincture of Foxglove. — Take of dried leaves of foxglove, one ounce ; brandy half a pint. Digest for a week, and filter through paper. Tincture of Cantharides. — Take of cantharides, bruised, two drachms, brandy, one pint. Digest for seven or eight days, and strain. Tincture of Myrrh. — Take of myrrh in powder, one ounce and a half; spirits, one pint. Digest for seven days, and strain. Paregoric Elixir. — Take of purified opium, flowers of Benzoin, camphor, and essential oil of annis-seed, each, two drachms ; brandy, two pints. Digest for eight or ten days, frequently shaking the bot- tle, and then strain the elixir. Turlington's Balsam. — Take of Benzoin, three ounces ; balsam of tolu, one ounce ; aloes, half an ounce ; brandy, two pints. — Digest for seven days, and strain. Rheumatic Tincture.— -Take of gum guaiacum, and vitriolated DISPENSATORY. 657 tartar, in powder, each, three ounces ; spirits, two pints. Digest for eight or ten days, and strain. A dose to he taken twice or thrice a-day. Bitters. — Take of gentian root, two ounces ; orange peel, and co- riander seeds, each, one ounce ; brandy, two pints. Digest for se- veral days, and then strain. Camphorated Spirits. — Take of camphor, two ounces ; brandy, one pint. Mix them together, that the camphor may be dissolved. Antimonial Wine. — Take of tartar emetic, one drachm ; boiling water, two ounces; wine, one pint. Dissolve the tartar emetic in the water, and when cold, add the wine. Dose, for adults, two tea- spoonsful every fifteen minutes, until it excites vomiting. To has- ten its operation, the patient should drink freely of warm water. As a diaphoretic, it may be given in doses, from twenty to thirty drops, every two or three hours. Domestic Remedies for Rheumatism. — Take of sarsaparilla and walnut shells, each, half a pound; antimony, half an ounce sus- pended in a bag ; water, three quarts. Simmer slowly by the fire down to two quarts. Strain and use a pint in broken doses daily. Or, take a large handful of rattle-snake root, bruised ; spirit, one quart; let it steep by the fire for several days, frequently shaking the bottle. Of this a wine-glassful is to be taken night and morning. Saturated Solution of Arsenic. — Take of arsenic, in powder, about one drachm ; water, half a pint. Boil it for half an hour in a Florence flask, or in a tin saucepan, let it stand to subside, and when cold, filter it through paper. To two ounces of this solution, add half an ounce of spirit of lavender. A dose to be taken twice or thrice a-day. Lime -Water. — Pour two gallons of water, gradually, upon a pound of fresh burnt quick-lime, and when the ebullition ceases, stir them well together ; then suffer the whole to stand at rest till the lime has settled ; after which strain off the clear liquor, and keep it in vessels closely stopt. Calcined oyster-shells may be used instead of quick-lime. Tar- Water. — Pour a gallon of water on two pounds of tar, and stir them strongly together with a wooden rod. When they have stood to settle two days, pour off the water for use. Caustic Alkali, or Soap Lees. — Mix two parts of quick-lime, with one of pot ashes; and suffer them to stand till the lixivium be formed, which must be carefully filtrated through paper before it be 83 658 DISPENSATORY. used. If the solution does not happen readily, a small quantity of water may be added to the mixture. Itch Lotion. — Take of corrosive sublimate, one drachm ; crude sal ammoniac, two drachms; water, one pint and a half. — Mix. Solution of Crude Sal Ammoniac. — Dissolve half an ounce of crude sal ammoniac in one pint and a half of cold water, and then add half a pint of vinegar. Saturnine, or Lead -Water. — Take of sugar of lead, two drachms; vinegar, one ounce ; water, one pint and half. — Mix. WARM AND DISCUTIENT LINIMENTS. Opodeldoc. — Take of Castile soap, powdered, three ounces, cam- phor, one ounce ; brandy, one pint. Digest the soap, in the spirit by the fire until it be dissolved, and then add the camphor. Volatile Liniment. — Is made by mixing one part of spirit of harts- horn with two of sweet oil, good hog's lard, or fresh butter from the churn : they should unite into a uniform, white, soapy mixture ; and if they do not, it is owing to the spirit of hartshorn not being suffi- ciently caustic. When lard or butter is made use of, they should be first melted ; they may then, like the oil, be mixed with the spirit of hartshorn, by shaking them together in a phial. Camphorated Oil. — Take of camphor, half an ounce ; olive oil, two ounces. Moisten the camphor with a little spirit, and then rub it in a mortar with the oil until dissolved. Anodyne Liniment — Is prepared by adding half an ounce of lau- danum to two ounces of either of the above liniments. Mindererus' Spirit — Applied warm, by means of a soft flannel, very powerfully tends to discuss an incipient tumour, or other in- flammatory swellings. Ether — Pour about a tea-spoonful into the hollow of the hand, and immediately apply it over the part affected, keeping the hand on the part until the ether be evaporated, or as long as the patient can bear the heat it excites. No remedy so suddenly and effectually re- moves cramps and all spasmodic pains. Warm Plaster. — Take of the gum plaster and Burgundy pitch, each an ounce ; of blistering plaster, one quarter of an ounce; melt and mix them together. This is a most useful application whenever DISPENSATORY. 659 it is required to keep up a constant perspiration, and gentle irritation of the skin, over any particular part affected with rheumatism, oi any internal pain, unattended with external inflammation. Charcoal Powder. — Put lumps of charcoal a second time into the fire until they are red hot ; then take them out, and as soon as they become cool, blow off the external ashes, and immediately reduce them to a fine powder, which must be kept in a corked bottle. This powder is admirable for correcting bad breath, as well as arrest- ing the progress of mortification. EYE WATER. Take of vinegar, one ounce ; spirits or brandy, half an ounce; rose or spring water, half a pint. The strength may be diminished or increased, according to circumstances. This is a useful application to weak, watery eyes, or to remove the pain and sense of pricking, experienced in the globes of the eyes, after they have been fatigued by close attention to some one object. Another. — Take of sugar of lead and white vitriol, each, twenty grains; spring water, half a pint. — Mix. After the sediment is formed, pour off the clear liquor, with which wash the eyes repeat- edly during the day, and at bed-time apply a thick fold of linen or cotton rag moistened with it, over the eyes. Another. — Take of corrosive sublimate, from two to four grains ; water, half a pint. — Mix. This solution may be used in general with great advantage in syphilitic or scrofulous cases, where the eye- lids have been long affected with chronic inflammation. ASTRINGENT WASHES. Take of lime-water, half a pint ; brandy, four ounces. — Mix. Or, lime-water, half a pint ; corrosive sublimate, fifteen grains. — Mix. Or, lime-water half a pint : tincture of myrrh, one ounce. — Mix. Or, make a solution, either of lunar caustic, or blue vitriol in water, of sufficient strength to produce a little smarting. To be ap- plied on lint to the sore. Solution of Kali. — Dissolve from one to two drachms of salt of tartar in half a pint of water. To be applied as above. 660 DISPENSATORY. GARGLES. Common Gargle. — Take of barley water, or flax-seed tea, half a pint ; crude sal ammoniac, one drachm. — Mix. Or, sage tea, half a pint ; vinegar, half an ounce ; nitre, one drachm ; honey, one ounce. — Mix* Or, take of decoction of barley, one pint ; nitre, six drachms, honey, three ounces. — Mix. These are mild, cooling applications, and very serviceable at the commencement of inflammatory affec- tions of the tonsils and fauces. Gargle of Borax. — Take of borax, two drachms ; flax-seed tea, or mucilage of quince-seed, six ounces ; honey, one ounce. The borax gargle is very much in use as a mild detergent in apthous af- fections in children, and for removing superficial inflammatory ul- cerations of the gums ; especially if attended with a copious secre- tion of saliva. Linseed Gargle. — Take of flax-seed tea, twelve ounces ; honey, two ounces ; elixir vitriol, half a drachm. Where mild astringents are indicated, this gargle will be found to answer very well. Astringent Gargles. — Take of sage tea, or infusion of roses, half a pint ; vinegar and honey, each, two ounces ; alum, half a drachm. —Mix. Or, infusion of oak bark, half a pint; honey, one ounce ; alum, half a drachm. — Mix. Detergent Gargle. — Take of astringent gargle, half a pint ; tinc- ture of myrrh, from half an ounce to an ounce. — Mix. Or, take of corrosive sublimate, three grains ; dissolved in spirit of wine, half an ounce; and then add decoction of bark, six ounces; tincture of myrrh, half an ounce ; honey, one ounce. — Mix. In ve- nereal cases, of long standing, the tonsils and uvula, or part of the fauces, are found in a state of ulceration ; in which cases, besides the internal administration of mercury, the parts should be frequently washed with the above gargle. INJECTIONS FOR GONORRHCEA. Take of white vitriol and sugar of lead, each, one scruple ; muci- lage of gum Arabic, or common water, half a pint. — Mix, and after standing ten or fifteen minutes, strain ofT the clear liquor. An ordi- nary syringe full, to be thrown up the urethra six or eight times a- day, after making water. DISPENSATORY. 661 Or, dissolve fifteen or twenty grains of white vitriol in half a pint of mucilage of gum Arabic or water. To be used as the preceding. Or, dissolve one grain and a half of corrosive sublimate in half a pint of water. To be used as above. Or, take of mercurial ointment, one drachm ; sweet oil, one ounce — Mix. This injection should be warmed previously to using. These injections may be made weaker or stronger, according to circumstances. The first and second injection are decidedly the best in recent cases. When the scalding of the urine is troublesome, four drops of mu- riatic acid to two ounces of water, or one part of acetated ammonia, to eight or ten of water, are often useful as injections. In obstinate cases of gonorrhoea the mercurial injections, as above, will be found most beneficial : and in obstinate gleets, the following have been employed with very happy effects. Injection of Tea. — Take of green tea, one drachm ; boiling water, six ounces; macerate in a close vessel till cold, and strain. Or, take of kino in powder, two drachms ; alum, one drachm ; mucilage of gum Arabic, one ounce ; spring water, one pound. — Mix and strain. Injection of Copaivi. — Take of balsam copaivi, one drachm ; mu- cilage of gum Arabic, half an ounce ; rose or spring water, six ounces. Rub the copaivi and mucilage well together, and add the water. This, as well as the preceding injection, is, perhaps, better fitted for females, when a discharge is kept up from a relaxed state of the folds of the vagina, whether arising from gonorrhoea, from too fre- quent coition, or from the fluor albus, or whites. At the commencement of gonorrhoea, the irritation is often so great as to occasion the greatest possible distress ; the urethra then being so exquisitely sensible that the slightest distension of its orifice or canal, even by fluids of the blandest nature, gives the most ex- quisite pain. The urine, in such cases, is scanty and high-coloured ; and whenever it is passed, aggravates all the symptoms, leaving an increased desire to pass more urine, attended with a burning smart- ing pain. The intention of cure, then, would be to lessen the in- flammation of the parts, by removing the distention, and of diminish- ing the stimulating properties of the urine. With this view, besides evacuating medicines and diaphoretics, particularly the camphorated powders and leeches, should be applied to the under part of the ure- thra along its whole course, and cold saturnine applications to the penis. 662 DISPENSATORY. CLYSTERS. Simple and Emollient Clysters. — Milk and water in equal parts. Flax-seed tea. Mallow tea. Infusion of quince-seed. Barley water. Mucilage of gum Arabic, or slippery elm. Thin starch. From half a pint to a pint of either of these should be administered a little more than milk warm. They are useful and efficacious where mere relaxing and emollient effects are required ; the addition of the mucilaginous substance will occasion them to be longer re- tained than simple water would be, and are particularly proper when any irritation or remarkable tenderness of the intestines exists : with the same intention, a table-spoonful of good sweet oil, fresh hog's lard, or fresh butter from the churn, may be added ; but, unless per- fectly fresh, should be omitted, as the least rancidity will irritate and injure. Common Clyster. — Take of barley water, or flax-seed tea, from one to two pints ; sweet oil, two or three ounces ; Glauber or Epsom salts, one or two ounces. — Mix. Or, take of warm water, one pint or more ; molasses, one gill, or brown sugar two table-spoons full ; hog's lard, one spoonful, or sweet oil, two ounces. — Mix. This quantity is intended for adults. Stimulating Clyster. — Common salt and brown sugar, each two large table-spoons full ; hog's lard, two table-spoons full ; or olive or castor oil, four ounces ; water, one pint. — Mix. Or, take of senna, one ounce ; spring water, two pints. Boil them till a pint only remains; and, to the strained liquor, add common salt and hog's lard, each two table-spoons full. — Mix. Turpentine Clyster. — Take of turpentine, half an ounce; the yolk of an egg, flax-seed tea, or solution of gum Arabic, ten ounces. Rub the turpentine with the egg till they are perfectly incorporated, and add the linseed infusion. The turpentine injection has fre- quently been of service in suppression of urine, arising from a stone in the bladder. Anodyne Clyster. — A gill of new milk, or thin starch, or the same quantity of any of the mucilaginous substances enumerated under the head of Simple and Emollient Clysters, with the addition of one or two tea-spoonsful of laudanum, for adults. In general, a patient will bear three times the quantity of laudanum administered in this way, than would be a proper dose when taken into the sto- mach: so that, to procure rest, twenty-five drops would be given in a draught, seventy-five may be administered in a clyster, and the sickness, and other ill consequences, which some persons complain of after laudanum has been taken into the stomach, seldom follow when administered by clysters. DISPENSATORY. 663 Nourishing Clysters. — May be formed by adding to a gill or half pint of beef tea, arrow-root, or gruel, twenty or thirty drops of lau- danum. The addition of laudanum is made to prevent the clyster from being rejected OINTMENTS. Simple Ointment. — Take of olive oil, five parts; white wax, two parts. Mix them together, by a slow fire, and stir until it be cold. Saturnine Ointment. — Take of sugar of lead, two drachms; white wax, two ounces; olive oil, half a pint. Rub the sugar of lead, previously powdered, with some part of the olive oil ; then add it to the wax melted with the remaining oil, and stir the mixture until it be cold. Basilicon Ointment. — Take of rosin and bees-wax, each, one pound; hog's lard, one pound and a half. Melt them together by a slow fire, and strain the mixture while hot. Turner's Cerate. — Take of calamine, prepared, yellow wax, each half a pound ; hog's lark, one pound. Melt the wax with the lard, and as soon as the mixture, exposed to the air, begins to thicken, mix with it the calamine, and stir the cerate until it be cold. Mercurial Ointment.— -Take of quicksilver, half a pound ; mut- ton suet, the more rancid the better, or old mercurial ointment, one ounce ; hog's lard, one pound. Triturate the mercury with the pre- pared suet and a small portion of the lard, till the globules perfectly disappear; after which add the remainder of the lard, and let the whole be intimately mixed. It is requisite that the trituration be constant and uniform, and continued in the first instance, till the globules be perfectly extinguished, and afterwards till the ointment be intimately mixed. If a small quantity of old mercurial ointment, or rancid lard, be employed, the extinction of the quicksilver is much more rapid and effectual. This ointment is principally employed, with the intention of introducing mercury in an active state into the circulating system, which may be affected on the sound skin of any part by gentle friction, particularly on the inside of the legs and thighs. Camphor, in the proportion of a drachm to an ounce of the ointment, is sometimes added, in order to render this application more stimulating and to promote the absorption of mercury. Hemorrhoidal Ointment. — Take of galls levigated, two parts; hog's lard, eight parts. — Mix. Tar Ointment. — Take of tar and mutton suet, each one pound. Melt them together, and strain through coarse linen. This is much extolled for removing tettery eruptions, and for curing scald-heads. 664 DISPENSATORY. Itch Ointment. — Take of hog's lard, two ounces; sulphuric acid, two drachms. This ointment should be formed in a Wedge wood's or glass morter. It is said to be an affectual cure for the itcfe. Blistering Plaster. — Take of wax, rosin, tallow, and cantharides, each equal parts. Having melted the three first ingredients together, sprinkle and mix in the flies powdered a little before they become firm. When the blistering plaster is not at band, its place may be supplied by sprinkling the flies over any ointment or paste, spread thin, on leather or cloth. CATAPLASMS AND POULTICES. Cataplasm of Alum, commonly called Alum Curd — Is made by briskty agitating the whites of two eggs with a lump of alum till a coagulum is formed. It is useful in some cases of ophthalmia, when attended with a watery excretion, if applied to the eye between two pieces of thin linen rag. The alum curd has been found an effica- cious remedy applied to chilblains, previous to the skin cracking and becoming sore. Cataplasm of Mustard. — Take of good mustard and flour, or crumbs of bread, each, equal parts ; sharp vinegar, sufficient to form a poultice. It may be rendered more stimulating, if necessary, by the addition of a little garlic or horse-radish. Cataplasm of Common Salt. — Take of linseed, or Indian meal, and crumbs of bread, each, equal parts; saturated solution of com- mon salt, sufficient to make a poultice. This form of poultice has lately been brought into considerable repute for the reduction of in- dolent strumous swellings and enlargement of the glands. After being some time used, it generally occasions very considerable redness upon the surface, and excites, not unfrequently, so much inflamma- tion upon the part to which it is applied, that it becomes necessary to abstain from its use, and substitute the common white bread and milk poultice in its stead ; as soon, however, as the inflammation subsides, the saline poultice should again be employed ; and by alter- nating this mode of practice, strumous swellings, and scrofulous en- largements, of a chronic, obstinate nature, have very frequently been totally dispersed. Saturnine Poultice. — Crumbs or slices of bread are to be soaked in lead water, which are afterwards to be simmered in an earthen vessel, over a gentle fire, to a due consistence. To superficial in- flammations, this form of cataplasm, or making a dough of corn meal and lead water frequently repeated, are very beneficial. DISPENSATORY. 665 Milk and Bread Poultice. — This poultice, which is generally in use, is commonly made by soaking crumbs or slices of bread in milk, and simmering them together over a gentle fire till they are reduced to the proper consistence of a poultice. The whole is then to be beat smooth with a spoon, and applied as warm as the patient's feel- ings will readily admit, which should be repeated every four hours. Flax-seed Poultice. — Take of flax-seed bruised, half a pound ; boiling water, half a pint, to be formed into a poultice. Or, This poultice may be made by stirring linseed powder into boiling water, in quantity sufficient to form it of a proper consistency. Carrot Poultice. — Boil any quantity of fresh carrots till they are sufficiently soft to be beat into a smooth, even pulp, which is to be applied as a poultice. This has been found very effectual for sweetening cancerous sores and foul ulcers, thereby rendering the condition of the patient much more comfortable. Turnips used in the same way have been found to produce the same effects, and ap- parently in a greater degree than carrots. Charcoal Poultice. — To a sufficient quantity of the bread and milk, or linseed poultice, stir in as much charcoal in fine powder as it will bear, and let the whole be well mixed. This cataplasm is often used to sweeten foul offensive ulcers and venereal sores, and for this purpose it is of great service; it will, likewise, often dispose them to assume a more favourable and healthy aspect. glossary; OR, EXPLANATION OF TECHNICAL TERMS. ABDOMEN, the belly. Abortion, miscarriage. Abscess, a tumour containing matter. Absorbents, medicines to correct acidity and absorb or dry up superfluous mois- ture. Abstemious, low living. decelerate, to quicken. Acescent, having a tendency to acidity. Acidulated, impregnated with acids. Acme, full height. Acrid, sharp and corrosive. Acute, this term is applied to a disease which is violent and tends to a speedy termination. Adult, of full age, beyond puberty. Affinity, likeness, resemblance. jSffudon, pouring one thing on another. After-birth, or placenta- cake, is the sub- stance by which the child is connected with the mother in the womb. After pains, see grinding pains. Ague-cake, enlargement of the spleen. Alcohol, rectified spirits of wine. Aliment, nourishment. Alimentary canal, or tube, the stomach and intestines. Alkali, any substance which mingled with acid, produces fermentation. Alternate, branches or leaves, or flowers, springing out regularly one above an- other. Alternate, changed by turns. Analogous, one like another. Annual, living only one year. Anodyne, composing medicines, and such as mitigate pains. Antidote, a medicine to destroy poisons. Antifogmatics, drams. Antipathy, an aversion to particular things. Antiphlogistic, counteracting inflammation. Antiscorbutic, good against the scurvy. Antiseptics, medicines to correct putridity or rottenness. Antispasmodic, whatever tends to prevent or to remove spasm. Antispasmodics, medicines for curing spasms, as laudanum and ether. Anus, the fundament. Aperient, opening. Apthous, resembling the thrush. Areola, the circle which surrounds the nipple on the breast. Aromatic, spicy, pungent. Artery, a conic canal, conveying the blood from the heart to all parts of the body. Astringents, medicines to correct looseness and debility. Atmosphere, surrounding air. Attenuants, medicines for reducing the body. Ataxic, irregularity of the symptoms, or of the animal functions. BIENNIAL, continuing alive for two years. Bile, or gall, a fluid secreted by the liver into the gall-bladder, and thence dis- charged into the intestines for the pur- pose of promoting digestion. Bougie, a taper body, introduced into a passage or sinus, to keep it open or to enlarge it. Bolus, a form of medicine in a mass, larger than pills. Bulbous root, as garlic and onion ; it is either, Solid as in the tulip and turnip, Scaly as in the lily, Coated as in the ouion. 66S GLOSSARY. CALCULOUS, stony or gravelly. Callous, hard or firm. Cantharides, the Spanish flies, used in blisters. Capillary, fine, hair like. Capsule, a dry hollow vessel containing the seed or fruit. Carious, rotten, applied principally to the bones and teeth. Carminatives, medicines for dispelling wind. Cataplasm, a poultice or soft plaster. Catarrh, a discharge from the head or throat. Cathartic, a purge. Catheter, a pipe to draw off urine. Catkin, a composition of flowers and chuff on a long slender thread shaped recepta- cle, the figure of the whole resembling a cat's tail. Caustics, burning applications. Cautery, the act of burning with a hot iron or caustic. Cutaneous, of or belonging to the skin. Characteristic, a mark, sign, or token. Charcoal, a coal made by burning wood under turf. Chronic, lingering disease, in opposition to acute. Chyle, a milky fluid separated from the aliment in the intestines, mixing with and forming the blood. Circulation, the motion of the blood, which is propelled by the heart through the arteries, and returned by the veins. Clammy sweats, cold glutinous. Cleansi?ig, see lochial discharge. Coagulum, a curd. Comatose, inclined to sleep. Compress, several folds of linen rags, a bandage. Concave, hollowed out like a bowl, as the petals of the cherry or the hawthorn ; and the broad-leafed plantain. Cone, or strobile, a species of seed vessel formed by a catkin with hardened scale ; containing a seed within the base of each scale ; as in the pine or fir. Confluent, running together. Constipation, obstruction, costiveness. Contagion, infectious matter. Contusion, a bruise. Convalescence, recovery from sickness. Convex, opposed to concave : rising like the surface of a globe. Convulsions, violent motions, fits. Corolla, blossoms, petals, or flower-leaves, is that beautiful part of a flower which first draws the attention, as the flower itself. Corroborants, tonics, or strengthening me- dicines. Corrosive, substances that consume or eat away. Cortex, bark, or covering. Cosmetic, beautifying. Crisis, a certain period in a disease at which there happens a decisive altera- tion, either for the better or worse. Critical, decisive or important. Crudity, rawness, indigestion. DEBILITY, weakness. Decoction, a preparation by boiling. Decumbent, lying down or declining. Deglutition, the act of swallowing. Deleterious, poisonous, deadly. Delirium, light-headedness. Demoniacal, baneful, hurtful. Demulcent, softening, sheathing. Dentition, teething. Detergent, cleansing. Diaphoretic, promoting perspiration. Diarrhoza, a looseness. Diathesis, disposition or habit of body. Dietetic, relating to diet, or regimen. Diluents, substances to dilute or make thin. Discutient, a medicine that has the power to repel. Dislocation, a joint put out of place. Disposition, tendency. Diuretic, whatever promotes the secretion of urine. Drastics, active or strong purges. Dyspeptic, belonging to bad digestion. ECCHYMOS1S, a tumour, the effect of blood-letting. Efflorescence, eruption, or the redness round it. Effluvia, exhalation. Egg-shaped, signifies a shape resembling the solid substance of an egg; or, in re- spect to leaves, it implies only the form of an egg, divided lengthwise. Emaciation, wasting of flesh. Empiric, a quack. Enamel, the outside covering of the teeth. Endemic, a disease peculiar to a certain district. Enervate, to weaken. Epidemic, contagious. Equilibrium, equal in weight. Eructation, a belch. Eruption, breaking out in pustules. Exacerbation, the increase of a disease. Excoriation, the loss of the skin. Excretion, discharge of animal fluids, or matter. Exhibit, to administer. Expectoration, a discharge from the breast. Extremities, arms and legs. FJECES, excrements. Farinaceous, mealy. Febrifuge, removing fever. Febrile, feverish. Fetid, of an offensive smell. Fibrous, composed of small threads or fibres. GLOSSARY. 660 First passages, stomach and bowels. Flatulent, producing wind. Flooding, an overflow of the menses. Fcetus, the child in the womb. Fomentation, partial bathing, by the appli- cation of flannels dipped in liquids. Fracture, a broken bone. Friction, the act of rubbing. Fungus, proud flesh. Fumigation, a vapour raised by burning. GANGRENE, a feeble circulation, fol- lowed by mortification. Gargle, a wash for the mouth and throat. Germen, or seed-bud, the lower part of a pistil, is destined to contain the embryo seed. Genus, the second subdivision of plants ; it comprehends an assemblage of species under the same class and order. Gland, a secretory organ. Glutinous, .gluey, sticky. Grinding, or after-pains : pains that occur after labour. Grog-blossoms, pimples on the face pro- duced by drinking. HEART-SHAPED, a term used to ex- press the form of a petal or leaf which resembles a heart divided lengthwise. Hectic fever, a slow consuming fever gene- rally attending the absorption of puru- lent, or other acrid matter into the blood. Hemorrhage, a discharge of blood. Hemorrhoidal, relating to the piles. Hepatic, relating to the liver. Hypochondriacal, melancholy, very deject- ed, low T in spirits. ICHOR, a thin watery humour. Imbecility, debility, weakness. Immersion, plunging under water. Imposthume, a collection of purulent matter. Inanition, emptiness. Incarnating, healing. Incrassate, to thicken. Indented, the edges of an indented leaf are hollowed, or deeply scolloped, the lobes standing asunder, as if part of the leaf had been cut out. The leaves of the oak and turnip are familiar examples. Indigenoxis, native to a country. Indigestible, difficult of digestion. Induration, hardening. Indisposition, a disorder of health. Inebriety, drunkenness. Infection, contagion. InJIammation, an increased action in a part. Inflated, distended, as if inflated like a blown up bladder. Infusion, steeping any thing in liquor with- out boiling, as tea is made. Inhale, to draw in by breath. Inspissate, to thicken. Intestinal, belonging to the intestines, or guts. Intestines, the internal parts of the body. Irrespirable, unfit to be breathed. Irritability, a disposition to contract from a stimulus. Juleps, mixtures, of simple and compound mixtures. LACTEALS, vessels containing chyle Languor, want of strength or spirits. Lateral, growing 1'rom the sides of the stems or stalks. Laxatives, relieving costiveness. Levigated, reduced to a fine powder. Ligature, a bandage ; any thing tied round another. Ligneous, woody. Liniment, a composition of the consistence of oil. Lobed, divided, or lip-shaped. Lotion, a wash. Lochial discharge, or cleansings, a discharge from the womb. MAGNUM DEI DONUM, the great gift of God. Mastication, act of chewing. Maturity, of full years. Meconium, the infant's first or black stools. Membrane, a web of fibres, interwoven, for covering certain parts. Menses, > ,, ,, . Menstruation, \ the monthl y courses Mephitic, suffocating, noxious. Meum et tuum, mine and thine. Miasmata, > , . , , , ,. Miasma \ mox " l & exhalation, or vapours. Miliary eruption, an eruption of pustules resembling the seeds of millet. Modus operandi, mode of operation. Morbid, diseased, corrupt. Mucilage, a glutinous, slimy substance. Mucus, resembling the matter discharged from the nose, lungs, &.c. NARCOTICS, medicines producing tor- por and sleep. Nausea, an inclination to vomit. Nervous, irritable. Nostrum, a patent or other medicine, the composition of which is kept secret by the proprietor. OBLONG, considerably longer than broad, and narrowed, though rounded at the ends ; as the leaves of the daisy. Qbtund, to blunt. CEdematous, swelled, as in a dropsical state of the skin. Opiates, medicines which promote sleep, as opium. Ophthalmia, a disease of the eyes. Ovate, or oval, egg-shaped. C70 GLOSSARY. PANCREAS, the sweet bread. Paralytic, relating to palsy. Paroxysms, a periodical fit or attack. Pectoral, medicines adapted to cure dis- eases of the breast. Pedical, a short foot stalk, or partial foot- stalk, being that part of a compound or branched fruit-stalk, which is the imme- diate support of a single flower, or floret. Pelvis, the bones at the lower part of the trunk of the body. Perennial, continuing for several years ; at least more than two, and regerminating several years successively. Pestilential, infectious. Petals, the leaves which constitute the blossoms or flowers are so called to dis- tinguish them from the other leaves of the plant. Phlegmatic, relaxed and abounding with phlegm. Phlogistic, inflammatory. Phthisical, consumptive. Pilch, napkin, clout. Placenta- cake. See after-birth. Plethoric, of a full habit. Plenitude, fulness of blood. Precarious, doubtful, uncertain. Predisposition, susceptibility of disease. Premature, too hasty, too early. Preternatural, unusual, not natural. Primary, original. Prolapsus, the falling down or out. Proximate cause, the immediate cause of disease. Ptyalism, a copious flow of spittle. Puerperal, of, or belonging to, child-bed. Pulmonary, belonging to the lungs. Purulent, matter of good quality. Pus, matter. Pustule, a purple or small swelling. Putrescence, rottenness. QUARTAN, returning every fourth day. Quickening, the motion of the child felt by the mother in the womb. RECTUM, the strait gut in which the faeces are contained. Red gum, an eruption so called. Refrigeration, a. chill, coldness. Regimen, regulation of food, air, exercise, &c. Remote cause, the inducing cause of disease. Repletion, the act of filling the body with food. Resolution, a termination without suppu- ration. Resolvents, dissolving medicines. Respiration, the act of breathing. Resuscitation, reviving, bringing to life. Retention, the retaining of some natural discharge. Rheumy, an acrid discharge. SALINE, consisting of salt. Saliva, spittle. Sanative, healing. Sanguiferous, carrying blood. Saponaceous, soapy. Saturnine lotion, lead water. Scorbutic, of, or belonging to, scurvy Scrofulous, of, or belonging to, the king's evil. Secondary, not primary ; a secondary fever is that which occurs after crisis. Secretion, the separation of fluids from the body. Secundines, the placenta, and membranes. Sedatives, composing medicines. Segments, the small part of a leaf, cup, or petal, included between the incision. Semen, the seed. Serous, thin, watery. Serrated, notched like a saw. Sinapism, a poultice made of flour, mus- tard, and vinegar. Slough, the parts that separate from a sore. Solitary, only one in a place ; as but one flower on a fruit stalk, or only one fruit- stalk proceeding from the same part of a plant. Soluble, loose, laxative. Spasm, cramp, convulsion. Specific, an infallible remedy. Spear-shaped, applied to a leaf, signifies that it is shaped like a spear or lance. Spherical, globular. Spike, a head or ear, as in rye, barley, wheat, &c. Spine, the back-bone. Stamina, the constitution or habit of the body. Stimulants, irritative medicines. Stomachics, medicines for the stomach. Strangury, a difficulty of making water. Striated, channelled, furrowed. Stupor, a suspension of sensibility. Styptic, a medicine stopping the discharge of blood. Sudorifics, medicines to promote sweating. Suppository, a candle, or any other sub- stance or composition, introduced into the rectum to produce a stool. Swooning, fainting. Symptomatic, a disease not primary, but arising from another in contradistinction to idiophatic. Syncope, a fainting or swooning. Synocha, inflammatory fever. TECHNICAL, belonging to arts. Temperament, a peculiar habit of body. Temperature, state of the air. Tertian, returning every third day. Tetany, the lock-jaw. Tonic, bracing, strengthening. Topical, local, confined to the diseased part. Tumour, a swelling. GLOSSARY. 671 Turgescence, an over fulness. Type, a mark. Typhus, a genus of fever comprehending those called nervous, yellow, and putrid. ULCER, a sore, generally ill-conditioned. Umbel, a composition of flowers, in which a number of slender fruit-stalks proceeds from the same centre, and rise nearly to the same height, so as to form a regular surface at the top. Hemlock, carrot, and low parsnip, are examples. These are said to be umbelliferous plants. Umbilical cord, the navel string. Urethra, the canal which conveys the urine. Uterine, belonging to the womb. Uterus, the womb. Uvula, the palate. VACCINE, vaccinous, belonging to, or matter of the cow-pox. Vagina, the passage to the womb. Valetudinarian, a weak, sickly person. Variolus, small-pox matter. Vascular, belonging to the vessels. Vehicle, a liquor to make medicines in. Venous, belonging to the veins. Ventilation, a free admission or motion of air. Venomous, } Virulent, I? 01 * ™™- Vermifuge, worm-dispelling medicines. Vertigo, giddiness. Vesicating, blistering. Villous, shaggy, rough, hairy. Virous, poisonous matter. Viscera, the entrails. Viscid, glutinous, tenacious. Vital, the seat of life. WHITES, the discharge from the womb Whorls, this term is applied either to branches, leaves or flowers, when they grow all round their respective stems, resembling, in some measure, the spokes round the nave of a wheel. INDEX A. Page 52 ABDOMEN, description of Abdominal Supporter of Mr. Betts, highly useful in cases of prolapsus uteri and pro- trusion of the vagina, . 457 Abortion, observations on 424, 425 prevention of . 426 Abscess, common . . . 350 Absorbents, class of . . 640 mixture, doses of 633 how prepared 640 Abstemious living, good effects of 79, 80 Acid, nitric, tonic, . . 654, 655 muriatic, useful in nerv- ous fever, — vegetable antiscorbutic 191 331 Acute rheumatism, . . . 254 Acidity, or heartburn, . 299, 417 Adams, John, his death and character noticed . . 284 Admonitory hints to ladies, 395 Advice to masters, . . . 33 to parents, . . . 476 Adulterated wines, to de- tect 600, 601 After pains, 443 After birth, caution respecting 433 mode of extracting, 439 Agaric, stops bleeding, . 518 Agrimony, useful in jaundice, 518 Ague and fever, .... 164 Air, its influence on the blood, 65 on the body, ... 66 85 Pags Air, necessity for its renew- al, ....... 68, 72 confined, bad effects of 69 warm, relaxes the body, 74 damp, checks perspiration, 74 — — the most wholesome, 74 impure, how restored, ....... 75, 198, 199 Air and temperature, how to be regulated in sickness, 610 Alder, black, antiseptic, . 519 Aloetic pills, how prepared 637 Alteratives, class of . . 655 Alterative diet drink . . 655 Alum, doses of ... . 62S curd, how prepared 664 whey, how prepared, 625 root, useful in cancers, 519 Alvine discharge, nature of 211 Americans, patriotism of . 149 Anatomical description of the human body, concise and interesting, .... 36 Anasarcous swellings, . . 317 Ankle, dislocation of . . 364 Angelica, good aromatic, 519 Anger, its ill effects on mind and body 116; melancholy, instances of 118; advantages of repressing 118; wonder- ful effects of music in sub- duing 118, 119 Animation suspended, how re- stored, 340, 4b? Animal heat depends on the circulation of the blood, 51 674 INDEX. Page Animal heat, depression of, how to be restored, 177, 194 Anodynes, class of, . . 645 Anodyne liniment, to prepare, 658 sudorific drops, doses of, 633 how prepared, 640 Anti-bilious pills, how prepar- ed, 636 Anti-dysenteric mixture, 633, 650 Antimonial wine, doses of 628 — - how prepared, . 657 powders and solution, 639 Antiphon promised to do upon souls what Hippocrates did on bodies Ill Antipathy to certain remedies, consequences of . . . 29, 615 Anus, imperforated . . 483 falling down of . . 349 Aperient medicines, import- ance of in fevers, . 176, 635 Aperient and diaphoretic pills, 635 Apoplexy, or apopletic fits 284 Appetites, three kinds of 77, 617 Apparent death, to resuscitate 339 Apparel, observations on 143 Apple, Peru, a valuable plant 520 Apple water, 626 Apthae, or thrush . . . 489 Arbutus, useful in gravel . 520 Ardent spirits, utility of . 82 ■ abuse of de- structive to body and soul 128, 129 Aristides, his goodness . 125 Arms, description of . . 37 dislocation of . . 363 fracture of . . . 367 Armstrong, Dr., remarks on use of stimulants in fevers, 193 Arria, her invincible love 97 Arrow root, very nutritious 520 Arsenic solution, doses of 628 how prepared . . 657 Art of preserving health . 64 Arteries, their use explained 39 Asarabacca, useful in whoop- ing-cough 520 Ascarides, worm . . . 462 Ascites, or dropsy of belly 316 Page Askew, his singular recovery 108 Asthma, treatment of . . 298 Astorgas dines on the heart of his mistress .... 103 Astringents, class of . . 650 Astringent mixture . . . 650 gargles and washes 660 Atheist, conversion of . . 34 — — — ■ punishment of . 158 Athenians, religious instruc- tions of the .... 160 Atmosphere, component parts of 67 Avarice, injurious to health 125 fatal instances of 126 Hippocrates' advice 126 Avens, antiseptic . . . 520 Azote, or corrupted air . 67 B. BACK-BONE, use of . 36 Backache-brake, for cough 521 Baker, Professor, praise due 518 Balm, useful in fevers . 521 Balsamic medicines in consump- tions, when useful, . . 272 Balsam, copaiva, doses . 628 remedy for gonorrhoea 322 Turlington's, how pre- pared 656 Barberry, useful in dysentery 521 Bark, Peruvian, caution in the use of 166 jacket, how prepared 166 Peruvian, substitutes for in bilious fever . . . 181 cold infusion of . 652 decoction of . . 652 tincture of ... 656 Barley-water, how prepared 620 Barrenness, observations on 464 Barton, Professor, his noble ef- forts to serve his fellow citi- zens 518 his unbounded liberal- ity 19 asserts the efficacy of oak bark in gangrene, 565; of poke weed in rheumatism, 572; of thorn apple in epi- INDEX. 675 Page lepsy, &c, 586 ; of tobacco to dislodge worms . . 590 Bastard ipecacuanha . . 521 Bashfulness, evidence of virtue 140 Bath, cold, when proper . 32 warm, efficacy of . 32, 43 regulation of . . . 202 Bayous, agency of in producing malignant fever . . . 392 Bayberry, useful in jaundice 521 Bearberry, useful in gravel 521 Beaufort, his dread of death 114 Beauty, wonderful effects of 395 Beaumont Dr., his experiments on digestion made in the case of St. Martin, who was woun- ded in the side ... 83 Bearing down of the womb 455 Bed-room, observations on 75 Beech drops, useful in cancers 521 Beef tea, how prepared . 623 Beer, recipes for ... 550 Beggar, anecdote of . . 88 Benne, useful in dysentery, and yields a good salad oil . 521 Bethroot, useful in hemorrhages 522 Bigelow, Professor, honourable mention of .... 518 testifies to the virtues ofgillenia 544 Bile, the manner in which it is secreted, and use of . 56 Bilious fever, treatment of 172 its fatality in Wash- ington 175 prevention of 182 Bind weed, purgative . . 522 Byrd, Colonel, celebrates the bastard ipecacuanha . 553 Bites of moschetoes . . 342 of venomous animals 343 of mad dogs . . 344 Bitters, how prepared, . 657 dangerous effects of 31 Bitter sweet, good for cutaneous disorders, &c. . . . 522 Blackberry, remedy in dysente- ry 522 Black snake-root, useful in fe- vers 603 Bladder, description of . 57 Page Bladder, distended, cause retroverted womb inflammation of of Bleeding at the nose . Bleeding piles . . . from wounds topical 370, 418 249 267 279 356 615 Blistering plaster, how prepared 664 Blistering plaster, substitutes for (See crowfoot, cuckoo-pint, mezereon, garlic, horse-radish.) Blood, circulation of . . 50 , how it is recruited 55 , spitting of . . 268 Blood-letting, how performed 369 Blood-letting, rules to be ob- served . . . 186, 200, 451 Blood root, cure for polypus 522 Blood wort, checks bleeding 523 Bloody flux 281 Blossoms, grog, cure of . 332 Blotches, or eruptions . 332-487 Boerhaave, Dr., verifies that re- ligion conduces to health 157 his singular mode of treating epilepsy . 115 Boils or tumours . . . 350 Bolea, captain, his singular mode of taking revenge . . 122 Bonaventure, his admiration of a beautiful woman . . 103 Bones of the human machine, description of 37 Boneset, remedy in agues 524 Bowman's-root, good emetic 524 Box-wood, excellent tonic Brain, seat of .... inflammation of Breasts, anatomy of . . swelling of, infants cancer of . . . 524 44 228 48 479 352 622 Bread soup, how prepared pudding, how pre- pared 623, 624 Breath, how to preserve its sweetness 253 Breeding sickness . . . 417 Bronchitis 212 and croup sometimes confounded .... "2 12 Broomrape, useful in cancers 524 676 INDEX. Page Brown, Professor, his remedy for tetanus .... 295 Buboes, management of . 328 Buckthorn, good purgative 524 Burch, captain, cured of abscess of liver by onions . . 566 Burdock, purines blood . 525 Burleigh, Lord, his just remark on religion .... 160 Burnet saxifrage, useful in asth- ma 525 Burns or scalds . . . 346 Butterfly weed, remedy, in cold and pleurisy .... 525 Butternut, excellent cathartic 525 Button snake-root, useful in gangrene 525 C. Caldwell, Professor, the manner he preserved the health of his son 75 - remarks on worms 498 — deserves high esteem 578 Calico tree, remedy for itch 526 Calimus, good aromatic . 526 Calomel, doses of . ... 629 Calves' feet jelly, how made 621 broth, how made 623 Camomile, stomachic . . 526 Camphorated powders, doses 633 how prepared 639 — mixture. . 648 liniment . . 658 spirits . . 657 Cancer, treatment of . . 352 of the womb . . 459 Cancer root, astringent . 527 Candleberry myrtle, emetic 527 Caraway, excellent aromatic 527 Carrol, Mrs., cured of bilious fever by porter . . . 174 Carrol, Charles, his death and character 245 Carbonic acid, or fixed air 68 Carrot, wild, diuretic . . 527 poultices how prepared 665 corrects fetid ulcers 527 Cartwright, Dr., thanks due to him for his essays on malig- nant fever 373 Cartwright, Dr. his manner of administering doses of medi- cine to his patients . . 393 Cartilages, description of 38 Castor oil, doses of . . 629 how made . . 527 Cataplasm, of mustard . 664 of common salt 664 of alum . . 664 Catarrh, or cold . . . 212 Cat gut, or goat's rue, remedy for worms 527 Cathartics, class of . 635 Cathartic mixture, doses of 633 how prepared . 636 Catheter, manner of introdu- cing. 279 Caustic alkali, doses of . 629 how prepared . 657 Caution to parents . . 476 to masters . . 33 Celandine, useful in cutaneous affections 527 Cellular membrane, use of 43 Centaury, good stomachic 528 Chalk, prepared, doses of 629 Chapman, Professor, his great zeal in diffusing knowledge 518 treatment of epidemic 238 attests the efficacy of seneca in obstructions of the menses 603, and of balsam co- paivi, in gonorrhoea . . 323 Chancres 328 Chalybeate wine, how prep. 654 Charcoal powder, how prep. 659 — poultice, how made 665 Chanty, godlike act . . 608 Charlemagne, nobleness of 97 Cheerfulness consistent with re- ligion 154 Cherry tree, wild, substitute for Peruvian bark . . . 528 Cheselden, Dr., on anatomy 37 Cheyne, Dr., his mode of treat- ing delirium .... 613 Chesterfield, Lord, on dress 143 Chicken pox . . . . 265 Chicken water, how made 623 INDEX. 677 Page Chickweed, red, remedy for hy- drophobia 528 Chilblains . . _ . 346 Child, position of in the womb 414 Child-bed, diseases of . 466 management of 440 Children, management of 442 Chills, how a return may be counteracted .... 170 Chills and fevers, vulgar mode of treating . . . , Chin, or whooping cough Chlorosis, or green sickne Chocolate, properties of . Cholera infantum, . . . morbus .... 610 503 403 83 495 304 — epidemic or malignant 305 Chordee 322 Chorea, or St. Vitus's dance 504 Chremes, story of, a lesson to the intemperate ... 78 Christian, his consolation 111 Chronothermal system, account of 514 Chyle, how conveyed . . 55 Cider, when wholesome . 82 Cinquefoil, used in bowel com- plaints 528 Circulation of the blood, how performed 49 Clap, or gonorrhoea . . 321 Cleanliness promotes health and preserves beauty . . 145 , its importance in sickness . . . 33, 471, 611 Cleavers, good for the gravel 529 Clinias, calmed by music 118 Clothing of infants ... 468 Cloruret of lime used with suc- cess in the cure of sore eyes in infants 239 Club-foot, management of 482 Clysters, or glysters, . . 662 Cocum, used in rheumatism 529 Cock-up-hat, useful in yaws 529 Coffee, properties of . . 83 Cohush, for rheumatism . 529 Cold, or catarrh ... 212 remarks on the popular remedies 213 of foot bathing . . 213 Page Cold, of cold drinks . . 213 of full vomiting . . 215 of steaming the head 216 inhaling vapour of hot wa- ter 218 prevention of . . 220 importance of avoiding the exciting causes . . . 229 exposure to intense 89, 221 Coldness of the extremities in fevers . . . 177, 194, 202 Cold water, its operation upon the stomach .... 213 , the impression it makes when externally ap- plied ...... 213 Cold bath when beneficial 32 Cold washing of infants . 471 Cold plague, its fatality, letter respecting .... 372 Colliquative sweats . . 274 Colic, treatment of . . . 302 Colic pains, in children . 492 Collection and preservation of vegetable substances . 606 Colts-foot, useful in coughs 529 Columbo, American, good tonic 529 Comfrey, astringent . . 530 Common ulcers . . . 353 Conception, signs of -. . 412 Conscience, the effects of, &c. 113 Congestion, signs of . , Conclusion and general re- marks Contagion how to be arrested Consumption .... use 176 618 198 269 of refrigera- ting medicines in . . 271 of balsamic do. 272 of inhalation and 273 of sedatives of exercise fumigation 274 Convulsions in children in pregnancy in labour . hysterical Corday, Charlotte, interesting history of Cordial mixture .... Coriander, good aromatic 27 b 492 421 438 288 138 647 530 678 INDEX. Page Cornaro, by temperance re- stores a constitution im- paired by dissipation 79 Corns, treatment of . . 349 Cosmetics, observations on 396 Costiveness, remarks on 301 — dangerous effects of, in pregnancy . . 415 ■ of infants . 491 Cough, management of . 223 ■ symptomatic . . 223 danger of using patent medicines in ... . 225 remedies recommend- ed 225, 226 mixture, how prepared 644 of the legs .. colic . Countenance, prognostic of disease 205 Cow parsnip, useful in epilepsy 530 Cow pox, or vaccine disease 258 Cox, Professor, praise due to 518 Craik, Dr. and Mrs., their death and character . 569 Crane's bill powerful styptic 530 Cramp, or tetances . . 293 — in pregnancy . . 421 of the stomach . 293 . . 294 . . 302 Crawford, Wm. H. Hon., tes- tifies to the efficacy of on- ions in croup .... 566 Crawford, Dr., his treatment of a hypochondriac . . 293 Cream of tartar, doses of 629 Cross-wort, useful in fevers 532 Croup and Bronchetis some- times taken for the same 212 Croup or hives .... 500 Crow-foot, excites blisters 532 Cruelty, instances of . . 117 Cuckold, useful in jaundice 532 Cuckow pint, used externally for blistering .... 532 Cucumber-root, useful in drop- sies 532 Cullen, Dr., celebrates horse- radish in hoarseness . 552 Cupping, how performed . 370 Cure-all, excellent tonic . 532 Currant wine, how to make 532 Page Currie, Dr., his improvement in the treatment of nervous fever 189 Custard apple, a good purga- tive 533 pudding how made 624 Cutaneous eruptions . . 331 Cutbush, Dr., his successful practice in the epidemic, bears testimony of the effi- cacy of acids in scurvey, 555; of tobacco in dropsy 591 Cutler, Hew Dr., deserving high commendations . . . 518 testifies to the efficacy of emetic weed and skunk cabbage in asthma, 536, 582 D. Dandelion, useful in visceral obstructions ..... 533 Darwin, Dr., gives an account of a parsimonious surgeon killing himself ... 113 Darwin, Dr., cites a case in which pride was effectually cured 136 his remedy to cor- rect bad breath, . . . 253 Davidge, Professor, his remedy for croup 501 Daviess, Colonel, his dying words 150 Deadly night-shade, useful in rheumatism, .... 563 Deafness, treatment of . 251 Death overmuch fearedby some 112 Deerberry, useful in asthma 533 Delirium treatment of . 452, 612 Delivery, or child-birth . 438 Denman, Dr., his mode of pre- venting convulsions. . 423 ■ — — — ■ his remarks on preternatural labour . . 436 Dentition, or teething . 494 Detergent gargles . . . 660 Devil's bit, vermifuge, &c. 533 Dewberry, useful in dysentery 533 INDEX. 679 Page Dewees treatment in immode- rate flow of the menses 406 in sexual weak- ness 412 Dexter, Prof, entitled to praise 518 Diabetes, or incontinence of urine, 276 Diaphragm, use of, . . 52 Digestion 83 — extraordinary case of St. Martin .... 83 an opportunity of seeing what was going on in the stomach of St. Martin 84 Diaphoretics, class of, . . 638 — drops, . 628, 638 Diarrhoea, or looseness, . 313 Diet, for a healthy state, . 83 recommended in bilious fever 182 for the sick, . . 619 ■ mode of preparing, . 619 Difficulty of urine, . . 276,418 Digestion, how performed, 52, 54 Dill, good aromatic, . . 533 Directions for preserving vege- table substances . . . 606 Diseases of pregnancy . 417 ■ —of childbed . . 442 — - prognostics of . 204 Dislocations, observations on 362 Dislocation of the jaw . 363 — : of the shoulder, 363 of the elbow, 364 ■ of the wrist or finger364 of the thigh 364 Dislocation of the knees and ankles ...... 364 Dispensatory .... 627 Dispositions of children, how to be managed . . . 474 Diuretics, class of . . , 641 Diuretic infusion and pills 642 Dock water, purifies the blood 533 Dog-wood, best substitute for the Peruvian bark . . 534 Domestic remedies for whoop- ing cough 614 for rheu- matism 657 Page Dorsey, Professor, his remedy for sore eyes .... 237 — - notice of his death and character 230 Doses of medicines, table of 628 Dover's powders, how prepared 639 . — — , — . doses of 634 Dragon's claw, useful in fevers 534 Dragon's root, used for blisters 534 Drastic purges .... 636 Dressing of infants . . . 468 Dress, love of, natural . . 141 — — neglect of, improper 143 — — advantages of wearing flannel ...... 144 Dropsy of the belly . . . 316 — of the cellular mem- brane, or anarsarcae . . 317 — of the head . . 490 — - of the ovarium . 461 ■ of the fallopian tubes 462 Drowned persons how to be treated ...... 340 Drunkards, reclaimed, in- stances of 131 — — — - ludicrous descrip- tion of 339 Drunkenness, its horrid conse- quences 130 Dysentery, treatment of = 281 E. Ear, description of . . . noise in, prognostic of disease ..... Ear-ache Esaymosis . Effervescing draught . Egg soup, how made . Eginardus, anecdote of Elder, common, aperient. — wine, how made Elecampane, expectorant Elegy on the death of Col. Jesse Ewell .... on a deluded girl . Elixir paragoric, doses of how prepared Elixir vitriol, doses of 45 208 251 370 63S 622 96 534 535 535 315 327 630 656 629 680 INDEX Page Elm, American, remedy in dysentery 535 Emetic weed, excellent emetic and remedy for asthma 535 Emetics, rules for their exhibi- tion 635 Emissions, involuntary . 325 Empirics, cause of increase 28 cures on which their fame is built .... 29 Enthusiasm, source of delusion 152 Envy, nature of ... . 123 — baneful effects of . 124 antidote against . 125 Epicurus, his dread of death 113 Epidemic, or typhoid pneu- monia 226 Epilepsy, or epileptic fits 285 Epispastics 383 Ergot, hastens delivery . 539 Eructations 300 Eruptions of the skin 331, 453, 486 Erysipelas, or St. Anthonv's fire 267, 524 Ether, vitriolic, doses of . 629 Essence of peppermint, doses of ...... • 629 Evacuations, importance of 94 alvine, prognos- tic of diseases . . . 211 Evergreen, diuretic . . 538 Ewell, James, Dr. memoir of xv Excretory vessels, use of . 40 Excoriations, or galling . 480 Exercise, promotes health 87 absolute necessity of 88 mode of prescrib- ing, in sickness ... 651 Expectorants, rules for their exhibition 643 Eye, description of . . 44 inflammation of . . 237 Eye-water, how prepared 659 F. Face, painful affection of 256 Faintingfits 286 in pregnant and ly- ing-in women . . 418, 439 Page Falling of the fundament 349 of the palate . . 235 of the navel strings 438 of the womb . . 455 Fallopian tubes, their use 58 False conception . . . 460 pains . . . . . 420 Fanaticism, dangerous conse- quences of .... 151 Fashion, its excess disgusting 141 Fear, its origin . . , . 112 turns the hair gray . 113 produces insanity . 113 Fear, superstitious foundation of 115, 475 Feather beds, necessity of airing 93 Febrifuge mixture and pow- ders . . . . . 634, 639 Feeding of children . . 470 Feeling, one of the senses 46 Feet, description of . . 38 Fennel, sweet, aromatic . 538 Fern, male and female, useful in coughs, and remedy for tapeworm, .... 538 Fever, in general . . . 162 bilious, or remittent 171 hectic, or consumption 269 inflammatory . . f 200 intermittent, or ague 164 malignant, or yellow 372 miliary .... 265 milk, in lying-in women 440 nervous, or typhus 184 puerperal . . . 453 scarlet .... 266 Fibres, description of . . 40 Fig-tree, a mild caustic . 539 Finger, dislocation and frac- ture of 364 Flag, blue, active cathartic 539 sweet, aromatic 539 Flannel, wearing of, promotes health 144 Flatulence, in infants . . 492 in adults . 300, 302 Flaxseed 539 , infusion of, good remedy in cough . . 226 syrup, how made 539 INDEX. 681 Page Flea-bane, promotes urine 540 Flies, potato, equal to Spanish 574 how collected 575 Flower-de-luce, cathartic 540 Fluor albus, or whites . . 409 Flour, caudle, how prepared 622 Flowers, pernicious effects of 74 Flux, or dysentery ... 281 Flux-root, remedy in colds 540 Food, how received into the stomach and digested . 54 rules to be observed in taking .... 78, 80, 616 Foxglove, a most valuable me- dicine in inflammatory com- plaints 540 Fractures of the limbs : . 362 of the small bones 364 of the ribs . . 368 French apple, cures epilepsy 542 Frost-wort, useful in king's evil 542 Frozen limbs, management of 221 Fumitory, useful in eruptions 543 G. Galen, how he became con- verted 34 Galling, of infants ... 480 Gall bladder, use of . . 57 Gamboge, doses of . . . 630 Gaming, a horrid practice 133 melancholy occur- rence of 134 good advice on . 134 Gangrene, or mortification 360 Garget, useful in rheumatism 543 Gargles, how prepared . 660 Garlic, excites blisters . . 543 Gentian, stomachic . . 543 Gillenia, common, emetic 544 Ginseng, demulcent and sub- stitute for tobacco . . 544 manner of preparing for exportation . . . 545 Glands, their use ... 40 Gleet, treatment of . . . 324 Glossary 667 Glyster, or clyster, simple and emollient 662 common . . . 662 86- Page Glyster, stimulating . . 662 anodyne . . . 662 turpentine . . . 662 nourishing . . . 663 mode of administering 654 Golden rod, a tonic bitter 545 Gonorrhoea 320 Gonorrheal inflammation of the testicle cured by purga- tives 324 Goose grass, useful in gravel complaints .... 545 Gout 319 doctor, anecdote of . 319 Gratitude, the most exalted virtue 153 Gravel 277 Greene, General, his death and character 229 Green sickness .... 403 Grief, injurious to health . 109 deep, cause of insanity and death 110 its best remedy . . 110 Gripes, in infants . . . 492 Grog blossoms .... 332 Ground holly, useful in gravel 546 Ground pine, useful in rheu- matism, Sec 546 Ground pink, remedy for worms 546 Guinea pepper .... 546 worm .... 344 Gun-shot wounds . . . 358 Gum pills 646 H. Hamilton, Honourable Paul, his description of button snake root 525 of the pleurisy root 571 of the squirrel ear 584 his mode of admin- istering the May apple . 558 Archibald, Lieut., his death and character 525 Harriet, her unhappy fate 101 Hartshorn, spirits, doses of 630 Hare lip, management of . 4S'2 Hart's tongue, remedy in di- arrhcea 546 682 INDEX. Page Harvey, his sublime sentiments 37 Hatred, destructive to mind and body 120 Head, description of . . 44 injuries of . . . 365 ■ water in the . . . 499 Headache 249 Hearing, difficulty of . . 251 Heart, description and use of 49 grand organ of circula- tion 50 Heart-burn 299 Heart's ease, useful in cuta- neous affections . . . 546 Heart snake-root, an emetic and diaphoretic . . . 547 Hectic fever 270 Hellebore, remedy in cuta- neous diseases . . 547, 548 Hemlock, useful in many ob- stinate cases .... 548 Hemorrhoids or piles . . 279 Hemorrhoidal ointment . 663 Henbane, useful in convulsions 549 Herb bennet, good for ague 549 trinity, for eruptions 549 Hernia, or ruptures . . 347 Hiccough 296 Hill, Dr., his effrontery . 580 Hippocrates, his desire to cure covetousness .... 126 Hip joint, rheumatic affection of 256 Hives or croup .... 500 Horehound, good for coughs 551 Hoarseness 218 Hog-bed, promotes the menses 549 Holwell, Col., his account of the black hole in Calcutta 69 Homoeopathy, account of 510 Homceopathic medicine . 512 medicines, pre- paration of .... 513 Hooded widow herb, antidote to canine madness . . 549 Hope, the source of human happiness 105 — its great influence on the state and disorders of the body 106 , ill-grounded . . 107 Hop beer, how made . . 550 Page Hops, anodyne and antiseptic 550 Horse-radish, stimulant . 552 Hosack, Dr., a distinguished botanist 518 Hospital, a cheap plan recom- mended to planters . . 34 — ought to be establish- ed in our sea port towns 34 Houseleek, useful in burns and stings of insects . . . 552 Hunger, painful sensation of, explained 55 Hunter, Dr., slept comfortably under snow .... 91 Husbands, affection of some 99 cruelty of some 131 Hydropathy, or water cure 506 Hydrophobia 344 Hydrocephalus, or water in the head 499 Hygieine, or the art of preserv- ing health 64 Hypochondriac disease . 290 Hypochondriacs, ludicrous ca- ses of 291, 292 Hypocrisy 151 Hyssop, useful in asthma, &c. 552 Hysteric fits 287 I. Idleness, the bane of virtue Iceland moss, decoction of, good for cough . . Ice-plant, useful in fits Imagination, force of . Imperforated anus . . vagina 105, 226 552 416 483 483 620 158 140 Imperial drink . . . Impiety, consequences of Impudence, disgusting Incontinence of urine, how treated by Dr. Bell . . 277 Incubus, or nightmare . 297 Indian hemp good for rheuma- tism 553 physic, safe emetic 553 tobacco, good for colic 553 turnip, good for coughs 553 Indigent, sick, often neglected 608 Indigestion or dyspepsia . 300 INDEX. 683 Page Indigo weed, emetic and ca- thartic 554 Indolence, source of disease 87 Infants, management of . 466 ., diseases of . . 478 Infection, how to arrest . 198 Inflammation of the brain 228 of the lungs 242 of the liver . 243 of the stomach 245 of the intestines 247 — of the kidneys 248 of the bladder 249 — of the breasts 447 of the womb 450 of the eyes . 237 — of the pleura 242 of the throat 230 Inflammable air, how to correct 71 Inflammatory fever . . . 200 Influenza 212 Infusion of roses . . . 650 of oak bark . . 650 of galls ... 650 of Peruvian bark 652 of Columbo . . 653 of gentian . . 653 Ingenhouz, Dr., his remarks on the properties of plants 73 Inhalations .... 218, 273 Injections for gonorrhoea . 660 Injuries of the head, &c. . 365 Inoculation for small-pox, from whence derived . . . 263 Intemperance, vice of . . 127 a miserable re- fuge from misfortune . 128 . reclaimation from 131 Intermittent, or ague and fever 164 Intermittent fever, best method of treating 169 remedies re- commended as highly bene- ficial 169, 170 Intestines, use of . . . 53 Intoxication, symptoms of 339 how to treat 339 Inversion of the womb . 445 Ipecacuanha, American, emetic 554 —doses of . . 630 Page Iron, carbonate of, useful in tic douloureaux .... 257 Iron filings, how exhibited 653 Issues 371 Itch 333 lotion, how prepared 658 Ives, Professor, attests the vir- tues of blood-root, in certain cases 523 Ivy 554 J. Jalap, doses of ... . Jamestown, or jimson weed, useful in many complaints Jaundice, or yellow gum . infantile . . . Jealousy, horrid effects of Jefferson, President, his death and character . . . Jerusalem oak, vermifuge Joan, queen of Naples, mur- ders her husband . . Johnson, Dr. formula to pre- serve the stomach and regu- late the action of the bowels in inflammation of the liver Jones, Hon. Dr., asserts the ef- ficacy of cotton in scalds Joy, excessive, often fatal Judkins' ointment, good for buboes Juniper, an excellent diuretic K. Kidneys, use of . ' . . . inflammation of 630 554 336 486 103 283 554 104 244 346 109 239 554 57 248 Kingston, Sir Wm., his cruel mode of taking revenge 121 King's evil 335 Knee, dislocation of . . 364 L. Labour 427 Laborious labour . . . 434 Lacedemonians, politeness of 140 Laceration of the parts . 445 684 INDEX. Page Lafiteau, Father, first discover- er of ginseng in America 545 Lambkill, for itch . . . 555 Lassitude, prognostic in fevers 208 Lavater's remarks on females 98 Laudanum, doses of . . 630 how prepared 656 Lavender thrift, for sore throat 555 Laurel, for diarrhoea . . 555 Laxative medicines . . 635 Leeches, mode of applying and preserving, and checking the discharge of blood . . 615 Legs, description of . . 38 fractures of . . . 365 Lemonade, how prepared 619 Lemon tree, antiseptic . 555 how to preserve the juice 555 Lettuce, garden, an excellent anodyne 555 wild, a powerful diu- retic 556 Lichen, useful in coughs . 556 Life-root, remedy for gravel 557 Ligaments, description and use of 38 Lightning, to recover persons apparently killed by . • 340 Lime water, how prepared 657 doses of . . 634 Limekiln, dangerous effects of 72 Lind, Dr., on the influence of the mind over the body 106 Liver, description and use of 56 inflammation of . 243 enlargement of . . 245 Lobelia, useful in venereal 557 Lochial discharge . . . 444 Lock jaw 294 Longings 178, 417 Looseness, or cholera infantum 495 Looseness, in pregnancy . 418 Love defined .... 96 influence of . . . 96, 97 propitious, conducive to health 100 disappointed . . 100, 101 Lover, false, a detestable cha- racter 104 Page Louisa, affecting history of 100, 101 Low spirits 290 Lumbago 256 Lues venera, or confirmed pox 326 Lungs, description and use of 48 inflammation of . 241 Lying-in women, diseases of 442 M. Madder, useful in visceral ob- structions 557 Mcintosh's, Dr., treatment of syphilis 329 Mac Pheeters, Dr., celebrates black mustard, as emetic, in malignant fever . . . 388 Macbride, Dr., finds blood root useful in hydrothorax . 523 Magnesia, doses of . . 630 Magnolia, good in rheumatism 557 Maiden hair, useful in coughs 558 Malignant fever .... 372 letter from Louisiana to the author respecting 372, 373 — Cartwright's essays on, noticed .... 374 symptoms of . 374 three distinct stages of 374 — treatment of 375, 388 animal and vegeta- ble putrefaction, agency of in producing . . . 385, 386 bayous do. . 392, 393 — — prevention of . 393 cholera. See cho- lera, epidemic or malignant 305 Malignant or putrid sore throat 232 Mallow, useful in dysentery and gravel .... 558 Mandrake, an excellent purga- tive 558 Manna, doses of . . . 630 Marsh, trefoil, tonic bitter 559 Marsh-mallow, good emollient 559 Marsh rosemary, for sore throat 559 Master-wort, tonic . 559 Materia Medica . . . 517 May apple, purgative . . 560 INDEX. 685 Page Mayrant, Col., celebrates Sam- son snake root as a remedy for dyspepsia .... 581 May weed, stomachic . 560 Mease, Dr., deserving of high praise 518 Measures and weights, table of 627 Measles 264 Meconium, observation on 469 Medicines, table and doses of 628 ————— approved manner of administering . - . 390 Medicine, the importance of possessing some knowledge of 28 ■ ■ necessary caution in the use of 30 — — - - subject to abuse 28 the necessity of tak- ing agreeably to directions 613 Membranes, description of 40, 43 Menstruation .... 398 -^— — — cessation of 400 — — — - — painful . . 401 suppression of 403 profuse . . 406 Mercurial pills, how prepared 655 ————— solution . . . 655 ointment . . 663 Mezereon, useful in venereal and cutaneous affections 560 Midriff, description and use of 52 Miliary fever .... 265 ' eruptions . . . 453 Milk fever 444 blotch 487 Milk, or silk weed, useful in gravel, &c 560 Milkwort, useful in coughs and colds ..... 560 Mind or soul, obscivations on 47 Mindererus spirits, how pre- pared 639 Mint, allays vomiting . . 561 Mineral tonics .... 651 Miscarriage ..... 424 Misletoe, useful in fits . 561 Mitchell, Professor, deserving high commendation 518 Modesty, its great influence 137 Mole, or false conception 460 Page Moore, Dr., cites a case rela- tive to imagination . . 416 Moorwort, remedy for toe itch 561 Mortification, or gangrene 360 Moschetoes, bite of . . 342 Motherwort, useful in nervous affections 561 Mountain tea, promotes men- strual discharge ... 561 Mouthroot, tonic bitter . 561 Mugwort, good stomachic 562 Mulberry tree, an excellent purgative 562 wine, how made 562 Mulled wine, to prepare . 625 Mullein, good for piles . 562 Mumps, treatment of . . 236 Muscles, description of . 39 Mustard, excellant stimulant 563 whey, how made 625 Music, powerful effects of 118 Mutton broth, how made 623 N. Narcotics, observations on 647 Navel cord, or string, manner of tying .... 431, 467 presentation of 438 Neopolitan, manifests unboun- ded love for his wife . 99 Nervous fever .... 184 headache . . . 250 Nerves, description and use of 39 Nettle-rash, treatment of . 332 Nettle, stinging, an excellent stimulant 563 Night-shade, usefel in rheuma- tism and in tic douloureaux 564 deadly, used in palsy, epilepsy, &c. - 563 Night-mare, or incubus . 297 Nipples, sore . , . . 448 mode of pre- venting 449 Nitre, doses of ... . 630 Nitric acid, diluted . . . 655 lac ammoniac, how pre- pared 643 Nitrous lozenges, how pre- pared 645 686 INDEX. Page Nose, bleeding from . . 267 Nostrils, description and use of 46 Nostrums, dangerous conse- quences of .... 28, 225 Nurses' Guide .... 608 Nurse, duty of ... . 609 , caution to 611, 613, 617 Nursing infants .... 474 Nutrition, proper for children 469 O. Oak, astringent, tonic, and antiseptic . . . 565, 566 Oak, poison, good for palsy 566 Obstructed menses . . . 403 Ointment for piles . . . 280 for scald bead . 335 simple ... 663 saturnine . . 663 basilicon . . 663 mercurial . . 663 — hemorrhoidal . 663 tar .... 663 itch .... 664 thorn-apple . . 586 Omentum or caul, description of 56 Onions, remedy in liver com- plaint and croup . . 566 Opiates, caution in the use of 242 Opium, doses of . . . 630 Opodeldoc, how prepared 658 Opthalmia or sore eyes . 239 strumus or sore eyes 239 Orange-tree, antiscorbutic 567 wine, how made . 567 Original imperfections . 481 Ovaria, ovaries, situation and use 58 Oxygen, or pure air . . 67 P. Ill Pagan religion, account of Painful affection of the face, or tic douloureaux . . 256 Pain of the ear ... . 251 stomach . 293 Page Pain of the head . . . 249 Pains, after, of lying-in women 443 false in pregnancy 421 of the back, thighs, and abdomen, in pregnancy 420, 421 Painful menstruation . . 401 Palate, elongation of . . 235 Palmer, Mr., anecdote of 321 Palpitation of the heart 203, 296 in pregnancy 418 Palsy, treatment of . . 289 Pancreas, or sweet bread, its use 57 Panado, how made . . 622 Papaw, purgative . . . 567 Papoose root, useful in ob- structed menses and dropsy 567 Paraphymosis .... 324 Parents, caution to . . . 476 Paragoric elixir, doses of . 630 how prepared . 656 Parrot, killed, by eating the berries of pride of China 576 Parsley, leaved, yellow root, a good stomachic . . . 567 ■ wild, useful in gravel 568 Passions, the active forces of the soul ..... 95 Patent medicines, why dan- gerous .... 28, 29, 225 Patriotism, definition of . 147 Themistocles . 148 of French soldier 148 of English sailor 149 — of Americans 149 Peach-tree, a mild cathartic 568 Pectoral drink, how made 620 mixture or emulsion. 634 the doses of .... Penny-royal, promotes menses 569 Peppermint, allays vomiting 569 Pepper, red, stimulant . 569 Peripneumony, or inflamma- tion of the lungs . . 242 Peritoneal inflammation . 451 Perspiration produced by ex- ternal applications . 177, 201 Petechial fever .... 184 Philemon, died laughing . 109 INDEX. 687 Page Phrensy, or inflammation of the brain 228 Philopcemon, the great, taken for a servant .... 143 Phymosis 323 Physic, Dr., his excellent ad- vice in hemorrhage of the extremities .... 356 Piles 279 Pills, mercurial .... 655 for inflammation of the liver , 244 purgative .... 637 — — of sugar of lead, and ipe- cacuanha 650 camphor and assafoetida 649 Pink root, excellent vermifuge 570 Pins, swallowing of . . 345 Piss-wort, promotes urine and menses 570 Placenta, or after birth, mode of extracting . . . 433,439 Plantain, antidote against the bite of venomous insects 570 Plaster, blistering, how made 664 , warm and stimulating 658 Pleurisy, treatment of . . 240 ■ — root, remedy in cold and pleurisy .... 571 Plurality of children . . 437 Plutarch's observations on bashfulness .... 140 Poison, swallowed . . . 342 — oak, useful in paralytics 571 — antidote for . . 572 Poke weed, useful in rheuma- tism 572 Polygonum, promotes urine 573 Polypody, mild laxative . 573 Polypus, in the womb . . 458 Pomegranate, mild astringent 573 Poplar tree, good tonic, &c. 573 Poppy, white, anodyne . 574 syrup of . . . 574 mode of cultivating and collecting the juice 574 Potato fly, mode of collecting 574 Potato, sweet, nutritious 574 wild, purgative . 575 pudding, how made 6'24 Potter, Professor, his remarks Page used on stimulantSj as fevers 193 Pox, treatment of . \ . 326 Prejudices, ill consequences of ..... . 29, 614 Pregnancy, signs of . 412, 413 — force of imagina- 416 417 27 435 tion in — diseases of Preliminary observations . Preternatural labour Prickly ash, remedy in rheu- matism, &c. . . . 575 — — — pear, remedy for corns 576 Pride of China, remedy for worms, scald head, &c. Progress of labour . Prognosis of fever . Prometheus, his history of in- temperance .... Prostrate glands, situation and use of Ptolemeus, cries for joy Puccoon, good for jaundice Puerperal fever . . . Pulse, its action described Purgative infusion, how pre- pared powder - electuary, doses how prepared pills and 634, Purging, or diarrhasa of infants Putrid fevers . . — sore throat 576 428 204 128 58 108 577 453 206 637 637 637 637 304 469 184 232 Q. Quacks, cause of their increase Quaker girl's attraction . Queen of the meadows, diuretic Quince tree, mucilaginous Quinine, preparation of . not to be administer- 28 146 577 577 652 ed at random in intermit- tent fever solution of . sulphate, pills of Quinsy, or inflammatory sore throat 169 654 654 230 688 INDEX, R Page Radish, antiscorbutic . . 577 Raleigh, Sir Walter, forbear- ance of . . . , . 118 Ramsay, Dr., his melancholy death 358 Rash, nettle . ... 332 Raspberry dissolves tartar on the teeth 577 Rattlesnake root, remedy for croup and cold . . . 577 violet ... 579 bite of . . 343 Rayschachius, sudden death of, from grief .... 110 Red cedar, substitute for savin 579 Red gum 486 Regimen, importance of in sickness ... 33, 609, 616 Religion, promotes health 150, 157 extremes in, to be avoided ..... 152 purifies and en- hances our enjoyments 154 Remittent, or bilious fever 171 or bilious fever, prevention of . . . . 182 Respiration, prognostic of dis- ease 207 Resuscitation of persons appa- rently dead .... 340 Revenge, horrid instance of 121 advice to the Ro- mans respecting . . . 121 Bolea's way of taking 122 Rheumatism 254 Rheumatic tincture, how pre- pared 656 Rhubarb, wild, purgative 579 Ribs, description and use of 37 Rice milk, how made . . 621 caudle, do. ... 622 pudding, do. . . . 624 Rickets 504 Ring worm 333 Rose or erysipelas ... 488 Rose, damask, mild laxative 579 willow, remedy in gleet, &c 580 Page Routs, dangerous tendency of 68 Rue, produces blisters, &c. 580 Ruptures .... 347, 483 Rush, Professor, esteems wine a preventive of disease 596 his death and character 199 Rust of steel, doses of 631 S. Sage, was supposed by the an- cients to prolong life . 58G Sago jelly, how prepared 620 Sailor, American, patriotism of 150 Sailors, deserve kind treatment 35 — too inattentive to health 182 Saliva, use of ... . 46 Sal ammoniac, volatile, dose of 631 crude, solution of 658 Salt of tartar, doses of . 631,642 Saline julep, or mixture, dose of 634 Saline, how prepared . . 638 Samson snake-root, remedy in dyspepsia 581 Sanicle, American, for cancers 581 Sarsaparilla, good for rheuma- tism ..-..•. 581 Sassafras, purifies the blood 587 Saturnine, or lead water, how prepared ..... 658 Scald head . • . . . 334 Scalds and burns . . . 346 Scarlet fever 266 Scirrhus or cancer . . . 352 Sciatic 256 Scrofula, or king's evil . 335 Scull cap, for hydrophobia 582 Scurvy 330 Scurvy-grass, antiscorbutic 582 Sea-sickness 338 Secretory vessels, their use 40, 55 Seminal weakness . . . 325 Senna, American . . . 582 Senses, inlets of pleasure 44 Setons and issues . . . 371 Sexual weakness . . . 409 Shippen, Dr. Wm., father of the Pennsylvania Univeisity 230 Ship fever . . • . . 184 Shaw, Professor, his death 568 INDEX. 689 Page Shiverings, in childbed . 443 Sight one of the senses . 46 Sickness and vomiting of in- fants 490 Sinapisms, how prepared . 664 Skin, the functions of ex- plained 40, 41 diseases of . . . 331 Skoke for ulcers and wounds 582 Skunk cabbage, useful in asth- ma 582 Slaves, brutally murdered 116 proper manner of treat- ing 34 Slave trade abominable . 71 Sleep, most reviving cordial 91 how to be regulated with infants 472 effects of too much or too little ...... 93 — — after dinner, whether advisable 93 talking or walking in 93 signs of, in fever . 209 Sleeplessness . . . 196, 420 Slow fever 184 Small-pox . . . . • 261 how managed in Queen Mary's time . . 262 history of . . 263 Smell, one of the senses . 46 Smith, Professor, discovers the utility of blood-root in poly- pus 523 Snakes or serpents, bite of 343 Snuffles of infants . . . 485 Soapwort, valuable in jaundice, &c 583 Socrates, maxim of . . 78 oolander, Dr., his advice to travellers in cold weather 89 Solution of arsenic, doses of 628 how pre- pared 657 Solution of crude sal ammoniac 658 of kali .... 659 Somnambulism and somnilo- quism 93 Sore eyes 237, 480 nipples 44S throat .... 230, 232 87 Page Soul, immortal .... 47 Sorrel, antiscorbutic . . 583 Southern wood, stomachic 583 South sea tea, diuretic . 583 Spaniards, their cruelty to the Indians 117 Spanish woman, her extraordi- nary hope 107 Speech, blessing of . . 47 Spence, Dr., attests the efficacy of foxglove in consumption 540 Spikenard, good in gout . 583 Spirit of mindererus, how pre- pared 639 — — of turpentine, mode of administering . . . 649 of lavender, doses of 631 Spitting of blood ... 268 Spleen, description of . 57 Spleenwort useful in coughs, &c 584 Spotted fever .... 184 Sprains and bruises . . 361 Spruce laurel, useful in venereal 584 Squirrel ear, antidote for the bites of serpents . . . 584 Star grass, an intense bitter 584 Stevenson, Dr., his remarks on bowel complaints . . 281 his mode of treat- 291 467 637 ing a hypochondriac Still-born infants, mode of re- covering Stimulant purgative pills . Stimulants, how to exhibit 647, 648 Stings of insects . . . 343 Stink weed, for cutaneous eruptions, &c. . . . 584 Stomach, description and use of 52 - aperture in St. Mar- tin's, described by Dr. Beau- mont Stools, prognostics in diseases St. Anthony's fire . . . St. Martin the young Canadian, experiments on digestion made in his case by Dr. Beau- mont Strangury .... 277, Strawberry, cooling and laxa- tive 83 206 267 83 419 584 690 INDEX. Page Stroke of the sun . . . 228 Structure of human machine 36 Strumous opthalmia or sore eyes : 239 Sumach, common, anti-vene- real 585 Sulphur, doses of . . . 631 Sudorific drops, or bolus . 640 Sun dew removes freckles 585 Superstition source of delusion 151 Suppression of urine . 276, 418 Sutures, mode of applying 357 St. Vitus's dance . . . 504 Swallowwort, good for cold 585 Swallowing of pins . . 345 Sweating, immoderate . 166 Swelled leg .... . 446 Swelling of feet in pregnancy 419 of head in infants 479 of breasts in do. 479 of scrotum in do. 479 Swine pox 265 Swooning or fainting . . 442 Sympathy 52, 56 System, the, certain states of in remittent fever in which the use of bark is forbidden 181 T. Table of medicines for family use ...... . 628 Table of weights and measures 627 Taliaferro, Hon. John, his re- medy for whitlow . . 350 Tansy, vermifuge . . . 585 Tape worm . . ... . . 463 Tapioca jelly, how made . 620 Tartar emetic, doses of . 632 Tartar on the teeth, how to re- move and prevent . . 253 Tar water, how prepared 657 Taste, one of the senses 46 Tea, properties of ... 82 Teeth, management of . 253 Teething 494 Temperance promotes health 78, 129, 132 Tendons, description and use of 39 Tetany or lock jaw . . 294 Page Tetter or ring-worm . . 333 Thatcher, Dr., deserves praise 518 Theodosius, emperor, his anger subdued by music . . 119 Thighs, description of h. 38 dislocation of . 364 fracture of . . . 364 Thomas, Dr., attests the effi- cacy of Cayenne pepper in putrid sore throat . . of charcoal to stop bleeding of the nose Thorax or breast, description of Thorn apple, remedy in mania, epilepsy, &c of a child- case 234 268 48 586 587 swallowing the seed Thoroughwort, useful in fevers 588 Throat root, for sore throat 589 sore 232 Thyme, good aromatic . 589 Thrush, or sore mouth . 489 Tic douloureaux . . . 256 remedies for 258 symptoms of 256 treatment of 257 632 632 656 656 656 656 656 656 656 334 620 632, Tincture of steel, doses of of myrrh . . of rhubarb of bark . . of Columbo . of foxglove of cantharides , rheumatic of laudanum Tinea, or scald head . Toast water, how made Tobacco, for colic, dropsy, &c. 589 used for tic doulou- 257 used for toothache 257 reaux Toe itch, good for toe or ground itch 593 Tongue, description and use of 47 appearance of, an im- 209 482 651 66* 252 portant prognostic Tongue-tied, how remedied Tonics, class of ... Tonic powders, and pills . Toothache ..... INDEX. 691 Page Toothache-tree, for rheuma- matism and venereal . 593 Toot rash - . . . . 487 Topical blood-letting . . 369 Touchwood, excellent styptic 593 Tourniquet, how to apply, 325, 356 Travellers in winter, caution to 90 Treacle posset, how made 621 Trefoil water, emetic, and ca- s thartic 593 Troup, Hon. G. M., his deaf- ness cured .... 252 Tulip bearing poplar, tonic 593 Turmeric, diaphoretic . 593 Turlington's balsam, how pre- pared 656 Turner's cerate .... 663 Twins, or plurality of children 437 Typhus fever, treatment of 184 Typhoid pneumonia, or epi- demic ...... 226 U. Ulceration of the navel . 479 Ulcers common . . . 353 ill-conditioned . 550 Ureter, description and use of 57 Urethra, description of . 58 Urine, prognostic in fever 210 difficulty in voiding 276, 418 incontinence of . 276 suppression of . . 278 Unicorn root, useful in colic 593 Uterus, description of . 57 Vaccine disease . . . 258 Vaccination discovered by Dr. Jenner in 1798, as a preven- tive against small-pox 263 Vagina, or neck of the womb 58 protrusion of . . 455 Valerian, wild, useful in nerv- ous disorders .... 593 Vanity, effects of . . . 134 cure of ... . 137 Vapours, or low spirits . 290 Vegetable substances, how col- lected and preserved . 606 Page Vegetation of plants, corrects impure air 73 Veins, their use .... 40 Venereal disease . . . 321 prevention of 330 Venesection, or bleeding, how performed 369 Vine, grape, cultivation of 594 Violet rattlesnake root, reme- dy for scrofulous tumours 602 , sweet, mild laxative 603 Virgins' bower, useful in cuta- neous affections . . . 603 Virginia, or black snake-root, promotes perspiration . 603 Volatile sal ammoniac, mode of administering . . 648 liniment, how prep. 658 Vitriol, white, doses of . 632 Vitriolic solution, doses of 634, 651 how prep. 650 Vital air 67 Voltaire, his conversion . 159 Vomiting and purging, or cholera morbus . . . 304 Vomiting in infants . . 490 W. Wakefulness, or inability to sleep Wake robin, for blistering Walnut, white, cathartic . Warm bath, virtues of 32, 43, — how to be regula- ted Warm and discutient liniments plaster Warts and corns . . . Washing of infants . . Washington, GenL, his death and character Mrs. L., her mi- raculous recovery Water cresses, antiscorbutic Water trefoil, antiscorbutic Water, impure, how to correct Water gruel, how made . Watery head .... Watery rupture .... Wayne, General, his death 174 604 604 202 202 658 658 349 471 179 b04 604 82 621 499 483 320 692 INDEX. '' Page Weakness of the stomach 300 Weaning • 473 Weems, Dr., his prescription 303 his death . 303 Wells, dry, danger of « . 72 Whitlow 350 White swelling .... 337 Whites, or sexual weakness 409 White gum 486 White caudle, how made 622 White bryony, purgative . 604 White wood, tonic . . . 604 Whooping-cough . . . 503 Willow, astringent and tonic 604 Wistar, Dr., attests the effica- cy of nitric acid in liver complaints .... 245 his death and cha- racter ...... 230 Wine, excellent preventive and remedy of diseases 594 use of, is economy 595 abuse of, injurious 595 receipts for making 597 adulteration of, how to detect 600 cautions in administer- ing in fevers .... 192 whey, how prepared 625 Winterberry, tonic . . . 605 Wintergreen, for itch . . 605 Womb, or uterus, description of 57 Page 455 445 459 458 450 439 Womb, falling down of inversion of . cancer of . . polypus in the inflammation of hemorrhage from Wood, betony, good in rheu- matism 605 Woodhouse, Prof., his death 567 Worms 462, 498 Worm-seed, vermifuge . 605 Worm-wood, stomachic . 605 Wounds 356 Wrists, dislocation of. . 364 Y. Yarrow, astringent, remedy for bruises and cancers Yeast, utility of, in nervous fevers corrects fetid ulcers receipt for making Yellow fever Yellow gum prevention of 605 188 550 551 372 393 486 Zimmerman, Dr., his judicious mode of treating religious melancholy .... 152