LIBRARY ■ Hi lOhi I nil ■ MH Hi u' r • i ■ HHMH Una CONGRESS 312571 ■■■HHI I e -5> C^ -V 'v FIFTY-FOURTH EDITION-ENLARGED AND REVISED. THE YSTERY OF MEDICINE EXPLAINED; A FAMILY PHYSICIAN, |0us^0iir Cpmp anion ; PREPARED FOR THE USE OF FAMILIES, Plantations, Ships, Travelers, &o. Br M. LAFAYETTE BYRN, M.D., 3RADUATE OP "THE UNIVERSITY OF THE CITY OF NEW YORK," AUTKOR OP " FOI80NI IN OUR FOOD," ETC. ETC. NEW YOKE: HURST & CO., PUBLISHER 75 NASSAU STREET. 1876. ^7! Kktbhsd, according to Act of Congress, in the year 1869, by M. LAFAYETTE BYRN, M.U. k the Clerk's Office of the District Court ot tne United Sit-es for the Southern District * New York. Ehtbred, according to Act of Congress, in the year 1876, by M. LAFAYETTE BYRN, M. D., In the office of the Librarian of Congress at Washingten, D. C. oV^ PREFACE. This book has been written for the " People I" — the rich, the poor, the old, the young, maie and female, the learned and the illiterate, those who arc well and those who are sick ; on land and on water, in the city and in the country, in the rural country-scat of the retired merchant or the log-cabin and camp-fire of the hardy pioneer or backwoodsman ; for the clerk of sedentary habits, and for the farmer who toils in rain and in sunshine; for the young man far away from home, and for the mother who keeps watch over her loved ones through the long hours of dreary night in sickness ; — in a word, foi the million. It is intended as a guide for preserving health and prolong- ing life, by giving that kind of information (couched in lan- guage free from medical technicalities), which has long been needed by the masses. It has been my aim not only to sim- plify the laws of health and physical education, but to give such plain descriptions of the various ailments which our bodies are subject to, that every one may know from the symptoms, each ailment or disease, and be enabled to give the best remedies, where a physician can not be had, or, in cases of emergency, to know what to do before the physician arrives, so as to alleviate suffering or be the means of saving life. Also, to enable the reader to treafintelligently and success ully marr , which de- velops from its inner sm face the ciliary pro- cesses, and the iris (6). of which the opening at 7 represents the pupil. We shall go more into details presently as to the nature of these several constituents of the tunics and other parts of the Cyc > at present wo will keep to general outlines, as represented in the dia- gram. The third tunic, then, is the rerina (8), which is carried forward to the lens (IS), by the zonula ci'iarU, a prolongation of its vascular layers passing along the front of the Canal of Petit ii>), which entirely surrounds the lens. In the space marked 10. is contained the aqueous humor ; 11 is the posterior chamber ; 12 the lens, more convex behind than before, and enclosed in its proper capsule; 13 marks the inner area of the globe tilled with a thin membrane called the hyaloid, and containing the vitreous humor ; 14 is the tubular aheath of the membrane, through which passes an artery connected with the capsule "t' the lens. and, at the back of the <\e, with the, optic nerve, as represented at 16. Of this nerve, 15 marks the luurUcuiaa, or aheath. THE EYEBALL DIVESTED OF ITS FIRST TUNIC. 1, Part of the outer tunic, the sclerotic ; 2, the optic nerve, communicating with the ball at the back ; 3, 3, distinguish the ont- line of the choroid coat; 4, the ciliary lig- ament, a dense white structure which surrounds, like a. broad ring, the circum- ference of the iris (5). This ligament serves as a bond of union between the ex- ternal aud middle tunics of the Eyeball, and serves to conne< t the cornea and scler- ota at their lines of junction with the iris and external layer of the choroid; 6, 6, mark the vence vorticosce ; and 7, 7, the trunks of these veins at the points where they have pierced the sclerotica ; 8, 8, the posterior ciliary veins which enter the Eyeball in company with the posterior cil- iary arteries, by pieiciug the sclerotica at 9. The course of one of the long ciliary nerves, accompanied by a vein, is marked by 10. 17 plate nn. Fig. 2. TBANSVERSE SECTION OF THE GLOBE OF THE EYE. 1, The divided edges of the three tis- sues, the sclerotic (outer), choroid (mid- dle and dark), and retina (inner), which last is composed of three membraneous layers, the external being serous, the middle nervous, and the internal vas- cular ; 2, the pupil, that central spot, which enlarges or contracts, according as more or less light is required to be admitted ; 3, the iris, so called from iris, a rainbow, on account of its variety of color in different individuals. It is composed of an anterior muscular layer, consisting of radiating fibres, which, converging from the eentre toward the circumference, have the power of dilating the pupil ; and also of circular fibres, which, surrounding the pupil like a sphincter performs the duty of contracting its area. The posterior, or hinder layer, is of a deep purple tint, .and is hence named uvea, from its resemblance to a ripe grape. This is the surface of the iris presented to view in the above section. 4, ciliary processes ; 5, scalloped anterior border of the retina. POSTERIOR SEGMENT OF A TRANsvi.km. m.< riOH 01 IBB EXE. 1, The three outer tunics ; 2, the entrance of the optic nerve, with fhe vein known as the anteria centralis retinae piercing its centre ; 4 is the foramen of Soemmering, situated in the middle of the axis of the eye. This is a circular spot, surrounded by a yellow halo, called the limbus luteus. This halo is commonly obscured by a fold of the retina (5). 18 PLATE XIV. EYE-ArPF.NDA.GES. MEIBOMIAN GLANDS. 1 2, The inner sides of the 3 3, the Conjunctiva; 4, the apertures of the glands, along each corner of the lids ; 5 5, 6 6, the Papillae lachrymales and the Puncta lachrymalia ; 7, the ap- ertures of the ducts of the Lachrymal gland. 1, The superior or upper tarsal carti- lage, along the lower border of which (2) are seen the openings of the Meibo- mian glands; 3, the inferior, or lower, tarsal cartilage, along the upper edges of which are also openings of the above- named glands ; 4, the superior or orbi- tal portion of the Lachrymal gland, from which come tears ; 5, its inferior or palpebral portion ; 6, the Lachrymal ducts, or channels through which the tears pass to the outer surface of the eye ; 7, the Plica semilunaris, containing a small plate of cartilage, which appears to be the rudiment of a third lid, such as is developed in some animuls ; 8, the Caruncula lachrymalis, the source of the whitish secretion which so constantly collects in the corner of the eye ; it is covered with minute hairs, which can sometimes be seen without the aid of a microscope ; 9, the Puncta lachrymalis, the point, or external commencement of the ducts, which terminate at the lachrymal sac, the position of which is marked by 12 ; as are the superior and Inferior lachrymal canals by 10 and 11. The nasal duct, marked by 15, and 14 is its dilation with the lower meatus of the nose. 19 MUSCLES OF TIIK KVK. 1. Sphenoid Bono; 2 thoOntic Nerve i :t. the Globe of the Bye; 4, the rpper Iffaaele, called the Levator Palpebrce the Lifl rot the Eyelids; 5, the Superior Oblique, m bom the direction In which it draws the Eyeball; ire see Ite cartilaginous ]>:■ '■ and the reflected portion passing downward to ite point of connection with the bull, beyond which th.> Inferior Oblique baa Ite bonv origin— the poinl of which la marked by the little square kn<>b The other four musolee are caUed Recti straight i the Superior hicias, sometimes called the Levator OeuU, erector of the eyes and sometimes Buperbut, beoanae its action elves an expression <■! pride; Ite opposite, 13 1 1 ■ . - Inferior I sometimes oalled Deprimut OeuH, depressor <>i" tin* eye, and Humutle, a- gfvina an expression of hnmillty : 10, the Rectuel ternue, aometl i called Adductor OeuU, Ban its drawing the Eyeball toward tb.enoae.and BiMtoriout,a sort of panning name, In ajlnaion to the onp, or orbit, towards which Itdlreotetbe Klanoe; Hand IS, Seetut Ex- ternum, tlu> one showing Its two heads of origin, and the other Its tei mi nation ; thi vening portion i i' una le [having been removed] ins the name of Abductor fA-u/i, beoanae it tarns the ball outward; Indianaoundut la nnother name for it, aa giving an expression of 8L-iirii Iu our diagram th • intiinal rectos passes behind the optto nerve, which partly oonoeala it; 1 1. the tunica abigcmUt, or wuiio tauk', funned, by the oxpuuaiou of the tendons of the four Recti mueelet. Fig. 2. SEPTUM OF THE NOSE AND ITS NERVES. 1, Nerve of the lobe of the nose ; 2, olfactory lobe ; 3, nerves of the septum ; 4, nerve f the palate. 20 SECTION OF MAMMAUY GLAND OH FEMALE BREAST. 1, 1, Galactophoroua Ducts ; 2, 2, Lobuli. (111'. IN Of THE MILK DUCTS ULTIMATE FOLLICLES OF THE MAMMAKY GLANDS. a, a, the Secreting Cells; 6, b the Nuclei. 21 PLATE XVII. DIAGRAM OF THE STRUCTURE OF THE 6K1N. a, Epidermis ; 6 6. Poros ; c e. Lay- era of epidermis and rett> mucoaum ; /, Iuhalent vessels; g g, Papilla) of the skin; h h, Coriam or true skin; d, d d. Bulbs of sudoriferous glands opening in the glands b b. Fig. 3. A SWEAT GLAND. A vertUal section of the sole of the foot — a, the Cuticle or Scarf Skin, the deeper layers of -which, dark in oolor, being called the rete mucomim ; b. the Pavilke ; c, the Cutis or Trne Skin ; and i/ is the Sweat Gland in a cavity of oily globules. PORES AND PAl'ILUE OF THE 6KLN. On the left is a Magnified View of the Ridges of the VERTICAL SECTION OF THE SKIN LARGELY MAGNIFIED. h Sweat Gland : i. a Hair enclosed in Onticle, as seen in the Palm of the Hand~w.th the its Follicles, and showing its pair of Openings of the Pores in their Furrows. On the right, Sebaceous Glands ; p, a Sebaceous the Cuticle has been removed, leaving corresponding Gland. rows of Papilla. PLATE XYLTL DEficniTTlON of Plate 18—1. Frontal branch of the fifth nerve of the bm in which bestows sensation alum-. II. onpetlor maxillary, or that branch of the tifih nerve which supplies the apper law, and which, lik- the last, arising from the sensitive roi t, beatowa aenaation alone. HI. Mental or inferior maxillary branch of the fifth nerve. '1 ins also comes li • 111 the ■enaitive root It Is called mental, becanse it is involved in thai expieaaion which indkatea the amotions of the mind. IV. Temporal bran- lies of the earns fifth nerve. They are dutabuted on the temples, and are for sensation. V. The only branch of the fifth nerve which arises from the smaller or motor root, and assists in the motl f those mnaclee which are employed in masticating or chewing. VI. \ II, VIII, IX. These arc spinal ncrvcM— the ti'st of the snns which come out between the vettebra, in the whole leneth of the spine, to supply the body generally viih motion and sensation. A The facial nerve. It ia situated in tim front ofthe ear, and La the motor nerve of the features. It sends branches i«i to the muscles of the forehead and eyebrows. Branches <6i to the e> elide. Branches to to the muscles which move the nostiils and iijuicr li]>. Branch* aid) to the lower Up. Branches <- 1 going down to the side of the neck. Connections (/)with the spinal nerves of the neck. 2 nerve (f) tO a portion Of tbe muscle that IS in the back of the head, and to muaclee i f tbe ear B Tl mis vagns, »r the wandering nerve, so named from its extenaive distribution. This la the grand respiratory nerve C The spinal accessory nerve l>. The ninth nerve,' which Is the motor nerve of the todgue. E. The nerve which supplies the diaphragm. P. Branch ol tbe sympathetic nerve, 6. A branch of tbe nervus vagus which goes to the superior portion of the larynx or windpipe. H. An- other brant b of the vagns which goes totheinferior portion of thelarynt. I. The nerve which goes to the tongue und upper part of the gullet, called the pharynx. 23 TLATE XIX. FlO. 1 MESENTERIC CIRCULATION BKTWEKN TIIE BOWELS AND ht'TUUUiST GLAN1J8. i.om.itlhinal bf.ction op a por- tion OP 1111. SMALL LNTKSTLNE. « - fe^ TOI/iff Bk 3SV 1 PAROTID GLAND OF A SHEEP (UNDER THE CHIN), PXHTBriTNG T IE BRANCHED AND LOBULATID CHARACTER OF THE GLANDS OF THE HU1IA.N SIOMACII, AND OTHER PARTS. MEDICAL EDUCATION. As there are so many impostors in large cities — men pretending to be physicians Mid Burgeons, and have never been properly qualified to act in such capacity, I have concluded to produce the evidence for the information and benefit of those who do not know me personally, of my Medical Education having been regularly completed in one of the first Medical Schools in America. I trust that hereafter, persons wishing to consult me, will be satisfied that they are placing themselves in the hands of a regularly educated physician. The following is a copy of the Diploma in Latin, (and also a translation in English,) awarded to M. L. Bykn by the University of the City of New York. March 3d. 1851 : Cancellarius. Professores et Concilium Universitatis TJrbis Neo Eboraci : — Omnibus et singulis nasce literas lecturis. Salutem in D<rd Jesus Christ. — Be it Knoicn, that it has pleased us under the authority bestowed by public charter in this institution, to adorn M. L. Btrn, an upright man, in the first place having undergone an exami- nation, imbued with the excellent art of medicine and science of surgery, with the title and degree Doctor of Medicine, and to grant him all rights, honors and privileges pertaining to the said degree. In Testimony, thereof, we affix to these letters of this University, the seal and our handwriting. Given from the buildings of the University of New York, the 3d day of March, 1851, and of the Independence of the United States, the 75th." (SIGNED. 1 JOHN W. DRAPER, Chancellor. GRANVILLE S. PATTISON, M. D., Professor of Anatomy. SSKS^ MARTIN PAINE, M. D., Professor of Materia Medico and The- jl l. s. ill rappntics. WW JOHN W. DRAPER, M. D., Prof of Chemistry and Physiology. &U=#&M E..BAKTLETT, M. D., Professor of the In-titutes and Practice of Medicine. G. S. BEDFORD, M. D., Professsor of Obstetrics. S. D. GOSS, M. D., Professor Surgery. ( JOHN C. GREEN, President. Council, \ WILLIAM B. MACLAY. Secretary. ( A. C. KINGSLAND, Mayor, THE MYSTERY OF MEDICINE HOW TO PRESERVE JIEALTH. The variety of temperaments or constitutions renders i! tutssi'irle for health to be very different in different persons hence what would preserve the health of one would occasion disease m another. Persons of a sanguine temperament, whoso -^selsare full, and whose fibres are firm and active, easily ex- cited to motion, and often to irregular actions, bear evacua- tions well ; and have their health best promoted by abstinence and low living, by avoiding excess of every kind, and particu- larly guarding against cold after active bodily exertions. Tho bilious temperament, with a constitution more acutely sensible, always more imtable, requires the same precautions as the sanguine ; but the evacuations best adapted, which are indeed almost indispensable to this kind of constitution, are the free and frequent use of the milder laxatives. To preserve the health of the melenicholic, of those whose complexion is dark, and whose powers are torpid, whose mind is dull, but perseve- ring, much exercise is required to assist digestion and to turn the circulating fluids to the skin. From the torpor of the bowels, to which persons of this temperament are peculiarly liable, they will demand the occasional use of purgatives of the alcetic kind ; their occupations and amusements should be varied and interesting to the mind. The phlegmatic temper- ament is pale in complexion, languid in its exertions ; the vessels, if full, are torpid, the constitution inactive; the mind not easily excited to exertion. The diet in this tem- perament, requires to be nutritive and somewhat stimulating, though it ought not to go the length of what would be called high living. The health of females has some peculiarities arising from the delicacy of their frame, the monthly discharge, the state of pregnancy, and of nursing. All these circumstances con- £C How to Preserve Health. etitute a condition very different from the robust and vigor- ous strength of man in the prime of life; yet equally perfect, relatively to the sex and the individual. The irritability of infants, and the nimble tricks of boyhood, are consistent with good health, though they would be unsuitable at a more ad- vanced period of life. Health varies in people of different occupations. The acute- ness of the senses which is necessary in some employment^ would be morbid in persons otherwise engaged. But some have various diseases or predispositions to disease, either ('e- rived from parents or acquired in the progress of life, which render health with them only a comparative term. The s<:;<»f. ulous can hardly be said in strictness ever to be in perfect health; but their disease may be dormant or undeveloped; and, in favorable circumstances, may permit the subject of it to enjoy an exemption from pain and inconvenience, D the end of a long life. Gouty and rheumatic patients ma;* also enjoy good health during the intervals of their attacks A IB. Atmospheric air, or that by which we are usually surround, ed, is not a simple, but a'compound body, consisting o:' at least fmir distinct substances, viz : oxygen, azote, carbonic acid, and aijiuous, or watery vapor. The two former substances, however, constitute glmost the whole of the atmospheric air near the surface of :he earth ; the other two are variable in their proportions ; the first ex- ists only in minute quantities, which it is difficu't to appre. ciate. Vital air, or oxygen, which constitutes about one-fourth of the atmosphere, is necessary to respiration and combustion, and an animal immersed in it will live much longer than in the same quantity of common air. The remaining three- fourths, called azote, or mephitic air, is totally incapable of supporting life or combustion for an instant. The oxygen which is received into the lungs of animals from the atmosphere, communicates the red color to the blood, and is the principal agent which imparts heat and activity to the system. When animals die tor want of oxy pen in the air, their blood is always found black. Independ- ently of its destruction by tl e respiration oi men and othei animals, there is a constant consumption of the oxygenous Eortion of atmospheric air, by the burning of combustible odies; by the fermentation and putrefaction of vegetable substances, etc. A diminished proportion, therefore, of the oxygen of our atmosphere, and an increased amount <>f carbonic arid and other deleterious gases, is undoubtedly produced from the Innumerable processes of combustion, putrefaction, and res- piration of men and animals, particularly in populous cities, the atmosphere of which is almost constantly prejudicial to health. In the open country there are few causes to contaminate the atmosphere, and the vegetable productions continually tend to make it more pure. The winds which agitate the atmosphere, and constantly occasion its change of place, waft the pure country air to the inhabitants of the cities, and dis- sipate that from which the oxygen has been in a great meas- ure extracted. The air of any place where a oumerous body of people is assembled together, especially if to the In i of the crowd there be added the vapor of a great number of candles, lamps, or gas-lights, is rendered extremely prejudi- cial, as these circumstances occasion a great consumption of oxygen. The tact is well known, that when air has been long con- fined and stagnated in mines, wells, and cellars, it becomes so extremely poisonous as to prove immediately fatal to those who imprudently attempt to enter such places. No person should descend into a well or cellar, which has been long closed without first letting down a lighted candle; if it burns clear there is no danger, but if it cease to burn, we may be sure that no one can enter without the utmost danger of immediate suffocation. It sometimes happens also, that when air is suffered to stagnate in rooms, hospitals, jails, ships, &a, it partakes of the same unwholesome or pernicious quality, and is a source of disease. It is obvious, therefore, that in all confined or crowded places, the correcting of vitiated air, by means of cleanliness and frequent ventilation, is of the highest importance to health, and the most effectual preser- vative from disease. No accumulation, therefore, of filth about our houses, clothes, or in the public streets,, should on any pretence be suffered to continue, especially during the heat of summer. It is a very injurious custom for a number of persons to occupy or sleep in a small apartment, and if it be very close, and a fire be kept in it, the danger is increased. The vapor of cha rcoal, when burnt in a close apartment, produces the most dangerous effects. Our houses, which are made close and almost air-tight, should be ventilated daily, by admitting a free circulation of air to pass through opposite windows ' 28 Air. and ©or beds ought to be frequently exposed to the influent of the open air also. Houses situated in low marshy situations, or near lakes cw ponds of Btagnant water, are constantly exposed to the infln. ence of damp and noxious exhalations. Anions: the most powerful means furnished by nature fos correcting air which has become unfit for breathing, is the growth and vegetation of plants. Animal bodies consuma oxygen, and give off carbonic acid; plants and vegetables consume carbonic acid, and give off oxygen. The generality of plants possess the property of correcting the most corrupt air within a few hours, when they are exposed to the light, of the sun ; during the night or in the shade, however, they destroy the purity of the air, which renders it a dangerous practice to allow plants to vegetate in apartments occupied for sleeping. Mae8HES. — The neighborhood of marshes is peculiarly un- wholesome, especially towards the decline of summer and during autumn, and more particularly after sunset. The ai? of marshy districts is loaded with an excess of dampness, and with the various gases given out during the putrefaction of the vegetable matters contained in the waters of the marsh. Per- sons exposed to this air are liable to various diseases, but espe- cially ague, bilious fevers, diarrhoeas, and dysenteries. They who breathe it habitually exhibit a pallid countenance, a bloated appearance of the abdomen and limbs, and are affected with loss of appetite and indigestion. Health is best pre- served in marshy districts by a regular and temperate life — exercise in the open air during the middle of the day, and by retiring as soon as the sun sets, within the house, and closing all the doors and windows except enough for ventilation. The sleeping apartment should be in the upper story, and rendered perfectly dry by a fire, lit a few hours before going to bed, and then extinguished. Exposure to the open air should, if possible, not take place in the morning before the 6un has had time to dispel the fog, which, at its rising, covers the surface of the marsh. Persons who are intemperate, or use ardent spirits habitually, are those most liable to suffer from the unwholesome air of marshes; such generally perish from diseases of the liver and dropsy. Night Air. — Many diseases are brought on by imprudent exposure of the body to the night air; and this, at all seasons, in every climate, and variety of temperature. The causes of this bad property of the night air, it is not. difficult to assign The heat is almost universally several degrees lower than ii Air. 2f. :he daytime; the air deposits dew and other moisture; the pores of the skin are open, from t lie exercise and fatigues of the day; the evening feverishness leaves the body in some degree debilitated and susceptible of external impressions; and from all these concurrent causes are produced the various effects of cold acting as a check to perspiration ; such as catarrhs, sore throats, coughs, consumptions, rheumatisms, asthmas, fevers, and dysenteries* In warm climates, the night air and dews, witli their tainted impregnations, act with much malignancy. In civilized life, and in crowded towns, how many fall victims to their own imprudence, in exposing them- selves to the cold, the damp, and the frostiness of the night air! Issuing from warm apartments with blazing fir from crowded churches, theatres, or ball-rooms, with exhausted strength, profuse perspiration, thin dresses, and much of the person uncovered, how many arc attacked with a benumbing cold and universal shivering, which prove the forerunners 01 dangerous inflammations of the brain, of the lungs, or of the bowels, which either cut them oft' in a few days, or lav the foundation of consumption or other lingering illness. Never 6tand to talk, even for a moment, in the open air, alter coming out of a heated or crowded room, or after active exercise. Such being the dangers of exposure to the night air, it ought to be inculcated on all, both young and old, to gnard against them, by avoiding all rash and hasty changes of place and tem- perature, by hardening the frame b} T due exercise and walking in the open air in the daytime ; and on occasions where the night air must be braved, taking care to be sufficiently clothed; and to avoid drawing in the cold air too strong or hastily with the mouth open. Always breathe through the nostrils for a short time after going out of a warm room into the cold air, keeping the mouth shut. Sea Air. — The air upon the sea and in its neighborhood is generally distinguished by its greater coldness, purity, and sharpness ; and is therefore in many cases directed to patients whose complaints do not affect their respiration, and who have vigor of constitution enough to derive benefit from the stimu- lus which such air occasions. A residence by the seaside is beneficial to persons of a scrofulous habit and debilitated con stitution, provided they take care not to expose themselves to cold and damp ; and in the fine season, when there is no reason against it, they ought to bathe. In complaints of the chest, the use of sea-bathing, and a residence near the sea, are more questionable ; and by such an inland rural situation, in a mild equable climate, is to be preferred. A sea voyage hag 30 Azr. Inner been famous for its good effects at the com men cement ot consumptive complaints; and these good effects may be as scribed partly to the good air at sea, partly to the affection of the stomach and skin induced by sea-sickness, and to the ex sitement of the mind, caused by change of scene and occupa- tions. \ kntilatjox. — The air, as we have already remarked, can not become stagnant or unchanged for even a short period without its becoming unfit for breathing, and destructive to the heiltli of those who breathe it. The streets of a city should therefore, be so laid cut as tc insure a constant and free circulation of air; hence the unwholesomeness of a resi- dence in narrow alleys, courts and passages. Not less impor- tant is the continued renewal of the air of our apartments — the ventilation of which, however, should be so conducted aa to prevent a current of air from blowing directly upon the persons within them. Our bed-chambers, in particular, should be freely ventilated during the day ; and even ;it night, when the windows are closed, the chimney should be left open, or, if the room is small, and the weather sultry, a door, opening into another room, or a window partly open, or the sash pulled down to admit fresh air. No consideration of economy should prevent the most constant attention being paid to proper ven- tilation, so essential is the latter to health and comfort. Cellars. — It is important that cellars shoiud be perfectly dry, kept strictly clean and freely ventilated. The damp and foul air so frequently generated in cellars, where dryness, cleanliness, and ventilation are not properly attended to, is often the cause of disease, not only in the persons who inhabit the house to which the cellar is attached, but in others resid- ing in the immediate neighborhood. No house can be con- sidered a healthy residence, in the cellar of which water is allowed to stagnate: this may easily be obviated, in most situ- ations, by a sink dug to gravel. The air of cellars can bfl preserved sufficiently dry and wholesome by free ventilation, the removal of all filth and corruptible materials, and fre- quently white-washing the w T alls. Cellars, especially when entirely under ground, are improper places of residence; ap- propriating them as places of residence for the poor, or as workshops, should be prohibited by law. Climate. — Climate is considered by physicians, not with reference to geographical situation, but to the state of region! as to the warmth and steadiness of their temperature, or the dryness or moisture of their atmosphere. The interior of con tiuents and islands is generally mountainous, and, in conso Clothing. SI qnenee, cold. From the bracing qualities of the prevailing winds, the inhabitants are robust, and disposed to tnflamnia toory diseases : invalids, or persons coming from warm climates, should, therefore, prepare themselves gradually for mountain ous regions, by not coming abruptly into those colder parts. CLOTHING. Clothing possesses no warmth in itself, but merely prevents the heat of the body from being carried off by the air, and other surrounding bodies, taster than it jan be supplied by the blood. The essential requisites for clothing are, that it be Boft and pliable, so as not to obstruct the free and easy motion of the joints, or occasion inconvenience by its weight or tight- ness ; that it be adequate to protect the body from the external influence of the atmosphere, and preserve it in that degree of temperature which is most agreeable, as well as best adapted to the exercise of its different healthy functions and motions; and that it does not produce any detrimental effects, occasion any unnecessary degree of perspiration, or absorb the vapors of the atmosphere. Clothes of a light color, have the least attraction for heat; those of a black, the greatest; the tirst mentioned are, therefore, most proper in hot, the last in cold weather. But besides these general properties of commodious and comfortable clothing,' it should be suited in quantity and ma- terial to the climate, the season of the year, the period of life, the constitution, and the habits and mode of living. Thus, a person who is engaged in a sedentary employment, will always require warmer clothing than one who is actively engaged in manual, or other labor demanding considerable muscular ex- ertion ; and the latter will always require an addition of clothing, the moment he has ceased from his active labors, to what is proper whilst engaged in them. Neither do young persons, or those in the prime of life, and in robust health, require clothing in the day, or covering in the night, of so warm a nature as persons advanced in years ; because the per- formance of their functions is more equal and vigorous, and of course, the generation of heat in the body is quicker, and of greater extent, than is the case in old age. One of the safest rules in the regulation of dress, is to adjust it to the vicissitudes or fluctuations of the season ; and this rule should be carefully attended to by the invalid, the delicate, the infirm, and the old. The winter clothing should not be left off too earl} ir. the spring, nor the summer clothing worn too late in the autumn. Neither should this rule be disregard 32 Clothing. ed by the young, and those in the enjoyment of perfect health The grand rule is, so to regulate the clothing, that, when ex posed to the external air, the difference of temperature experienced, shall not be such as to produce any unpleasant impression, whatever may be the inclemency of the weather, when we go abroad. Thinner clothing are necessary within doors than without, and a greater warmth of clothing after night, and during cold, damp weather, than during the day, and when the air is perfectly dry. Persons of delicate and irritable constitutions, whose powers of life are feeble, and whose circulation is languid and irregu- lar, are very apt to suffer severely by a very slight diminution of the temperature of their skin. This is also the case with invalids. All such persons, therefore, ought rather to exceed, than be deficient in the quantity and warmth of their clothing. But while clothing should not be too light, or too small iu amount, neither should it be too heavy, or too much in quan- tity. The effects are equally mischievous. By over-clothing, too much perspiration is drawn out of the body, by which the frame is greatly weakened, and coldness and numbness of the extremities are occasioned. Tight clothes are invariably detrimental to the health, com- fort, and symmetry of the body. By the pressure they make upon the muscles, and the impediment they offer to their free exercise, they produce in them an emaciation and debility which prevent them from supporting properly the natural and graceful position of the body, or effecting its active movements with sufficient vigor. They prevent also, the free circulation of the blood, and cause it to accumulate in the veins of the head, lungs, or abdomen. When the pressure of the clothes, or any part of them, is around the neck, it is apt to produce head- ache, discoloration of the face, giddiness, and apoplexy, or other diseases of the brain ; when upon the chest and waist, it prevents the full development of the lungs, impedes breathing, and interferes with the proper action of the heart, in conse- quence of which, the health of the whole system suffers ; when around the abdomen, the stomach, liver, and bowels are affect- ed, and indigestion is produced, or the nutrition of the whole body is rendered imperfect. The clothes, therefore, should be perfectly loose, leaving to every part the fullest liberty, and to all their natural and unconstrained motions. Avoid muffling up the neck, head, ears, n, pro- duced by tight lacing. Bnch casing and confining are deadly foes to health and life, as everything is which prevents perfi ci freedom of action to the vital organs. Tie- ribs, perhaps, may be more easily changed than any of the other hones of tin- body. 1 it very structure is such that the constant pressure or tightness of clothing, day after day. needs to be but slight to bend the ribs downward or inward. During childhood, the bones are soft and pliable, and readily accommodate themselves to any position which is habitual. Tight-fitting dresses on a young lady from the ape of fourteen to twenty, are the only appliances needed to make her sadly deformed in chest for the remainder of her life, which cannot be of long duration in consequence. It is well known that a loose and easy dress contributes much to give the sex the fine proportions of body that are observable in the Grecian statues, and which serve as models to modern artists, Nature being too much disfigured among us to afford such models now. The Greek women were ignorant of the ar after long fasting. Nothing can be more injudicious than to sit down to a sub- Btantial dinner or supper, immediately after a fatiguing walk, ride, or other violent exertion. Every man should rest lor some time after exercise, before he Bits down to eat. In taking exercise, the dress should be free and easy, par- ticularly aboui the neck and joints. In violent exercise.-, a flannel waistcoat ought to be worn cext the skin, to obviate the possibility of injury from a sud- den chilling of the surface of the body. It will alwavs ne found very refreshing, after fatiguing exer- cise, to wash the feet in tepid water, before going to bed. Serious thinking, when we are walking or taking other exercise, soon fatigues ns; hut it' we give ourselves up to amusing thoughts, or the conversation of agreeable and intel- ligent friends, the good effects resulting from exercise are increased. It is very desirable to have a certain object or spol by which the exertion i.- to he bounded. Exercise undertaken merely as a task, or without being connected with some pur- pose by which the mind is asfreeably occupied and excited, is seldom productive of much advantage. Walking. — There is no exercise so natural to us, or in every respect so conducive to health, as walking. It is the most perfect kind of exercise in which the human body can be employed ; lor by it every limb is pur in motion, and the cir- culation of the blood i^ effectually carried on, throughout the minutest veins and arteries of the system. A\ alking is of two kinds, cither on plain ground or where there are ascents. The latter is in every respect greatly pre- ferable. "Walking against a high wind is very severe exer- cise, and not to be recommended. As, from various circumstances, persons residing in large towns, and engaged in sedentary occupations, cannot take all that exercise abroad, which is necessary for their health, they oug'rt, at least as much as possible, to accustom themselves to walk about, even in their own houses, instead of sitting con- stantly at a desk or table. The following rules are recommended to the attention of those who make use of this excellent species of exercise : The most proper walk, for health, is in a pure and dry air, and in rather an elevated, situation, avoiding marshy and damp places. iO Exercise. In the summer season, the -walk should be taken morning and evening, but by no means during the middle of the day, unless thi' person be guarded from the oppressive heat of the sun. In winter, the best period of the day for walking is usually after breakfast, or from ten to one o'clock. ]r is advisable, occasionally, to change the direction of the walk. We ought to accustom ourselves to a very steady and regular, but not to a very quick pace ; in setting out. it should be rather Blower than what we afterwards indulge in. An agreeable companion during a walk contributes much to serenity of mind ; but unless the manner of walking of both is similar, as well as the taste and character congenial, it & I tl r to walk alone. To read dining a walk is highly detrimental to the eyes, arid destroys almost all the good effects that can be derived from the exercise. Swimming. — For the young, the robust, and healthy, swim- ming is an excellent recreation. It combines all the advan- to be derived from bathing, with active exercise of nearly every part of the body. Swimming, however, as well from the powerful and constant exertion it demands, and the coldness of the water in which the body is immersed, is im« proper for the debilitated, or those exhausted at the time from fatigue. Hiding. — Next to walking, riding on horseback is the most salutary and useful species of exercise, especially for invalids. Persons laboring under ill health, whether occasioned by too long continued sedentary habits, or from defective diges- tion, as well as those predisposed to consumption, will expe- rience from the exercise of riding the most decided advantage. In riding to preserve health, eight or ten miles a day are sufficient to answer all the purposes; but, in riding to restore health, these little excursions will avail nothing. To attain the latter object, the mind, as well as the body, must be roused from its languor. Upon this account, long journeys are recommended to such people, in order, by the variety or Dovelt\ nf the scenes through which the invalid passes, to awok< >i divert the mind. Many have, by these means been rised into health. Royn ..— Rowing a boat, to those who are not daily accus- tome I to the task, may he ranked among the most active ixercise. To the robust and those in perfect health tnis , \v\mn not carried to the extent of producing very <•■ -able fatigue, is one admirably calculated to im- Appetite. i 1 part atr eng th to the arms, and breadth and development to the chest, when, however, it is too frequently repeated, to the neglect of other species of exercise, it is very apt to produce a partial and ungraceful expansion of the frame. Friction. — Friction of the skin, in conjunction with regular bathing, forms a very important means of preserving ana im- proving the health of the body. It removes thoroughly from the surface every species of impurity which may accidentally adhere to it, and promotes the freedom of the blood's circula- tion in the minute vessels of the skin. It promotes the growth and development of the muscles — invigorates the dim-stive organs, and imparts a comfortable glow and an increased energy to the whole system, by which it is rendered less liable, during cold and changeable weather, to become affected with disease. Though useful to all, frictions are peculiarly adapted to in- crease the health and vigor of persons of debilitated habits, who lead a sedentary life, are subject to dyspepsia, gout, and rheumatism, or who are particularly liable to be affected by cold by slight variations of the weather. Their whole bodies, more particularly their limbs and the front part of the body, should be rubbed for a few minutes, morning and evening, with a flesh-brush or coarse towel, until the surface begin.- to grow red, and assumes an agreeable glow. In many cases, sponging the body with cool or tepid water, will be found to increase the good effects to be derived from the practice. It is preferable to the too-often repeated and much abused plung- ing into' a bath-tub, which is practised to a great extent at present, in cities especially. Frictions are highly useful in the case of delicate females ; and in children they promote their growth and activity, and prevent many of the diseases to which they are liable. The best time for using friction is in the morning, when the stomach is not distended with food. They who are subject to wakefulness and disturbed sleep will And, in addition to a properly regulated diet and active exercise in' the open air, that sponging the body with tepid water, followed by brisk frictions of the surface, will more effectually induce quiet re- pose than any other means. APPETITE. There are three kinds of appetite : 1st. The natural or healthy appetite, which is stimulated and satisfied with the most simple food ; 2d. The artificial appetite, or that excited by condimeuts, liquors, pickles, high-seasoned dishes, variety 42 Appetite. of food, wine, etc., and which remains only so long as th« operation of these stimulants continues: 3d. The appetite of habit, or that by which persons enjoying no inconsiderable health, accustom themselves to take food at stated hours, but frequently without relishing it. The true and healthy appe- tite alone can ascertain the quantity of food proper for the 'ndividual. If we were seldom to trespass the due limits of emperaneo, our natural appetite would be able accurately to determine how much food we may consume with satisfaction and benefit, but the age we live in is one of intemperance in eating as well as everything else. If, after a meal, we feel ourselves refreshed, and as cheerful as before it, or more so, we may be assured that we have taken no more than a proper quantity of food ; for, if the right measure be exceeded, tor- por, heaviness, and relaxation, are the necessary consequences ; our digestion will be impaired, and a variety of complaints gradually induced. Hunger. — As a general rule, the sensation of hunger should as seldom as possible be allowed to occur; for, although the old proverb, " hunger is the best sauce for our food," is true, if the term hunger be used merely to signify keenness of ap~ the / yet, the moment it becomes a painful sensation, stomach and other organs suffer, and the energies of the sys- tem are, to a certain extent, prostrated. Abstinence. — Abstinence from food, for a limited period, is often, during health, of very great importance ; it is one of the most powerful means of obviating the effects of any accidental excess, of warding off an impending attack of disease, and of removing those disorders of the stomach, incident upon the introduction into it of food of an improper kind. Occasional abstinence from food, by omitting a meal or two, or substitut- ing for an animal diet, a bowl of gruel, or a slice of bread and tea, restores the force of the digestive organs, by diminishing their action, and giving them rest, and time to resume then healthful energies; while, at the same time, when the system is rapidly verging into disease, or the vessels are overloaded with blood, it removes from the first a stimulus which might increase its deviation from health, and upon the second, it acts as an evacuant, by allowing the secretions time to t'oinre from them their excessive amount of fluids. The studious, as well as they who lead sedentary lives, are especially uenelited >J occasional abstinence; as such persons, from the wan >t* suf- ficient exercise, are generally the severest sufferers from diseases of repletion, and from a disordered state of the diges- tive organs. A]>j>chU. 43 Food. — Excess of food, even of the lightest aud most whole some kind, interrupts digestion, oppresses and irritates the Btomach, produces a feverish heat of the surface, load r esse is witu an excess of blood, and when snflSi not taken, riders the body nnwieldy, by the accumulation oi fit beneath the skin, and around the internal organs. Partak- ing of a great variety of food atone meal, is injurious; it causes more to oe eaten than is proper, and impedes the digestive powers of the stomach. ' "With respect to the solid <>r fluid nature of our t.><»d, a certain degree of solidity assists its digestibility ; soups, jellies, gravies, and the like, are more readily digested, when bread or other solid substance is added to them, than when they are eaten alone. A sufficient bulk of food in the stomach, to give it a gentle stimulus and dis- tension, is absolutely necessary for healthy digestion: it is on this account, that all condensed articles which contain much nutriment in a very small space, are unwholesome, [n regard to the concentration of food, very erroneous and injurious opinions generally prevail. It is supposed, by most pert that by extracting the nutritious principle or principles of any given article of food, they are able, with greater certainty and effect, to nourish the body of the sick and delicate; thus, we continually hear of strong beef-tea, pure arrow-root jelly, and the like, beiug prepared with great care for such persons. But many of our readers will be much surprised to hear, that dogs and other animals, fed on the strongest beet-tea, orpure jelly alone, rapidly emaciate, and die within a short period, and that precisely tlje same consequences would ensue, were the strongest man confined to the same food. A certain bulk, therefore, of food taken into the stomach, is essential to nutri- tion ; and all attempts to combine too much nutriment in too small a mass, materially impairs the wholesomeness of our food. Vegetable Food. — Although vegetable food requires ft longer time to digest in the stomach than animal, and not- withstanding the latter presents a larger amount of nutritive matter in a smaller bulk than the former; yet the human sys- tem can derive from vegetable food as great a quantity of suitable nourishment as from animal, while the former pro- duces much less excitement and heat, and is far less liable to produce over-fullness of the blood-vessels, or to predispose the organs to disease. As a general rule, it will be found that they who make use of a diet, consisting chiefly of vegetable substances, properly cooked, such as rice, oatmeal, potatoes &c, have a manifest advantage in looks, strength and spirits 4A Appetite. over those who partake largely of animal food ; they are rc« markable tor the firm, healthy plumpness of their muscles, and the transparency of their skins. The diet of children, and young persons generally, should consist almost exclusively oi vegetables and milk. In summer, and in warm climates, a greater proportion of vegetable food is required than in winter and in cold climates. They who, with a sufficiency of daily exercise in the open air, to preserve the activity of the diges- tive organs, nevertheless spend ordinarily a life of case and comparative inaction, will find their health and comfort better promoted by a diet principally vegetable, than by animal food. Towards the decline of life, though, the amount of ani- mal food should be gradually increased. Animal Food. — Man is destined to live upon both animal and vegetable food, and a proper combination of both con stitutes the aliment which, generally speaking, is best adapted to his taste, and the one by which the health and vigor of hii system is under most circumstances best sustained. The nourishment communicated by both animal and vege- table food is much the same; but the animal product is tba most easily separated by the digestive organs, and is afforded in the greatest amount, The blood of the individual who par- takes largely of animal food, is richer than the blood of those fed principally upon a vegetable aliment. The first gives, likewise, a greater tendency to inflammatory affections than the latter. For those who are accustomed to active and la- borious employments, a greater amount of animal food will be E roper than for the sedentary and inactive. •Infants require jss animal food than children, children than adults, and wo- men than men. In summer, the quantity of animal food should always be diminished, whatever may be the habits or occupa- tions of the individual. In winter, and in the more northern climates, a more permanent and stimulating nourishment is required than under opposite circumstances: this is best afford- ed by animal l'ood. The different kinds of animal food differ in the degree of nourishment they afford, as well as in the ease with which they are digested. Thus, the flesh o( full- grown animals is much more digestible and nutritious than that of their young; and as it respects the larger animals, this rule is without exception. Beef and mutton, for example, are more easily digested:, and more wholesome than veal and lamb. The aex of animals, too, influences the nature of the food; the flesh of the female being more delicate than that of tha male. The mode of killing, too, gives a tenderness 10 the flesh. Hunted animals are more tender than those that are Appetite. 45 killed on the spot. The flesh of animals which are allowed to range freely in the open air, Is more wholesome and nutritious than of such as are stall-fed. In general, the flesh which Is dark colored, and which contains a large proportion of fibrin, is more digestible and nutritions than the whirr flesh of ani- mals. The black meat of fowls, so called, is more nourishing than the white meat, (the breast, &c.) Thus the flesh of do- mestic fowls is not so readily dissolved in the Btomach as that of the different kinds of game. By cooking, animal food is changed in its texture, being generally rendered softer, and easier of digestion; but by improper modes of cooking, a re- verse effect is produced, the food being rendered indigestible, unnutritious and unwholesome. Varieties of Animal and Vegetable Food. — Gelatine, or animal jelly, is highly nutritious; but in its separate or concentrated state, it is difficult of digestion ; hence, the im- propriety of the dyspeptic, and persons of weak stomachl generally, being fed upon strong soups, calve-' feet jelly, and similar articles of food. Calves' Feet Jelly. — Plain calves' feel jelly, or that which is sweetened, is grateful to the palate, very nutritious, and not very difficult of digestion; it is sometimes a useful article of diet for convalescents ; it may be taken cold, or dissolved in warm water, according to circumstances. It should, however, only be given occasionally, or in moderation ; for jelly, like all other concentrated food, is not so readily converted into blood, a/3 many other articles which contain a less amount of nutri- ment. The addition of wine and spices to the jelly, renders if, an improper article of diet under most circumstances. Albumen - . — The purest example of albumen is that presented by the white of the egg ; it nevertheless enters largely into the composition of many of the animal fluids and solids. As an article of food, it is at once readily converted into blood, it I eing taken up by the absorbent vessels, without its being re- quired to undergo digestion, while at the same time it is highly nutritious. The injurious effects resulting from the eating of hard boiled eggs, are occasioned in a great measure by the effects of the heat upon the oily matter of the yolk. Milk. — This is one of the most valuable presents which a bountiful providence has bestowed upon man. In many in- stances, either alone, or in combination with vegetables, it has formed the sole sustenance of life — maintaining fully the health and robustness of the system, without any of the disadvantage! which result from an excess of animal food on the one hand, or the diminished strength and vigor which have been sup- 40 Appetite. posed to be the effect of a purely vegetable diet, on the other. Incalculable would be the benefits which would result to the working and laboring classes of our country, were they t< tubstitntc this wholesome and nourishing food in their fami lies, for the expensive and unnutritious slops, which, under the name of tea or coffee, constitute the chief of their morning and e veiling meals : or, to substitute a tumbler of milk for the pernicious dram of ardent spirits, beer, porter, or ale. For children, milk with bread, or a simple preparation ot milk with rice, or with eggs and sugar, is perhaps the best and most wholesome food that can be devised: it should, at least, form the principal part of their nourishment for the first few years of their lite. Milk, to be perfectly wholesome, should be drawn from sound, young animals, supplied with a sufficiency of their na- tural food, and allowed free exercise in the open air. The best mode of using it. is, undoubtedly, in its raw state, and when it has stood about two hours after being drawn. Eggs. — Eggs contain a great deal of nourishment in a small bulk ; and when perfectly fresh, and soft boiled, they consti- tute a species of food of very easy digestion. When hard boiled, and especially when fried, they are indigestible and stimulating. Cheese. — All kinds of cheese are of difficult digestion ; and can with safety be made use of, only in very small quantities, as a condiment along with other food. The idea entertained by many, that a portion of old cheese taken with the desert aids digestion, is perfectly absurd. When cheese has advanc- ed very near to a state of putrefaction, though eaten by certain epicures, it is at once disgusting to the senses, and injurious to the stomach. Certain changes which cheese occasionally un- dergoes, impart to it poisonous properties. Roasted or cooked cheese, is very indigestible, and liable to occasion painful sen- sations in the stomach, headache, sour belchings, feverish heat of the skin, and disturbed sleep. When eaten, cheese should always be combined with a large portion of bread. Butter. — Butter is used as a sauce to many articles of food, and is frequently added to Hour to be baked into cakes and pastry, and it is in both these forms injurious, for though it dors not prodnce effects that are immediately apparent, it lays the foundation of stomach complaints of the greatest obsti- nacy. Its use in this form is also very apt to give rise to disease* of the skhi, very difficult to cure. Persons laboring under stomach complaints should not use much butter in any Api'ft)te. -i7 Tor;)!. It is also very nnwlvolesomc when lioatcd. It is a bad part of the management of children, to pamper their palat !9 hv frequently indulging them with butter; as il is apl to give rise to a gross and unhealthy habit of body, characterized by the frequent appearance of boils and other sores, discharges from behind the ears, Arc, or eruptions on the head, and other parts of the skin. Fat affords a rich nutriment, requiring, however, strong powers of digestion, and adapted only t<> the healthy and la- borious; it is more wholesome, however, when eaten with a proper quantity of lean, or with a considerable addition of farinaceous aliment in the form of potatoes, bread, rice, &C, etc. Beef. — Beef affords a strong, easily digested, and whole- some nourishment; it should be tender, fat, and well mixed, (lean and fat) and taken from a bullock of middle age. Of its different parts, tluzfat is less easily digested than the lean; the tongue and also the tripe, being ot a more dense texture than the other parts, are more indigestible. The best mode of preparing beef, is by roasting, or boiling. Beef-steaks appear to be the form, however, in which its nutritious quali- ties are best retained. The excessive body of fat which is accumulated upon what is called prise beef, adds nothing to its goodness, but on the contrary, renders it less wholesome and nutritious. Mutton". — Mutton is a highly nutritious and wholesome meat. It appears to be the most digestible of all animal food. The flesh of the male animal, however, has in general so strong and disagreeable a taste, and is, besides, so exceedingly coarse, and difficult of digestion, that it is only adapted to persons of strong digestive powers. Ewe-mutton, if it is more than be- tween three and four years old, is likewise tough and coarse. Wether-mutton, or the flesh of the castrated animal, is most esteemed, and is by far the sweetest and most digestible. Lamb being less heating, and less dense than mutton, is bet- ter suited to persons convalescent from acute diseases ; but by the majority of patients laboring under indigestion, or any other severe affection of the stomach, it is not found so diges- tible or proper a diet as wether-mutton. It is, however, to jr orsons in health, a light and wdiodesome food, especially when the lamb is not killed too young. A lamb that lias been al lowed to suck five or six months, is fatter and more muscular, and in every respect better, than one which has been killed when two months old, and before it has had time to attain its proper consistency. *3 Appetite. Venison — The flesh of the deer is reckoned a great delica cv ; it is nutritions, savory, and easy of digestion. V"eal. — The flesh of the calf, like that of all young animals, abounds in gelatinous matter; it is far less easy of digestion , Ji an the flesli of the ox, or beef. For persons in health, the most proper mode of cooking veal is by roasting or baking. Veal Broth produces a laxative effect upon the bowels, and is a very suitable food for persons troubled with costive- ness. Pork. — Good pork is unquestionably a very savory food, and affords strong nourishment, well suited, as an occasional diet, to persons who lead an active or laborious life ; but it is not easily digested, nor can it be considered so wholesome as beef or mutton. The too frequent and long continued use of this meat favors obesity or fatness, and is apt to disorder the stomach and bowels, and occasions pimrdes or boils upon the 6kin. Bacon. — It is a strong, very indigestible, and stimulating food, adapted only to persons of robust frame, and accustomed to laborious occupations. The best mode of cooking bacon is by boiling it with vegetables. When fried with eggs, it is decidedly unwholesome. Ham. — When properly cured, and when boiled, ham is a very palatable and wholesome food. It is, however, stimulat- ing and difficult of digestion, and only suited to such persons as are in full health and exercise much, in the open air. Fried ham is still more indigestible than that which is boiled. Sausages. — In whatever form they are eaten, sausages are an indigestible and unwholesome food, fitted only for the stomach of the most robust. When sausages have been long kept, particularly in a damp place, they are apt to undergo certain changes, in consequence of which they become poi- sonous. Poultry. — Poultry, in the common acceptation of the term, includes all the domesticated birds used as food, as the common fowl, turkey, duck, and goose. In point of digestibility they rank nearly in the order we have enumerated them. Chicken Soup. — Chicken soup, when properly prepared, if a light food, adapted to many invalids and to persons conva iescent from fevers. For their use it should be prepared iron, the fleshy or lean parts of the chicken, well boiled in water with a little salt, the scum and fat being taken off as it rises. Fisu. — Fish are less nutritious than the nesh of warm-blood ed animals, while to most stomachs they are more difficult of digestion. When used habitually, they are apt to induce dis> Appetite. 4'.» eases of the skin and disorders of the bowels. The fat offish is still more indigestible than that of other animals, and readily turns rancid on the stomach. When not in season, all kinds of fish everywhere, are very indigestible and unwhole- some. The beel mode of cooking ti>h is by boiling; stewed or fried ii si i are very indigestible. Salted and dried fish are a still more unwholesome food than such as are eaten fresh. Butter and the acid fruits form improper sauces for fish, caus- ing it almost always to oppress and irritate the stomach : nor should fish and milk ever he taken at the same meal; this com- bination has frequently occasioned severe bowel complaints. Salt-water fish are the best. Those fish which have scales are, in general, the most easily digested, and the best Salted Meat. — Salted meat is more difficult of digestion than that which is eaten fresh ; it is also less nutritious, both from the pickle in which it is immersed washing out, a- it Mere, a considerable amount of its nutritive parts, and fr<>m the chemical change which it always undergoes to a greater or less extent. When used as food, salted meat should always be well boiled, and eaten with a large quantity of vegeta- bles. Crabs and Lobsters, in whatever manner cooked, arc indi- gestible and decidedly unwholesome. The Mussel, a shell-fish often used as food, is highly indigestible and unwholesome. Oysters, when taken raw or after being slightly cooked by roasting, are a iglit, nutritious, and easily digested food. The hard white part, or eye, should always be rejected. "When thoroughly cooked, particularly when stewed or fried, oysters constitute, on the other hand, one of the most indigestible and pernicious articles of food in ordinary use. When out of sea- son, oysters are always unwholesome. The juice of the oyster, thickened with grated, biscuit and warmed, is sometimes an excellent diet for persons laboring under, great delicacy of stomach. Soups. — For the laboring classes generally, there is scarcely a more wholesome and economical article of diet than soup. We allude now to the ordinary domestic soups, prepared from beef, mutton, or veal, with the addition of various vegetables. In the preparation of soup, the meat and vegetables should be well boiled, and whatever seasoning is added to increase the flavor, care should be taken that it be not thereby rendered too stimulating. The combinations of flour and batter, which are sometimes met with in soups, under the denomination of fiimplings, are highly indigestible and improper. Soup should 50 Appetite. always be eaten with plenty of broad : tin's irises it that decree of consistency which, in all our food, appears to cause it tc be the most readily acted upon by the stomach. Many suppose that soups generally are calculated only for those whose powers of digestion are weak; but this is a mis- take, the reverse being generally the case. When the digestive powers are weak or deranged, it will almost always be found that solid food agrees the best, particularly solid animal food; this the stomach seems to digest with ease and in a very short •time; whereas, liquid food is apt, in such cases, unduly to dis- tend the stomach and to require a greater strength of digestive ■power. Rice. — When mixed with other food, it furnishes a whole- some article of diet. Rice is supposed to be in some degree astringent ; and in looseness of the bowels, the water iu which it has been boiled forms an excellent drink. By its mild mu- cilaginous properties, it aids greatly also in allaying irritation in all diseases of the bowels. Oats. — The meal obtained by grinding the grain of oata affords a wholesome and nutritious food, used, boiled with wa- ter, in the form of gruel, or made into thin cakes. Gruel. — By gruel is generally understood oat-meat or Indian meal boiled in water. Thin plain oat-meal gruel, or a gruel made in the same way from Indian meal, is a useful diet for convalescents from fevers, and for those who have committed an excess in eating. Rye affords a meal, the food prepared from which, though less nutritious than wheat, is nevertheless wholesome and suf- ficiently nourishing. Rye bread is more difficult, however, of digestion, and is apt to turn sour in the stomach and to irritate the bowels. Barley. — Barley forms an excellent article of nourishment when boiled in water, or made into cakes. Barley bread is not, however, a very pleasant nor wholesome food. Barley- watek. — The water in which barley is well boiled, forms one of our best drinks, in various fevers and other dis- eases. Maize, or Indian Corn. — The meal made by grinding Indian corn, prepared in various ways, but especially when made into mush, or with the addition of wheat Hour baked into bread, furnishes a most wholesome, nourishing, and pal- atable food, and one w r ell adapted for the support of the active and laborious generally. Indian bread, properly prepared, were it not from habit and fashion, would recommend itself tc every palate by its agreeable flavor, and the beauty of its ap Appetite. 51 pearance; it is far preferable to the ordinary bread mada from wheat alone. To make this bread, a mush should be made of the Indian meal in the usual way ; into this, when cold, with the addition of a very small quantity of warm water, and a little salt and yeast, is to be kneaded a sufficiency of wheat flour to make it into a paste; when sufficiently raised) it is to be again kneaded, and baked in the same manner as bread. Bread. — New bread is particularly unwholesome and indi- gestible. The only apparent exception is in the case of new rolls, which healthy stomachs manage to digest pretty well, provided they be well baked, and the crust beare a consider- able proportion to the whole. Bread slightly toasted, but not burned, is a wholesome diet, esprjiallv for persons upon whose stomachs most articles ot vegetable food, including bread in its ordinary state, are apt to turn sonr. In eating toast, the butter should nol be spread upon it until it is cold. Panado. — The crumb of wheaten bread softened with ins water. It forms an excellent diet for children ; for those affected with fevers, and for women during the first days alter delivery. Ginger-bread. — When w.ell baked, and eaten in modera- tion, it affords, under many circumstances, a useful stimulus to the stomach. It is an excellent article for individuals going to sea ; it being frequently, in cases of sea-sickness, retained on the stomach, when every other article is immediately rejected. Travelers, also, on setting out early in the morning, will iind, that eating a small portion ot* it, will afford a-grateiul stimulus to the stomach, when they have been obliged to commence their journey without breakfasting. Pastry, or dough mixed with butter, is used in a great variety of forms, and though grateful to the taste, is highly indigestible, and injurious to health. At dinner, in the shape of pies and tarts, pastry is thrown into the already loaded stomach, and the over-taxed powers of that organ arc unable to digest what is difficult to manage when they are the mo3t vigorous. To children, pastry is peculiarly unsuitable ; they who use it much, are subject to runnings from the ears, dis orders of the bowels, eruptions on the skin, and inflammatory complaints of various kinds. Puddings, when composed of flour, or crumbs of bread, combined with suet and dried fruit, are extremely indiges- tible, and constitute ^o of the most unwholesome dishee r o2 Cookery. served at meals. Puddings and dumplings made of batter, baked or boiled, are also indigestible, and unwholesome. Bread and milk pudding, as well as rice pudding, is readily digested, and may be eaten in moderation, without injury. Sago, boiled with water, or milk, furnishes an agreeable and nourishing jelly; it is easy of digestion, and excites the system but little ; and is an excellent article of diet for con- valescents and for children. Potatoes constitute an article of diet, which, whether we have reference to the nourishment it affords, the agreeablenesa of its flavor, its wholesome qualities, and the extent to which it is consumed, is certainly of the greatest importance to man. Potatoes are the lightest and most nutritious of those vege- tables which are served at table in their natural state ; and, next to bread, the very best accompaniment to every kind of animal food. The dry, mealy kinds are the best, and should always be preferred to those which are hard and waxy. The best manner of cooking the potato, is by boiling in two waters, or by roasting. Finely mashed, or fried potatoes, are indiges- tible and oppressive to the stomach. Cabbage affords but little nutriment, is very flatulent, and where the stomach is delicate or irritable, it is very apt to produce uneasy sensations, cholic, &c. Boiling in two waters deprives it, in a great degree, of that unpleasant taste and smell, which are so disagreeable to many palates. Soukcrout forms an excellent and wholesome vegetable food for the crews of ships destined for long voyages ; and for all persons so situated as to be deprived of a sufficient supply of fresh vegetables. In regard to its effects upon individuals, whose powers of digestion are impaired, the same remarks will apply as to cabbage in its recent state. COOKER T. When meat is boiled too long or too fast, if it contains much albumen, as in beef, we shall obtain a hard and indigestible mass, like an over-boiled egg ; or in young meats, such as veal, where there is more gelatine, the result will be a gelatinous substance, not easily digestible. Young and viscid food, therefore, as veal, chickens, &c, are more wholesome when roasted than when boiled, and are easier digested. Boiling is very properly applied to vegetables ; as it renders them mora soluble in the stomach, and deprives them of a quantity of ail and other particles which are pernicious to weak stomacha The quality of the water used in boiling requires some atten Cook*. /•//. 53 Hon; mutton boiled in hard water is more tender and juicy than when soft water is used, while hard water renders vege- tables harder and less digestible. Roasting.— By this process, the fibre of meats is mad.- crisp die fat melted, and the water evaporated. When underdone roasted meat may be more nourishing; but, from the close- qcss ot its texture, it will not be s.. easily digested. Meat loses more by roasting than by boiling; by boiling, mutton loses one-fifth, and beef one-fourth ; but by roasting, they lose one-third of their weight. Frying is, perhaps, the most objectionable of all the opera- tions of cookery. The heat is applied through the medium of boiling mi or fat, which i> rendered scorched, and therefore extremely Liable to disagree with the Btomach. Beoiling. — By this operation, the sudden browning <>r hard- ening of the burtace prevents the evaporation of the juices of the meat, and imparts a peculiar tenderness to it. Bui the over-excited health brought on by eating meats thus cooked, is peculiarly liable to become changed into disease from very slight causes. Baking. — Baked meats are not so easily digested, on account of the greater retention of their oils. Such dishes, accordingly, require the stimulus of various seasonings to increase the di- gestive powers of the stomach. As there is often much pastry, made with butter, used to confine the juices ot' the meats baked, such accompaniments render meat pies of all kinds of food the most difficult of digestion. Stkwing has a similar effect to boiling in depriving the meat of much of its nourishing juices ; but as the fluid in which the meat is stewed is made use of as food in connection with the latter, little nourishment is absolutely lost by this mode of cooking. Stewed meat is less easily digested than that which is boiled ; it is also more stimulating. Simple stewing is a mode of cookery well adapted for the food eaten by those of robust frames and laborious habits. Meals. — Regularity in the number of meals, and the periods at which they are taken, is of the first importance , on it much of the equable and pleasant enjoyment of health depends. In general, three meals, in the course of the day, seem the most desirable, and the best adapted to the wants and constitution of the human frame; while, at the same time, this number is best suited to the powers of the digestive organs. The practice which leaves the great bulk of the day without a meal, and then crowds two or three together, is manifestly bad, as it produces in the body a state of exhaustion and fa- 5± Cookery. tigue, which strongly tends to enfeeble the powers of digestion To confirm and preserve health, whatever maybe the numbei of meals Taken, they should be eaten at regular times and stat- ed periods. Six o'clock dinners, are only another way of lestroying health, and shortening life. The extremes of too Jong fasting, and too frequent repletion, should be carefully aTOided : for the langor of exhaustion and the fever cf reple- tion, are equally injurious to the healthy state of the stomach : its muscular fibres are debilitated by excess ; while a collapsed state o\' the organ occasions its loss of tone and energy, and Buperindnces constitutional weakness. And it should be re- membered, that one meal should be duly digested before the introduction of another into the stomach. Breakfast. — During sleep, the whole of the food taken the previous day has probably been digested; but, in general, it is proper to interpose some time between rising and taking breakfast, and take some light exercise. DmNEK. — The period for dining appears to be well chosen for the active classes of society more especially. Dinner should always consist of one kind of meat, plainly cooked. Variety of food, like too much seasoning, keeps up the appe- tite after the wants of the system are satisfied ; the stomach is oppressed by too great a quantity of food, and digestion is im- peded even to a greater extent than were the same amount to be eaten of a single dish. Let it be recollected, also, that dishes compounded of a number of ingredients, the natural qualities of which are completely disguised, by the refinements of cookery, are altogether unwholesome : many of them are little better than poisons. It is all-important that sufficient time should be allowed for this meal, in order that the food may be properly chewed, without which its digestion will be greatly retarded. If the food be sufficiently plain and juicy, thirst will seldom be experienced ; but when a desire to drink is experienced, a moderate draught of water will be proper. But no other liquor should be taken — water is the only natural diluent of our food, every other liquor impedes its digestion. The custom in use among some people of taking drums or bit- ters before meals, for the purpose of whetting the appetite, is highly pernicious, and has quite a contrary tendency to that designed, as it relaxes the stomach, and consequently enfeebles t for the operations it has to perform. Nor is the fashion of taking wine, or brandy and water, during dinner, less repre- hensible. The use of bottled cider, porter, or beverage, during this meal, is also injurious, as it unnecessarily distends the stomach, and thus prevents its muscular contractions, at the Cook. /■//. 55 rery time when it is necessary they should be brought into action, aiitl preserved in their full vigor. T<> Bay the leasl of all these vuigai errors in diet, they check the process of diges- tion, and paralyze the powers of the stomach. Supper. —As the powers of the body, and digestion amon« die rest, are diminished in their activity during sleep, it is an unsafe meaeure to load the stomach at bed-time with a quan- tity or various kinds of food. Do not eat meal for supper. Under no circumstance should food of any kind be taken for two or three hours before retiring to rest. Drinks. — In warm weather a much greater quantity of drink is demanded, than when the atmosphere is temperate or cold. This arises from the stimulating effects of heat npon t! e tent; but chiefly by the waste ot the fluid portion of the blood, occasioned by the increased perspiration. For the same rea Bons, active exercise or labor augments the thirst. Salted, high-seasoned, and all stimulating food increase the demand for drink, by stimulating ihe lining membrane of the mouth, throat, and digestive organs, and increasing the viscidity and exciting properties of the biood. Nature calls for water to take out the salt or other stimulating substances contained in the food, so that digestion may be more easily accom- plished. Persons in good health, generally, take a great portion of their drinks, especially at dinner, of the temperature of the atmosphere ; but in weaker stomachs, the drinks may be re- quired to be a little warmed, though it is seldom safe to take them habitually very hot j and far less is it proper to chill the energies of the stomach, by cold or iced drinks. The quantity of drink taken, is also of much consequence to good digestion ; a large volume of fluid will prevent the food from being pro- perly acted upon by the stomach ; and if there be too little, the mass will be dry and hard. Different kinds of food require different quantities of liquid : animal food requires more than vegetable ; roasted, more than boiled ; and baked meat, more still than roasted. . To drink much before a meal, is unwise ; but to drink more or less, during a meal, according to the na- ture of the food, assists digestion. Toast-water is perfectly wholesome, and agrees frequently with persons whose stomachs do not relish pure water. It has b slightly nutritive quality, and may be allowed m all the fe- verish and other cases, where cooling drinks are proper. Whey affords a bland, easily assimilated nourishment increasing the secretions, and tending to produce a beneficial change in the fluids of the body. It contains a considerable 56 Cookei'y. amount of sugar, which renders it sufficiently nutritious. As a drink, whey is well adapted to allay thirst in hot weather. Buttermilk contains but little nutritious matter / but, in warm weather, it forms an excellent cooling drink, and, with bread, may constitute a considerable part of the diet of children. Tea. — The properties of tea seem to be those of an astrin- gent and narcotic ; but like some other narcotics, in smaJ. quantity, its first effect is that of a very gentle stimulant, and certain kinds of it, when taken pretty strong, and near the usual time of going to rest, have the effect of keeping off sleep ; but when weak, and taken moderately, and tempered with cream and sugar, it acts merely as a grateful diluent, and produces a slight exhilaration. Tea and coffee, when used in moderation, are beneficial, by preventing the waste of the tissues of the body. Of course, where they disagree with the system, as we observe in some temperaments, they must be discontinued. The green and high-flavored teas are those which are the least wholesome. Tea should not be taken soon after dinner. The following rules, respecting the use of tea, will be found useful: — Carefully avoid the high-priced and high flavored teas, more especially if green. Take with it, at all times, a good proportion of milk, and some sugar, as correctives to any possible noxious qualities present. Make the infusion proper- ly, with water, soft, and otherwise of a good quality, and in a boiling state. Take less tea in the morning than in the eve- ning. Coffee. — The infusion of coffee acts as a stimulant upon the stomach, the heart and the nervous system, increasing the cir- culation of the blood, augmenting the heat of the skin, and exhilarating the mind; these, its immediate effects, are follow- ed, however, by an equal degree of depression in the functions of those several organs : the excitement and subsequent depres sion being in proportion always to the strength of the infusion, and the quantity drank. Coffee bears a strong analogy, in its effects upon the system, to wine, ardent spirits, and opium; from the latter, its effects, however, are very different in de- cree. Coffee, therefore, when drank very strong, or indulged in to excess, is unquestionably injurious ; it seldom fails to disorder the stomach, impair its digestive powers, and in del ioate habits it often occasions watchfulness, palpitation of the heart, head-ache, and many of those complaints, vaguely de« Dominated nervous. To the dyspeptic and sedentary especially it forms a very improper article of diet. When taken weak Cleanliness. 57 and with plenty of cream or milk and sugar, it may however be indulged in sparingly, by persons in health, and who lead aciivc lives, without much inconvenience. Coffee should never he taken late in the evening, in consequence of its ten- dency to prevent s.eep. CLEANLINESS. Personal cleanliness consists in the careful removal of <3vcv_.« impurity from the surface of the body, whether generated by itself, and attached to the clothing in immediate contact n th it, or contracted from the air and other matters with which the body is accidentally or constantly surrounded. Allowing impurities to accumulate upon the surface not only gives rise to a disgusting effluvia, by which the air the individual breathes is contaminated, but occasions various eruptive dis- eases of the skin, and the internal organs sympathize with it. Whatever suspends or impedes the functions of the surface, whether cold or filth, a derangement to a greater or less ex- tent of the internal organs invariably results. By the action of the numerous blood-vessels of the skin, there is removed from out the system, in the form of an insensible perspiration, an immense amount of matter, the retention of which would be productive of uncomfortable feelings or disease. The means of preserving the purity of the skin is frequent ablutions with water, with the addition occasionally of soap and frictions. The ablution of the body should be frequent and general, and not confined simply to the face, neck and hands. Washing the entire surface in water of a proper tempe- rature, and at short intervals, would sensibly increase the si rength, health, and pleasurable feelings of all, whatever may be t) leir sex, age, or condition in life. Frequent change of clothing is equally necessary. Domestic cleanliness is of scarcely less importance to the preservation of health than that of the per- son and clothing. Fiom every apartment of our dwellings, as well as from the yards, cellars, vaults, and outhouses attached to them, should every species of filth, every thing which by its decomposition is liable to contaminate the air, be immediately removed. We should prevent all accumulations of filth and stagnant yater in the streets, courts, and alleys of towns, drain marshes, and keep sinks, and privies well cleaned out, and frequently, jn warm weather more especially, dissolve one pound of sul- phate of iron, (common green vitriol or copperas,) in a pail of not water, and throw some down the sinks, privies, &c— 58 Cleanliness. Never leave slops, or any thing offensive, in sleeping apart ment8, but let them be removed at once, more especially in cases of sickness. Many families have been prostrated with various forme of fevers, dysentery, or other diseases, by the slops from the kitchen being thrown into the yard, and there decomposing, and generating poisonous gases. Unless their debility be very great, and unless it be productive of much pain and suffering to move them, the bed and body linen of the sick should be kept very clean, and fre- quently changed ; their apartment should be cleaned and wel 1 aired, and all offensive discharges should be very carefully and speedily removed. Soap. — In addition to the perspiration which is thrown out by the skin, a portion of which always remains upon the sur- face, the latter is constantly lubricated by an oily fluid. This oily exudation greases the linen when it is worn for too long a time — catches the dust floating in the air, and causes it to ad- here to the skin, and likewise retains in contact with our bodies, a portion of the dead matter, which it is the office oi the skin to discharge from the system. The removal of this deposit, which is constantly accumulating, is absolutely neces sary, as well for personal comfort as for the preservation oi health. It cannot be effectually removed without the occa- sional nse of soap, with which it combines without difficulty. Washing all over, with soap and water, occasionally, is very necessary. Mechanics, and they who, from any cause, are peculiarly liable to have deposited upon their skin, dust, dirt, or any foreign matters, should wash with soap and water often, and also rub afterwards well with a rough dry towel, as /'ell for the preservation of the skin as of their health general/. If you can only get a bowl of cold water, some .^ood soap and a rough towel, you can have all the advances to be derived from the most fashionable bath-tub — onlj being care- fa! to avoid getting cold, by thorough rubbing of the surface with a dry ' )wel, after the washing all over in soap and water. The ordinary brown and yeliow kinds of soap are altogether unfitted for cleansing the skin, as they irritate it, and when frequently used, tnosl generally cause it to become rough, chapped, or covered with painful and unsightly pimples. Most if not all, of the colored and variegated soaps, prepared express- ly for the toilet, are equally objectionable. IV/e w/'ite soap ought, therefore, to be; invariably used in ablutions of th* fact and hands, or of the surface generally. 59 A Curved, Hound-Shouldered, and Erect Spine. flow v iry distressing, and yet how common it is to see curved or deformed '., ines. flie habits of children, especially of girls, if not corrected in tiino, create a tearful frequency of this spinal detect. Nature has given to all, both tr.ale ana female, a sufficiency of hone and muscle to Bustain them in the most graOwtful and healthy position, and when these are correctly and faith- fully used, and their strength developed, they fulfil their intended purposes, anil keep .fie form erect. Look at the following illustrations of improper positions o> the body, and you will be able to tell the cause of these deformed epines. F>g. i. Fig. 2. Fig. 3. Old Style and New Style of Desks and Seats for ScJiools. Too many schools *re furnished with seats of the same uniform height. If they are high enough for the larger scholars, they are too high for the smaller children. (See fig. l.j In sitting, a child should find a support for the back, and rest for the entire ahigh-bones and feet, otherwise the bones of these, bein|» soft and growing, are ln»ble to become .distorted, or out of shape. Fig. 2 repre- eents a proper position, and fig. 3 an improper position, for sitting. Proper and Improper Positions to lie in Bed. Curvatures of the spine may be caused by too many pillows upon which tb l^d rests while in bed, as represented above. Young persons should lie ad lifiM-ly level as possible, with the head but slightly raised if at a'l. As they ad- vance in life, a more elevated position of the head may be desirable. Most peo- ple he upon the right side ; some lie upon the back, but this latter position is not favorable to those who are liable to nightmaie. A frequent change of posi- tion is very desirable. If you awake during the night, change your position. Sleep. 61 SLEET. It is highly important that every body should understand that sound, refreshing sleep is of the utmost consequence to the health of the body, and the vigor of the mind. Among the marks and symptoms of long, life, that of being naturally a regular and sound sleeper, is considered to be one of the surest indications. Great watchfulness, by accelerating the consumption of the fluids and solids, abridges life, and a proper quantity of repose must tend to its prolongation. Quantity of Sleep. — What number of hours are necessary to be passed in sleep, is a question that has occasioned much discussion. The opinion generally entertained by the ablest physicians, is, that from seven, to eight hours, in the four-and- twenty, constitute, generally speaking, the proper time, and that this period should scarcely ever dc exceeded by adults, in the enjoyment of health, though the delicate require more than the vigorous, women more than men, and very young children more than either; but it is worthy of particular re- mark, that the sick and weakly seldom require more than eight hours, or at the most, nine hours, and will rarely, if ever, fail to be injured by a longer indulgence. Proper time for Sleep. — Nature certainly intended exer- cise for the day, and rest for the night. Working at night and sleeping in the day time will, sooner or later, destroy the best constitution. Another point to be considered is, that by the custom of sitting up late at night, the eyes suffer severely, day-light being much more favorable to those delicate organs, than any artificial light whatsoever. The plan of. going to bed early, and rising betimes, has been called the golden rule for the preservation of health and the attainment of long life, and it is a maxim sanctioned by va- rious proverbial expressions. Indulging in sleep during the day-time, and more especially after dinner, is always productive of more or less injury to health, while it is never found to produce even that temporary feeling of refreshment which results from the same amount of repose taken at night. Best Means of Promoting Sleep. — The principa. circum- stances to be attended to, in order to procure refreshing sleep, are, the nature and quantity of our food and exercise ; the size and ventilation of the bed-chamber ; the quality of the bed and of its coverings ; and the state of the mind. It is certain that a full stomach almost invariably occasions restless nights, and it is, therefore, an important rule to make a very light supper. 62 Sleep. "With some persons, the most effectual methods of procuring sleep will fail, unless exercise be resorted to in the open air. Pure air has of itself an exhilarating and soothing effect on the mind, conducive to sound repose. It is an excellent plan when the exercise of the day has been limited, to walk up and down a large room or passage for half an hour, or more, before noing to bed. and the use of the dumb-bells for a part of the time will augment its good effects. If, notwithstanding an adherence to the preceding -nles, sleep is still found to be unsound and unref resiling, a brisk use of the tlesh-brush, before going to bed, or rising from the bed, and freely ventilating it, will often produce a very favor- able change. Another excellent practice, in case you have gone to bed, and cannot sleep, is to rise, shake the bed well, draw the up- per clothes down to the feet, and walk about the room, warmly clad, till both you and the bed are aired. Opiates and sleeping draughts should never be resorted to, to procure rest — once resorted to, their habitual use will become neces- sary, as *lecp will not occur without their aid ; while by their prejudicial influence upon the stomach and other organs, their employment will never fail, gradually, to undermine the health of the system. The following miscellaneous rules respecting sleep deserve to be recorded in this place : Many real or imaginary inva- lids lie long in bed in the morning, to make up for a deficiency of sleep in the night time ; but this ought not to bepermitted, for the body must necessarily be enervated by long continu- ance in a hot and foul air. By rising early, and going to bed in due time, their sleep will become sound and refreshing, which otherwise they cannot expect to be the case. It is an indispensable rule, that fat people should avoid soft beds, and should sleep little and rise early, this being the only chance they have of keeping their bulk within due bounds. Such Eersons as are subject to cold feet, ought to have their legs etter covered than the rest of the body, when they are in bed. We should never suffer ourselves to doze, or fall asleep, before we go to bed. Reading in bed at night is a most per- nicious custom ; it strains the eyes, prevents sleep, and injure? the health, Remember, sleep is sound, sweet, and refreshing according as the mind is free from uneasiness, and the diges- tive organs are easy, quiet and clear. Beds. — The use of feather beds is very common ir this country, especially in the rural districts, yet there can be no doubt that they are highly injurious to health. To the invalid, Sleep. 63 ami to young persons who arc disposed to distortion of the spine and shoulder, they are particularly hurtful. Such as consider them a necessary Luxury in the winter, should inva- riably exchange them for a mattress in the spring and summer. The injury resulting from feather beds is occasioned, princi- pally, by their accumulating too much heat about the body, and in this manner causing a profuse and debi !::iriuir per spiration, and predisposing the Bystem to the influem t slight changes 01 temperature. JBy yielding nnetmally to the pressure of the body, the latter is thrown into a di >rted position, whieh being resumed regularly almost every night, is Liable to cause in the young and weakly a permanent d< tormity. Corn husk or shuck mattresses are superior to every other kind of bed, and it is highly desirable they should be generally adopt- ed. By those whose means will not permit the purchase of hair mattressess, those of moss or straw will be found an excellent substitute. Feather beds are more injurious to the health of children, than even of adults, and especially if they are weakly. In very cold climates feather beds are often necessary, and the aged may often require them, in order to preserve or increase their heat, whieh is sometimes inconsiderable, and if lessened would prevent their sleeping. Young people and invalids, in particular, ought to avoid many, and heavy, bed-clothes. The use of curtains to the bed should he avoided : they are injurious, by preventing the proper circulation of the air breathed by those who occupy the bed, and by accumulating dust, cause it to be inhaled into and irritate the lungs. Beds and bed clothes are apt to become damp for want of proper airing when not constantly used. Colds, rheumatisms, and even more fajal complaints may be caused by occupying a damp bed. Beds, instead of being made up soon after the persons rise from them, should be turned down, or their cov- erings thrown separately over the backs of chairs, and thus ex- posed to the fresh air from the open windows during the day. Bed-Rooms. — xV bed-room ought not to be situated on the ground floor: an elevated apartment is particularly recom- mended. It should be airy, large, and lofty. The more airy a bed-room is, the better ; and it will be still better if it be also exposed to the influence of the sun. A bed-room ought to be well ventilated in the day time, as it is principally oc- cupied in the night, when all the doors and windows are shut. The windows should be kept open as much as the season will admit of, during the day. 64 The Passions. Keeping open the windows of bed-rooms during the night ought never, however, to be attempted, but with the greatest caution, except a small space for ventilation, by lowering the „op sash, when practicable, or raising the lower one slightly. Dc not sleep in a very warm room. Unless there is an apprehension of damp, a bedroom should rarely have a fire in it. They who live in hot countries ought to be very particular regarding the place they sleep in. The apartment should be roomy, dark, shaded from the rays of the sun and moon ; temperate as to heat and cold, and rathei inclined to coolness than heat; while a free admission of air ia allowed during the day time, the windows should be carefully closed as soon as the night sets in. Dreaming. — As a general rule, dreaming may be prevented by whatever causes perfect and uninterrupted sleep ; such aa sufficient exercise during the day, temperance in eating and drinking, a cheerful and contented mind, and the avoidance o( late or heavy supper, or of strong tea or coffee during tho evening. Many of the sudden deaths which take place during the night, in persons apparently in the full enjoyment of health, are to be attributed to night-mare. The nigld-mare is a certain uneasy feeling during sleep, as of great anxiety and difficulty of breathing, and of strong but ineffectual efforts to shake off some incumbent pressure, or to relieve one's-self from great inconvenience. ' It commonly arises from an imperfect and unhealthy digestion, from heavy suppers, and from a constrained uneasy posture of the body. Such persons as are subject to the night-mare should take no food whatever in the evening, should keep the bowels open, and should sleep upon a mattress with the head and shoulders raised. THE PASSIONS. Joy. — Instances are not wanting, in which this passion when unexpectedly excited and violent, has produced disease, cr even immediate death ; but when moderate, and existing only in the form of cheerfulness, it has a beneficial effect in preserving health, as well as in the cure of disease. Hope. — Of all the passions, hope is the mildest; and, though it operates without any visible commotion of the mind or of the body, it has a most powerful influence on the health of the one, and the serenity of the other: it contributes, indeed, so much to the welfare of both, that if it were extinguished, we could neither enjoy any pleasure in this life, nor any prospect of happiness in the life to come ; but by the beneficent will of L'rovidence, it is the last of the passions that forsakes us. The Passions. 65 Love ip «">ne of the strongest and most absorbing passions with which the mind is affected, and has al its commencement when happy, and properly guided by reason, a favorable influ ence on all the functions or the body; but being often in its progress attended with other passions, such as rear and.;'m/- ousy, it is liable to become the source of infinite disquietude, IS r o passion undermines the constitution so insidiously, as violent and unreasonable or misplaced love. While the whole Foul is occupied with the thoughts of a pleasing attachment both the mind and the body become languid from the contin- uance of vehement desire ; and should there arise any prospect, real or imaginary, of being frustrated in its gratification, the person is agitated with all the horrors and pernicious effects of despair. Love, when violent and unsuccessful, frequently produces a wasting of the body, terminating sooner or later in death. Fear — When intense or habitually indulged in, ir destroys the energies of both mind and body, retards the motion of the blood, obstructs digestion, and prevents the proper nutrition of the body. Violent terror has been known, in an instant, to turn the hair perfectly white, and in other instances, to produce loss of mind, or even instantaneous death. By weakening the energies of the system, this passion disposes greatly to disease during the prevalence of epidemics. Grief. — There is no passion more injurious to health than grief when it sinks deep into the mind. By enfeebling the whole nervous system, it depresses the motion of the heart, and retards the circulation of the blood ; it disorders the storaach and bowels, and ultimately every other organ of the body, producing indigestion, consumption, and other chronic diseases. Grief long continued, often gives a shock to the constitution that nothing can retrieve. Grief, like fear, predisposes to an attack of epidemical diseases. Anger is a passion suddenly excited, and which often no less suddenly subsides. The nerves are unduly excited ; the pulsation of the heart and arteries, and with theifl the motion of the blood, are sometimes so much increased, as to occasion the bursting of some of the minute vessels of the brain or lungs. The stomach, liver and bowels, are often violently affected by intense anger — digestion is always disordered, a violent colie is sometimes produced, and very often all the symptoms of jaundice. Thus it is often the immediate agent in the production of fevers, inflammations, spitting of blood, apoplexy, and other acute disorders. An essential means for their subjection, is a regular, active mode of life, a mild and moderate diet, and G6 Care of the Hair the abandonment of all intense excitements and stimulating drinks. Anxiety of Mind, when constantly indulged in, destroys the digestive powers of the stomach, impairs the functions ot the lungs, disturbs the regular circulation of the blood, and mpedes the nutrition of the system. It is a fruitful source ol •chronic affections of the stomach, liver, heart, lungs and brain Even the anxiety induced, in a sensitive mind, by the ill-liu •mor, caprice and unkind treatment of others, is deeply felt, and proves highly injurious to health. CARE OF THE HAIR. Whatever has a tendency to impede the passage of the fluids by whieh the hair is nourished, from the root along the cavity which exists in the centre of each hair, must necessarily pre- vent its proper growth — render it thin, and deprive it of its 6oft and glossy appearance. There can be little doubt that this is the effect, to a certain extent, of the practice of twisting the hair from its natural position, and of plaiting or firmly braiding it, pursued in obedience to the dictates of fashion, by most females. Whenever the hair becomes thin and irregular, or its beauty is otherwise impaired, nothing is better calculated to restore its proper growth than cutting it short. Frequently cutting the hair also prevents it from splitting at the ends. In children, keeping the hair short is a circumstance of no little importance. Nothing is more common than to see a luxuriant head of hair accompanied in children by paleness of complexion, weak eyes, and frequent complaints of headache. The hair of children should be cut short until they are eight or nine years old. There is good reason for believing, that children who have a great quantity of hair, are those most liable to eruptions, as scald head, &c. : it is at least certain, that in them eruptions are very difficult to remove. Mothers, whose vanity may be alarmed lest repeated cutting the hair for s# many years,, should make it coarse, may be as sn red they have no cause for this apprehension. When there is any tendency to sores or eruptions on the head of children, line combs are very apt to promote them The seldomer a line comb is applied to the head of an infant the better. However, the head should be well washed witl a good lather of soap and cold water (once a week), afterward washing the soap out with clean water, rubbing with a dr) towel, and then giving the hair a good brushing. Washing the hair "m cold water every day, is a great advantage to it Preservation of the Sight — Care of the Bowels. 67 PRESERVATION OF T IT E SIGHT. Die following are the general rules for preserving the sight unimpaired for the longest possible period. All sudden changes from darkness to light, and the contrary, liould he avoided as much as possible. Avoid looking attentively at minute objects, cither at dawn 11 twilight, and in dark places. Avoid Bitting near a dazzling or intense light, as of a lamp w candle, and facing a hot fire. Avoid reading or sewing much by an imperfect light, as well as by artificial lights of anv kind. Avoid all dazzling and glaring sunshine, especially when it is reflected from snow, white sand, or other light colored bodies. Avoid rubbing or fretting the eyes in any manner, and wip- ing them with cotton handkerchiefs. Avoid all spirituous and heating liquors, rich and highly seasoned food, mid ewry species of intemperance, all of which invariably injure the eye-s and impaii their sight- CARE OF TIIE B O W E L S . An evacuation once in the twenty-four hours is the best standard of frequency — this, in general, takes place whenever the digestive organs are in a state of health. Confinement to a diet composed chiefly of dry animal food, or of food highly seasoned — the use of fresh bread, and of warm rolls and cakes, very generally induce a costive state of the bowels. Costiveness is very common also in persons who use little exercise, or who pass the greater part of the day within doors in occupations of a sedentary character — females are much more subject to it than males. Lying in bed to a late hour in the morning is unfavorable to a regular condition of the bowels. Early riser's, who pass several hours of the morning walking abroad in the open air, seldom complain of any want of regu- larity in their stools. The daily use of wine, especially the red or astringent varieties, retards very materially the natural discharges from the bowels. The same effect takes place in persons who past ehs greater part of their time in company, and who from a ''alse delicacy resist the calls of nature. In costiveness, besides early rising, daily exercise of the bodj in the open air, and abstinence from wine and ardent spirits, the d.et should be composed principally of vegetable food Plain soups, especially of veal and mutton, with the addition 68 Feet. of the ordinary vegetables, well boiled and not to) highly sea soned. will be found a very excellent diet for those inclined, to COS ti ven ess. Fresh fruits, perfectly ripe, or fruit cooked, with or without the addition of sugar or molasses, are gently lax Btive. Spinach, when in season, and properly boiled, is also a very pleasant and wholesome vegetable for persons of costive habits. Bran bread, or wheaten bread with an admixture of rye or Indian meal, is better suited to the habitually costive than bread composed entirely of tine wheat flour. For drink, those troubled with costiveness should, make use of water, cither alone, or with the addition of a small quantity of sugar or molasses. A very pleasant drink is made by dissolving currant jelly in water, or by pouring boiling water upon sliced apples or peaches, and allowing it to stand until cold. This acts gently upon the bowels. Buttermilk, or sweet whey, may likewise be occasionally drank with advantage by those whose discharges are defective : all ardent spirits and wines, especi- ally those of an astringent nature, should be carefully avoided. The method recommended by the celebrated Locke, for pro- curing a regular discharge from the bowels, is founded on correct principles, and should not be neglected ; it is, " to solicit nature, by going regularly to stool every morning, whether one has a call or not." To remove costiveness, individuals should be extremely cautious in resorting to purgatives, or those medicines, under whatever name they may be sold, which have the effect of inducing evacuations from the bowels. The frequent use of these articles, however mild their operation may appear to be, tends to disturb the stomach and bowels ; and consequently to vitiate or retard digestion. T 11 E F KET . The feet are extremely subject to the impression of cold, and when chilled, in consequence of the close sympathy between theui-'iud other parts of the body, disease is apt to be occa- sioned in some one of the internal organs. They should be protected always from cold and damp, but when accidentally wet, the shoes and stockings should be immediately changed, and the feet bathed in cold water and rubbed perfectly dry with a coarse cloth. Tight and misshapen shoes are injurious, by preventing the circulation of the blood, causing coldness of the feet, and" producing corns. The feet are generally much neglected. They should be washed at least once every day, and rubbed well afterwards with a rough towel, or flesh brush, Tlun ehoea are killing thousands of females every year — away Physical Education and Diseases of Children. 69 with them at once. Females should wear thick, warm shoes, at all times during cold or damp weather. PHYSICAL EDUCATION AND DISEASE^ OF CHILDREN. General Symptoms of Disease. — It is often difficult in very poung children to determine the disease with which the little iuffeier is afflicted, — for as we can obtain no information from the patient relative to his feelings or the liistory of his maiady, we arc obliged to form an opinion from external symptoms alone. The symptom- of disease are nearly the same in child- hood as in maturer age. The sleep, motions, breathing, evacuations, pulse, appetite and mental manifestations, all afford important appearances. The countenance is in most cases an important index of disease ; when the expression is calm or lighted up by a smile, it indicates a state of ease and a regular performance of all the functions: frowning or con- traction of the features, pale. red. or blue tint of the face, rolling up of the eves, swelling of the upper lip, twitching of the muscles, dilatation or spreading of the nostrils, are all evi- dence of approaching or confirmed disease. The sleep, in a healthy infant is quiet and profound, and indicates a state of ease and comfort; but if there is sleeplessness, sudden starting during sleep, slight spasms, screaming, fright, or deep and laborious sleep, there is some disturbance of the brain or stom- ach and bowels. Crying is the natural language of infancy, and the only means by which very young infants express their wants and sufferings. Healthy infants cry but seldom, and then only to express some slight uneasiness or vexation : but violent parox- ysms of crying, (unless from anger,) plaintive moaning, short and suppressed, a hoarse or shrill cry, indicate disease. The breathing in health is full, easy and regular, — but it sometimes becomes slow, irregular, difficult, short, laboring, rattling, shrill "crowing" intermittent, or attended with rough, sneezing or hiccup in sickness. The tongue and mouth sometimes show important charac- teristics of disease: paleness or redness, brown or white fur, dryness, swelling, trembling, ulcers or cracks in the tongue are signs of disease. Unusual redness of the gums and throat, increased or diminished secretion of saliva, (spittle,) bitter taste or brown scum on the teeth, also point to diseased action in some part of the system. The skin, in health is soft, slightly moist and warm, and has a slight crimson tint of the blood 70 Management of Children but when it becomes harsh, dry, hot, shriveled, pale, cold, clammy, blue, red, or yellow, some disease exists. A cold profuse perspiration shows debility or other disease : many of the eruptions of the skin indicate disease of the digestive >rgans ; itching and tingling of the skin are signs of irritation from worms or other causes. The breath, if rancid, sour o r unpleasant, is the result of fever, indigestion or ulceration. The evacuations from the stomach, bowels and bladder, are ir most cases peculiarly characteristic, and are important symp- toms: frequent vomiting of curdlike, green, bilious, sour, bloody or black matter, is evidence of disease of the brain, Stomach, liver, kidneys or bowels. When the evacuation*; from the bowels are frequent, slimy, bloody, green, black, gray, or profuse and destitute of odor, or mixed with flakes af mucus or pieces of undigested food, or when great costiveneea is present, there is disorder of tho digestive organs. If the urine i Q white, red, of unpleasant odor, or deposits a brown or gray sediment, (or settlings.) is scanty, profuse, or passed with dimculty, there is morbid action of the kidneys or some other part. The development of the bones is often indicative of some disease : narrowness of the chest and very prominent breast bone, great length of body and limbs, large joints, curvature of the bones of the legs, briitleness of the bones, large head, weak joints, open seams, (sutures,) in the skull, and crooked back, all indicate a rickety, scrofulous or debilitated state of the system. The symptoms above enumerated are sufficient to enable the common observer to detect the existence of disease. MAN A GEMENT OF CHILDREN. Am. — A constant supply of pure air is indispensable to the health of every human being, from the first moment of exist- ence to the end of life. Tiiis is even more necessary for infants than for adults, on account of the rapidityof the cir- culation and breathing, and the weak and irritable state of the nervous system. Children confined in badly aired rooms, bee une pale, feeble, irritable and finally consumptive. The air in their sleeping rooms should not be too warm, as this causes oppressive breathing, too great perspiration, feverish cess and oppression of the head. Neither should it bo ten cold) for this cheeks the insensible perspiration which is con stantly going on during health. Very cold air also closes the pores on the mucus membrane <>f the nose, throat, windpips and lungs, and inflammation and fever ensue. Beware how vou attempt to "harden" your children by putting them to 71 Illustration* of Healthy and Unhealthy Fosittons of the Body, Correct Position. Incorrect Position. Seohow that round-shouldered youth is sitting with his Bhoulders against the back of the chair, and the lower portion of his spine several inohes from it, giving his body the shape of .a half-hoop. Parents should regard Buch a position in their children with apprehension as to the result, and should r< itify il at once. The other young gent has learned a thing or two worth knowing, as yon will see by his manly, dignified position in his chair. II.' may be President yet— who knows? Healthy Position. Unhealthy Position. An upright position, in either sitting or walking, favors a healthy action of all the various organs of the system, and besides it gives a graceful and dignified appearance to the human form. Children and adults are more or less inclined to lean forward with their heads upon their elbows, even when their seats are provided with backs ; such a position oft-repeated must in time result unfavor- ably. There is a very " don't care" kind of look about one of these young ladies; if she lives long enough, she icill eare. Improper Position. Propeb Position. ' Learn to sit up, young man, and to imitate your opposite neighbor ; for the unnatural position which you have assumed will never make you a good writer A. bold upright position, with the pen held loosely between the fingers, and determined purpose to imitate some definite copy as nearly as possible, is the only true road to success in the art of writing or good penmanship. This young- ster on the left looks as if he was ' ' bowing his back for a heavy burthen " — and BO he is ; if he don't quit it, he will have burthen enough. Management of Children 73 sleep La a very cold room; croup and inflammation of th6 iangs are often thus produced. Children should be carried or permitted to go into the open air often, and always with their faces bare unless the weather be inclement. The face should never be muffled or covered during sleep. The temperature of the nursery and Bleeping room should never exceed G5° or 70° ; older persona should not judge of this by their own feelings, as u decree of eo.j dangerous to an infant. Keep a thermometer, and go by that! Bathing. — The infant may be bathed every morning during the first two or three months, in tepid water, after which the bath maybe nearly or quite cold. The idea that the cold bath is best for all children, is erroneous, — it is equally wrong to suppose none but the warm bath is safe and beneficial. Some infants have not sufficient vitality and strength t<> bring about reaction so as to recover from the shock and regain their natural warmth, but become weak, chilly and sick, by the use of the cold bath. Those of a robust and fall habit if body on the contrary, by the use of the warm hath are affected by congestions of the stomach, lungs and brain, and suffer from indigestion, headache and convulsions. For pale, feeble and irritable children, the tepid bath is usually the best adapted: the temperature of this bath is from 80° to 90°. For those of active circulation, good digestive powers and robust health, the temperature may be 60°, — constituting the cold bath. Immediately after bathing, the surface of the body and limbs should be well dried and rubbed with a linen napkin, and the child dressed and allowed to exercise. The cold bath should not be used during profuse perspiration, during a chill, nor sooner than three hours after eating. If there is roughness or smarting «f the skin after bathing, it may be rubbed with a very little sweet oil, or a little starch powder. Children are easily bathed by a cloth, or soft sponge and basin of water. In bathing infants, the head should always be wet, but not wished with soap, as this fades the hair. Too frequent use of the cold bath produces eruptions on the skin, debility and disease of the heart. Clothing. — Every part of the person should be covered ex cept the head, face and hands. Bare arms and low-neck dresses may be very pretty to look at, but it is a dangerous practice; many times little children are thus sacrificed lo the whims of folly and fashion. The habit of putting caps on infants is useless and injurious/ 74 Management of Children. the habit of allowing tliem to go barefoot is vulgar and cruel; the practice of swaming or bandaging the bodies of children, is totally useless, and very pernicious to their health and com- fort. Soft, white woolen flannel should be worn next to the {-kin during winter and the colder part of spring and autumn. When the flannel is laid off, cotton may be substituted by degrees : this may be done also, at any time when woolen ppears to be too irritating, as sometimes happens. The night elothes should be light and perfectly loose : the whole dress should be fastened by means of buttons, hooks and eyes and tapes, to avoid wounds from pins. Sleep. — The sleep should be voluntary, and not forced or induced by medicines or rocking; neither should it be dis- turbed for the purpose of washing, nursing or dressing. Young children require a soft, warm couch in winter, but during warm weather they should lie upon beds tilled with straw, cotton, curled hair, moss or corn-husks. The pillow should be of the same material as the bed, to prevent the head becoming too much heated, and avoid taking cold, earache, catarrh and smithes. During the first three or four months it is better to allow the child to sleep with the mother, — after which it may sleep alone, (if the weather is warm,) in a cradle, cot or couch. The habit of rocking infants, if frequent or long continued, is injurious, — but if gentle and only occasionally during waking hours, it is both harmless and pleasing "to the child. The bed or cradle should be high and without curtains: that old fashioned contrivance called a "trundle bed," is a vile relic of barbarism, and deserves to be totally banished from civil- ized society. The position should be occasionally changed during sleep : this prevents too much pressure on any part, accumulation of heat, deformity of the head, and fatigue. The room in which the child sleeps should be partially dark- ened : during waking, it requires the stimulus of a mellnw light, this conduces both to its health and cheerfulness. The eves, however, should not be long exposed to the intense glar- ng light of tiie sun, lire or lamp. All perfumery, flowers, medicines or food, or anythihg exhaling a .stmng odor, should be excluded from sleeping apartments. Children ought never to sleep with old or sicl persons : neither should they be fondled or kissed by old, dis- eased or strange persons, for fear of incurring some disease .Young children should he protected against loud noises strong odors, and sudden frig/its. Children of more advanced age should retire early, and rise early in the morning. Exkkoise. — During the first few months of infancy, but Management of Children. 75 little exercise is required, — nor does the organization admit of more than a small amount of passive and gentle movement; The infant may be carried about in the arms within doors, — or when the weather is pleasant it may be carried in the arms or irawn in a wagon, laying on a pillow, in the open nir, a few minutes at a time, several times daily. .Ml rongh tots in (j, jolting and dc mdUng are injurious. For the first two months, the infant cannol be placed in the erect j><>slurc Without the risk of deformity. "When the infant indicates some desire to sit alone and move about, he may be allowed to sit, lie or roll about on the floor with the utmost freedom. When riding, the position should be often cha/nged, and nursing should be done equally upon the right and left side, to avoid deformity of the head or spine. It is better that the child should not attempt to stand or walk before the ninth or tenth month : it should rather be encouraged to creep until it acquires sufficient strength and firmness to walk voluntarily. Children should not be con- fined to little chairs, "baby junipers," or any apparatus for restraint ; although it may relieve the mother or. gratify the laziness of the nurse, — it is still unnatural and injurious to the delicate growing system of the child. After the age of two years, girls as well as boys should be permitted to roam free and unconfined over the wide field of nature, and inhale the " pure breath of heaven." The first six or eight years of childhood should be passed in various kinds of exercise and amusements. Confinement in school rooms or shops, or at desks, or to any laborious occupation previous to that age, is always injurious and unkind. Nothing is gained and much is lost by sending a child to school too young. No child under six years should be sent to school, and even then only a few hours at a time. Children should be indulged in pursuing little mechanical operations, and in learning to build and construct whatever their tastes ma} r incline them to : they should be taught to admire the beauties of nature, rather than be supplied with the various little toys and expensive contrivances of art. They should be permitted to take short rambles for the pur- pose ol collecting flowers, insects, minerals or fruits, or to observe the habits of animals and birds, and enjoy the pro- spect of natural scenery. Dkinks. — Infants feel the sensation of thirst, as early aa that of hunger, and are highly gratified and benefitted by a small quantity of cold water several times daily. 76' Nourishment of Infants. Restlessness and crying are often caused by thirst, but mis taken for colic or hunger, and the infant is dosed with cordiali or opiates, or forced to take the breast, which only increase* its distress, perhaps surfeits the stomach and causes nausea and vomiting. This leads to the apprehension that he is sick, and dose succeeds dose, till disease is often produced, — when a spoonfull of cold water would have removed all unpleasant sensations. Many people think it is a " healthy sign " for a child to throw up its milk, when the whole trouble is that the child has too much milk and too little water ! ( Very cold, as well as very hot drinks should be avoided.) Diet. — As a general rule the mother's milk should be the only food for the first nine or ten months ; no solid food should be allowed until a sufficient number of teeth are developed, to enable the child to chew. When it becomes necessary to increase the amount of food derived from the breast, — or to " bring up the child by hand," cows' milk is the best substitute : it should be mixed with an equal quantity of warm water and a little loaf sugar added. All preparations of gruel, panada, broth, soup or solid food, are unfit for the diet of an infant. Animal food is too strong and stimulating for infants before the first set of teeth are complete. After teething is completed, a more solid and nutritious diet may be allowed. Food. — Care is requisite that too much of one kind of food be not taken, — but rather a due proportion of several kinds : the food should not be taken too fast or swallowed without being well chewed. Sugar and other sweet substances are not injurious when taken in due quantity and with other arti- cles of diet j all sweet and ripe fruits, when freed from the seeds, stones and skins, are wholesome and nutritious in small quantities. Sour or green fruits are decidedly pernicious, — cherries of most kinds, and also some kinds of grapes, are peculiarly unwholesome : ripe fruits, either dried or recent, when cooked or preserved and made palatable with sugar, are not objectionable for children. NOURISHMENT OF INFANTS. Tub foundation of incurable chronic diseases, and of con- stitutional debility in after-life, is often laid within the first month, or even tirst few days, after birth, by improper man- agement ; and a great amount of the suffering and mortality wliich occurs daring infancy must be ascribed to the same prevailing source. The custom of feeding children with inap- propriate articles of food, very soon after birth, is wrong, lie Nourishment of Infants. 77 sooner is the infant washed and dressed, than tne nurse is ready with her spoon and cup of gruel, pulverized crackers dissolved in water. <>r some such preparation, to fill its stomach to the utmost of its capacity ; and this pr0CC6B of Stuffing is continued with a ruinous degree of diligence and perseverance. The digestive organs of the new-born babe are thus often seriously injured during the first twenty-four hours. Nature herself seems to point out the impropriety of this practice. She withholds the nourishment which she provides (the milk) until many hours after birth. I do not mean t<» inculcate that nourishment is to be entirely withheld from the infant until the milk is secreted under all circumstances : but lam per- suaded that, with healthy infants, several hours, at least, should be suffered to pass immediately after birth before any food is introduced into its stomach, and not, under any circum- stances, give food to the child until it has first hen put to the mother's breast several times, to sec if the milk will not be excited to flow. In nine cases out of ten, perhaps, the griping, flatulency, diarrhoea, and colic, which so frequently harass infants, during the first half year after birth, are the results of indigestion, brought on by errors in diet. To relieve the colic, griping, flatulency, diarrhoea, &c, which ensue, recourse is had to cat-mint tea, aniseed tea, Godfrey's cordial, pare- goric, or some other palliative or nostrum, and thus an addi- tional cause of indigestion is brought into operation. The screams and restlessness of the infant occasioned by the griping and colic, are frequently regarded as manifestations of hunger. To appease this supposed craving, the stomach is almost constantly kept in a state of distension with food ; and thus the helpless babe has no chance of escaping from the tor- ments and ruinous consequences of its unfortunate situation. Great distress and suffering are sometimes witnessed during the early period of infancy from indigestion, and consequent irritation of the stomach and bowels, even where the child .is wholly nourished by the breast. For when, during the timt which intervenes between the secretion of milk and the birth of the child, crude articles of nourishment 'are introduced into the infant's stomach, the digestive powers are often at once so deranged' and impaired, that even the wholesome and conge- uial fluid furnished by the mother will not be easily digested and acidity, flatulency, and colic, will continue to harass the child until the digestive powers gradually acquire a greater degree of vigor. Let the child's stomach be once or twice filled during the ■first twenty -four hours with gruel, or any of the ordinary 78 Nourishment of If/ants. preparations employed by nurses for this purpose, and the chances will probably be as ten to one that sourness of the Btomach, vomiting, colic, griping, &c, will supervene. There is no period throughout the whole course of life in which the observance of caution, in relation to the food, is of greater moment than in the comparatively short interval which passei between the birth of the infant and the secretion of its natu- ral aliment (milk). Do not be in too great haste to give pur gative medicine to a child, soon after it is born, to open its bowels. Active purgatives are sometimes given for this pur pose ; and there is much reason for believing that the infant's digestive organs are often injured in this manner. The very best thing to stimulate a secretion of milk is apply- ing the child to the breast, for a few minutes at a time, (com- mencing as soon as the mother is comfortably settled in bed,) every half an hour or so. If the child is hungry, his efforts will be the more vigorous to. procure nourishment. A mixture of two parts of fresh cow's milk and one part of warm water, approaches nearer to the nature of human milk than anything else that can be conveniently procured. Of this a few tea- spoonfuls may be given in cases where the secretion has been long delayed, carefully avoiding overcharging the stomach until the mother's breasts are ready to yield their more con genial nutriment. In order to excite the early secretion of milk, it will be proper to let the child draw the breasts, for a few minutes, soon after the mother is comfortably fixed in bed, provided her health and strength will admit of it. After the secretion of milk is once fully established, and furnished in sufficient quantity, the infant should be nourished exclusively by the breast. Not even the mild and simple fluid just men- tioned should be allowed, unless some special reason exist for the use of additional nourishment. It seldom occurs in healthy mothers, that the quantity of milk supplied by the breast is not sufficient to afford adequate nourishment to the child for the first two or three months, and, in general, much longer, without the necessity of any additional artificial tood. I he infant should be nourished exclusively by the breast until the Jirxt teeth make their appearance. !No other kind of nourishment whatever should be allowed before this period, unless from deficiency of milk or some other cause, the use of additional nourishment becomes necessary. After the first teeth have come out, small portions of barley water, thiniy prepared arrow-root, or a mixture of equal parts of cow's milk and water, may be given two or three times daily, in addition tu the nourishment drawn from the breasts. 1 do not mean to Nourishment of Infants. 79 lay that, when the child arrives at this stage, it becomes neee»" 8a?"i/, or even, proper, as a general rule, to exhibit any addi- tional articles of food. In general, however, the simple and mild liquids just mentioned may be given at this period with very little risk of unpleasant consequences, tor the digestive organs have by this time acquired a degree of power and activity sufficient to obviate the painful and disturbing effects which would arise from the use of such food during the tirst four or five weeks after birth. It is also of much consequence that the food should be introduced into the stomach as gradually as practicable. This can be most conveniently done by causing the infant to suck the fluid from a bottle, furnished with the usual tube, the mouth-piece of which i> pierced wit 1 1 a small opening. 13y this contrivance, the child will receive its food in the same gradual manner a- when nourished at tha breast, and it will rarely take more than its appetite calls for, an error which is frequently committed when/''/ with a spo m After the seventh month, small portions of the preparations of food just mentioned (such as corn starch, pulverized crackers with milk and water to soften them, gruel, made of oatmeal or wdieat flour, &c.,) should be given at regular periods, throe or four times daily. This will prepare the infant for the sud den change which it has to undergo, in the character of ita food, when it is weaned, and thereby tend to lessen the Liabil- ity to unpleasant consequences from the change. Infants who have been moderately fed with suitable articles of food some time previous to weaning, almost always accommodate them- selves much more readily, and with much less uneasiness to the change, than such as have seldom or never received any other nourishment than that which they draw from the mother's or nurse's breasts. Mothers ought neyer to delegate the suckling of their in- fants to others. This sacred office should rest with the mother alone. The mother who submits the suckling of her infant to another, while her own breasts are ready to furnish an ample supply of milk, can scarcely possess an amiable and moral heart. It can scarcely be doubted that the mother } s milk is, in gen- eral, better adapted to the constitutional temperament of her offspring than that furnished by others. Besides, when the suckling of the infant is submitted to a nurse, it is liable to various sources of injury and disorder, which are, in a great degree, if not entirely, obviated when this important duty is performed by the mother. No hired nurse can be depended on to give the tender care, and have the affectionate regard, fat a child that its own mother has. 80 Nourishment of Infants. Unfortunately, however, mothers are not always in a condi- tion that enables them to suckle their own infants, and the employment of a wet-nurse, or recourse to artificial nursing, is unavoidable. The causes which may prevent a mother from nursing her child are : A decided deficiency or total failure in the secretion of milk, in consequence of disease or torpor of the breasts ; a bad state of milk, rendering it decidedly preju- dicial to the health of the child ; the presence of a morbid taint, or some communicable chronic diseas , in the mother's system ; when suckling gives rise to painful or dangerous affections in the mother, as colic, cough, distressing nervous affections, great weakness, epilepsy, &c. "When causes of this kind render it improper or impractica- ble for the mother to nurse her child, it then becomes a ques- tion whether a wet-nurse should be employed, or artificial nursing resorted to. It would, in general, be much better to nurse the child artificially, under the eye of its mother, than to place it entirely at the mercy of the wet-nurse. Nurses, doubtless, are sometimes found to whom a child may be safely intrusted ; but experience has but too often shown that the reverse is the case. Attention must also be paid to the previous and present health of the nurse. No woman who has led a debauched course of life, even though reformed, can be regarded as a perfectly safe nurse, however careful and attentive she might otherwise be. Females of this description are apt to have their systems contaminated with some morbid taint, which may give an unwholesome quality to the milk, and injure the child's constitution. The existence of scabby or scaly erup- tions on the skin, unless they are of transient character, and of chronic ulcers, particularly on the legs, should be regarded as sufficient objections to a nurse. A manifest scrofulous habit, also, is decidedly objectionable. The age of the milk is another point of considerable importance. Milk that is six or seven months old seldom agrees well with infants during the first two or three months after birth. In general, the milk becomes much more rich and nutritious after the fourth month than it is previous to this period ; and milk of this kind, from its requiring stronger digestive powers than younger milk, often gives rise to much disturbance of the stomach and bowels in new-born infants. As a general rule, therefore, the age of the milk should not vary much from that of the cliild, up to about the fourth month. After this period, isuch a relation between the ages of the milk and child is not of much importance — for a child five or six months old and Nourishment of Infants. 81 upwards, may be nourished by a fresh breast with entire aafety. The occurrence of the menstrual evacuation daring nursing, is almost invariably attended with diminution and deteriora- tion of the milk, and constitutes a well-grounded objection to a wet-nurse. This is more especially the case during the first three or four months of infancy. When a child at this early period is put to the breast of a nurse who menstruates, it. rarely fails to experience derangements of the stomach and bowels. After the seventh or eighth month of age, there is much less inconvenience and disorder to be apprehended from this source; but, even at this advanced period of infancy, the milk of a nurse, thus circumstanced, may give rise to disturb- ances in the digestive organs, and should, if possible, te avoided. Nature here, as elsewhere, is a safe guide. "We perceive that menstruation is almost universally suspended during the period of suckling ; and we may presume that this arrangement of nature is designed for some useful purpose — for the well-being, doubtless, of the infant. Nature, there- fore, as well as experience, indicates the propriety of with- holding the breast from the child when, from constitutional peculiarity, or some accidental influence, the monthly turns make their appearance in the nurse or the mother. A nurse who has but one good breast should never be se- lected. A child suckled by one breast only, is apt to contract the habit of squinting, from having its eyes constantly directed to one side. Some attention should also be paid to the nurse's nipples. If they are very small, the child will be apt to fatigue itself in sucking, without being able fully to satisfy its wants. This defect can seldom be properly remedied. The practice of drawing out the nipples by suction, with a pipe or bottle, will be of advantage; but when the nipples are veiy small, and deeply imbedded in the breast, it can scarcely re- medy the evil. In some instances the nipples yield the milk so freely, that the child is continually harassed by a sense of strangulation, while suckling, from inability to swallow as ra- pidly as the milk issaes into its mouth. This may, in general, be remedied by passing a piece of fine tape or elastic pretty firmly round the base of the nipple ; or the nurse may com- press the nipple moderately between the first and second fingers, while the child is suckling. Finally, particular regard should be had to the temper and moral habits of the nurse. An irritable, passionate, and sour tempered female, is but illy suited for this important duty Not on 1 }" is the child liable to be maltreated by a nurse of this •j Nourishment of Infants. ■character, during the fits of ill-nature and passion ; but the most serious and alarming effects may he produced on its ten- •dcr organization, by the milk of such a nnrse. It is well known that violent anger, and habitual sourness of temper are peculiarly apt to give a pernicious quality to 'be milk. Chil- dren have been thrown into convulsions, by suckling soon after the nurse has been agitated by violent anger, rage or fright ; ;find alarming vomiting and purging is particularly apt to occur from this cause. Indeed, every kind of inordinate ex- citement, or depression of the mind is unfavorable to the recretion of healthy milk. Protracted grief, sorrow, or mental distress and anxiety in the nurse, seldom fail to exert a pre- judicial influence on the health of the nursling. This circumstance ought not to be overlooked, in choosing a wet- nurse. Artificial Xursing. — Under judicious management, infanta will, in general, experience no particular inconvenience from a course of artificial nursing; and, as a general rule, this mode of nourishing children, when properly conducted, is upon the whole preferable to the employment of a wet-nurse, whose competency and fitness is doubtful. Tin's preference, however, is founded rather on the greater risk which the child incurs of being maltreated and neglected, when submitted to the ex- clusive care of a wet-nurse, than when nursed artificially, undor the immediate superintendence of a parent. There are circumstances, in relation to the condition of the child, which render the employment of a wet-nurse, notwith- standing all the risks that have been mentioned, preferable to artificial nursing. Very young, and peculiarly delicate and feeble infants, seldom do well when raised by the hand. Fresh and wholesome milk from the breasts of the mother, or a healthy nurse, is almost indispensable to the well-being of an infant thus circumstanced. The same observations apply to infants, whose stomachs and bowels are peculiarly weak and irritable. Finally, if upon trial, the slightest and most appro- priate kinds of artificial food are found to disorder the stomach and bowels, the life of the infant will very probably depend on its being nursed by a fresh and wholesome breast. Sometimes the mother, though incapable of supplying 9 sufficient quantity of nourishment by the breast, is still able to furnish small portions of wholesome milk, and when this ii the case she ought, by all means, to continue suckling the oitild, in conjunction with the use of artificial nourishment. .Par- ticular care should be taken to keep the bottle perfectly clean aud sweet. It should be well washed, both inside and out- Nourishment of Infants 83 fide, with liot water, every morning and evening. The same food should not be suffered to remain in the bottle more than three hours. After the child has satisfied its appetite, no neio supply of food should be added to what may have been left. The quantity of nonrishmenl pnt into the bottle, shonld nol be much greater than what may be deemed fully sufficient for one nursing. By these precautions the food will always »weet, and free from offensive or irritating qualities. Nursing bottles are now easily obtained in almost every part of tho country. "When the child uses the bottle, it should be taken up and supported in an easy position, on the lap or anna of the nurse, imitating the position of the mother's breast. The child should be kept quiet for at least thirty or forty minutes after having received its nourishment. Rest is particularly favorable to digestion. Children, who are entirely nursed by artificial diet, BhorJd be restricted to the use of the milk-and-water mixture men- tioned above, until several teeth have made their appearance. They will, in general, enjoy more perfect health and thrive better, when nourished exclusively with this simple food, than under the use of any other nourishment that can be made. After the third month, however, the proportion of milk should be somewhat increased : namely, three parts of milk to one part of water. After the first teeth are protruded, the food may be a little more varied and substantial. Grated crackers dissoled in warm water; oat-meal gruel ; liquid preparations of arrow-root, tapioca, or sago ; milk thickened with rice flour, and thin pap, may be allowed in moderate auantities along with the ordinary milk-and-water mixture. Allien these pre- parations do not agree with the child's stomach, they should be used with an equal portion of weak mutton, chicken, or beef broth, clear and well freed from fat. A mixture of this kind is, in general, easily digested, and rarely causes any un- pleasant effects, when used after the first teeth have made their appearance. After the first grinding teeth are protruded, weak broths, slightly thickened with oat-meal, rice flour, arrow-root, or grat- ed crackers, mixed with milk, constitute, in general, the most appropriate articles of nourishment. A small portion of stale bread may also be allowed, two or three times daily, at this 6tage of infancy. The animal food driven to young children should be plainly roasted or boiled. l?ried and broiled meats, and all food heated a second time, by hashing or mincing, being less digestible, should be avoided. " Many people, from a mis- taken expectation of strengthening weakly children, give them 84 Nourishment of Inf more auimp] food, and Bometimea twice or thrice a day : bui it will he fonnd much more frequently to add to debility than to the increase of strength. Those children, on the whole, who eat the least animal food, are the most healthy. Nothing is more absurd than the notion that, in early life, children re quire a variety of food. The peculiarly excitable state of the system during teething and the consequent tendency to feverish irritation, render the free use of animal food decidedly objectionable during this of childhood. Small portions of the more digestible meats may be allowed to healthy children, once daily, with little or no risk of injury ; but they should never be permitted to form the principal part of the food. The lean parts of mut- ton, lamb, tender beef, game, and fowl, should be selected. Veal, pork, pig, goose, duck, and all kinds of salted meat- being of much more difficult digestion, can seldom be used without impeding digestion, and finally injuring the tone of the stomach. Veal is decidedly the most objectionable of a'j the meats in common use for children. Fresh fish, boiled, and taken in moderate portions, seldom disagrees with the stom- achs of children, and may be used, occasionally, with perfect propriety. Soft boiled eggs, too, form an appropriate article of nourishment for children after the first teeth have come out. Winn fried, or boiled hard, they are altogether unsuitable Strongly seasoned meats, compound dishes, hashes, meat pies, and pastry, are to be wholly rejected. The introduction of fresh food into the stomach before that which was previously taken is entirely digested, seldom fails to operate injuriously. As a general rule, from three to four hours may be regarded as a suitable interval between the meal.-, li' the child requires nourishment between the regulai meals, small portions of liquid food, such as milk, &c, should be used. When solid animal food forms a part of the diet of children, it should be taken at noon, or in the forenoon. Pure water, with or without small portions oii milk, con- stitutes the best drink for children. Candies and Sweetmeats. — Indulgence in the use of sweet- meats is a copious source of disease and mortality during childhood. Fruits preserved with their skins, as raisins, are particularly pernicious. The skin of all fruits is of difficult digestion. The conduct of parents, in relation to this subject, is oflei extremely irrational and pernicious in its consequences. Tliej would not themselves venture on the frequent and free use of confectioneries of this kind; and yet will indu'ge their chil Nourishment of Infants. 85 dren without scarcely any restraint, in the use of these pernicious luxuries. The sicklier and weakei the child is, the more apt, in general, is it to be allowed these destructive gra- tifications. The pale, feeble, and sickly child, whose stomach is hardly able to digest the most simple and appropriate food, is sought to be appeased and delighted by the luscious and scarcely digestible articles of the confectioner, [ndigi stion, bowel irritation, terminating often in ulceration and incurable diarrhoea, are the frequent consequences of such conduct ; and at best, such indulgence must prolong the feeble and Bickly condition of the child, and not unfrequently eventuate in per- manent debility. With regard to the use etween or after school hours, is a barbarous " march of civilization." These intervals should be devoted to innocent amusement and bodily exercise. Exposure. — Infants ought to be early accustomed to the fresh and open air. The practice of confining them, during the first live or six weeks, to close and heated rooms, has a di- rect tendency to impair the energies of the system, and to impede its healthful development. Pure air is most grateful to the feelings of children. After having been carried out, but a few times, they evince, even at a very early age, a strong desire to return to the open air. While yet on the arms of the nurse, they anxiously point to the door, and make efforts to approach and open it. When they can scareely crawl, they instineti vely advance towards that part of the room from whieh they have a prospect of escaping. When the weather is clear and of a mild temperature, infanti Nourishment of Infants. 91 ihould -ie earned into the open air once or twice daily, as soo^ as tliev are three or four weeks old. Daring cold and d weatln r, they should be occasionally conveyed into an adjoin ing well-aired room: avoiding, however, Btrong currents ol air, or sitting with them near an open window, important as the enjoyment of fresh air is to the health and comfort of infants, care should he taken to accustom them gradually to the im- pressions of the external air — more especially when the atmosphere is cold and damp. The practice of exposing chil- dren, soon Ifter birth, at once to the opeD and cold air, with the view of "hardening them," as it is called, is attended with considerable risk ol" injury, and should not be permitted by parents, except when the weather is clear and very mild. Even in summer, the infant should not, as a general rule, be carried at once into the external air, without having been pre- viously accustomed to the air of a well-ventilated chamber. After the child is three or four days old, it ought to be con- veyed, several times daily, into an adjoining room having, at first, only the windows open, and in four or five days utter- wards, the doors also, so as to admit a free circulation of the air through every part of the room. This having been prac- tised for ten or twelve days, the child may then be carried out of doors, and permitted to enjoy the pure and open air. At first, it should not be allowed to remain out of doors more than live or ten minutes at a time, but gradually extended. Hanging up the linen of children, or drying their diapers in the place where they sleep, is very improper. Weaning. — Tht> only thing that is usually regarded by mothers, in fixing on the time for weaning, is the age of the infant. The child is suckled until it attains a certain age, without any regard to the development of its digestive powers, or the state of its health and constitutional vigor. By thiu course, children may be kept at the breast, long after the vigor oi the digestive functions, and the demands of the system re- quire a more substantial and nutritive diet ; and on the other hand, they may be separated from the breast before the stom ach has acquired sufficient energy to digest with due facility a stronger and less congenial food. The progressive develop- ment of the digestive powers, and the demands of the organi- sation in relation to nourishment, are very various ainon^ different infants. It is particularly important that the con dition of '.nfants, with regard to these circumstances, should be consulted in regulating the period of nursing. The ob vious correspondence which exists between the successive appearance of the teeth, aud the development of the diges- 92 Nourishment of Infants. tire powers, afford us a safe guide in relation to this sub ject. The progress of teething is, doubtless, our safest guide in re- gulating the nourishment of infants, and in deciding on tha period at which they may with propriety be put on the ex- clusive use of artificial food. Not un frequently, however, circumstances of an irregular or morbid character render it expedient, or even indispensable, to wean the child, before it has attained the age and development which, under ordinary circumstances, would be deemed requisite to justify its final separation from the breast. The mother may be affected with some constitutional disease, which may so contaminate her milk, as to render it highly injurious to the child's health, if she continues to nourish it at the breast. Mothers, affected with scrofula, or ulcerated ca?i- cer, should, on no account, suckle their infants. The mother may also be so exhausted and debilitated by an attack of some acute disease, and the measures requisite to subdue it, that she cannot continue to suckle her infant, with- out increasing her prostration and superinducing a train of alarming and highly distressing affections. The same difficulty is apt to occur in mothers of a feeble, delicate and nervous habit of body, particularly when the digestive powers are weak, or so disordered that nourishing and substantial aliment cannot be taken. Under these circumstances, suckling can seldom be continued without producing the worst effects. Many young ladies, on becoming mothers, are incapable of supporting the constant drain to which the wants of their in fants subject them. They lose their good looks, become gradually weaker and paler, and, as their strength declines, they become more and more afflicted with a variety of harass- ing nervous affections. Medicinal means are of no permanent advantage. They may procure more or less temporary miti- gation of the symptoms, but they are wholly inadequate to the removal of the malady. Nothing but weaning will suffice — and the entire separation of the child from the breast is generally soon followed by a progressive subsidence of the sufferings of the patient. On the part of the mother, the effects of unduly protracted nursing are sometimes extremely pernicious. We not unfre- quently see women pale, debilitated, and constantly tormented with dyspeptic and nervous affections, suckling their infanta for eighteen or twenty months, and occasionally rnuih longer without suspecting that their sufferings and ill-health aroth« result of exhaustion from the constant drain of nursinar. Nourishment of Infants. 03 Many .ziothers are able to 6uckle their children until thev arrive at the proper period of weaning without the least in- convenience, who, nevertheless, will sutler very serious de- rangements of health when the nursing is extended considera- bly beyond the tunc which nature points out as the proper period for terminating it. On the part of the infant, also, Buckling, when continued much beyond the proper period, is apt to exert a highly inju- rious influence. It is well known that after the eleventh' or twelfth month the milk almost invariably becomes diminished in quantity, as well as more or less deteriorated in quality ; and, in proportion as the nursing la protracted, so will it lose more and more its nutritious and wholesome character. In many instances, indeed, the milk begins to deteriorate as early as the ninth or tenth month, corresponding in this respect with the proper period of weaning as it is usually indicated by the progress of teething. Children who are suckled an undue length of time generally gradually lose their \'vcA\ and healthy appearance. The countenance becomes very pale, and acquires a languid, fretful, and sickly expression. In some instances the milk loses its wholesome properties at an early period, without any very serious or obvious derange- ment of health in the mother's system. When this occurs, the infant often throws up the milk, soon after nursing, and becomes harassed with colic, griping, acidity, and diarrhoea, attended with paleness, debility, emaciation, and frequently with scabby eruptions about the face and head. If the child becomes affected in this manner, when nourished exclusively at the breast, we may presume that the milk has become de- praved and injurious to its digestive organs. If any doubt exist as to the agency of the milk in the production of the disorder, the breast should be withheld from the child as long as can be done without any particular inconvenience to the mother, and artificial nourishment, or the milk of a nurse, substituted. If the mother's milk has been the cause of the child's illness, an obvious abatement of the symptoms will Soon take place ; and should this occur, the child ought to bo gradually entirely separated from the mother. The recurrence of the menses, during nursing, exerts, in many cases, a decidedly prejudicial influence on the proper- ties of the milk, and often renders weaning necessary before the usual period of separating the child from the breast. When the mother finds the child becoming sickly, feeble, and annoyed with disorder of the stomach and bowels, after her monthly sickness has returned, or after she finds herself in a 91 m Diseases of Children. state of pregnancy,' and relief is not obtained, in due time, fron: the use of a impropriate remedial means, the child ought to be gradually weaned. Should a woman with an infant at her breast, again become pregnant, one of two things will usually take place : either she will miscarry, or her milk will become impoverished in quality and diminished in quantity. It was not intended by nature that the processes of pregnancy and nursing should go on simultaneously; but, on the con- trary, that the one should commence when the other had ter- minated ; and experience sufficiently proves, that they will not proceed well together. Attention should also be paid to the season of the" year, in fixing on the period of weaning. In general, weaning may ba accomplished with less inconvenience and risk of unpleasant consequences to the child, during the mild months of April, May, September, October, and the early part of November, than whilst the weather is inclement. Exercise in the open air is always highly beneficial to the child at the time of weaning. It tends to fortify the system of the child, and to enable its diges- tive organs to bear, without inconvenience, the change of nou- rishment. In consequence of the peculiar tendency of wamj weather to excite summer complaint, particularly in cities or large towns, it is in general inexpedient to separate children from the breast during the months of June, July and August ; for the transition from the mother's milk to an exclusive arti- ficial nourishment during this season, has a decided tendency to favor the occurrence of this dangerous disease. Neverthe- less, should the child be suffering from a deteriorated state of the milk, it ought to be separated from the breast without any regard to season : for a bad condition of the milk would doubt- less be more injurious in this respect than a suitable artificial nourishment. The child should, at the 6ame time, have tha proper bathing, out-door exercise, etc. DISEASES OF C H I Z. D 11 E X . Difficult Tketiiing. — Teething is not usually attended witb much suffering or danger ; yet when there is much predispo- sition to disease during this process, any exciting cause may produce violent and dangerous symptoms. The first teeth usually begin to penetrate the gums about the seventh month of infancy — they sometimes, however, appear as early as the third or fourth, and in some cases as late as the twelfth or fif teenth. In difficult teething there is redness and tenderness of the gums, increased flow of saliva or spittle, thirst, looseness of the bowels, slight fever, restlessness and sometimes eruption! Diseases of Children. 95 on the skin. In the more severe cases there aie often ulcers of the gums, diarrhea or dysentery, inflammation of the brain or Dowels, spasm of the windpipe, convulsions and death. These cases require perfect cleanliness, qniet, pnre air, vegetable diet, cooi drinks, mild purgatives, and lancing of the gums. Be careful not to give anything to check the bowels suddenly) in cases of looseness during teething, as the head is apt t<> become the seat of very serious disease in such cases, producing spasms, and sometimes inflammation of the brain. Giving the child, three or four times a day, a spoonful or two of blackberry root tea (cold), is about as good, in cases of diarrhea during teeth- ing;, as .anything else. Flannel should he worn next the skin, and let the child live on the mildest food, or the breast-milk, accord- ing to the age. Toothache. — This may occur from decay of the tooth and ex- posure of the nerve, from inflammation of the nerve, >j\\\n- or membrane lining the socket, or from ulceration at the root of the tooth. If tiic tooth is much decayed, dark colored, or ulcerated, it should be extracted : if the pain is caused by in- flamed gums or socket, the gums should be freely lanced, warm fomentations, such as hops and vinegar, with hot water, re- newed every half hour, applied to the face, and a gentle purge administered — castor oil, one teaspoonful, syrup of rhubarb, one to* two teaspoonfuls, or the same quantity of Rochelle salts in a gill of cold water. When the tooth has a cavity in it so as to expose the nerve and cause pain, the application of a piece of cotton wet in some stimulating medicine, such as oil of cloves, or cinnamon, or paregoric and camphor, or a mixture of line salt and alum, put into the tooth on a piece of wet cotton, and renewed every half hour, will usually give relief. Inflamed Gums. — During the first teething the gums are very liable to become inflamed ; in some cases it is slight, and in others severe, and productive of serious c-jnsequences. The gums first become red, or dark-colored, swelled and painful, child languid, feverish, thirsty, tongue furred, appetite im- paired, and sleep disturbed. When the inflammation occurs before the double teeth appear, it often destroys the new teeth : and when the inflammation proceeds to ulceration— if this is not speedily checked, the other teeth become black, loose, and decayed. There is a flow of spittle, sometimes mixed with blood, the breath is unpleasant, countenance pale, and some- times severe attacks of diarrhea. This condition is caused by too much, or improper food, filthiness of the teeth, neglect to lance the gums in difficult teething, biting hard substances, and 96 Diseases of Children. disorder of the stomach. The gums should be freely scarrified (lanced) the bowels regulated, and some astringent medicine, inch as Btrong green or black tea (cold), tea made of white oak bark, etc., applied frequently to the gums, the teeth cleaned and all decayed ones extracted : the diet should be very light, and the general health improved by gentle tonics; a tea made from a mixture of equal parts of bruised gentian root, wild cherry bark, and orange-peel or sassafras bark — say one table- spoonful of the mixture in a pint of boiling water, cover up and let Btand for one hour and a half ; of this one or two table- Bpoon fuls may be taken before each meal (cold.) TiiKtsir. — Four or live varieties of inflamed mouth are Jo scribed by authors; but the most common of these are simple inflammation and thrush. The symptoms of the first are, red- ness and drvness of the mouth, the infant manifesting pais when attempting to nurse — caused by teething, bad diet., sharp acrid substances, cold, or over exertion of the muscles ct the tongue and mouth in attempting to nurse from a bad lj- form< d nipple. By removing the cause, and the use of simple washes and mild purges, a cure is soon effected. Thrush is confined in its attacks mostly to nursing infants. At the be- ginning of an attack the child is restless, the mouth red, dry, and h'-r, digestion is disturbed, and there is difficulty in nurs- ing: after one or two days, small white spots appear on the tongue and mouth, and sometimes spread over the entire sur- face. In the course of the disease, patches of curdlike matter fall off, and the spots are again covered as before ; it sometimes extend- backwards into the throat, or ulcerates and becomes both tedious and troublesome — in some cases it proves fatal. It is caused by improper diet, filthiness, impure air, disorder of the stomach and bowels, sudden stopping of diarrhea, and nursing from a sore nipple or a diseased nurse. In mild eases, pure air, proper diet, cleanliness, mild purgatives — same aa those recommended in treating toothache, and soothing washes (hor tea and sage tea mixed, is very good,) for the mouth, will remove the complaint. The first thing to be done when an infant is affected with thrush, is to correct the acid state of the bowels by a few grains of calcined magnesia — or if the bowels be relaxed, by chalk, following the magnesia by a half teaspoonful of castor oil. This may be repeated every second day. The quality of the milk, and the state of the nipple of the mother are to be exam- ined. Milk and water — two parts of the former to one of the latter — in which a little isinglass should bo dissolved if there is diarrhea, is to be the sole addition to the mother's milk; all Diseases of Children. 97 sugar is to be avoided. If the slate of the bowels fie corrected, the thrush will generally gel well, hut it is expedient to assist the cure by the use of a solution of borax in water — one teaspoon- ful to halt" a pint — used to wash the mouth. WTien the ca mild, the ciml-likc patches will separate in seven or eight day.-, leaving a healing surface below, and the mouth s i gets well, if it be not injudieiously scrubbed ("cleaned ") daily by the urse. Bleeping from the ISTose. — This is sometimes a frequent and troublesome disease with ehihlren, caused by injuries of the nose, fullness of the bloodvessels of. the head, &c. In robust persons troubled with dizziness and headache, it is often benelicial, and, unless excessive, need not be restrained ; but in those of a pale and weak habit, it may, it" long continued, produce debility and dropsy. Jt may usually be restrained by the application of cold water to the head and neck, snuffing cold water, or alum water, up the nose, or stopping the nos> trils with lint or cotton. When these means tail, more effi- cient ones must be employed. Gargling a strong tea, made of white oak bark, when cold, in the throat, then suddenly closing the mouth, and xt<><,]>; ,,- nostrils, repeated every few minutes, if necessary, will usually stop it. Raising both hands above the head, while the nose is kept closed by an assistant, is a good and simple remedy. To prevent a return, bathe the head in cold water, night and morning, live principally on a vegetable diet, keep the bowels regular, and avoid exposing the head to the heat of the sun. Using a rough towel or a tlesh brush, night and morning, to rub the surface of the body and lower extremities, is advisa- ble. Canker of the Mouth. — This occurs in children of weak, scrofulous constitution, who are ill-fed and exposed to the in- fluences of unhealthy habitations ; and most generally imme- diately after acute disease, particularly measles. The first symptom of the disease is a red, hard, angry -looking spot on the cheek, which quickly opens into a gangrenous, (mortified) ulcer inside the mouth, the gums become affected, the teeth irop out, the breath is very unpleasant, and the extending llceration goes on destroying the cheek and contiguous parts, ;ill it :'s either stopped or death ensues. As the iirst cause of this fearful affection is traceable to poverty of constitution, the first remedial measure is to nour- ish. The strongest meat-soup — beef-tea is the best — must be given in small quantities, frequently repeated ; milk and egg?, PS Croup. • f the litt.e patient will take tlieir.. Wine may be allowed if he debility is extreme, but scarcely, if at all, should fever run high, and there is much heat of skin. A drachm of chlorate of potash is to be dissolved in six ounces of water, and to this added twenty drops of muriatic acid. A tablespoonful of the mixture to be given to a child of six years of age every four hours; it may be slightly sweetened. Half-grain doses of quinine, or an ounce of infusion (or tea) of Peruvian bark, may be given twice or three times in the twenty-four houre. A wash made of one tcaspoonful of salt, dissolved in half a pint oi' water, should be frequently applied. The case ought to be seen by a medical man as soon as possible. CIt O UP. Tins is recognized as one of the most dangerous diseases of childhood. Its progress is rapid, and its treatment, to be sue cessful, admits of no delay. Fortunately, if taken in time, il is greatly under the control of well-directed treatment. Ita dangerous nature must ever make proper medical advice a necessity, but the importance of early active remedial meas- ures renders it, at the same time, highly desirable that treat- ment should be resorted to without the slightest delay. The great danger in croup arises not only from the possibility of the narrow chink in the larynx, or upper part of the wind pipe, through which the air passes, becoming closed by swell- ing, but also from the remarkable product of a peculiar in- flammation which is formed upon, or thrown out by, the lining membrane of the parts. This formation, "false membrane" as it is named, resembles thin leather of an ash color. It takes the form of the tube which it lines, and, indeed, is sometimes coughed up in perfect tubular portions. However, when this false membrane forms, death is the result usually. Croup may begin very suddenly. A child goes to bed, to all appearance perfectly well, and in the course of two or three hours comes a cough, which strikes even the most unob servant as peculiar, which falling upon the ear of the anxious parent, who has ever heard it before, tells at once of danger. the child seems as if it coughed through a, brazen tube. ±'ei- haps at first the little invalid is not awakened, and if now visited is found Hushed and fevered, moaning slightly, perhaps, and restless, the breathing slightly quickened ; the cough comes again, the child awakes, or is awakened ; if it speaks, the voice is hoarse; if it cries, hoarser still. Should the dis- ease be neglected at this time, or go on uncontrolled, the cough, still retaining its peculiar character, becomes more Group. 99 trequent; the breathing, quickened, is also accompanied oy the characteristic dry wheezing occasioned by narrowing oV the passage through which the air is drawn; the head Ie thrown back in the efforts to breathe, respiration is insuffi- ciently performed, and the blood being insufficiently changed begins to evince its deteriorated character in the blue color of the lips, the dusky coldness of the skin, and the affection of the brain which gives rise to partial insensibility or delirium. The pulse, previously quick, becomes still quicker, but at the same time feebler, and at last the child dies in a state of almost unconscious suffocation. There may, however, in the progress of the disease, be intervals of comparative ease, alternating with paroxysms of spasmodic obstruction to the breathing, threatening, and sometimes causing, immediate suffocation. The average duration of a fatal attack of croup is from three to four days, but it may, and does, terminate much more speedily. When under proper treatment the dis- ease is checked, the first best sign is the cough beginning to "loosen," the breathing at the same time becoming tranquil, and the skin moist; the pulse changes from its hard > heat to one of a softer and a slower character. Croup does not, however, invariably begin suddenly — 'frequently the child has been suffering, apparently, from common cold in the head. and the attack of croup seems to be a consequence of the in- flammatory affection of the membrane of the nose and throat extending into the windpipe, and taking on the peculiar char- acter of the more fatal disease. At other times there has been slight drowsiness for some days previously, but not suffi- ciently well marked to attract attention, although at the same time, from hoarseness not being common among children, its occurrence should always rouse suspicion, especially if the child itself, or any of the family, have suffered from croup. Sometimes a child will have a croupy cough for some nights in succession before the attack of the real formed disease ; and parents are apt to be lulled into security by the fact, that in children susceptible of croup any cough partakes more or less of the shrill croupy sound. Another, and highly dangerous, form of croup is that in which the inflammation commences in the throat, the tonsils, and soft palate, which quickly be- come covered with an ash-colored membrane. At first the child is supposed to be merely suffering from sore throat, for there may be little or no cough, or embarrassment of breath- ing, but the inflammation extends downward into the air pas- sages, and the croupy symptoms become developed ; by the time this stage is reached the case is all but hopeless. Fortu- 100 Croup. lately this dreaded disease, the most distressing, perhaps, hj * which n parent can lose a child, is, in every form but the last, amenable to proper remedies, if adopted at once. So strik ingly, indeed, is this the case, that it is very common to find parents taking the matter in their own hands after they have seen a child treated for the disease once or twice, keeping, as they ouglit to do. a supply of the proper medicines constantly at hand, and by their prompt application nipping the first at- tack in the bud ; the medical attendant is either not sent for, or, if he is, it is only to find that the proper treatment has been followed and the disease checked. The great remedy in croup is emetics, or medicines which sicken the little sufferer at the stomach, and cause vomiting. A teaspoonful of the syrup of ipecac, or four grains of the powder, given at the very beginning of the disease, will usually produce vomiting in a short time ; if not, let the dosa be repeated until that effect is produced. If ipecac is not to be had, as is often the case, at that hour of the night, one tesj- spoonful of powdered alum, mixed with a tablespoonful or two of .sweetened water, given, will usually produce vomiting ; or, if nothing better can be had, from ten to thirty drops of antimonial wine, (according to the age of the child,) give a every fifteen minutes, until it has the effect of vomiting. If the child is not better within an hour after the firtt vomiting, the emetic should be repeated. Besides this, apply some stimulating liniment to the throat, and around the uppor part of the chest, front and back, and also keep a piece of flannel bound around the throat. A mixture of turpentine, sweet oil, spirits camphor, and whisky, (or spirits of any kind,) in equal parts, will make a good liniment, applying it with a woollen cloth or the hand, and afterwards putting on flannel next the skin. If all these ingredienls are not to be had, use such as you have, even one of them alone. let th« child drink freely of toast water or thin gruel. Besides this treatment, keep the child carefully wrapped up, to prevent checking the perspiration ; and also produce a moisture in the room as soon as possible, by means of hot water poured over mullein leaves, hops, sage, and horehounu, all mixed together, or either one, if all cannot be had, using a Ul ge pan, pail, or dish, so that the steam arising therefrom will impart its moisture readily to the air of the room. And if the child be large enough, let it inhale frequently from an old tea-pot the vapor of hot water and mullein leaves, or some of the other ingredients mentioned above. Also, give a good dose of caskr oil or other suitable medi Croup. 1U1 k ne, t3 purge the bowels. When the child is getting better, Le careful of a relapse. Do not suffer it to bo exposed to the cold air ont of doors till entirely well. If a case of incipient croup be thus treated, it will, in all probability, and may be, Bubdued withoul medical assistance, though it is certainly safer to have it ; but if the fever : - ex- tremely high, and if the breathing has any approach to a crowing sound, medical attendance must be procured if possi- ble, and with the shortest possible delay. Always Lear in mind that tin's disease must be promptly In The causes of croup are almost invariably connected with cold and moisture, and particularly during east winds ; but it may also be occasioned by the removal ol wrappings from the throat, and exposure to a cool air when a child is heated. Children liable to croup arc Btill more so after attacks of acute or debilitating disease. The prevention of croup is, of course, of the highest im- portance, and, therefore, the causes of it must be avoided in every way. Slight colds should never be neglected in children or families thus predisposed, but should !>'■ treated by confinement to the house, or to bed if requisite, by milk diet, diluent drinks, and by the tolu (1 oz.) and mucila£ 02.) cough mixture, with the addition of wine of ipecac (i oz.), one tcaspoonful of the mixture every four hours ; paregoric should also be given to allay troublesome cough, and, in fact, those measures recommended in cold carried out. The sus- ceptibility may also be lessened by not clothing the throat too warmly, and by the regular practice of bathing the throat and chest well with cold water every morning, rubbing afterward with a rough towel, till thorough reaction ensues. This prac- tice is. of course, better commenced in warm weather, and not too soon after an attack of the disease. Flannel should always be worn next the skin, and care taken particularly that bed- chambers and rooms children habitually live in are not too warm, and never occupied while the floors are wet after wash- Jig. A residence a distance from water is to be preferred. Spasmodic or Ckoweng Croup. — This disease differs very much from the membranous croup. It is a species of eonvul sive or spasmodic affection of the muscles of the larynx (upper part of windpipe), which, by narrowing and closing the chink in that organ, through which the air passes, occasions the sound of the breathing to resemble that of the true inflammatory dis- ease. This spurious croup is often an alarming, and sometimes a fatal disease ; it generally occurs before the end of the third 7ear of life, and in consequence of irritations acting more or less at a distance from the affected parts which receives the 102 Colds and Snuffles. impressions through its nerves. Enlargement of the glands oi the neck, affections such as eruptions of the scalp, the irrita Hod "i" teething', or the presence of irritating matter in the bowels, may any of them give rise to this affection. It cornea on suddenly ; the child is seized in a moment with "catching at the breath," struggles, the face changes color, and the veins are full. If the spasm be not relaxed after a few ineffectua; efforts at breathing, the child must die ; but if the spasm gives way, the air is drawn into the chest with a crowing, croupy Bound. It is of much importance that this spasmodic diseaso should he distinguished from real inflammatory croup, on ac- count of the very different treatment required ; it may be known by the absence of fever, the stopping of the breath be- ing much mart instantaneous than that which occurs in the real disease. In an affection presenting symptoms so sudden and so alarming, Immediate remedies must be used ; a little cold water should be dashed on the face at once, and, as recom- mended by Dr. Watson, a sponge dipped in hot water applied t<> the fore part of the throat, and after removing it apply a flannel bandage saturated with some stimulating liniment, medical assistance being of course procured if possible. In the meantime, set the child in an upright position, with the head leaning forward, and exposed to the fresh air for a few moments, the body being at the same time well wrapped up. if not relieved, rub the spine (back bone) thoroughly with the open hand, moistened with the liniment previously mentioned, or any other which may be on hand. When the spasmodic fit is over, examine the gums, and if red and inflamed let them be lanced. Also give a mild pur- gative every day or two until well. A teaspoonful of syrup of rhubarb, or castor oil, will answer. Colds and Snuffles. — During the first month, most children are affected with colds, commonly in the nose, called sn utiles. Warming the feet at the tire, will often be sufficient to cure them. J3ut when the disease is attended with fever, it is best to administer three grains of ipecac, mixed in four table spoon- fuls of warm water, and one table spoonful to be given every twenty minutes, until vomiting is produced. The bowels should be kept open with magnesia, rhubarb, manna, or eastoi oil, in small doses. Repeat the ipecac next day if the disease is not better. Vabjous Ebdptions of the Skin. — Children, particularly those not daily bathed, or washed in water, are very subject to a great variety of eruptions on their skin, commencing somft- imes the first week of their birth. Diilerent names, as rer warm water and castor oil up the bowels, and as soon as the child can swallow, give a good brisk purge of castor oil, Rochelle salts, (one table spoonful in water,) or rhubard and magnesia. Rubbing chloroform on the temples and back-bone is also some times beneficial in severe cases, as also is pounded ice, wrapped 'n a bladder or piece of cloth, and applied to the head. When there is a tendency to frequent returns, it will be proper, besides keeping the bowels open, to give repeatedly a few drops of tincture of asafoetida, mixed witli oil of anise. In all cases of weakness, the strength is to be supported by suit- able nourishment, even by injections of beef tea. SOB E HEAD. Some children, are subject to sore head. It often be- gins on the fore part of the head, in large white scabs, which, if neglected, spread over the head, forehead and face, in large patches. In the beginning, generally, it is dry ; at other times, it is moist and has a thin discharge. Medical writers have named this complaint crusta lactea, or milky crust, from its appearance. The children of the lower order of country persons, who are gross in feeding, are most subject to it ; and it seems to be occasioned by a want of cleanliness and exercise, which children, who have a bountiful supply ot nourishment, require ; but to which parents, in this situation, are not often disposed, or seldomer have opportunity to afford L10 Scald Head—Meadet. them. A cabbage leaf is :i very Common application, as il promotes a discharge from the head, which is supposed neces- sary, previous to t lie cure ; but as such a discharge is in no way necessary, and as it makes the head uncommonly often five, it is better not to encourage it, and the sooner the com plaint is cured the better. For that purpose, take of brand v [or whisky) and water, each equal parts ; mix them together, and bathe the parts of the head and tare where the complain! is, once a day, and immediately afterwards lay on a plaster of basilicon ointment, (made of lard, eight ounces; resin, five ounces; yellow wax, two ounces; melted together,) spread upon a linen rag, which is also to be renewed every day, after each washing with the brandy and water. Two'or three doses of purgative medicine must be given during the cure. Bath ing in the sea, or salt and water, will be of great use. SCALD HEAD. Tins is different from the oreceding, as the soreness ia confined altogether to the head, but will extend to the neck if neglected. It begins in distinct brownish spots, that form a scab and discharge a thick, gluey matter, that sticks amongst the hair. The spots increase and enlarge so aa to cover a great part of the head. When these spots are dis- covered, the hair upon and about them must be cut as close aa possible, and they must be washed well, every day once or twice, with soap and water. Should that not prove sufficient to remove them, they may be daily anointed with a little tar ointment, (a mixture of tar and fresh lard, in equal propor- tions,) or Barbadoes tar mixed with sweet oil, in equal pro- portions, with the point of the finger, which rarely fails of a cure. The scald head, which is either this complaint in the extreme or nearly allied to it, may be treated in the same manner, and which will be going as far as can with propriety be attempted before consulting a physician. MEASLES. The symptoms of the measles are, a sickness, a heaviness, a thirst, a short, dry, husky cough, witli hoarseness, a sneezing, a running at the nose, and a running and thin discharge from the eyes, which appear red and much inflamed, particularly the eyelids, with sometimes cold shiverings. These symptoms are commonly slight at first, and increase till the measles coma out, which generally happens on fie fourth day from the first attack, although children will frequently be much indieposed for a week before they come out. At the first appearance r.!' Measles. 1 1 1 the measles, they look like flea bites upon the face and neck, in distant spots ; but soon after, the face, neck and breast are covered in patches, resembling a thick rash, that does not seem to rise above the skin, although it may be discovered by tho touch and feci of the hand, to be a little prominent or raised upon the face and breast, but not upon the other parts of the body. The measles, like the small-pox, come oul first upon the upper part of the body, and last of all upon the feel : and they observe the same progressive regularity in going off. This disease is attended with much depression and dejec- tion.,, and sickness at the stomach. It is very comn for the most lively children to lie in a stupor, or state of heaviness and seeming insensibility, from the second day of the attack, during the whole of the complaint, which continues three days after the first coming out ; on the third day the eruption begins to look paler, and, on the fourth, goes oil' with a mealy appearance upon the skin. During the whole of the com- plaint there is considerable fever, which often, with the cough and a difficulty of breathing, increases in proportion as the disorder advances, and will sometimes be the most violent and severe at the height, or turn, of the measles; sometimes the fever, cough, and other symptoms abate, and the child re- covers, in part, his spirits soon after the measles come out, but not generally. The patient must not be kept either very warm or very cold ; he ought not to be kept near the lire, nor yet suffered to breathe the cold air; it will be best to confine him to one room that is moderately and temperately warm. Cold air will add to his hoarseness, and make the cough worse. His drink may be water, barley water, milk and water, balm tea, saffron tea, or anything of the kind ; but water, or milk and water, seems most agreeable to children at this time. What "he drinks ought to be a little wanned, but not hot. Wine, cor- dials, and all stimulating drinks are improper and injurious. ■ These precautions are always to be observed on the first at- tack of the measles. It will always be proper to give some- thing at the beginning, to procure two or three loose stools, as the infusion of senna, salts, castor oil, prunes, or manna, &c. Mustard plasters, applied between the shoulders or to the sides, have been found of great use in abating the cough an relieving 'die breathing, and may safely be applied at any period of the disease, if the cough and breathing be bad Cupping the sides and back is also of value. A fever always accompanies the measles, and is the cause of the drowsiness and stupor which children have in the be- 112 Measles. ginning, and often during the whole of the complaint. Noth. ing will so sensibly check and abate this fever, remove the drowsiness, and restore a child's spirits, as repeated doses of ipecac and spirits nitre. Mix live grains of powdered ipecac, (or cne tableapoonful of the syrup,) and one tablespoonral of spirits nitre, and two ounces of cold water, together. Of this give one teaspoonful every three or four hours, unless there is much sickness at the stomach. It may be begun with on the second or third day ; and after the stools have been pro- cured, as above directed, while the fever and heaviness con- tinue, ir will be particularly proper to give it in the evening, at which time the fever is most severe, and if it operates, as it generally does, both by vomit and stool, it will give most sensible relief — the fever, heat, and oppression will be con- siderably abated, and the child will be much more easy and cheerful, and more tranquil and composed, than befo; a taking it. Tiie fever and cough will frequently continue, without much abatement, for a few days, or a week, after the measles aie entirely gone, but which may be greatly relieved, or entirely removed, by giving a gentle purgative every second day. It may also be known that the fever continues while the dullness, thirst, and want of appetite remain, and during which time the purgatives ought to be given, at proper intervals, if no other cause forbids it. It may also as certainly be known that the fever is gone off when the child's spirits and appetite re- turn. The danger from the measles is much increased when they happen to be connected with the small-pox or hooping- cough ; and, therefore, so circumstanced, they require more medical attention than is generally bestowed upon them. The eyes, and particularly the eye-lids, will sometimes re- main sore, swelled, and inflamed after the measels. The cough also, will oftentimes continue for sometime after the fever and every other remains of the measels are gone. While either the sore eyes, or the cough remain, the child ought nut to be suffered to go out of doors, or to be exposed to the cold ; as the air, in eold weather particularly, is very apt to add to and greatly aggravate these complaints, and may make them very troublesome and tedious. Too much caution, therefore, in avoiding cold, cannot be observed during the disease or while there are any remains of sore eyes, or cough. The measelb sometimes leave these symptoms for the remainder of life— • which most frequently may be attributed to a too early ventur- it\g -jut, which of course would have been pre7ented by scar sotutble conjincment within doom. Worms. 113 wo it m a . When a child gets sick, and the mother can find no other elation of the difficulty, she is almost sure to attribute it to worms. She is ol'tcner wrong than right. Worms of dif- ferent kinds are often found in the bowels; hut there are chiefly two met with in children, the lumbricus, or long worm, having a great resemblance to the common earth worm, and the ascaris, or small white worm, like a hit of thread. These two kinds inhabit different parts of the bowels, the small worms being confined to the lower part, whilst the other is found much higher. It is extremely difficult to account for the production of worms. It is observable, that few infants have worms till after they are weaned, which is to be account- ed for on the principle that the bowels are in better order during suckling than afterwards, when the diet is more varied and indigestible. Worms may exist without producing any symptoms, until they either accumulate in considerable quantity, when they cause more or less irritation in the bowels, or some slight in- disposition takes place, and they, by their irritation, increase it, All the injury they produce, is that of irritation : but the degree of this, and the effects of it, must vary, not merely ac- cording to the number of worms, and their movements, but also according to the state of the bowels themselves. It is also to be remembered, that as a weakened state of the bowels is fa- forable for the accumulation of worms, many of the symptoms may proceed from that state alone, independent of the new irritation from worms. The long worms may be suspected to exist, when the child complains of frequent griping or pain in the belly, has repeat- ed and unexpected, attacks of looseness, variable appetite, be- ing sometimes seized suddenly with extreme hunger, has swelling of the belly, especially at night, disturbed sleep, frightful dreams, and grinding of the teeth. Always give chil- dren something to eat at once when they thus cry out with hunger. A failure to do this has caused the worms to pierce the bowels through, and cause death, when a slice of bread and butt er would have saved its life. Besides these symptoms, we also observe that the countenance is alternately pale and flush' ed / the child picks its nose, has bad breath, dry cough, and sometimes slow feifer, or convulsive affections. These symp- toms may exist in different degrees, and are ultimately attend- ed with the expulsion of worms, either by vomiting or stool. It has been supposed that a very obstinate and protracted fe- ver, called " worm fever" might also be produced : but this J 14 Hooping Cough. generally depends more upon costivencss, or a deranged state of the "bowels, than simply upon worms. It resembles a most formidable disease, "water on the brain." A variety of worm medicines have been employed, such as ■tin powder, tansey, sulphur, hellebore, worm seed, cowage, In- dian pink root, be repeated every day or othef day for four or five days, unless the symptoms lessen For a violent fit of coughing, the best remedy Is, to ponr in the back of the mouth a teaspoonful of melted hog's lard or sweet oil, which sheathes the part, and lessens the irritation. The tinc- ture of asafcetida, twenty to thirty drops every four hour-, is highly recommended. A child grown enough for the purpose, will find some relief in holding warm water in the hack of the throat. It is of great importance to children in this complaint, to keep the skin in good condition. A coarse flannel shirt around the breast, has been of great service by keeping up friction on the surface. With the flesh brush or a ball of woof, the surface of the body should be rubbed every night. K\.-r- cise in the open air, while the body is kept comfortable, is ad- visable, as well as change of residence for a few week-, which scarcely ever fails to afford relief. The juice of garlic sweet- ened, lessens the cough. A solution of soda, also of alum-, in doses of three or four grains, and sweetened with liquorice. given night and morning, is a valuable remedy. A mixture of twenty grains of tartar emetic and an ounce of tincture of Spanish flies, nightly rubbed on the stomach, is a remedy highly extolled. COSTI VENESS. This complaint is sometimes hereditary, or natural to the child; when this is the case, and it does not exceed proper bounds, it may not require the use of any remedy; but should the infant's health begin to suffer from frequent attacks of colic, flatulence, etc., it should be attended to, as it may produce convulsions or fits, inflammation of the bowels, or other diseases of a difficult and lingering nature, or establish a costive habit for life. If the predisposition has descended from the mother of the same habit, or in other words, if the mother herself is subject to costiveness, the child may be relieved for a short time, but 't will again return. When this is the case, the mother, if pos- sible, should change the quality of the milk, by being atten- tive to her diet, and take occasionally some mild purgative, which will alter the quality of her milk ; for this purpose there is no medicine superior, or more innocent than magnesia and Epsom salts, of equal quantities, mixed and ground very fine in a mortar. Of this, take a teaspoonful or two in a tumbler of water every morning on an empty stomach. When the cos- tiveness originates from the child's food, it must be changed 116 Diseases of the Ear. and simple medicines given occasionally, to act as a mild purge, such as fire or ten grains of magnesia, rhubarb or manna, a tea ipoonfnl of Bweel oil, or castor oil. But the best plan in such cases is to allow the mother, if the child is nursing, or the child itself if ir has been weaned, a plentiful supply of syrup, mo- la--, s, and stewed fruit, at meals, and ripe fruit uncooked, be- tween meals, and teaching the child to go to stool at regular hours. ( '/,//,//■• n ofU n have a disposition to go to stool but put ■ill the effort of nature passes. The mother should be attentive in these matters if she wants her children to bs healthy in body, happy in mind, and sound sleepers at night. DISEASES OF THE EAR. Acute inflammation of the ear is known by the swelling, acute pain and noise in the head, and pain in swallowing or moving the lower jaw. Chronic inflammation is a£ tended by some degree of deafness and discharge of minu- ter; The disease is caused by colds, foreign bodies in the ear, measles, scarlet fever and scrofula. Nervous earache oc- curs in paroxysms of severe pain in the ear, and shooting over the lace, head, neck and shoulder. It is caused by sudden cold, decayed teeth, and sometimes by fullness of blood. The warm foot bath, with some ground mustard and salt in the water, and hot applications to the ear and face, usually gl\ e relief. A drop or two, each, of laudanum and sweet oil put into the ear on a piece of warm wool, is an old and valuable remedy, to be repeated every hour or two if necessary. Hold- ing hot coffee or tea in the mouth is also good, or gargling the throat well with tea or coffee, and then spirting the liquid out through the nose by stooping forward with the mouth closed. A bag of hops steamed over boiling water, then allowed to cool sufficiently to be agreeable, and applied to the ear, often affords relief in a short time, h an insect is in the ear pour warm sweet oil into it; this will generally cause it to come out to get air. Foreign bodies, 6uch as beans, coffee, dust, etc., sometimes get into the ear and cause intense pain : they may be removed by syringing the ear with water, or by a small probe or Mount wire, doubled, or bent into the proper shape. Great care must be exercised not to hurt the drum of t lie ear. Running fkom tub Ears. — AVhen the discharge after an abscess does not disappear, or when running from the ean shows itself after acute diseases, such as measles, scarlet fever, et<-., the .symptom must not be neglected, and should be ex- amined into by a medical man. It is most common in chil- dren of a weak or scrofulous constitution, and may be with oi Malignant Sore Throat. 117 without disease of the bone ; in the latter case the discharge if extremely offensive, and often stains the linen black. These discharges must not be too quickly stopped, neither can they De allowed to go on without risk ; in the former case, the sud- den stoppage may throw back the disease upon the brain ; in the latter, this organ or its membranes may become affected by its gradual extension to them through the bones. Counter- irritation, by blisters, or tartar emetic ointment, (ten grains of the powder to one teaspoonful of lard, well mixed, and applied once a day till little pimples appear) behind the ears ; keep the bowels open regularly. The general tonic treatment as re- commended in some other diseases of children already treated of, and syringing with slightly astringent washes, such as one grain of lunar caustic, or two of white vitriol, to the ounce of water, or a wash of strong green tea will constitute the most appropriate treatment. MALIGN AN T SOB E THROAT. This species of sore throat differs from that which at- tends malignant scarlet fever. It is usually limited to the upper part of the throat. It begins with redness, swell- ing of the tonsils, bloated face, flow of tears, chills and flashes of fever : the redness of the throat soon changes to a dull ash color, and then to brown or black — there is thirst, hoarseness, difficulty in swallowing, nausea, sometimes vomit- ing and diarrhoea. In the more severe cases there is a bloody or watery discharge from the nose, and an offensive discharge from the throat — the tongue becomes brown, dry, and coated, there is often an eruption on the skin, sinking of the powers of life, and finally death in severe cases. Most medical writers consider this disease contagious — it is caused also by cold, wet, insufficient clothing and food, bad air, and want of personal neatness : it is a very dangerous dis- ease, and requires prompt and efficient treatment. A phy- sician should be immediately called in ; in the meantime, or in cases where one can not be had, give the patient an emetic of ipecac ; then give a purgative of one teaspoonful or two of Rochelle salts, in half a gill of luke-warm water. Apply a mustard plaster to the throat, and give every hour or two a gargle of sweet oil or melted lard, mixed with a few drops of •pirits camphor and a little sulphate of iron (green vitriol) dis solved in w r ater. A gargle made of Cayenne pepper and oak bark tea, not too strong, with a little salt in it, is also good. Also a gargle made of yeast and finely powdered charcoal has been used 118 Choking — Cholera Infantum. with great benefit. When the patient is weak the strength must be supported by tonics, such as wine and infusion (or tea) of Peruvian barks, or one grain of quinine, three times a day .Where there is a feeling 01 suffocation or choking, it is advis- able to produce vomiting, either by tickling the throat with a feather, or giving a dose of ipecac, to clear the throat. CHOKING. Children sometimes get choked by bits of food or stones of fruit, which produce cough, blueness of the face, gagging. Bometimea nose-bleed and convulsions — and if relief is not given, death ensues. When a child ia choked, he should he held with the head downwards and receive two or three smart blows on the back between the shoulders: if this does not give relief, the mouth should be thrown wide open, and some person should endeavor t" dislodge the substance, either bringing it out of the mouth or gently pushing it downwards ; a few swallows of water may enable it to pass into the stomach. CHOLERA INFANTUM. (Summer Complaint.) Tins is one of the most fatal diseases to which the period of infancy is subject : it occurs mostly among children under the age of two years, and during the warmer part of the season. t is said by authors to be a disease peculiar to the United States. It usually commences with a profuse discharge from the bowela of a light-colored fluid ; after a short time the extreme irritability of the stomach is manifested by the constant vomit- ing of everything swallowed. The discharges from the bowela sometimes contain Hakes of mucus: the passages are often involuntary, and attended by much irritability and debility: the tongue is coated with a white slimy matter, the skin dry, pulse quick and small, much thirst, bowels hot, sometimes bloated and tender: there is, at times, moaning cr sudden Screeching, indicating acute pain. Digestion is so far suspended that whatever is eaten passes unchanged. In some cast/s delirium comes on early, and the little sufferer dies in one <>i- two days from the attack: at other times the disease continues until extreme emaciation is pro- duced; the skin has a wrinkled, dirty appearance, bathed in co!«l perspiration, the features sharp, eyes large and glaring, tlie whole countenance has the appearance of old age. Tho cholera of infants is mostly a disease «>f the mucus coat and glands of the bowels —often accompanied by enlargement o\* Dysentery. 119 thelivei. It is caused by impure, stagnant, or confined air, cooing in contact with the sensitive surface of the air passages, Bkin and digestive organs, and improper food. The disease maybe produced by all the causes which pro- duce diarrhoea : it seems mostly to prevail in low, damp situ- ations, in towns and cities. Perfect cleanliness, pure air, good diet, and change of location when it depends on that, are in- dispensable in addition to medical skill. When the child can not be taken to the country, take it -often into the open air, in the cool of the day in good weather It should be confined entirely to the breast-milk when nursing or if weaned, let its food be arrow-root, tapioca, corn starch rice flour, and milk. Put it in the warm bath once a day ; keep flannel next the skin, and the bowels moistened out- wardly frequently by vinegar and water, and the arms, hands, feet and legs, frequently rubbed with whisky or any kind of spirits. Give small pieces of ice to melt in the mouth in pre- ference to water. For the vomiting, give a few chops of es- sence of peppermint in water frequently, or essence of cinna- mon, or a tea made of allspice (cold), in which there is a little gum arabic and a teaspoonful or two of prepared chalk t<> the cupful of tea. Of this give a teaspoonful every hour. Acidity or gourness of the stomach seems to be the great difficulty in this disease, and, as a consequence, suddenly checking the bowels will not do until the preparation of chalk has to some extent corrected this sourness. If the discharges become very offensive, a mixture of charcoal, finely powdered, with chalk and white sugar, equal parts, and thick mucilage of gum ara- bic given three or four times a day will be advisable. Mucilage of gum arabic or thick slippery elm water, made by putting the slippery elm in cold water, to which add one teaspoonful of spirits of nitre to the half pint, given in tea- spoonful doses, is also a good remedy. Sometimes nothing will afford relief as quick as one half grain of calomel given every four hours, and continued until the passages are more natural. DYSENTERY. This disease consists of inflammation, which is confined mostly to the large bowels. In some cases, however, the in fiammation extends to the small bowels and even the stomach. The symptoms are griping, frequent and small discharges of slimy matter (mucus,) mixed with blood: the first discharges are usually, however, thin and watery, the bowels are tender, dry and hot, there is some fever, furred tongue, and sometimes vomiting. When these symptoms are not abated by timely 120 Incontinence of Urine. remedies they arc apt to increase in intensity until terminated by death. Dysentery is caused by changes of weather, improper diet, worms, hot wet weather, impure air, want of sufficient food, unhealthy milk. etc. When the attack is attended by profuse discharge of blood the case is more favorable than if no biood appears. The diet should be restricted to animal broths, boiled rice, and the like ; the clothes kept clean, the child put into the warm bath once or twice a day, fomentations of hops and vine- gar, stimulating liniment applied to the bowels ; the drinks should be barley water, gum arabic water and flaxseed or slippery elm tea: injections of tea of oak bark, or starch and laudanum, four to ten drops, according to the age, and repeat- ed three times a day if needed, are also of much value. The allspice tea, etc., recommended under the head of Summer Complaint, will be found advisable also in this disease. Also the flannel next the skin, bathing with vinegar, etc. INCONTINENCE OF URINE. This is a common disease among young children — and is often the result of a careless and filthy habit of neglecting the calls of nature, and not endeavoring to restrain their de- sires. It usually occurs at night, the child allowing the urine to pass even while awake, rather than to rise and evacuate the bladder. It is also caused by palsy of the bladder or some of its appendages, or by an irritable state of that organ. The discharge of urine is most apt to take place when the child is lying on his back : the urine sometimes scalds and irritates the legs and produces sores. Incontinence of urine is caused by the improper use of irritating medicines, certain articles of food, and by diseases of other parts of the body. The habit of incontinence, although an unpleasant one, demands indulgence and pity, rather than blame and punish- ment in most cases. Children thus afflicted should not be allowed much drink or fluid food ; they should be made to urinate immediately before retiring, and also to rise at stated kours <>/ the night for the same purpose The best position iu bed, in order to prevent involuntary discharge, is on the side. The diet should be digestible ana nutrieious, and the bowels regular — the cold hip bath at night will be of service. A tea made of uva ursi, or buchu leaves, a table spoonful of which may be given three times a day often cures the irritability of the bladder, on which the habit dcDcmU, or alters the quality of the urine, which causes its in- voluntary flow. Rickets — Foreign Bodies in the Nose. 121 It I C K E T S . RroKK'is depend upon disordered nutrition, and some alter* ation of the blood from its healthy standard. It has usually however, been supposed to depend upon a deficiency of phos- phate and carbonate of lime in the food, to furnish the necessary earthy matter to the bones — and therefore has been considered peculiarly a disease of the bones. But recent investigations Bhow that it docs sometimes occur when there is no deficiency of lime — and that the whole system, particularly the muscles, brain and nerves, are equally implicated with the bones. It is an affection peculiar to childhood, and supposed to depend upon the action of the causes which favor the development of scrofula. The signs of rickets are, a softened gristly state of the bones, large joints, large head, prominent forehead, straightness of the ribs and flatness of the sides of the chest, prominent breast bone, looseness of texture in the bones, crook- ed legs and distorted spine : many other symptoms of scrofula are sometimes also present. This, like scrofula, disposes the system to other diseases : the treatment of rickets is nearly the same as that of scrofula, (which you will find in its proper place in another part of this work,) — rickets, however, is a more curable disease, and less apt to continue after adult age. FOREIGN BODIES IN THE NOSE. The nose, like the ear, is very liable to be made by children the receptacle for any thing that will pass into it; beans, but- tons, stones, &c. Sometimes they have been in the nose, uunoticed, for days or weeks, and are not discovered until in- flammation of, and perhaps discharge of matter from, the I ning membrane attracts attention ; a reason, when such synip- loms occur in a child, for always examining the nose for the tresence of foreign bodies. The extraction of a foreign body from the nostril is always best done by a surgeon. If, how- ever, circumstances render it desirable to attempt the extrac- tion without waiting, it must be done by means of the flat end of a probe, or of a bodkin, bent about the eighth of an inch, •early at right angles with the rest of the instrument, which bent end being carefully passed beyond the body, must be ased as a scoop to take it out. The flat end of a pair of Iweezens also answers for this purpose, or use them as a pair of forceps, if the foreign substance can be got hold of. Some- times, when the foreign body is not very far in the one nostril, if that on the opposite side be closed, and the child can be made to blow forcibly through the other, the obstruction will be shot out. 122 Weak Ankles — Bronchitis. The lining membrane of the nose is liable to become inflam- ed and ulcerated. In a mild case, washing with warm watei — if necessary, by means of a syringe — containing a little car Donate of BOda in solution, will be of service: soap and watei is also gjod. It is a common popular error to suppose that the nose communicates with the brain: it is sufficient to remark that it does not. WEAK ANKLES, If children are put on their feet when too young, before hav ing requisite strength, or who are allowed or taught to turn their toes outward too much, or those who are of a weak and relaxed muscular system, are apt to have weak and crooked ankles, or bowed legs. The soles of the feet are flat, the an- kles turn inward s<» that the child walks almost on the ankle joint, and with lameness and difficulty. The general health should be improved by a good diet, cold bathing, and exercise in the open air : the child should also wear high boots madt of leather sufficiently stiff to support the ankles in the proper form and position. Also use friction with the hand or rough towel to the legs and feet every day. BRONCHITIS, This is an inflammation of the bronchial, or air tubes of the lungs, and is common to childhood. It commences with chills, flashes of heat, slight cough, oppression and tightness in the chest, breathing difficult, wheezing and rattling, and hoarse- ness of the voice. Breathing is more distressing when the patient is lying down— the cough is at first dry, but a copious discharge of stringy phlegm, resembling white of eggs, soon appears, with some relief to the cough: the skin is dry, and the tongue is covered with a white mucus. In more severe cases, these symptoms may all be augmented and attended with much danger. The disease is caused by cold, wet, sud- den changes of weather, insufficient clothing, loud speaking. crying, dust, and noxious vapors. When a physician can be procured, in cases of this kind, as well as in inflammation of the lungs, by all means do so ; but as delays are always dan- gerous, while you may be endeavoring to procure a physician, or if y< u can not obtain one, the following ccurse of treatment is advisable: — In the first place, give the child a purge 01 say, one or two tea spoonsful of Itochelle safts in a wine glass (or half gill) of cold water; or castor oil will answer as well, made more palatable by a little essence of lemon, peppermint, or cinnamon. Also, of the following mixture, let tlie child take one tea spoonful every four hours, unless vomiting is pro- 123 Cultivation and Carelessnets. A form repre- senting a full- ohested \\ oman. — Such u person would naturally have a strong con- stitution, and could endure a great amount of labor, either mentally or physioally. T h e European ladies are more generally of the above form than the Ameri- can, because they take more interest in cultivating a full chest and tine form. In future let it bo truthfully Mid that the American ladies not only have "pretty faces" but healthy forms. FORMS THAT CAN BB CULTIVATED. This is a fac-simita in form of a great many women that are daily met with. Such persons are usually troubled with that sinking sensation, or ■ goneness " at the pit of the stomach, which is alwaj a pro- duced by the- pressure upon it in sto and might be pi ed by rare in keeping back the shoulders, „ expanding the chest, FORMS CONTRACT- S . , • ., . , • i bd by cashless- :Uid taking that kind ness ok habit, of exercise so much needed, but so much neglected, called "House-work I" We here see re- presented a full- chested and erect man, one so rarely seen, although it is no more than can be obtained in near- ly every person by cultivation. A per- son with such a chest would usually be free from disease of the Lungs or the Heart, and would have all the indica- tions of being a ro- bust and long-Jived person. It is as •»sy to have this form as an improper Me, by a little timely training. This represents a man of stooping form, with small Lungs and Chest. Such a per- son would be almost sure to have some disease of the Lungs, Heart, or Stomach, and would naturally be Consumptive and short-lived, because the vital powers are small. Care should be taken to avoid con- tracting such a form. It is simply the result of carelessness and habit. Inflammation of the Lungs — Stammering. 125 dnced ; if so, reduce the dose : — Take one table spoonful of syrup of ipecac, (or five grains of the powder,) half a gill of cold Water, one table spoonful of spirits of nitre, 20 grains of chlorate of potash, and a few drops of essence of lemon or cin- namon, mix thoroughly together and keep in a cold place, to be used while the active symptoms continue. Also, wrap the chest and neck in a flannel cloth, saturated (soaked) with this mixture : — Sweet oil, spirits of turpentine, spirits camphor, of each one ounce, to which add a table spoonful of laudanum, and shake well before using. Renew this twice a day. The child should be allowed to drink freely of cold water, in which put plenty of grim arabic, or slippery elm. The bow- els should be moved every second day, to remove the phlegm which is usually swallowed by the child. In robust children, if there is much fever and oppressed breathing, a few leeches appiied to the chest will be advisable ; or the application of cupping may be tried once a day for two or three days. When the inflammation is somewhat reduced, applying a more stimu- lating liniment all over the chest will expedite the cure. A table spoonful of tincture of cayenne pepper added to the lin- iment of turpentine, &c, will be about as good as any — appli- ed twice or thrice a day. INFLAMMATION OF THE LUNGS. Among children, as well as adults, this is a frequent and dangerous disease. It begins with symptoms similar to those of bronchitis, and is produced by nearly the same causes. — The treatment is the same as in Bronchitis. STAMMERING. Stammering in the speech cannot be said to be a disease, being rather a functional disorder. This is evident from the fact, that, under certain circumstances, an habitual stammerer does not stammer, and that cases have occurred in which most inveterate stammering has been completely cured by the exer- tion of the will. Moreover, stammering is often caused either by imitation in children or by nervousness in both children and adults. This nervousness is often the result of debility, and of weak constitution — a fact which should not be lost sight of, for, if such be the case, every means of strengthening should be used. At the same time, while the general health is sustained, much may be done by checking children, and making them speak at all times slowly. Much pains with children, and much perseverance and self-command in adults, is required in the efforts to overcome this defect. The one 126 Socket Fever. great matter of importance in curing children or others of Btamrnering is, as soon as the least hesitancy in speech, o! stammering, is observed, make the patient stop at once, then draw in afutt hfcath, filling the lungs thoroughly, when they can begin again. Let this rule be observed only a short time and you will be surprised at the rapid improvement. The difficulty, in almost every case I have observed, has been that the person attempts to talk when he has already exhausted the air from the lungs. Overcome this, and the case is cured. SCARLET FEVER. In this disease, usually, the first symptom complained of, in the incipient stage is sore throat, either accompa- nied or quickly succeeded by the usual symptoms of a feverish attack, shivering, headache, loss of appetite, perhapa vomiting, followed by heat of skin, quick pulse, and thirst. The eruption appears early, on the second' day after the first symptoms of indisposition. It first shows itself in the form of minute red points on the chest and arms, especially about the elbows, the points becoming more numerous, till they form one diffused surface of a tolerably bright scarlet eruption, which extends to the neck, face, and abdomen, and body gen erally. On the second day, when the eruption is appearing, the symptoms of general fever, and especially the heat of skin, continue unabated, the throat is more inflamed, and the tongue assumes the appearance characteristic of this disease. It is probably covered with a white, creamy-looking fur, through which, on its forepart, about the tip especially, pro- ject red points. This appearance may continue, but \u many cases the fur comes off, as it were, in patches at a time, and ultimately leaves 'the tongue preternaturally clean and red. The eruption in scarlet fever generally looks more patchy upon the extremities than it does upon the body. In a moderately favorable case of scarlet fever, the eruption begins to fade be- tween the third and fourth day from its appearance, and with it the feverish symptoms, and other general symptoms of the disease, such as sore throat, &c. The chief care is required until the peeling off of the skin is completed. During thi% period also the power of communicating the disease foj coita* gion appears to be retained. Favorable cases of scarlet fever pass through the course nearly as described above, but there are much severer forma of the disease. The feverish symptoms from the first may have a high inflammatory form; or the reverse may give evi dence of an extreme condition of bodily -weakness, with a ten Scarlet Fever. 127 dcncy to malignant or severe disease. In such eases the eruption is slow, and, when it does appear, patchy, and dusky in color, the swelling of the throat is greatj and, it' they can be seen, the tonsils are evidently ulcerated, the breath offen- sive, the tongue swollen, and swallowing difficult, if not im- possible. Offensive discharges tak e place from the nose, and at the same time there is extreme weakness, with delirium. Scarlet fever requires confinement Co bed, in a well venti- lated room; the diet should be kept low, and consist of milk, corn-starch, farina, &c, and the patient may be freely indulged with drinks, such as flax-seed tea, with a slice <>t' lemon in it, &c. The patient must not be so warmly covered with bed- clothes as to keep up feverish heat. The first thing to be done, in all cases of scarlet fever, is, in the very outset, to give a good vomit, of ipecac, so as to clear the stomach. In a great majority of cases this will render the disease less dangerous and more easily managed, and very often will almost cut short, as it were, or break up the disease. If the heat of skin is great, sponging the surface of the body with tepid water, with or without the addition of a little vinegar, is at once most beneficial and grateful'to the patient. A gentle purge should be repeated once or twice in the course of the disi a tablespoontul of castor-oil, a dose of magnesia and rhubarb, or from half to a whole seidlitz powder, may be required. From five to ten grains (according to age) of chlorate of potash, given every six or eight hours, dissolved in a little sugar and water, is one of the most appropriate cooling medi- cines in this disease. If the feverish symptoms run high, of course the lowering and cooling remedies must be more actively enforced. In most cases much relief is afforded to the throat by the frequent use of warm gargles, made either with simple gruel, or with gruel with one or two tablespoonfnls of vinegar to each half- pint. Externally, hot bran or bread poultices, frequently re- newed, are also of much service to the throat. Great enlarge- ment of the glands around the jaw and in the neck must always be regarded seriously. "When a case of scarlet fever presents symptoms of great severity, every method of sup porting the strength by wine, broths, &c, must be used, and the preparations of chlorate of potash employed both inter nally and as washes and gaigles to the nose, mouth, tonsils, r two pocks on each arm. About the third day after the vaccination, there is a red, elevated pimple, which, on the fourth, is surrounded by a faint red circle; on the fifth day there is a pearl-colored pim- ple filled with transparent fluid, on the eighth day the pock is at its height of development, at which time there is usually some lever, chills, lassitude, and more or less pain and swelling of the arm and giamls of the arm-pit : by the tenth day the pock is led and painful, on the eleventh it begins to shrink and assumes a darker color, so that by the fourteenth day it is covered by a thick, brown scab, which tails oil' about the eighteenth day, leaving a white sear. All the care necessary is to see that the vaccination passes through its course without getting the part injured / and should there he much fever give a gentle purgative. To preserve a " scab," keep it in a dry bottle or vial, wrapped in paper, and the mouth well corked, with some beeswax over it. NETTLE-RASH. It cannot be better described than as an eruption which closely resembles nettle-stings, both in appearance and in the sensations it gives rise to. When acute, it is generally accom- panied with more or less fever. The nettle-rash, in almost all cases, arises from disorder of the digestive organs, caused either by indigestible food, or, in some persons, by particular kinds of food. Kernels or seeds, such as almond, peach, be connected with teething, the gums should be scarified. Wheat flour, applied to the affected parts, or pow ■I, is beneficial. I X 1} I G E S TION. Tuts is manifested by the food being imperfectly, or not at all, digested, but is discharged by vomiting or stool without being changed ; there are often no symptoms of inflammation. Indigot ion in infants is almost invariably caused by too much or improper food. The most common symptoms of indigestion are, nausea, vomiting, sour odor of the breath, the milk discharged is sometimes curdled, and at others unaltered, and there are more or less griping colic pains. Children who are weaned early, or reared without the breast, are liable to attacks of in- digestion, and often become pale, weak, emaciated, the tongue furred, bowels bloated and tender, mouth sore, thirst, fretful- ucsb, moaning, eyes glassy, and finally, in some cases, death ends the suffering. Jn older children, indigestion is caused by unripe fruits, too much food, confectionery, pastry, impro- perly cooked or hard food, eating too often and at irregular and unsuitable hours. A flections of the brain, convulsions, spasm of the windpipe and inflammation, sometimes result from this disease. The child should be carried or permitted to go into the open air; the tepid bath and flesh brush should also be used every morning. Also give from four to six grains of rhubarb and magnesia, or a teaspoonfuj of castor oil, once every second day, and let the child's diet be so regulated as to avoid those things which have caused the disease. It .1 J K II O X T H E BRAIN. Children of scrofulous constitution are most liable to this disease, and should he closely watched, especially from tha Water on the Brain. 13 J second to the sixth or seventh year of Etc, the most genera, period of attack, and particularly after the child has suffered from any of Hie diseases i icidental to childhood. At first, the patient is languid, looks heavy, is subjecf to irregular Iieata and chills; the appetite is variable, the bowels irregular, and the discharge^ from them unnatural in color. The sleep is disturbed ; there is frequent starting, moaning, perhaps scream- ing; the teeth are grated, and the thumbs folded across the palm of the hand. When awake the brow is contracted; the nose is continually picked, and the child, if able To speak, com- plains of the head, which is hot. As the disease advanc< yond the first stage, all these symptoms become more marked, and probably obstinate vomiting,' and when the stomach is empty, retching occurs. Toward the termination of the dis- ease, insensibility, dilated pupils, convulsions, etc., come on; but long before the latter stages, the case should be under proper medical treatment. The object here is to put parents on their guard as to the advances of an insidious and very fatal malady — not to induce them to incur the responsibility of its treatment. Many of the symptoms above detailed undoubt- edly occur, in less alarming combination, in many of the dis- eases of children ; but come as they may, and when they may, they should not be neglected. Some amount of treatment ought however to be employed to save time, and the most im- portant and safest indication is to give a brisk purgative, say one teaspoonful or two of Uochelle salts in a teacupful of wa- ter. The head is to be kept cold, and quiet strictly to be ob- served. One or two leeches may be applied to the temples, and then obtain proper medical advice soon as possible. Its causes are numerous, but sometimes the disease arises without any being distinctly traceable ; the irritation of teething, long- continued disorder of the digestive organs, falls or blows on the head, exposure of the child's head to the heat of the sun, and fevers, may any of them give the first impetus to the dis- eased tendencies. Those children who are most liable to its at- tack are often the most endowed intellectually ; and there is a morbid tendency to excitement in the brain, which gives it power beyond what is .natural to its age. If permitted or en- couraged, the child will give up. the. sports and exercises o f 'its time of life, for the sake of mental employment, and sometimes a parent's pride permits the erroneous system, which, in ah probability leads either to early death from active disease of the brain, or to the possession in after life of a sickly bod\ and insrbid mind. In no children is it so necessary to insist up^n strict observance of all the laws of physical health, previous 7 136 Diet for Sick Children. treated of in this work, as in those who exhibit precocious de relopment of mind. DIET FOR SICK C II I L D R E iV. Under this head will he found many valuable recipes foi preparing suitable diet for the sick room. They can be relied on, as they have been prepared with a view to their adapta- tion to the delicate stomachs of children during sickness, be sides being "not bad to take," many of them, by well children or grown people. Panada. — Four boiling water on toasted bread, and season witli butter, white sugar, lemon and nutmeg. Sailed Custard. — Beat one c^j: in one pint of milk, add 6alt and sugar to the taste, and boil two minutes. Starch Pudding. — To one pint of boiling milk, add two tablespoonfuls of starch, and one egg, beaten together; season with sugar, salt, wine and nutmeg, and boil one minute. Rice Caudle. — Make a paste of two tablespoonfuls of rice flour in a little cold water, boil in one pint of water, and season with salt and nutmeg. Dyspepsia 11 read. — Mix together three quarts of unbolted wheat four, one quart of warm water, one gill of fresh yeast, one gill of molasses, and two teaspoonfuls of salt ; let it rise, and bake. Lemonade. — To one pint of water add the juice of one lemon, and the beaten whites of two eggs ; sweeten with white sugar. Orange Jelly. — Squeeze the juice from six oranges and half a lemon, add half a pound of white sugar, half a piut of water, boil, and strain through flannel ; then add one ounce of isinglass, and, when this is well dissolved, put it into a mould or dish to cool. Biscuit Jelly. — Soak one biscuit or Boston cracker in one f>int of water, boil, and add white sugar, wine and nutmeg or emon to the taste. Sayo Jelly. — Soak two tablespoonfuls of sago in water one hour; ponr off the water and boil the sago in half a pint of water, until it is transparent; then season with salt, lemon, wine and sugar to the taste. Tapioca j/ly. — Soak the tapioca eight hours, and then pre pare like sago jelly. Isinglass Jelly. — Boil two ounces of isinglass in one quart of water down to one pint, and add one ounce of white lemon candy. Mice Jelly. — Boil three tablespoonfuls of rice and three of Diet for Sick Children. 137 white sugar, in just sufficient water to cover it, until it bo comes a ]elly, and season to the taste. Calves* Feet Jelly. — Boil one calf's foot in two quarts of water till reduced to one pint, strain, and, when cold, skira carefully, and add one teaspoonful of salt, the whites of three eggs, beaten with four ounces of white sugar, one gill of wine, and the juice of two lemons; boil the whole, stirring con- stantly, for four minutes, then strain through flannel. Moss Jelly. — Soak half an ounce of Irish moss a few min- ctes in cold water, then drain it off, and boil it in one quart of water until it becomes a jelly ; strain, and season with cin- namon, wine and white sugar. Rice Pudding. — Boil one teacupful of soaked rice in one quart of milk, then add two tablespoonfuls of white sugar and one egg y beaten together, and one teaspoonful of salt ; bake one hour. Milk Toast. — Toast a thin slice of wheaten bread slightly brown, pour on to it some boiling milk, and season with nut- meg and salt. Boston Cracker Toast. — Split Boston crackers, toast them brown, pour on boiling water, and drain it off; then season with butter, sugar, lemon juice, and nutmeg or orange peel. Broiled Meat. — Broil the lean round or sirloin of beef or mutton, on the coals, until tender, and season with salt or tomato catsup. Boiled Eggs. — Boil eggs until the white is partly cooked, and the yolk slightly turned ; remove from the shell, and sea- eon with salt. Boast Potatoes. — Roast pink-eyed potatoes in the fire until well done, remove the outside crust, mash, and season with salt and cream. Oaten Gruel. — Boil two tablespoonfuls of sifted oat meal in one quart of water for ten minutes, then add a teaspoonful of 3alt, one of wine, one of lemon juice, and a little nutmeg. Indian Gruel. Boil two tablespoonfuls of Indian meal in one quart of water for twenty minutes, add salt, sugar and nutmeg, or lemon to suit the taste. Sweet Com Gruel. — Boil three tablespoonfuls of dried sweet corn in one quart of water for half an hour, season with salt and strain through linen. Sago Milk. — Soak a teaspoonful of sago in a pint of cold water one hour ; pour off the water and boil the sago in a pint and a half of milk fifteen minutes, stirring constantly. Season with salt, sugar, ginger or nutmeg, and sometimes wine. 133 Diet for Sick Children. Sago Mucilage. — Soak a teaspoon ful of sago in a pint of warn; water two hoars, then boil the same fifteen minutes. Etirring constantly ; season with salt, lemon juice, engrar, ant meg and wine. Arrow root and tapioca may be prepared in the same way as sago. Be(f Tea. — Cut die pound of lean fresh beef into shreds, and boil in one quart of water tor twenty minutes ; add onf teaspoonful of salt and strain through lineu. Mutton Broth. — Boil the same quantity of lean fresh mut ton and water as above, for one hour ; add a few crusts ol bread — season with salt and parsley, and strain. Milk Porridge. — Boil one pint of water and one of milk; add one tablespoonful of wheat flour made into a thin paste, season with suit and boil five minutes. Oyster Soup. — Boil four oysters in one pint of water for live minutes, add one small cracker and a little salt. jBarhy Water. — Boil two ounces of pearl barley in o»\e quart of water down to one pint — season with salt, lemon a^d sugar, and strain through linen. Apple Tin. — B<>il a middle-sized sour apple in one pint of wa- ter, strain and sweeten with white sugar. Peach tea may be made in the same way after removing the stone. Wine Whey. — Boil one pint of new milk, and while boiling, add a large wine glass full of sherry or madeira wine ; let it boil a few minutes, remove it from the fire, let it cool a few minutes, then strain from the curd and sweeten with white sugar. Tamarind Water. — Boil six tamarinds in one pint of water for ten minutes, and strain through linen. This is a gentle purgative. Currant Water. — Boil equal quantities of currant juice and water a few minutes; strain through flannel and season with orange peel and loaf sugar Cherry water, may be made in the same way. Chicken Water. — Take half a chicken, remove the fat, break the bones, and boil in two quarts of water for half an hour; add two teaspooiifuls of salt, and strain through linen Diseases of Females. 139 f >1&JD:^SE2S OF FEMALES. MONTHLY TURNS, Oil MENSTRUATION, This important function should be well understoo I by both male and female, as by so doing many of the ills of life could be avoided, and things which otherwise would bo mysterious A/e rendered intelligible. From the womb of every healthy woman who is not preg- nant, or who does not give suck, there is a discharge of a mud haying the appearance of blood, at certain periods, from the time of puberty to old age, called menstruation, or courses. Some few menstruate while they continue to give suck, more frequently after having suckled over six months. Some are said to menstruate during pregnancy, but which latter is very doubtful, for it will be borne in mind that the menstrual dis- charge is not blood, but a secretion resembling blood, and that every such discharge from the womb is not metistrual, but may be blood, dependent on morbid action. Although the term unwell, is by common acceptance used among women, yet, a woman during menstruation cannot from that cause alone be said to be unwell, for that is a process of health, and which, when regular, requires very seldom more than to be let alone. This is a very important process to females, and ought to be partieularly so to mothers who have daughters coming to ma- turity : that mother is very remiss in her duty who does not inform her child that menstruation is expected, and point out to her what it is, so that the child may not be taken by sur- prise, and through fear and alarm do things, which may lay the foundation of disease and unhappiness during life. The delicacy attendant on the subject too frequently prevents the afflicted from obtaining the necessary information, and gives rise to groping in the dark, and administering medicine at random. It should "be borne in mind that the time of life at which menstruation commences, depends some upon the climate, much upon the constitution, and delicacy of living ; in thi country, girls begin to menstruate from the fourteenth to tht eighteenth year of their age, but seldom later without incon venience ; but if they are luxuriously educated, menstruatiofl usually commences at a more early period. About the time tnat the constitution is establishing menstruation, a variety of important changes show themselves: the complexion is im- 140 D-iseases of Females. proved; the countenance is more expressive and animated; the attitudes more graceful ; the tone of the voice more har- monious ; the whole frame expands ; the breasts are enlarged ; the nipples protrude, r do not appear, and symptoms of ill health be present, great care and attention will be required, that proper remedies bo administered. RETENTION OF THE MENSES Oil COUliSES. This is a condition in which the courses do not appear at the proper age, in consequence of which the health sutlers. The general rules for the treatment of which are, that when robust, florid girls, about the age of fifteen or sixteen, begin to com- plain of flushings, headache, and general uneasiness, they should observe a spare diet, consisting chiefly of vegetables; use moderate exercise, carefully avoid all that is violent, par- ticularly in crowded and heated rooms; should carefully attend to the state of their bowels, and keep them freely open by saline purgatives; such as cream of tartar, Epsom salts, Ilochelle salts, one tablespoonful, of either, in a glass of water before breakfast, every second or third morning, or a seidlitz powder. If the symptoms continue or increase, and the dis- charge of the menses does not take place, take a tablespoonful of Epsom salts every two hours, beginning in the morning, until freely purged ; bathe the feet and legs, or rather sit awhile in warm water for several evenings ; after the bathing remove all moisture, and rub the feet and legs freely with a coarse cloth. In obstinate cases this proceeding will require to be repeated, for two or three times, at the end of every four weeks. On the other hand, relaxed and feeble young women, with pale complexions, when they are subject to delay in the ap- {>earance of the menstrual evacuation, and are suffering in lealth in consequence thereof, should make use of such reme- dies as strengthen the system in general. One grain of quinine, taken night and morning, on an empty stomach, is an excellent tonic, or mix together the following : Gentian root, half an ounce; Columbo root, half an ounce ; orange peel and wild cherry bark, each, half an ounce ; all to be beat or ground tine, and put with half a pint of whisky and same quantity of water. Let stand for ten days, then strain, and take a tablespoonful half an hour before each meal, during the use of which the bowels must be kept open, and a more nutri- tious yet easily digested diet allowed. Take sufficient exercise 142 Diseases of Females. in the open air, such as riding on horseback, jumping the rope in moderation, or (Talking with agreeable persons, so that cheerfulness is blended with exercise. For the same reason, a journey, a short residence at watering-places of public resort, independent of the quality of their springs, contribute greatly iO r'leir relict'; and when the impregnation of such springs ia chalybeate, (iron,) they may he drank with moderation, re- membering to precede their use by an active purge, by which chalybeatea and all tonics are rendered not only more safe, but more beneficial. When the young girl thinks, from her feeling, that nature ia making an effort to bring forth the discharge, which is known by an increase of uneasy feeling in the back, hips, or lower part of the belly, she is to use the warm bath as before directed. Owing to previous debility, or other diseases, the courses are sometimes retained or obstructed, and no medicine or treat- ment will avail until the disease under which the person labora be removed. Retention of the menses for a length of time soon under- mines the general health, even in the best constitutions, and degenerates into what is called green sickness, a very danger- ous disease, and difficult to cftre. Every symptom of feeble- ness prevails — a pale skin, and even a greenish complexion, succeeds to the rosy hue df health; the lips and gums become almost white, the breath offensive, the skin under the eyes puffy, and of a leaden color, the whole body lax, swollen and doughy; the judgment, memory and natural cheerfulness im- paired ; the pulse is generally slow and feeble, but easily ex- cited, and it is then accompanied by shortness of breath, a palpitation of the heart, and an almost unconquerable disin- clination to motion ; the appetite is destroyed, and the stomach so deranged that the food, instead of being digested, sours on the stomach. Hence the patient finds gratification in chalk, lime, pieces of old wall, and other improper .substances; there k also costiveness. The treatment should be more energetic under such circum- stances ; it should be commenced by removing the costiveness by repeated doses of active purgatives, such as ten grains of jalap with four grains of aloes well mixed, and made into f bolus, or pills, with some syrup, and followed, in six hourt after, by one tablespoonful of castor oil, or a gill of senna tea, which should be repeated every four hours, until free evacua- tions take place; to he repeated every two or three days, ac- cording to the eilect of the preceding, until the feverish or inflammatory symptoms have been removed ; after which tha Diseases of females. 143 conic mixture may be used, as formerly prescribed. During ihe use of either of these, the bowels must be prevented ' > becoming costive; but, should sourness of tne stomach be present, which is known byaburning sensation at the stomach, sour bclchings, sour taste in the mouth, soreness or tendernesa of the stomach, particularly on external pressure, the follow- ing preparation should be used occasionally with the above: Loaf sugar, four teaspoonsful ; essence of cinnamon or pep- permint, two teaspoonsful; powdered rhubarb, two teaspoons- ful; carbonate of soda, one teaspoonful .; carbonate of mag- nesia, four teaspoonsful; mix well in a bowl, adding half a pint of cold water. The dose is, one tablespoonful night and morning. Wearing flannel drawers, using moderate exercise, never going to the length of fatigue, and the aversion to motion to be overcome, by proposing such exercise as may be most agreeable, a nourishing diet, such as may agree best with the stomach, is the proper course to pursue ; and at such times aa the menstrual efforts are felt, to assist them by the hip bath, and friction of the feet and legs. SUPPRESSION OF THE MEXSES. After being fully established, if the courses are arrested, or do not return at their usual period, when not caused by preg- nancy or suckling, it is called a suppression. The most fruit- ful sources of these derangements are exposure to cold, in some form or other, violent exercise, great mental agitation during their flow or immediately before their appearance. As soon as it is discovered that they are arrested, remedies should be immediately employed ; if their suppression be not compli- cated with general disease, it is not difficult to induce their re- turn. The feet and legs should be bathed, or the person should sit in warm water ; an anodyne may be given, such as a tea- spoonful of elixir paregoric, or anodyne cordial ; promoting its operation by catmint, penneroyal, or spruce pine tea. Should these remedies fail, and there is pain in the head, back, and lower extremities, and the circulation excited, yon should purge the bowels freely. After the free operation, give fifteen drops of antimonial wine, with live of laudanum, or ten of paregoric, in a spoonful of water, repeated every two hours, until nausea be produced; then reduce the dose to one-half. If the feverish symptoms still continue the purging must be repeated on the third day following, and either of the medi- cines again used as before directed; during which time a very sow diet is necessary. This treatment must be jmrsued until the fever shall be abated and the pain relieved. 144 Diseases of Females. You must not expect the courses immediately to return, but probably they will at the next period be restored ; and in order to facilitate their re-appearance, an active purge should be administered about four days before they are expected, DEFICIENT AND PAINFUL MENSTRUATION. Few persons have an idea of the amount of suffering among females from this disease. It seldom attacks any until they have menstruated some time with considerable regularity, and little or no pain ; afterwards, they begin to suffer more or less pain, which increases until it becomes grinding and severe as those in labor. It soon affects the general health; the patient loses her com- plexion, and becomes very irritable and fretful. At the ap- proach of each menstrual period, the pain generally begins in the back, extends to the loins and hips, to which soon ensues an alternate and pressing down pain resembling in severity and suffering those of labor. At first a slight discharge takes place, but which suddenly ceases, after some time is renewed and becomes more plentiful, which, together with the pain, gradually ceases. The appearance of the discbarge differs from that of a healthy menstruation, being mixed with lumps, and clots of flaky matter, having the appearance of membrane or skin. The breasts sympathizing with the womb, frequently swell and become painful. Women are mostly barren who have this disease in a severe form. Painful menstruation must be treated by having the bowel well opened a few days before the anticipated attack, in beinjj confined to a very light vegetable diet, strictly avoiding tha use of all spiritous liquors. The patient should be kept in bed, drink freely of tea made either of penneroyal, catmint, sage, or the leaves of spruce pine, until the discharge be fully estab- lished ; after which the pain seldom returns for that period. Bateman's drops, or tea made of the bark of the root of tulip poplar true, lovage, tansy, hops, or black snake root, may be used. What I have found the best in my own practice is this : Get at a drug store four ounces of tincture of ergot ; com- mence about a day or two before the expected return of the monthly sickness, and take a teaspoonful every four hours, until the discharge h fully established. Take a purgative tefore commencing with the ergot. Do the same way for two or three periods of the courses. The directions heretofore given as re- fards diet, clothing, and exercise, keeping the feet warm and ry, and the bowels open, together with an occasional use oi Diseatum <>f Females. 1 J5 the warm bath should bp stri.tly adhered to, and persevered in for a considerable length of time. Sometimes one or two grains of powdered ipecac, or half a teaspoonful of the syrup taker, awry two hours, will bring on the flow freely, when other means fail. Keep warm in bed while nsing the ipecac. PROF U S i: M i: V 8 T RUATIO V . There is a great difference in different women as to the amount of the discharge dnring their courses. When a Beauty evacuation is followed by a general uneasiness, a sense of fullness, flushing and headache, it is to 1"' considered a suppression; and when a considerable flow is followed by lan- guor, paleness and general weakness it i> to be considered as profuse, and should be checked. If feverish symptoms, Bnch as headache, oppressed breath- ing, increased heat, and a full, firm pulse, precede or accom- pany a sudden and profuse flow of menses, the evacuation fre- quently becomes its own cure; and if the woman be careful to keep her bowels open by moderate purgatives, to observe a spare diet, to drink only cold water, to keep her person cool by thin clothing, sleep on a hard bed, and have free exposure to the open air, she may not only moderate the evacuation in future, but probably will derive considerable advantage from its present excess. But if, notwithstanding these precautions, the flow continue or return, still accompanied with the above febrile symptoms, she must take a brisk purgative of Epsom salts, or senna and salts, to be repeated until fuU and free evacuations from the bowels take place. Also if necessary. take one or two grains of ipecac, or a half teaspoonful of the syrup of ipecac every two hours until sickness at the stomach is produced, hut not vomiting. Should there be such a profuse flow as to cause great pros- tration, faintness, vomiting, the lips becoming pale, nails blue, extremities cold, with convulsive twitchings, the danger is great, and it is then no longer profuse menstruation, but must be considered a true uterine hemorrhage / she must lie down on a hard bed, and be kept perfectly quiet. Motion of every kind must be forbidden, not even permit her to turn herself; she must be freely supplied with fresh air, or the use of the fan drink cold, or even iced water; bladders half filled with cold water, or cloths wrung out of cold water, applied to the belly, and frequently renewed, provided there is no chill on her at the time. These, together with oak bark tea, or alum whey every hour or two, with the addition of from ten 1o fifteen drops of laudanum to each dose ; all to be given cold. These I"i6 Diseases of Females. proceedings generally give relief, or at least will control the die ease, ami probably preserve life until medical aid can be pro cured, which should ahvays be bad if possible. After the hemorrhage lias been moderated, sbe must for many days avoid exertion, remaining in bed, be confined to a strictly vegetable dirt, and avoid every kind of spices, and also all spirit". us and fermented liquors. Keep her bowels open by the use of purgatives, such as Rochelle salts — one teaspoonful in a glasaof water — castor oil or magnesia, taking three times a day ■some light tonic bitters, such as cold watery infusion or tea made of wild cherry bark, thorough wort (boneset) or dog-wood bark, and while the body is to be kept cool, the feet are to be kept warm and dry ; if they are cold, they must be frequently rubbed with a woolen cloth or flesh-brush. CESSATION OF THE MENSES. As a general rule, a woman ceases to have the menstrua, flow between the age of forty and fifty ; in some women gradu- ally, in others more suddenly. This is an important and criti- cal period of a woman's life, and great care is to be exercised that the health of the patient be not injured by improper treat- ment. The greater number of cases require only to be let alone ; many, particularly the weakly, will probably be bene- fited by the cessation, and will enjoy better health. When, therefore, this discharge shall decline or altogether cease, and not be succeeded by other disease, it will require no other at- tention than a strict regard to temperance, so as not to inter- rupt nature in effecting an important change. But in constitu- tions in which there is a predisposition to some disease, the cessation, more particularly the sudden stoppage of the courses will expose the woman to an attack of that disease. Therefore, if upon the decline of menstruation there shall occur general feverish uneasiness, such as flushings, restlessness, headache, throbbing, either in the head or under the ears, singing 01 ringing in the ears, dizziness, darting pain through the head. palpitation of the heart, piles, hard or painful swelling of the legs, it will then be necessary in addition to strict temperance, both as regards body and mind, to keep the bowels freely open by the occasional use of salts, seidlitz powders, castor oil, senna, or if necessary, more active purgatives, such as cream cf tartai and jalap, etc. These remedies and precautions will have to be persisted in for some time, at such intervals as the urgency of the symptoms may require, and should be so timed as tci anticipate the attacks, until the system becomes used to the change. Diseases of Females. 147 At this time of life, some women, instead of the menses ceasing, become subject to repeated and excessive discharges; in such cases, before the patient b< ncs weakened by ex- haustion, and if the discharge be accompanied by fever, it will be necessary to use gentle laxatives and anodynes, such as a teaspoonful, each, of cream of tartar and sulphur in a glass < t water before breakfast. Also put one tablespoonful of spirits nitre in a tumbler of cold water, ami take one tablespoonftl every three hours. As an anodyne, take half a teaspoonful of paregoric in a little water at bed time. But if such dischargea become so excessive as to come under the denomination of uterine hemorrhage as formerly described, the case should be treated the same as advised in that disease. If it occurs that a woman, after menstruation has ceased foi a few periods, becomes again subject t<» discharges either of blood, or matter resembling that from a boil, especially if it be accompanied with pain at a particular spot, darting from thence across the abdomen, through the hips or down the thighs, there is reason to apprehend cancer, or other serious ulcers in the womb or adjacent parts. It is advisable to have such caseg placed under medical advice. Nothing has a greater tendency to retard the progress of these cases, than a strict regard to temperance, and nothing will more surely hasten their ad- vancement into incurable disease than the opposite course. UTERINE OH WOMB DISEASES. Fluor Albus, ok Whites. — Female weakness, (as this dis- ease is often called.) is among the most prevalent ailments among women : even young girls before marriage, are often troubled with it without applying for medical aid, owing to false notions of modesty. It is a discharge from the privates, not colored with blood ; in general, if the disease be not the consequence of falling down of the womb, or other organic derangement of that organ, the discharge is easily arrested, when taken in the first stage. At first, it is in most cases strictly local, but if suffered to run on, its necessary conse- quence is to undermine the constitution, and ruin the general health. The discharge is at first mild and semi-transparent, resembling in appearance that of the white of eggs, or thin starch made by boiling ; but becomes in its progress opaque or milky, yellow, greenish, and scalding — so much so as to ir ritate and inflame the parts over which it passes. In the first stage it is accompanied by little or no pain, but as it progress- es towards the second, and succeeding stages, the person suf- fers from loss of appetite, pain in the back and loins, weariness 113 Diseases of Females. and fever. When persons of a robust and full habit are bud ject to this disease, or when it occurs in more delicate con- stitutions, bnt accompanied by a feverish state of the system, the treatment should be commenced by a purgative of ten grains of rhubarb, a dose of senna, or castor oil. A cooiing and spare diet is absolutely necessary, and cleanliness must be strictly enforced. In order to secure this latter requisite, (which is all important to the speedy termination of the dis ease,) injections of lnke-warm water, or milk and water of the same temperature, should be thrown up the privates three or four times a day : this may be accomplished by the use of the female Byringe, to be obtained at most drug-stores. When the feverish state of the system is thus in some degree subdued, gentle astringent injections will be proper ; such as weak tea of white oak bark, with or without a small portion of alum; or 20 grains of white vitriol, 100 drops of laudanum, and half a pint of water, to be used three times daily. Injections of green or black tea, very strong, or tea made from sassafras, 6age, or dogwood bark, (cold) thrown up the private parts three or four times a day ; also, at the same time, washing the outer parts in cold water, and always keep the bowels open, is ad- visable. When the disease has already progressed until it has passed the inflammatory stage, or is not originally attended by a feverish state of the system, but by general -weakness; an ina- bility or disinclination to exercise ; pain in the back and loins, want of appetite, (fee, — after the purging, as above directed, and during the use of the astringent injections, the tonic bit- ters previously mentioned, (of wild cherry bark, &c.) together with bathing the outer parts in cold water thoroughly three or four times a day, should be used. In those cases in which the discharge is offensive and of a greenish color, or re sembling matter discharged from a boil and streaked with blood, it is advisable for the purpose of cleansing out the va- gina, (or canal,) first, immediately preceding each astringent injection, to throw up a few syringes full of weak soapsuds. Too great attention cannot be paid to cleanliness, and indeed all other directions are useless if that be neglected. The outer parts should be well washed with soap and water two or three times a week. If this course of treatment does not effect a cure, make no delay in seeking advice of a physician. FALLING OF TUB WOMB. Whkn a prolapsns takes place, an uneasy dragging sensatior Diseases of Females. 149 charge is perceived, sometimes bloody, accompanied with a kind 01 pressing or bearing down ; an inclination to go to stool, frequently a light slimy purging and a sense of numbness shooting down the thighs ; when first rising from*a lying to a standing position, a sensation of falling from above into the passage below, which prevents the tree evacuation of urine ; these symptoms all subside, or are much mitigated by lying down. Whatever weakens the parts concerned, has a tenden- cy to produce this disease :' such as, frequeni miscarriages; improper treatment during labor; severe and protracted labor; the use of instruments in delivery; too early rising, and too violent exercise after delivery; improper treatment of profuse menstruation; long continued whites; violent exertion during menstruation, such as jumping, dancing, lifting heavy weights ; blows on the abdomen, &c, are the most frequent causes. The means of care, m those cases in which the womb will not return to its place on lying down, is to lower the head and shoulders, whilst the hips are somewhat elevated, then with the finger oil< i, gently press the prolapsed part into its proper situation, and lie down for many days, or in severe cases, weeks, and two or three times a day make use of astringent injections as men- tioned in treating whites. If the bowels are costive, some gentle cathartic, such as castor oil, seidlitz powders, magnesia, &c, should be administered, but all irritating purgatives, as well as stimulating diet aud drinks, strictly avoided. If these means fail, recourse must be had to the use of a pessary, which can be obtained at most any drug-store. The " King Pessary" we consider preferable. It should be taken out once or twice a week, and washed in soap and water; and at the same time, inject a pint of cold green tea up the privates. PMEGNAXCT—Its Signs and Diseases. During pregnancy, the natural irritability of the womb being increased, manifests itself by a variety of symptoms and sympathies. Although such symptoms may, and frequently do, arise from other causes than pregnancy, still, when a healthy married woman finds that the menstrual discharge does not return at its usual period, finds her breasts enlarge, and the circle which surrounds the nipple change from a light pink to a dark brown color, and that she soon after becomes subject to languor, nausea, and vomiting in the morning, heart-burn during the day, and some degree of restlessness and want of sleep during the night, she may with confidence attribute these symptoms to pregnancy. Women who have 150 Diseases of Females. borne children will, in consequence of their peculiar feelings formerly experienced, seldom be mistaken in their judgment whilst those who wish to hide their pregnancy, and others from an overweening anxiety to have children, will be led into many ridiculous and frequently dangerous errors. As all, or at least most, of the symptoms abov^e mentioned may be pre- sent, yet no pregnancy exist, therefore, in cases of doubt, it would be most expedient to act as though it did, for, about the end of the third and beginning of the fourth month, the rising of the womb, and the feeling of a tumor or fullness below the Btomach — and, between the fourth and fifth month, the motion of the child, termed k- qnickening" — will, generally, put the matter beyond doubt ; no risk can be encountered by thus de- laying any measures which might have an injurious tendency in case of pregnancy. Diseases of Pregnancy. — A common attendant on early pregnancy is a slight degree of feverishness, but which, unless* excessive or accompanied with other diseases, will seldom re- quire any other remedy than to open the bowels, and a low diet, ot which fruit and vegetables should form the principal part ; there is generally a dislike to animal food of every kind, and it should l>e avoided as much as possible, for, if indulged in, it gives rise to much inconvenience. Another means of keeping up a healthy action, and thereby obviating the effects of lever, is moderate exercise in the open air. It is a mistake to suppose that pregnant women should be encouraged in living more luxuriously and indolently than what is habitual to them ; they should, therefore, not be confined to close or heated apartments, bat be allowed a full share of out-door ex- ercise, yet be cautioned to guard against extremes, such as carrying or lifting heavy burthens, running, jumping, dancing, &c. The irritation of the fever will cause them to be fretful, peevish, and desponding, which is often by others mistaken for ill-temper, which erroneous opinion only leads to further inconvenience and unliappiness. AVomen, whose happiness always is a matter of deep interest to the civilized man and Christian, are, during tin; state of pregnancy r , more than at any other time, entitled to the tender regard ami affectionate consolation of their friends, particularly of those who claim the title of husband. The desires ami dislikes of pregnan*. women should not be overlooked, and the effects of despond- ency prevented by kind words and by everything calculated to encourage them. Frequently the feverish heat, full pulse, headache, uneasiness find restlessness continue to increase as pregnancy advances, Diseases of Females. 151 becoming sometimeb very distressing and alarming; recourse should then be had to purgatives, after which two or three doses of soda powders, during the day, or cooling drink of water, acidulated with lemon juice, vinegar, cream of tartar, tamarinds, cherries, plums, &c. The mild purging may ho ■epeated as occasion requires, but should not be excessive, or riueh as produces griping. Morning sickness is one of the early symptoms of preg- nancy, which generally ceases after quickening, and returns towards the conclusion, sometimes at intervale during the whole period, which, when moderate and confined to the earlj part of the day, should be left to nature, not being of a dan- gerous tendency, but generally found serviceable, as a woman will generally find she enjoys more rase during the remamdei of the day after having vomited in the morning than when she has not. When sickness and vomiting prove more severe, and the stomach continues to reject the food taken dining the day, re- course should be had to medicine. "When the vomiting is ac- companied by a costive state of the bowels, a tablespoonful of carbonate of magnesia should be given several time? during the day, until they are moved, and continued once or twice a day for some time ; or the following : water, one gill ; loaf sugar, two teaspoousful ; essence of cinnamon, one teaspoon- f ul ; rhubarb, one teaspoonful; calcined magnesia, one tea- spoonful — mix together. Of this mixture one tablespoonful may be given every four hours. A seidlitz powder taken occasionally will be found useful. If the vomiting be accompanied by a diarrhoea, a tea- spoonful of prepared chalk, diffused in cold water, three or four times a day, soda powders, lime water and sweet milk, or a piece of flannel moistened with laudanum and camphor ap- plied to the pit of the stomach, will all prove very service- able. Heartburn is a painful sensation of heat in the throat and stomach, attended with a sudden coming up of thin, sour froth into the mouth. There is often reason to think that it ia occasioned by food highly seasoned, or not easily digested, and by fermented liquors — and sometimes by sleeping in a sitting posture after a meal — but it most frequently depends upon some sympathy of the stomach with the womb, and although more disagreeable and difficult to remove than dangerous, and always removed by delivery, yet there are some cases which are extremely distiessiug, and cannot be considered as entirely void of danger. 152 Diseases of Females. Even if we cannot remove this unpleasant attendant on pregnancy until after delivery, it may he much mitigated bj giving, two or three times a day, a large teaspoonral of car- bonate of magnesia, or prepared chalk, in cold water; a table- gpoont'ul of lime water, or ten grains of carbonate of soda in a gill of fresh water. In obstinate cases, the following wil. be found a very beneficial prescription: Water, half a gill { essence of cinnamon, one teaspoonfui ; calcined magnesia, one teaspoonful ; hartshorn, ten drops ; mix and put into a bottle. Two or three teaspoonsful may be given occasionally, particu- larly alter meals, each dose to be take): in a large tablespoon- ful of water. It' costiveness prevails, it should b'e removed by gentle purgatives. Magnesia is among the best in this case. Cost ic- ness is one of the most prevalent, as well as the most obstinate, diseases of pregnancy, and is, generally, most ne- glected. When excessive, it gives rise to many other affec- tions, such as colicy pains, headache, flushing of the face, frequent desire to make water, unavailing straining at stool, piles, palpitation of the heart. Costiveness, if not the cause of vomiting, heartburn, and flatulence, is known much to in- ert 086 tht m f and there is much reason to believe it is frequently the cause of abortion, and therefore of much importance that it should be removed. But, in accomplishing this, care should be used to select proper purgatives, strictly avoiding all such as are griping, as profuse purging is hurtful in pregnancy. Small doses of Epsom salts, seidlitz powders, manna, senna and manna, castor oil, rhubarb, sulphur and cream of tartar, are the most proper purgatives. Ihese ought to be used in rather small and repeated doses than given largely. Much may be done to remove this unpleasant state of tho bowels by a suitable diet. Bread made of unbolted ground flour, (called sometimes " Graham flour,") and bran tea, sweet- ened with molasses,.or manna, deservedly rank high; also such other articles as are known to have a laxative effect upon the bowels should not be neglected. Stewed fruits at meals, or ripe fruit uncooked, once, or twice a day, or a roasted apple at bed time, assist in keeping the bowels open. If the bowela have been in a costive state for many days, it will always be advisable to assist the operation of the medicines by an injec- tion, composed of a pint of milk and water, with the addition of a tableepoonful of melted lard, or sweet oil, which will facilitate the evacuation, and cause the medicines to operate with Less pain and sickness. Piles. — They are a cause of much suffering to pregnant women, and, in consequence of the delicacy attendant, thej Diseases of Females. 153 srill generally suffer a long time in silence rather than apply for aid. The treatment proper for this disease will be found unde. the head of Piles, in another part of this work. Strangury, or Pain and Difficulty in Urinating. — This is a frequent desire to pass the urine, and painful discharge in small quantities. It is sometimes caused by not complying with the calls of nature, and retaining the urine toe long, but most frequently arises, during the early period of pregnancy, from the sympathy which exists between the womb and blad- der ; subsequently, from the pressure of the enlarged womb, a retroversion or falling down of the womb, from its pressure against the neck of the bladder, may also give rise to it; in such cases, a tumor in the passage will be evident, For the relief of* strangury, the bowels should be moved by laxatives, assisted by injections up the bowels of lukewarm water, in the meantime drinking frequently of tea made either of elm bark, marsh mallows, flax-seed, parsley root, or lovage, adding three or four times a day, to some of the tea, twenty drops of spirits of nitre, and five drops of laudanum, or, in the place of the laudanum, twenty of paregoric. Should the strangury be caused by the falling down of the womb, it must be re- moved by replacing it according to the directions formerly given, and, while so attempting to replace the womb, let her make effort to void urine ; and if the bladder be thus emptied the tumor will probably return by further gentle pressure up- wards, and, if so, she should keep her bed for some days. Itching of the Outer Parts, with an irresistible desire to Bcratch, is, in some cases, a very distressing complaint, more so, as women will suffer intense misery in silence, and, even when forced to consult medical men, will not make it known, unless drawn from them by close and repeated questioning. Women are liable to this affection at any time of life ; it is frequently dependent on some disease of the bladder or womb, and when so no treatment will avail as a cure, unless the primary disease be first removed; it is also sometimes an original disease, and sometimes appears to be caused by the pregnant state, and in all cases where having previously ex- is*eu is much increased during pregnancy. Use the following mixture : "Water, half a pint ; borax, three tablespoonsful tincture of myrrh, one tablespoonful ; laudanum, one tea- spoonful. To be injected into the passage, two, three, or four times a day, and during the intervals to keep pledgets of old linen, or a soft sponge, moistened with the same, in close com tact with the outer parts, where there is the most itching 15 A Diseasts <>f Females. Avoid scratching as much as possible. The bowels should b* kept well opened by proper purgatives. "Wet tea leaves o» hops applied to the parte are often beneficial. Champs, in the legs, which are very troublesome sometimes may generally be relieved by some stimulating liniment o> mixture of vinegar and mustard rubbed on the parts. More exercise should be taken. ABORTION, OR MISCARRIAGE, Is the expulsion of the contents of the pregnan* womb, at a {>eriod of pregnancy so early as to render it impossible for the ife of the child to continue. Although in many cases no evident cause can be assigned for the prodnction of this unpleasant occurrence, it may be mostly traced to some of the following: violent exercise; severe fatigue ; sudden exertion; contusions or shocks on tie body; heating and stimulating food; indulgence in spiritoii and other intoxicating liquors ; violent operations of emeti< b and purgatives ; fear, grief, and excessive joy ; a full gross hab A and feverish state of the system ; exciting and debilitating dis- eases. A delicate frame, and weakly constitution, will pro dispose to it, yet, there are some in whom there exists a predisposition to abortion, and who nevertheless appear other- wise healthy ; in such, the slightest causes will excite the womb to cast off the contents ; and having once done so, are apt to miscarry again, and if the habit be once accpuired, it becomes very difficult to remove — ruining the health of women, and disappointing the fondest hopes of parents. The first symptoms are, the absence of the usual morning sickness, a subsidence of the breasts, discharge of water or of blood from the womb, commonly known by the name of flood- ing ; pains in the back, loins, and lower parts of the belly coining on in paroxysms with intervals ot ease, resembling those of labor. The hemorrhage being the surest symptom of abortion, de- mands our first regard, for if it continues, abortion must ensue. If then, this alarming symptom be present, our only hope lies in restraining it. Yet it must he borne in mind that frequent' ly the hemorrhage is the effect of the aborting process already going on, and therefore the discharge cannot be stopped until the contents of the womb have been cast off; but still we can generally, by correct conduct, so moderate it that the womau will be sustained, and her life he preserved. The bowels must be attended to ; if costive, to be opened by some gentle purgative, (Koehelle salts or castor oil,) and Diseases of Femahs. lod if oiarn.cea be present, it must be relieved by a few drops of laudanum or of paregoric. She must lie down and keep quiet^ dii a hard bed with light covering; every tiling that will heat the body and quicken the circulation mus1 be carefully avoided, cold air freely admitted into the room, and she \>c kept perfectly still, every kind of exertion strictly forbidden even to conversing with her friends ; the diet must consist who.ly of vegetables, fruits, butter milk, cold water, lemon- ade ; all -cordials, spiritous liquors, spices, and stimulating food must be rejected. Cloths wrung out of cold water, or vinegai and water, should be applied to the back, bowels, thighs, and external parts ; and w T hen the heat of the body is considerable, and the hemorrhage profuse, the coldness of these applications may be increased by ice or snow ; but these cold applications are limited to the stage of excitement, and to be discontinued 611 their producing pain or a continued chill. If the ivvv is reduced, and the system brought rather below the natural heat, then, if there be a continued pain, thirty or fifty drops of laudanum, given in a spoonful of vinegar, or one-fourth of a grain of opium, with half a grain of ipecae made into a bolus, two, three, or fonr times a day, will abate it. But if the pains be in paroxysms, with ease between them, and bearing down with expulsive effort, and more particularly if this kind of pains have preceded the flooding, then opium and laudanum a">-e improper, as they will prolong the suffering. Very little expectation can be had of saving the child, our attention must then be directed chiefly to the saving of the mother ; for if the contents of the womb must be parted with, the sooner the bitter — which laudanum and opium retard. The aforesaid treatment to be pursued steadily from day to day, until all appearance of abortion shall have vanished, and then to try, by rising slowly and without exertion, whether she is safe in so doing ; but on the least appearance of the return of flood- ing or pain, again resume the bed as before. During all thin time the bowels must be kept gently open. If the case be one of exhaustion, of which if the reader will judge by the symptoms before mentioned as indicative of that state, the treatment must be varied accordingly. Before she has been brought into this state, she wall probably have flood ©d much, and the hemorrhage will be considerably diminished at least for the time. Fainting, or disposition to it, will then be the most prominent and alarming symptom, which is not oidy a consequence of the loss of much blood, but is the re- medy which nature makes use of to check the further effusion. This, although very alarming to those unacquainted with its 156 Diseases of Fetnales. good effects, should not in recent flooding be interfered with; no efforts should be made to rouse her, or prevent a recurrence of fainting by administering cordials or other stimulants ; but ehe should be left in that languid state which always accompa- nies fainting: during which the blood moves slowly through the vessels, and an opportunity is afforded for the mouths of the bleeding vessels to contract, the blood to coagulate, and the bleeding to be stopped. When some time has been allow- ed for the contraction of the blood vessels, and coagulation of the blood, and the fainting should still continue to an alarm- ing degree, dash cold water on the face, give a tablespoonful of wine, or a teaspoonful of brandy, or camphorated spirits, or twenty drops of ether, in fresh water, which repeat every ten, twenty, or thirty minutes, as the recovery may be quick or slow, having regard to the hemorrhage ; if it show a disposi- tion to return, desist from the brandy, &c, which, at all events, must be used no longer than absolutely necessary to call back the powers of life, which, when recovered, must be left to themselves ; keep her perfectly quiet, not permitting her to speak or move hand or foot. After being somewhat restored, having still hopes of averting the abortion, and there be pain, opiates may be given, as before mentioned, a soda powder, in the state of effervescence, given a few times at in- tervals of a few hours, and if there be still a slight discharge, alum whey may be given. Occasionally cases of pregnancy occur, accompanied by a alow or chronic hemorrhage, continuing for many days in a Bmall degree, sometimes being scarcely perceptible, at other times more profuse, but not sufficient to excite much alarm, until some new excitement or exertion, suddenly brings on for- midable hemorrhage, and abortion with great risk of life to the woman, takes place. A dull, heavy, aching pain in the back, at all times easily excited into a sharp, pungent pain, darting through the womb, in different directions, and down thfl thighs is commonly attendant. In such cases the most perfect quietude in bed must be ob- served, and the mind kept tranquil, and free from every excite- ment or care. Also injections of cold green tea two or three times a day up the privates, may be employed, and cloths wrung out of the same laid across the bowels, renewing the application frequently. Abortion vbom External Violence. — External violence is very frequent cause of miscarriage. A pregnant woman hav- ing received an injury from which abortion might be appre- hended, should immediately be put to bed, and kept perfectly Diveses of Female ft. 157 quiet ; if chilly, snmcwarm, not hot tea, be givon her for drink, and moderately warm covering, but ho longer than the chill may oontinnc; as soon as that is off, or if no chill lias taken place, then to be kept coo!, admitting the fresh air lively, and cold water tor drink, and when fever shall succeed Buch injury, give a dose of Epsom salts, or Rochelle salts. When the Bowels have been freely moved, put one teaspoonful of spirits nitre, one of paregoric, and twenty drops of essence of pepper- ment into a tumbler of cold water, and of this mixture let a tablespoonful be taken every hour or two. Of course, rest in bed must be enjoined, and perfect quiet, etc., as before mentioned. Also the cold green tea to the oowels. In all cases where there is reason to fear abortion, a state of absolute rest in bed is to be enforced with great perseverance, as the first rule of practice. By rest alone, without any other assistance, hemorrhages maybe restrained and abortion pre- vented; but without it, no woman can be safe. All other means will be unavailing unless assisted by rest. Even after the immediate alarm of the attack is over, and she be in a pros- perous state of recovery, she must still recollect her danger. She should be confined to a hard bed, for several days after, and keep her room for a much longer period. If an abortion does take place even after all that can be done, the case must be treated the same as after an ordinary confine- ment. Swelling of the Lower Limbs. — This is sometimes very troublesome ; it can, to a certain extent, be relieved by keep- ing the bowels open, and giving fifteen drops of spirits of nitre in half a glass of cold water three times a day. Palpitation of the Heart — When it occurs in pregnant women, may be relieved by taking fifteen drops every four hours of a mixture composed of equal parts of tincture of vale- rian and spirits of lavender in a little water. Take more exer- cise and avoid costiveness of the bowels. Bandaging the Bowels, for a length of time before confine- ment, is of very great benefit, with delicate females, or in cases of unusual enlargement. The Nipples. — During the last months of pregnancy they ihould. be daily bathed in a tea made of oak bark, borax, or alum water, or strong green or black tea (cold). This will harden or toughen them so that they are not near as likely to become sore, soon after confinement. And women who are subject to having sore nipp^s, should draw them out with a breast-pump, or get a friend to do it for her once every day 158 Midwifery, durinsr the last fonr or live weeks before confinement. They thus become hardened beforehand. Too lfUOH os in k Feet. — It is not good for cither the mother or her child, for her to lie too much in the erect posture, more especially those of a delicate constitution. Sitting down or lying down for a few minutes at a time, several times during the day, will he of Bigna] benefit, as it keeps the womb from settling down too low. Cbamps ix the Stomacit, may be relieved by drinking a few spoonfuls of a tea made of cloves and cinnamon, repeated as occasion may require. MIDWIFERY. LAB OB. This takes place at the completion of the term of pregnancy, a period of about forty weeks, or nine months. At this period, the child being able to live without its connection with the mother, the womb begins to contract itself so as to lessen its cavity, and thereby expel or thrust off its contents, which are propelled downwards, towards the mouth of the womb, which opens and dilates so as to give them a ready exit, at the same time those parts through which they are required to pass, assume a disposition to dilate or open. Natural Labor. — All such as come on at the full period of nine months, in which the head of the child presents or comes first, and which are completed by the unaided efforts of na- ture; are so denominated from the frequency of their occur- rence, and the regularity 'with which they proceed. The first stage of labor commences with the true labor pains, and ends when the mouth of the womb is completely opened, about the time the membranes usually burst and the waters are discharged. The second stage is occupied in the passage of the chihfs head so low as to begin to press lpon, and to dilate the external parts. These two stages frequently go on iogether, although the mouth of the womb is usually dilated before the head has descended low down; yet it sometimes "lappens that it is unyielding and not disposed to dilate, attd therefore descends before the head, which is thus covered by the neck of the womb, presents at the external opening. The tLird stage of labor commences with the distention of the ex- ternal parts into the form of a large protuberant tumor, and continues until the external orifice shall be so far dilated as tc The Female Pelcis. We have here a front view of the Pelvis. 1. 1. The ossa ii* nominata, or hip bones. 2. The sacrum, perforated with two rows of holes, for the transmission of nerves. 3. The simiphr/sis pubis, or os pubis. 4. The coccyx. 5. 5. Articula- tions for the thigh bones. The antero- posterior diameter of the brim, from symphysis pubis to middle of sacrum, measures four inches and a half. The transverse, from the middle of the brim on one side, to the same point on the opposite, five inches and quartei The obligue diameter measures about five inches. The anteroposterior and transverse diameters of the outlet measure, each, four inches. The cavity of the pelvis measures, in depth, one inch and a half in front, and four inches and a half poo teriorfr. 160 THE WOMB. This most important organ in woman is situated in the cavity of the pelvis— from whence, when distended, in preg- nancy, it rises into the abdomen, with the general lining membrane of which and the pelvis, called the peritoneum, it is covered. It is of a flattened pear-shape, and it is held in its place by elastic ligaments. In its unimpregnated state it is about three inches in length by two in breadth across the broadest part, and odc in thickness. At the period of puberty it weighs about one and a half ounces ; after parturition, from two to'three ounces ; and in the ninth month of utero-gestation, from two to four pounds. It is supplied with glands, vessels THE WOMB AND ITS APPENDAGES. a, Right Ovary ; b, b, the Fimbriae ; c, c, the Fallo- pian Tubes; d, an Ovum being grasped by the Fimbria! ; e. an Ovum descending the Fallopian Tube to' tlie Womb; /, Cavity of the Womb; 7, Walls of the Womb ; h. Wall of t Vagina ; a, (7, wans oi me » "iu»; ». « k, k, Ligaments of tho Organs. and nerves, the latter of which constitute an extensive net- work over its entire surface. The ovaries are two in number— one on each side ot tae uterus, in the groin. They are nearly as large as the male testicles, and perform a corresponding function. When the germ (or ovum) has been perfected in the ovary,tf is cast out, and seized by the extremity of one of the fallopian tubes, through which it is conducted to the uterus. Midwifery. 1G1 suffer the child to pass through it. The last stage is taken up in the care of the infant, in tying and cutting the navel string, nnd in receiving or gently aiding the delivery of the after birth. Midwives should keep this division of labor into four stages constantly in their minds, and perfectly understand what is going on during each, by which they will avoid all unneces- sary hurry and confusion, and they will expect no more in any one period than is intended by nature to be then performed. Examination of the Passagk. — To perform this properly, and to draw from it certain conclusions in intricate cases, can be acquired only by attentive practice and experience^ aided by previous anatomical knowledge of the parts. But we hope to be able to give a few plain directions, which may teach others how to judge of their progress, and to direct them in the conduct of a natural labor ; and also to discover those which are unnatural, and are likely to be difficult. It is a rule among physicians never to perform the operation except in the presence of the nurse, or some other married woman ; but with female midwives, this delicacy is not absolutely necessary ; still it is advisable that some other woman be present. The patient should lie on her side or back on the edge of the bed, with her knees drawn up, and a light covering should be thrown over her. The midwife sitting at the side of the bed, the forefinger anointed with lard or sweet oil, is to be carried up to the outer parts into which tne finger is to be cautiously introduced. The introduction should be made with all possible tenderness, care- fully avoiding all hurry, force or rudeness, by which the parts may be irritated or wounded ; and, above all things, take care not to break or burst the membranes. The linger will probably first reach the neck of the womb, covering the head of the child, and pressing down into the vagina, or birth passage; passing the finger toward the back- bone, and upward, the mouth of the womb will generally be found (in the beginning of labor) far back and high up, very different in different women. In some, hard and irregular ; in others, thick, soft, and smooth, a little opea, and beginning to discharge a thick mucus ; whilst in some few it is worn quite away, although still close shut. The examination is to be com- menced a little before the time that a pain is expected, and should be continued during the pain, and until it ceases, so that the effect of the pains upon the internal orifice or opening may be noticed ; and having the finger introduced, continue it until satisfied of all that is desired, or can then be discovered. If the mouth of the womb be pressed down tight, and begins to open during the pain ; if this general tightness relax during 162 Midwifery. the intermission, and especially if those parts remain soft- and slippery, and a thick mucus, with or without some tinge of blood, begin to ooze from them, we conclude the labor to be actually begun. But if, on the contrary, we discover no extraordinary pressure, and the mouth of the womb be neither opened during the pain nor relaxed again as the pain goes off, we may conclude the present pains to be false — that labor has not yet begun. False Pains — Frequently resemble true labor-pams so ex- actly as to be mistaken for them, particularly by young women with their first child. But they are carefully to be distin- guished from true labor, or the mistake may lead to error and mismanagement. If it is ascertained that the pains are false, the woman, if she be' feverish, with a full pulse, and hot skin, should be put to rest in bed ; if costive, the bowels should be moved by a gentle purgative, assisted by an injection ua the bowels, of warm water, and perspiration to be promote* 1 by drinking frequent draughts of weak tea. By such means false pains will generally be removed ; but if they still con- tinue after the fever has been moderated, and the bowels opened, a teaspoonful of paregoric, or twenty drops of "lauda- num given (and repeated if necessary, in two hours), assisted by rest and quiet, will seldom fail in suppressing them. First Signs of Labor. — Some days before the time, a wo- man begins to feel the symptoms of her approaching labor, 6be moves with difficulty, and frequently complains of restlessness and pain in her back and loins. As the period approaches she becomes smaller around the abdomen. Sometimes a diarrhea comes on, but generally she is rather costive ; she perceives some enlargement, relaxation, and a degree of forcing down of the external parts, and frequently a glairy mucus tinged with blood, is discharged ; but this latter symptom more frequently comes on after labor has actually begun. It is often the case that the anxiety, restlessness and uneasi- ness of this period prompt many women to wish it over ; and some are so imprudent as to attempt to shorten it by rough exercise, with a view to bring on their labor. But no conduct can be more faulty or absurd ; at any rate, they increase the present uneasiness, and should they succeed in their attempts to precipitate their labor, before nature is properly prepared for it, they will unquestionably render it more tedious, more painful, and more difficult. On the contrary, let them, accord- ing to the dictates of nature, give themselves more rest that usual, attend carefully to the state of their bowels, keeping them freely open. The subsidence of the belly, which denotes the approach of Midwifery. 163 labor, is caused by the womb beginning to contract at the up- per part, and proves, not only that the womb lias began to act, but, that it is prepared to act in a favorable manner. In like manner, the discharge of mucus, and the relaxation and distension of the external parts, show that they are prepared to dilate. The difficulty in urinating is owing io the pressure of the child's head upon the neck of the bladder ; the constant desire to pass the urine, to the same pressure upon the body of the bladder; both are favorable symptoms, and indi< i natural presentation of the child. Diarrhea is sometimes a sign of labor, which, if moderate, is always favorable and should not be interfered with ; if pro- fuse, a few drops of laudanum will generally check it. Costiveness, when it exists, is not only distressing for the present, by increasing heat, restlessness and pain, but may become very inconvenient during labor. If, therefore; a preg- nant woman has neglected to pay attention to this circum- stance before, she must now take care to remove it. by mild laxatives, or rather by repeated injections of warm water, which is the best mode at this late period, when all active medi- cines are improper. First Stagk of Labor. — The first stage of natural labor, which is occupied in opening the internal orifice of the womb, frequently commences with a slight shivering, which, when connected with regular pains, is rather a favorable symptom; but, if succeeded by fever, is unfavorable. But most common- ly, labor begins with pain in the back and loins, stretching from thence across the bell} 7 , and ending at the upper part of the thighs. It soon leaves the woman free, and returns again pe- riodically, at longer or shorter intervals. These pains, at first, are slight, and return at long intervals ; but soon the intervals grow shorter, and the pains become exceedingly sharp and cut- ting, and, at the same time, the mucus discharge from the outer parts is generally discolored by some blood ; after which, the very sharp and cutting sensation commonly abates ; and, although the pains grow stronger, return at shorter intervals, and the pressing down increases, they become less distressing, and are borne with less impatience. On making an examination at this period, (which should be very seldom, and always with the greatest caution, for fear of breaking the membranes,) this variety of the severity and sharpness of the pains, will be found connected with the situa- tion, and to depend on the state of the mouth of the womb. At first, it is found far back, and high up, with edges more thick and hard, and the opening small and hardlv perceptible; 16-J- Midwifery. as the pains continue, the internal orifice or mouth of the womb descends, and comes forward; the edges become twin and soft, the opening enlarges, and after pome time, will admil the finger — a small bag is then felt within, which, during the pain, tightens, and is distended, hut, as the pain goes off, be- comea loose. As the internal orifice enlarges, this hag passea through, and assists in dilating it, until the thick edges of the orifice, or mouth, being entirely obliterated, the membraneous bag, no longer supported by them, gives way, and the waters arc discharged. Sickness and vomiting are frequent and salu- tary symptoms of this stage of labor, the nausea contributes to the entire relaxation of the whole system, and the retching adds somewhat to the dilating effects of the pains. The duration of this first stage of labor is very different in different women, and in the same women at different labors — but, in general, it requires more time with the first child than with those which follow — and in all women, it commonly takes up more time than any other stage of labor. If the mem- branes burst early, before the labor begins, or very soon after, then, the mouth of the womb, requiring to be dilated by the child's head, the pains, in the back are more grinding, and the dilation or opening, in all respects, more tedious and more painful, but still requires only more time, patience, and cau- tion. And, if the neck of the womb descends very low, before the mouth begins to dilate, as it sometimes does, it likewise tends to protract this stage of labor. Bear in mind, that in this stage, no skill or art of the mid- wife, no exertion of the woman, can in the least contribute either to lessen the severity of the pains or shorten their dura- tion. They are intended by nature to accomplish a necessary and important object, that is, the complete opening of the in- ternal orifice of the womb, which, from a hard ring of somo considerable thickness, and generally close shut, is to be soft- ened, relaxed, and worn away, until it is entirely obliterated, and so astonishingly enlarged, as to permit t'he child to pass through. Nevertheless, if we can during this stage neither lessen the woman's pain, nor shorten its duration ; and, although we are forbid interfering in any manner with the progress of natural Labor, yet the presence of a midwife, or such other woman as may lie selected to otliciate, is far from being useless, hut (e very necessary. They should inquire into the state of the patient's bowels, and, unless they be in a laxative state, ad- minister an injection; indeed, whenever there is time for it, it is a good rule always to do this, as by its effects the injection Midwifery. 165 Las in all respects a tendency to promote and render labor easy, and is particularly useful in the case of a first child. She must likewise pay attention to the evacuation of the urine — ■ direct her patient to discharge it frequently, and it' she fail in one posture to try another; sitting over warm water, or tying on either side, on her hack with her hips raised ; on her knees with the head low. Should all these efforts l'ail, the midwife should, while the patient is lying on her hack, her head and shoulders lower than her hips, and during the remission of pain, introduce a linger under the puhes, or front part, and endeavor to raise the child's head a little from its pressure on the lieek of the bladder; and while SO raised let the patient make effort to void urine ; and if notwithstanding these efforts, a total suppression should take place, she must be relieved early in labor by the catheter. For, as Labor advances, the difficulty of discharging the urine will increase — the pain of the distended bladder may become so great, as to intercept and suspend those of labor — and the bladder being over dis- tended, may lose its power of contracting ever alter ; and may inflame, and bring on fever, convulsions, mortification and death. Such are the evils which may follow negleoi — but which can very generally be avoided by proper care. But, we would here remark, that the above suppression must not be mistaken and confounded with that suppression, which takes f)lace towards the conclusion of the labor, when the child shall lave descended low down, the pains being forcing with con- siderable effort, and there is reason to hope that the labor will soon be completed — this latter suppression will soon be reliev- ed by delivery. After such attentions as before mentioned, the labor is to b«* suffered to go on without any interference — the pains continu- ing gradually to open the internal orifice of the womb, and force the membranes through it, in the form of a purse, which, acting as a soft wedge, contributes in the easiest way to its further dilation. Of this, the midwife may now and then as- sure herself by examination. Although the finger may be introduced on the accession of a pain, no accurate examination must be made until it remits, lest the membranes should be burst, and the waters let out before the internal orifice be fully dilated, which aeeident always protracts labor, and renders it more painful and more difficult. Do not make too frequent examination ; it is injurious, by removing the mucus from the soft parts, intended by nature for lubricating them, and causes irritation. The abominable practice of stretching the soft parts of the lt>G Midwifery. mother by the midwife, under the idea of making room for tho child to pass, is preposterous and cruel. It is impossible to censure this idle, indecent, and dangerous practice too se- verely ; it is always wrong, nor can there be any one period in any labor, the most easy and natural, the most tedious and dif- ficult, in which it can be of the least use, and in which it will nut unavoidably do great mischief. • Therefore, leaving nature to her own unassisted and undis- turbed efforts, the midwife is to encourage her patient, by appearing perfectly calm and easy herself, without hurry 01 assumed importance — by assuring her, that as far as can now be discovered, all matters are natural ; by encouraging cheer- ful conversation with those around, permitting her to walk about the chamber, or from room to room, to sit or lie down, as she finds most agreeable, and if she can, to sleep between the pains — but although inclined to it, she should not lie constant, until the mouth of the womb shall be completely opened. The midwife should excite the hopes and confidence of the patient, by manifesting her own ease and firm belief in the natural progress and happy termination of the labor ; hope and confidence will very much tend to give regularity and strength to the pains, whilst on the contrary, fear and despon- dency will tend to disturb and protract the labor. Let there be no " hobgoblin" stories, " ghost tales," nor superstitious nonsense in the room of a woman in confinement. Partaking of food at the proper time during labor, is allow- able, but it should always be light and sparing. There is great impropriety in directing the patient, at this period, to assist her pains, as it is called, by holding her breath. and exerting her strength ; by forcing, straining, and bearing down — which inevitably will exhaust and waste her strength, now in the beginning of labor, which may be necessary for her support at the conclusion. Young women, with their first la- bor, are most apt, from impatience, to be guilty of this error, by which they necessarily overheat themselves, and may bring »>n a fever; it may likewise occasion a premature bursting of the membranes. A still more dangerous practice is that of giving strong aromatic teas, cordial, and spiritous liquors, with a view to Btrengthen the pains; but which can only increase the resist- ance to their proper eii'ect, by healing the patient, bringing on fever, and checking the natural secretiuns; on the contrary, h-t i he patient's food, if she take any, consist of cooling fruits, thin gruel, and wreak hroths; and her drink, lemonade, apple water, weak tea, oi what is still better, fresh water. In sum Midwifery. 167 mor, lot her chamber be kept cool bj open doors and win- dows : and in winter, comfortable but Dwt too warm. The patient should be strongly impressed with the fact, that the best state of mind she can be in at the time of Labor, is that of submission to the necessities of her situation ; that those who are most patient, actually surfer the least — that, it' they are resigned to their pains, it is impossible for them to uo wrong — and that attention is far more frequently required to prevent hurry, than to forward a labor. Instead, therefore, of despairing, and thinking they are abandoned in the hour of their distiess, all women should believe, and find comfort in the reflection, that they are at those times under the peculiar care of Providence — and that their safety in child-birth is en- sured by more numerous and powerful resources than under any other circumstances, though to appearances less dan- gerous. The practice of gathering many attendants, is certainly very improper, and is one from which serious inconvenience has re- sulted ; yet, the presence of a few elderly women is of very great service. If their attendance is requested, it becomes them to consider for what purpose — most assuredly, to assist in an important business, in which the welfare of one of thei/ sex is at stake ; and not by indulging in idle gossip, and mag- nified reports and misrepresentations of unfortunate cases, and perhaps such as never occurred, to overwhelm the sick wo- men in gloom, fear, and despondency. All questioning and unnecessary inquiry, all smothered and mysterious conversa- tions, should be carefully abstained from, as highly injurious. On the other hand, all levity of conduct, and unfeeling mirth, should be as strictly guarded against, as having an equally in- jurious tendency, by creating excitement in the mind of the patient, owing to its annoyance. The first stage of labor is thus to be passed, now and then cautiously examining its progress ; in doing which, when the internal orifice is sufficiently open to admit the finger, the head of the child may frequently be felt and distinguished by its regular shape, smoothness, and hardness, through the mem- branes ; and may be made another source of consolation and encouragement to the patient, by assuring her of it. But w must be cautious how we predict a speedy termination of tht labor, for many circumstances which we can not at the time discover, may concur to deceive us, and nothing will tend more to render the patient anxious, and robs us of her confidence, than disappointment in this respect. It will now be proper to arrange the patient's dress and bed 163 Midwifery. Aflannel petticoat, and short-°:< >wn, with the shift turned up ovoi the hips, bo as to preserve it dry : but any dress will do if it be not too cumbersome, and the under side of which can be don- bled up under her hips as she lies on the bed. On the middle of the bed lay a quilt or blanket, four double; over this the sheet, doubled back toward the head of the bed. Near the foot of the bed, on that place where the patient will lie when Bhe is being delivered, put down upon the under bed a folded sheet with oneend hanging over,so that the midwife may take the edge of it on her lap ; over this latter sheet, a blanket or qnilt doubled and redoubled, but not hanging over. Apiece of thin oil-cloth under all these, is also advisable, to keep all moisture, etc., from getting on the bed. This arrangement will be found very convenient during labor, and by means of which the patient, after she has been delivered, may be mado dry and comfortable with very little fatigue — it being a matter of very considerable importance to have the woman put to bed dry. If another bed is intended for her lying-in, it should be prepared as was first above directed, but without the sheet being reflected upward ; and after delivery, she is to be lifted from one to the other, without being suffered to rise up. Second Stage of Labor. — This stage of labor commences with a full and complete dilatation or opening of the internal orifice of the womb, and is ended when the child's head has gunk through the brim of the pelvis (or bones) so low as to begin to rest upon and distend the soft parts of the mother. These cir- cumstances can be certainly known only by examination ; but there is, likewise, a remarkable change in the patient's manner of expressing them. Whilst the internal urifice of the womb is opening, the pains are cutting, sharp, and grinding — the patient is restless, bears them with impatience, and expresses her sense of them by sharp and shrill cries; but when this is accomplished, or nearly bo, the pains become more supportable) and the patient finds herself instinctively called upon to make Borne v ►funtary exertion. She lies quiet, holds her breath, and expresses her sense of pain in a grave tone of voice, or fre- quently bears' them in silence. About the commencement of this stage of labor, as pre- viously stated, the membranes frequently break, and the water is discharged. This in well formed women, especially such as have borne Beveral children, is generally a period of borne little alarm ; as, when the child ib small, the head falls almost by its own gravity through the pelvis, and delivery succeeds immediately ; for this circumstance the midwife should always be prepared; and for some time previous at Midwifery. 169 least, the patient should be land on her led, that at all events, the necessary assistance maybe afforded, and thai no accident may happen from hurry, confn&ion, or mismanagement. But more frequently this stage of labor takes up a longer time; and although in a well-formed woman- and a small child, it may end in a few minutes after the perfect opening of the in- ternal orifice, in others it may sometimes require many hours. Of course the duration of this stage of labor depends on the proportion which exists between the size of the child's head and the openings of the bones, or upon some irregularity iu ita shape, or some awkwardness in the presentation of the head — circumstances which nature, when left to herself most fre- quently will vary, so as wonderfully to adapt one to the other in every stage and progress of the labor. The imperfect hard- ening of the bones in the child, and the loose manner in which they are connected by membranes, is the provision which na- ture has made for overcoming these difficulties. Where the head is large and the pelvis or bony passage narrow, the bones ride over one another as the head is forced through the brim, and the shape becomes more oval and pointed, entering the brim of the pelvis or outer bony passage, with one ear towards the lowest portion of the back-hone, and the other toward the pubes or front part, that is, with the narrowest part of the head to the narrowest part of the mother ; it turns as it descends, where it finds most room, until the face is brought into the hol- ow of the sacrum, or lower pari of the back-bone, and the ver- tex, or smallest and most pointed part of the head, to the ex- ternal orifice. Our great care in this stage of labor, especially when it proves tedious, is to regulate our patient's conduct, to soothe her sufferings, tG calm her fears, and above all things, make her to avoid fatigue by over exertion. Although the woman feels some disposition to voluntary efforts, she is not to be en- couraged to exert herself during her pains, more than she can ^ell avoid. The bursting of the membranes, likewise, is a circumstance of great uncertainty : it most frequently happens at the end of the first stage, or during the second stage ; but it sometimes occurs with the first pain, sometimes many days, or even weeks before the commencement of labor — at other times, after hav- ing, in the form of a distended sack, contributed to dilate the internal orifice of the womb, they continue in the same man- ner to dilate the vagina, or canal leading to the outer parts, and external orifice ; and now and then are expelled entire, cover- ing the child's head with the placenta (afterbirth), and water 170 Midwifery. but this is a circumstance by no means to be wished, and ought Dot to l»e permitted, as it may be followed by a dan gerous flooding, or by an inversion of the womb. Whenever therefore, the l»ag appears at the external parts, it ought to be raptured, and the water let out, which is now easily done by keeping the finger hard against them, or by placing the end of the finger firmly on the presenting part of the child covered by the membranes, in the absence of the pain, and keeping it m contact during the succeeding pain, which will seldom fail to rupture the membranes; for that point on which the finger i« kept will have to hear the whole of the pressure of the water urged upon it by the effort of the womb. During this stag6 of labor women are less inclined to move than during the first stage ; still they are not to be confined to one posture, but in- dulged, and permitted to rise from the bed, to walk about, and endure some pains by leaning over the back of a chair, sup- ported by their friends, or kneeling at the side of the bed. Jt is just at this time that the impatience and apprehensions of the patient are frequently much excited, the pains return at short intervals, and are strong and bearing ; she longs and hopes, and strives for a speedy termination, and it require? much prudence and no little management to check her im- patience, at the same time that we support her hopes. She may he assured of her safety, but must he informed that much of that will depend upon her proper conduct, and longer time, and above all things, the midwife must not appear too busy in any apparent or real efforts to shorten it. Third Stage of Labor. — This begins at the time when the head of the child, baying sunk through the pelvis, or bones, begins to re.->t on, and distends the soft parts of the mother, at which lime the vertex, or central top of the head, presents at the external parts, and the forehead and face occupy the hol- low of the sacrum, or curved lower part of the baek-bone, and continues until the perineum, or space between the pri- vates and the fundament, being stretched and distended into the form of a large protuberant tumor, the external parts is so far dilated as to sutler the head and body of the child to pass through without injury. The pains during this period, whilst the perineum ami soft parts are undergoing so great distension, become more severe, and at last, when the child's head is pass- ing the external parts, are most exquisite. But they always are least when the labor has been suii'ered to go on from the first with little or no interference, and mueh more excruciat- ing and dangerous, when these tender parts have been fretted and inHauied by improper conduct at the beginning. Midic)Jery. 171 The part which is most apt to suffer during this period, ia the perineum, or space between the privates and the funda ment, which, from the extent of one inch, or an inch and a half, and thickness of the hand, is stretched to that of four or five inches, and reduced to the thinness of paper, so that in the most natural and well-conducted labor, it will sometimes give way at this extremely thin edge. The perineum and adjoin- big parts are relaxed, and prepared for so great a change by the secretion of a large quantity of mucus, by which the parts aie softened, and a disposition to yield and Btretch, is given to them, at the same time that they are lubricated by it, 80 as to suffer the child to slide through them ; and whenever there happens to be a deficiency of this mucus, <>r when, by impro- per handling, it has been rubbed off, and its secret inn checked, or when a violent and sudden labor does not allow sufficient time for this secretion to take place and give to those parts a proper disposition to dilate, the perineum is apt to be torn. always an unfortunate accident, and one which, it' extensive, subjects the woman to great misery and inconvenience during the rest of her life. It should be your great care in a natural labor, to prevent this, and to which attention should be directed, from the very commencement of labor to the complete delivery of the patient. With this view, avoid irritating these extremely tender parts by too frequent and unnecessary examination, or rude and pre- f)osterous attempts to stretch and extend them, as well as avoid leating the patient by improper diet, cordials, and spiritons liquors in the commencement. During this stage of labor, a woman becomes less inclined and less able to move, and the delivery may be expected to be accomplish 3d in a short time. She is, therefore, now, or rather before, S she was not there already, to be laid on her bed in a proper posture for delivery ; that is, on the folded blanket or quill, ^t the foot of the bed, on her back, her clothes being turned up under her, and she laid near the edge of the bed, and her knees moderately drawn up and her feet sup- ported against the bed post, or against some person sitting on the bed, taking care not to draw her legs too much up toward the belly, nor to separate the knees very wide ; both of whicli put the perineum on the stretch, and increase the danger of its being torn. The bed being prepared, and the woman laid on it aa directed, the midwife is to sit herself behind on a low chair, taking the end of the folded sheet, which had been laid across the bed, on her knees : she will then find herself must ccn- 1"2 Midwifery. veniently placed to afford every assistance. Still, Iiowoter she has nothing to do, and it may require some time before she will perceive the perineum sufficiently distended, and the ex ternal parts so tar dilated that the crown of the child's head eh all begin, during each pain, tq protrude. She is then to taka into her left hand a soft linen or cotton cloth, which, being several times folded, and placing it over the tumor, with hei fingers extended, and the palm over the perineum, make a gentle pressure on the tumor during each pain, so as in some measure to retard the sudden advance of the child's head, or rather, to be ready to retard it, when a violent pain shall threaten too sudden a delivery ; for, let it again be recollected that in a slow labor, well managed from the beginning, i/nere the soft parts are properly prepared to yield, the perineum never is torn, and that all the danger of this unfortunate acci- dent arises from a sudden and violent labor, or one that has been mismanaged in the beginning, or the patient throwing herself beyond the reach and support of the midwife. Any considerable resistance is seldom necessary : but as the child's head passes through the external orifice, it is always proper, whilst one hand is kept in the position just now de- scribed, to place the lingers and thumb of the other hand col- lected together, upon the protruding part of the child's head ; in this position, the midwife has it in her power to make such resistance with her hand as the rapidity with which it advances may require ; and to make it on the head, rather than on the perineum, the dilatation of which by too great pressure may be prevented, and the perineum itself bruised. Experience alone can teach the degree of resistance required, and until the midwife has acquired this experience, she must exercise her judgment, and be cautions not to make more than is necessary, for by too much, mischief may also be done, and where the labor has been well conducted from the beginning much is seldom required. The direction in whieh the pressure on the perineum ie made, is likewise of some consequence; it must not be directed upward and backward, but it must be directed upward and forward toward the pubes, or front ; by which, as the centre of the head advances under the arch of that bone, the nape of the child's neck will be pressed up against it, and immediately relieve the perineum. When it is perceived towards the last, that from early mismanagement, or trom any other cause, these parts are not properly pin-pared to dilate, ami there is a dry- ness and rigidity about them, we are directed to anoint the parts with hog's lard Or sweet oil, once or twice, and over that. Midwif- /■>:. 1~3 to applv h soft flannel wrung out of warm water; this, we have reason to believe, is of advantage, as it promotes the secretion of the mucus, and otherwise relaxes the parts. At this moment the sufferings are at the highest — extremely severe, and sometimes almost beyond endurance; ami, in hope* of shortening their continuance, she is often inclined, and too frequently called on to exert her utmost strength. Still, how- ever, her present safety and future comfort may very much de- pend upon submission, patience, and gaining a little mora time ; and all extraordinary exertion beyond what she is in some measure compelled to make, is hazardous. Therefore, do not discourage her crying out, but encourage her to speak, by asking questions, which will check the bearing down efforts, and gain a little more time, which may 1m- accessary, not only to the safety of the perineum, but to the preservation of her life. Just before the birth, the head is often found to advance during the pains, and to retire again as they remit; and this alternate advancing and retiring is frequently of much conse- quence to the perineum, by the strength and elasticity of which it is generally occasioned, and which, after some little time, will thereby become perfectly relaxed, and easily distended. If, however, it should lodge upon the chin of the child, by in- troducing a linger within, between the pains, it may easily be slipped over it, and the next pain the head will generally be delivered ; but this must not be attempted whilst the perineum is tense, nor during a pain, but only when it is relaxed and easily distended. As the head emerges from the external parts, it should be received by the midwife on the extended fingers and palm of the hand, stretching the lingers round, so as to ex- amine whether the mouth and nose be covered by any of the membranes, or any part of the clothing, by which its breath- ing might be obstructed, still keeping the hand in contact with the perineum, and under the child's chin. A short respite ensues when the head is delivered ; but the pains soon returning, the shoulders of the child are perceived as they descend, to make the same turns as the head had done before ; and after a pain or two, they are delivered, the one toward the abdomen, and the other toward the back of the mother. While they are passing the external orifice, the same attention is to be paid to the perineum which the passage of the head rendered necessary, as the distension is rather greater, and the danger of laceration not diminished, which, in fact, has frequently taken place at this period, through neglect of the midwife, in diced by the supposition that the danger waa 174: Midwifery. all over as soon as the head was delivered. The next pax ad- vance* it to the hips, so that the arms of the chihl are delivered with little <>r no assistance. Another short respite again takes place, -whilst the hips of the child advance, of which one or two pains etfeet the delivery, and the birth of the child is ac- complished. In this gradual way, time is allowed for the regular con tractions of the womb, from the top, around the afterbirth, pressing it down before it ; whereas, in a more sudden delivery, when the head, shoulders, and body of the child are ejected by a single pain, the womb may, and frequently does, contract from its sides, expelling the child, but retaining the afterbirth high up in the top. The midwife should, therefore, never, as it "is too frequently done, take hold of the child's head, and drag it forth : a most dangerous practice — generally the cause of severe after-pains, and frequently the cause of much worse consequences, as a ruptured perineum, retained afterbirth, flooding, inversion (turning inside out), or falling of the womb, by which many women have lost their lives. " At the time of the child's emerging from the external parts, the extreme suffering of women will impel them to implore anxiously for relief; her friends also will call upon the mid- wife and expect her to assist in the delivery, and not unfr?- quently medical aid is sent for at this stage when it is utterly impossible for the physician to arrive before the case has ter- minated, unless he be very convenient ; but no entreaties shou id cause the midwife to deviate from correct principles, and make her endeavor to hasten the expulsion of the head; after that event there is not so much inducement. Should there, how- ever, be a considerable interval betwixt the expulsion of the head and of new pains, she may press gently on the belly, or cause gentle pressure to be made by some assistant. Or she may gently insinuate the finger into the arm pit, and slightly pull or agitate the child, so as to excite the womb to contract — even this assistance is rarely required. But on no account ub she to attempt the delivery by pulling the head. The birth of the child is always followed by the discharge of what water had been retained in the womb, frequently by 6ome clots of blood, and generally by some fresh blood flowing from those parts of the womb from which the afterbirth ha£ been wholly, or in part detached. Fourth Stage ok Labor. — After the child has be/m delivered it should be laid in an easy posture on its aide, a little inclined towards the back, and close to the mother ; its head and bodj should be covered, with its face and mouth exposed to the air Midwifery. 175 The mother at this time is generally in great heat, and wet with perspiration; and in consequence of her exertions suddenly ceasing, and being much fatigued, she is very flj>t to suffer from a chill, often followed by disease, which, if qo1 dangerous, will yet delay her recovery; some additional covering should, there- fore, he carefully spread over her, without causing a current of air. The doors and windows should now be shut, if the wea- ther be cool, and some dry clothes slipped under, should the part of the bed on which she is lying, be wet: whilst, however, these directions are being executed by the nurse and other assistants, our attention should be directed to the child. Duties relative to the child. — Our firsl object is to ascer- tain whether breathing be established. Should this be fully es- tablished, and the pulsation or beating in the cord have cased, the midwife may at once separate it from the mother. This is done by applying two strings, one about two inches from the umbilicus or navel of the child, the other about one inch further and cut between them ; this should not be done under the bed- clothes, but uncovered, that she may see distinctly what she is doing, for fear of cutting some part of the child, which has happened with careless midwives. Sometimes a finger or a toe has been thus cut off. The child should not be separated from the mother, until the pulsation in the cord has ceased. Any strong piece of string, tape or ribbon, will answer, and it should be tied sufficiently tight to prevent the blood from escaping. But if the child fail to cry, or breathe freely soon after delivery, our attention should be directed to ascertain the cause — and to the use of proper means for inducing breathing. In determining the treatment necessary to be pursued, the first thing to be ascer- tained, is, whether circulation is still going on in the cord; which is done by squeezing it between the thumb and fingers, to see whether it continues to beat or pulsate. In .cases in which this is going on, we need in general apprehend no great danger, as long as it continues ; some cold water or spirits should be dashed on the child's breast; if this does not succeed, the little finger, surrounded by a piece of fine rag, should be made use of, to re- move any mucus that may have collected in the mouth or throat of the infant. If we have reason to infer that the impediment is situated in the wind-pipe, the hips and the body of the child should be elevated higher than the head with the mouth down ward, at the same time gently shaking, so as to assist the mucus in flowing out of the mouth. As soon as this takes place, the child generally cries lustily. But, should the child be still-born, and the pulsation in the cord have ceased, it should immediately be seperated from the mother, as above directed, as no good can arise 176 Midwifery. from suffering it to remain any longer in connection with her. In these cases, after having carefully removed any mucus that may have collected in the mouth or throat as formerly directed, we should endeavor to imitate natural breathing by placing the mouth immediately in contact with that of the child, and forcibly breathing into it, whilst, at the same time, the nostrils are held, to prevent the air from passing through them. Should we be successful inforcine air into the chest, which will be known by the elevation of it, and should it not 3e immediately returned, gentle pressure must be made upon the breast of the child, so as to cause its expulsion — occasionally elevating the hips and body to permit any mucus which may have collected in the throat or wind-pipe to flow out. In addition to this, warm ap- plications should be made, by applying heated clothes to the child, with gentle friction upon the chest. Should breathing not be immediately established by this method of proceeding, it should not be at once relinquished, for in many cases, persever- ance in properly directed efforts will prove successful. After the child has been separated from the mother, accord- ing to the above directions, it should at once be delivered over to an assistant, who should proceed to wash it immediately, but if no such assistance be present, it may be wrapped up in a warm, soft cloth, (flannel is preferable,) leaving an opening, only suffi- cient to admit the air necessary for its breathing, and laid on its side in a warm place, until the mother be safely put to bed. The delivery of the after-birth. — This should also be left to the efforts of nature, unless some deviation call for our interference. If the delivery has been properly conducted, the womb will have contracted successively, upon the body, hips and lower extremities of the child — so that by the time they are de- livered, it will be only sufficient to contain the afterbirth; and the succeeding contractions not only contribute to separate it from the womb, but press it out into the passage, and from thence it is delivered, and thus prevents any serious hemorrhage. Some Mood is generally discharged from the womb after the birth of the child, and always after the delivery of the after-birth. A small quantity, therefore, to the amount of even a pound, is no reason for alarm. A short interval, however, generally hap- pens after the birth of the child, before the contractions of the womb are manifested by actual pains, which time is required in the care of the child. No interference is necessary, if strong pains come on in half an hour. The contractions of the womb will throw the after-birth out of the passage, which is the very best security against either flooding or after-pains. But, if within that time, there be no Midwifery. 177 contractile force exerted by the womb, the mid-wife should take the cord in the left hand, and pass a finger of the right hand up along the passage ; if she can, with the end of the finger, reach that pari of the after-birth to which the cord is attached, she may rest satisfied that all is safe ; and that the womb lias he- gun to contract and throw it off; hut if, on the contrary, she cannot reach the root of the string, the after-birth is probably still attached to the womb. Under these circumstances, she should place her open hand upon the patient's belly, and it she find the worn!) soft and resting on the lower side, she must take it in the hollowof her hand, and raise it towards the middle of the belly, press it moderately and rub the surface of the belly over gently, and change the patient's posture from side to back or from back to side; she will then very probably soon perceive the womb to contract, by its assuming the form of a ball of considerable firmness. She may now again take the cord in her left hand, putting it just so much on the stretch, as to pre- vent the after-birth (which descends a little during inspiration) from ascending again during expiration, still holding the end in her hand, pass the fingers of the other hand as high as possible toward the root of the cord, and pull gently while at the same time, an assistant should make gentle pressure upon the belly with the open hand, by which the womb is frequently excited to make vigorous contractions. "Whenthe after-birth shall have le- scended into the passage, and is somewhat protruding from the . external parts, it is best then to leave it entirely to the expulsive efforts of the womb. The most common cause of delay in tne delivery of the after- birh is this want of expulsive pains; and this inaction of the womb is a very common consequence of fatigue after a severe or tedious labor, especially if mismanaged. But this weakness, so far from being a reason for haste and precipitancy, is a most powerful argument for waiting, and making no attempts to sep- arate and extract the after-birth; a hasty delivery of which, he- fore the womb has begun to contract with some degree of vigor, will expose the patient to great danger ot a flooding or inversion of the womb. Under such circumstances, therefore, our efforts must be directed to compose the patient's mind, and attempt to excite the action of the womb as previously directed. Great care should be taken by the mid- wife how she exerts any considerable force on the cord, which in some instances is small; in others, inserted by several branches into the after-birth, and easily torn from it — at all times an inconvenience, and on some occasions a very serious accident. Or, if the string should be so strong as to endure much force, more terrible accidents may fo.».» ITS Midwifery. low; the after-birth may be torn from its attachment to the w<>ml>. of which a violent flooding will be the consequence, or the womb may be id part or wholly inverted, turned in side out •and actually brought out oi the body, which has been the unhap- py consequence of iinprudenl force applied to the cord. Let it, •therefore, be an invariable rule, never to tighten the cord, •and put it on the stretch, until the womb can be felt like a hard lump or ball under the hand applied to the woman's belly; on the same principle, coughing, sneezing, or blowing into the hands, and every such exertion of the woman, are likewise improper as they tend to cause flooding. Should the after-birth however be retained or flooding ensue, directions for the treat- ment of them will be found under those different heads when treating of the dangers of difficult or tedious labor. The after-birth being delivered, carry the finger into the passage up along the membranes, which are continued from the edge of thfi after-birth, and slowly and cautiously assist them in coming away; for if they are left, they cause after-pains, and in a few days a very offensive smell. Putting to bed. — The external parts should be annointed with lard or sweet oil, and a soft cloth applied ; and lift her to the upper part of the bed, having previously brought down the reflected part of the sheet ; while sh^ is being lifted let some assistant bring down her clothes which had been for security tuck- ed up over her hips; if she has lain in a petticoat, it ought now to be removed, and the clothes from above supply its place. When laid in her place she should be covered with bed-clothes, more or less, as she may be inclined to be chilly. A towel, four or five double, is then to be applied to the belly, and over that a broad bandage round the waist, is pinned so low, as to take in the bottom of the belly, and afford some support to its loose and relaxed sides, but not so tight as to give the least pain or uneasi- ness. The use of such a bandage is evident, but a tivistedhand- kc?'chicf, applied in the form of a cord, and drawn down tight, as is frequently done, (to keep down the mother, as the women express it,) is the very extreme of absurdity and must do harm, yet, when a broad bandage is skillfully applied, as here directed, it will be found very agreeable and very comfortable by the woman, and has a tendency to prevent and relieve that faintness, which is sometimes very alarming to women, recently deliv- ered. We would observe, that with regard to putting to bed, if the patient be much exhausted and fainty, it had better not be attempted to move her before some hours, only change her posture so as to extend her limbs, putting dry clothes under her; give her some nourishment until she is somewhat recruited. For Midwifery. 179 immediate nourishment we would advise as the best, a cup of coffee, with plenty of milk, and as much BUgar as may be agree- able, or chocolate, either with a few mouthfuls of bread and butter, or rusk or boiled milk with some stale bread in it, yet, if the exhaustion be very great, a small portion of wine and water, or a tea-spoonful of brandy, with some fresh water, may be al- lowed, or panada, with the same quantity of wine or brandy in it ; but unless the feebleness be very great, we would advise \\\ ■ abstinence from all and every intoxicating liquor. After-pains. — Very few women but who will be troubles with after-pains, harassing them, and disturbing thai repose so necessary to their comfort. Those pains', however, very much depend for their severity, upon the manner in which the after- birth has been delivered, yet it must be considered thai they sometimes follow the best conducted and mosf natural deliveries. They come on soon after delivery, resembling in some manner those of labor, returning in paroxysms, though with Longerinter- vals between them, throwing off during their action whatever lumps of blood may remain in the cavity of the womb. It' these are in a moderate degree, and not of very frequent recurrence, they demand no remedy — but, more frequently, they are very excruciating, and therefore call for remedies. Opiates, are the surest means to be relied on; two tea-spoon- fulls of Paregoric, or twenty drops of Laudanum, with thirty of Sp. Camphor, or thirty drops of Laudanum by itself: either of these, given in fresh water, repeated in half doses for a few times at intervals of an hour or so, will seldom fail to give relief. — There will be some who cannot use Laudanum ; for such, use fomentations of Hops and Vinegar or Camphor to the bowels, occasionally, just warm enough to be agreeable. A horizontal position, laying down in bed, should be observed for nine days or more, and a low diet is always necessary. Every indication of pain and soreness, should be early attended to; directions for which will be hereafter prescribed. If the woman should have no evacution from her bowels within three days, one should be procured by the use of Castor Oil, Sedlitz Powders, or injections of warm water up the bowels And, if within tenor twelve hours, she passes no urine, she should be solicited to do so, and, if necessary, be aided by fomentation of clothes wrung out of warm water. The following will be found very beneficial: Spirits of Nitre, four table-spoonfulls ; Laudanum, half a tea- spoonfull, forty drops of which, may be given every hour in wa- ter until relief be obtained: but should these also fail after a fair trial, recourse must be had to the catheter. Washing the child. — Children when bora are frequently 190 Midwifery. coated with a tenacious unctions substance, wnich is somewhat difficult to remove. It 1ms been found by experience, that rub- he child ov.-r with hog's lard, until it becomes completely incorporated and mixed with this substance, and then making I soft dryflannel to remove it, is the most simple, expedi- tious and perfect mannerof getting rid of it. Afterwards, warm Boap-suds may be used. The process of washing should be per- formed, bo as not to unnecessarily expose the child to the influ- ence of cold ; it in the winter it should be done near the fire. _ It may also be well enough here, to insist upon the person haying charge of this office, to use as much despatch as is compatible with the proper execution of her duty, as it is to be feared, much injury is frequently done the child by too long exposure. Alter washing, it should be carefully dried. The highly injudici- ous and culpable practice which some nurses have, of using spir- its to bathe the body and head, especially the latter, should be strictly prohibited, as it tends to carry off the heat by evapora- tion. Be careful not to expose the child to a strong light or to get any soap in its eyes. After having performed the necessary cleansing and washing of the child, the next thing to be at- tended to, is, dressing the naval. Nothing more is necessary, than after examining if it be properly secured, to pass the remain- der of the cord through a hole made in the centre of a piece of linen or cotton rag, with the extremity of the cord towards the breast, fold the cloth over it so as to envelope it, and secure it by a bandage about two inches broad, pinned round the belly. Be careful not to pin the bandage too tight. Dressing the child. — Let its clothes be put on loose, as every- thing like lacing, or tight clothing, prevents the proper exercise of the lungs, impedes the circulation, — and sometimes entails impaired health, and a bad shape for life. Nothing is needed on the head except the weather is very cold. The rest of the child's clothing should consist of a shift, and a wrapper of fine flannel, with a diaper. All children cry when shifted and dressed, therefore the more short and simple the process can be, the better. Also, be careful of pins, always using those with elastic and protected points. First operations from the Bowels. — The bowels of all newly born infants are loaded with amattter, technically called the meconium. It has been found, that it conduces much to the health and comfort of the child to carry off this substance, and its retention has even been known to give rise to fatal disea- ses. But dangerous as its presence may be, it should not lead to the administration of active and violent purges to remove it , for. there is no practice fraught with worse and more dangerous Midwifery. 181 consequences than this. The mother's milk is the best purge foran infant, or a little molasses and water. If this, h»wever, should not be sufficient to produce the desired effect, the child generally shows symptoms of being ill at ease ; will become sleepy ; fre- quently starting up ; moan and cry loudly. As soon as we find this to be the case, and especially if the stools still possess a tena- cious and greenish appearance, resort must be had to a tea- spoonful of Caster oil, administered warm, and repeated in fair tours, should the first not produce the necessary evacuations. A mild injection of warm milk and water, with some molasses dissolved in it, will also assist much; as soon as the evacuations assume their proper color and consistence, which might be com- pared to tolerably thick mustard, all purgative medicines should be immediately relinquished. We have now described the process of an ordinary natural labor, and any woman endowed with com- mon understanding, may, by a careful study ot these remarks, ea- sily quality herseli to give every necessary assistance in ordinary cases of natural labor, and distinguish most of those of difficult/ in time to have a physician sent for. DISEASES AFTER DELIVERY. FLOODiNG.-If after the woman is put to bed, she loses too much blood it will manifest itself by a faintness; it will be neces- sary to observe that, if she has been over heated by too much clothing, or the temperature of the room, this should be remedied jj the removal of some of the clothes, and fresh air freely ad- mitted, cold water should be freely and repeatedly sprinkled on her face, a cold hand rubbod over her belly, a towel or napkin several times doubled and wet with cold water applied to the belly confined by a broad bandage, and to be renewed it it becomes warm; frequent drinks of cold water must be given her; if she has repeated vomiting, a dose of soda powders after every motion, *dll have a good effect; if these should fail, and the case become alarming, a lump of alum, about the size and shape of a hen's egg, and a nick cut around the middle, so that a tape can be se- curely tied round it, which is then to be pushed (enclosed in the hand) into the womb, and ft there for sometime; and when it has accomplished the restraining of the flooding, it should be s 1 owly withdrawn by pulling the tape. The applications of coif have their limits: they must be discontinued when they have ccom- plished the restraining of the hemorrhage ; or, if they fail, and are productive of continued chills, it may then be supposed that ail the advantages to be expected from them are obtained; they must, therefore, then be omitted. If the system does not show signs of returning life, and the patient continues to become 183 Midwifery. colder, and appears in imminent danger of dying, stimulants are then administered in small quantities and often repeated, as the urgency of the symptoms may require. Wine or brandy, dilated with water and made warm, will answer; a julep made of theyolk oi eggs and warm wine, or part of brandy or whisky, di- luted with three parte of water, sweetened with loaf sugar,flavor- ed with a lew drops of'Ess. Cinnamon, isalsoan excellent cordial If there be pain, fifty drops of Laudanum, or teaspoonful of Pa- regoric, may occasionally be added to the stimulents; but the exhibition of these must cease as the patient shows signs 01 the return of life. Above all, she is not to be disturbed, or raised to an erect posture, but with perfect quiet — the small por» tion of life is to be carefully husbanded; for there is often % power of living in a quiescent state, or when laying down, when the patient would be destroyed by the least exertion, or by be- ing raised to an erect position ; she ought, therefore, not to be raised or even moved, before she is quite revived ; and then, only with the utmost care. Persons have suddenly and unex- pectedly died through want of attention to this matter. And when immediate danger is no longer apprehended, the flooding ceased, it will still not be prudent to replenish the emptied ves- sels too hastily by high living, for, by so doing, the blood ves- sels may be easily again stimulated to immoderate action, and the hemorrhage renewed. Fainting. — Sometimes this comes on immediately after de- livery ; but, more frequently, not before an hour after. Some person ought, therefore, have the special observance of the pa- tient during that time, as the fainting may come on suddenly and unexpectedly ; if it be caused by flooding, the method to be pursued has been considered in the preceding paragraph: but if it proceed from other causes which we are perhaps unable satis- factorily to assign, a tea-spoonfull of Paregoric, two tea spoon- fuls of Bateman's Drojis, twenty drops of Ether or Spirits of Camphor, or either of these in some fresh water, together with fresh air, aiul forcibly sprinkling fresh water on the face, will generally soon be found to afford relief; frequently the fit. will be terminated by vomiting. Fainting appears in some manner OOnnected with the sudden evacuation of the contents of the abdomen; as a preventive from this cause, the bandage should be applied; this should, in all eases of fainting alter delivery, be examined, and if it has moved, so as not to give the necessary Support, it should be rectified and tightened. Inflammation and soreness of the external parts — After delivery there is sometimes much inflammation and swell- ing of the external parts: by washing and bathing with warm milk and water, and almoin ting with fresh lard, it will in general Midwifery. 183 go off in a feAf days; but if it continue to get worse, so as to re- quire attention, the parts are to be several times a day anointed with *he following cerate: Beeswax 4 ounces. Lard 6 ounces, add to this. Sugar of Lend 20 grains, dissolved in two table bi a- fills of vinegar, melted uyer a fire, and simmer for half an hour; strain, and stir until cool. It the parts be hoi and tender the fol- lowing poultice will be found very useful: — one handful] of Hojis with three of Wheat Bran, pour over them boiling water sufficient to make them into a poultice, which wrap in a piece of line muslin, and apply it warm over the parts after putting on the above cerate. MlLF FEVER. — The secretion of milk is usually accompanied with a slight fever, often amounting to a considerable degree of inflammatory action, preceded by shivering, and going off witli perspiration; it is in general more Bevere, and of longer continuance with the liist than with subsequent children. If properly, managed, it will seldom continue longer than twenty- four hours; during its continuance the breasts are full, hard, and painful, which distinguishes this from fever. A tea-spoonful of Spirits of Nitre, in a gill of toast water, should be given every two hours; balm, sage, mint, or elder flower tea should lie freely drank about luke- warm, and a poultice of bread and milk freely spread with lard and applied warm to the breasts. Sore Nipples. — These are the immediate result of some in- flammatory state of the system. The inflammation impelling the evacuation of the milk, the suction of the child peels the outer skin from the nipple, — the inner skin cracks, from which blood is discharged. As a means of prevention, when the important and highly interesting duties of a mother are about to devolve on her, she should, during the last two months of her preg- nancy, have her nipples drawn out by some other person or by breast-pump — at first, very gently and but oncea-day; and, as she approaches towards the completion of her time, more force Bhould be used, (but at no time so much as to cause pain,) and the freq uency of the operation increased to three times a day. After each suction the nipple should be washed with cold water, and exposed for a few minutes to the air. As soon as the mother gets settled in bed and rested, the child should be put to the breasts. When the nipples become sore or tender a Poultice of Flaxseed meal anointed with sweet oil or Lard, should be kept to the nipple all the time except wdien necessary to remove it long enough for the child to nurse. This is bettei than any other application. When the nipple feels tender on the child sucking it, the attention should immediately be di- rected to the state of the system ; if costiveness prevail, to have 184 Midwifery. the bowels moved; and if fever prevail either general, or local in the breast, then to live on low diet. Always attend to gently drawing out the nipple forthe child before putting it to the breast, and immediately after the child has finished its suctioD,to wash the nipple with cool Sassafras or Sage Tea. By care and at- tention to this treatmenl on the occurrence of sore nipples, they will in general be relieved. Sore BbeaSTS. — Sore nipples, and their consequent disten- tion from milk, are perhaps the most fruitful source of inflam- mation of the breast, and also the most uncontrollable kind: those which arise from cold or from that feverish state called the weed, will generally be more under the control of remedies. Sometimes, a chill will precede affections of the breast; at other times, a painful swelling, without a chill. In either case, fever is soon excited — pain and swelling increase rapidly. There are two varieties: one is confined to the cellular or spongy sub- stance between the skin and the breast, and is soon brought to an issue; the other is within the substance of the breast, and is more slow in its progress, and frequently renders the breast, ever after, useless — which the first variety, of itself never does. The patient should be put to bed, and under the most rigid restrictions of diet — allowed no kind of animal food, nor any kind of spices, or stimulants; toasted bread, and water only should be allowed unless the patient has been previously much reduced; then bread and milk, mush and milk, tea or coffee, may be taken. Her drink should be water, or cool tea of tam- arinds, apples, cherries, peaches, or cream of tartar whey: she should be kept in a room not too warm, and a purge of Castor oil, Rochelle or Epsom salts, be given so as to open the bowels freely. Local bleeding, by cupping or leaching, on the body, near the circular margin of the breast, will answer a good pur- pose. For a local application to the breast, take hot vinegar, pour it over some hops, let it stand for a few minutes, strain out the hops, soak tine linen or muslin cloths in it, and apply them frequently warm to the breast. They will be found particularly useful when the breasl becomes much distended With milk, and cannot be drawn: it will diminish the secretion, and relieve the swelling. The breast, however, should be drawn as long as il can be done, always washing the -nipple clean before the child is put to it. This treatment is to be continued through the whole course, until we have no more hopes of a resolution or scatter- ing the hardness, and suppuration or coming to a head is con- sidered inevitable; then the further reduction of tke sywem, by purgatives and low diet, will be unnecessary, Ac this Midwifery. 185 stage a plaster of honey, lard and flour, is among the best ap- plications. It we have reason to believe that niattei is formed, and is ready for its exit, then a small poultice oi bread and milk, smeared with lard, should be applied, slightly warm, to that part where we think it will burst or have to be opened. As soon as there appears a small, elevated, Boft, rather dark spot, which elevation is easily indented with the finger, but which also quickly reappears upon the withdrawal of the fingei and gives the sensation of having a fluid enclosed; thai Bhould be punctured with a lancet, and the matter discharged. The bread and milk poultice should then be again applied : after a few days, it may be dressed with basilicoD ointment, or some other cerate, until the part be healed. If there remain a hard lump in the breast, it should be rubbed with camphorated oil, opodeldoc, or volatile liniment, keeping the parts covered with fine flannel. Ephemeral fever, or weed. — This is a fever of common occurrence to lying-in women. It is usually of short duration, the paroxysm being completed generally within twenty-four hours, and always within forty-eight. It consists of a cold, a hot, and a sweating stage; but if care be not taken, the paroxysm is apt to return, and Ave either have a distinct inter- mitting fever established, or sometimes, from the co-operation of additional causes, a continued and a very troublesome fever is produced. It is generally caused by exposure to cold, irregu- larities of diet, fatigue, want of rest, &c. It is ushered iu by a shivering fit, accompanied by pains in the back. When the cold stage has continued for some time, the hot one commences, and this ends in profuse perspiration, which either carries of! the disease completely, or procures great remission of the symp- toms. The head is usually pained, often intensely, especially over the eyes, in the first two stages, and in some instances ac- companied by a slight delirium. The thirst is considerable, the stomach generally oppressed with wind, and the bowels bound. The pulse, until the third stage has somewhat advanced, is ex- tremely rapid. In the cold stage, we give frequent small quanti- ties of warm tea, such as Virginia snakeroot, balm, mint, or sage; and apply a bladder filled with warm water, ,or a dry warm flan- nel, to the stomach and back, and something warm to the feet ; by tnis, we shorten the cold stage, and hasten on the hot stage. When the chilliness is gone off, and the hot stage is fully estab- blished, we then gradually remove the warm application and lessen the quantity of bed-clothes. We now also, in the plact* of warm drink, give cooler, about lukewarm, such as toast wa- ter, lemonade or apple water. If the heat of the body be very 186 Midwife ry. great, and the thirst distressing, soda powders will l>e found to be very grateful; but the water in which the powders are dissolved should be previously made about lukewarm: these may be repeated every half hour during the continuance of the hot stage. When we find the heat of the system considerably diminished, the paic and restlessness much abated, together with other symptoms o< of perspiration about the breast, we then add some covering, and again resort to the free use of the teas, fresh made, and given warm, but not hot ; keeping the patient perfectly quiet, in a state of gentle perspiration, for the space of five or six hours. We then refrain from the use of the teas; and, when the piocess is over, the patient is to be cautiously shifted, the clothes being {>reviously well dried and warmed; and, if she have an inclination, et her have something to eat. During the whole course of the paroxysm, we must carefully guard against the sudden applica- tion of cold — it renews the shivering and prolongs the disease; but, at the same time, we must also avoid too much heat. A com- fortable room, with a moderate quantity of bed-clothes, is what we are to have for the patient. Do not give purgatives until the sweating stage is over, for fear of giving the patient frvssh cold, but then a dose of Castor oil or Epsom Salts may be given. — By the foregoing treatment we shall frequently be abl'e to confine the disease to one paroxysm ; it however will in some cases return at irregular periods ; if the intermission become longer it is favorable, but if they become shorter it is unfavorable; if it does return the same treatment must again be pursued. Lochia and its derangements. — We mean by the termfo- chia those bloody discharges from the womb after delivery, which continue for some days, becoming greenish, ana lastly pale, then decrease, in quantity, and disappear altogether within a month, and often in a shorter time. The variableness of this evacuation should prevent it from becoming an object of very great solicitude ; for it differs very much in different women, and in the same woman at different confinements. If 1the quantity discharged is small, therefore, or its entirely ceasing to flow at a very early period, need not create any degree of alarm, if the woman be, otherwise, in as good a condition as may be expected from her, situation; and, no irritating or propelling medicines should be used : they cannot do any good, and may be productive of many evils. Inthosecases in which no very ob- vious cause can be assigned for the derangement, and which nevertheless appear to be producing injurious effects, some mild purgative should be administered, and, after its operation, some weak Cammomile or Sage tea : these, with occasionally sitting up, will frequently restore the discharge. Midwifery. 187 SWELLED OB MILK LEG OF LYIXG-iy WOMEN, During or arter confinement, women are liable to a swelling ol the legs, called milk leg; its firs! symptoms are gr< ai pain and difficulty in moving the leg. The disease does uol appear to !»* connected with any peculiarity oi constitution or preceding com- plaint, nor the kinu of preceding labor, or on the treatmenl fore or after chilcL-Witn. It occurs at any period from the first or second day, to two or three weeks after delivery ; it is preceded by general uneasiness, lowness oi spirits. Blight pains about the womb, with a discharge from it peculiarly offensive. These symptoms seldom command much attention, until the patient is sensed with pain on the inside oi the limb, commonly about the call" ut the leg, which soon extends from the heel to the groin, along the* course of the vessels called absorbents. The limb soon after begins to swell : the soreness extends all over it, so that it cannot hear the slightest touch, and every attempt to move gives exquisite pain ; the skin becomes glossy and pale, the countenance is expressive of great anguish and dejection, the pulse is quick, the heat of the skin increased, the tongue white, and the urine muddy. These Bymptoms strongly mark the presence of some irritating matter; and nodoubl it isin the womb. The prevention must depend on cleansiig the birth-place, by injecting water so as to enter and cleanse it : also injecting powdered charcoal and water (one tea-spoonfull to the pint of cold water) up the birth-place three or four times a day. The cure of this complaint is often tedious; sometimes the other leg takes on the disease, as the first subsides. The bowels should be opened by some good purgatives once in every two days The leg may be rubbed with a mixture in equal parts of Sweet oil, Laudanum, and Spirits of Camphor, frequently through the day, and poultices' of Bread Or Flaxseed meal applied du- ring the night to the groin and upper part of the leg. When the soreness has somewhat subsided, bathe the leg in a mixture of half a pint of Whiskey and one quart of cold Water, night and morning, while at the same time the leg must be tightly bandaged, beginning at the toes and going up entirely to the groin, the bandaging to be renewed, night and morning, as the swelling decreases. Keep the affected leg elevated on pillows, higher than the body, and give a wine glass of Tea of Wild Cherry bark, Dog wood bark, or Culumbo root, before each meal, when the patient io getting better. 188 Pimples or Worms in the Face. VARIOUS DISEASES, PIMPLES OR WORMS IN THE FACE. This is an affection usually met with in young persons of both sexes. It is characterized by small, more or less, red pimples, which penetrate the tissue of the skin to a greater or less depth, and is slow in coming to a head. There are seve- ral varieties mentioned by dermatologists; acne simplex, which appears od the forehead, face and shoulders, the pustule in the form oi small, hard, red elevations, inflamed at the lower portion, in which pus forms, which is thin and mixed with a thick seb- aceous (sticky) matter. They dry off, leaving a dark red rais- ed mark. When the pustules are mixed with a number of black circular points, wliich are the orifices of fbllices (or bags) filled ft-ith sebaceous matter, and are often converted into pustules, it is what is known as acne punctata or maggot pimple — worms in the skin. These follices are the habitation of a small parasi- tic insect, called Acarus folliculorum. If not attended to, they are liable to spread and accumulate, and disfigure the face sim- ilar to marks from a mild form of small pox. If let alone two or three weeks, the tops of the pustule become yellow, break and suffer a yellowish pus to escape, and, by pressure, a kind of " core" looking substance is forced out. It mostly appears on the face, but may extend to the back, and become \ ery severe and troublesome. A similar trouble is often produced by the continued use of intoxicating drinks, and known by the name of " copper nose," " grog nose," " gro^-blossom.4," &c. As this disease is usually produced by too rich food, the remedy consists in living on less meat and more vegetable Jood, taking once or twice a week a Seidlitz powder, and washing the face two or three times a day in Bay rum, Cologne water, or, if noth- ing better, common whiskey. SHINGLES. Shingles is usually situated near the waisi, surrounding one-half of the trunk of the body, like a zone or belt : it may however, extend in other directions over the trunk ; it is always situated on one side, and that, generally, the right. The eruption of shingles is generally preceded by symptoms of general indisposition, and especially by severe darting pain in the parts where it is about to appear. At first reel patches show themselves at the extremities of the site of future eruption, Small Pox. lSr» and gradually become move numerous till they form a line — up- on these patches, shining points form, which gradually enlarge into vc icles, or blisters, a little under the size of small peas, these vesicles containing a clear fluid, which gradually becomes thick and cloudy in appearance. At length in the course of eight or ten days, the vesicles burst, discharge and dry oil in the form of scabs, or, it may be, in very weak subjects, leaves sores or ulcerations. The belief was formerly entertained among physi- cians, and still retains its hold of the popular mind, that if the belt of the eruption of shingles was continued round the oody, bo as to meet, the disease proved fatal. This is perfectly erro* neous. When the disease occurs in the young and robust, the diet must be reduced to milk and bread, or vegetables, and all sources of heat and excitement avoided. Five grains of blue pill at night, followed by a dose of senna or Seidlitz powder in the morn- ing, may be repeated once or twice ; and, in the course of the disease, if there is much fever, five grains each of the carbon- ate and nitrate of potash, may be taken twice or three times a day, dissolved in half a tumblerful! of water; or the proportion of carbonate of potash may be doubled, and a teaspoonful of le- mon-juice used to form the effervescing draught. The painful itching of shingles often causes much distress. It may some- times be allayed by simply keeping the eruption covered with a cloth soaked in tepid water, or by using the common lead lotion, (half a teaspoonfull of sugar of lead to a cup of water) in the same way. Pencilling the shingly eruption with a strong solu- tion of lunar caustic (ten grains to the ounce of water,) as re- commended in erysipelas, is found to relieve the severe pain. — Applying Tincture of Iodine with a Camel's hair brush, or soft linen mop, once a day, is also highly recommended by medical men. When shingles occurs in the aged and debilitated, instead of the diet being reduced, it requires, perhaps, to be improved ; at all events, the system must be sustained with nourishing broths, and with one grain of quinine three times a day. SMALL POX. The small pox attacks people of all ages ; but the young of both sexes are more liable to it than those who are much ad- vanced in life ; and it may prevail at all seasons of the year ; but in general is most prevalent in the spring and summer. It very seldom happens that a person is attacked a second time with the disease, however afterwards exposed to its infection. The disease is divided into two kinds — the distinct and confluent. In the distinct, the eruptions are quite separate from eactiotb.er, 190 Small Pox. but in the affluent kind, they run much into one another.—* The distinct may be distinguished from the confluent, before the eruption appears, by the mildness of its attack, by the in- flammatory state of the fever, and by the late appearance of the eruption Th" disease commences with shivering and languor, followed by heat, thirst, and headache; then- is usually either pain or great oppression at the pit of the stomach, and not unfrequently vomiting; there is severe pain in the back or loins, an i in children not uncommonly, and more rarely in adults, convulsions On the third day after the setting in of the above symptoms, usual- ly toward evening, minute red spots, somewhat resembling hYa bites, show themselves on the forehead, the neck, the wrists, and arms, the chest and abdomen, and finally on the extremi- ties: this, is the course of the eruption, but it does not reach the lower extremities till at least the fourth day. If the erup- tion on the parts first mentioned is discovered over night, by morning it is much more distinct, and the spots are much more, numerous than they first appeared to be; they are, too, slight- ly elevated — from this they continue enlarging j n the third day after their appearance, they contain a little fluid on their summits, which gradually increases in quantity. Towards the fifth or sixth day, they contain pus or matter. About the sev- enth or eighth day of the eruption they begin to " crust," that is, to break, allowing their contents to escape, and then to har- den into a crust or scale. At this period of the disease, that of " maturation," the eighth day of the eruption, the eleventh of the disease, what is called the secondary fever comes on; the fever, which had more or less abated after the eruption appear- ed, becomes again aggravated, and continues so for a few days. At length, if the disease has progressed favorably, toward the end of the third week from the first showing of the eruption, some of the scabs begin to separate and fall off, leaving either a pit or a stain of a deep red color. Such are some of the most prominent characteristics of small- pox. This disease is to be treated, by avoiding every thing of a beating, inflammatory nature ; and by keening the subject of it in a cool, quiescent state. The diet shou'wt be of the vegetable and mildest kind ; and the drinks of a similar kind, made agree- able by the addition of the most palatable acids. The bowel? are to be kept open by a table spoonfull of Rochelle salts, or Epsom salts, in a glass of cold water, once every two or three days, or a Seidlitz powder will answer ; and, above all, the pa tient is to have cool and pure air — never oppressed by clothing Warts. 191 or a heated room. The temperature of the chamber Bhould al- ways be sueli that he may experience no disagreeable degree of heat; but rather a sensation of cold : and, except lie complains of being chilly, no fear need be entertained of carrying the cool- ing regimen too far. His bed should be a mat trass covered only with a few bed clothes. But although the bowels should be kept open throughout the disease, when the eruption is coming out all attempts at purging should be dropped, cooling drinks, such as Lemonade, toast wa- ter, &c. being given. If the surface is very hard and dry, spong- ing with tepid water is very useful and agreeable. WTiea the secondary fever comes on, it may be requisite to act I <■ freely on the bowels by means of the purgatives already mentioned, while at the same time the distressing restlessness requires opia- ifltes; twenty to forty drops of Laudanum or a tea-8] nfnll or two of Paregoric, may be given at bed time. Jn Borne cases, if signs of sinking come on, with weak pulse, tardy eruptions, and pustules not filling, all lowering measures an- to be avoided, and good broths, wine, wine whey, &c. administered, as the case may require. The principles of treatment are, in the onset of the disease to moderate the fever and through it the erup- tion, by cooling purgatives, (such as mentioned above,) when the eruption is coming out, to interfere but little beyond keep- ing the bowels easy, regulating the diet according to the strength; and, again, in the stage of secondary fever, to purge moderately. If much swelling and distress about the throat should result in the course of the disease, leeches ought to be applied, in num- ber proportioned to the age and constitution of the patient. — This treatment employed in a case far distant from medical aid might save life. To prevent being "Poc-marked" or scarred by the disease, keep the face, neck, hands, &c, well anointed with Sweet oil or Lard, until the inflammatory stage, and fever ia passed, and guard against scratching or picking the scabs. WAHTS. These are enlargements and thickening of the different coats of the skin, or one part growing into or through the other, caus- ing the skin to break, and admitting this unnatural growth to protrude through. They are most common with children, and generally occur on the hands, sometimes on the face. In the latter situation they are better not interfered with. When si- tuated on the hands, they often disappear of themselves. — When their removal is desired, strong acetic acid, or very strong vinegar, applied every two or three days, is the best re- medy. Nitric acid is sometimes applied, or caustic, with the same beneficial effect. The juice of the green rind of the com- 192 Corns. mon black walnut, applied once a day for a week or two, will usually remove warts. When warts have a narrow neck, a horse hair or silk string, tied t ight around them near the skin, will ioon make them fall off. When a wart on the face, especially in those advanced in life, appears inclined to become ulcerated, or irritated, it ought not to be interfered with, but show it to a physician. CORXS. Tight shoes are one of the most frequent causes of corns ; they are often troublesome to females and other-s who are particularly attentive to appearance, and who wish to exhibit a neat and small foot, by compressing it in a shoe of too narrow dimen- sions. Corns sometimes exist without giving much pain or trouble ; but in other cases, they give so much uneasiness, as absolutely to incapacitate for walking. They are made more particularly intolerable, by every thing that quickens the circulation, or which heats the feet, or causes the corn to press on the neighboring parts. Tight shoes, much walking, warm weather, heating li- quors, all tend to render the uneasiness of corns very great, and they are generally worse in summer than in winter ; and persona are frequently obliged to sit down to take off their shoes, and rest the foot in a horizontal posture. Corns may often be readily cured, by avoiding the above ex- citing causes, by wearing large soft shoes, adapted in form to the shape of the feet, and by continuing for some time at rest. It is useful to take a considerable number of folds of linen, covered with some softening ointment, cut a hole in the middle for the corn to lie in, and to apply them to the foot ; and if it be on the sole of the foot, it may be useful to have an additional moveable sole, with a hole cut in it in like manner. If, along with this mechanical and palliative treatment, we use the fol- lowing method, a corn will be easily and quickly eradicated : it is to be touched with lunar caustic, and wrapped round with adhesive plaster ; and generally at the end of a fortnight, the dead skin will be removed, with the corn adherent to it. If the corn does not come away, the operation is to be repeated. Se- veral other remedies of the same kind are recommended, of which the principal are, soap plasters or mercurial plasters, or blistering ointment. The following plan may also be tried : every night and morning the foot is to be put into warm water for half an hour, while there, the corn is to be well rubbed with soap. All the soft white out side of the corn is afterwards to be scraped off with a blunt knife, or what is better, with a piece of pumice-stone ; but we must not persist in this scraping, Barbers Itch. 193 if there is pain in any part of it. This tivai mentis to be contin- ued without intermission fill thecorn is totally eradicated, which it will be in about a fortnight. Strong vinegar, applied to oorns, after bathing in warm water, once a day, is also a good remedy. It is generally a difficult and painful operation to cut out a corn. Unless it be completely taken out, it is apt to grow again, and this it does taster than if it had been let alone. In old people, it is highly dangerous to cut a corn, as this fre quently excites an inflammation, and consequent mortification which cany off the patient unless carefully treated. Bunions. — This is the result oi chronic inflammation of the Mucous Bag (or Bursa) which is situated over the front of the great toe, and is generally caused by tight shoes. It ought to be attended to at once; one or two Leeches, warm fomenta- tions of hops and hot water with vinegar and a poultice used to allay irritation, and the offending si me being at once discarded. A wrong position of the bones at the joint is a frequent attendant, and, perhaps, an antecedent cause oi bunion. When the disease is fully formed, the best plan is to avoid, by the make oi the shoe, &c. &c. , every source of irritant pressure. [Bathing of- ten in salt and water is advisable. BARBER'S ITCU. This is an eruption of inflamed but not very hard tubercle* (or pimples) appearing on the hairy parts of the face, — the chin, uppeu lip and whiskers — sometimes in the eyebrows or the neck, and on the scalp. It usually clusters together in ir- regular patches, with the hair passing through the little eleva- ted points. The pimples are of a pale yellow color, and in a few days they burst ; matter then runs out forming a hard brownish crust, which fall off in a few days, leaving pimples of a purple color, which are slow in healing. Before the appearance of the eruption, there is heat, pain and a tingling sensation in the parts. In the treatment avoid the use of a razor altogether, live on a low diet, and bathe the parts in a solution of sugar of lead in water, [one Teaspoonfull to the half-pint of water] three or four times a day. Give a mild purgative of Eochelle Salts, a dose of Senna or a Seidlitz Powder, about twice a week. Also wash the parts thoroughly in soap and water twice a week. Also take one gill of Tea made from Sarsaparilla root before each meal. 194 Inflammation on the Brain. INFLAMMATION OF THE BRAIX. Its characteristics are violent fever, severe pain in the head, redness* of the face and eyes, great intolerance of light and sound, watchfulness, and delirium. It is usually preceded by long continued watching, pains in the neck and crown of the bead, defect of memory, diminution of urine, and irregular pulse. As the disease advances, the eyes sparkle greatly, there is ferocity in the countenance, restlessness, deafness, ravings, and increased pulsation in the arteries of the neck and temples. The tongue is dry and of a yellow or Llack color, the face of a deep red, and the poise becomes small, quick and hard. It is always a most alarming disease, and often terminates fatally about the third or seventh day. It is produced by all causes which tend to excite apoplexy or fullness of the blood vessels of the head, — such as exposure to the hot sun, &c. The patient should be bled from the arm freely ; and it ought to be done, if practicable, while he is sitting up. Bleeding by cupping the temples, and by the application of several leeches, should not be neglected if the symptoms are violent. Cold ap- plications of ice, or iced water to the head are to be made and renewed frequently. Powerful purgatives are to be adminis- tered ; ^ alap ana Cream Tartar, of each one or two tea- spoonsfuk, in a gil] of cold water,) and injections of ten or fifteen grains of tarta- emetic in half-pint of warm water should be given daily so dig as the symptoms continue violent. The patient's h«*id snould be kept as elevated as possible, to lessen mi- ''.^termination of blood to it: and the same effect will be produced by partially scalding the feet, or by blistering the arms and legs — but these are only to be applied after the vio- lent symptoms are reduced. When the fever subsides, and the mind returns to reason, it will be very necessary to observe the utmost caution respecting all exciting causes : as when the in- flammation has once been excited, slight causes bring it on again. The diet and drinks are to be of the mildest kind. Light should be excluded, and indeed every thing which can excite the system, particularly a hot room and foul air. A showei bath, or cold water poured on the head, every morning, after the patient's recovery, will go far to prevent a return of the di- sease. The bowels should be kept open, by all means, to pre vent a termination of blood to the head. Delirium Tremens. 195 DELIRIUM TREMENS, Usually this disease is the result of the excessive and contin- n*^i use of intoxicating liquors, though it may also be produced by opium. The first symptom oi this disease is a state of rest- less irritation, and if the exciting cause l^- continued, sleepL ss- nesfe follows; there is no rest, and if there is any approach to sleep, it is haunted by dreams ami imaginary figures that ex- cite the greatest dread. The nature of the disease is, unhappi- ly, in almost all cases too palpable, from its exciting cause. It is an exhausted condition of the brain and nervous system ; and the great effort must he to alleviate this exhaustion, which is too great even for sleep. Opium is the remedy among others, and must he given in full doses. A medical man, will, of course, give it more freely at once than anotherperson ; but is a confirmed case of delirium tremens, thirty drops of laudanum, should bo given at once, and ten drops every hour afterward, until sleep has been procured. Often it happens that the stom- ach is in so irritable a condition that it will retain neither food nor medicine ; in such a case the opium is better given solid, in the form of pill, one grain and a half at first, and half a grain repeated at hour intervals, if requisite. If the stomach m still irritable, a drop of creasote, in a little spirit and water, may be given, and a mustard-plaster applied to the pit of the stomach. In cases of delirium tremens, the liver is more or less* affected and a purgative with opium had better be given. Five grains of powdered opium, ten grains of calomel and twenty of compound colocynth pill, are to he compounded together and divided into twelve pills ; of these, two or three should be given for the first dose, and one at intervals of an hour between each, till six have been given. Under this treatment, after sleep has continued for some time, the bowels are generally acted upon, with immense discharge of dark, black-looking bile, much to the relief of the patient. After this, the remaining pills may be given, two every night, and castor-oil in the morning, if re- quired ; five, ten, or fifteen-drop doses of laudanum, or two teaspoonful doses of paregoric, being given, if the nervous irri- tation is unsubdued, or threatens to return. After the nervous irritation has tolerably well subsided, the next object must be to restore the tone of the stomach. Eight-grain doses of the carbonates of soda or potash combined with a bitter tonic, as columbo, gentian, or chamomile tea, may be given for this pur- pose, every eight hours ; or one grain of quinine every three hours in water will be found useful 196 Apoplexy or Apoplectic Fits. During the whole treatment, it has been customary to allow tin* unfortunate subject of the disease a certain regulated por- tion of alcoholic stimulant, such as brandy and water, in some degree proportioned to the previous habits ; but it is much the better way to give one grain of quinine every two or three hours, and, as booii as the Btomach will bear it, the nourishment of strong meat-broths, yolk of raw egg, heat up with boiling water and lemonade should be given. If the tongue is very- red at the tip, and it' the pit of the stomach is very tender, milk should be substituted for the above ; fifteen drops of the solution of carbonate of potash, or one or two tablespoonfuls of fluid magnesia or of lime-water, may be added to the milk with advantage. In cases of persistent sickness, soda water, and ice given in small fragments, frequently repeated, are often useful. The reception of nourishment by the system is of the highest importance in this disease : so much indeed, is this the case that as long as a man continues to take food freely, he is not likel 7 to become the subject of delirium tremens. One point never to be lost sight of in this disease, is that the stomach must net become empty — even cold water, to keep down thirst should 1-e given if food will not agree with the stomach — mustard-plasters to the spine and stomach are often of great advantage. APOPLEXY OR APOPLECTIC FITS. This is characterized by a sudden diminution of all the senses, and the patient falls down. The heart and arteries — unlike i a fainting, continue to perform their functions. The peculki breathing and profound apparent sleep, distinguish it from an attack of palsy : ami the absence of convulsions makes the difference between it and Epileptic Fits. It chiefly attacks in advanced life and those of short necks and large heads — of full habit of body, free eaters, and great drinkers of ardent spirits. The immediate cause of these fits, is a compression of the brain : often occasioned by the bursting of a blood vessel within ; Bometimes from the sympathy of the brain with the stomach — as in case of persons drunk or under the operation of opium or other poisons. It is sometimes preceded by giddiness, pain in the head, drowsiness, loss of memory, and faltering of the voice : though frequently it occurs suddenly, the person falling down without the least warning. In cases of apoplexy, the person should have the head eleva- ted : and ice applied to it, or cold water, applied by means oi folded cloths and frequently renewed and free air admitted : all bandages or any thing compressing, particularly around the neck — should be removed. In persons of full habit, thev Palsy, 197 ahouiv\ ous&litly be bled freely : particularly from the temples by cupping and leeches : and it is to be repeated according to circumstances. They should be cupped over the head — and in- deed the more they are cupped the better. A large blister sh< >uld be applied to the neck and shoulders. An injection of one table* spoonful of Epsom Salts dissolved in a pint <»1 Lukewarm water, with three grains of tartar emetic, should be given. Emetic or vomits of ipecac after oiher evacuations have been found ser- viceable. Mustard, or water nearly scalding hot, should be ap- plied to the feet, to rouse the system. All who have rea.sun to apprehend this dreadful disease, should live very low, on a vegetable diet, lead a very industrious life, and cause the re- turn of any suppressed evacuation or renewal of sores which have been healed. The bowels, by all means, must be kept open, and the head bathed in cold water by means of pouring, or a shower bath, every morning, and never let the hair grow long. PARALYSIS, OR PALSY. This is produced by the same causes which produce apoplexy : by suppression of evacuations : by constant hand- ling of lead and inhaling the fumes of poisonous metals: and by sedentary and luxurious living. When it takes place in persons of full habits, as in apoplexy, free evacuations by local bleeding, with cupping and leeches to the temples, and purges of castor oil, salts, seidlitz powders, or Borne good purgative pill are necessary. Electricity and galvan- ism have proved serviceable in chronic cases. When the di- sease affects several different parts of the body, it is customary to use stimulants interna-lly, and externally to the affected part. Those most used are mustard, horse-radish, garlic, hartshorn, ether, and oil of turpentine, in their ordinary doses, and to be frequently changed the one for the other. The parts affected with the palsy may be rubbed with the volatile linament, (a mixture of hartshorn and sweet oil,) oils of turpentine, and sassafras, red pepper, and Spanish flies in spirit, powdered mus- tard, in short, anything may be used that will irritate the skin. In cases attended with loss of appetite and great weakness, give a tea made of wild cherry bark, columbo root, gentian root, or boneset, (cold,) three times a day. Palsj of the lower extremities frequently arises from -a di- sease in the backbone : and the most successful treatment, is to keep issues or blisters constantly discharging from the surface of the part where the disease commences. Children are most subject to this disease. Sometimes it comes on suddenly, and 198, Sun Stroke. at others is preceded by a sense of feebleness, languor, and numbness in the extremities — occasional stumbling, and drag- ging the legs, instead of lifting them properly. If parents would early pay attention to such symptoms in their children, and have blisters applied at once to the back bone, where there seems oil feeling to be a little tenderness, they would save many children from deformity tor life. However, in many cased, it is caused in children by worms, colds, &c., and in such cases can be removed by a few doses of castor oil, and giving the child some warm boneset tea, to make it sweat freely — taking care that it does not take cold after it. Lead Palsy occurs in those who have long been exposed to the influence of the poison, and the majority of those attack- ed have suffered from lead colic. The attack is preceded by lassitude and a feeling of numbness, and by stiffness of the farts about to be affected, the loss of power gradually coming on. n a few cases, loss of feeling is also observed. Lead palsy is not confined to the hand and arm, but affects other portions of the body, although the former is its most frequent site. The most dangerous form of this disease affects the muscles of respiration, i breathing] which moves the ribs, and proves quickly fatal, t is well here to give a caution to those who are employed amid lead or its preparations, that they should observe the ut- most cleanliness, especially at meals, for there is good reason to believe that the poison often finds its way into the system from carelessness on this point. Shaking Palsy, in one form, is generally the result of old age ; in another it is more traceable to direct disease of the brain and is very apt to occur in those who have drank freely. I{ comes .on veiy insidiously, and even under the best care is a ver hopeless affection as regards cure. This is a different affection from the "mercurial tremour," with which those work in that metal, such as gilders, are liable to be attacked. SUX STROKE. This begins by thirst, dizziness, headache, and sometimes there is vomiting or difficult breathing, The symptoms, in fact are pretty much the same as Apoplexy : the patient should atonce be taken into a cool shady place, and the first thing have a bucket of cold water poured slowly over his head, and, in all other respects treat the ease the same as a case of Apoplexy, observing the cautions therein recommended, after the patient recovers, (Shower -bath to the head even day, &c.) Hydrophobia, or Bite of Mad Dog. 199 uybhophobia, on bite of mad bog. Owing to the frequency of this frightful malady, we shall be as explicit in the description, of symptoms, &c, as possible. After a person has been bitten by a rabid dog, the wound heals in the same manner as an ordinary wound from the same cause would. After an uncertain interval of, say between six weeks and eighteen months — the following symp- toms begin to be noticeable : The patient experiences pain, 01 some uneasy or unnatural sensation, in the situation of the bite. If it has healed up, the scar tingles or aches, or feels cold, or stiff, or numb ; sometimes it becomes visibly red, swelled, or purple. The pain or uneasiness extends from the sore or scar toward the central parts of the body. Very soon after this re- newal of local irritation — within a very few hours perhaps, but certainly within a very few days, during which the patient feels ill and uncomfortable — the specific constitutional symptoms h"gin. He is hurried and irritable ; speaks of pain and stiffness perhaps, about his neck and throat ; unexpectedly, he finds himself unable to swallow fluids, and every attempt to do so brings ona paroxysm of choking and sobbing of a very distressful kind to behold ; and this continues for two or three days, till the patient dies ex- hausted. Hydrophobia has never been cured when once the decided symptoms have shown themselves. The disease by the inoculation of which hydrophobia may be produced in man, is common in the d< >g, and it has been com- municated by the fox, the wolf, the jackal, and the cat. It has been produced by the saliva (or spittle) of the human being, the horse, the hen, and the duck. All animals are susceptible of the disease, when bitten by a mad dog, also fowls. The disease cannot be caused by the saliva of a mad dog getting on the skin, unless there be an abrasion, crack, pimples or sore, but when it gets on the mucus membrane, as of the mouth, nose, &c, it almost always pro- duces its peculiar effects. The scratch of a cat or dog will not produce the disease, only on account of those animals getting the saliva on their paws, which is very often the case. It is still more interesting to inquire whether the saliva of a human being laboring under hydrophobia be capable of inoc- ulating another human being with the same complaint ? The disease has undoubtedly been so produced. If this be so, the fact will teach us — not to desert or neglect these unhappy patients, but to minister to their wants with certain precautions, bo as not to suffer their saliva to come in contact with any sore or abraded surface ; nor with any mucous surface. On the 200 Hydrophobia, or Bite of Mad Dog. other hand, all carefulness of that kind will he unnecessary, if the disease cannot be propagated by the human saliva. " Is a man who has been bitten by a mad dog, and in whost case no precautions hav< bet n taken, a doomed man? Will he be sure to have the disease, and therefore die of it? By no means. But few upon tin '.whole of those who are so bitten be- come affected with hydrophobia. When a person has been bitten byadog or cat suspected to be mad the beast ought by no means to be killed, but to be se- am (I end kepi under surviellance, and suffered, if it should so happen, to die of the disease. If he do not die, in other words if he be really not mad, that will soon appear, and the mind ot patient will then be relieved from a very painful state of sus- pense and uncertainty, which might otherwise have haunted him for months or years. Should the dog die mad, the in- i'nred person will be no worse off than if the animal had been tilled in the first instance; nay, in one respect he will be better off, inasmuch as certainty of evil is preferable to perpetual and uneasy doubt. There are gross errors prevalent with regard to the signs of madness in the dog. The mad dog never has fits, in the commencement, he may have convulsive struggles when dying. It is a very common belief that a mad dog, like an hydrophobic man, will shun water ; and if he take to a river, that is thought to be conclusive evidence that he is not mad. But the truth is, that the disease in the quadruped cannot be called hy- drophobia; there is no dread of water, but an unquenchable thirst; no spasm attending the effort to swallow, but sometimes in dogs an inability to swallow from paralysis of the muscles about the jaws and throat. They will stand lap, lapping without getting any of the liquid down. They fly eagerly to the water; and Mr. Youatt states that all other quadrupeds, with perhaps an occasional exception in the horse, drink with ease and with increased avidity. There is another superstitious opinion not at all uncommon, viz. that healthy dogs recognize one that is mad, and far him *nd run away from his presence. This is quite unfounded. Equally mistaken are the notions that the mad dog exhales a peculiar and offensive smell, and that he may be known by his running with his tail between his legs ; except when weary and exhausted he seeks his home. The earliest symptoms of madness in the dog, are sullenness, fidgetiness, continual shifting of posture, a steadfast gaze, expressive of suspicion, an earnest licking of some part, on which a scar may generally be found. If the ear be the affected nart. Hydrophobia, or Bite of Mad Dog. 201 the dog is incessantly and violently scratching it. If it be the foot, he gnaws it till the integuments are destroyed. Occasion- ally vomiting and a depraved appetiteare very early noticeable. The dog will pick up and swallow bits of Unread or silk from the carpet, hair, straw, and frequently he will lap his own urine, and devour his own excrement. Then the animal becomes irascible, and flies fiercely at strangers, is impatient of c< >m icti< in, seizes the whip or stick, quarrels with his own companions. eagerly hunts and worries cats, demolishes his bed, and, if chained up, makes violent efforts to escape, tearing his kennel to pieces with his teeth. If he be at large, he usually attacks only those dogs that come in his way; but if he be naturally ferocious, he will diligently and perseveringly sick his enemy. Many cautions are annually put forth about tin- dog days, for muzzling dogs, and so on. Very good and proper advice; but if those who have noticed the statistics of the disease may be depended upon, it would be as appropriate at one period oi the year as at another. Some people think this disorder in dogs is produced in warm weather on account of a want of water, the notion is a mistaken one. When an individual has been bitten by an animal respecting which the slightest suspicion of hydrophobia exists, the one remedy cannot be to quickly resorted to— complete excision of the bitten part. Some persons have possessed sufficient nerve to do this for themselves— few perhaps could — but it has been effected by unprofessional persons for others : in- deed, there might be more danger in waiting many hours for a surgeon than in submitting to an unprofessional operation. The method of excision most to be trusted, is the insertion of a 6kewer oi wood, made to fit into the wound caused by the tooth, and carrying the incision so far round, that the entire hollow or cone of flesh is cut out along with the piece of wood. This might be done with safety in the thick part of the calves of the legs or the back part of the thighs, &c. Where excision is not resorted to, the free application of lunar caustic or aquafortis, whichever may be most readily procured, would be advisable ; or, in lieu of these, a piece of iron, heated to white- ness, may be inserted into the wound, so as thoroughly to de- stroy the surface which may have been poisoned. In the event of none of the above measures being submitted to, or available, the wound may be thoroughly icashedfor hours, by means of a Stream of warm water poured upon it from a height ; a cup- ping-glass being applied at intervals, and of course in the meantime procure the services of a physician. When an indi- vidual is thought to be attacked with the hydrophobia, if the 202 Lock- J aw, or Tetanus. hope of saving life is small, much may be done to alleviate so terrible an infliction by proper care. The most perfect quiet- ness possible must be. observed to prevent as much as may be the recurrence of the paroxysms of suffering. Thirty or forty drops of Laudanum given as the occasion may require, are ad- visable — ii the patient can swallow : if not we must depend on chloroform, which can.be inhaled without difficulty, until rest is obtained — and repeated as may be needed. If ice can be taken, it is said to afford relief put into the mouth in small morsels ; it has also been found of service applied to the back o* the neck. Anyhow the experiment is worth trying. It has been stated that applying ice in bags or sacks to the backbone, has checked the disease ; when it can be had of course give it a trial. LOCK-JAW, OR TETANUS, This is an involuntary and almost constant contraction of the several muscles of the body, while the senses remain perfect. It is called Lock Jaw on account of the Jaws being locked together, as it were by the contraction of the muscles. The set of muscles most generally affected, after those of the jaw*, are those of the back; the patient, by the spasm, is bent like an arch, so that the back of the head and the heels alone touch the bed ; occasionally the body is bent forward. The disease most frequently commences with a sensation of stiffness and 6oreness of the muscles of the neck and jaws ; the latter be- come fixed, and the spasm extends more or less over the body. This extensive cramp is attended with the most severe pain, which is also, in most cases, experienced severely about the pit of the stomach, being dependent doubtless on the spasm of the diaphragm. The most usual exciting causes of lock-jaw or tetanus are wounds, especially of a punctured character, but in some per- sons the very slightest injury is sufficient to develope the disease. It is Liable to prevail among the wounded after battles, if ex- posed to much bad weather; indeed cold will occasionally give riso to lock-jaw independent of injury. When lock-jaw arises from a wound, it shows itself in from four days to three weeks after the injury. It is a very fatal disease, the greater portion ot those affected by it dying; some, however, recover. In the treatment of lock-jaw, begin by giving large doses of Laudanum, say, from thirty to sixty drops if it can possibly be swallowed, and* repeated at intervals of from half an hour to an hour, as long as the system remains unaffected by the drug: Sterility or Barrenness. • 203 if the medicine cannot be given by the month, it rou3t be by injection. In addition to the above, the affusion with cold water may relieve. The patient having been taken out of bed ; and a quantity of cold water dashed over the body and down the spine, is immediately to be rubbed dry and replaced in bed quiet sleep may possibly follow. While the jaws are firmly closed, nourishment cannot of course be given in tin- usual way; * medical man will probably administer it by means of a tube passed into .the stomach, either by Qe nose or by mouth, pass- ing it behind the teeth; until his arrival, should that be de- layed, the administration of small injections of meat-broth will assist in keeping up the strength. Mustard plasters applied the entire length of the back-bone or spine, until pain and redness is produced, and after their re- moval, the application of cloths soaked in a mixture <>1 equal parts of Sweet oil, Laudanum and Chloroform, and over them oil silk or writing paper, is a treatment I would by all means advise. Sometimes large doses of Ipecac or Antimonial wine, given until nausea is produced, will relax the muscles; the bow- els should first be moved, however, by injections. STERILITY, OR BARRENNESS. This, sometimes, proceeds from defective organization. These cases are, however, very rare, and cannot be cured by art. The next general cause is a torpor, and irregular action in the womb and its appendages, which by proper management ought to be cured. The most important means of rousing the womb, will be round in exciting the breasts to their natural action. The con- nection between the womb and the breasts, has often been re- marked : it is scarcely possible to excite an action in the one, without affecting the other. The most natural action for the breasts, is the secretion of milk. They have often been excited to the discharge, without nregrancy. A child losing its mother, and sleeping with a female friend, has been known in the night to get the nipple in the mouth, and to .excite the flow of milk by the morning, and the child was abundantly nourished afterwards at the breast of the maid. The idea wished to be conveyed is, that to stimulate the womb of a woman who has been barren or unfruitful, it is only necessary to cause a flow of milk for a short time iu her breasts by applying a child, (as in the case just cited) and that the stimulus thus brought to bear on^ the womb and its appenda- ges, will cause the woman to conceive and bear children. I give this not as my own opinion, but as the opinion of justly 204 Chills, or Fever and Ague. celebrated medical men. To those who have been barren and who desire the companionship and blessings of children on whom they may lavish their love, and perchance their property, the experiment is worth trying. CUILLS, OR FEVER AND AGUE. This disease prevails mostly in the fall of the year, and near lowlands, marshes, and on the water courses of rivers. The dis- ease occurs at stated and very various intervals — either daily, or every second, third or fourth day. Ague and fever, is generally divided by writers into three itages : — the cold, the hot, and the sweating, and is thus de- scribed. — The cold stage commences with a sense of languor, of weakness, and aversion to motion and to food, with frequent yawning and stretching. The face and extremities become pale ; the features shrink, as do all parts of the body ; the skin appears constricted, as if it had been exposed to cold. At length, the patient feels very cold, and universal shaking comes on : breathing is small, frequent and anxious ; the urine is almost colorlesss : sensibility is impaired ; the pulse is small, frequent and sometimes irregular. These symptoms abating after a short time, the second stage commences with an increase of heat over the whole body, redness of the face, dryness of the skin, thirst, pain in the head, throb- bing in the temple, anxiety, and restlessness : the breathing be- comes more full and free, but still frequent ; the tongue is furred, and the pulse becomes regular, hard and full ; in cases of great severity, delirium is apt to occur. These symptoms having continued tor some time, a moisture breaks out on the forehead, and by degrees becomes a sweat, which gradually extends over the whole body. As this contin- ues to flow, the heat of the body abates, the thirst ceases, the urine deposits a sediment ; breathing is free and full, and most of the functions are restored to their ordinary state ; the patient, however, being Left in a state of weakness proportion- ate to the violence of the preceding attack. Although this is the description of a common fit of ague and fever, it is .subject to great variations in every stage ; de- pending on as great variety in causes and peculiarity of consti- tutions. The treatment, whether the disease recurs every day or otherwise, is the same. Our object is to shorten the duration ot the fit when it comes on, and to prevent its recurrence. The treatment when the fit comes on, is, in the cold stage, to take any weak tea as hot as possible ; to apply hot appli- cations to the teet : and to lessen the shaking, it is of service Chills, or Fever and Ague. 205 tograpp tf)e limbs very tight, or to apply tight bandages around them to compress the muscles. When this stage subsides, the drinks should be continued, and twenty drops of spirits of nitre in two tablespoonfuls of water Bhould be given hourly, to favor the sweating. If the symptoms run alarmingly high, as is sometimes the case in congestive chill*, black pepper tea with a little wine, brandy or whisky in it, should be given occasion- ally, while at the same time we try to produce vomiting by tick- ling the thrqat with the ringer or a feather, and use friction with hot cloths, &c. During the sweating stage, the patient should not be kept very warm, but not exposed to such a current of air as might endanger the sudden suppression of the perspiration; when it ceases the patient should be wiped dry with a rough towel, have the clothes changed and partake of some suitable nourishment. Of course the great object »n this disease must be to break the chill, or prevent its recurrence. For this purpose nothing is equal to Quinine. Commence six hours before the expected attacks of the chill, and take from one to three grains of the quinine every two hours, until the time for having the chill is past. Do the same way the next period, or day when a chill is expected. When the chill has been broken up, then every sixth or seventh day afterwards, take the quinine, until the fourth week or twenty eighth day has passed. The quinine may be taken in powder, mixed in a tablespoonful or two of cold water, or in the form of a pill. The patient should not eat much the day that the chill is ex- pected , and must also avoid exposure to the night air, and wear flannel, next the skin. Bathing with a sponge and water, (to whicb a little salt has been added) night and morning, is advisa- ble. As a strengthening bitter tonic take a wineglassful of tea, [colo j made from wild cherry, or dogwood bark, orcolumbo root, before each meal. In the most obdurate cases, I have found the above treat- ment successful, in my practice in Mississippi and Tennessee, as well as since living in the city of New York. One thing should be observed, however, that before giving the quinine, in the very beginning, it is best to purge the bowels freely. Give five to ten grains of blue mass (blue pill) with half a grain of ipecac, at bedtime, to be followed the following morning by a dose of castor oil or a seidlitz powder, and repeat them, if necessary to work off the blue pill. You are then ready to begin with the qninine treatment as above mentioned. <*Wj Bilious, or Remittent Fever. BILIOUS OR REMITTENT FEVER. This is nothing more than the Chills, or Ague and Fever, ex cept in this form <»f the disease there are no intermissions, (of entire absence of the symptoms,) though there are remissions or partial suspension of the fever, followed by something like a chill or coldness of the nose, &c. The treatment consists in giving Quinine in the same doses as ordered for Ague and Fever, only it should be given every three hours, both day and night, until the fever is broken up, and between each dose of the Quinine give twenty drops of Spirits of Nitre in half a glass of water. Cold applications to the head (cloths wrung out of cold water or water and vinegar, are about as good as any,) will be benefi- cial. Allow cool drinks of lemonade and slippery elm-water, or gum arabic \vater, &c. Give the blue pill, &c, as before refer- red to, before beginning the use of the Quinine, and during convalescence use the bitter tonics, kio all the time. Also, take inwardly the following; tincture or extract of skullcap, tincture ut valerian, tincture of hyosciamus, (henhanc) spirits lavender, of each one ounce, du.se, one tea- Bpoonf'ul three times a day. Keep the bowels open, take plenty of exercise in the air and avoid all kinds of excitement. A sponge bath ev iv morning, is agood remedy, also pouring water [or a. shower- bath] on the head at the same time, is recommended hy physicians. DliOirXTXG. This is of such frequent occurrence that every man, woman and child, should know what to do in eases «.t apparent death from drowning — in fact it should he a part oi the education of our chidren, from the fact that it often happens that children are the only persons present when nut- ut their Little playmates falls into the water, and while going for help the sufferer dies for want, of the proper attention. The first thing to be done when a person apparently drowned is rescued from the water, is to wipe and cleanse thoroughly the mouth and nostrils — the next to apply warmth to the body. This last cannot possibly he done as long as it ia covered with wet clothing ; and it this is the case, it should be removed, cut off, if necessary for haste — as quickly as possible. If there is a house or shelter of any kind very near the spot where the body is got out, it may be taken to it at once, and before the clothes are removed ; but if such is not'the case, pro- vided dry coverings are at hand, the wet clothes should be strip- ped ojff on the spot. Wrapping the body in blankets is always to be preferred. In removing the body it is best done by laying it on the back or side, on some flat board, such as a door or shutter, the head and shoulders beinsc well raised ; but if there is nothing at hand on which the body can be laid, care should be taken in carrying it that the head is well supported neither allowed to fall back, nor forward upon the chest. As soon as may be, warmth is to be applied to the entire external surface ; if a warm bath is available, it should be used, if not, the body is to be covered up with warm things ; bags of hot bran, hot salt, or sand, or any other convenient vehicles for heat, are to be placed wherever they can be without interfering with the necessary man- ipulations : to the pit of the stomach and to the feet especially, their application is to be used. Frictions with stimulants of some kind, such as camphorated oil, brandy or any other spirit o]._> Drowning. mixed with oil. of— turpentine, should, any of them, br aged warm, and bo rubbed in with a flannel; a warm stimulant injec- tion, consisting ol gruel, containing a tablespoonful of tur- pentine, or double the quantity of brandy, may be given, and strong-smelling salts held to the nostrils at intervals. Artific- ial breathing, recommended by some, is condemned by others. Certainly the old method ot using bellows and other means to inflate the lungs was much more likely to do harm than good, particularly in the hands ot the unprofessional, who would be much more likely to inflate the stomach, and thus impede the breathing. Attempts to imitate the- natural process of respira- tion may, however, be made, by pressing inward the ribs and pit ot tbe stomach, and allowing them to rise again by their own elasticity, repeating this process twenty times in the minute. External warmth and continued friction, with care taken that the shoulders and head arc raised, the mouth and nostrils freti, and carefully keeping the patient wrapped up in blankets, are o( the greatest imp< irtance. For the more easy application of reme • dies, the body should be laid on a table of convenient height. It is necessary to notice also what oitgJdnot to be done ; foi many old and most injurions modes of treatment are still apt to be resorted to by the ignorant and prejudiced. Most of these have originated in the idea that water swallowed was, or had something to do with the cause of death ; hence patients have been hung up by the heels, rolled on barrels, choked with emet- ics, under the idea of making them disgorge the water. If* there is much water swallowed — as sometimes happens— it would be better to remove it ; but any means which unpro- fessional persons can use for its removal would only be a worse evil. If a medical man is present, and thinks well to use the stomach-pump quickly, remove the water and replace it with a small quantity of hot brandy and water, it may be ot service, but no attempts should be made to give any thing by the mouth as long as unconsciousness continues. Never despair of these cases, for when all hope seems to have vanished and no sign of life been given for one, two, or four, six. or even eight hours, the perseverance of those around lms been at last rewarded, and life preserved. After a person has been restored to consciousness, there may be considerable congestion ol blood about the head, which may require leeches or scarifying the temples. In all cases of recov- ary, the greatest care must be taken to preserve the re-excited actions ; if stimulants are thought requisite they must be given cautiously ; guard against any excitement from friends or rela- tives ; and support the strength by tea, coffee, soups, &c, Hanging. 213 Mid let the patient be warmly wrapped in blankets in bed until the perspiration is started, after which they may be consid- ered safe. HANGING. This may cause death in three ways : by simply compressing the wind-pipe, by which death is caused by suffocation ; by apoplexy, from compression of the veins of the neck, or by dislo- cating the neck, which is not often the rase. Recovery from hanging must, in some degree, depend upon the completeness or not, of the interruption to the passage of air through the wind-pipe for any time ; it is not likely that resusci- tation will be effected if this thing has continued four minutes. The first thing to be done when a person is found banging is, of course, to cut them clown at once, to loosen the material around the neck, to dash cold water over them, and to bleed from a vein in the arm or foot, or temple. In such an emer- gency, a person would be justified in cutting across the tempi.', where the artery runs, (or beats), with a sharp knife of any kind, allowing the blood to flow freely. The bleeding could be checked when desired by pressing with the thumb over the part or putting burnt alum into the wound. With the except- ion of applying heat, and removing the clothing, the treatment of hanging is very much the same as in cases of apparent death from drowning. I should advise, however, that as soon as life is thoroughly restored, and after the patient has had time to think over his folly a little, incases of attempted suicide, by what- ever means may have been selected, that the person so offend- ing should be thoroughly flogged, and then made to do the state some service for a month or two. The prevalence of this 6in, and the consequent notoriety that is given to deaths from this cause in the newspaper press of the day, should be looked upon by every body with disfavor. No man or woman who thus tries to rush unbidden into the presence of God, deserves a falling tear, or a newspaper notice, unless insanity has been the cause. CHOKE-DAMP, Or Apparent Dea't/t from Inhaling Carbonic Acid Gas. How many sad instances of deaths from this cause every year, and yet a little knowledge ,such as we have tried plainly to im- part in this book, would have prevented an occurrence of this kind. Old wells, brewers' vats, the holds of ships, &c, are all liable to become the receptacles for carbonic acid gas, which, formed form some decomposing vegetable matter, lies like a 214; Choice-Damp. stratum of water at the bottom. Should any one incautiously descend so as to become enveloped in the carbonic acid atmos- phere, breathing is either instantly stopped by spasmodic closure of the clunk at' the upper portion of the windpipe^ and com- plete Buftocation is the consequence; or the gas, it sufficiently diluted with air tube drawn into the lungs, speedily manifests Its narcotic effects upon the system, and the person quickly la Is in a complete state oi stupor. The breathing becomes difficult, ami after a time ceases ; the countenance is purple or pale, .and there may be convulsion and frothing at the mouth. _ In such a case the body ot the individual must be removed, if possible, and 'as soon as possible, from the poisonous atmosphere, or the latter must be destroyed or dispersed. The many fatal accidents which have occurred from persons venturing rashly into wells, and such like places, might be a Warning lor the future, and prompt the invariable eiw./doy- menl of the simple test of lowering a lighted candle into the suspected place. If the flame be extinguished, the atmos- phere is destructive to life; if it burn even with a JuMe and km in ish d intensity, there is danger. Of the various modes tor destroying a carbonic acid atmosphere, none is more speedily effective than the introduction into it oi newly slaked lime, either spread upon a board, or mixed with water, and dashed into the place ; fresh lime, having a powerful affinity for car- bonic acid, quickly absorbs it. In the absence oi lime, a quantity of fresh water dashed freely doivn, so as jit the same time'to absorb the gas and promote circulation o, air will be serviceable ; or large bundles of combustible material, which will cause currents of air, may, when blazing freely, be thrown in Caution in the first instance is the best preservative ; but in the event of an individual dropping in an atmosphere ol choke-damp, it is perfectly useless for others to rush in to bring him out ; they can no more « xist in it than he could, and m stooping to lift a fallen body, they become all the more thoroughly immersed in the poisonous gas, Instead of rashly sacrificing life in the ill-directed endeavor to rescue another, let those who are present dash bucket after bucket oi water or weak lime and water into the place, and or. the fallen person, until the unextinguished ^»» e tokena f ha1 thefatdl il V n,,s l ,ht ,7 is weakened at least ; and when they do venture m, trover the mouth a cloth soaked in lime-water, or ol simple water, il tW Other cannot Ik- obtained. When from any cause, a person gets into choke-damp ad above described, cold water should be dashed rvee y over the in- dividual as soon as removed into the open air, ami this measure, Stroke of Lightning. 215 rUioceKted by heat applied to the surface, stimulant embroca- tions to the chest, spine, &c., stimulant injections, and ammonia held at intervals to the nostrils, while artificial breathing (as described under the head of Drowning) is at the same time Drought into action, and steadily persevered in for some hours. Carbonic acid is produced during fermentation, or by slow de- composition uf vegetable matter, such as damp straw, sawdust, wood-chips, &c. It is the gas disengaged in effervescing liquors generally ; it is also produced, along with other vapors of "vhich carbon torms a constituent, in tin' burning of charcoal. Poisoning by charcoal fumes, either by design or a scident, is not an unfrequent occurrences In the latter case it usually oc- curs from persons ignorant ly retiring to sleep in a closed-uproom, in which burning charcoal is used as a means of warmth. The carbonic acid and other fames disengaged, act slowly and insidi- ously, and exert so powerful a narcotizing or stupifying effect, that those exposed to the influence are quickly rendered unable to re- medy the circumstances, and perted insensibility ensues. Too of- ten it happens that the discovery of the accident does not take place until morning, long after it is too late to remedy the fatal effects; the sufferers being usually found dead. It living, they will probably be perfectly insensible ; the countenance pale and livid. Immediate removal to the open air, and free exposure to its influence by removal of the greater part of the clothing, is the first proceeding, Avhen the treatment recommended in cases 01 poisoning from choke-damp should be followed. Carbonic acid is largely given off in the process of lime burning, and per- sons who have incautiously slept in the immediate neighborhood of a lime-kiln, have been destroyed by it. STROKE OF LIGHTNING. Every summer tells the story of death from lightning. There can be no doubt that in many instances life could be preserved by the application of the proper treatment in time. Persons who are stunned, but not killed, by lightning, generally remain in a state of insensibility for some time, the breathing being slow and deep, the muscular system relaxed. In such cases it will be proper to use means tor preserving the animal warmth, which has a tendency to become depressed, to keep up artificial breathing as recommended under head of Drowning, to use mus- tard-plasters to the spine and pit ol the stomach, to administer, from time to time, a little hartshorn in water, if the patient can swallow — if not, to give a warm injection, containing half an ounce of turpentine — or to use such other means as are recommended Under Drowning and Choke-damp, which may seem adapted 216 Cramps. to the case. It is a common idea, that persons who have been killed by lightning do not stiffen, and that the blood remains fluid, but this is erroneous. It would, considering how often the fact is reiterated, seem almost superfluous to point out the ordinaiy precautious which those who chance to be exposed to a storm ol thunder and lightning ought to adopt ; but not a summer pas- ses without lives being lost from sheer ignorance. Harvest laborers and othenwill persist in sheltering under trees ; people will continue to put up even iron umbrellas in the midst of a thunder-stonn, and mowers walk unconcernedly home with their scythes over their shoulders. If an individual is overtaken by a thunder-storm in a place where trees abound, he should avoid them as much as possible. A thorough soakingwill be rather a protection than otherwise. If, on the contrary, the po- sition is on a wide plain, where the body is the highest object, lying ons, when drank under the same circumstances as cold water, have all been known toproducethe same dangerous and fatal effects. The means to he tried tor giving relief is strong stimulation, by large doses of laudanum, ether, spirits, &c. ; and above all, it isnecessary that the patient should not he permitted to remain tor an instant in a recumbenl posture ; but sJiOUlCt M kept in constant motion until relit ved. A mixture of whiskey, brandy or gin, two to four tablespoonsful, cayenne pepper, halt teaspOOntuL and ot laudanum thirty drops, to he taken in a little water as hot as it can he drank, will usually give speedy relief. The dose may need repeating in halt an hour. *or children reduce this dose according to age. At the same time Bite of Venemous Snakes. 219 hot applications to the pit of the stomach, such as hot salt, sand, meal, ashes, &c., or a mixture oi ground mustard and pep- per, with warm vinegar, applied in the same way. When heated, persons should abstain from drinking very cold water. Gargling the throat, or washing out the mouth in eold water, will allay thirst until the person has time to cool off. Where the powers of lite appear to be suddenly suspended, the same remedies should he used which have been so success- fully employed in recovering persons supposed to lie dead from drowning. Care should be taken in this, as in all cases of ap- parent death, to prevent the patient's suffering from being sur- rounded or attended by too many people The act is kindly meant but it is very dangerous for the patient. BITE OF VENOMOUS SNAKES. This may very properly be called a poisoned wound, for the the poison is inserted at the same time the bite or wound is inflicted. The wound in itself is generally trifling, perhaps not more than a scratch, but speedy death may follow. Immediately after being bitten by a poisonous snake, the parts begin to swell, and there is terrible and speedy depression of the vital powers of the system generally. When an individ- ual suffers from a wound known or believed to be poisonous, immediate steps should be taken to prevent if possible, the pois- on being aborbed into the system. The steps to be taken are sufficiently detailed in the article on hydrophobia. In addition to the local treatment of the wound (mentioned under head of Hydrophobia) continued friction with some oily material appears to be most generally useful, while, at the same time, stimulants are freely given internally to counteract the de- pression. Of course, any stimulant first attainable should be used; but hartshorn, is most highly recommended, taken in teaspoonful doses every ten minutes, in a half a gill of water, until reaction has been established, and the patient is better ; being free from poison and the swelling checked. However, hartshorn may not be so handy to get at. Then take half a glassful of brandy, whiskey or spirits of any kind, every fifteen or twenty minutes, until the patient is fully under its influence, which will be when he is " dead drunk." It should not be forgotten that the part bitten shoukl in a moment be cut out, and then freely washed with water until hartshorn or caustic can be applied, which can not always be obtained on the spot, but as soon as they can h% either of them, apply to the bitten part. 220 Neuralgia. NEURALGIA. This is a most prevalent disease of this fast age in which we Kve. Of its nature but little can be told, only that it is seared in the nerves, though bavins its origin, often, no doubt, in the excessive use of tea, coffee, rum and tobacco. However, some of the worst cases have been connected with diseased growth of bone in different parts of the head or face, especially about the canals through which the nerves pass : other severe cases have been found to depend upon irritation excited by foreign bodies acting upon some of the nerve branches ; de- cayed teeth are not unfrequently connected with the disease. Tht- most general seat of neuralgic pain is in the head or face; but the fingers, the chest, the abdomen, &c, may any of them become affected. Persons afflicted with this disease have described it as a "plunging," darting pain of the most intense and agonizing kind : but, excepl in Long-continued cases, there is no external mark — no redness, swelling, or heat, to indicate the disorder to others, and many a sufferer from this disease has been taunted with playing " Old Soldier," — a most cruel and unkind proce- dure. After a severe attack of neuralgia, the skin is often left tender, and when the pain has recurred frequently, exquisitely tender swelling of the part has been known to come on. The access of the pain is usually sudden, its remission equally so, and it is generally periodical in its attacks : it is suspended du- ring sleep. Among the exciting causes of neuralgia are damp and cold, or damp alone, if combined with malaria, such as cause ague ; exposure to currents of cold air, more particularly if the indivi- dual is heated. Debility of constitution renders the individual much more susceptible to those and other exciting causes; it has often, too, been traced to anxiety of mind. It has been observed sometimes, that sudden attacks of neu- ralgic pain in various parts of the body, have been traced to temporary stomach disorders, such as superabundant acid, &c. If the patient is resident in a climate or situation Likely to excite it, some chan~e should, if possible, be made; this will probably be most beneficial if the removal be to a dry, warm air; but should disease have commenced in a cold, dry dis- trict, change to a moist, but warm one, will probably offer most advantage. If disorder of the stomach exists, it must, of course, be rectified, by giving purgatives, such as any ordinary good purgative pill, oradoseoi' Etochelle salts, Rhubarb, Seidlits powder, or Castor oil, two or three times a week. After that, if Seasickness. 221 the disease still continues, quinine, given in one or two grain doses, every six or eight hours, will most probably be of ser- vice. Carbonate of iron, in from half drachm to drachm doses, is a most useful remedy, especially in weak constitutions. Blis- ters behind the ears, or at the back of the neck, are often va- luable aids in the treatment of neuralgia of the face. To relieve the paroxism of pain, a sponge, or piece of flannel, dipped in boiling water, or vinegar and water, and applied as hot as it can borne over the site of the pain, will often allay its severity, -or remove it altogether. Opium internally may be given in very severe cases, or rubbed on the part. Chloroform applied to the affected part by means of a piece of lint snaked in it and covered with oil Silk, is a very successful application, and should be tried if it can be procured. A liniment made of Tincture of Arnica and Laudanum, in equal parts, applied often to the part affect- ed will afford speedy relief. Five grains of morphine, thorough- ly rubbed up into a tablespoonful of lard, to make an ointment, to which add ten drops of oil of lemon, while mixing, makes a good application to the painful parts, put on with the ball of the fingers' every two or three hours. Friction to the affected parts with the dry hand, three times a day, during the intervals, should be strictly attended to, with a view to break up the disease. Electricity is often beneficial, when all other means fail. SEASICKNESS. If any of my readers have ever known what it is to be " Sea- sick," they can, no doubt, say, with the author, who dreads the Sea on that account more than any thing else, that a sail on the ocean wave is more sick than romantic. This sickness is considered to be dependent on some pecu- liar affection of the brain, produced by the rocking motion of the vessel. The affection is more readily caused by long heaving waves, than by a short rough sea. The best preven- tives of sea-sickness seem to be the horizontal posture, as near the centre of the vessel, and therefore of the centre of motion, as possible — that is, where the motion is least. Exposure to the open air renders the liability less. Stimulants, combined with sedatives, certainly appear to have considerable effect in preventing or alleviating the affection. A pill, composed of four grains of cayenne peper, with two or three of extract of henbane, taken at intervals, may be found useful. Creasote is also an excellent antidote. — one or two drops made into a pill with bread crumb, to be repeated, if necessary, once or twice during the day. Some persons find themselves less liable to sea-sick- £22 Seasickness. ness if they take food freely — with others the reverse is the case; the effect probably depends upon the state of the digestive pow- ers of the stomach, temporary or permanent. If these are vigor. ous, the excitement of digesting food acts probably as a conn- tar-agent to tlif cause ol the nausea. Sea- sickness, of itself, ia rarely injurious, but it should be a subject of consideration with persons who are liable (or Likely to be) to head-atl'ection, who are the subjects of rupture, prolapsus, &c, how tar they should incur the risk of these being aggravated by the mechanical act- ion of vomiting' Some who do not sutler from sickness while on the water, experience nausea and other uncomfortable sensa- tions after Landing — an effect, doubtless, diif to a partial disturb- ance oi the digestive organs, and probably to biliary disorder. — One or two doses, of Rochelle salts, or Castor oil, will, general- ly remove the inconvenience. Borne persons have been greatly, and often permanently re- lieved of sea-sickness, by taking from three to five drops of chloroform, put on a lump of sugar and swallowed immediate- ly, then going to bed, and, if possible, going to sleep. With children, rubbing the pit of the stomach with a sponge dipped in a few drops of ether, chloroform, or laudanum, or the three mixed together, will afford relief ; or a cloth with some of this mixture dropped upon it and laid on the pit of the stomach, will answer. Varicocele.— Almost the first symptom that is observed in the genital organs, produced either by masturbation or ex- cessive indulgence with females or other causes, is a flabbv, relaxed condition of the privates ; the testicles hang lower than usual, the spermatic cord is relaxed, and there is a dull, aching, heavy, dragging feeling in the parts, with sometimes, in more advanced stages, pains shooting up occasionally into the groin and lower part of the abdomen, and also a heavy aching feeling in the small of the back. There is enlargement of one side, usually the left, and the scrotum feels like a bag of worms. There is pain, and at times a coldness and numb- ness in the privates. The disease is quite prevalent : the author lias had no less than three hundred cases within the last few years, and has treated them successfully. This disease requires a properly constructed bandage etc. Send $2.00 and 1 will forward my improved Ventilated Bandage, free bv mail, with directions for treatment. Address M. Lafayette Byrn, M. D.; P. O. Box 4669, N. Y. You should not neglect this disease, or it may cause you much trouble und inconvenience. Hypochondria. 223 HYI'OCnOXDIilA, or Loivness of Spirits. Mild cases of tliis disease are called very often the " Blues" Bometimes Hypo, etc. It is a condition of the mind, produced Dy real or imaginary causes, which should be remedied aa speedily as possible, before it gets too firm a hold on the system. The common symptoms are, loss of, or a variable appetite, a troublesome flatulency in the stomach or bowels, sour belch ings, costiveness, a copious discharge of pale urine, spasmodic pains in various parts of the body, giddiness, dimness of sight, palpitation of the heart, general sleeplessness, and often an utter inability of fixing the attention upon any subject of im- portance, or engaging in any thing that demands vigor or courage. The mental feelings, and peculiar train of ideas thnt haunt the imagination and overwhelm the judgment, exhibit an infinite diversity : sometimes the hypochondriac is tormented with a visionary or exaggerated sense of pain, or of some concealed disease ; a whimsical dislike of particular persons, places, or things ; groundless apprehensions of per- sonal danger, or poverty ; a general listlessness and disgust, or an irksomeness and weariness of life. In other instances, the disease is strikingly accompanied with peevishness and general malevolence ; the patients are soon tired with all things ; discontented, disquieted upon every light occasion, or no occasion ; often tempted to make way with themselves ; they cannot die, they will not live ; they complain, weep, lament, and think they lead a most miserable life : never waa any one so bad. The whims that are sometimes seriously entertained under this complaint are of the most ludicrous description. Men have imagined that they were a lump of butter, and were afraid to go into the sunshine or near the fire for fear of melting ; others, that they were continually in some place of dan- ger, and likely to be killed at any moment ; some have thought they had toads, snakes, and no telling how many imaginary things in their stomach that would sooner or later destroy them. As to the causes of this disease, there may be a strong constitutional predisposition, or the disease may be the conse- quence of a sedentary life of any kind, especially severe study protracted to a late hour in the night, and rarely relieved by social intercourse or exercise ; debauched, dissolute habits • great excesses in eating and drinking ; the immoderate use of mercury, violent purgatives, the suppression of some habi- tual discharge or long-continued eruption. Some peculiar affec- tion, such as congestion or fullness of one or more of the im portant organs within the abdomen, is a frequent cause. 2-2* Hiccup. The principal objects of treatment in this disease are, to re move the indigestion, to strengthen the body, and to enliven the Bpirits; and one. of the best plans with which we are acquainted, for the fulfillment of these intentions, is, constant exercise and change of place, with a sponge bath about three times a week, early hours, regular meals, and pleasant conver- sation, the bowels being at the same time carefully regulated by the occasional use of gentle purgatives, and the stomach strengthened by some appropriate tonic medi«ine. A tea made from gentian root, dog wood, or wild cherry bark, half a glassful before each meal, taken cold, is recommended as about the best. Exercise in the open air, whether walking or on horseback, is the best ; this should be combined, if possi- ble, with agreeable company and constant change of air and scene. Traveling is a powerful remedy in this disease, since it is often one of the most effectual means in removing indi- gestion, of strengthening the body, and exhilarating the spirits ; and where the patient's circumstances will permit, it ought invariably to be one of the first measures resorted to, as it will undoubtedly be found one of the best. The patient should accustom himself to early rising, and regular meals of nourish- ing and easily-digested food. The bowels are almost always torpid in this disease, and will, therefore, require constant attention in selecting articles of diet which are of an opening quality, such as stewed fruits at meals, ripe fruit uncooked, between meals, roast apples after tea, etc., with an occasional employment of medicine if needed. Regular daily frictioo over the limbs and bo\rels, with the flesh-brush, is advisable. The moral management is of very great importance in this disease, for assiduous kindness and consoling conversation pro- duce a deep effect. The patient should rarely be opposed in the expression of his sentiments, and never with ridicule. A very important object is to gain the patient's confidence, and in order to effect this, we must humor his foibles, and seem to fall in with his views. When he is dwelling upon * some imaginary disease, it must be prescribed for, and should hia anxiety pass in succession from one complaint to another, they ought all to be prescribed for in their turn. That in bettei than trying to argue him out of his " notion." HICCUP, or HICCOUGH. This is an affection too well known to require any descrip tion. It is a sudden jerking spasm of the diaphragm (cr mid riff), expelling the air from the lungs with a peculiar sound Giddiness. 22o Acidity of the stomach or eating some .article of food which disagrees with the stomach is usually the cause of the disease. Generally it is a trivial and transient inconvenience, but its occurrence in the last stages of acute disease is a grave (often fatal" symptom, indicative of approaching death. There are cases however, differing from either of the above ; it some- times occurs in the persons, more especially of young females, of an hysterical tendency, and may continue for weeks with- out cessation, except during the hours of sleep, in spite of all kinds of treatment. The causes of ordinary hiccup are gene- rally fasting, or some sudden stimulant taken into the stomach, such as highly seasoned soup ; and the affection generally subsides of its own accord. When inconvenient, nothing is sc likely to remove it as some active emotion of the mind sud- denly excited. Startle the patient by slapping on the back, clapping the hands unexpectedly behind the head, chase around the room as if in pursuit of a rat or mouse, etc. Any thing to engage the patient's mind quickly. The continued sipping and swallowing of cold' water is a frequent domestic remedy, a few drops of peppermint in a glass of water or a teaspoonful of soda in a glass of water will often remove it. If further treatment is necessary, press firmly on the two col- lar hones for a few moments: this w ri often work like a charm. A few drops of laudanum, hartshorn, or paregoric, in water are also good remedies. GIDDINESS or DIZZINESS OF THE HEAD. Tiikke are few diseases of a simple character, that are pro- ductive of more unpleasantness to an individual than a " swim- ming " in the head, as it is often called. Some disorder of the circulation of the blood in the head is a probable direct cause of giddiness, and this is most palpable after persons have been confined to bed or to the horizontal position for a short time : on first assuming the erect posture, giddiness is generally ex- perienced. Intoxication is an example to a certain extent of the same thing. A mere passing giddiness is probably owing to some cause which a little attention to the state of the stomach will correct ; but repeated attacks, especially if accompanied with palpitation of the heart, or pain and heat about the, head, indicate danger, and no time should be lost in consulting a physician. The treatment of course must be according to the cause of the disease. If produced by toe long application of the mind to any subject or study, leave it of", and take recreation. If caused by dyspepsia, reduce the diet, and leave off the use of indigestible articles of food. If ■22G Headache. costive, take purgatives two or three times a week ; a dose of Rochcilc salts or a Seidlitz powder on an empty stomach, oi fire grains of blue pill, with rive of Dover's powder made into a pill at bed time, followed the next morning by the Rochelle Baits or Seidlitz powder, will have a most happy effect, and eat such articles of food as will keep the bowels open, (see Hypochondria^) Abstain from the use of coffee, tea, and in- toxicating liquors, take plenty of active out-door exercise, avoid meats for supper, bathe the head often in cold water, and keep the feet warm and dry. HE AD A CHE. It is Scarcely necessary for me to say that it is unwise ever to negh'd headaches. They are sources of great suffering, and often lead to serious derangements of the general healtk Headaches are more common among civilized than uncivilized nations, more frequent among females than males, among those of sensitive feeling than otherwise, and among the se- dentary than those who are more in the open air, or who take active bodily exercise. Headaches are of various forms, dependent on their various causes, such as Plethoric headaches in those who are stout, robust, or full-blooded ; sometimes it lasts but a few hours, 01 it may continue for several weeks. Sick Headache — so called from the nausea or sickness at tU stomach, which attends the pain in the head. Biliod8 Headache — occurring most in summer or fall ; i* affects persons mostly who have dark complexion, dark hair and melancholy disposition. Nervous headaches are more common among females than males. The pain is usually acute and darting, and is made worse by light, and with a feeling as if the temples were being pressed together, and a " swimming" in the head. There is sometimes a sense of sickness, with a dread of fall- ing and great despondency, or restlessness. The bowels are generally costive and the sight dim. The pain comes on most- ly of a morning and lasts through the day, going off* in. the evening. Besides the above-named varieties, there are also Hysteric headache, headache from Exhaustion, Brow Ague, Iihemna tic headache, etc. The great point about these different varieties cf headache is, that there is a cause for them, if you will but find it out, ami most of them therefore can be cured. Not merely rel'uv- ing the headache when you have it, but preventing the recur Headache. 227 fence of the disease. How many persons with premature grey hair, a care-worn and wrinkled face, an oldish look and lose of memory, . ; P. O. Box, 4669, New York. (Office 49 Nassau St.) This very troublesome disease is fully described on the following pages, which all should read carefully. Catarrh in tlie Head. 231 rising to the feet keep up the pressure. If it is Rupture, the tumor or enlargement will not make its appearance in the acrotum or bag — if it is Varicocele, it will immediately be- come full again, and feel like a bag of cords or worms. Per- sons who have Rupture must not allow the bowels to become costive, as straining at stool is highly injurious. CATARRH IX THE HEAD. This disease is usually the result of a cold in the head, which through mismanagement, inattention, constitutional predis- position, an enfeebled state of the system, a scrofulous taint of the blood, or other unfavorable circumstances, runs into a chronic state. From this apparently trilling complaint, with which every one is forced to make acquaintance, at some sea- son of the year or other, is developed a disease as frequent and offensive as it is dangerous, and which in its progress is apt to affect seriously some of the most important organs of the hu- man economy, and to be instrumental in causing the impair- ment or loss of smell, taste, or bearing, and even loss ol life itself. This disease is popularly recognized by the name vt' Ca- tarrh in the head. The first sensation is usually a feeling of dryness and heat in the nose, and a frequent inclination to sneezing. There is an inability to breathe freely, as the nose becomes stopped up, sometimes on one side, sometimes on the other. Soon a clear, watery, irritating discharge makes its appear- ance, excoriating the nostrils and edges of the lips, which become red and somewhat swollen. After a few days the dis- charge becomes thick, yellowish, extremely frequent, and continues to be a marked feature of the disease, and a source of much danger and the greatest annoyance. After more or less time, it becomes thick, very disagreeable, and assumes an extremely offensive odor. It is usually so profuse as to re- quire, when confined to the nose, the frequent application of the handkerchief, or if it drops into the throat, which is more particularly the case, while laying down, a constant coughing, and sometimes both. Sleep is frequently disturbed by a sensation of choking, caused by the presence of the discharge in the throat. Owing to the heat in the head, the watery portion of the discharge often evaporates, and, assuming a condition of solidity, is Je posited upon the membrane of the nose and upper part of the throat, in the shape of crusts or hardened lumps. The accu- mulation of these incrustations produces a feeling of discom fort, a id narrows the passages so as to embarrass respiration. 232 Catarrh in the Read. Therefore, frequent efforts have to be made to remove them, either by forcibly blowing the nose or by persistent hawking. During sleep these incrustations accumulate more rapidly, and the feeling is therefore most uncomfortable in the morning. Sometimes all efforts to clear the throat are futile until after breakfast, or after something warm is swallowed. The dis- charge, which is at first without smell, assumes in the progress of the complaint an excessively offensive odor, the breath par- ticipates in this, and becomes occasionally so revoltingly offen- sive as to render the patient an object of disgust to himself as well as to others. Ulceration of tiie mucous membrane of the nose takes place occasionally. The accumulation of the dis- charge, together with the thickened condition of the mucous membrane, renders breathing through the nose very difficult, and oftentimes impossible, necessitating respiration principally through the mouth — a method very deleterious to the general health, but more particularly so to the lungs. Sometimes the voice loses its musical quality, and assumes a discordant, harsh and nasal character; the sense of smell becomes much im- paired or entirely lost, and the same effect, though less frequent, is produced on the sense of taste. Occasionally, while blowing the nose, a crackling or bubbling sound will be heard in the ear, and hearing will be found quite thick and stopped up, but returns suddenly with something like a snap- ping sound. This is sometimes repeated, until, at one time, hearing does not return, and remains permanently injured. Noises in the head of every conceivable description will make their appearance and add to the distress of the sufferer, and hearing may be lost so gradually that a considerable degree of deafness may exist before the person is really aware of the fact. The eyes are apt to become weak, irritable, and disposed to water on exposure to cold and wind, or after the slightest exertion. A pain, more or less acute, or a distressing feeling of pressure is experienced over the eyes, and sometimes on the top or back of the head, and also pain in the face, closely re- sembling neuralgia, for which it is very often mistaken. The distress in the head weakens the memory and produces irrita- bility and moroseness of disposition. The stomach generally suffers more or less, is weak and irritable ; the appetite is va- riable, and is nearly always bad in the morning. In severe cates, the system becomes feeble and prostrated, and there ia an aversion or inability to either physical or mental exertion. Not [infrequently catarrh proves fatal, either by debilitating the system and wearing out the patient, or by traveling down- ward and producing throat affections, bronchitis, and finally Catarrh in the Head. 233 oonsitmption. It may be safely asserted that after hereditary predisposition catarrh is the most frequent and important cause of this fatal complaint. The symptoms of catarrh vary considerably in different in- dividuals, and the degree of their severity depends upon con- stitutional peculiarities and various external influences. "With Borne the complaint continues for a number of years in a mild form without causing any of the injurious results above de- scribed, while with others all the worst effects are produced in a very short space of time ; and cases, apparently most harm- less, may, thiough imprudent exposure, additional cold, or unfavorable changes of the weather, suddenly exhibit all the violence and malignity which characterizes the severest ones. In the treatment of this disease but little can be done with- out medical treatment by a physician who can take into con- sideration the age, occupation, how long the disease lias existed, the condition of the general system, &c. The author of this work has had extensive experience in the treatment of this disease during the last few years, having treated patients from most of the States of the Union ; and I was led to exam- ine very closely into its nature, and the best treatment adapted thereto ; and having seen tried the various popular " Catarrh Remedies" sold by those who knew nothing of medicine, as well as the usual treatment of the medical profession, without satisfactory results, I came to the conclusion that the inhala- tion of medicated vapors was the best treatment. I invented an Inhaler, which is now extensively used by the profession. The Inhaler is fully illustrated on page 220. From my long experience in the treatment of this disease, I have be- come familiar with its different phases, and what is necessarv for a cure, and to those suffering with this malady, I would offer my professional services, with the full assurance of a satisfactory result. (Refer to page 229.) 234 Spitting of Blood. SPITTING OF BLOOD. This is a more 'serious discharge of blood than is generally eupposed, and many cases of this kind suffered to linger along unattended to, terminate in consumption. The discharge is of a bright red color, brought up by hawking and spitting, fre- quently preceded by a saltish taste in the mouth, a sense of heaviness about the heart, difficult and painful breathing, and dry, tickling cough. It differs from blood brought from the stomach ; that from the latter is of a more dark and clotted appearance. It most commonly occurs at ages from fifteen to thirty, and may be occasioned by any violent action of body or mind: by the suppression of accustomed evacuations: by a rariiied air ; and most frequently takes place in persons of long necks and narrow chests: often in families subject to similar complaints. Bleeding from the lungs may occur in every degree, from a mere tinge of the expectoration, to the copious coughing up of fluid blood. The blood is coughed up, whereas, when it cornea from the stomach, it is vomited, a distinction which appears evident enough, but which is not always readily made in prac- tice. The management of hemorrhage from the lungs must be that recommended for hemorrhage generally. Until medi- cal assistance can be procured, perfect quiet is to be observed, cool air, especially on the chest, freely admitted, and cold, or iced and acidulated drinks given plentifully. Alum will also be found useful ; either letting it dissolve in the mouth and swallowing it, or dissolving a teaspoonful in a little water, and taking it as may be needed. Should the attack continue and medical assistance still be absent, cupping on the chest, or between the shoulders, might be had recourse to; or in an ex- treme case, when medical aid is far distant, one grain and a half of sugar of lead may be given, made into pill with crumb of bread, every two, or three, or four hours, being washed down by a draught of vinegar and water. The expressed juice of the common nettle is sometimes popularly used, and, it ia said, efficaciously, to check bleeding from the lungs ; the dose is one teaspoonful three times a day. The inhalation of the smoke from the burning leaves of the belladonna is said to check the immediate flow of blood from the lungs. For tliife purpose one teaspoonful of the cut and dried leaves is to be thrown upon live coals, and the fumes inhaled. Another val uable, because such a ready means of checking bleeding froi; the lungs, is to eat freely of suit, or drink salt and water every ten or fifteen minutes. When there is troublesome cough, it should be relieved by thirty or forty drops of paregoric, givec Typhus Fever. 235 occasionally, as required. Persons of scrofulous constitution, or who have any malformation (imperfectly formed) of the chest, are most liable to suffer from it. It rarely occurs in children. The exciting causes of this form of hemorrhage are such as call the lungs into active, 6trong, or continued exer- tion, such as violent bodily movements, much loud exercise of the voice, playing on wind instruments, &c. ; these things must, therefore, be sedulously avoided by those who have any tendency to the disorder. Temperance and moderation, 6trict attention to the condition of the bowels, and to all things ne- cessary to preserve health, as detailed in the first part of this work, will be necessary. While treating of this subject, it should be mentioned that persons are often needlessly much alarmed, from thinking they are expectorating blood, while the fluid simply comes from the throat or gums, or, it may be, is the consequence of blood from the nose trickling down the back of the throat. To test the matter, a slight attempt at coughing should be made ; if the bleeding is not from the lungs, there will be no fresh blood coughed up. TYPHUS, OR TYPHOID FEVER. This has been called by different names, such as malignant fever, continued fever, slow fever, &c. ; but for all practical purposes, in a work like this, we prefer the name most famil- iar with the people, so they will better understand our mean- ing. This is an affection of the whole system, and by medical men is subdivided into several types or forms ; but it would B'Brve no good purpose to enter into these here. The manage- ment of a disease so gravely important as fever can never be legitimately undertaken by unprofessional persons, if medical assistance is procurable ; but as a provision for circumstances when this is absent, the less complicated the account both of the disease and its treatment, the more likely it is to be man- aged with advantage. The first symptoms of incipient fever are usually displayed through the nervous system. The indi- vidual feels an unaccountable languor, and complains of head- ache and shivering, cannot exert his powers either in the da- ties or pleasures of life, is easily tired, sleep is disturbed, tha appetite is impaired, the skin looks dusky and the eyes heavy, the p^lse quickens, and at length the feeling of general illness drives the patient to bed. The attack, however, may com- mence much more suddenly — a shivering, or, as the people in many places call it, an " ague fit," may be the first symptom ; or severe headache, or vomiting, or fainting, or even convul- sion may be the first symptom of the impending malady 236 Typhus Fever. When fever is fairly established, the pulse ranges above 100 th'_ tongue is furred, probably brownish and dry, sleep is dis- turbed or supplanted by delirium, the muscular power is diminished, and the mind indifferent to passing circumstances ; dark incrustations collect about the teeth ; the patient sinks down in bed, and perhaps passes the natural evacuations un- consciously, thus displaying the most evident signs of debility. This condition may increase till it terminates in death, or tends toward recovery, either by some marked crisis, such as profuse perspiration, or by an almost imperceptible amend- ment. Tranquil sleop, improved aspect of the countenance, the skin cooler and with more tendency to moisture, the tongue cleaning at the edges, and a natural desire for food, all give signs that the disease is passing away ; on the other hand, if a fatal issue is approaching, the general weakness increases, the patient Blips down in the bed in consequence, and lies in a state of dreamy muttering; there is convulsive starting of the fingers or other parts of the body, picking at the bedclothes, the insensibility to external impressions increases, and proba- bly stupor closes life. The above are the general features of fever, whether simply continued, or when it runs out to the more serious forms of typhoid, low, nervous, or typhus fever. There are many other indications which occur, but which it would serve no good purpose to detail here ; all that is required is that the disease should be recognizable, so that its general management may be properly and intelligently conducted when it falls to the lot of an unprofessional person to have the direction. In the first place it must be remembered, that for continued fever we have no cure, that is, we have no medicine which we can give with the tolerable certainty of removing the disease, as quinine removes ague: it must be vanquished by the pow- ers of the constitution, by the tendency to health, and our endeavor must be to place these powers in the most favorable condition possible for the struggle, and, where they appear to be insufficient, assist. Sometimes the constitutional power will throw off fever at the very onset. Probably few medical men have not experienced in their ow.i persons, when attending fever patients, that they had contracted the disease, and that after all its symptoms ha(* been in course of development for four-and-twenty, or even eight-and-forty hours, it has been cast off, probably, by per- spiration or diarrhoea, and health restored. From this almost ephemeral attack, to the week after week of continued fever, the disease may be thrown off at any period of its course. A Typhus Fever. 237 person attacked with fever ought to be placed in as roomy and well-aired a situation as possible — better even in a barn than in a close or crowded room ; the greatest cleanliness as regards everything around must be observed, and perfect quietude ; if thirst is present, it should be liberally indulged with simple acidulated drinks, such as lemonade and toast-water, mixed ; flax-seed tea, cold, &c. ; if nourishment is taken, it should be given in moderate quantities, and consist principally of milk ind farinaceous preparations, corn starch, farina, or grapes, oranges, and ripe fruits, if they do not create flatulence or diar- rhoea, are allowable. If the skin is hot or dry, it should be sponged with water ; this practice is beneficial, more or less, in most cases. By these simple means of management, almost without medicine, beyond some gentle purgative, as castor oil, &c, at intervals, to keep the bowels perfectly free of their ne- cessarily depraved contents, many a case of fever may be well conducted to a favorable issue, with much more certainty than under a more meddlesome treatment — care being taken when signs of amendment show themselves, that there is not too great hurry in giving or permitting stwng nourishment. In more serious forms of fever, the same principle of treat- ment must be kept in view, but more urgent symptoms may call for more active interference ; violent delirium may require the treatment pointed out under the article devoted to the sub- ject ; difficulty of breathing and cough may render a blister on the chest desirable, or tenderness of the bowels on pressure, particularly in the right lower side of the abdomen, near the aip bone, may call for the application of half a dozen leeches. Diarrhoea may require to be checked, by small doses of pare- goric, or drinking occasionally a wine glassful of allspice tea, with a little prepared chalk in it, or constipation removed by gentle aperients ; castor oil or rheubarb or senna will general- ly be found safest and best, or injections of weak soap-suda. Sleeplessness at night, with convulsive starting of the lingers, may require laudanum, ten to forty drops; or the general sinking of the powers, the pulse becoming feeble and easily extinguished, may call for the administration of wine or bran- dy in teaspoonful doses, every hour or two, according to symptoms, with strong meat-broth, or gravy, in frequently re- peated small quantities. At this time care must be taken to observe whether urine is passed ; if there seems to be diffi- culty, a bag of hot bran on the lower part of the body will possibly make it easier ; if it dribbles away, means should be taken to protect the back and hips of the patient from being retted with it. This may be done in various ways, either by 23 S Typhus Fever. waterproof material, or by constant renewal of dry cloths; it is much better effected, however, by hags of bran, or a sponge so placed as to absorb the urine as it comes away. If with every quart of bran, four ounces of the diluted sulphuric acid be mixed, it will neutralize the ammoniacal emanations which so quickly arise wherever urine collects. It is often the case, that patients who lie long in fever be- come liable to bed-sores, or ulcerations on the prominent parte of the body which are subject to pressure as they lie; these are, especially the back and hips, points of the shoulder-blades, back of the head, tips of the ears, &c. When these ulcera- tions form, they not only add materially to the sufferings of the patient, but may become the cause of a fatal termination to a case that might otherwise have recovered. They should, if possible, be prevented. The parts named above should be frequently examined, and on the slightest appearance of red- ness, the skin at the spot should be rubbed with whisky, bran- dy, bay rum, or spirits of camphor. When the skin has ac- tually broken, it may be dressed with simple spermaceti ointment spread on linen ; lead plaster spread on soft leather is often useful, (see directions for making under head of " Me- dicines,") or the white of egg beat up with alum. Both as a preventive and as a remedy after the sores have formed, the parts should be relieved from pressure as much as possible by various arrangements of cushions, &c, the elastic ones made for the purpose being the most suitable. The foregoing are the general principles on which a case of fever is to he managed ,' by attention to them an unprofessional person will he much more likely to do good than by meddlesome interference. Attention to the ventilation of the room, to the perfect cleanliness of the patient and of every thing around — free supply of diluent drinks, as previously stated, and care that the bowels are duly, but not forcibly relieved of their always depraved contents, ought to constitute the chief re eources of the domestic management of fever. Again it is repeated, fever is not a disease to be cured) but to be guided to a safe termination. In regard to the causes of fever, they may be enumerated as follows : Predisposing — whatever lowers, either temporarily or permanently, the standard of the general health ; and Direct — contagion and the products of animal or vegetable decomposition. Attention is called before closing to the employment of fresh yeast in cases of fever, particularly of a low, malig- nant or putrid tendency, in which it is most useful. It it Typhus Fever. 239 (*iven in tablespoonful doses, repeated every three or four hours. It should also be borne in mind in the treatment of these fevers, that the patient should be allowed to partake freely oC ffum arabic dissolved in cold water; or slippery elm water, arlding a few drops of spirits nitre occasionally. Also let him have a piece of some pleasant bark, root, or herb in his month constantly (if agreeable) to chew on ; it promotes the flow of laliva or spittle, and saves much suffering from dryness of the month. A piece of orange or lemon peel, sassafras root, an gelica root, dogwood bark, or things of that kind, are admis- sible. When in the course of the disease there is a tendency to sinking, do not be afraid to give one or two grains of quinine every three or four hours, to be given in smaller doses or left off entirely if much headache should follow its use. In the early period or forming stage of this disease, an emetic will often be found advantageous. A dose of ipecac may be administered, and its operation promoted by giving the patient large quantities of weak camomile tea or warm water. After the patient has rested from the effects of the emetic, a dose of castor oil should be administered, and fol- lowed by purgative injections if necessary. The purgative should be again repeated, after a short interval, provided the Hist dose has not the effect of producing full and free evacu- ations from the bowels. When these are obtained, they re- lieve the oppression of the stomach ; render the tongue clean and soft, mitigate the thirst and restlessness, and the morbid heat of the surface, and prevent that formidable oppression of the brain and nervous system upon which the symptoms of colapse, which attend the second stage of the disease, depend. Whenever the symptoms of excitement run high, the patient feeling hot and restless, and the skin being universally and steadily above the natural temperature, and at the same time perfectly dry, no remedy has been found to act with so much promptitude, and to be productive of greater benefit, than the application of cold water to the surface of the body. It may be used in the form of ablution, or sponging ; the patient is then to be wiped perfectly dry, and covered up in bed ; after svhieh a bowl of warm tea or thin gruel is to be given him. It can only be employed, however, during the height of the fever, when the heat of the skin is steadily above the natural temperature, and no tendency to perspiration is present. When the head is much affected, cold should be applied to the scalp in the same manner as was directed in bilious fever 240 Yellow Fever. TE L LO W FEVER. This is a disease peculiar to warm climates, and is more r prevalent, and in the worst form in proportion to the greatef teat of the season; however, heat alone is not sufficient to produce yellow fever. It is attended with great diversity ol symptoms in different cases. In some patients it commences with symptoms which would appear to indicate a perfectly mill disease. In general, it attacks suddenly, with a chill, pain in the head, back and limbs, and occasionally with ? nausea or vomiting. The eyes appear red and inflamed, and feel hot and painful, the pupils are sometimes dilated, but more generally contracted. The chill is commonly of very short duration ; as it goes off, the pulse becomes, in general, full and quick, the skin very hot and dry, the face flushed, the eyes red and watery. The face has an expression similar to that of a person intoxicated ; there is great oppression and tightness at the pit of the stomach, with constant restlessness and frequent sighing ; the bowels are costive, the tongue white and coated, or of a bright red color. The heat of the skin and pains in the head and limbs augment rapidly during the first thirty-six hours, and then gradually decrease, so that at the end of the third day there is either a very great remission of symptoms, or even complete intermission of the disease, ter- minating in the recovery of the patient. "When an imperfect intermission only takes place, it is in a few hours succeeded by pain and a sense of burning in the stomach, constant nau- sea, with efforts to vomit, discharging at first only a little thick green mucus. The pulse is now small, quick, and irre- gular; the stomach sore to the touch, the bowels costive or griped, and the tongue brown and dry. The symptoms rapidly increase, until at length the sense of heat and pain of the stomach cease, and vomiting of a black, flaky matter, re- sembling coffee-grounds, takes place, called " black vomit." The patient now often feels quite easy, thinks he is getting better, rises out of bed and walks about, but soon becomes ex- hausted, and falls into convulsions, or into a state of lethargy, terminating in death. Some patients become drowsy, and die without a struggle; in others, death is preceded by the discharge from the mouth, nose and ears, of a dark-colored blood. The skin of most becomes of a bright yellow before the black vomit occurs. In some instances which terminate fatally, there is no vomiting of black fluid at any period oj t)is disease. The predisposing and exciting causes of yellow fever are the Yellow Fever. 241 bame as in other fevers : namely, exposure to heat, fatigue, cold, intemperance, fear, anxiety, etc. In regard to the treatment of yellow fever, this must vary according to the stage of the attack, and the violence of the Bvmptoms by which it is attended. In the early or forming period of the disease, marked by a slight disorder of tho stomach, headache, pains in the limbs, lassitude, and a sense of chilliness, much advantage may be derived from the use of the warm bath, brisk frictions of the surface, and the adminis- tration of calomel, followed in the course of a few hours by castor oil, ten to fifteen grains ; injections of soap suds also will be beneficial in procuring a speedy evacuation of the con- tents of the bowels. At a later period of the disease, when all the prominent symptoms are fully developed, when there is heat of the skin, burning pain and sense of distress at the stomach, with soreness upon pressure, a mustard plaster ap- plied for a few minutes at a time, every hour, will often afford relief: or leeches or cups maybe applied over the stomach. Cold water applied to the surface during the height of the fever, by sponging, should never be neglected. It is among the most powerful means we possess of reducing the violent excitement by which this fever is attended. When the head is much affected, after the application of leeches or cups to the temples or nape of the neck, keeping the head constantly wet with cold vinegar, water, or the application to the shaved scalp of a bladder partly filled with powdered ice, will be pro- ductive of the most decided benefit. The thirst of the patient is to be quenched by small and repeated draughts of some cold beverage : iced water or lemonade, toast or barley water, with the addition of ice, will be found among the best. In cases attended with great irri- tability of the stomach, we know of no remedy from which more advantage will be obtained than from a teaspoonful of powdered ice occasionally repeated. It is to be recollected, that the foregoing remedies are only adapted to the first stage of the disease, and if judiciously and vigorously employed, the danger of the second stage will be avoided, and the most unpleasant symptoms diminished within the first twenty-four hours. In the second stage of yellow fever, onr hopes of arresting the fatal progress of the case are but slender. The same treat- ment as to the gum arabic and slippery elm water, for cooling drinks, etc., also, the quinine, when symptoms of sinking appear, which was recommended in typhoid fever, is as appli- cable in yellow fever. In fact, I would recommend in tho 242 Vomiting of Blood. very beginning, as soon as the bowels have been opened, to give a mixture composed of two grains of quinine, Ave graina of powdered charcoal, and one grain of powdered sassafras bark, to be repeated every two hours. This will not interfere with the other treatment, and will by its power of keeping vj) the strength on the one hand, and its antiseptic properties on the other, be well worthy a trial. VOMITING OF BLOOD. Trns is usually preceded by a feeling of heaviness and pain about the stomach, but without cough. Generally it is pre- ceded by nausea, loss of appetite, etc. There is often pain or uneasiness in the left side, with anxiety and a sense of tight- ness in the chest. The blood discharged is generally dark colored, clotted, and often mixed with some of the contents of the stomach. In some cases there is also a discharge of dark colored blood by stool. The anfount of blood vomited is various. Sometimes a large quantity is thrown up at once, when the disease ceases, and does not again occur; but in general the vomiting is repeated at short intervals, until the patient is completely exhausted. Vomiting of blood may occur in persons of a full habit and robust constitution, but is most common in those who are weakly, or who have labored for a considerable time under a disease of the digestive organs. The most frequent causes appear to be grief, or other de- pressing or violent passions ; costiveness, especially if occur- ring in a constitution in which the stomach is particularly irritable ; blows on the region of the organ affected ; fullness of habit, combined with an intemperate mode of life; the use of intoxicating drinks ; the suppression of the menstrual flux, or of the discharge from bleeding piles ; acrid or irritating sub- stances taken into the stomach, and the abuse of emetics and active purgatives. It is, in general, easily distinguished from spitting of blood, by the blood being here brought up by vomiting, and by its being of a darker color. It is also generally mixed with some of the contents of the stomach. In spitting of blood, on the contrary, the fluid discharged from the lungs is brought U[ by hawking or coughing, and is generally of a bright red color. When a person is attacked with vomiting of blood, he should be kept perfectly quiet, in a room, the air of which ia rather cool than warm, and his dress should be loosed so as to prevent any pressure upon the stomach. If the complain* Vomiting of Blood. 243 occnr in a person of a full habit, and possessing considerable perioral strength, cups or leeches should be freely applied over the stomach. In cases occurring in debilitated habits, or where the discharge of blood has already lowered considerably the strength, cups alone over the stomach will be proper, and these should be applied without 8GO/rifying. If the bowels are costive, they should he opened by an in- jection of warm water mixed with thin gruel and a little soap suds. The thirst in this complaint is always considerable; it may be allayed by the patient taking small quantities of gum arabic, slippery elm, or toast water perfectly cold. In many cases where vomiting is incessant, advantage will be derived from the administration of an occasional spoonful of iced water, or even of powdered ice. When the vomiting of blood has been produced by suppress- ed menses or a cessation of the discharge from bleeding piles, leeches should be applied about the upper part of the thighs, or to the anus (outlet of the bowels) — the patient's feet should be immersed in hot water, to which salt or mustard has been added, and afterwards mustard poultices applied to the ankles. If it be necessary, from the great discharge of blood, promptly to put a stop to the vomiting, twenty-live grains of ipecac should be taken, in a little warm water, and if the tirst dose fail to stop it, a second may be administered after an interval of two or three hours. Ipecac is frequently of very great ser- vice in this complaint. It is applicable to the case of strong as well as of weakly persons. Sugar of lead is, in many cases, a medicine of great value here, as well as in all other profuse bleedings. Combining it with the ipecac is often advantageous: we may give two grains of the sugar of lead with two of the ipecac. Calomel iu grain doses, every two hours, will in some instances speed- ily arrest the vomiting; it should be given combined with live grains of gum arabic, and mixed with a little water. After the blood has ceased to flow, and the patient begins to recover himself, the further treatment of the case will de- pend in a great measure upon the nature of the symptoms which remain. The occasional application of cups or mustard plasters to the stomach will still be demanded, in most cases. The diet recommended under Dyspepsia will, iu genera', be the most proper. 244 Dropsy. t> u or ST . Thk disease to which the term drop*y is most usually appli ed, i> that general swelling over tlio whole body, of a soft and doughy feel, accompanied with great weakness, and otliei symptoms to 1>e hereafter described ; or it is that swelling of the l>elly, from the accumulation of a watery fluid within, by which it is often distended to a prodigious size. (ti nkral Dijopsy is a swelling of the external parts of the body, from a collection of fluid chiefly under the skin ; the swelling firet appearing on particular parts only, but at length gradually extending to the whole surface. The swelling in dropsy is always soft and uniform over any member; and when pressure is made upon the skin with the ringer, a pit or hollow is formed by the water being pressed out of some of the cells beneath, into the neighboring ones. Soon after the pressure is removed, the swelling returns to its former fulf- ness. Generally, the swelling appears first on the lower ex- tremities, and that only in the evening; it is seldom, at a.i early period of the disease, very perceptible in the morning. The more a person has been in the erect posture through tin day, the greater is the swelling towards evening. It is easy to be seen, that this is owing to the water making its way down- wards by its own weight; while the posture during sleep allows it either to diffuse itself equally over the whole bod;,', or if the quantity be great, and the disease far advanced, lo accumulate in the upper parts of the body, and to occasion the swelled face, and closed-up eyes, which some dropsical pa- tients exhibit in the morning. Sometimes the fluid which ig accumulated immediately under the skin, oozes out through the pores of the skin; sometimes being too thick to do so, it raises the outer skin in blisters. Sometimes again, the skin not allowing the water to pass through it, is hardened by dis- tention, and gives the swelling an unusual degree of firmness. General dropsy is almost always attended with scantiness of urine, which is generally high-colored, and after cooling, leta fall a copious reddish sediment or settlings. There is also an unusual degree of thirst; the appetite is generally bad; and there is a feeling of debility, with sluggishness, drowsinees, and disinclination to motion. Exhausting diseases of various kinds, copious and long-con- tinued discharges of blood, or any other weakening cause, may produce a debility of the system, which leads to drcpsy. In- temperance in the use of strong liquors, especially dram-drink- ing, is one of the most common, intractable, and fatal causeb Dropsy. 2*5 jf dropsy. Profuse bleeding has been already n entioned aa causing general debility, and as producing dropsy. From the account given of the causes of dropsy, it is evident that, while they continue to act, it will he useless to attempt carrying off the accumulated fluid, and therefore one of our first objects must be to put a stop to those causes. In a dram- drinker, or an indolent, debilitated person, it will be in vain to give drugs, or to direct any particular diet, however salu- tary, till these bad habits are given up. "We are next to attempt to get rid of the water already accumulated. Some- times very strong purgatives, particularly those which produce laige watery stools, procure a very rapid discharge of the ac- cumulated fluid ; of this kind are gamboge, scammony, and the like ; or jalap in combination with aloes, scammony, gam- boge, or cream of tartar. A powder for this purpose may consist of eight grains of aloes, ten of jalap, ana six of gam- boge or scammony, to be taken in a bolus, or suspended in syrup or mucilage, to be repeated, if necessary, every two or three days. Or ten grains of jalap, with a teaspoonful or twe of cream tarter, may be used, given in a wine glass of cold Water, on an empty stomach. Another class of remedies much used in dropsy, are medicines that act on the kidneys, and could we insure the success of their operation, we should be better pleased to carry off the dropsical waters in this way, than by any other method whatever. Cream of tartar is, perhaps, one of the best diuretics in general dropsy. Dissolve a large tablespoonful of cream tartar in half pint of water, and take a tablespoonful of the mixture every hour or two. Or mix one tablespoonful of spirits nitre with half pint of water, and take one tablespoonful every two hours. It is an important improvement in the cure of dropsies, that the patient is not restricted in the quantity of fluid which ho chooses to drink, but that a plentiful allowance of watery li- quors is considered as rather conducive to a cure, by convey- ing to the kidneys any diuretic we mean to employ, and even as of itself greatly promoting their action. Friction is another means of promoting the action of the absorbents; and exer- cise, if the patient can take it, may have the same effect : and when the swelling is abated in the morning, skilful and equa- ble bandaging (commencing at the toes and going upwards to the knees, or further,) will prevent the swelling of the legs toWarus night. When by these or other means, we have man- aged to get rid of the water already effused, our next object is to prevent its re-accumulation ; and by-strengthening the sys- tem, to complete the cure of the disease. Exercise, and the 246 Asthma. proper regulation of tlie diet, are important items in tins plan ; and are t<> be accompanied, in the debilitated, by tonic medi- cines, as Peruvian bark tea, (one tablespoonful of the bark to half pint of hot water,) of which take, when cold, one-third of this mixture before each meal. Or the tea of wild cherry bark may be given in the same way. Great attention is to be paid to the state of the bowels, to keep them open and free; and we must not neglect to keep op a proper action of the skip and of the kidneys, by wearing flannel next the skin, and giv ing some water-melon seed tea, occasionally through the day or a few drops of spirits of nitre in a little water, three or four times a day. Also bear in mind that the sponge-bath of sal s and water, over the entire surface of the body and limbs, once a day, to be followed by a rough towel and flesh brush, musi not be neglected, and should be continued for two or three months. ASTHMA, OB PHTHISIC. Tins disease is an affection of the lungs, which conies on by spells, most generally at night, and is attended by a frequent, difficult, and short respiration, together with a wheezing noise tightness across the chest, and a cough ; all of which symp toms are much increased when the patient is lying down. Changes in the weather, peculiarity of situation, errors ic diet, anxiety, fatigue, mental excitement, may any of them produce a paroxysm of asthma in the predisposed. The at- tack itself is indicated by feelings of indigestion and flatulence, headache, chilliness, languor, and drowsiness. After having experienced these sensations during the day, the asthmatic individual is probably awakened from his iirst sleep by a dis- tressing sensation of constriction of the chest ; he is forced to sit up in bed, laboring for breath, or, it may be, to seek an open window. The distressed state of the breathing, if not relieved by remedies, continues for some hours, and at last gradually subsides; the characteristic wheezing becomes less ; the cough, almost impossible before, is now brought out, and sleep, never more welcome, comes on. The latter stage of the paroxysm of asthma is generally accompanied with expectora- tion ol mucus — sometimes it is not; ami upon this a distinction into dry and humid (or moist) asthma is founded. Confirmed asthmatics have a distressed cast of countenance, and acquire a peculiar rounding or elevation of the shoulders, perfectly characteristic. Asthma may occur at any period of life, but is more general about the middle; and men are more com monly the subjects of it than women. The remedies are various; what gives immediate and full relief to one person Asthma. 217 tola, ly fails in another. The practice of umokijig the leaves and stems of stramonium, or thorn-apple, is now extensively and popularly resorted to ; with some it succeeds admirably; to other* it seems to be hurtful ; it may be tried. ./Ether and laudanum is a favorite combination ; half a teaspoonful of the iormer along with twenty drops of the latter being given in a wine-glassful of water. A teaspoonful of hartshorn may be •ubstituted for the aether, but is not so efficacious. Twenty grains of powdered ipecac, given in half a wineglassful of water, to act as an emetic, may be of service, particularly if the attack has come on after a full meal, or if there is any suspicion of the stomach being loaded. Some experience much benefit from strong coffee, drank without milk or sugar. The inhalation of chloroform, a few drops Bprinkled on a pock- et-handkerchief, has lately been found to afford relief; the fumes of burning nitre (saltpetre) diffused through the air of the apartment, by means of pieces of blotting-paper dipped in a thorough solution of the salt, and dried, is also useful. One of these, about the size of the hand, ignited and placed upon a plate in the room, quickly diffuses its fumes throughout the apartment. When there is great dryness and deficient expec- toration, steam from bitter herbs, (as in catarrh in the head,) inhaled either simply or with a few drops of sulphuric aether, is worth a trial. If there is much acidity of stomach, ten or fifteen grains of carbonate of soda with a teaspoonful of harts- horn in a little water should be given. Indeed, when an attack of asthma is threatened or has come on, care must be always taken, as far as possible, to remove any existing dis- ordered action. A cup of warm tea and retirement to a warm bed will remove the chilly sensation. Costiveness of the bowels ought to be relieved by a gentle dose of castor oil, or of rhubarb and magnesia ; flatulence or acidity is corrected by a mixture of water, in which some essence of peppermint and prepared chalk have been put, given every hour. Flatu- lence particularly must oe obviated, and all sources of it avoided Effervescing draughts, soda-water, and such -like, are almost always hurtful. The effects of situation and of atmospheric peculiarity upon asthmatics are most varied ; some can breathe freely in clear dry air, which drives others iato a damp cellar for temporary relief : a close, warm room which suits one will be unbearable to another. Individuals who are never free from asthma in some situations, lose their attack as soon as they are removed. These are peculiarities of which all should be aware. Cer- tain odors produce asthmatic breathing in the predisposed ; — 248 Scalds and Bums. the powder of ipecac is notorious for this effect ; and the sine! of new-made hay, so pleasant to most persons, produces hay asthma in a few unfortunate individuals. Sponging the chest and shoulders every morning with cold Fait water, friction being afterwards made with a rough towel or flesh brush, is a practice to be recommended, provided no other predisposition forbids. A few drops of BBther, put into :> gill of cold tar-water, and inhaled by means of one of the Inhalers recommended in ca- tarrh in the head, will be of service in some cases. SCALDS A N D B URNS. The frequency of accidents of this kind makes it obligatory for every individual to be posted as to the best treatment in such cases, as it is necessary to apply our remedies at once, to be the most successful, for in all accidents from scalds and burns, it seems to be of the utmost importance to apply a remedy at the instant; for by this means the violent anguish is allayed, and blistering, which in scalds, at, least, is usually so considerable as to lay the foundation for a tedious curative process, is in a great degree prevented. In the case of slight burns and of scalds, generally the best application is the cotton wadding in sheets; it should be used to envelop the injured parts, double if possible, and bound or bandaged on with moderate firmness. If this mode of treat- ment be resorted to within the first twenty minutes after the injury, nothing more need be done; the cotton may be allowed to remain on from twenty-four hours to three or four days, according to the severity of the accident. Under its uso blistering rarely occurs, amd if it has commenced before the application, it subsides quickly and painlessly. For the first ten minutes after the cotton-dressing is put on, the pain of tho injured parts seems increased, but ere long it diminishes, mid the inflamed skin appears to relieve itself by gentle perspira- tion. In the cases such as above named, when cotton is to bo procured — and no house in the country ought to be without one or two sheets of it— it is perfectly unnecessary to use any other measures. A lotion made with six tablespoonfuls of vinegar to a pint of water may with advantage be kept constantly applied to a burn, if it be not exh nsivi — a saturated solution of carbonate of soda has likewise been recommended. Cold water is perhaps the most directly grateful application to a burnt or scalded surface, and if continued sufficiently long, w'll undoubtedly restore the usual condition of the part, but it Scalds and Burns. 2±9 must be persevered with for many hours; and when a burn or scald is extrusive, this is a serious objection, in conseqnence of the extreme constitutional depression which bo often l'< Hows the accident, especially in the young. We would warn pa- rents of the necessity of watching closely the effects of even slight injuries of this kind upon children, particularly when the chest or abdomen are the seat of the accident: extreme depression — requiring the use of stimulants — may unexpect edly come on, and death, from an apparently very slight cause, be the result. Wlten cotton is not readily procurable, Hour sprinkled ever the surface is an admirable substitute, even in slight burns, but is more useful still in those severe effects oi heat in which the parts are deeply destroyed by the action of tire; in these cases, Hour applied at once, and repeated again and again for days together, whatever slight moisture seems oozing through the caked covering it forms — is the mosl gene- rally applicable, pleasant, and safest remedy; a little fresh 6weet-oil applied to the surface in the first instance will make it adhere. Applying a thick coat of white lead paint lias been found an excellent remedy. It should not be washed off, but suffered to remain on until cast off by nature's own process. "Whatever application is used in the treatment of a burn, should be calculated to exclude t/ie action of the external air y it, ought to be one, also, which does not require frequent chang- ing I the more extensive the surface involved in the accident, ttoe greater care should be taken not to expose it to air, which increases pain, and adds to the general depression of the sys- tem. This depression must always be carefully watched, and combated by the use of ammonia, wine, or spirit, sufficient to support without stimulating. When pain is excessive, and is irritating the nervous system, a gentle opiate is required ; but in some of the severest burns, the sensation, not only in the injured part, but generally, is either wholly or partially abo- lished, in consequence of the shock to the nervous system at large. This is always a bad symptom. In the less severe forms of injury from heat, if the cotton, the Hour, or cold water, have been properly used, little after-treatment is neces- sary ; but when a burn has been neglected or badly treated, the blisters broken, and when the true skin beneath is inflam- ed and secreting matter, a simple tepid bread and water poul- tice should, in tiie first place, be applied for six or eight hours, and after it an ointment composed of one tablespoonful of white lead paint, rubbed up with same amount of perfectly fresh lard. This ointment spread on linen quickly relieves the very painful condition of the injured surface. One teaspoon 250 Scalds and Burns. ful of powdered sugar of lead will do when the paint can Dot be had. rubbed np with oi.e tablespoonful of lard. In cases (it* deep burn, with destruction of the parts, aftei the flour has been applied some days, it begins to be pushed *>1f by the matter formed underneath: at this time poultice? are to be continued until the caked flour is separated, and the surface below exposed, after which the simple dressing with tepid water will generally be the best and safest applica- tion ; or, in a later stage, if healing is slow, use the lead oint ment recommended above. During the cure of burns involving contiguous parts, such as the Angers, care must always be taken to keep the surface! asunder by the interposed dressings: otherwise they may grow together. After extensive burns or scalds, the constitu- tion requires attention — the stimulating treatment of the first few hours or days must be dropped when feverish symptoms come on, and mild and cooling diet, gentle purgatives, and cooling drinks, as lemonade, apple tea, toast-water, &c., ad- ministered : opium or laudanum, in ordinary doses, being given if requisite, to allay T pain or nervous irritation. This system will again require to be changed for one of strongei nourishment — meat soups, meat and wine, or other stimuli, if there is continued discharge. The use of stimulating diet, however, requires caution, on account of the tendency to in- flammation of the lining membrane of the stomach and bowels, which exists during convalescence from injury to the skin by heat. The sores left by burns have some peculiarities. They shoot oni fungous, or proud flesh, as it is vulgarly called; they are difficult to heal : and when they do heal, contract so much as often to produce great deformity. To arrest the growth of this over-growing flesh, sprinkle the part with burnt alum, once or twice a day, or apply lunar caustic as often as may be required. I will state, in concluding this subject, that during my re- sidence in Mississippi, during the years 1S40-50, 1 had occasion in my practice very often to try the application of lunar caus- tic to recent burns and scalds, with the happiest effects — the pain ceasing almost immediately, and the parts healing in a short time. It was applied with a camel's hair brush or linen mop at once, and again in a few days, if healing did not seem to be going on satisfactorily. Twenty grains of caustic Jiabohed in an ounce of water, were the proportions used. Jiueumatism. 251 BITE UMA TISM. i» is disease is divided into the chronic and the acute ; being- knovvn by the former appellation when there is no great degree of inflammation or fever, but merely pains; and by the latter when botli fever and inflammation exist. It may arise at all times of the year ; but the Spring and Autumn are the seasons in which it is most prevalent. It at- tacks persons of all ages, but very young people are more ex- empt from it than adults. Jhose whose employments subject them to exposures to great heat and cold, are particularly liable to Rheumatism. Obstructed perspiration, occasioned by wearing wet clothes, lying in damp linen, sleeping on the ground, or in damp cellars or basements, or by being exposed to cool air when the body ha- been heated by exercise, or by coming from a crowded room into the cool air, the causes which usually produce Rheu- matism. Those w r ho are much afflicted with this complaint, are very apt to be sensible of the approach of wet weather, by wardering pains about them at that, period. Chronic Rheumatism is attended with pains in the head, shoulders and other large joints, which at times are confined to one paiticular part, and at others shift from one joint to an- other without occasioning any inflammation or fever; and in this manner the complaint continues often for a considerable time, and at length goes off, leaving the parts which have been affected in a stuie of debility, and liable to fresh impressions on the approach of bad weather. Acute Rheumatism usually commences with languor, chilli- ness, succeeded by heat, thirst, restlessness, and a quick pulse* there is also a sense of weight, coolness of the limbs, and con- fined bowels. In the course of a day or two, inflammation, with acute pain and swelling, makes its appearauce in one or more of the larger joints of the body. The pain is frequently tran- sitory, and apt to shift from joint to joint, leaving the partpre- riously occupied, swollen, red and extremely tender to the touch. The pulse now becomes full and hard ; the tongue preserves a steady whiteness ; the bowels are commonly very costive ; the urine high-colored ; and often there is a profuse sweating, un- attended by relief. Sometimes, however, the pain is the first symptom, and the fever follows. When the pain is not very severe, and confined to a few parts, the fever is slight ; when it is severe and felt in many parts, the fever is more considerable, and it is most so when the pains extend over the whole body. Both the pain and fever generally suffer an increase in the evening, and a 252 Rheumatism. remission towards morning. The pains are nrjch increased on the slightest motion requiring the action of the muscles affect ed, ami are most severe, as well as most apt to shift their place, in the night time. The fever abates sooner than the local symptoms, and is rarely protracted beyond a fortnight or three weeks. The pains, for the most part, are the last symptom which leaves the patient When an individual who has either suffered from an attack of acute rheumatism, or is hereditarily predisposed to it, or indeed when any one, after exposure likely to produce an attack, suspects the disease to he impending, the first effort should be to excite the free action of the skin. If a warm or vapor bath can be procured, it is highly desirable; if it can- not, the best substitute will be a well-warmed bed with hot bran bags, or hot bottles, and the free use of warm drinks. A mixture composed of half an ounce of spirit of nitre, one drachm of paregoric, and fifteen drops of wine of ipecac, in a wineglassful of water, may be given every four or five hours. To the above draught, ten grains of the bicarbonate of potash may be added with advantage. Under the above circum- stances, any stimulant sweating may be given with benefit, even a little gin, or other spirit, or wine, well diluted with hot water; these stimuli being used, of course, only at first, and while jfeiw is not yet present. When an attack of acute rheumatism is established, if medi- cal assistance is not immediately procurable, the patient must he kept in bed, moderately warm, the thirst quenched by the free use of simple warm drinks, and the diet reduced to a very low scale, any thing like alcoholic stimuli, or animal prepara- tions, being strictly forbidden, except in the case of very debilitated persons, when animal broths, such as beef-tea, may be permitted in moderation. If fever runs high, tartar emetic, in from an eighth to a fourth of a grain dose, may be given every four, live, or six hours, and with this, from six to ten drops of laudanum may be combined, to alleviate the pain. Dover's powder, in doses from ten to twenty grains, may be given at bed time, and followed by a purgative of castor oil next morning. The above measures might with safety bo adopted, under peculiar circumstances, in the absence of medi- cal assistance. There are, however, many other modes of treatment. That by large doses of nitrate of potash, or salt petre, has had its advocates, and may be tried : the mode of administration, as laid down by Dr. Basham, is to dissolve two ounces of the saltpetre in two quarts of water, and to give this quantity in the course of twenty-four hours. Thif Rheumatism. 253 treatment, which i& said to he very successful at times, might be available in the absence at least of other remedies; ofcouise, if symptoms indicative of irritation of the stomach or howels came on, it would require to be abandoned. More recently the treatment of acute rheumatism by lemon-juice has come into practice, and seems in many cases to answer extremely well. This treatment has {he advantage of being perfectly safe, and therefore, where the lemon-juice can he procured, may, without danger, be pursued in the absence of a medical man. One tablespoonful, or half an ounce of lemon- juice, is to he given every four hours. The "alkaline treat- ment" of acute rheumatism is followed by some fifteen to thirty grains cf bicarbonate of potash being given, well diluted in water, every four hours. As regards the local treatment of the inflamed joints, little is to be done in a disease which shifts its site as rapidly as acute rheumatism; for even if it can be driven from one joint, it must, as long as the poison is in the constitution, .-how itself elsewhere, it may he in the heart. "When the joints are much swollen and painful, much ease may be given by enveloping them in a large quantity of the soft carded cotton — "cotton wool" — over which there is wrap- ped completely a piece of oiled silk, or oiled paper. By this air-tight covering, the joints are kept in a perfect vapor bath, and when it is removed after twelve or twenty-four hours, the wool will be found saturated with moisture which is strongly acid. The causes of acute rheumatism already pointed out will suggest to most persons the precautions to be adopted, espe- cially when liability to the disease exists. Cold and wet are particularly to be guarded against, and, after exposure, the preventive measures already laid down adopted. Flannel or woolen, worn next the skin, must always be regarded as one of the chief preventives ; it should of course be proportioned in thickness to the season and temperature. Persons of full habit, liable to rheumatic attacks, should avoid malt liquor generally, should take animal food sparing- ly, and avoid violent exertions which heat the body. Persons of spare or feeble habit, may live better, and indeed require to keep up the condition of the body to as good a pitch ae In chronic rheumatism, instead of heat, there is often a sen sation of cold around the affected parts. The chronic nature of this disease must generally place it under proper medical control; the chief efforts of the unprofessional must be to correct any slight deviations from the general health, to pro 2o4 Rheumatism. tect tlio affected parts especially from cold by mean* of warro clothing, and to use friction, cither with simple oil, or by means of liniment of camphor, sweet oil, and laudanum, in equal parts. Much comfort is not only derived from friction, but, if combined with proper exercise of the joint or joints, it may do inncli to prevent permanent deformity. In ehronw rheumatism, warmth of climate is of much importance, and as much should be done toward the attainment of this V circumstances will permit. Chronic rheumatism, properly so called, is such as alove described ; but the term rheumatism, or rheumatic pa»n, is also used to a great variety of anomalous pains, and from this has arisen considerable confusion. The best marked of these is "muscular rheumatism," which affects chiefly the ihicl* muscles, such as those of the shoulders, arms, neck, loins &c This form of rheumatism often comes on suddenly, after ex- posure to a current of cold air — sometimes after cold bathing; its chief characteristic is severe pain, when the affected mus- cles are thrown into action. This muscular rheumatism seema to be a purely local affection, and is generally removable by purely local remedies. Of these, the best is a large hot bran or other poultice, or some other means of applying heat and moisture, applied over the affected part, for a few hours; this often at once cures — care of course must be taken to protect the part to which the heat lias been applied, by a covering of flannel. After the hot application is removed, if the heat does not entirely cure, and even instead of it at times, a liniment of camphor, sweet oil and laudanum, in equal parts, or volatilo liniment, mixed with laudanum, either alone or combined, with one-third of turpentine, may be used to advantage; two or three teaspoonfuls being well rubbed into the part every few hours. Any notice of rheumatism at the present day must be im- perfect, without some allusion to electric and galvanic agen- cies, galvanic rings, electric chains, &c. That these appliances ave at times of apparent service in cases of chronic rheumatism is undoubted, and if such is the case, we are not justified in rejecting their aid because we cannot exactly explain the why and wherefore of their action. The author has found, as a general thing, that the wine of col chicum, given in from two to live drop doses, three times a day, gradually increasing the dose until sickness at the stomach has een produced, or looseness of the bowels, or both ; and then go- ing back again to the small doses, (after a day or two,) and gra- dually increasing again if necessary, has been the most reliable remedy in rheumatism. A liniment of whisky, (or alcohol) kero Nemous Debility. 255 sine oil, laudanum, sweet oil and turpentine in equal parts, applied as needed, is about the best local application. NERVOUS DEBILITY. ITS CAUSES AND TUK CUKE. IT IS ntODUCED BY EXCESSES IN MARRIED LIFK, ETC. The most potential cause by which this disease is induced is the vicious habit of youth, though it may follow more innocent causes in those of mature age. It is incomparably the most serious affection by which the male portion of the race is assailed, as by the ceaseless losses of the generative secretions the general health is not only greatly depreciated, but the virile capacity also becomes so enfeebled by its ravages, that finally the masculine attribute becomes wholly passive or destroyed. It superinduces a species of atony, or wasting away of the genital organs, which often amounts to a paralyzed condition, imparting to them the appearance of imperfect development which is often real, as the disease, if present in the early years of adolescence, effectually retards and arrests develop- ment and stunts capacity. It is a fixed physiological fact that there is an intimate sympathy between the genital organs and the mind — a fact which fully explains the despondency, the gloom and misery, the loss of memory, the day dreams, the erratic visions, the hypochondria, and other evidences of mental disorder by which the sufferers from this disease are distressed. In consequence of the deterioration of the mind which the disease occasions, development of the mental functions are sadly interfered with, capacity of acquirement is lessened, progress is arrested, and hence the frequent observation of the precocious youth becoming the dull adult. The sufferer from the deplorable disease, constantly presents the evidences of his affection as the facial expression con- stantly conveys to others the fact of its existence ; his skin is pale and sallow, the eyes are surrounded by dark circles and are quite lustless, the pupils are sluggish and dilated, and the countenancs has a troubled, haggard and furtive expression. His manner also betrays his sufferings and decrepitude, as do what he will he cannot conquer his shyness, or retiring habit; the ease with which he becomes confused, his aversion to society, a want of steadiness and decision in locomotion, the deficient power in the lower extremities, and many peculiar movements all betray a mind ill at ease. . It is not an uncommon fact for the mental troubles to be- 25G N rooua Debility. come so grave as to induce the most serious disorders, such as delusions, insanity, dementia, and epilepsy. A slight knowledge of physiology will teach the reader why this affection is so pre-eminently destructive of mental and physical vigor, and of the vitality of the procreative organs. The general functions are controlled and governed by nerves radiating from the sacred plexus — a network of ner- vous tissue situated at the posterior wall of the pelvis — precisely as taste, sight, hearing, etc., are directed by nerves arising in ganglionic centres of the brain. A constant and unnatural loss of the generative secretion invariably induces atony, or paralysis of the plexus, causing the relaxed condition of the generative vesicles and the general unmanly condition of the organs. The generative iiuid is also the most highly vitalized secre- tion of the whole body, being rich in phosphorus, and the various phosphates which also constitute the principal element of the nervous tissue. It is, therefore, apparent to everyone, that the involuntary expenditure of the secretions as fast as secreted deprives the nervous system of its normal and required stock of phosphorus, and that this poverty is the cause of the debiiiry and devita- lized condition of the nervous system and of the decadence or complete destruction of such functions immediately under the control of the nervous system as the virile capacity or power of generation. One of the most sad and deplorable fancies of some of those who suffer from this unmanly effection is to regard the invol- untary losses as an evidence of high physical power, a relief of surcharged and exuberant manhood, and a natural sequel of continence. This delusion has been the ruin of many, and no one should be guided by such a fallacious thought, chouM it even come in the shape of professional advice. Every discharge of the generative secretion, if not occurring in the natural orgasm, is unnatural, and the result of a dis- eased condition, and is sure to affect the general health and the tone of the virile capacity. All who give themselves up to this odious and criminal habit are not so severely punished, but there are none who are not more or less so. The frequency of the pollution, the variety of temperament, and several circumstances indepen- dent of either, occasion considerable differences. The symptoms we have, the more frequently witnessed are a total derangement of the stomach, which occasions a loss of appetite or an irregular loss of food ; in others, acute pains, above fe.il Nervous Debility. 257 during the time of digestion, or habitual vomitings, which resist every remedy so long as they continue under their de- lusions ; a weakness of the organs of respiration, whence fre- quently result hoarseness, weakness of voice and shortness of breath, upon making any short violent exertions, and finally, total relaxation of the nervous system. Let me here be permitted to insert some fragments of letters, which united, will form a sufficiently complete picture of the physical disorders produced by the imprudent habits of youth : — " I plainly feel, " wrote one patient, " that this impru- dence has diminished the strength of my faculties, and above all, my memory. Age, assisted by reason, has for some time cured me of that wretched penchant, but the evil is done. To an affection and extroardinary sensitiveness of the nervous system, and the accidents it occasions, are added a weakness, an uneasiness, and ennui, a distress of mind which seems per- tinaciously to adhere to me ; I am worn out by an almost con- tinual loss of the generative fluid; my countenance has become pale, and almost cadaverous , pimples and blotches are breaking out all over my face ; the weakness of my body- renders all motion a trouble to me ; that of my legs is such that I have frequently great difficulty in keeping myself on my feet, and I dare not venture to leave my room ; my di- gestion is so bad that my food passes through almost unchanged three or four hours after taking it; my chest is loaded with plegm, which keeps me in continual pain, and the expectora- tion wears me out, " This is a brief description of my miseries, which are still more aggravated by the mournful certitude I have acquired, that each succeeding day will be more painful than the pre- vious one." " Did not religion restrain me," says another, "I should already have put an end to a life so much the more cruel as it is my own fault." In fact, there is no situation in the world worse than that of mental affliction ; pain is no comparison to it, and when joined to a crowd of physical evils, it is not astonishing that the suf- ferer should wish for death as the greatest blessing, and con- sider life (if so wretched an existence can be called life), as a real misfortune. The following case is more brief and less terrible : — "I had the misfortune to contract that habit which too soon ruined my temperament and constitution ; my state of late years has been truly pitiable, my nerves are extremely weak, my hands are always trembling without power, and contiually clammy with 25S Nervoui Debility. per?pirati<>n ; I am subject to violent spasms of the stomach, pains in the head, arms, lege, and in the loins and chest, fre- quently accompanied with a cough, which is very harassing; my appetite is voracious, yet 1 nail away considerably, and my face becomes every day more cadavorons, and full of pimples and blotches." Nothing perhaps weakens the intellect so much as these habits, which takes possession of the whole mind and atten- tion, and prevent their victims from following their respective vocations, rendering them stupid, dull and thoughtful, and destroying their vivacity, cheerfulness and health, bringing on consumption, weakness, barrenness, and all that dreadful train of complaints which make the timid uncertain, full of whims, and ridiculous. It is the imperative duly of every sufferer from this disease, no matter how seldom the unnatural losses occur, to engage the >. rvict 8 of a competent and experienced physician, so thai the integrity of the general health and the quality of the masculine capacitu 8 will be both saved fo?n further decadence, and again restored to the normal standard of excellence. The excesses of early married life are often the cause of Nervous Debility and its train of evils, simply because the parties do not know what excesses are, having never been taught a little of the common sense for the million which can be lound all through this book. Unmarried men, also, who give way to wholly and unbridled passion, by their associa- tion with women of a certain class, almost invariably bring about a condition of body and mind but little different from those who indulge in the vicious habits of youth. Sometimes seminal losses are caused by the presence of worms in the rectum, orlowt r bowel, as well as by intei nalpUes. These things produce local irritation and excitement, caus- ing a dream of a lascivious nature, and the loss of seminal fluid during Bleep. It will thus be seen that it is not only the vicious habits of youth that bring about nervous debility and all its train of evils, so that each case must be investi- gated by the physician and treated according to its c ius . Those desiring the professional skill of the author, will please write out your case, age, occupation, how long affected, and all your present symptoms, and whether any of the causes above alluded to have any bearing on your case. En- close $5.00 (and 1^5 cents for postage) addressed to M. La- FAYKrii. I'vKN, M. D., P. O. box 4,669, New York (office, 49 Nassau Btreet). Do not be afraid of describing your case too minutely — I want to know all the facts relating to it. Impotence. 259 IMP OTENCE. This mortifying condition follows nervous debility in most of cases, where that disease is allowed full and unchecked sway. The disease (Impotence) often follows or is produced by other causes; such as sedentary habits, intense study, etc. It implies an incapacity to engage in the marital act, and not loss of procreative power, that is termed sterility. It is dependent upon atony or weakness of the nerves of the sacral plexus, a condition spoken of under the head of ner- vous debility, and frequently caused by that affection, though it, may be brought about by injuries and diseases at the base of the brain or spine, and by whatever depletes the nervous system of its required stock of phosphorus. The virile capacity is the strongest of all the human forces, and remains as long as any one, and does not, as erroneously supposed, decay in advance of the other forces. While an enfeebled capacity may be perfectly natural in advanced age, complete impotence at any time is the result of a morbid process and inconsonant with the harmony of the physical economy. It is a well-established medico-psychological fact that vig- orous integrity of the virile powers is absolutely necessary for the welfare of both body and mind, and for a well-bal- anced moral sense. A loss of manhood signifies more than mere virile imbecility, it also invariably denotes a loss of physical elasticity, mental acuteness, and moral tone. These are indisputable facts and fully realized by all those who have sustained more or less loss of coitive power. Im- potence is, therefore, one of the most deplorable diseases, making the sufferer a miserable being. A man without the status and functions of his sex, depreciating his physical capacity, and mental activity. Whenever the virile capacity evinces the least degree of decadence it should excite immediate concern, as the process of decay is in all cases a progressive one, as every case of partial impotence, sooner or later becomes complete, unless arrested by the skill of a physician. No one should place confidence in the hope that the recu- perative powers of unaided nature will effect a restoration of coitive capacity, as dependence upon such means of reinvigora- tion always ends in disappointment. The only judicious course to pursue when decadence of capacity is first observed is to engage the aid of an experienced and skillful physician who will interpose the required treatment to arrest the process of deterioration, and to imbue the organs with renewed vigor. 2C0 Impotence. It is very frequently the case with those who have been guilty of youthful imprudence that they never attain full vigor of manhood, a fact of which they are profoundly ignor- ant. It is, therefore, of the utmost importance that such persons should consult a competent physician before a mari- tal alliance is consummated, so as to be secured against the mortifying experience of many matrimonial novitiates. Greater diagnostic skill and familiarity with pathology is required for investigation into the character of each individ- ual case of lost manhood than for any other unnatural condi- tion, and no physician, however eminently successful he may be in other professional spheres, can give decisive or reliable advice, or successfully treat the affection, unless he has made this particular disease his life-long study, or possess the skill which can only be acquired by the treatment of many thous- ands of cases. It is, therefore, the plain duty of every one of depreciatea manhood to seek counsel only of the physician who makes the treatment of this condition a specialty. IVe are justified in giving this advice, by the fact that we have seen very many cases where, the injudicious treatment of inexperienced physicians has very measurably increased the virile debility, and in not a few cases an incurable condi- tion. The virile powers can always be restored, but assuredly only by judicious and appropriate treatment. The Physi- cian, in ordinary practice, relies entirely on the so-called aphrodisiacs, or medicines supposed to excite the amative p>assions, and upon such agents as give tenacity to the spine. Of course failure ensues, because such remedial agents are highly improper, and always do more harm than good. A restoration of virile power can only be accomplished by the removal of the paralyzed condition of the genital nerves, and by restoring the base of the brain to a healthy func- tional activity; each case presents different features to which treatment must he adopted, or else failure will ensue; a rou- tine practice i=> out of the question, yet nearly all physicians expect to enre all cases by the employment of the same remedial agents. In the treatment of this condition, our success is very gratifying, and no one who feels inclined to engage our ser- vices need entertain any doul is aa to our ability to restore virile capacity, even to the extent of his most ardent hopes. As a final admonition to this class of patients, we most earnestly advise them not to remain contented with partial Impotence. 2C1 vigor of the virile capacity, as complete manhood is conso- nant only with the integrity of the mental and physical organisms, as well as with the nobility of the sex. And as appropriate treatment will restore manhood, every sufferer should engage the services of a physician. They need skillful and scientific treatment in the use of Direct Local Remedies which none can give except a physician well skilled in the use of the local remedy, as nine-tenths of these cases cannot be cured without it. We meet, daily, cases be- yond the control of medicines, which are permanently cured by the use of this local application. We most respectfully proffer our services to this class of patients, being justified in doing so by the indisputable fact that with our facilities and vast experience we can cure all curable cases of this malady. Give your age, occupation, how long affected and all particulars, enclosing $5.00 (and 25 cents for postage). Direct to M. Lafayettk JBykx, M. D., P. O. box 46G9, New York. (Office 49 Nassau St.; Do not understand me as saying that all cases can be cured. If, upon receiving a statement of your case, I am fully satis- fied that I cannot materially benefit you. I shall return you your money, if you have paid any, or decline to accept pay unless I feel confident of doing you good service, in this pe- culiar malady — and this, I may say, is my rule in all cases presented to me for medical treatment for any disease or ail- ment. ABSCESS, This may be properly called the collection of pus, or matter in a cavity formed in the substance of any soft parts of the body. The contained matter, or pus, may be either of a healthy or of an unhealthy character ; if the former, it is of a yellowish-white color, cream-like in consistence, and pos- sesses a faint sickly odor ; in the latter case, it may resemble whey, with bits of curdy substances floating in it, or it may be bloody and offensive. Common abscess. An abscess formed on some external part of the body, which has been previously the seat of inflamma- tion. Whenever inflammation occurs, the most proper course is to endeavor to remove it by an early resort to appropriate remedies, before it causes suppuration, (or the formation of an abscsss ;) but if this latter canuot be prevented, we must endeavor to accelerate its progress by warm fomentations of bitter herbs, such as hops and vinegar, boneset, sage, or hore- hound, and hot water, &c , and by poultices. These are to be 2G2 Abscess. made of bread and milk; oat-meal or linseed-meal and watei or slippery elin ; and to promote the ripening of an abscese in the inside of the mouth, a roasted tig or apple may be used. "When the tonsils (or almonds of the ear) are tending to sup- pu ration, [or coming to a bead), the patient should draw into tl a mouth the steam of boiling water, alone, or with a little vinegar and hops added to it. In general, those poultices are best which retain their heat the longest, and they should be frequently changed, to prevent their becoming cold, and thus having a contrary effect to what we wish them to have. The tendency to snppnration may be known by the inflammation continuing long; by the stretching pain becoming less ; by a throbbing sensation, and the patients being afl'ected with cold shiverings. When an abscess forms in a place under our in- spection, it is accompanied with swelling, whiteness, or yel- lowness of the skin, and a soft feel, as if there were a thickish fluid in a bag. "When matter is formed, it must be discharg- ed, and nature endeavors to accomplish this by causing the matter to have a tendency to the nearest outlet: thus an ab- scess formed in a fleshy part of the body will point to the skin ; one in the lungs will burst in the air-cells; and one in the liver, either into the belly, or externally through the side. When the abscess is quite ripe, which is known by the pain being lessened, and the matter pointing or coming to a parti- cular spot, it is, in general, best to give it vent by opening it with a lancet, or other clean cutting instrument; and this, in the position or situation which is lowest, on purpose to let the abscess empty itself by the weight of the fluid. It is better to have a free vent of our own making, than to allow the mat- ter to And its way under the skin, to distant and inconvenient parts, or to allow the matter to discharge itself by a ragged and irregular opening. It is almost always proper to make the cut large, as a small one is nearly as painful, and as it is liable to close too soon, and thus occasion the necessity of repeating the operation. When the abscess is large and deep, a small piece of lint should be put between the lips of the wound, that it may close from the bottom, and this is to be re- newed at each dressing. The poultices are still to be con tinned till the thick yellow appearance of the matter changee into a thin watery discharge ; after this it is proper to discon tinue them, and to dress with simple cerate, made of wax. lard, and sweet oil melted together, in equal parts by weight, or any good healing ointment. When it is wished, as much as possible, to exclude the ail from the inside of an abscess, an opening is made by passing Boil. 263 * brofad cutting needle, for the purpose of bringing through the sides of the abscess a skein of silk or cotton. This is desirable, particularly in lumbar abscesses, or those collections of matter which come from the inside of the belly, and point at the up- per part of the thigh ; as air admitted into them is often found to be the cause of hectic fever, and consequent generally ill health. The degree of danger which attends an abscess, depends on its situation and its consequences. If it is situated in the lungs, it may burst into the air cells, and prove fatal by suffocation ; or if in the liver, etc., it may be effused within tin- cavity of tho peritoneum (or lining membrane of the bowels) and excite in flammation there. Large abscesses are dangerous by the wast- ing discharge with which they are accompanied ; and by the glow fever and general symptoms which, in certain constitu- tions, follow them. BOIL. A Boil is a small tumor common to every part of the surface of the body; hard, tender to the touch, and coming to a head, with a hard core in the centre. It is chiefly found in persons of a full habit, and great vigor ; but is sometimes met with al- so in debilitated patients, who are evidently suffering from ill health. When it occurs in strong and vigorous patients, they should i>e put on a low diet, and some cooling opening medicine should be given, as a dose of salts, or cream of tartar, or sen- na-tea with the addition of salts. If the boil be large, and at- tended with considerable swelling, pain and fever, small doses of ipecac, half grain to one grain, should be given every three hours. A common poultice should be applied to the boil till it suppurates and breaks, when it may be dressed twice a day with any good healing ointment, (see Medicines, their doses, uses, and manner of preparation,) till it heals. If the ulcer gets into an indolent state, and wants stimulating, in order to its healing, we may apply the basilicon ointment. Boils not nnfrequently arise in weakly habits, and where the constitution is evidently in an unhealthy state ; in such cases, the patient should be put on a nourishing diet ; he should take daily exer- cise, if possible, in the open air, and use the sponge-bath and frictions to the surface every other day. The compound de- eo'tion or \ei of sarsaparilla is an excellent medicine, and may ry tpjte 7 ! t V j*? times a day, in one gill deses. 264 Gum-fioU — Mamillary Abscess. GUM-BOIL. Guk-Botlb arc sometimes limited to the fcubstance of the- gums, and sometimes connected with the decay of a tooth, 01 its socket. In the first variety, it is a disease of only a few days' duration, and ceasee almost as soon as the boil bursts, or is opened ; in the second, it will often continue troublesome •till the decayed tooth is extracted. Gum-boils, when connected with decayed teeth, rarely dis- perse without coming to a head, and it is, therefore, generally l>ctter to encourage this process, by the use of warm fomenta- tions^ (previously alluded to under head of Abscess,) or poul- tices, than to repel it. An early opening of the tumor is of importance, as, from the structure of the parts concerned, the walls of the abscess are mostly tough and thick, and the con- fined matter seldom obtains a natural exit with sufficient free- dom. A little mild opening medicine, as salts, cream of tartar, or senna-tea, every other day, will be found useful ; and after the abscess has burst, or being opened, washing the mouth once or twice a day with an astringent lotion, will tend materi- ally to make the cure permanent. Twenty grains of sulphate of zinc, dissolved in half a pint of rosewater, will be a suitable lotion for this purpose, or cold green tea will answer. MAMMARY ABSCESS or GATHERED BREAST. Tins is an abscess seated in the female breast, affecting chiefly women after confinement, or during the period of suck- ling. Previous to the birth of the child, a great quantity of blood is sent to the womb to supply materials for the growth and nourishment of the child ; but when the child is born, and requires food of another 6ort, the blood then flows in great quantity to the breasts, and occasions, in some constitutions, feverislmess, known by the name of milk-fever ; and, in others, severe local pain of the breasts, followed by suppuration, or coming to a head. Independent of the milk-fever, inflamma- tion and abscess of the breast may arise from checking the Sow of milk at too early a period ; from exposure to cold, fright, mental anxiety ; too great motion of the arm, when the breast is large and distended ; blows, and pressure from tighl clothes. But the abscess of the breast often occurs, when nr obvious cause can be assigned. The pain arising from the in flammation of so large and tender a structure is very gieat and occasions very severe distress. The breast sometimes put* on the appearance of several distinct swellings, has a knotted feel, and the pain often extends to the armpit. At first, we must endeavor, if possible, to put a stop to the inflammation Lumbar Abscss. 265 and to prevent its coming to a head. This is to bo done by giving frequent doses of cooling laxatives, as of salts ; by ap- plying cold or tepid fomentations to the breast, and by having the milk regularly drawn off. "We are also to apply leeches in great numbers, and to rub the breast gently with a little warm sweet oil and turpentine. The diet is to be very spare and cooling. If we fail in relieving the inflammatory state, our next en- deavor is, to bring it to a head, by poultices, and to discharge the matter, when ripe, by a large opening. When a suppura- ting breast is left to itself to break, it too frequently allows the matter to work itself into various winding holes, and to make its way out by different openings, occasioning a long and wast- ing discharge ; to prevent this, there is no method so sure as making a large and free incision, and thus lay open, through all their depth, the hollows from which the matter flows. When a hardness remains in the breast, after inflammation and abscess, it is to be dispersed by frictions with camphorated oil and spirits of turpentine ; attention being paid to the avoiding of external injury from tight clothing, &c, and the general health and state of the bowels are to be attended to. L U MB AM ABSCESS. This is a very troublesome complaint. It is a collection of matter forming at the loins internally, and making its appear- ance at the upper part of the thigh. At the commencement of the disease, there is some difficulty in walking, and an un- easiness is felt about the loins ; but, m general, there are large collections of matter formed without much previous pain, and without any indication of disease, till it begins to show itself by an external swelling. It is sometimes connected with disease of the bones of the spine ; but in many cases there is no such combination. It very often occurs in scrofulous constitutions, without any obvi- ous cause, and it may proceed from blows on the back and .oins, and from exposure to cold and damp, as by lying on wet ground. Should there be any symptoms to lead us to suspect the com- plaint coming on, we are to endeavor to prevent it, by keeping the patient at rest, and by the application of leeches or cups to th •oins, by blisters, and purgative medicines. The great difficul- ty in the treatment of this disease is, to determine on the mode of opening the abscess, when we have decided that such a measure is proper. It is found by very general experience, that when these large collections of matter are freely opened, 266 Carbuncle and admission is given to the external air, very terrible conse- quences ensne; and that the patient sailers from slow lever. wasting discharges of matter, and, at length, death is caused. A plan which has been adopted with success for opening these abscesses, is. to make an oblique opening, large em ugh to discharge the flakes of matter and clots of blood from th« cavity, then to cover the wound carefully, and get it to heal as quickly as possible. When the matter collects again, a fresh opening is made, and the same method pursued as before, When the abscess has been opened, or when it has burst, which we must always endeavor to anticipate and prevent, the strength of the patient is to be supported by nourishing diet, b} a liberal allowance of a tea made from Peruvian bark or om grain of Quinine, before each meal ; and, in some cases, the use of wine ; at the same time, moderating the slow fever, by sponging the body with vinegar and water, and by paving a proper attention to the action of the stomach and bowels. When possible, a physician should be had to attend to such a formidable disease as this. CARBUNCLE. In this distressing disease, for it is one attended with much suffering, the first symptoms are great heat and violent pain in some part of the body, on which arises a kind of pimple, at- tended with great itching; below which a round, but very deep-seated, and extremely hard tumor may be felt with the lingers. This tumor soon assumes a dark red, or purple colcr about the centre, but is considerably paler about the edges. A little blister frequently appears on the top, which, as it oc- casions an intolerable itching, is often scratched by the patient. The blister being thus broken, a brown watery fluid is dischar- ged, and a scab makes its appearance. Many such pimples are sometimes produced upon one tumor, in consequence of the patient's scratching the part. Considerable local pain always attends the disease. As the complaint advances, several open- ings generally form in the tumor. Through these, there ia discharged a greenish, bloody, offensive, irritating matter. The internal sloughing is often very extensive, even when uo sign of it can be outwardly discovered. With regard to the local treatment of a carbuncle, the grand thing is to make an early and free incision into the tumor, 80 as to allow the sloughs and matter to escape readily. As much of the contents as possible is to be at once pressed out, and theu the part is to be covered with a poultice. Fomentations will also be found to afford considerable relief, both before and Sickness from Unhealthy Meats. 267 aftei nn opening has been made. As the discharge is exceed- ingly offensive ant unpleasant odor, or when cooked looks unnatural, or that has any peculiar unpleasant taste. A whole family has been prostrated with sickness by partaking of a joint, or a piece of meat, or a fish, a little tainted or having some unpleasant taste. As it was cooked and on the table, rather than throw it away, a dinnei has been made off it, costing much suffering, and perhaps, death. The slightest taint of this kind in meat shows that it would be unsafe to eat it. PILES. There are two kinds of tumors observed in piles, the first being an enlargement of the veins, caused by the obstruction of the blood, which are in the immediate vicinity of the lower bowel. They are of a dark bluish color, soft and elastic to tho touch, and considerably lessened by pressure; they occur in regular clusters, and extend high up in the bowels ; these sometimes inflame, burst, and discharge blood profusely. The other variety of tumors consist of a thickened, eondensed, hard lump, of a pale red or brownish color, situated a 6mall distance above the margin of the rectum, or outlet of the bowel ; the latter are firm, and more fleshy than the former ; these may inflame, ulcerate, or remain entire, and give rise to very painful and distressing sensations. When Piles are accompanied by a discharge of blood, they are called Bleeding, if not, Blind Piles. A common consequence of this affection is a kind of bearing down sensation ; there is also heat, and throbbing in the part, varying from a moderate degree of these sensations to the most excruciating suffering; these are caused by the great flow of blood to the parts. Sometime the inner coat of the bowels protrude at every evacuation, forming what is called Prolapsus, or falling of the bowels ; this is the effect of lon^ continued irritation and weakness of that organ. In some instances the patient experiences nervous pains, which are indescribable, and known only to the sufferer, which commence immediately after an evacuation, and continue from thirty minutes to several hours ; these sensations are very annoying and sometimes very distressing. This disease, when of long continuance, is attended by pain and weakness in the back, irritation of the kidneys and bladder, and other organs in the vicinity, pain and numbness in the legs and feet, a sense of etraitness about the chest, and unnatural fulness of the abdo- Piles. 26? men, accompanied with palpitation of the heart, and oppression Individuals sometimes experience previous to an attack of Piles, symptoms denoting great derangement in the circula- tion ; there is a sense of weight and pressure in the abdomen, with a peculiar feeling of uneasiness in the bowels, costiveness, and a sensation of bearing down in the parts, attended with pain in the back and loins, nausea, and slight pains in the ■tomach, scanty and high-colored urine, pale countenance, confused sensations in the head, weariness, and irritable and discontented state of mind, and a sense of fulness and oppres- sion in the region of the stomach. This disease is caused by drastic purgatives, torpidity of the Jiver, costiveness, sitting on cold stones, on the wet ground, &c. Sedentary occupations, and high living, of course render the above causes more liable to produce the disease ; some indi- viduals afflicted with the Piles, are in the habit of remaining at stool, and after the bowels have been evacuated of their con- tents, they frequently experience sensations similar to those preceding the calls of nature ; they feel as though there was something more that should be removed, and with this im- pression, great efforts are made to expel the delayed contents of the bowels, but all in vain ; the efforts are ineffectual, and are followed with pain and anguish. Let the patient remember that these sensations are produced by the descent of internal Pile Tumors, while the bowels are being evacuated, and that very violent expulsive efforts pro- trude them still farther. Use as little effort as possible, and you will facilitate the cure, and save yourself much unnecessary suffering After the bowels have been moved, remain quiet for a short time, to allow the parts to resume their natural position. Much walking or long standing is very injurious, and should be avoided as much as possible. In cases of Piles, accompanied by falling down of the lower part of the bowel, so as to protrude externally, the following treatment should be resorted to ; — Take of white oak bark one ounce, boiling water a pint ; boil the bark in the water in a tin vessel, and let stand one hour, then strain through muslin. When cold, inject about a gill up the bowel morning and night, or it may be used as a wash to the protruding part of the bowels. Or the following may be used. Take one ounce of lard, nutgall finely powdered two drachms, fifteen grains of sugar of lead, ten grains of powdered opium, (or four grains of mornhme which will answer as well.) Mix all thoroughly together; of this put about a teaspoonful or two up the 270 Stings of Poisonous Insects. bowel with the finder two or three times a day. "When th* bowel is down, first put it up by pushing it back with tho index finger well oiled, before using the ointment. This oint- ment, or the wash can be used in all cases that are very painful, or even ice applied to Piles when they come down and are painful, will be found very soothing; to be applied constantly while the pain lasts. Where ice cannot be had the coldest water will be found a good substitute, by applying linen clotha dipped in the water, to be removed as often as they become warm. The oak-bark wash will be the best to use in cases of excessive bleeding from the bowels in the Bleeding Piles, to be injected into the bowel every three hours. A handful of hops, boiled in a quart of water for half an hour, then allowed to ( 1, and applied as a wash or an injec- tion is also a good remedy. The most thorough cure of this disease, however, is between the attacks, to inject half to one pint of cold water up the bowels night and morning, at same time washing the outei parts in cold water. Besides this, keep the boweUopen by eating freely of .-tewed fruit, such as dried apples, peaches, figs, raisins, t week, and if all seems going on well, not moved again for ten days at least, unless for some special purpose. If a fracture \fl often disturbed or pulled about during the process of consoli- dation, it may chance that this will only be effected imperfect- ly, and what is called a false joint formed ; that is, the broken part, instead of being firm, moves like a joint, and the limb is useless. It had better be crooked or shortened. Much care is always required that a limb which has been fractured is not used too soon after the accident; otherwise it may be either snapped again, or it may be bent. FRACTURE OF THE LOWER JAW. Tins bone is liable to fracture in all its parts. The symp- toms are. severe pain at the time of the accident; an inequali- ty is perceived in passing the fingers along the bottom of the jaw; the teeth, on examination, are found unequal; and on taking the two sides in the hands, it is easy to reduce the teeth V) their proper level, and in doing so, the grating motion is perceived. To reduce the fracture, nothing more is necessary than to shut the mouth, and forcibly push upwards the lower fragment, until the teeth contained in it come in contact with those of •"he upper jaw, when it is to be supposed the parts are in pro per place. The simplest and best plan to keep the parts m place, is to avail yourself of the support given by the teeth in the upper jaw, by binding the fragments firmly against them and this can be very conveniently done by means of a simpl rollei of common cotton muslin passed repeatedly round th top of the head and under the chin. It may be further secured by passing a few turns of it round the back of the neck and ic front of the chin. 276 Fracture of the Bibs. The patient Bhonld be nourished fifteen or twenty days on spoon victuals, sucked between the teeth ; and the only addi- tional remark we have to make, is that when the teeth at the fractured bone are loose, they are not to he touched; much less removed, as that would convert the simple into a compound fracture, or, in other words, admit the air to the broken parte of the hone. The following treatment is recommended by some surgeons, as being the most simple: — Two narrow wedges of cork, about an inch and a halt' long, a quarter thick at the base, and sloping to a point, are placed between the teeth, one on each side: a piece of pasteboard softened in warm water, or of guttapercha, is then to be moulded round the jaw, and fixed, either by a bandage or handkerchief going over the crown of the head. By this method, space is left between the front teeth for the administration of liquid nourishment. The sufi'erer should riuse the mouth frequently with tincture of myrrh and water. FRACTURE OF THE RIBS. These are generally broken near the middle. The fracture is ascertained by a severe pain felt at the injured spot in every motion of the body, even in breathing: by careful examina- tion with the hand ; and by feeling the crating of the bones, particularly when the patient coughs. This grating sensation may be felt by another person laying the hand on the injured parts. The oidy treatment necessary, is to pass a roller about six inches wide repeatedly around the chest, and as tight aa the patient can suiter it to be drawn. It is to be prevented from falling down by shoulder straps. "When the edges of the bone have wounded the lungs, some times there is spitting of blood ; and violent, if not fatal, inflammation may follow. On this account, an individual who has suffered from fractured ribs should be especially careful, and for some little time after the accident should reduce hie usual diet considerably. The application of the hot bag of bran for some days after the accident will afford much relief, and it may be used over the usual bandage. When ribs on both sides of the chest are injured, this, with leeches if requi- site, should be the sole application ; the patient beingconfined to bed for at. least a fortnight or three weeks, in the posture found to he the easiest, which will probably be a half-sitting one, supported by pillows, or some other means. When the ribs on one side only are injured, less confinement is required, nut the chest should he encircled, as firmly as can be borne comfortably, with a band of stout calico, from ei^ht to ten Fractvv* of the Ar?n, and <>/ the Forearm. 277 inches wide, and double ; tliis should go once and a half round, and be sewed. A month will probably be required for the cure FRACTURE OF THE ARM. This most generally occurs about half way between the shoulder and elbow. When it is broken directly across, and near the middle of the bone, no great derangement takes place ; the limb preserves its length, and its form too, unless it bo moved. The mode of treating this fracture, is to set the patient on a chair; one person is to hold the body, with his arm around the chest; another the foream (between the wrist and elbow) bent at right angles over the breast, and to raise it a littlo from the side, and extend it, when the operator is to place the two ends of 'he bone in contact; to pass around the arm, from the elbow to the shoulder, a roller, moderately to compress the part without impeding the circulation, lie then applies a splint of wood, firm paste-board, or of raw hide, on the top of the arm, from the elbow to the shoulder; then another on the outside, of similar Length ; and in the inner side of the arm another, from the armpit to the lower part of the elbow. These are to be secured by another roller or bandage. Folds of flannel are to be placed in the armpit, to give some support, and the forearm is to be suspended in a sling. At the expira- tion of a week, the parts are to be examined, and, if found out of place, to be rectified ; the joint at the elbow should be yently and carefully moved, in order to prevent stiffness ; and this ought to be repeated, after the first week, once every other day. At the end of three weeks, it is recommended to alter the dressing and substitute splints, which instead cf keep- ing the arm bent at right angles, will keep it nearly extended. This is done to prevent its partial deformity. FRACTURES OF THE FOREARM. The forearm (extending from the wrist to the elbow), is com- posed of two bones ; and sometimes only one of them is broken, at others both. The symptoms are, great pain at tl e time of the accident, increased by motion of the hand ; an inability to turn the hand either up or down, and the grating common to all moveable fractures. To reduce the fracture, the forearm is bent to a right angle with the arm; an assistant takes a firm hold of the arm just above the elbow ; a roller is to be applied, extending from the Uand to a little above the elbow ; two splints, broader than the arm, made of either of the materials before mentioned, are to be applied, one on the inner and the other on the outer 278 Fractures of the Tliigh. side of llic hand, extending from the fingers up to the elbow leaving the thumb upwards, projecting between them. The hollow places should be tilled up with tow or cotton, and a bandage applied around, to preserve the whole in place. In about ten davs the parts are to be examined, to see that all is going on right. In thirty or forty days, the union is generally completed. The elbow and wrist should he moved every other day, as in fractures of the arm, after the first week. "When only one of the bones is broken, the treatment should be *Vie same. When the bone at the elbow is fractured, it is drawn up by the muscles attached to it, leaving a considerable space be- tween the broken parts. The proper treatment of this acci- dent is .to extend or straighten the arm, and apply a broad bandage around the arm, one beginning at the fingers and extending up to the elbow joint, and the other beginning at the shoulder and extending down, to the elbow joint, to com- press the muscles, and thereby prevent their action iu separa- ting the broken part. The separated bone is to be pushed down to its natural place, and a long compress placed on it, over which is to be applied a roller extending the greater way over the arm and forearm, (as explained before) ; a large long splint is to be put on, extending from the inner part of the arm to the hand, and a roller is to be applied from beginning to end, commencing at the hand. It should be so passed around the elbow as to form a kind of figure of 8, in order that the upper part of the bone may be kept down by its oblique compression. In about thirty days, the joint may be very gently moved by the hand of an assistant — but it is not to be attempted by the patient for nearly double that time, as the parts otherwise might be ruptured again. In fractures of the bones of the hand and fingers, all that is requisite is to restore the parts as accurately as practicable to their natural position, and preserve them in as quiet a stato as possible; taking care, as in all other cases, to prevent the inflammation faom extending too far. FRACTURES OF THE THIGH. THESE can be no doubt, but that in all such cases when sur gical aid can, it will be obtained. Dut in ease of this bejng iniposs.ble, it may be of service to add, that the patient is to be laid on a maltrass on boards, with a hole in it for the eva- cuation of his bowels. — That instead of the splints, usually recommended on such occasions, it may suilice to have a box umdo without a top, just wide enough to receive the limb, and Fractures of tfie Knee Pan. 279 of length to extend six or nine hiclioa leyond the foot, up to or near the crotch, with the outer plank, or side of the box. to extend by itself up to or near the armpit. In this part there is to he a couple of holes, for tieing a bandage securely The limb is to be placed in the box, with a pocket handker- chief so equally applied to the foot, that it shall not hind too much on any one part. Another pocket handkerchief is to be applied between the thighs; one end to go under the crotch, up to the hole in the outside plank of the box; the other end is to go up in front to the other hole, and the two ends are to he tied together. -The next operation, is to pul. the limb downwards, and put the hones in place: and the handkerchief around the foot is to be extended and secured to the end of the box by any contrivance that will hold it. Thus the handkerchief between the thighs will preserve the extension above, and that at the foot will extend the lower limb, and it may occasionally be drawn tighter. This rude sketch, will enable you to do Borne good on such occasions. The hex ought not only to be made of firm mate- rials, but should he well lined or stuffed in every part where it touches the flesh of the patient, with finely carded and 6moothly placed cotton or tow, to prevent excoriations. FRACTURES OF TUB KX E E t FAN. When this accident occurs, the patient generally falls; though sometimes he gets up and by dragging the limb side- ways, ma} r be able to walk, taking great care not to bend the knee. A depression or hollow at the place or tract are is per- ceived, and commonly the upper is found considerubly drawn op from the inferior part, which is fastened to the lower bone. The great object to be attended to in the treatment of these fractures, is to preserve the fragments as near as possible toge- ther, so that the substance connecting them may he as short as possible, and the motions of the joint be perfectly preserved. — In proportion to the violence producing the fracture, should be the attention to keep down inflammation. The local treatment consists in keeping the limb at rest, in an extended posture : and by a splint and bandages preserv- ing the contact of the fragments. This is done by taking a piece of plank about half an inch thick and three inches wide, and extending from the upper end of the thigh to the heel. Upon this splint, covered with folds of cotton or flannel so as to fill up the inequalities of the limb, the patient's leg and thigh are to be placed. A common roller is to be carefully applied 280 Fracture of the Leg. from the foot to the knee, and one from the top of the thigh down to the knee, so as to equally compress all parts, leaving nono exposed ; but yon are to observe, in passing the roller over the knee, as in the case of the elbow, it is to be so done as to press down the upper to the lower part, making, as in the other case, the figure 8 ; so that the roller as frequently passes one part below, the other above the fragment several times, when it is to be continued to the thigh. A compress of folds of flannel, should previously be put over the knee. The limb is then to be equally bandaged to the splint under- neath. Some surgeons recommend too slips or bands of doubled muslin, each a yard long, to be nailed underneath the splint, at a distance of six inches from each other, and about the middle of the splint, or just so as to be onderneath the knee. These bands are to be passed — the lower one above the upper fragment, and the upper one below, — so as still to make the figure 8, and press down the upper to the lower part. The joint should gently be moved by an assistant about the thirtieth day, to lie continued moderately every other day, to prevent stillness. FRACTURES OF THE LEO. In fractures where the bone is broke directly across, it is merely necessary to reduce the fracture w T ith the hand, when the limb is extended, and apply a roller from the foot to the knee ; then two splints, one to each side, of pasteboard or thin plank, extending from the knee to the sole of the foot ; and over these splints another roller is to be applied, to pre- eerve them in their places. The bandages should never be drawn too tight, as the limb will swell, and they may do in- jury by compression. The limb is now to be placed on a f)illow, and put in a box, or, what will answer, between two ong slips of plank, which are to be tied around, so as to sup- port the whole. When the fracture, instead of being directly across, is in an oblique direction, it is necessary to dress the limb in the same way as in fractures of the thigh bone ; excepting that, when the fracture is not near the knee, the upper part of the boa may be fastened a little below or around the knee ; and there- fore its external side need extend no farther. There should be a hole in the upper part of both the inner and outer aide of the box, and the handkerchief or band should be so made as to pass From the knee through each ot these holes, where it is to be fastened. Another handkerchief is then to be ap- plied around the foot, which is to be extended j then the endE Fracture of the Collar Bone. 281 oi the handkerchief fastened to the end of the box, so as to pieserve the extension of the limb. Of course, a roller is first applied around the leg from the foot to the knee ; and the bos is to be well supplied with cotton or tow, to till up the ine- qualities of the limb. FRACTURE OF THE COLLAR BONE, "When »t is broke, the part nearest the shoulder is drawn downward^ by the weight of the arm ; the arm of the affected gidfc falls over upon the breast, and the patient is unable to raise his hand upon his head. lie leans to the fractured side ; the grating of tiio bones may be perceived ; and the finger passing over the bone, will readily detect the place of frac- ture. This fracture haft frequently been successfully treated, by 6imply keeping the patient laying down, with his arm so placed that the broken edges of the bone may be in contact. But most commonly it is dressed in the following manner: — A bolster or pad is to be made of quilted cloths, in the Bhape of a wedge, about as long as the arm, four inches wide, and at least three inches thic)'. This is to be put under the arm, tho base close to the armpit, the point down the side ; and it is here to be well secured by a roller passing around the body, and so turned over the shoulder that it cannot be displaced : a contrivance which anyone can make, who will exercise com- mon sense. The patient being seated on a stool, and held by an assistant, the operator is to bend the elbow at right angles, and the forearm is to be supported by a sling around the neck, the arm and elbow are to be pressed to the side ; the wedge above acts as a point for the extension of the broken bone, and it is to be bound down in that state by a wide roller passing around the body and over the elbow. It is impossible to give an accurate description of the particular manner of applying the bandages. By tne exertion of sound sense, it can be done to effect the main objects, which are, first, to preserve in place Aie wedge underneath the arm ; second, support the arm bent on the breast; and third, to press down and keep the elbow on the side, so that it shall cause the extension of the upper part of the arm, and consequently the broken bone. A slip jf adhesive plaster will be sufficient to cover the brokeD bone. 2S2 Dislocations, or Out of Joint. DISLOCATIONS, or OUT OF JO TXT. Tm: necessity for the Bpeedy reduction of a dislocation is great, from the fact that every day increases the difficulty of its performance : and when a certain time lias elapsed, no force which can be exerted — consistent with safety to life and limb — will be adequate to return the displaced bone, paitly owmg to the resistance of the muscles, but also to obliteration or doing away with the cavity which tunned the one portion o' the joint. ' When dislocation occurs, two different actions take 'place ; one, that by which the bone is driven from il3 usual position ; the other, the action of the muscles, which tend s^ili further to draw it from its proper site as soon as the balance o) resistance of bone against bone is removed. It is, too, in most eases, the action of the muscles which tends to keep the bono displaced, and to resist the efforts made to replace it. This :s evident from the fact, that if a person be seen immediately after a dislocation, and while suffering from the faintness which almost invariably accompanies the accident, and while tho muscles are necessarily in a state of weakness and relaxation ; the dislocation may often be reduced with the greatest possible ease, even by the unskilled; and further, when the surgeon has to deal with a case of dislocation in a Strong and muscular subject, he endeavors to produce this faintness — if that following the accident has passed away — by bleeding, nauseating medicines, warm baths, &c. ; chloroform and aetuer inhaled are used by surgeons and physicians, but are not safe in inexperienced hands. When, therefore, a dislocation occurs, the bone is not simply pushed out of its place, but is drawn for the most part upward, or toward the body; the dislocated bone of the finger is drawn upward over its fellow; the arm-bone, in dislocation of the shoulder, may be drawn upward, or into the arm-pit — in this case downward, it is true, as regards the joint, but still toward the body; and the same will be found to be the case in most forms of dislocation. The first object, there- fore, in treating a dislocation, must be to draw it down from or out of the situation to and in which it has been drawn and is retained by the muscles of the limb, and to get it as neai the corresponding part of the joint, or, in other words, as neai the part from which it has been dislocated, as possible. If the dislocated bone is thus drawn down to. or near to the level of» the other portion of the joint from widen it, has been re- moved, the muscles will of themselves tend to draw it into itfi old position. A good deal is often said about the adjustment, &c, ece., of the bone in reducing dislocations ; and though, Dislocations, or Out of Joint. 283 oeiliaps, useful in some cases, in many nothing of the kind ia required, at least unprofessional persons should not attempt it all fliat is to be done is, give the muscles the chance, of draw- ing the bone into its old place, by bringing it to a position in which this can l»e effected. This is often exemplified in cases in which much force is used in the reduction of a dislocation ; if the force he kept up strongly, the hone cannot he drawn in- to its socket, because the force is stronger than the muscles of the patient ; but relax the external force for a moment, and without any fitting or adjustment, the bone is instantly drawn into its proper position by the power of its own muscles. There is yet another important principle involved in the reduction of dislocations. It has been pointed out how the bone farthest from the body — which is usually drawn up — is to be drawn down ; but, that this may be done properly, the bone above it must be fax/, otherwise it will he drawn down too. This is easily effected in such cases as the ancle or the wrist, by any one grasping and holding firmly either the leg or the forearm ; but in the case of the hip or the shoulder, more management is requisite. Again, in " making the extension," that is, using the forcible effort to return the dislocated bone to its place, the extending force will best be made in the direction in which the limb is tix.ed, and in tne manner most likely to bring the joint portion, or "articulation " of the displaced bone, as near to the old position as possible, and it must be applied directly to the bone which is displaced. Thus, in dislocation of the shoulder, the reducing force is applied to the arm-bone; in dislocation of the hip to that of the thigh. This extending power may sim ply be by the hand, but a cloth, or band of some kind, put round the member to be replaced, is often more advantageous. The particular dislocations most likely to be recognized and to be remedied by unprofessional persons, are those of the small joints, such as lingers and toes ; of the wrist and ancle ; of the elbow, shoulder, and lower jaw. Dislocations of the lingers or toes may generally be made out by any person, and should, if possible, be reduced at once; the dislocated bone being grasped, and forcibly pulled into {)lace ; or a noose, made with a piece of tape, may be used. Dis- oeatior of the thumb, it should be known, is extremely diffi- cult of reduction, and should this not be effected at once, the attempt ought to be given up until the surgeon's arrival'; it is, moreover, one of the dislocations which may be left unre- duced with less subsequent inconvenience than many others. Dislocation of the ancle is very generally accompanied with 284 Dislocations, or Out of Joint. fracture, hut the distortion is often so great ami evident, and the suffering so severe, that when the accident does occur tar from proper aid, some attempt ought to he made to put the displaced parts into better position. For this purpose, while one individual grasps the leg firmly, another, putting cno hand on the heel and the other on the instep, should endeavor, while steadily pulling downward, to hring the joint into its natural position. Dislocation oftiik "Whist is produced by the forearm being tightly grasped by one individual, the surgeon laying hold 01 the patient's hand in his, and endeavoring by steady pulling downward, and flight up and down movement, to hring the joint into its proper condition. Dislocation of the Elbow, if attended to quickly after the accident, may often he easily reduced hy seating the person in a chair, carrying the arm well hehind the hack, and pulling, not very forcibly, upon the forearm. Both these dislocations — of the wrist and elhow — may he suspected, when, after violence — particularly such as is calcu- lated to push either the hand or lower arm upward — inability to use the limb below the seat of the injury, and distortion and impaired motion of the joint, are unaccompanied with any grating sensation, such as occurs when a bone is fractured. Dislocation of the Shoulder is generally occasioned by violence applied to the elbow, or hy falls, while the arm is not close down to the side of the body. Sometimes the exact dis- crimination of an injury to the shoulder joint is a matter of much difficulty, for fracture alone or fractures with dislocation may occur. At other times, particularly in thin persons, it is tolerably easy made out — more so if the examination is made be- fore swelling comes on. In addition to the general symptoms of dislocation already enumerated, the injured shoulder will be perceptibly altered in shape; it will appear more depressed and Hatter than the sound one, and if the hand is placed upon the spot which ought to be occupied by the round head of the arm bone — and this may be discovered by examination of the unin- jured shoulder — it will be found hollow ; and further, if the arm be now gently moved about, and its bone traced up toward the shoulder, it will be found moving in some unusual position, most probably in the arm-pit. Supposing, therefore, that the case is sufficiently clear, the means for the reduction ought to be set about as speedily as possible — if it can be, while faint- ness from the injuries continues. One method of reducing dis- location of the arm-bone into the arm-pit frequently employed is for both patient and surgeon to lie down upon the ground bide Dislocation of the Lower Jaw. 285 Ly side, bat with their heads different ways, and so that the Burgeon having previously taken off his hoot, can place hii heel in fne arm-pit of the patient, while he grasps the hand, or a towel lixed to the arm of the effected side ; in this way, while the heel is used to push against the displaced hone in the arm- pit it, combined with the pulling exerted by the surgeon upon the limb of the patient, tends to give a leverage by which the bone is so placed that it can be drawn into the socket by the muscles. This method may be a convenient one, when only one person is in company with the individual to whom the accident has happened. The following is the most useful and most generally resorted to method of reducing a dislocation of the shoulder. The patient being seated on a chair, a largo towel or a table cloth, folded broad, is to be passed round the chest, close under the arm-pit of the affected side, crossed over the opposite shoulder, and held either by a strong assistant or fastened to some fixed point. By this application, the shoulder blade is fixed ; the arm itself is then to be pulled, chiefly in the direction in which it has been fixed, firmly, stead il;/, and dow- ly ; this being done, either directly by the hands of assistants, or by a towel fastened round the arm by the hitehnoose. If when this steady pull has been persevered in for some time, the displaced bone does not get into place, the effect of sud- denly taking oft* the attention of the patient may be tried, either by some sudden exclamation, or by dashing a little cold water in the face. By such a proceeding, the muscles which resist the reducing or pulling force applied to the arm, are for a moment, so to speak, thrown off their guard, and that moment may suffice to permit the bone to pass into its socket. DISLOCATION OF THE LOWER JAW. This accident, in most cases, is produced by yawning, 01 opening the mouth excessively wide. It is sometimes produced by a blow upon the chin while the mouth is opened. Tho symptoms of its occurrence «re, an inability to close the mouth ; immediately before the ears an empty hollow space is per- ceived ; the cheeks and temples are flattened ; the spittle flows from the mouth ; speech and swallowing are difficult, and the chin projects forward. When the jaw continues dislocated several days, these symptoms are not so strongly marked, though they are still in greater or lesser degree. To effect the reduction, the patient is to be seated on a low chair, his head supported against the head of an assistant ; the operator is to defend his thumbs with a piece of leather or linen be is then to place them as far back on the jaw teeth as he can ' 286 Dislocation of the Collar Bone — Contusions. the fingers :\re then placed under the ch in; and while lie pressei down the back teeth with his thumbs, he at the same time raises up the chin with his fingers ; and then the chin is pushed backwards, when the parts become replaced very sudtlenly. As this is done, the operator is as quickly to move his lingers from under the teeth to the check. After the operation, the patient should fur some days live on soup, &c, in order that the jaw may be at rest to recover its strength. DISLOCATION OF THE COLLAR BONE. This accident is generally occasioned by falling on the shoul- der, and is ascertained by examining with the fingers; the end of the bone being found under tin- skin covering the elevated point of the shoulder hone, then' causing considerable projec- tion. The patient inclines his head to the affected side, and moves the arm and shoulder as little as possible. The treat- ment of this accident is precisely the same with that oi fracture of the collar bone. CONTUSIONS or BliCTSES. The had consequences of bruises are not invariably propor- tioned to the force which has operated ; much depends on the nature and situation of the part. When a contusion takes place over a hone which is thinly covered with soft parts, the latter always suffer very severely, in consequence of being pressed at the time of the accident, between two hard bodies. Bruises of the shin thus frequently cause death of the soft parts, and troublesome sores. Contusions affecting the large joints are always serious cases; the inflammation occasioned is generally obstinate, and abscesses and other diseases which may follow, are consequences sufficient to excite serious alarm. In the treatment of bruises, the practitioner has three indi- cations, which ought successively to claim his attention in tho progress of such cases. The fir6t is to prevent and diminish the inflammation, which, from the violence done, must be expected to arise. To effect this, the bruised parts should be kept perfectly at rest, and covered with linen, constantly wet with cold water, or sugar of lead and water, one teaspoonful to the pint. "When the muscles are bruised, these are to be kept in a relaxed posi- tion, and at rest, until the effects of the bruise are entirely removed. If the bruise has been very violent, it will be proper to apply leeches, and this repeatedly. In every instance, the bowels should be kept well open with saline purgatives, seid Sjyrains. 28;' lit* ponders, Rochelle and Epsom salts, etc., and the patient put upon a low diet. A second object in the cure of bruises, is to promote the absorption of the extravasated or bruised blood by liniments, etc. These may at once be employed in all ordinary contu- sions, not attended with too much violence; for then nothing is so beneficial as maintaining a continual evaporation from the bruised pt»rt, by means of cold applications, and at tin same time, repeatedly applying leeches. In common bruises, however, a solution of salammoniac in water, or vinegar and water, is an excellent application ; but most surgeons are in the habit of ordering slightly stimulating liniments for all ordinary contusions, and certainly they do much good in accelerating the absorption of the bruised blood. The soap and eamphorated liniments are as good as any that can be employed. In many cases, unattended with any threatening appear- ances of inflammation, but in which there is a good deal of bruised blood and fluid, bandages act very beneficially, by the remarkable power they have of exciting the action of the lymphatics (absorbents) by means of the pressure which they produce. A third object in the treatment in contusions, is to restore the parts to their proper tone. Rubbing the parts with lini- ments has a good effect in this way. But, notwithstanding such applications, it is often observed that bruised parts con- tinue for a long while weak; and swell, when the patient takes exercise, or allows them to hang down. Pouring cold water two or three times a day, on a part thus circumstanced, is the very best measure which can be adopted. A bandage should also be worn, if the situation of the part will permit. These measures, together with perseverance in the use of lini- ments, and in exercise, giadually increased, will soon bring everything into its natural siate again. SPRAINS. Injuries of this kind generally affect the wrists, ankles, and knees, being produced by sudden or violent exertions, slipping, or falling, etc. They are followed by violent pain immediately, and then swelling and inflammation. There is generally a rupture of the blood vessels within, and consequently an eifu gion of blood. The skin is not discolored for some hours after which it generally becomes of a dark bluish or red* col or .ncreasing or disappearing, from the inflammatory state, in proportion to the extent ot injury. The best remedy for lessening the effects of a sprain, is thai 2SS Wounm. nearest at hand — cold water. As soon as the accident hap pons, the part should be plunged in cold water, or a few pitchers oi cold water poured over it. The next remedy Is rest, perfed rert: the part being kept rather elevated, never hanging down. The cold applications stop the effusion of blood, hi id promote its absorption : the elevation of the part retards the passage of blood to it. It is customary to apply brown paper, Crags are as good), wet with vinegar, or spirits, and water to the part, and continue them wet on the part for sev- eral days. Sugar of lead and water, a teaspoonful to the pint is also a good application. Spirits of comphor, or opodeldoc, may with advantage be rubbed over the part, and it should gently be daily rubbed with the hand or a ball of cotton. Should inflammation come on, you must purge freely, live on low diet, and continue the cool applications of sugar of lead and water, etc. Leeches on the spot most inflamed, will do great good, and so will cupping near it. If the part be much dis- tended and painful, poultices at night of flaxseed, or elm bark, will aid in removing it. But if you will have patience in tho first instance to confine yourself and follow the first directions, you will probably never have need of other advice. But from very trivial accidents of this nature, the neglect of necessary precaution has been followed by a loss of the joint, by stiff- ness, by decay of the bone, and loss of the limb in conse- quence. If pains or numbness remain after the sprained part is otherwise relieved, the pouring of water on it from an elevated spout, and frequently rubbing it with camphorated spirits, two or three times a day or more, will be the proper remedies. wo uirns. In cases of wounds, even of a trifling nature, comparatively, there is generally much excitement. This should be over- come by the exercise of good judgment and common sense. Then, the first circumstance, generally, which calls for atten- tion as the consequence of a wound is the effusion of blood, but none of the consequences, perhaps, exhibit greater varia- tion. Sometimes an extensive injury may by inflicted, even the arm torn off at the shoulder, and yet the loss of blood be extreme.y small ; on the other hand, a puncture with a pen- knife, if it penetrates an artery, may be sufficient to place life in the greatest immediate jeopardy. As a general rule, prob- ably, putting the opening of larg« vessels out of the question, a greater amount of blood is lost after simple cuts than after any other description of wound. When laceration or bruising Wounds. 289 takes place, there is usually, by stretching, or otherwise, of the coats of the arteries, a sufficient amount of mechanical imped- iment caused to modify greatly, if not wholly to prevent, any hemorrhage, When a wound is small, the best method of treatment is to tie it up at once with a piece of linen rag; this is usually sufficient at once to stop the bleeding, particularly if rest and position are attended to; the small quantity of blood which may exude, quickly dries upon the wound, and forms a kind of glue which effectually excludes the air. As no better dressing can be used, it may be left on till the cut is well ; in some cases, before using the linen, it may be advisa- ble to draw the edges of even a small cut together, by means of adhesive plaster, or material of some kind. Although linen is mentioned in the above directions, of course, should it not be at hand, soft calico may be used, or other soft material. When a wound is extensive and the bleeding ] roiuse, it will not do to bind it up in this way: first, ", cause it proba- bly would not be sufficient to arrest the flow, and if it did so ultimately, it would retain a large amount of clotted blood, either in or about the wound, in such a way as to interfere with the healing process. In a large wound, therefore, it is necessary that the bleeding should be almost entirely arrested before it is dressed, that is, closed up, ody which can be easily reached, removed — all parts not absolutely detached from the body are to be placed as nearly as possible in the natural position, stitches and plaster* being used to retain them, and free exit left for the discharge cif matter; over these there must be applied either poultice, or cloths dipped in cold water, and a bandage may be necessary or not, according to circumstances, which those in attendance must direct to the best of their judgment. Punctured Wounds. — As a general rule, these require no other treatment than the extraction of any foreign substance which may be left in them, when it can be easily done ; and to lessen the chance of inflammation, by keeping a warm poultice on them, to preserve the surface relaxed, and facili- tate the discharge of any matter which may be tunned at the bottom of the puncture. When inflammation is threatened, the means to prevent and lessen it have been pointed out under head of Bruises, &c, and should be pursued. These wounds sometimes end in convulsions of the muscles, and are most apt to be followed by lockjaw. Sometimes it is found necessary to dilate the wound and fully divide any nerve or tendon which may have been punctured ; sometimes a blister over the part has succeeded without the division. WOUNDS OF THE JOINTS. In all cases of wounded joints, it is important to place the limb in such a posture as to favor the union of the sides of the wound, in order to prevent the admission of air, which seldom fails to produce general irritation. Not only absolute rest ia to be enjoined, but a very low diet, with slight laxatives. The parts should always, when practicable, be brought together, and kept so by slips of adhesive plaster, in preference to sewing them up : and when they are to be stitched, the needle should only pass through tlte skin, and never to enter the cavity of Jie joint, where they would increase the inflammation. Treat- ed iu this way, they very generally speedily unite without inflammation. In order more effectually to procure absolute rest of the joints, it is neeessary to apply splints to tit the parts, which being lined with soft materials, occasion no inconvenience. Iu wounds of the knee, ankle or elbow, these splints are indis- pensably necessary. When there is reason to apprehend a stiff joint, it is necessary to choose the position of the limb in which the stillness will be least inconvenient to the patient, and to preserve that posture during the cure. If, for example, 202 Whitlow or Felon. the elbow wore to heal with the arm permanently extended v the limb would be almost useless; whereas, an arm bent ai the elbow, may be useful. — And the reverse in the knee, aa an extended leg would favor walking. WIITTLOW OH FELON. ^ Thts is a disease with which very many persons are pain f nil y acquainted. It is a painful and distressing inflammation, Beated at tlie end of a finger or thumb, generally terminating in the formation of matter. The inflammation appears in dif- ferent parts, either at the root, or side of the nail, or near the end of the finger, or underneath the whole of the soft parts: or underneath the immediate covering of the bone, and the bone itself. The most distressing kind is that where the ten- dons are affected, and the inflammation extends along the hand, up the arm — sometimes rendering amputation necessary. In the treatment of this affection, we should act with an en- ergy "proportionate to the degree of disease. In all eases of fever, blood-letting by leeches, from the part, purges and low diet, should be enjoined. In common cases, repeatedly scald- ing the linger by suddenly dipping it in boiling water, proves sufficient. It is much better to use the strongest lye, than Mater for this purpose. Coating the entire part with caustic, (nitrate of silver) will also sometimes check the disease. A blister plaster should be applied around the whole linger, in order to excite action on the surface, to relieve that under- neath ; and it ought to be kept continually discharging. When matter is formed under the nail, it should be scraped away over it, and a small puncture made for letting it out. When- ever there is reason to believe that matter is formed in any fart, by all means, freely cut down to it, and give vent to it. mmediate relief from pain will be had, and an end be put to the danger of prolonged, distressing, and dangerous inflamma- tion: for the subsidence of the inflammation and healing of the part are very rapid; whereas, when the parts burst, a* in common boils, these operations are very tedious and painful. Of course, after opening a felon in this manner, poultices Should be frequently applied until the healing is nearly com- pleted, then liasilicon ointment is more proper, cr some heal mg oiutmeut twice a day. Cancer. 293 CANCER. Tms disease is not treated of here with the expectation that the unprofessional will at any time attempt the cure of this most dreadful malady, bat to point out its symptoms, that it may be guarded against in time, and also to offer such sug- gestions for the alleviation of the sufferings of the patient an may be employed when a physician can not be had to attend co it. Cancer is of two kinds, the scirrhous, or hard, and the open or ulcerated ; but these may be more properly regarded as different stages of the same disease. By occult or scirrhous cancer, is meant a hard tumor, for the most part accompanied by sharp darting pains, which recur more or less frequently. This tumor, in the course of time, breaks and ulcerates ; and then is more strictly denominated cancer. The parts of the body subject to cancer are the following: the female breast and the womb ; the lips, especially the lower one, the tongue, the skin, the tonsils, the lower opening of the stomach, and some other parts, chiefly glandular. Chimney-sweepers are subject to a cancerous affection of the scrotum. In general, cancer begins at a small spot, and extends from thence in all directions. Its progress is more or Less quick in different instances. In general, it is too true, that scirrhus is seldom or never dispersed, and that it causes, finally, the neigh- boring parts, whatever their nature may be, to put on the same diseased action ; and thus the skin, the muscle, r suppura- tion in the ear, insects are attracted by it, and deposit their eggs, which in time produce worms. Patients so affected should take care to stop the ear when they go to sleep, in summer and autumn. A slight infusion of tobacco in oil of almonds may be dropped into the ear; and this proves fatal to worms. A very frequent cause of deafness or impaired hearing, is the obstruction of the passage by thickened or hardened wax. The symptoms arising from this cause are deafness, a sensation as of a noise or clash vrfien eating, or of heavy sounds, as of a hammer. This kind of deafness is not very difficult of cure. A little olive oil, or oil of almonds is to be dropped into the ear, and retained there by a piece of cotton ; and when the wax is softened, it is to be taken out with a small scooped instrument. Injecting warm water with a little soap, by a syringe, is a method of getting rid of the hardened wax, equally simple and efficacious. A deficiency of the wax may occasion a degiee of deafness. When this is the case we are to drop in two drops every night of the following mixture Sweet oil, spirits of turpentine, sulphuric ether, of each, equal parts. Shake well before using. The bowels must be kept gently open. When the wax is of bad quality, which is known by its deviation from the healthy color and consistence, it may be improved by frequently washing the passage; and 206 Deafness, and Diseases of the Ear. giving once or twice a day, a wine-glassful of the infusion 01 tea, or quassia with a teaspoonful of equal parts of rhubarb and magnesia. Discharges of matter take place from the passage in consequence of inflammation going on to suppura- tion, from scrofulous ulcers, from abscesses after fevers, from small-pox, measles, and other canses. These discharges not nnfrequently are attended with the loss of the small bones; and in general, total deafness is the consequence. Exposure to cold frequently produces inflammation about the ear, at> tended with very acute pain, (commonly termed ear-ache), which continues very troublesome, and oven alarming, till the patient is relieved by the discharge of matter. This in£am matory state is to be treated by local bleeding (leeches and cupping), the injection of tepid water, and by fomenfathti? of hops, or hoarhound and vinegar, and the passage should be protected from eold air by the introduction of wool oi cotton' Sometimes there is disease in the drum of the ear, attended with offensive, thick discharge, which makes its appearance at the internal opening, shows that the membrane of the drum is destroyed ; and so much disease is in the internal parts, that the small bones are discharged externally. In time, a con- tinual discharge from the ear takes place, and tho disorgan- ization is so complete, that a total loss of hearing is the con- sequence. If this disease be noticed in its early stage, if there is acute pain, followed by a discharge of matter, we know It is from inflammation, and we are to palliate or remove this by topical bleedings (leeches and cupping), purgatives, and small doses of ipecac every three hours; and are on iio account to inject stimulating spirituous fluids. When the disease threat- ens to be more chronic, we are to use blisters and setons, afl auxiliaries to our cure; to employ laxative medicines, and to foment the part as before noticed; and when there is little active inflammation, to throw in a stringent injection as of sul- phate ol zinc, a teaspoonful to half a [tint of water. If thero are fungous growths (proud flesh), they are to oe touched with caustic. Sometimes there is deafness from insensibility of the nerves of hearing, though the structure of the parts may be perfect. W we can ascertain this to be the case, we are advised to pul the patient on low diet, and to give saline purgatives, seidlitz powders, salt & etc., once or twice a week, applyirg blisters occasionally bemnd the ears. The application of electricity nay oe tried. Mortification. 297 MOltTIFl C A TI O X. The, followi/jg symptoms will indicate that mortification lias taken place. When any part of the body loses all motion, sensibility and natural heat, and becomes of a brown, livid, or black color, it is said to be affected with sphacelus, that is, complete death or mortification. As long as any sensibi- lity, motion, arid warmth continue, the state of the disorder •fi termed gangrene or mortification. In inflammations of the external parts which terminate in mortification, the process observed is as follows: the pain ceases, the purulent, thick matter, becomes acrid (irritating) and sanious, (watery), bubbles of air are set at liberty, collect- ing in small blisters under the skin, or distending the whole organ by swelling. The blood is coagulated (clotted) in the vessels of the gangrened part, and the circulation can not he restored. In many cases, a slight delirium comes on, foil.. wed either by dejection of spirits or calmness of mind ; but in each case attended with a peculiarly wild expression of counte- nance; though sometimes with a very peculiar expression of serenity, and a blackness under the eyes. The pulse is usually quick, low, and often intermitting. In the earliest stages, deep incisions are attended with a discharge of blood, still florid (or red), but the skin, the muscles, etc., soon melt down into a brownish offensive mass. We conclude that similar processes take place in the internal parts when they become mortified. When this occurs in strangulated hernia, (rupture) or in inflammation of the bowels, a remission of the violent pain takes place, and the patient and his friends are deluded with the hope of complete relief; but the experienced physician knows the treacherous symptom, and must not deceive them with false hopes. There is a peculiar kind of mortification called dry gangrene, in which the disease begins in one of the toes, particularly in old people, and very often after a person has been paring a corn or toe-nail. It sometimes stops spon- taneously, and deprives the patient of some of his toes, or even of his foot and leg, as cleanly as if it had been amputated by a surgical operation : at other times it has been successfully treated by giving large doses of opium. In this form of mor- tification, the parts affected are perfectly dry, hard, and not liable to run Into putrefaction. Mortification is brought about by general or local causes. Those wnich affect the general system, are the violent inflam- tn&tor) fevers, or the jail and hospital fever; as also scurvy and dropsy, long-continued or intense cold, and some internal changes, which we can not trace nor explain. The local causes 29S Mortification. of mortification are numerous. Some of them are burns, ox cossive cold, the application of caustics, the strangulation ol a part, as in hernia, severe bruises, as gun-shot wounds, bad fracture*, violent inflammation, pressure on large blood-vessel3, by tnmora, &<•. Long continuance in one posture, as when a person is confined to bed, gives occasion to gangrene of the parts where the bones have the least flesh upon them, and which are therefore much exposed to pressure ; as the # shoulder blades the haunch-hones, and the lower part of the spine Hospital gangrene is produced by some indescribable state of the air in hospitals, jails, and ships. During its prevalence, the smalt est scratch or ulcer is apt to turn to a fatal gangrene. In dropsy, occurring in a broken-down and debilitared constitu- tion, if a few punctures be made to let out the effused fluid, or a blister he applied, these are apt to run into gangrene; it ia also not unusual for spontaneous blisters to form and hreakon such dropsical limbs, and to go on to mortification. When inflammation is so violent and strong as to give reason to fear that it will end in mortification, it is a call for us to use with great dilligence, purging, low diet, cold applications, and the other means for abating it, taking care that we do not continue them too long, lest we add to the debility and exhaus- tion which are to follow. When the mortification has fairly begun, our remedies must be very different from those which counteract inflammation. We are now to prevent debility by giving a nourishing diet and tonics. Of the class of tonics, the most efficacious is the Peruvian bark ; and in a great variety of cases, the good effects of the Peruvian bark are very remarkable. Taken in the form of tea, (cold), a gill three times a day ; or one tablespoonful of the tincture. When the weakness is very great, the use of quinine, two grains three or four times a day, or wine may occasionally be required, as also ammonia and other stimulants. We must be careful not to give these remedies when there is much strength of pulse and inflammatory symptoms remaining. When our remedies are successful, and the mortification is about to cease, a separation takes place at the verge of the sound part, caused by a slight degree of inflammation. Some have advised cold lotions near the verge of the morti- fied part, to check the further progress of inflammation ; bu fomentations and poultices are commonly preferred. To the common poultices, in some cases, are added powdered charcoal or yeast, to correct the offensive odor and to counteract putre faction. Stale beer grounds, or port wine, with linseed meal, make a good poultice. It is necessary to give vert to putrid Fortign Bodies in the Gullet or Throat. 2U9 matte;, and for this purpose pretty deep incisions are required through the dead parts. After the mortified parts have completely separated, and a healthy running ulcer is left, the latter is to be treated by common poultices, until healing commences, when the use of strips of adhesive plaster applied over the surface of the ulcer, and proper bandages, will, in general, cause it specdly to heal ever. Washing the parts with castile soap and tepid water, ts also advisable. FOREIGN BODIES IX THE GULLET or THROAT. It is not at all an uncommon occurrence for foreign bodies to stick in the gullet, as pieces of crust, or meat not completely chewed, or small bones, beans, stones, pins, or pieces of money. Some of these would produce a very bad effect if not quickly removed from the gullet; and perhaps still worse, if pushed down into the stomach ; but sometimes pretty large bodies have passed downwards into the stomach, and have been dis- charged by stool in a few days, without any inconvenience. Pins and other sharp bodies, when they have stuck in the throat, have been returned by swallowing a piece of tough meat tied to a strong thread, and then pulling it up again. If the detained body can be with safety pushed down, the pro- bang, a flexible piece of whalebone, with a piece of sponge se- cured to its end, is the proper instrument. If the bodies can not be easily moved up or down, endeavors should not be con- tinued long, lest inflammation come on. When endeavors fail, the patient must be treated as if laboring under an inflam- matory disease, and the same treatment will be required if an inflammation takes place in the part, after the obstructing body is removed. A proper degree of agitation has sometimes suc- ceeded in removing the body sticking in the gullet, better than instruments. Thus, a blow on the back has often forced up a fiubstav.3e thac has stuck in the gullet, or passed into the wind- pipe. Pins which have stuck in the gullet have been dis- charged by ridim? on a horse or in a carriage. Above all things, in ?ases o? this kind, try to " keep cool, as the saying is, for in the excitement more harm may be done than good. A knowledge of the nature of the substance in the throat should direct you in extracting it; always being careful in the use 01 anything in the shape of a hook, that the throat may be not in- {ured ; the patent must be firmly held, to avoid accidents from lis sudden movements. $00 Gravel. OR J TEL, or STONE Iff THE BL ADD Eli. In this disease it must be observed that the urinary sand 01 era v el deposited od the sides or bottom of a receiving vessel jb of two kinds, red and white ; and it is of great importance to distinguish the one from the other, as they proceed from different causes, and require a different mode of treatment. The symptoms of red gravel are well known. The shade of color may vary from a reddish brown, or pink, to a perfect red In 6uch cases the urinary secretion is generally small in quant tity, and high colored, and the disease infiammatory: the nearer the deposit approaches to a perfect red, the more severe in general are the symptoms. White gravel is less common, hut has long been observed to be attended by very distressing symptoms. These consist in great irritability of the system, and derangement of the digestive organs generally. There is often a sallow, haggard expression of countenance; and as the disease proceeds, symp- toms somewhat analogous to those of diabetes, (or great How of urine), begin to appear, such as great languor and depression of spirits, coldness of the legs, and other symptoms of extreme debility. The urine is invariably pale, and voided in greater quantity than usual ; and after standing, for a greater or less time, always deposits a most copious precipitate of a white fine powder. In all such cases, the urine is extremely prone to decomposition, and emits a most disgusting odor. The chief cause seems to be a want of constitutional vigor, and especially in the digestive organs; the periods of life in which this disease occurs most frequently, are from infancy to the age of puberty, and in declining years: while it is rarely met with during the busy and restless term of the prime of life, these complaints being seldom met with in warm climates. The drinking of bard water often influences very sensibly the 6tate of the complaint. White gravel may often be very dis- tinctly traced to an injury of the back. In a healthy state the urine is always an add secretion, and it is the excess of its acid that holds the earthly salts it con- tains in solution. l\\ from any cause, it be deprived of this ex- cess, or, in other words, the secretion of its acid be unduly diminished, the earthy parts are no longer held in solution, and a teiidancy to form white sand or gravel immediately com* mences. If, on the contrary, the acid be in greater excess than usual, instead of deficient, or if the natural secretion ot the earthy constituents of the urine be r its virtues in gravel and stone, by physicans of high authority It may be combined or alternated with the alka- 502 Gravel lies; and where general debility exists, or there h a discharge ►f pus-like matter from the bladder, denoting ulceration, or a Amity condition of its secreting vessels, it is at once an appro- priate and excellent medicine. The dose is from a half to one teaspoonful of the powder, twice or three times a day; or a strong tea may be made by pouring hot water upon the leaves of the plant ; to three tablespoonfuls of which may be added ten grains of bi-carbonate of soda, and drank three times a day. In eases of white gravel, it may he given in conjunction with the nitric or mntriatic acid, ten drops to the pint of uva nrsi tea. to be taken through a quill or straw, to protect the teeth. The diet of persons troubled with red gravel should be mod- erate in quantity, but of a nutritious and wholesome quality, consisting principally of fresh animal food and vegetables. All acids mnst be carefully avoided, and likewise heavy bread, fat meats, hard boiled puddings, and soups. Active exercise is of great importance in all gravelly dis orders; and flannel should be constantly worn next the skin. Now, in regard to the cases of white sand or gravel, an acid is the best medicine, and all the acids seem to answer the pur- nose, though the muriatic, nitric, and citric acids, have been in the greatest repute. The citric acid, or lemon-juice, is pr > ferable for children, as being the pleasantest, and that which may be persevered in for the longest time: it may be mixed with water in any proportion that is agreeable. The muriatic acid may be given in doses of from five to twenty drops, twice or three times a day, in a wineglassful of water; and the nitric acid in doses of from five to twelve drops, in the sama proportion of fluid, to be sucked through a quill or straw, to prevent injury to the teeth. The diet should be nutritious, easy of digestion, and mode- rate in quantity, and be as largely as possible intermixed with acids, salads, fruits, and especially oranges and lemons. Wa- ter, saturated with carbonic acid, to be found in most of the drug-stores, in the form of "carbonated water," is the best common beverage in this kind of gravel, and, attention being paid to diet and exercise, will sometimes be alone a sufficient remedy. When pain attends the gravei, opium or extract of henbane should be occasionally administered, according to the urgenev of that symptom. Thirty or forty drops of laudanum, or twen ty of the solution of sulphate of morphia, or from five to ten grains of the extract of henluine, may be given alone, or in any drink which the patient may be taking, and repeated unti- the pain is relieved. Opium seems generally preferal Je in thf Gravel. 803 white gravel ; and henbane in the red* In white gravel, the solution of acetate of morphia is particularly indicated as an anodyne, since the acid it contains is an appropriate and efficient remedy for the complaint, and, at the same time, counteracts the injurious effects likely to result from the frequent use of Opium, when taken in any of its common forms. In case of great pain and irritation about the urinary organs, an opiate injection will be proper, and often of much service ; (ten to twenty drops of laudanum, in half pint of tepid water,) or two or three grains of opium may be made into a pill, and inserted within the lower portion of the bowel as a suppository. A burgundy pitch or galbanum plaster may be applied over the loins with advantage. Whether the gravel be white or red, when a small stone passes from the kidneys into the bladder there is generally a fit of pain and irritation; to relieve which, the warm bath, or hot fomentations of hops, wormwood, &c., together with forty or fifty drops of laudanum every three hours, will lie the most proper and effectual remedies. The passing of a small stono from the kidneys to the bladder, is denoted by a fixed pain in the region of the affected kidney, with a numbness of the thigh on the same side. The pain is sometimes very acute, and ac- companied with nausea and fainting, but the pulse is rarely accelerated. During the whole of the passage from the kid- neys, the urine is usually high colored, and frequently mixed with blood. Stone in the Bladder. — The symptoms of stone in bladder are, a sort of itching along the urethra, particularly at the extremity ; frequent propensities to make water, and go to Btool ; great pain in voiding the urine, and difficulty in retain- ing it; the stream of urine being liable to stop suddenly, while flowing in a full current, although the bladder is not empty, so that the fluid is expelled by tits as it were ; and the pain being greatest towards the end of, and just after the eva- cuation. There is a dull pain about the neck of the bladder, together with a sense of weight, or pressure, at the lower part of the belly ; and a large quantity of mucus (or slime) is mixed with the urine, and sometimes the latter is tinged with blood, especially after exercise The causes of stone in the bladder are the same as thoe which give rise to gravel. The medical treatment to be employed in cases of stone is precisely the same as that for gravel, both in regard to the re- medies and diet. There is this difference between gravel and Btone, that, in the former, active exercise is highly advisable ; 304 Strangulated Hernia, or Rupture. whereas, during the actual presence of stone in the bladder, the patient's exercise ought, For obvious reasons, to be less ac- tive and constant. An injection of castor oil has great effect in relieving tha sufferings occasioned by stone in the bladder; the introduc- tion of a lubricating fluid into the bladder, under such circnm- stances, is productive of ease and advantage. One or two junces injected when the bladder is empty, through a catheter is about the proper quantity, used once in every two or throe days, as may be necessary. STRANGULATED HERNIA, or RUPTURE. As this is liable to occur at any time, in those who are rup- tured, if not protected by a proper truss, it should be care- fully studied, BO that it can be detected ill time to send for medical aid. When either an old rupture from some cause hag become strangulated, or when some sudden exertion has at once produced rupture and strangulation, the following symptoms occur: there is a swelling at the place of the rupture, painfnl. to the touch, and increased by coughing, sneezing, or .by the upright posture. These symptoms are followed by sickness, retching, costivences, with a frequent hard pulse, and other attendants of fever. The cause of these symptoms is the stric- ture made on the bowel, by the part through which it pro- trudes. The object of cure, is therefore to relieve the bowel from this pressure, which is to be effected either by returning the intestine into the belly, by the same aperture through which it came out, or by enlarging the aperture by an opera- tion, which can only be done by a surgeon. Our first efforts should be to replace the bowel by the hand, if possible ; and various methods are to be put in practice, to produce the relaxation necessary for that purpose: place the patient on his hack, with the thighs and knees bent; and make pressure on the tumor in a direction obliquely upwards and outwards, if it be an inguinal hernia, (running obliquely a.ong the lower portion of the abdomen,) but the pressure must at first be made down wards, towards the thigh, and then upwards if the hernia be femoral, (running down into the upper part of the thigh.) In a young and strong person, bleeding is very proper, both to induce relaxation, and to pre- vent inflammatory symptoms. The warm bath may be tried also to induce relaxation. With a view to diminish the bulk of the swelling, and so to render it more easily replaced, cold has been applied to the external parts, by means of i^e or of ether. An injection of the infusion of tobacco produces an Ulcers, or Sores. 305 extreme relaxation of the whole system, and so lias conduced to the replacement of protruded bowels. The strength of the infusion is a drachm of the leaves to a pint of boiling water; this is infused for ten minutes ; one-half is injected at first, and the other a little afterwards, if no proper effect is produc- ed hy the first. The tobacco injection is, however, a remedy of the greatest danger^ and must never be administered, except hi/ an experienced practitioner. These attempts to reduce the bowel, may be made for a longer or shorter period, according to the symptoms of each case. Much handling will add to the danger of inflammation which is already so great; and too long delay will allow the bowels to get into a state of mor- tifieation. Always procure a physician in these eases, if possible. Ruptures in Infants. — Ruptures in different parts, espe- cially at the navel, are not unfrequent occurrence- in infancy ; fortunately, they are not attended with so much danger as similar disorders in grown people. "When the disease is confin- ed to the navel, a broad piece of flannel, in the form of a roller, together with pieces of adhesive plaster applied over the part with a ball of cotton, forming what has been termed by surgeons a graduated compress, by affording a safe and firm support, prove so useful, that as the infant acquires strength, the rupture commonly disappears. The other varieties of rup- ture are often cured by the natural increase of size and strength in the body, and require chiefly attention to the due regulation of the bowels, and the daily use of the cold bath. No truss ought to be employed for at least the first two years of life. ULCERS, or SORES It may seem almost unnecessary to state that there are a great many varieties of ulcers, requiring a corresponding va- riety of treatment. "We have first the Simple Purulent ok Running Ulcer. — Some ulcers are covered with matter of a white color, of a thick consistence, and which readily separates from the surface of the sore. There is a number of little eminences covering the bottom of the ulcer, called granulations, which are small, red, and point- ed at the top. As soon as they have risen to the level of the surrounding skin, those next the old skin become smooth, and are covered with a thin film, which afterwards becomes cloudy looking, and forms skin. The principal thing to be done in the treatment of this kind of ulcer, is to keep the surface clean, by putting on a little dry lint, and a pledget (several folds of muslin) over it, covered with simple ointment^ made of equal parts of lard, beeswax an.l tallow. In eome patients, 306 Ulcers, or Sores. ointment irritate? and inflames the neighboring skin. Ban dagea sometimes irritate the pore, and disturb the healing pro- cess; bnt when they do not, they are useful in giving a moderate support to the parts, and in defending those that are newly formed. Ulcers in Wkakknfd Parts. Other ulcers are in parti which arc too weak to carry ou the actions necessary to their re- covery. In them, the granulations are larger, more round, and less compact than those formed on ulcers in healthy parts. "When they have come up to the level of the healthy parts, they do not readily form skin, but rising still higher, lose alto- gether the power of forming it. When the parts are still weaker, the granulations sometimes fill up the hollow of the ulcer, and then are suddenly absorbed, leaving the sore as deep as ever. Ulcers are very much under the influence of what- ever affects the constitution ; and change of weather, emotions of the mind, and some other agents, quickly occasion a change in their condition. Such ulcers as we have been describing, require general as well as local treatment; one grain of quin- ine three times a day, or a tea of dogwood bark, cold, in wine- glassful doses, and nutritious diet, are to be given ; and tho granulations are to be kept from rising too much, by the pru- dent application of blue vitriol, lunar caustic and burnt alum, weakened sufficiently by proper admixture of ointment to act as stimulants, and not as caustics. This will give a pro- per and healthy action to the granulating surface; whereas the destroying of the rising parts by caustics, seems rather to encourage the growth. Bandages and proper support to the parts, are highly useful. These ulcers, in weak parts, do not seem to be the better of poultices, or other relaxing applica- tions ; powders rarely do good, and perhaps the best dressing is the citrine ointment, (see " Medicines, their doses and uses), more or less diluted, if required. Irritable Ulckrs. — There are certain ulcsrs, which may be called irritable ulcers. The margin of the surrounding skin is jagged, and terminating in an edge which is sharp and undermined. There is no distinct appearance of granulations, but a whitish spongy substance, covered with a thin watery or milky discharge. Everything that touches the surface gives pain, and commonly makes the ulcer bleed. The pain sometimes comes on in paroxysms, and causes convulsive mo tions of the limb. Such ulcers seldom do well without a fro quest change of treatment. Fomentations with peppy heads, hops, chamomile flowers, or hemlock leaves, are sometimes of use in irritable ulcers. When poultices are prescribed, the_j Wens. 307 tfliHirid never be allowed to rest or bear weight on the sore limb. Powdered applications are generally too stimulating l-ir irritable ulcers, and bandages also prove hurtful. Fre- quent washing with cold water, or pouring upon them a stream of cold water, will often be found beneficial in this variety of ulcers. A tea made of oak bark, mixed with tar water, w\\\ sometimes act like a charm in healing this kind of ulcer. Indolent Ulcers are those which have the edges of the surrounding skin thick, prominent, smooth, and rounded. The surface of the granulations is smooth and glossy ; the matter is thin and watery, and the bottom of the ulcer is nearly level. A great proportion of the ulcers in hospitals are of the most indolent kind. Indolent ulcers form granulations, but fre- quently they are all of a sudden absorbed, and in a few hours the sore becomes as much increased in size as it had been diminished for many weeks. The principal applications re- quired for indolent ulcers are those of a stimulating nature, as the basilicon ointment, and occasionally sprinkling with red precipitate. Pressure is to be made by a roller, and by Blips of adhesive plaster. Be careful to soften the dressings always before taking them oft", by means of warm water or soap suds. The tea of oak bark and tar water is also advisable in this kind of ulcer, or the application of a wash made of a tea- spoonful of blue stone in a pint of water once a day, or the lunar caustic, will sometimes be necessary. WENS. A description of these is here given for the benefit of the reader, in detecting tumors of this kind, not expecting any domestic treatment can often be successful. Tumors on the surface of the body are distinguished by surgeons according to the nature of their contents, and they require treatment varied according to circumstances. Wen is the common popular name for any fleshy excrescence or tumor growing on any part of the body ; most frequently, however, it is applied to tumors about the throat and neck. Sometimes wens are attached by a narrow neck, and may be removed by the knife, or by ligature ^being tied with silk around its neck) ; at other times they have a broad base, and are so supplied with large blood-vessels that they cannot be removed at all, or cut, without the utmost risk. Sometimes wens are tilled with a curdy or cheese- looking matter, and are contained in a cyst or bag, which must be dissected out, along with its coutents, and the cut skin will Leal and leave very little deformity ; in other cases, the tumor is fungus hc&matodes, 308 Wry Neck — Varicose. or bloody cancer, which pretty certainly destroys the patient, The bronchocele, or goitre, (on the front part of the neck,) ia to be treated with iodine ointment, or tincture of iodine, ap- plied once every day or two, and the tincture of iodine inter- nally (ten drops three times a day in a i_rl 1 1 of sweetened water, on an empty 6tomach). Sometimes very large wens contain a mixed substance, resembling fat or marrow ; they have a firm fleshy feel, and sometimes attain an enormous size. Wll T XEC K. This term is generally applied to a long-continued or per- manent turning of the head to one side. It is different from the pain and stiffness which occur from cold and rheumatism, and which prevent the free motion of the head. It arisea from various morbid conditions of the part, either from distor- tions of the spine, from palsy of some of the nerves going to the muscles that move the head, or from some altered struc- ture of the muscles themselves. The removal of this affec- tion, when possible, is accomplished by treatment adapted to the particular cause inducing it. The bones of the neck may be aidwd by machinery, by which they can be kept in a pro- per position, if the subject is young ; blistering, friction, and shampooing, long persevered in, have been of service in the paralytic affections of the nerves and muscles ; and at one- time it was a favorite practice to cut across the large muscle extending from the ear to the breast-bone, which was gene- rally supposed to be in fault. This severe measure very often was unsuccessful, and is hardly ever to be recommended, even when performed by the best surgeons. VARICOSE, or ENLARGED VEINS, This condition of the veins is found mostly in the lower ex- tremities, and is sometimes a troublesome and painful disease. Of course the longer it goes on without being cured the worse it becomes. The affection consists, essentially, in the veins becoming elongated (or stretched longer), so as to permit of their assuming a tortuous, knotted condition, while they are at the same time enlarged. This state is usually associ- ated with obliteration or deficiency, more or less, of the valves within the veins, so that the weight of the entire column of blood bears with distensive force upon the vessels, and upon those parts of them which are most dependent. The most frequent causes of the varicose veins, are such as cause impe- diment to the upward flow of the blood through the largt veins of the abdomen. In this way, pregnancy, if frequent, Foreign Substances in the Eyes. 309 it a most common exciter of the condition : habitual costive m-ss, diseases of the liver, tumors of any kind within the ab- iomen, act in a similar manner. The truss worn on account of rupture, or garters too tightly tied, likewise excite the vari- cose condition, which is usually more common in persons wh^se occupations require much standing, especially if they are tall. The veins and limbs generally should be supported by some one of the forms of elastic stocking: these can now be ob- tained at so moderate a price, that none need be without their valuable aid. It is often surprising how immediately the use of well applied mechanical support, such as the elastic stock- ing affords, removes the uneasy and painful sensations con- nected with the condition of the veins in question. Some in- dividuals cannot, however, wear an elastic stocking of any kind; for such cases, an elastic tape or bandage fixed to the foot by a stirrup, and wound spirally round the liml>. has been successfully employed. Spaces of about three inches being left between the spirals, each time the band crosses the vein, it acts like a valve. Frequently a bandage of muslin or calico, wet and rolled moderately tight, beginning at the toes and going up the limb as may be requisite, will answer *all purposes. It should be put on when the patient is lying down, and reapplied twice a day. Let the limb be plunged into cold water, or laid down and cold water poured over the limb, beginning at the toes and going along above the knee, each time before the bandage is applied. FOREIGN SUBSTANCES IN THE EYES. This is often the cause of much suffering as well as uneasi- ness of mind. Persons often go a long ways to a physician on account of some little substance getting into the eye, when the exercise of a little judgment and tact on the part of by- standers would save the patient time, expense, ami suffering, by removing it before it had time to produce much local irri- tation. The membrane, which covers the inside of the lids and white of the eye, is, from its exposed situation, liable to become inflamed from various causes. Minute particles of dust or other substances getting into the eye, and becoming fixed in the lining of the upper eyelid, between it and the globe, cause an amount of pain and irritation which could scarcely be credited from their size, but which is well ac- counted for by the accurate apposition of the two surfaces be- tween which they lie. A particle so situated may be discov- 310 Stye— Sore Eyes. ered without much difficulty by a second party examining the sufferer with the head thrown back, while he slightly everts, (turns inside out), the upper lid with the thumb and finger The slightest speck of foreign matter must be removed, and no better instrument can be employed for the purpose than a piece of not over-stiff writing-paper twisted, or where it can be had, a camel's hair pencil. Those who work in metals are apt to get minute scales imbedded in the forepart of ihe ball; they cause much uritation, and are often so extremely difficult to remove that a surgeon's assistance is required. Pieces of iron or steel can often be removed by a magnet (loadstone), or magnetized piece of iron : bringing it in contact with the foreign substance, it attracts it, and. adhering to the magnet is taken out. Never rub the eye when there is dust or other foreign substance in it, it may injure the ball of the eye by friction. STYE. This is a boil or abscess in the lid of the eye, usually caused by the duct or opening leading from the little glands becom- ing obstructed. When once they make their appearance they are troublesome, as one attack after another is apt to follow. The treatment consists in mild purgatives, a spare diet, and local applications, such as warm fomentations of hops, etc., 01 poultices in a muslin bag, lest the particles get into the eye. When it breaks and gets well, bathe the eye three or foul times a day in cold water. SORE ETES. Tni8*being a disease of such frequent occurrence, and by being neglected or improperly treated, often occasioning loss of sight, every person should understand how to treat it. The first symptom of inflammation of the eye is a sensation as if a particle of some kind had lodged in the eye, and if an examination be made there will be seen, not only an enlarge- ment of any small blood-vessels that may be generally visible on the white of the eye, but a new development of others, the appearance varying from the slightest apparent inerease of vascularity or fullness, to the most intensely red inflammation. At the same time there is considerable increase in the mucous secretion — not in the tears, as is often supposed — and in bad cases this becomes purulent or mixed with matter. There is, sometimes, considerable swelling of the surface, usually dis- tinguished as the white of the eye. The above in the most superficial form of inflammation to which the eye >'s subject; if neglected it may extend itself over the Cvi£4* or iroiu pt*rl Sore Eyes. 311 of the eye-ball and produce permanent blindness. It is undis- tinguishable from the next form, or inflammation of the scle- rotic coat, or whites of the eyes, by the si/.e and winding char- acter of the small blood-vessels, and by their being slightly movable along with the conjunctiva, or membrane, itself, when the lids are drawn down. It is important that these distinc- tive characters should be attended to in the first place, that no error may be committed between this form and a more serious and deep-seated inflammation of the eye, and also that proper treatment may be used. A great error is committed *n treating this form of inflammation by means of warm fomentations, etc., applications tending rather to keep up than to cure the disease, which is generally quickly removed by astringents and cold applications. A drop of laudanum mixed with six of cold water, put in the eye, repeated two or three t : .mes will often cure the disorder; or a lotion of sulphate of zinc, from one to three grains to the ounce of water, will be found efficient; but the best of all is the solution of nitrate of silver, or lunar caustic, of the strength of four grains to the ounce of water. Of this, a single drop may be introduced into the in- flamed eye twice or three times in the twenty-four hours. Great care should be exercised to get the exact strength here given, as it is a dangerous remedy if made too strong. The eye, of course, should be exercised as little as possible, and if the bowels are confined or the stomach disordered, five grains of blue pill every second night, followed the next morning by a seidlitz powder or castor oil will be found useful. If the dis- ease is obstinate, a blister to the back of the neck may be applied with advantage. The disease which lias just been treated of, is a compara- tively mild disorder, but under certain circumstances it be- comes much more virulent. The secretion of matter is very great, and acquires the power of propagating the disease by contagion from one person to another. Newly-born and young infants frequently suffer from a 6evere form of this disease, which often shows itself within three days after birth. The inflammation is intense, and the matter often accumulates largely between the lids, gushing out when they are separated. In scrofulous children especially, the affection is often obstinate. The nitrate of silver in solu- tion, is the best application, and small doses of quinine the best internal remedy. Syringing between the lids with a solution of alum, four grains to the ounce of water, six or eight times a day, is also recommended. A little lard should be used on the edges to prevent them sticking together. 312 Defects of Vision. In inflammation of the sclerotic or outer coat of the ball itself (or whites of the eyes) there is more actual pain, it ig more deeply seated, and the redness seen on the white of the eve is more of a pink line than in the other form of the disease just treated of, the vessels appear much smaller and straighter radiate as it were from the cornea or front of the eye, and are not movable; the affection is generally a more se-ious one than the other. Active treatment is necessary; leeches should be freely applied to the temples, or behind the ears, or capping on the hack of the neck resorted to; the bowels must be freely pnrged with ten grainsofblue pill mixed with ten of rhubarb, followed next morning, if necessary, by a dose of castor oil or Rochelle salts, in the first instance, and then calomel in two- grain doses, given at intervals of six or eight hours. The diet must be reduced as low as possible, all stimulants avoided every attempt at exertion even of the unaffected eye forbidden^ and the person confined to a darkened room, the only local application being continued hot fomentation to the eye (of hops in a bag, on which hot water has heen poured), and a blister between the shoulders. By a continuation of the above treat- ment, even till the gums get sore with the mercury, much may he done in cases where a physician can not be had, hut where possible, a medical man should be called to attend to it. DEFECTS OF VISION. Long-Sigiitkoness.— This is a condition of the vision often met with in aged persons. It consists in near objects bein« confusedly seen, while those at a distance can be distinguished very clearly. It is thought, usually, to depend on the "eye be- coming flattened, from which results an alteration in the con- vergency of the rays of light, so that the "focus" is formed behind the retina, or the expanded nerve of the inner part of the eye. The delect is to be remedied by the use of convex glasses, which must be adapted to the eye by the individual affected. ' 8hort-8ightedii£S8 i of course, is just the reverse, produced by the eyeball being too round or prominent; and is to be reme- died by the use of concave glasses, properly adapted to each individual case. While on this subject, we would take occasion to warn oui readers against reading in railroad cars, or any vehicle, toAiit in motion. It is very injurious to the sight, by the constant Btrain or effort to fix the " focus. 1 ' Railroad conductors from thiscause have become blind. We would also warn the reader against the use of what uii Growing in of the Toenail— Inflammati/i of the Tonsils. 313 been lately brought into use, by extensive advetrising, called u eye sharpeners" to produce a greater convexity of the eve hall, by applying the instrument to the front of the eyeball. Such things are very injurious to the eyes, in unprofessional hands. G It OWING IN OF THE TOE- NAIL. This is a frequent and troublesome complaint, caused by the Bail pressing down into the soft parts, and kept up by its con- tinuance. It is generally the result of tight, or misshapen boots and shoes. There are many palliative methods of treating this affection, such as the use of caustics, scraping the nail away, the appli- cation of poultices, etc. ; but perhaps there is no certain mode of treatment but the thorough removal of the entire half of the nail up to the root, on the offending side. This, of course, ought to be done by a physician. Wearing an - old shoe," or loose slipper, or going barefooted for a while, will afford great relief, and sometimes effect a cure, especially if the foot is often soaked in water, and the nail scraped thin in the middle. INFLAMMATION OF THE TONSILS, or Sore Throat Sore throat of this kind usually commences with chilliness, and often flushes of heat; the tonsils and back part of the throat soon become red, swollen, and painful. The pain is acute and darting, and usually extends to one or both ears. It is increased by eveiy attempt to swallow, and by external pressure. These local symptoms are generally attended with 6ome degree of fever. Swallowing is greatly impeded as the disease increases, and speaking, and even breathing, are en- tered difficult In a few cases, small white spots are to be observed upon the tonsils. When the inflammation is very violent, the eyes become red, swollen and watery ; the cheeks flushed and swollen, and the patient is unable to open his mouth. Externally, large tumors can be felt, or even some- times seen by the eye, on each side the jaws. The sense of suffocation is intolerable, and the patient is obliged to be sup- ported in an erect posture. When inflammation of the tonsil occurs repeatedly in the aame individual, within a short space of time, a peculiar sus- ceptibility to the disease is established, so that it is produced by 'he slightest causes afterwards. The 'active symptoms in this disease may either rapidly de- cli.nt or produce suppuration and an abscess in the throat; or remaining a long time in a chronic state, cause an enlarged 314 Inflammation of the Tonsih. and hardened condition of the tonsils, by which sometime* breathing Bwallowing and speech are so much affected as to require the removal of the organs by a surgical operation. At the wry commencement of the attack, before the inflam- mation of the throat is of any considerable extent, an emetic of ipecac, ten to fifteen grains, given in warm water, will fre- quently be found to remove it at once. When, however, tht disease has run some time, or is from the first of a violent grade, bleeding, bj T leeches to the throat, will be demanded. This shonld he succeeded by a dose of Epsom salts or castor oil, or when the act of swallowing is attended with great diffi- culty, a tablespoonful of the following mixture may be taken every two or three hours: Epsom salts, one ounce; nitre, (saltpetre,) one drachm; tartar emetic, two grains; and boil- ing water, twelve ounces. This, with the occasional use of the warm foot-hath, an injection of warm water, will have the effect of opening the bowels, producing a gentle perspiration, and reducing the inflammation. A variety of acid and astringent gargles have been proposed in this disease, but there are few cases in which the patient can make use of gargles in such a manner as to derive much ad- vantage from them. In general, more benefit will be derived from inhaling the vapor of warm water or vinegar and water, or of bitter herbs, &c, as ordered in catarrh in the head, which may readily be directed to the throat by means of a common funnel. If the inflammation should not be reduced by these means, a large blister is to be applied around the throat, 01 the tin oat may be enveloped for five or ten minutes with a cloth wet vvith spirits of turpentine. At the same time, the mixture directed above, with the inhalations, should be continued. Volatile and other liniments to the throat, which is so fre- quently resorted to in this disease, is productive of little good, and in some cases is even injurious, poultices seeming to afl'ord more relief. The patient should be allowed nothing in the form of food or drink, during the disease, excepting barley, beef tea, soup, or gum water, rendered slightly acid by the addition of lemon-juice. When we discover that the swellings in the throat appear evidently inclined to suppurate, or come to a head, this should be encouraged \>y the frequent inhalation of the steam of hot water, (as before recommended,) and in certain instances bv poultices externally. The moment they become soft thev should he punctured with a lancet, to allow of a dischaige of the contained matter. After this., a gargle of sage teu. alutr Inflammation of the Larynx. 315 and Iiiiii'O/, several times in the coarse of tlie day, will com- plete the cute. We shoiuu Lear in mind the great liability to a recurrence of the disease, which will point out the importance of the patient being un his guard for a considerable time subse- quently to his n.cjvory, against exposure to cold or damp, to sudden transitions of temperature, &c. Bathing the thsuut night and morning in cold water is a good means of prevcuidiig a return of the disease, in those who have been subject tj ii. IN FLA3IMATION OF THE LARYNX; (Or top of the Windpipe.) This commences with Jiu usual symptoms of fever, from irritation or local inflammation. The voice very quickly be- comes hoarse and indistinct, sometimes entirely extinct ; the breathing laborious, with a painful sense of constriction in the throat; on examining the back part of the throat, we now find that every portion of it is ot an intense, dark red color, and considerably swollen. The face soon becomes red and bloated, the eyes red, swollen and often protuberant, as in cases of strangulation. The pulse is very quick and frequent, and the tongue coated. Every attempt to swallow is attended with intolerable distress ; the muscles of the throat and chest being thrown into violent spasmodic action, threatening the patient with instant suffocation, aud causing him to cry out for the admission of more air into the room. This disease is extremely acute and rapid in its progress, often destroying life, by suffocation, in a day or two, or even in less time, unless attacked in its very commencement by the jaost active remedies. In many of its symptoms it bears a close resemblance to croup, and to distinguish them from each other is not always very easy. This, however, is not of much importance, as the treatment of the two diseases does not differ in any important particular. This is an affection which calls for the exercise of the most energetic and best-directed medical treatment as soon as it can be procured. But it is of the highest importance that no time ahould be lost, even while waiting for that aid, and that some properly directed means should be at once resorted to. First, from half a dozen to two dozen of leeches, according to the strength of the patient, should be applied to the throat am 1 ivppei par*, of the chest ; or, if leeches cannot be obtained 316 Cold in the Head. from six to twelve ounces of Mood fire to be taken from tho back of tlu- neck by cupping. Tarter emetic, in eighth of a grain doses, or twenty drops of antiinonial wine, is to be re- peated at intervals of from one to two hours, at Jimt, and calomel given in fonr grain does every four hours, with a quarter of a grain of opium in every, or every second dose, should purging ensue. Hot bran poultices are to be kept constantly to the throat, the feet put in hot water, and advan- tage may be derived from breathing the steam of hot water, and hitter herbs, &c, as recommended under the head of Ca- tarrh in the Head ; the patient, of course, being kept perfectly quiet in bed. These measures will do all that can be done until the arrival of a physician. COLD I If THE HEAD. It is unnecessary to give the symptoms of this disease, as they are too well known to all by frequent and unpleasant expe- rience. However familiar we may be with this disease, yet we should not look upon it as a trivial affair. From its ten- dency to recur, and also to produce and keep up irritation of the lungs, it. is not only not to be neglected, but should be necked atjirxt, if possible, and for this purpose various me- thods of treatment are recommended. The injection of a solution of sulphate of zinc, five grains to the ounce, into the nostrils, at the very commencement of the disorder, has been said to stop it without fail. A teaspoonful of paregoric, or six or eight grains of Dover's powder, when taken at bedtime repeated for two or three nights, will often check a cold in the head at once ; and the usual system of hot foot-baths, confine- ment to bed, low diet, and diluent drinks, along with boneset tea, is certainly calculated to mitigate the disorder, and may be followed with advantage. It is the common practice to drink copiously of tea, gruel, or some other diluent during a cold ; as lonir as this promotes perspiration it is of some utility, and although it augments the flow from the nose, it has the effect of diminishing its acrimony or irritating qualities, by dilution. It is the acrimony of this discharge, which reacting on the membrane, keeps up the inflammation, and its accom- panying disagreeable symptoms. On this circumstance de- pends the efficacy of a measure directly opposed to that just noticed t- we mean t vomiting. When this has been continued for about twelve hours, then use the following mixture : water, eight ounces (about one gill) ; syrup of ipecac, one table-spoonful, or five grains of the powder; chlorate of potash, one drachm, or about one tea- spoonful ; spirits of nitre, two tablespoonfuls. Dose : a teaspoonful every three hours ; if much sickness of the sto- mach is produced, not so often. Let the patient have plentj of cooling drinks, such as flax-seed tea, gum arabic, or slip 320 Pleurisy — Inflammation of the Siomach. pery elm water, t<»n?t water, etc. The bowels to be moved nccasionally by a d<>se of castor oil. r l e zr n j s r . Tiik symptoms of tins disease are very similar to those of inflammation of the lungs, at least, requiring usually a phy- sician to tell the difference. However, the treatment recom mended for that disease, is adapted in every respect for rleuriay INFLAMMATION OF THE STOMACH. Tnoron not a very frequent disease, this is a very painfu. and dangerous one The symptoms arc marked by a more or less acute pain and feeling of burning in the region of the stomach ; these Bymptoms are aggravated by every thing taken into the stomach, by the motions of the body, and by pressure. Inflammation may come on very gradually, or be suddenly developed, according to the causes by which it has been pro- duced. When the disease is fully developed, the pulse is very small, hard, and frequent ; there exist great anxiety, oppres- sion, and a greater prostration of strength than in most other acute inflammatory affections. Every thing taken into the stomach occasions vomiting with painful reachings. Hiccup is also an early symptom. The features of the face are con- tracted, shrunk, and altered from their natural expression. There is distressing thirst, a continual tossing of the body, constant wakefulness, and in general a costive state of the bowels. In violent cases there is difficulty of breathing, with increase of pain on a deep inspiration. In the course of the disease, fever, with intense heat of the skin is sometimes developed, and at others, delirium, convulsions, and stupor. Inflammation of the stomach is produced by large draughts of cold fluids taken when the patient is in a profuse perspira- tion, or over-fatigued by exercise ; cold applied externally, under similar circumstances ; contusions or blows upon the abdomen, intemperance in eating; hard or irritating articles taken into the stomach, the violent operation of emetics ; or the excessive use of ardent spirits. Inflammation of the stomach is always a dangerous com- plaint, terminating fatally, when violent, in the course of a few hours, or when less acute, producing a long series of distressing and painful symptoms, and causing incurable disorganization ot the stomach, or by sympathy, producing disease of the skin, joints or brain; therefore it is all-important that it be treated in every case with promptness and energy. Inflammation of the Bowels. 32* Tlu region of the stomach should be covered with leeches, and the flow of blood encouraged after they have fallen off, by warm fomentations. This treatment is the one adapted to the more acute cases, the important object being to reduce the inflammation with as little delay as possible. In all cases of inflammation of the stomach leeches are an important and indispensable remedy, and they should be repeated again and again, until the local symptoms are entirely removed ; their number and the intervals of their application being adapted always to the urgency of the disease, and when some degree of inflammation still remains, the region of the stomach may De covered with a blister. In regard to internal remedies, there is none, with the exception of minute portions, frequently repeated, of cold gum arabic water, or iced water, but what would have the effect of irritating the stomach and increasing the inflammation. The vomiting and sense of burning by which the patient is often so mucli distressed, can be relieved only by the leeches, and by the cold fluids just alluded to. In 6ome cases, advantage has been derived from a teaspoonful of powdered ice slowly swallowed, and occasionally repeated. Bathing the feet in warm water, and the application of mustard to the ankles, will, in some cases, be found beneficial. The bowels should be kept regularly open by injections of warm milk and water, or soap suds, etc. Chronic inflammation of the stomach is to be treated by the judicious application of leeches, by a very spare diet, of barley- water, gum-arabic water, tapioca or panado; by blisters to the region of the stomach, by the warm bath and frictions of the skin, and by gentle daily exercise in the pure open air, friction over the region of the stomach, etc. INFLAMMATION OF THE BOWELS. This disease, in its symptoms, does not differ widely from the foregoing, and perhaps in a majority of cases, at least in a partial degree, accompanies it. Inflammation of the bowels usually commences with a slight chill, and a sense of uneasiness in some portion of the abdomen, at first intermittent, but gra- dually becoming permanent, and finally changing to a fixed pain which spreads over the whole abdomen. The latter is somewhat swollen, and sore to the touch. Obstinate costive- ness generally attends the disease, and sometimes severe vomiting. The pulse is very small, hard and frequent, and the tongue dry andfurred. The thirst is extreme, the urine high- colored, small in quantity, and most commonly discharged with difficulty. The breathing is short and laborious, andlhe 322 Inflammation of the Bowels. patient generally lies upon his back, with his knees drawn np towards his breast. If the disease be allowed to proceed, these .symptoms augment in violence. The abdomen becomes orreatly distended with air, small mucous discharges take place From the bowels, with considerable straining ; the action of •the bowels sometimes becomes inverted, and the contents of the bowels are discharged by the mouth. Suddenly the gony of the patient ceases, he appears to have obtained relief from his disease, but his intermittent and scarcely per- ceptible pulse, the paleness and livid hue of his face, the icy coldness of his extremities, and other alarming symptoms, indicate that mortification has taken place, which is quickly succeeded by death. Inflammation of the intestines may be distinguished from colic by the presence of more or less fever, by the fixed and continued pain, increased upon pressure, and by the hard, frequent pulse. In colic, there is no fever, the pain comes otj in paroxysms, with distinct intervals of rest, and is diminished rather than increased by pressure. In the treatment of this disease leeches are to be applied over the seat of the pain, and repeated so long as the loc*l symptoms remain, and the strength of the patient will perm: c followed by a blister. The same cold fluids internally, w U be proper, as those ordered in inflammation of the stomaci After the violenee of the inflammation has been reduce t, four grains of calomel, every two hours, should be given, con- bined with mucilage of gum arabic, until a copious evacuation from the bowels is obtained; the operation of the calomel being aided by laxative injections (See Medicines, their uses and doses). In some cases, fifteen grains of calomel with two of opium, will produce a very prompt evacuation, and relieve greatly the remaining symptoms of the case. During convalescence from inflammation of both stomach and bowels, the greatest caution must be observed, by a mild, well-regulated diet ; abstinence from all stimulating drinks ; by guarding against exposure to cold, and over exertion of the body ; by keeping the bowels regular, and using gentle daily exercise in the open air, wearing flannel next the skin, spon^ ing the body with water once a day, followed by frictior. with a rough towel, etc. Diseases of the Liver. 323 DISEASES OF THE LIVER. Acute Inflammation. — As in other forms of inflammatory diseases this is generally ushered in by a chill, succeeded by all the symptoms of fever. To these are soon added pain in the region of the liver, sometimes acute and shooting, with a sense of fullness in the right side; at others, fixed and severe, or deep-seated. The pain commonly extends to the breast, collar-bone, and shoulder of the right side. The pain in the side is increased by pressure, especially when the patient lies upon his left side. The pain is often increased during breath- ing, and it is in consequence often impeded, more especially when the portion of the liver in contact with the diaphragm is inflamed. A severe cough is then also generally present, and in the course of the disease, hiccup commonly occurs. The cough in this disease is usually dry, short and fre- quent. From the cough and difficulty of breathing, which so often attend inflammation of the liver, it is often mistaken for in- flammation of the lungs ; happily, the treatment of the two diseases does not materially differ. The skin, eyes and urine have the same deep yellow tint as in jaundice. The pulse is various, being sometimes small and feeble, at others, full and strong; but most commonly hard. The urine is ordinarily high-colored, the heat of the skin and the thirst considerable ; the mouth dry, and the tongue coated with a yellowish mucus, which, in the course of the disease, becomes often dark brown or even black. There is likewise wakefulness, restlessness, and in a few instances, delirium. A favorable termination is often preceded by a discharge of blood from the nose, or from piles ; sometimes by a copious perspiration, or increased discharge of mucus from the lungs. A copious flow of deep-colored urine, occurring about the fourth day, and depositing, after standing, a red or whitish sediment, is also a favorable symptom ; the same is true of free bilious discharges from the bowels. From the obstinancy of the symptoms, we are to fear an ab- scess. As soon as it is formed, the acute pain in the side is changed into a feeling of weight and pulsation ; the former being increased when the patient lies upon the left side. There are also frequent irregular shiverings, and finally, all the bymptoms of hectic fever. When the abscess is seated on the sxternal surface of the liver, a tumor and fluctuation of a fluid can be detected just below the ribs, on the right side, and by an incision, the matter may be evacuated, by which the chance of the patient's recovery will be greatly increased. When the 324 Diseases of the Liver, abeeess is more deeply seated, an adhesion taking place be tween the liver and intestines, the matter may find its waj into the cavity of the latter, and be discharged by stool. In this ease, the patiefit often recovers. Its most common causes are the action of excessive heal upon the skin ; sudden changes of weather ; the sudden ap plication of cold or damp to the body when heated; contu- sions or violent blows upon the head or other parts of the body ; the excessive use of wines and spiritous liquors ; high living, and intemperance generally; violent passions of the mind, particularly anger and rage; the suppression of various habitual discharges, and irritations of the stomach generally. In the treatment of this form of liver disease, which is an inflammation, the treatment is the same as for inflammation of the lungs, bowels, dy, during this disease. When the case is chronic, leeches or cups, applied occasi- onally to the region of the bladder, will be advisable ; the bnvels should be kept open, and a warm bath taken twice a week at bed-time. Opiates, as ten drops laudanum, half tea- spoonful of paregoric, or ten grains of Dover's powders, at bed-time, will be necessary to ease pain and procure rest. MUMPS. This is a very common affection : it is a painful imflamma- tion of the parotid glands, situated behind the angle of the jaw, and often extending lower down. Though sometimes confined to one side of the jaw, it usually occurs on both sides • it is at first clearly defined and moveable, but soon become fixed, and spreads to a considerable extent. It increases in Biz3 till the fourth day, and often involves the neighboring glands in the inflammation ; it is supposed to be contagious, and often prevails as an epidemic. After the fourth day, the 6welling gradually declines ; a^d. foi tne most part, it is unat- 328 Angina Pectoris, or Breast Pang. tended throughout with fever, and scarcely ever calls foi medica* aid. As the swelling of the throat subsides, it not [infrequently happens, that a swelling takes place in the pri- vates of males, and in the breasts of females. Generally, all that is requisite in this affection is, to keep the head and face moderately warm, to avoid exposure to cold to observe a mild diet, and to open the bowels by a very gen tie purgative, as a dose of magnesia, rhubarb, or salts. When the privates and breasts simply enlarge, they ought not to be interfered with ; but should they be painful, and tend to suppurate or break, a purgative of Epsor i salts, or "Rochelle salts should be given, a few leeches applied, and af- terwards a warm poultice. Should high fever occur, with other alarming symptoms, the asual means of reducing inflammation must be applied — purg- ing, small doses of ipecac, every two hours, with cooling washes, such as green tea (cold), tea of mullien leaves, &c. ANGINA PECTORIS, or BREAST PANGf {Pain in the Breast.) This disease has been called by several names, as will be seen above. It is a disease characterized by a sharp pain and oppression, seated at the lower end of the breast bone, inclin- ing to the left side ; it comes on in paroxysms, and is accom- panied with great uneasiness, difficulty of breathing, violent palpitation of the heart, and a sense of impending suffoca- tion. In the first stage of the disease, the pain is felt chiefly after some exertion, as going up stairs, or up a hill, or walking quickly, particularly when the stomach is full ; but in the more advanced stages, slighter exertions are sufficient to cause a paroxysm of pain, as walking, riding, coughing, sneezing, or speaking ; passions of the mind also have the same tenden- cy. In the first stage, the uneasy and threatening symptoms soon go off; but afterwards they continue longer and are mort> distressing, causing the patient to fear immediate dissolution. During the paroxysm, the pulse is feeble and irregular, the face pule, and eovered with a cold sweat, and the patient ap- pears as if in a fit of apoplexy, without the power of sense 01 mot ion. The disease makes occasional attacks, at longer or shorter intervals, for years, and at last suddenly puts a period to the patient's life. This affection appears to be of a spasmodic or convulsive nature, as is shown by the manner of treatment, which is nnst Diseases of the Heart. 329 successful. It is fDund to attack chiefly those who are of the make which has bee* 1 supposed most liable to apoplexy, viz., those with large heads and short necks, and who lead a seden tary, luxurious and inactive life, who are disposed to be cor- pulent, and especially such as are of a gouty habit. It seldom attacks persons under fifty years of age. Our treatment should consist in preventing, as well as cur- ug, by diminishing the quantity of blood in the system, by purgatives sufficient to keep the bowels open, spare diet, and avoiding everything that would quicken the circulation. During the paroxysm, stimulants must be very cautiously em ployed ; the head and temples are to be bathed with cold water and vinegar ; a slight bleeding may be necessary to relieve the overloaded heart, gentle pressure should also be employed on the left side, to empty the Jieart / mustard should be applied to the extremities, and on the appearance of re- turning breathing, hartshorn is to be applied to the nose at intervals. The disease has been mitigated by forming issues in some part of the body. Also by blisters, or tartar emetic ointment applied to the chest. Mustard to the ankles, and active purgatives, are almost always beneficial. Persons who are subject to this disease should be careful to ghun all mental irritation, and every outburst of passion or ex- citement that would hurry the circulation. Moderate exercise should be daily taken in the open air, but no violent exertion indulged in ; and all attempts at going up a rising ground should be avoided, or if made, should be with the utmost care. The food should be plain, moderate in quantity, and easily digestible ; such as is not liable to occasion flatulence. Fer- mented and distilled liquors are altogether improper. On any appearance of fullness of blood, animal food should be entirely abandoned, and mild purgatives (epsom salts, rhubarb, castor oil, rochelle salts, &c.) frequently taken. A perpetual blister or other irritation in the region of the heart is sometimes use- ful, and warm bathing to the feet and legs will help still fur- ther to prevent the undue flow of blood to the other parts of the body. Mustard or cayenne pepper in the warm water, wil render the bath more stimulating and of greater service. DISEASES OF THE H E A M T . Owing to the use of tobacco and intoxicating drinks, which prevail to such a fearful extent at the present day, diseases of the heart are greatly on the increase. Each issue of the morning paper, almost, records the " sudden death" of some loved one, who has left home and friends in apparent good 330 Disease* of the Heart. health "in the morning," but is brought home cold in the em brace of death. What a pity that intelligent beings should use such deadly poisons ! However, diseases of the heart are brought about by other causes ; still, where there is any ten- dency to the disease, or it naturally exists, though unknown to the individual, rum and tobacco render it doubly dan- gerous. If from any cause one or more of the valves. of the heart should become deficient, it is evident that each time they close, a small portion of blood will pass back, or " regurgitate," intc the heart— and this actually occurs in cases of disease. Ane the consequence of the long-continued and constantly-repeated disordered action is to cause stretching, or " dilatation," of the cavity which receives the regurgitated blood. This one in- stance will explain how one slight derangement in the nicely- balanced machinery of this important organ gives rise to another. From somewhat analogous causes, the blood may regurgitate into, or be dammed up in the lungs, or in other parts of the body, causing hemorrhage, dropsy, &c. Sometimes there may be impediments to the circulation ; the valves above alluded to, or others, may not yield as they should do, or there may be other causes which render it diffi- cult for the heart to propel the blood through the body. In such a case, the heart, like any other muscle under similar cir cumstances, acquires increase of substance, in consequence of the continued increased exertion demanded of it, to maintain the proper circulation ; and thus we have a cause and efiect, producing enlargement of the heart — an evil certainly, but a lesser evil to prevent a greater, for in this very enlargement — this strengthening, as it were, of the heart to do its extra work — the patient's safety lies. Of course there are many other forms of heart disease, but the above instances will convey some rational idea of the na- ture and peculiarities of the disorders of the organ in general. It would be quite profitless in this work to enter into anything like detail respecting diseases of the heart or trheir treatment; disorders so varied in their nature and symptoms, can only be properly investigated and managed by a medical man, con- versant with the mechanism and the functions of the human frame at large, and in their relations of mutual dependence. Affections of the heart are manifested by pain in the chest difficult breathing, cough, palpitation, &c. ; and at other timo by faintings, giddiness, irregular pulse, &c. ; but there is not one of these symptoms, or any combination of them, which may not be developed under certain bodily conditions, al Diseases of the Heart. 331 though the heart 16 perfectly sound. None, therefore, need alarm themselves merely because such symptoms occur ; they happen at times more or less to all ; still they ought not to be neglected : if they continue to recur, a medical man should be consulted. If there is no disease the mind is set at rest, and any genera', disorder which may have caused the symptoms irill probably be rectified. The above cautions are given, because there is no class of diseases of which people are so apt to fancy themselves the subjects as those of the heart ; and the more they think of the symptoms, the more likely are they to continue or increase, from an organ so intimately connected with the emotions of the mind as the heart. Even if the heart be unaffected, it is by no means advisable to permit it to con- tinue to be functionally disordered, (irregular in its actions,) either by mental emotion or by sj-mpaihy with other organs, for the functional disorder may end in organic disease ; that it does so sometimes is evident from the fact that there is no more fertile source of heart disease than those convulsions, either commercial or political, which occasionally agitate so- ciety. When disease of the heart, either insipient or confirmed, does exist, it cannot too soon be discovered by examination, nor the necessary precautions and regulated mode of life too 60on adopted ; for with these precautions, a large majority of persons who are the subjects of heart affection may not only continue to live for years, sometimes many years, but to enjoy life. True, the knowledge to any one that he is himself the subject of heart disease may be uncomfortable, but it cannot oe unprofitable. He may be aware that heart diseases are sometimes apt to have a^ sudden termination, and that Ms life may be somewhat more in jeopardy than that of an unaffected person ; but surely to every right-thinking man, this fact would rather be an argument why he should know his real condition. The possibility of his being called away from the affairs of this life without warning, should be a reason for his keeping them well arranged ; and still more important, should it be a reason that in conducting his earthly stewardship, he should do it, not only with reference to this world, but to give account of it in another. And when the many chances and 2ontingcncies of life are considered, the consciousness of being the subject of heart disease amounts to little- more than such contingencies assuming a more prominent position in the mind ; and to the individual it may be a merciful dispensation of providence, as, being reminded more frequently of the un- certainty of human life, he may be constrained to look for a 332 Diseases of tin Heart. realization of true happiness only beyond this vale of tears,— the Christian's home in heaven ! Besides the two already mentioned, there are other causes of disease of the heart : mental disturbance and agitation is a most frequent one ; also mental depression and grief, which, if long continued, appear to exert much influence over the organ, and to make the phrase " a broken heart" not altogether a poetical fiction. Violent passion strongly affects the heart — its indulgence may lay the foundation of disease, which its repetition strengthens, and may bring to a fatal termination. Rheumatism, or rather rheumatic fever, is probably another of the most fertile sources of heart affection. In this disease, inflammation of some portion of the membranes covering or lining the heart, is apt to occur, and to be followed by such effects as induce permanent change. Violent physical exer- tion.-, and dissipation of all kinds, are causes of disease of the heart. It has been said that persons with heart affections may continue to live and enjoy life, but it must be under a more regulated and restricted system of living than is imperative on persons in health. Every thing which may be a cause of heart affection must also be a source of aggravation ; all men- tal or physical excitement especially so. When these aro guarded against, the rest may be summed up in — strict atten- tion to the general health. Whenever an old symptom be- comes aggravated, or a new one, such as swelling of the legs, &c, appears, medical advice should always be obtained. Palpitation of the Heart. — This is often caused by the various emotions of the mind, as fear, joy, anger, or excite- ment of the mind from any cause. When it arises, however, on every trivial occasion either of mental emotion or of physi- cal exertion, or without occasion at all, as it often does, even during rest in bed, then it requires attention, not solely on account of the discomfort it gives rise to, but because it may lay the foundation of disease of the organ which is so con- stantly subject to over-excitement. Affections of the heart become more common after seasons of much public excitement of any kind — an effect traceable only to the frequent dis- turbance of the organ by the passions or emotions of the mind. Independent of disease, palpitation of the heart is liable to occur in the young of both sexes, and in females particularly, soon after the age of puberty — in the latter being very gene- rally associated with hysterical tendencies ; in such cases, it ia met with in its most aggravated forms, and often of such violence as to prove alarming. In any case the tendency to Diseases of the Heart. 333 palpitation is more common in the nervous temperament, and ib increased by whatever gives undue predominance to that temperament, such as indolence, luxurious habits, and the indulgence of feelings and imagination artificially excited ; and having once begun, it is kept up and aggravated by the continued attention with which the mind is apt to dwell upon the ailment. The individuals subject to it easily imagine themselves as subjects of heart disease, watch every motion almost of the heart, and thus under the influence of their own imaginary fears, produce the very symptoms they dread. This nervous condition (for it is generally nothing else) is only to be got rid of by those measures which give a more vigorous and healthy tone both to mind and body. The false excitement of imaginative literature, I mean reading trashy aovels, etc., if it has been indulged in, must be exchanged for something which calls for some healthy mental interest. Where it can be adopted, the pursuit of some branch of natural history, botany, geology, or any other out-door occupation, are the best pursuits ; they occupy the mind, and draw it away from its own morbid fancies, even in the time of exercise, which is rendered doubly invigorating by the mental excitement which accompanies it. Along witli these means, a system of diet calculated to give good nourishment should be adopted ; heated and ill-ventilated rooms, above all things, are to be avoided, early hours observed, and if a feather bed has been habitually lain upon, a firm hair or husk mattrass should be substituted. One article of diet requires especial mention, as being pecu- liarly injurious in such cases ; tea of any kind is better avoided, but green tea is absolute poison / coffee is scarcely allowable, and cocoa or milk should invariably be substituted for either of the above more stimulant beverages; wine or malt liquor may be injurious, or the reverse, according to the previous habits of the patient and the nature of the case ; if depression or debility follow their withdrawal, the tendency to palpita- tion is certain to be increased. In addition to these measures, regulation of the bowels, the use of the shower-bath, :r better, of the douche, or water poured down the spine, and occasional mustard plasters on the chest or between the shoulders, are all useful, especially if, as frequently happens in cases of aggra- vated palpitation, any tenderness of the spine is found to exist. In cases of nervous palpitation, medicine is not much called for, unless to remedy other disorders, such as indigestion, Some patients derive much benefit from a teaspoonful of a mix- ture of equal parts of tincture of valerian, tincture of htubane, and spirits lavender: taken twice or three times a day in water, 334 Scurvy. Hartshorn in teaspoonful doses with cold water, iscften useful, especially if there is much flatulence ; or ether may be taken in ten or fifteen drop doses, either alone or with the above- mentioned remedies given in water. The ether, however, ia .nore generally serviceable as a remedy, during an attack of palpitation than when taken regularly. In most cases of this kind it will be found necessary to change the remedies occa sionally, or they will lose their effect. SC UR VY. By medical writers, and by well-informed non-professional men, the term scurvy is now applied to that disease which is produced by a long abstinence from fresh vegetable food, ex- posure to damp, and the influence of the depressing passions, and which is therefore frequently observed in long voyages, in camps, and in besieged towns. It comes on gradually, with heaviness and aversion to motion, with dejection of spirits, anxiety, and great debility. The countenance becomes sallow and bloated, the breathing is easily hurried, the teeth become loose, the gums are spongy, and bleed when slightly touched ; and livid (or purple) spots appear on different parts of the body. A very curious circumstance sometimes occurs in scurvy: old wounds, which have been long healed, break out afresh, k' the disease is not checked, the joints become swelled and stiff, the tendons (sinews) of the legs stiff and contracted ; a dark colored blood issues from the nose, the ears, and other parts ; offensive stools are discharged, and the patient dies with symptoms of diarrhoea or dysentery. The cause of scurvy is long confinement to a diet destitute of a due admixture of fresh vegetable substances. The fre- quent occurrence of scurvy in long voyages, during which the ship's crew are compelled to live much on salt provisions, and in besieged towns, where the provisions are scantyand bad, and in cold, damp and poor situations, where human life is with difficulty supported, is thus accounted for. Among othor very exciting causes, we are to reckon want of cleanliness and ven- tilation, a damp and cold atmosphere, and, above all, depress- ing passions. It has been ascertained that by keeping the shij perfectly clean and dry, by allowing the men as much recrea tion and exercise as possible, and by taking to eea a propel supply of lime or lemon juice, and distributing to the shij s com pany a portion of it every day, when their fresh provisions begin to fail, they may be kept from scurvy as effectually ae any number of persons living on shore, and using fresh veg- etables every day. This has, for a considerable number of Scurvy. years, been .ascertained on a very extensive scale of expe- rience. From one to two ounces a day are a sufficient quantity for this salutary purpose ; and it may be given diluted with water, or made into lemonade, with sugar and water, so as to form a healthful and refreshing beverage. When in any indi- viduals the tendency to scurvy appears stronger than in others, as indicated by the spongy and easy bleeding gums, by stiff- ness of the hamstring, by inertness and dejection of spirits, it will be properto give an ounce of the juice three or four times a day till the tendency is diminished. Lime juice is apt to ferment, and not to keep properly, owing to the quantity oi pulp and mucilage squeezed out along with it. To prevent this fermentation, it is proper to mix with it a little alcohol or carbonate of lime. It has been ascertained by experiment that the curative properties of the lemon juice depends very much y& the potash which exists in combination with the acid. So that cream tartar and the carbonate of potash given in small ind repeated doses, say one teaspoonful three times a day in t glass of water, will act well where the lemon juice can not be had. And so far as our experience goes, the same powerful yet simple agent which prevents scurvy, is also fully sutiicient to cure it. When circumstances admit of it, and we are able to procure for a ship's company an abundant supply of fresh meat and vegetables, this is the natural and appropriate remedy ; but in the last stages of the disease, when the debility is great, it is a matter of much danger to take the sick on shore, as they not unfrequently die in the boat that carries them thither ; and instances have even occurred of the land air being too oppressive for the lungs of those, who did not previously show marks of so great feebleness. It is by far the safest way to attempt the cure of the men on hoard their ships / and when the disease abates a little, and the strength is beginning to return, it may then be accelerated by a removal on shore, and by the usual diet and exercise to be found there. Many aux- iliary circumstances are to be called into action, both in the cure, and prevention of scurvy ; the greatest attention to ven- tilation and cleanliness, frequently washing the ship in line weather, fumigation between decks by the vapors of the nitric or muriatic acid, by pouring either of them over a small quantity of common brown sugar, or pieces of zinc, iron, etc. attention to increase the real comfort of the men, and to check all intemperance; to promote regularity of discipline and cheerfulness of mind. \ arious articles are to be used in diet which counteract the pernicious tendency of a long continued use of salt provisions, as spruce or treacle 836 Consumption. sonrcrout, preparations of oatmeal, and occasionally parboiled fresh vegetables, such as water cresses, radishes, scurvy grass, lettuce and the like, which may be eaten raw; or cabbage, turnips, spillage, cauliflowers, boiled ; or ripe fruits, as oranges, melons, pine-apples, plantain, etc. CONSUMPTION. This disease has been truly termed the " great destroyer of our race/' It enters the cottage and the castle ; it kills th* rich and the poor, the old and the young, and regards not sei or condition, but rushes on, slaying its tens of thousands every year. Consumption is only a portion, strictly speaking, of a constitutional malady which very frequently develops its in- tensity in the organs of respiration, (the lungs), but may do so in other modes and in other organs of the body. Its constitu- tional nature requires to be impressed upon the mind of people in general ; for, regarded only as a disease of the lungs, alarm is not taken, nor are remedies generally resorted to until its effects upon these organs become manifest ; "the antecedent period in which the constitution is giving way is overlooked, and that time is lost in which the first indications of disease might have been successfully attended to. We may -state that the causes of pulmonary consumption are all those which occasion debility generally, not excepting the most frequent of all, hereditary predisposition, or that tendency to the disease which exists so strongly in some families, that no care or precaution can ward it off, nor pre- vent it seizing in succession member after member of a house- hold. Fortunately, this intensity of hereditary transmission ia not so very frequent, but there are few families in which the tendency does not more or less exist ; there are few which can- not number amid their deceased relatives some victim of con- sumption With a susceptibility so widely diffused, it becomes a serious consideration with all by what this tendency is en- couraged, and how it may be diminished. The first considera- tion that presents is marriage. There can be no question, that from errors in the contraction of this great engagement of life, ranch of the hereditary tendency to consumption is de- veloped, and especially when the union is between parties nearly related by blood ; doubly so if the predisposition already exists in the family. Delicacy or debility of either parent, particularly of the father, is very apt to entail consumptive tendencies" upon the children; and the same follows if the parents are either too young, or if the father be advanced in l\fc. The mistake is a very common one, that marriage and Consumption. 237 child-bearing act as a check upon the progress of consump- tion, and the step is often advised even to the comparatively young with this view. The error is a serious one ; nothing can be more trying even to a healthy female than having a family before the constitution is formed ; and most certainly it is so to the weak. It is true, apparent temporary amendment of con- sumptive symptoms sometimes occurs, but the powers of life are sapped by the too early call on their exertions. Great care is required near the approach of the age of puberty, especially in the case of those who have displayed any scrofulous or consumptive tendency. The development of the body which is going on requires a full supply of the most nutritious food, animal food particularly. The secre- tions should, if possible, be kept in healthy activity, and, more especially, all sources of exhaustion most strictly avoided. Youths especially must be warned against-the evil of prolonged physical exertion • and not less so against the mental efforts, which those especially, who partake of the nervous and exci- table constitution of the hereditary consumptive, are apt to give way to, in competitions at school or college. Along with the consumptive tendency, two very different conditions of physical development are found. In the one, there is the fair fine skin and bright red complexion, the fair hair, the light eye, with its pearly looking white, and the tapering fingers ; in the other, the dark hair and skin, the latter almost dirty-looking, and the swollen-looking upper lip. Consumption varies much in its initiatory stage; sometimes it steals upon the patient most slowly and imperceptibly ; at others, developed probably by some acute attack, it appears to start at once into activity. Generally, for a considerable period before marked symptoms — or at least symptoms which attract general attention — show themselves, the person has felt weak, languid, and complained much of cold, probably has sunk in flesh, and a short dry cough has come on, apparently without cause, or there has been continued dyspepsia. If the patient is a female, the monthly discharge has become irre- gular, or stopped. It may be that these symptoms have been aggravated during winter, and disappeared partially or en- tirely with the advent of warm weather. Such symptoms may go on for a longer or shorter period, ebbing and flowing, but still gaining ground, or they may progress more unremittingly, though still slowly, or become suddenly aggravated by taking cold, some unusual fatigue, or the like. The emaciation be- comes too evident to escape notice, the cough is unabated and becomes troublesome, the voice assumes a peculiar hollow 338 Consumption. eound, the breathing is quickened, and it may be that spil.th.g m" blood, profuse night perspirations, or even diarrhoea, have sel in before the patient's condition excites either alarm in tlioir own mind or in that of their friends. Indeed it very frequently happens that the patient is the last to take the alarm, the last to entertain the idea of the fatality of the dis- ease, of which this hopefulness of recovery is a well-marked symptom. As regards the prospect of recovery from consumption — for recovery does undoubtedly take place — much depends upon the original and existing constitution and the habits, past or present, of the individual, and the worldly means within his power. When once the disease has become established in an indi- vidual <.H' strong hereditary tendency to it, or in one who \r.i broken down his constitution by dissipation or intemperance, or who is the subject of some other debilitating disease, lmpo pf amendment can be but small. If, on the contrary, the affe > tion is more probably induced, and rather accidental than tl e result of original constitutional tendency, the probability ia that under proper management, and with the aid of the grett curative ] towers of cod-liver oil, and medicated inhalation, (s< o Catarrh in the Head in another part of this work) not on' y amendment, but permanent recovery may be obtained. "Win v consumption has advanced beyond its first 6tage, all the symp- toms already mentioned are increased, the cough and perspin- tion particularly become more distressing, and the tendency to diarrhoea, (frequently with severe spasmodic pain in the bowels.) notably increased ; expectoration is often difficult, either from weakness or from the thick matter expectorated ; the hair falls off, and emaciation continues. The prevention of so fatal a disease as consumption is a more important subject in a work like the present, than its treat- ment ; and in those predisposed, the preventive or "prophy- lactic " system must be continued life through, even into old age. It is a popular error, that by the time middle life is r< ached the liability to consumption is over. Such is not the case, for even the '• three score and ten " is sometimes termin- ated by the disease. In any condition of life, the question of tendency or not to consumptive disease should influence the choice of field lot exertion, and not only of field, but also of the nature of the business of life. Any occupation which renders the inhalation of irritating substances unavoidable, is to be avoided by the consumptively inclined man ; and not less so, that which Consumption. 339 involves confinement in a constrained position or in a close room. The most eligible employments are those which require muscular exertion of not too exhausting a kind, and without too great exposure to the weather ; the gardener, the carpenter, butcher, the farm-servant, arc all less likely to be the victims of the disease. In whatever situation or grade of life, however, a person may be placed who is predisposed to consumption, much may be done to keep up the powers of resistance by keeping up the general health to the highest possible stand- ard, by diet, early hours, attention to the skin, etc. (See " Ih/w to preserve Health" in the first part of this work.) The chest and shoulders should be bathed every morning with cold saltwater, and rubbed afterward to promote reaction. Cheerfulness of mind and moderate mental exertion are im- portant, while perfect temperance in the use of alcoholic stimuli is indispensable; but any change to their total disuse cannot be made suddenly, if the patient lias been accustomed thereto without danger. All the usual sources from which "cold is taken" are to be shunned, particularly wet feet, sitting in damp clothes, crowded ball-rooms, and public assem- blies ; and, lastly, when exposure to cold air, especially to east winds, or to the foggy atmosphere of night, is unavoidable, the protection of a respirator to go over the mouth and nos- trils — a silk handkerchief being about the handiest — should be resorted to. Medical men are often asked their opinion as to the commu- nicability of consumption from one person to another. . That it is not generally coinmunicalde is certain ; that it has been thought to be so under circumstances of predisposition, and when there has been close communication between two per- sons, should be sufficient to caution other members of a con- sumptive family from hanging too much over one affected with the disease ; and certainly in any case forbid the occupation of the same bed. This disease has thus been brought under consideration more with a view of pointing out the preventive re?n.edies, and the general course to be pursued by those predisposed to the disease, than any curative treatment after the disease has advanced too far to be treated by any course of domestic medication. A physician should be called to the patient at as early a period as possible, and above all things avoid the thousand and one remedies that are daily advertised by men whose chief talent consists in knowing how " to make money." 340 Dyspepsia^ or Indigestion. 1) F S PEP 81 A or I X DIG E .ST/O N . This distressing complaint has been Baid truly to be "nc respecter of persons ; " its symptoms are usually well known; it originates or is brought about by :i gre«*it variety of causes: among which it is often found associated with a diseased state of tin- //>/*. Persons who have used spirits of any kind to < -. or stimulants of any description, such as Bpices <>r highly seasoned food, and those also who have used toharno to freal excess, by which the coats and functions of the stomach ave been impaired and debilitated, are liable to indigestion. A costive habit, acquired by permitting the bowels to remain too long without evacuation, will bring on this disease, and persons who are long confined to any stationary or sedentary business, without taking the necessary exercise, are often subject to it. When the complaint is firmly seated in the stomach, it is marked by belchings of wind, gnawing and disagreeable sen- sations at the pit of the stomach, risings of sour and bitter acid into the throat, occasioned by the food not being properly digested; great irregularity of appetite, which is sometimes voracious and at oth n- times greatly deficient, and a sinking and oppressive debility or weakness of the stomach. In addition to these symptoms of indigestion, on gratifying the appetite at any time, the stomach in a short time afterwards becomes oppressed with sensations of weight and fullness, the head becomes confused, the sleep very much disturbed, the bowels very irregular and costive, the urine high-colored, and the poor victim commences taking medicines for relief, and brooding in dejected silence over thousands of unhappy retro- spections of his past life, and countless melancholy anticipa- tions of the future. Should disease of the liver be connected with this disease, a dead and heavy pain will be felt in the right side; the water deposited in the chamber will have, on cooling and settling a brick-dust colored sediment, which, if permitted to remain any length of time, will adhere in rings of a reddish hue to the inner sides of the urinal; a pain will be felt in the top of the shoulder and back of the neck; the feet and hands will frequently become benumbed, or what is called " getting to sleep," from want of regular circulation ; the complexion will become of a yellowish hue or tinge, and general uneasiness ol the whole system will be felt. The treatment of this disease consists in keeping the bowels ope?i regularly. If they are not rendered so by the use of 6te\ved fruit and ripe fruit uncooked, with injections of hall Dint of cold water up the bowels every morning, a dose of Heartburn, or Sourness of the Stomach. 341 9ome mild purgative medicine should be taken. (See " Medi- cines, their doses and uses,") so that the bowels are opened, every day. Friction and percussion, by striking with the open hand, gently over the region of the stomach for a few minutes, half an hour before each meal, should be attended to, and be 6ure to never eat as much as the stomach seems to crave, that is, always "get up hungry" and never eat any article of food known to disagree with the stomach. Eat slow and ai regidar hours. Avoid the use of intoxicating drinks, and do not eat meats for supper; sleep on a hard bod and take a sponge bath every morning, followed by the use of a dry, rough towel and the flesh-brush ; take plenty of active out- door exercise, and partake of a mixed diet / and above all avoid the poison called tobacco, in every form. HEARTBURN, or SOURNESS OF THE STOMACH, IIkartbitrn is found to exist under very different conditions of the system. It is prevalent, frequently, with females, during pregnancy, the causes of which were explained under the head ot " Pregnancy and its Diseases." It is also of the greatest consequence to the dyspeptic ; and may be caused by any thing which interrupts the process of digestion, especially costiveness of the bowels. The symptoms of this disease con- sist of a burning sensation, felt either at the pit of the stomach or top of the throat, and occasioned by undue acidity, or by irritating substances in the stomach. It is generally relieved by soda, magnesia, or chalk, ten grains in a little water, or twenty drops of hartshorn in a wineglassful of cold water — which neutralizes the acid. It is not, however, advisable to have too frequent recurrence to these palliative remedies, for they are only palliatives, — they cannot be taken habitually without weakening, not only the stomach, but the system gen- erally. Heartburn cannot continue to recur without there being an error somewhere ; either the diet is badly regulated, or the digestive organs require something more than simple neutralization of the superabundant acid. This acid is a badly- formed gastric juice, and if it is neutralized, whatever diges- tive power it might possess is destroyed ; consequently the stomach is called upon to secrete another supply before the food can be digested — a call upon its powers which cannot fail to be injurious. Moreover, persons finding how quickly a dose of alkaline medicine removes the uncomfortable sen- sation ot heartburn, are very apt to trust to the palliative, and continue their indulgences, rather than to practice the self denial requisite to effect a cure of the cause. 342 Watcrbrash — Jaundice. Prevention, therefore, or removal of the cause, is what is of most importance in tins disease. The bowels must be kept open by mild purgatives, s<> that there is an operation regu iarly every day. Every thing known to disagree with the stomach must l>e avoided, exercise taken in the open air, and all the means pointed ont under the head of " How to preserve Health,"' strictly adhered to. WA TE It BB ASH Mkdical men have strange names for diseases, as well ac those who are not medical men. Pyrosis is the medical name for this disease, bnt usually called Waterbrash. It is a pe- culiar affection of the Btomach, in which the patient brings up frequently a considerable quantity of thin watery liquid, some- times insipid, at others intensely acid. Before the fluid ia brought up, often there is more or less pain experienced at the pit of the Btomach. This complaint attacks, mostly, persona past the middle age, particularly females, and the tit comes OU generally in the morning and afternoon. It usually begins with a severe pain in the pit of the stomach, attended with a feeling of constriction, or oppression, and soon after a quantity of thin watery fluid is thrown up, which is sometimes insipid, at other times it has a highly acid or burning taste. The causes of this complaint are various, but whatever disorders the Btomach may give rise to it. It appears to be owing to a peculiar state of irritation of the stomach ; and is most cer- tainly relieved by the use of the white oxyde of bismuth, from two to three grains made into pills with extract of gentian, three times a day. This medicine will often perfectly cure waterhrax/i ; but attention to the diet, as laid down under dys- pepsia, is of much consequence, and will be absolutely neces- sary in order to render the cure permanent. A diet of plain animal food may be allowed, with which may be united the use of biscuits, home-made bread, ami preparati me of rice and milk. Daily exercise musl also be taken, and frictions, with the flesh-brush, over the region of the stomach and bowels, are of no small service. The bowels must of course be kept open by purgatives, when necessary, even wl en making use of other curative means J A UN DIC E . This disease is often improperly called "jai dcra :" it is elm racterized by yellowness of the eyes and skin, whitish <>r ciay- eolored stools, and saffron-colored urine, which communicatee to Bubstances immerBed in it a saffron dye. Jaundice is cajs Jaundice. 343 ed by the duet or tube leading from tlio gall-bladder to the stomach, becoming stopped >tj>, — that is, something in the first place stops the flow of hie from the liver ; and jaundice, which consists in an absorption of bile into the blood, is the result. Probably, gall-stones, or thickened bile, are the most com- mon obstructions; but tumors which press upon the duct, or spasm, may also stop the bile and induce jaundice. Jaundice has sometimes been caused by violent mental emotions, (un- easiness of mind, from various causes,) also, an irregular or sedentary mode of living will produce it as well as intemper- ance, especially continued indulgence in spirituous lienors. The presence of bile in the blood is quickly manifested by the color of the skin, and also more particularly of the white of the eye; the shade of color varying from the slightest percep- tible tinge, to deep golden yellow, or even brown. At the same time, the stools become white and chalky-looking, and the urine — sometimes the perspiration — is deeply tinged with bile; the constitutional symptoms are generally those of dis- ordered digestion, (see Dyspepsia,) headache, languor, <&c. The principal objects of treatment are, to allay irritation in the stomach and bowels, and to remove the obstruction Exist- ing to the free passage of the bile, through the biliary ducts, and along the bowels. It wdll be frequently found, that the best means of allaying irritation in these parts will be the most effectual in removing the jaundice. In the young and robust, bleeding by leeches applied over the region of the liver, will often be demanded, especially in recent cases ; cupping over the stomach and region of the liver is generally an im- portant remedy. The patient should also take a warm bath at ninety-six or seven degrees, every other morning about eleven o'clock, with the following pills during the day : Castile soap, a drachm and a half; rhubarb, in powder, eight grains; ipecac, in powder, ten grains; oil of juniper, ten drops; syrup of orange peel or lemon, a sufficient quantity to make the whole into twenty- four pills. Three to be taken twice or three times a day. Or when there is a good deal of pain in the bowels, the following may be used instead : compound extract of colocynth, and extract of henbane, of each, a drachm ; divide into twenty- four pills ; one, two, or three to be taken as above directed. Gentle purging is perhaps the most beneficial mode in most of cases; one or two tablespoonfuls of both the Epsom and Glauber's salt may be dissolved in half a pint of lukewarm water, and taken every morning for a fortnight ; and resumed for another fortnight or three weeks after being, laid aside for 344 J////,- Sickness— Cohc. If there is much pain in the affected side, mustard plasters or poultices, applied frequently, will be of much service. Sometimes giving an emetic of ipecac will cause the gall-stcne or thick bile to pass into the stomach, and thus relieve the difficulty at oucc. Many persons who have resided long in a hot climate, con tract a sallow, yellowish complexion, which hue often pervade? the whole skin ; this is generally regarded as a mild sort of jaundice, or as arising from the absorption of the bile, but it is usually of a different nature. In most instances, it is not owing to this cause, but t<> a peculiar alteration in the circu- lation, on the external surface of the body, in consequence of the skin's sympathizing with a weakened and irritated con- dition of the digestive organs, more especially of the stomach and bowels. MILK SICKNESS. This is a peculiar affection which occurs in many of the Southern and Western States, in the autumn. It has been called by various names, such as " swamp sickness," " tires," "slows." " stiff joints," " river sickness," "puking fever," &c. It affects both the cattle that eat of the herb which causes the disease, and also the persons who use the milk taken, from tho cow, or who eat the tiesh of animals affected with the dis- ease. It has not as yet been satisfactorily settled what kind of an herb or plant causes this sickness; however, the symptoms si low it to be a narcotic, or 2>oison. There is vomiting, purg- ing, extreme nervous agitation, great prostration, trembling, &c. The treatment consists in giving plenty of warm sweet- ened water every few minutes, until the stomach has been emptied by vomiting; then a mustard plaster over the stom- ach and bowels, and injections up the bowels of lukewarm water, until the bowels operate, after which a mild purge of castor oil. The patient must be kept perfectly quiet in bed; should symptoms of sinking show themselves, give stimulants — brandy, whisky, wine, hartshorn, or whatever is handy To allay the thirst, give strong coffee (cold) without sugar 01 milk. COLIC Tins disease is produced by so many different causes, is so varied in its symptoms, under different circumstances, and re quiring treatment suited to its different causes and symptoms, that we have thought it best to treat it under 'he following divisions : Colic fbom INDIGESTION. — Among the most common symp tomb occasioned by an excess in eating, whereby the stomach Colic. 316 hi leaded beyond what is compatible with the regular and healthy performance of its functions, is a violent pain or colic, accompanied with nausea, headache, and dizziness, preceding the ejection of the contents of the stomach by vomiting; and terminating subsequently in a griping looseness of the bowels. But it is iu.t only by excess of tood that this species of colic is produced; it is occasioned also by the quality of the food* various high-jcasoned and made dishes; certain articles of a highly indigestible nature; malt liquors; cider and wines of a bad quality; the stones, kernels, husks and enveloping mem- brane of various fruits, swallowed when the latter have been eaten, &c, frequently give rise to it. We find it, however, in many instances originating after meals, from causes more obscure, and accompanied by various additional symptoms of a much more violent and distressing nature, as though the food itself had proved poisonous, or some poisonous substance had been intermixed with it. Occasionally these additional symp- toms consist of an intolerable feeling of suffocation ; a feeling of constriction in the throat; the face and eyes become swol- len; with excessive thirst; a burning heat over the whole surface; a feeling of itching or prickling in the skin, and an eruption, sometimes in the form of minute raised points, at others in that of larger elevations: the skin peeling off on the subsidence of the attack: in addition to which we sometimes have a species of delirium, with twitching of the muscles. At other times the symptoms consist of great anxiety ; difficulty of breathing ; dejection of spirits ; spasms of the lirrbs, as well as of the bowels and muscles of the abdomen ; coldness of the extremities; loss of sight and hearing; convulsions, &c. The first of these two last varieties of colic from indigestion arises in general from a peculiarity of the individual, the con- dition of the stomach at the time of eating, or from some pecu- liar principle connected with animal food of a particular description. The articles of animal food which in general give rise to the species of colic under consideration, are various shell-fish, mussels, crabs, lobsters, &c. Animal substances, in the process of cooking, or in the dif- ferent processes to which they are subjected with the view of preserving them for future use, or from their being improperly jr too long kept, may undergo a change, rendering them im- proper arti^es of food. The second variety mentioned of the colic from indigestion is produced generally by eating deleterious vegetable sub- stances, eitker mixed with our food or eaten in mistake for healthy articles. . 3±0 Colic. The treatment in all the varieties of this species of colic is to W commenced witb an emetic, in order to unload tl'6 stomach of the offending matter. "Where the disease has been induced merely by a surfeit, or by too rich food, a dose of ipecac will be proper: in Borne cases, even warm water wil. be sufficient; bnt in the two other varieties, a more prompt and powerful emetic is demanded, and it has been recom- mended to prescribe immediately a full dose of the sulphate of zinc (twenty grains, in a gill of warm water.) The emetic is to be followed by a brisk purge, which may be aided in it? (juration by injections up the bowels. In the second variety, the vital powers of the system are in general rapidly, and to a most alarming extent, exhausted ; it therefore becomes neces- fury. as soon as possible after the evacuation of the stomach to rou6e the system, by the administration of the most diffusible stimulants and cordials, such as Bulphuric ether, ginger tea <-r cayenne pepper tea ; and vinegar, diluted with water anc sweetened, should l»e drank in abundance. These remedies may be aided by stimulant applications to the extremities, and all the other means of rousing the vital powers from thcii Btate of exhaustion. In the second variety, the treatment dif- fers but little from that already laid down. The great indica- tion is to get rid of the offensive matter as quickly as possibly by active emetics and purgatives; afterwards to rouse the system by external stimulants, mustard, friction, &c. ; and to subdue the irritation and general convulsions by opiates. A mixture of ether and laudanum, ten drops of each, in water, is an excellent internal remedy ; and in many cases, much advantage will be derived from the plentiful use of water and vinegar, sweetened with sugar. Fla'itij nt Colic. — In addition to the general symptoms of colic, in this species we meet with a considerable and unequal distension of the abdomen, occurring suddenly. There is a rumbling of wind in the bowels, and a frequent expulsion of it both up and down. These discharges of wind in general occasion some relief to the patient, and the pain is also dimin- ished by pressure upon the abdomen, bending the body for- ward, &c. Flatulent colic is produced by every thing which occasions derangement in the Btomach and bowels, and it is frequently complicated with dyspepsia. In many cases of Una disease, the affection appears to be induced by a morbid pro duction of air by the bowels themselves, but in general it ia dependent upon t lie Use of fermentable substances as articles of diet, particularly vegetables. The fruits of the season, cabbage, beans and peas, new cider, wines, beer and porter, honey, onions, various kinds of nuts, &c, &c, being introduced Colic. 347 into tlit? stomach when that organ is in a state of debility frequently undergo a rapid fermentation, and give rise to an enormous development of gas, producing the symptoms pecu- liar to this species of colic. In the flatulent form of colic, onr indications are to relieve the spasm, exjH the wind distending the bowels, and after- irards, by a proper regulation of the diet and the judicious Administration of tonic remedies, to restore the healthy action of the stomach and bowels. Immediately upon an attack of flatulent colic, if we are convinced that no degree of inflam mation exists in any portion of the bowels, we should admin- ister ten drops of laudanum in combination with some aromatic or diffusible stimulant; (strong essence of peppermint being about the best, ten to twenty drops.) and at the same time apply mustard plasters or stimulating fomentations externally to the abdomen. Vinegar and hops will be found very good, or large bran poultices, frequently renewed, will answer. The best internal remedy is probably a combination of ether and laudanum, in' proportions suited to the age of the patient and the violence of the case, exhibited in a draught of aniseed or mint water, or the compound tincture of lavender; at the same time we may administer injections, composed of some aromatic, a little cinnamon tea, mixed with soap suds may answer, out the one most to be depended on. is composed of a teaspoon - ful or two of turpentine and a sufficient quantity of pepper- mint rubbed up with a proper portion of some thin mucilage, or thin gruel ; tincture of assafcetida and laudanum, ten to twenty drops of each ; assafcetida, a few drops in gruel, has also been recommended, in the form of injection. In many cases, hartshorn, in doses of twenty drops in water every half hour, will give prompt relief. After the pain has somewhat subsided, it will be proper to administer an active but mild purgative; the best is probably magnesia, combined with calo- mel, to which should be added a few drops of essence x>f pep- permint. There is anDther form of colic caused by costiveness. The disease will be known by the fact that nothing in the way of diet having been taken to produce the symptoms, and is more gradual in its attack ; a feeling of uncomfortable fullness in the bowel* being felt for some days before the attack ; also loss of appetite, headache, restlessness, &c. The treatment must consist of giving an emetic, injectior.s of soap suds up the bowels, and a brisk purgative and mustard plasters to the bowels, until relief is obtained, then being careful afterwards to keep the bowels regular. (See Cosiiveness.) G48 Colic. Diuoua Coup. — Tliis form of the disease is marked by h violent and intolerable pain of the bowels, which in gome cases seem to be, as it were, tied together, and in others closely puckered up, and with a sensation as though they were boreo throngh with a sharp pointed instrument ; the pain occasionally abates, but quickly returns. In the beginning, the pain is not fixed to one particular spot, as it is in the progress of the dis- order, while vomiting also is less frequent, and the bowela more easily yield to the action of purgatives ; but, as the pain increases, it becomes obstinately fixed to one place. Frequent vomiting succeeds; the bowels become more and more costive, until at length the symptoms, rapidly increasing in violence, unless the patient be speedily relieved, a total inversion of the action of the bowels takes place. Every thing administered by the mouth, or injected into the bowels, is then thrown up violently by vomiting; the matters discharged from the stomach are various in appearance; sometimes of a green, yellow or dark color. In this disease there is violent irritation of the bowels, in consequence of which they are thrown into a state of spasmo- dic contraction, by the vitiated secretions poured into them from the liver and surrounding glands. Though this is a formidable disease, if taken in time it can >e successfully treated in most of cases. In every case where the symptoms are of any considerable violence, particularly if the patient be of a robust habit, it will oe proper to commence the treatment of bilious colic by apply- ing leeches to the bowels, and afterwards a warm poultice to encourage the bleeding from the parts; or if leeches are not handy, scarifying, and the application of cups will be advisable. Immediately after the leeches, or cupping, ten grains of calo- mel and one of opium in combination, should be administered by the mouth, and the patient may at the same time be im- mersed in a warm bath ; or if this be not practicable, warm fomentations of hops and vinegar, should be applied over the >vhole of the abdomen, and continued for some length of time. If, after a reasonable time (two or three hours), the patient ia not better, the calomel and opium should be repeated. This will asually relax the spasm of the bowels, and at the same timeexcite die healthy action of the liver, and unload the bowels of the diseased secretions by which the irritation is kept up The action of the calomel may be assisted by injections of a laxa tive nature thrown into the bowels, and frequently repeated Mr, where the stomach will receive and retain it, W3 may fol Costiveness of the Bowels. 349 low the calomel by Rochelle salts or castor oil, in repeated dopes. When the stomach is very irritable, and frequent vomiting present, these symptoms will in general he relieved by the calomel and opium ; we may at the same time, however, ex- hihit the effervescing mixture (soda' powders), and a large blister or mustard plaster should be applied over the stomach. In every case where the symptoms are violent and obstinate, the application of a blister or mustard plaster, after the em- ployment of warm fomentations has been continued for some length of time, will be of advantage, and should not be neglected. After the violence of the disease has been removed, we should next direct our attention to restore to the liver, the stomach, and bowels their healthy action. This is to be done by giving small doses, say five to ten grains of rhubarb, half grain of opium, and half grain of ipecac every four hours. Of course the diet of the patient should be light, nourishing, easy of digestion, and taken in small quantities at a time. lie should particularly avoid all fat, coarse and irritating articles of food, all crude vegetables, and all stimulating liquors; he thould make use daily of moderate exercise, but above all, riding on horseback. Bilious Colic is a disease which is easily reproduced by any impropriety of diet or regimen, or by exposure to cold or clamp, and all these exciting causes of the disease should be carefully guarded against by the patient for some considerable time. He should be particularly guarded against over-heating himself, either by exposure to the sun or by over-exertion, and particularly when such has been the case, should he be cau- tious not to expose himself to cold, either by throwing off any portion of his usual clothing, sitting in a draught of air, going out into the night air, or drinking cold fluids. His bowels should be kept moderately open either by the use of the ripe fruits of the season or some gentle laxative, and intoxicating drinks should be by all means avoided. COSTIVENESS OF THE BOWELS. The bowels, generally speaking, ought to operate thoroughly once in the twenty-four hours. In persons who do not expe- rience such relief it may be called a case of costiveness of the bowels. There are, however, exceptions to this rule ; with some individuals, a single evacuation of the bowels once every three or four days, and even less often, seems to be sufficient, and perfectly compatible with their enjoyment of perfect health ; and when such is the case it is of course superfluous 350 Costiveness of the Bowels. So endeavor to correct it. rind if is better to let well alone. If however, n conjunction with this condition of the bowels, the person suffers from headache, from languor, from distention •jf the abdomen, if the breath is disagreeable, and the tongue fnrred, the state is not compatible with health, and should be corrected. There are numerous causes producing this disease, a few of which will b<> enumerated. Tne nature of the food, as might he expected, exerts considerable influence ; bread badly made, and especially if alum be mixed with it, cheese, milk with some persons, farinacious articles, such as arrow-root or ground rice, and fond of too concentrated a character, all tend to pro- duce costiveness. Deficient exercise, particularly if combined with much exertion of mind; am r drain upon the system, as in suckling, abundant perspiration, loss of nervous power, an 1 old age have the same effects. The large bowel is very frequently the seat of the costiveness ; it loses tone, allows itself to he distended, sometimes to a a enormous extent, or contracts to a very narrow calibre in soire portion of its course. Lastly, a very common inducing cau:f Epsom salts, dissolved in a pint of water, of which a wineglassful or two ia taken at bed time, often operates freely next morning DIARRIHEA, or LOOSENESS. This complaint consists in a too frequent discharge from the bowels, in consequence of their increased secretion and motion. The appearance of the stools is various: sometimes being thick, thin, .-limy, whitish, yellow, green, dark brown. &c. Each discharge is preceded by a feeling of weight in the lower part of the belly, which, for the time, is relieved by the evacuation. The causes of diarrhoea are very numerous, but may, perhaps, be classed under three heads — nervous causes, causes which act upon the surface of the body, and irritating causes which act directly upon the bowels themselves. Influences affecting the surface of the body, particularly cold, and especially cold feet, often produce diarrhoea. Cold nights succeeding hot days are often said to occasion the dis- ease ; but it is also remarkable, that diarrhoea is apt to occur at the breaking up of a long frost — indeed to be epidemic, that is, of general prevalence. But it has been noticed that the most frequent cause of diarrhoea, however, is irritation in the bowels themselves, caused either by undigested or indigestible food, by acid, by acrid, morbid bile, or by the deficiency of that fluid permit- ting the digested food to become unduly changed. It may also be caused by costiveness, or by the lodgment of such matters as the skins of dried peas or beans, or of raisins, in the folds of the large bowel. Some persons habitually have a relaxed condition of the bowels, which is natural, and at the same time essential for health, and then to check it" ia dangerous. It is evident, that in a disease depending upon so many and various causes, a duo discrimination of these ia requisite for proper treatment. It must not, either, be lost bight of, that aiarrhoea is in many cases salutary — an effort oi nature to free the constitution from such morbid mattei which, if retained, would produce disorder or disease. On t|iis account, the simpler forms of diarrhoea are better left to right themselves, so long n» they keep within moderate Diarrhoea, or Looseness. 353 bounds. This caution is particularly to be observed with regard to that which occurs in the teething of children, which, when moderate, is a safeguard ; but when it becomes so fre- quent that the child is evidently weakened by it, and especi ally if the evacuations appear to be losing their healthy character and become like shreds of skin, or streaked with blood — in such cases, a warm bath for six or eight minutes should be used, for two or three evenings in succession ; isinglass or gelatine given in the milk-food, and a teaspoonful of the castor-oil emulsion with the yolk of egg beat up together, in equal proportions, with a little mucilage of gum Arabic, given three or four times a day, each dose containing a drop of paregoric. In diarrhoea, resulting from exposure to cold, the best plan of treatment is to modeiately re-excite the skin by giving small doses of ipecac every two hours; taking in tin; mean- time some ginger-tea, mixed with a little blackberry brandy. If diarrhoea is caused by irritating matters in the bowels, one thing is evident — it cannot be properly relieved unless the bowels are freed from the irritating matters. It may, it is true, be stopped under these circumstances, but it will recur, unless the irritating substances have been removed by purg- ing, previous to the use of the astringent medicine, and the continuance of the diarrhoea is merely the consequence of the previous irritation. In many cases in which the diarrhoea is owing to irritating matters in the bowels, particularly to bile, all that is requisite is to diminish the acridity by means of drinks of slippery elm, or gum arabic water, or flax-seed tea, largely used, to which, if there is acid in the stomach, a little carbonate of soda or prepared chalk is to be added. In other cases, when the action of the bowels is constant, painful, and exhausting, it is absolutely necessary to check these symptoms in the first place, and to soothe the bowels, before means are resorted to for freeing them from the irritant cause. For the former purpose, a dose of paregoric, or a mixture of one tea- spoonful of paregoric, four tablespoonfuls of water, and one of prepared chalk, repeated if necessary, will answer as well as any ; or a strong tea made of allspice and cinnamon, with a little chalk, given every hour, will answer. Mustard to the bowels will ease pain, and often helps the disease very quick ly. If the active diarrhoea does not, from its comparative mildness, require these remedies at first, or when it is suffi- ciently moderated, the bowels should be thoroughly cleared out with a tablespoonful dose of castor oil, to which ten drops of laudanum may be added ; this will probably clear away the 3. r >4 Cholera. irritating matters, if they consist of indigestible substances. When castor oil cannot bo, or is not taken, the host substitute is twenty grains of rhubarb and fifteen of calcined magnesia, with some aromatic, as cinnamon or allspice, or a teaspopnfu] of tincture of rhubarb, and, if there is much pain, live to ten drops of laudanum, the dose being repeated, if requisite. Af- ter the action of the opening medicine, one or two doses of astringent medicine, as mentioned above, may again be re- quired, as the bowels are apt to keep up acting simply from irritability. If the disease has been permitted to pass into the stage of irritation, when there is tendency to fever, the belly tender, the tongue red, and the motions resemble shreds of skin, 01 pieces of jelly, and are mixed with blood, the c?.se is of thai serious nature that medical assistance should at once be ob- tained, if it has not been so before. In the meantime, the mixture of castor oil with yolk of eixg;, in small doses, will bo found the safest and most effectual medicine ; two tablespoon- fills, with five drops of laudanum, being given every four hours, and starch and laudanum injections, the diet being aa unirritating as possible, and containing abundance of gelatine. A most excellent drink in these cases is rice-water, in each pint of which from a quarter to a whole ounce of gelatine or isinglass is dissolved, with a piece of toasted bread introduced to flavor it, or a little cinnamon. Also, a blister or mustard plaster will be of very great service in some cases. Flannel should be worn next to the skin in all these cases. CHOLERA. As w r e do notpropose making this a " historical" work, only a short chapter will be devoted to the subject of cholera, sim- ply giving its symptoms, its manner of propagation, the meant of prevention, and its treatment. The true nature of this terrible disease is not known. How- ever, such is»not the case with respect, to those conditions of body, and still more with respect to the external circumstances, which favor the attacks of the scourge and foster it into activity. Dirt, bad air, bad water, bad food, insufficient cloth- ing, excitement of any kind, and irregular and vicious habits all favor the production of cholera when the disease is pre vailing as an epidemic; and were it not for these, singly 01 combined, it would, in all probability, become a comparative- ly manageable disease. The symptoms of this disease are pretty generally known, even to the unprofessional reader. However, a reference tc Cholera. 355 the principal or more prominent symptoms, will be in place here. The violence of its symptoms, and the fearful rapidity with which it often terminates life, render cholera one of our most alarming diseases. Occasionally, but more frequently in hot climates than in temperate ones, persons are, as it were, pros- trated at once by the cholera poison, and die, perhaps within an hour of the first attack, without any other symptoms than total collapse of the powers of life. aEore generally the sei- zure is not so sudden : probably there has been slight diarr- hoea, or rumbling movements of the bowels, with sinking 6ensation at the stomach, for some days previously ; or, at nil events, the person has felt unwell. When the disease sets in earnestly, which in the larger proportion of cases it docs dur- ing the night, the patient vomits, and is purged with more or less frequency and violence, the evacuations quickly coming to resemble thin gruel or rice-water; cramps ot the limbs suc- ceed, the surface becomes cold, blue, bathed in sweat, and has, particularly the fingers, a peculiar shrunken appearance ; the tongue is cold, the pulse imperceptible; the urine is suppress- ed, and the voice acquires a peculiar pitch of tone. Many die in this, the collapse stage of the disease ; but if it is passed through, reaction comes on, the surface gets warm, the thirst continues, the quick pulse becomes perceptible, the tongue is dry and brown, and delirium is present ; in short, fever is es- tablished, and may end either in recovery or death. Many persons do wrong, during the prevalence of cholera, by making material changes in their ordinary modes of living, and, by so disordering the regularity of the functions, lay themselves open to attacks of the disease. Of course, if a man is aware that he is habitually indulging in practices injurious to health, such as intemperance, debauchery, &c. &c, he only acts wisely as regards his physical safety in changing those habits ; but it is hazardous to alter regular modes of living, which have hitherto been found compatible with good health — it being understood that whatever tends to lower the stand- ard of health favors the attack of the disease. There is, how- ever, one important precaution which ought to be observed, at all times, but more particularly during the epidemic ot* cho- lera : the perfect purity of the drinking water should be ascertained, and its freedom from all decomposing organic matters made certain. Care is also to be observed not to take active -purgatives, especially salines, such as Epsom or Rochelle salts, seidlitz powders, etc., which produce watery evacuations ; if aperienJ 356 Cholera. medicine is required, it ought to be of a warm character, such as magnesia and rhubarb, with some aromatic, (cinnamon 01 allspice), for whatever produces free action of the bowels apparently increases the susceptibility to attack. For this reason, too, the slightest tendency to diarrhoea should at one* be arrested by a dose of paregoric, or landanam, or what is preferable, a mixture of prepared chalk, one tablespoon ful, cinnamon or allspice powdered, one tablespoonful, white sugar and flonr, one tablespoonful each, water, one wine-glass; pare- foric, two tablespoonfuls ; Cayenne pepper, half a teaspoonful. [ix, and take a teaspoonful every half hour, or as may be needed, and the use of milk ami farinaceous preparations (corn starch, farina, flour, etc.,) containing gelatine, for food. The speedy adoption of these measures, in places distant from medical assistance, might do much to check the disease. Should the astringents above recommended fail, use the reme- dies recommended below. As to the actual treatment of the disease itself, when fully established, many different methods have been proposed and practised, and few of them, perhaps without apparent advan- tage in some cases, but as j'et no treatment which can be called decidedly successful (a cure), has been discovered. The treatment which would be safe in the hands of others than medical men would be about the following : When vomiting and purging have set in, with cramps, give the fol- lowing mixture : Tincture of Cayenne pepper, laudanum, spirits of camphor, of each one ounce ; spirits of hartshorn, half an ounce ; mix together and take one tablespoonful every hour or half hour according to the symptoms. Or give one graiu of opium, one of camphor, one of Cayenne pepper, (made into a pill with a little flour and water) every hour, or as may be needed. The patient should be wrapped at once in a blanket, or flannels next the skin. For the cramps use the following aa a liniment : Tincture of Cayenne pepper, spirits of hartshorn, chloroform, turpentine, or kerosine oil, two ounces of each. Mix and rub over the affected parts with a woolen cloth. Be careful to remove the contents of the chamber from the room immediately 'and bury it in the ground. Also mix with the discharges from the stomach and bowels, as soon as voided, some sulphate of iron (common green vitriol), also dissolve some of the green vitriol in hot water, and set the same in vessels around the room and in the different parts of the house ; and then throw some down the sinks, privy, cellar, and such places, once every day. Keep the sick chamber well aired, and by all means try to cheer and comfort the patient, so as Dysentery, or Bloody Flux. 307 to kv«p up lils spirits. A mixture of mustard and Cayenne pepper moistened with strong vinegar, applied to the stomach and bowels is good to check the vomiting and purging-, or ap- plied to the limbs for cramps. During the prevalence of this disease the greatest care ia necessary in regard to cleanliness, ventilation, etc. (See *' flow to Preserve Health" in first part of this work). It may be mentioned also that warm bricks or warm stones, irons, or hot salt should be applied to the limbs or body where there is coldness or cramps. An injection up the bowels of half a tea- epoonnil of laudanum, four or five tablespoonfuls of brandy oi whisky, with a little thin starch, is often very beneficial in the active stage of this disease, to be repeated if necessary. DYSENTERY or BLOODY FLUX. This differs from f a pint of water, in which has been dissolved twenty grains of sugar of lead, and two grains of opium, may be administered every three or four hours; or injections of allspice tea, cold, in same quantity, »s often a good remedy. DIABETES, or GREAT FLOW OF URINE. In this disease there is discharged an unusual large quantity of urine; sometimes the amount js enormous, and the urine contains a great deal of saccharine (or sweet) matter. The attack of this complaint is generally slow and gradual ; the urine is clear and transparent as spring water, and accompa- nied by a faint smell, as if mixed with rosemary leaves. These bymptoms generally occur without pain, and are usually attended with a voracious or greedy appetite. The serious nature of the affection renders it one of those which should be trusted for treatment only to medical hands. The same reason renders it important that its first symptoms should be known, that they may not be neglected. It may creep on a persor insidiously, or be suddenly developed. The first and mosl prominent symptom which usually awakens attention, is the frequent call to pass urine abundantly, at the same time the thirst is extreme. lr. addition to the symptoms already mentioned, the mouth is dry, and the tongue clammy and sticky, often very red ; there is flatulence and indigestion, and the bowels are generally costive. Emaciation and general debility also occur ; pain and Weakness in the loins, and feebleness of the limbs. The lead ing symptom, however, is the discharge of urine, which hag been known to exceed fc-riy 'pints in the twenty-four hours 562 Dialitts, or Great Flow of Urine. At the commencement of tlie disease the urine may still retair thenrinous properties of the diluted secretion; but this passe? into the saccharine (sweet) condition. If yeast be added tc the urine, it ferments, and alcohol is formed, the sugar par- taking more of the character of grape, or fermentable sugar, than of the cane. Diabetes is often accompanied by other diseases, especially by pulmonary consumption. The dietetic treatment of diabetes is probably of more importance than the medicinal; the chief precaution being the avoidance of what- ever — either sugar of any kind, or vegetable starchy matter- is capable of being converted into grape or fermentable sugar This, of course, involves the prohibition of bread made from ordinary flour, which contains all the starchy matter of the grain. This privation is always much felt and complained of, and various substitutes have been proposed. The following, by Dr. Percy, is probably the best : — " Take sixteen pounds of potatoes, washed true from starch; three-quarters of a pound of mutton suet, half a pound of fresh butter, twelve eggs, half an ounce of carbonate of soda, and two ounces of dilute (half water and half acid) hydrochloric, (muriatic) acid. Thisquan tity to be divided into eight cakes, and baked in a quick oven until nicely browned. " It is, as must be obvious, an expensive article, but with many diabetic patients this will not be an object of considera- tion. It is somewhat improved in taste by being slightly toasted." Animal diet is principally to be depended upon for nour- ishment, and some of the green garden vegetables, such aa rpinach, are permitted. Distilled water, 01 boiled water, but not toast-water, may be used for drink. Dr. Prout, in some cases, found porter beneficial ; and, in France, claret has been given with advantage. Persons who sutler from any suspected tendency to diabetes cannot attend too strictly to the state of the digestive organs. Wet feet must be particularly avoided, and flannel should be worn next to the Bkin ; while all sources of debility must ba guarded against. All that can be done by others than medical men, will be to follow out the directions given above, as regards diet, &c; also keeping the bowels open by mild purgatives, as castor oil, &c, and if there is restlessness at night, twenty drops of laudanum, or a tcaspoouful of paregoric, at bed time. It has been stated by some medical men of eminence that emetics o ipecac, given once a day for a few days, has checked the dioease and the patient has recovered. Jt is worthy of a tru* 1 where you cau uot have the attendance of a medical man. Bloody Urine. 30? BLOODY URINE. Tins is produced by external violence, as blows, bruises, Arc. • or it may be the consequence of violent exercise, as in riding or jumping; or it may be occasioned by the irritation of a etc ne in the kidney or bladder; it may also take place with- out any cause that we are able to ascertain. In some cases, tlie quantity of blood voided is very large, and the debility Id Sliced is very alarming. In the treatment of the disease, we are to be guided by the cause by which it has been produced. When it is occasioned by external violence, we are to dimin- ish inflammatory symptoms by topical bleedings, (leeches, and cupping over the lower part of the abdomen and small of the back,) by giving mild purgatives, and directing the patient to drink largely of diluent drinks, such as flaxseed tea, lemonade, &c, to which a little spirits nitre may be added, in order to dilute the contents of the bladder. If the symptoms lead ua to believe that stone or a gravelly complaint is the cause of the disease, that must be attended t<>, for the treatment of which, see " Gravel." The spontaneous voiding of blood is to be checked by the application of cold to the region of the bladder, and by injecting cold water into the bowels. Small doses of opium, laudanum, or paregoric, may be given to al- lay irritation. Blood is sometimes discharged with the urine. mixed with matter. In all of these cases, a tea made of equal parts of uva ursi and buchu leaves, taken in doses of a wine- glassful, three or four times a day, are the best remedies. RETENTION OF URINE. By this is meant that the urine, though secreted by the kid- neys and conveyed into the bladder, it is not discharged in the usua'. way. The distinguishing symptom is a swelling at the lower part of the belly, occasioned by the distended bladder, and accom- panied by pain on pressure ; fever, and deficiency of urine, either total or partial. Sometimes the bladder may be dis- tended, although there may be a jxirtial flow of urine, and without graat care patients may be deceived by this circum- stance, ii violent efforts at expulsion take place, some por- tions of urine may be discharged, and the patient may be iUf posed merely to labor under a strangury, i^or difficulty in Voiding urine.) By examination of the lower part of the bel ly, and the introduction of the catheter, the disease may, however, almost always be ascertained. Retention of the urine may arise from palsy of the bladder, which is not an unusual occurrence in advanced life. Palsy of the bladder may be owi«g to a person acquiring 364 Svjyression of Urine. the habit of not evacuating tlie bladder when nature prompt* him to do so. Retention of nrine occurs also in tlie malignant forms of typhus fever. It comes on sometimes gradually. with a degree of debility which hinders the patient from com- pletely emptying the bladder, so that he still feels a desire to ao so. The inconvenience increases; at length, the patient is unable to discharge any urine, and the bladder becomes dis- tended. In cases of retention, the urine is to be drawn off by the catheter, and when relief is given by this means, it is not unusual for the bladder to recover its tone; pretty speedily, when the complaint has come suddenly on, and more slowly, when it has been gradual in its progress. In addition to the regular emptying of the bladder by the catheter, we are to try the effect of cold applications to the parts, and of blisters to the lower part of the back. Regularity in the times of passing the urine will have a beneficial effect also. Sometimes ten or twenty drops of tinc- ture of cantharides (Spanish fly,) taken three or four times a day, will excite the bladder to contraction, and the urine be thus thrown off. SUPPRESSION OF URINE. Tim is a condition of the system in which the urine is not secreted in the same quantities as usual; it is in one respect just tlie opposite of Diabetes, or too great a secretion of urine. It is mostly a disea R « of old persons. The symptoms are: the patient passes no water, and if the catheter should be introduc- ed, still none passes; the patient complains of feeling " un- well ;" sometimes there is nausea and restlessness at night; if there is much perspiration, it has the smell of urine. The treatment consists in putting the patient into a warm bath for fifteen or twenty minutes; the application of cups over the kidneys, followed by mustard plasters, or warm fo- mentations of hops, flaxseed meal and slippery elm. Give a dose of Epsom sails or castor oil, and also twenty drops of spi- rits nitre in a little gum-arabic water, every hour. Some times a tea (given cold) made of peach leaves, uva ursi or bu chu, and taken freely, will have the most happy effect. Or a strong tea made of Virginia snake-root, given hot, every hour, to produce perspiration, will 6tart the secretion of the kidneys. Strangury — Diphtheria. SOS STRANGUR Y. This is a frequent desire of mating water, attended with much difficulty and pain in voiding it. It arises from various causes, as an inflammation of the urethra, of the neck of the bladder, or of other neighboring parts; the application of a blaster when the matter of the eantharides is taken into the body, the internal use of eantharides in powder or in tincture; wxcess in drinking wines or spirituous liquors, or from gravel- ly particles in the passage. It is sometimes a symptom of gout, and ver y often arises from disease of the prostate gland, (situated at the neek of the bladder.) "When Btrangury is owing to the application of a blister, the patient should take plentifully of diluent drinks, as barley-water or thin gruel, slippery elm or gum-arabic water; to which a little spirits nitre may be added. In severe cases, fomentations <>r poul- tices to the urethra and neighboring parts may be required; and it will be proper to use injections to evacuate the bowels, as the accumulation in them will increase the strangury, from whatever cause it originates. If the strangury is an attend- ant on inflammation, it must be treated by local blood-letting, by leeches, by cooling purgatives, by fomentations, the warm bath, &c. ; and if from spasm, an opiate (laudanum or pare- goric) by the mouth or by injections, according to age, *fcc, will be proper and beneficial. D IFUTHER I A. This is a peculiar affection, met with mostly in children, and is characterized by a feeling of great prostration and want of appetite ; paleness, dryness, or a feeling of roughness in the throat ; swelling of the tongue and at first, perhaps, a little redness about the palate, &c. This feeling may continue a day or two, or more, before more active symptoms set in. Then, on examining the throat, palate, &c.,it will be observed that they exhibit small, white, or yellowish patches, having a lardy or curdy appearance ; there is also at this time swelling of the glands of the throat, some difficulty in swallowing, (fee. The patches are at first small and distinct from each other, but may soon spread until the inside of the mouth and throat are covered. In a short time a bloody fluid oozes from the affected parts, coloring the spittle. There are also at this time red and inflamed spots or patches on some part of the throat ; some- times it is of a greyish color, and looks as if it had been cauterized or burnt with caustic. There is also, in bad cases, a discharge, of a thin, offensive fluid, sometimes tinged with 366 Diphtheria. bleed from the nostrils and the month; and also at time* bleeding from the nose. Tin's false membrane, or patches, is thrown off from time to time, but is speedily reproduced, though thinner and of a more whitish appearance. Sometimes these patches of false membrane become softened and mixed with th< spittle, or absorbed, instead of being thrown off. This disease, when it terminates fatally, generally does so by the peculiar inflammation extending into the stomach and Vowels, or the lungs. Whitish patches sometimes appear in ordinary sore throat, so that you must not take this as a sure symptom of diphtheria; the latter can be told by the tact that the patches dose, to children, will expel worms after many other remedies fail. I may be used also as a tea, iu colds, etc. 368 inula Helenium, or Elecampane. (THE BOOT.) Tins plant is possessed of pretty energetic tonic properties. It acta likewise as an excitant, owing to the camphorated oil which it contains. It is an excellent article, in combination with others, in colds and coughs, In pulmonary irritation, (as in consumption, etc), and in 6ome forms of indigestion, when it proceeds from a debility of the digestive organs. It may be given in powder, decoction or infusion. Dose of the powder, from half to one drachm ; decoction or infusion (tea), from half an oumf to one ounce, every three or four hours. Z(A Hedeoma Pulegioides, or American Pennyroyal. This is found in all parts of the United States and Canada, in dry woods, plains, etc. The fresh or dried plant chewed and the juice swallowed, is good to expel wind from the stomach ; made into a tea, and taken warm, it produces perspiration very freely. In case of suppressed menstruation from cold or fright, a tea made of this plant, given warm at bed time, often assists nature to restore it ; taken as a tea, mixed with a little spirits, it is good to cure pains and cramps caused by drinking cold water, suppressed perspiration, etc. The tea should be taken strong, warm, and freely. Sanguinaria Canadensis, or Blood Root. (THE root.) This is an emetic (producing vomiting), narcotic (i educing the pulse and quieting the nerves), expectorant (for cough), etc. It must be used with care, to avoid taking an over dose. It is recommended in rheumatism, diseases of the liver, typhoid — pheumonia, coughs, colds, etc. Dose, from one to five grains of the root powdered, and given in the form of a pill, every three or four hours, according to the symptoms, disease, etc. 871 Eupatorium JPerfoliatum, or Boneset. (THE LEAVES AND FLOWERS.) This is a plant found in most parts of the United States. The whole plant is exceedingly bitter ; taken as a tea, warm, it pro- duces vomiting ; taken cold, it acts as a gentle purgative. A wine glass or about a gill of the tea taken cold, half an hour before each meal, acts as an excellent tonic, and will act almost like a charm on some persons who can not take quinine or other tonics. The leaves may be powdered also, and given iD mucilage ; ten or fifteen grains three times a day, as a toni« and alterative. Berbwis Vulgaris, or Barberry. (the bush.) This shrub blossoms in April and May ; the berries ripen in June. The whole shrub, even the root, is acid or sour ; the bark is yellow and bitter. The berries contain a red and very eour juice, that is beneficial in chronic dysentry, or diarrhoea ; also, as a cooling drink mixed with water, sugar, and orange peel, or cinnamon bark ; it is useful in fevers for abating heat and quenching thirst. A syrup may also be made from the hemes or bark ; or a tea may be made of the bark, mixing cin namon or allspice to suit the taste, and give a wine glass, cold, every three hours. The bark or berries added to hard cider, and used freely three times a day, are recommended in disease* of the liver. 373 Aralia Racemosa, or Common Spikenard. (the root.) This grows in deep woods and good soils, from Kew England to the far South and West. The root is a healing pectoral, stimu' lant cordial, and causing gentle perspiration. It is much used by the Indians ; the roots bruised, chewed, or pulverized is used by them in all kinds of sores, bruises, and ulcers. In coughs and colds the root may be used freely, boiled in syrup ; or i may be used as a tea, cold, mixed with flaxseed-tea, lemonade, or toast-water, when the cough is troublesome. A little piece of the root chewed and the juice swallowed is also beneficial in allaying a tickling cough 374 Cornus Sevicea, or Rose Willow (THE BAKK.) This grows near brooks, along the hanks of rivers, and on upland Keadows; it is known throughout the United States by vhe name of red rose-willow, which distinguishes il from the hlacl- tcilbte, or the pvss wil- fett, which grows in swamps, and along the sides of moist meadows. It is a powerful attringent and tonic— preferred by some to the Peruvian hark or Coluuibo Root, and is much employed in the Northern States, in substanc* or oth( rwise, in diarrhOBa and dyspepsia. In vomiting, this is an excellenl reraedv, given in the form of an infusion ; in the vomiting particularl) arising from pregnancy. This is a valuable article. It is mostly admin- istered in the form of infusion, or tea, given cold. 375 Lsclepiaa Tuberosa, or Pleurisy Root. (THE ROOT.) This is a valuable popular remedy, and a mild sudorific (causing sweat- ing) acting safely, without producing any stimulating effect upon the body. Its action is specifically upon the lungs, to assist suppressed expectoration, aud to relieve the difficult breathing of patients laboring under pleurisy. It relieves difficulty of breathing aud pains in the chest. It sometimes acts as a mild purgative, aud is suitable to the complaints of children. In low stages of typhus fever, and other diseases of a like nature, it has been known to excite perspiration when other medicines have failed. Front twenty grains to a drachm of the root, in powder, may be given several times a day ; but as a diaphoretic (to produce sweating), it is be** given in decoction or infusion (tea), made in the proportion of an ounce U, the quart of water, and given in the dose of a teacupral every two 01 throe hours till it operates. 376 Liatris, or Devil's Bit. (TBS BOOT.) Tanacetum Vttlgare, or Tansey- (THE LEAVES.) Liatris; or, Devil's Bit. (The Root.) The root of this plant has a bitterish, pun- gent, spicy taste, and smells like turpentine or juniper. It is a powerful diuretic (acting on the kidneys) yet acting mildly, and may be used freely without danger ; it also acts ob a diaphoretic, producing perspiration ; and is also a tonic, strengthening the system; it is also good bruised, and applied to ulcers, sores, etc. It is a useful medicine in dropsy, sore throat, gravel, scrofula, etc. A wineglass full of the tea, or infusion (cold), given every three hours, is good to operate on the kidneys, or taken warm tc produce perspiration ; or three times a day (cold) before meals as a tonic ; or ten grain* of the powder may be given three times a day in syruc Tanacetdm Vcloark; or Tansey. (The Leaves.) This grows in moist pastur«6 edge of cornfields, and is cultivated in gardens. Given in the form of tea, warm, ^mt not too strong, it produces perspiration freely, and is good in debilitated person*; a wine-glass may be taken, cold, three times a day in dropsy, hysterics, and disease ei the kidneys. It is good taken warm to excel wind from the stomach. fflttjl Aspidium Filix Mass, or Male Fern. (THE BOOT.) This plant grows in shady pine forests from New Jersey to "Virginia ; It is likewise a native of Europe, Asia and North of Africa. It is used as a remedy against tape worm. Dose of the powdered root from one to two teaspoonfuls, given with powdered white sugar, white of egg, beat up, or the thick juice or water of slippery elm ; this dose to be re peated night and morning for two days ; then give a brisk purgative of castor oil, and should that not operate in three hours, give a dose ol Ep*om or Rochelle salts 378 Cassia Senna, or Alexandria Senna. (THK leaves ) This is a very useful cathartic, operating effectually and mildly. It is necessary to combine this article with other in- gredients, such as manna, aniseed, etc., to prevent its griping effects. It is often administered, principally in the form of in- fusion. Infusion of Senna is made thus : Take of Senna leaves an ounce and a half; ginger root, sliced, a drachm; aniseeds or caraway seeds, a drachm; boiling water, a pint. Macerate (keep warm) for an hour in a covered vessel, and strain the liquor. Take one half for a dose, the balance to be taken in three hours if necessary. 379 Arislotoch ia Se rperitaria, or Virginia Snake Hoot. Asclepias Syriaca, Ov Common Silk Weed. Arislotochia Serpentania ; or, Virginia Snake Root. (The Root.) This was first Introduced as a remedy against snake bites, from which it derives its name, and was used by the Indians for that purpose. It possesses powerful and lasting stimulant virtues; Dut besides this general action, it acts also on the skin, producing perspiration. It is very useful in all cases where there is not active inflammation, in promoting perspiration, especially in typhoid fevers, etc. Dose of the powder, ten to twenty grains, in syrup or flaxseed-tea ; or it may be used as an infusion (or tea), which is preferable, putting half an ounce to a pint of boiling water ; of which four or five tablespoonfuls may be girex every three or four hours. Asclepias Syriaca ; or Common Silk Weed. (The Root.) This plant, growin plentifully throughout the United States, along roadsides and sandy grounds, is a pow erful diuretic (operating on the kidneys), and is useful in dropsy. Boil eight ounces ol the root in six quarts of rain water down to three quarts; strain before using. For dropsy, take a gill of this decoction four times a day, increasing the dose, or otherwise, according to the symptoms. It is used the same way for suppression of urine. It may b« taken ia powder, twenty to thirty grains three times a day. 3S0 Crocus Sativus, or Garden Saffron. Is small doses, saffron is employed as a diaphoretic, soon causing per- bpiration ; in large doses, it acts upon the whole animal economy in the same way as a stimulus. It extends its action considerably to the uterus, (won b.) It is useful to allay the lumbar pains (in the back) which ac- company menstruation In 6ome females. It is useful also in ch.orosis or jrreen sickness, hysterics, r spasms, &c.) Dose— In powder, twelve grains. To make an Infusion, put half t« one drachm, in one pint of boiling water; let stand half an hour; give i wine glass full every two hours. It is very valuable in all eruptive distaso-i, •och as measles, small pox, &c. 381 lTyoscyamus Niger, or Black Henbane. (the plant.) Tms is an annual plant, native of Europe, but grows plentifully in this country, along road-sides and among rubbish, flowering in July. This plant applied externally, made into a poultice or fomentation, is useful to allay pain in all cases of obstinate and painful inflammations, such as boils, fistulas, eore throat, and swelling of the breast. The dose and manner of administration, internally, will be found under the head of Medicines, their doses and uses ; and also in the treatmeat of varions forms of diseases treated of in this work. 382 Scutillaria Lateri folia, or Scull Cap. (THE PLANT.) This is found in all parts of the United States, in meadows, woods, near water, &c, flowering in the summer. It is highly recommended for St. Vitus' Dance, given in the form of tea, (cold,) a wine glass full, or more, three times a day on an empty stomach. Given in the same way, it is highly ro commended also for worms, to be followed the third day by a purge of castor oil. The plant or leaves may also be powdered, a^id givou ir doees of from ten to fifteen grains three time? & day. 383 LIST OF MEDICINES. Their Doses and Uses. Proper Time to Give Medicines. — This is a matter of con- siderable importance, and should not be overlooked. There are certain times of the day more convenient than others for giving some medicines. Purgative medicines should, in grcneral, be given late at night, or early in the morning; the towels not being so easily acted upon during the time of sleep ; for this reason pills and other medicines which do not aot speedily, when given in the evening, have time to dissolve fully, and to produce their due effect on the bowels. Saline purgatives, such as salts, &c, are best given in the day time, that the cooler state of the surface may determine their action tc the kidneys. Emetics are best given in the evening, as tl.ey produce tendency to sleep and perspiration, which are b;st encouraged by retiring to bed. Medicines for verspira- thn should not be given during the process of digestion. QUALIFICATIONS OF ATTENDANTS ON THE SICK. There is very little doubt but that recovery from sickness depends materially on the nurse, or attendants upon patients, as well upon refraining from officious interference, as giving tamely attention. All the necessary qualifications can seldom be found in any on-e ; but the nearer they can be got to follow the following directions, the better : Great attention to cleanliness of the mouth, the body, the bed, and the room ; often washing the mouth, and speedily removing all filth ; changing the clothes with as little labor to the sick as possible, being^ careful not to give them cold — the greater the perspiration, the more frequently changing will be necessary. Keep the room always of a moderate degree of warmth, regulated by the season, with that all-important article, more wanted in sickness than in health, fresh air, to be gently admitted without & current, and no bed-curtains being allowed. Keep quiet ; disturb the sick as little as possible, by talking or making any kind of noise ; never communicate anv bad news, — remembering that perfect rest lo the patient is of great importance. Administer with faithfulness, and in the most palatable Btatfc, the medicines prescribed, and observe their effects: which report to the prescribes Unpalatable pills may safely be surrounded by a thin piece of paper, jelly, or gold leaf; the 3S4 List of Medicines, grreat disgust to medicine being frequently caused by the nauseating manner in which it is given. Have in readiness a bed-pan, and never suffer the patient hen very weak, to sit up on it long, as in that state they may expire from exhaustion. A cheap and ready mode at all times, of making a proper pan, would be to saw down a pai) or bucket to a depth of three inches, on which a top can be placed, with a hole in it like that of a privy. _ This of course applies to situations in which no better facilities are at hand. Keep constantly a supply of various articles for drink, in a proper state of the weak 'kind of teas, in addition to such medicinal drinks as are prescribed, which, when solely en- forced, prove disgusting; remember to give but small Siantities at a time; not very cold, as they increase thirst. rinks can be made of any of the garden herbs generally used for teas ; of toasted bread, barley, of apples, cut up in water of gruel, elm-bark, flax-seed, of lemonade, of chicken, or lean fresh meats, of tamarinds, vinegar, or cream of tartar, of cur- rant jelly ; in short, of any thing used in families, possessing no stimulating powers. Spirits, in any state of combination, wine, porter, cider, and the like stimulating drinks, unless particularly directed or called for from fainting or the disease of the patient, must be carefully avoided. Diet is a subject too, to which the nurse should pay the greatest attention. As this must vary with each varying state of the system, it is impossible to give any further directions in this place, than to state that in high fevers, it should be very moderate, entirely of small quantities of vegetables, and that in low fevers, it should be of well-seasoned, palatable food ; the more like that the sick person had been accustomed to, the better ; but take care to give it often, and little at a time, as a full meal, in such states of system, often produces death. INJECTIONS. Administer an injection when required, of whatever article directed. These often operate only by their bulk ; and, un- less given as medicine, their component parts are not mate- rial ; they are generally made of warm water, with salt, or soap, or sugar, or oil, and tho common syringe is the instru- ment generally used ; but the best kind is what is called the Rubber Extension Syringe, to be found now in most drug 6tores. In order to give it, the patient should be laid on the side at the edge of the bed, a little over the edge, the kneea drawn up near the belly, and then the pipe, with the finger before it, is to be applied to the fundament ; and on pushing Their Doses and Uses, 3S5 I in, [he finger is to be taken away. It is gently to be pushed a little backwards, or towards the back bone, and then the 3<>u tents is to be forced out with one hand while with the other !l •• syringe is firmly held. It only requires that the- injection *hroperly applied, otherwise it is worse than useless. If, there- ore, none but the surgeon can undertake the task, it neces- sitates a much more frequent attendance on his part, than might otherwise be requisite. In general, the first few appli- cations of a bandage will be made by the medical attendant himself, and ought to be in the presence of the individual to whom the duty may be afterward deputed. By careful atten- tion on the one hand, and kind explanation on the other, much may be learned and taught, but not all, as the inexpe- rienced bandager will discover on the first attempt. By all means, therefore, let the first attempt be made on some ons in health, before the call is made to the invalid. Attention to the following directions will facilitate the application of the previous practical lesson, or in some measure supply its place, if from circumstances it has been wanting. Whatever the material, the width of the bandage or roller must be pro- portioned, in some degree, to the size of the part to which it is to be applied. If too narrow, it is apt to be stringy, and to cut ; if too broad, it does not adapt itself readily to the inequalities, and the pressure is unequal. For an ordinary sized adult male leg, a bandage of 2| inches broad is a good proportion ; for the arm of the same person, one of two inches ought to be sufficiently well adapted. The material for bandages must neither be too strong nor too weak ; ordinary " shirting " or " calico " is a very convenient texture. The length, of course, must vary according to what is required, but rollers are usually put up in six or eight yard lengths ; they are better torn in one continuous strip, free from joinings, and without 6elvage edge. The strip, when prepared for use, must be rolled up as firmly as possible, into a single head. If the bandage is a new one, of calico or linen, the loose threads of the roll at each end must be roved off, otherwise they become troublesome when the roller is applied. Bandages may be applied in simple circles (B), in spiral, etc., or in reverses (C). They are also applied in various other forms, to suit the differ ent portions of the body. In applying a bandage, the rolled up strip being held in the right hand, the end which is com menced with is secured by the first turn. If it be the simple circular bandage, round the trunk of the body, or round a limb of nearly equal girth throughout, either naturally or from swelling, the roller is carried round and round, each suc- ceeding turn slightly overlapping the one before it. If the 390 How to Apply Bandages. spiral bandage be required, the rolls are carried up very obliquely; bat it', as most likely, it is the reversed bandage, then wherever the inequality of the parts prevents its being laid on flatly and evenly, the bandage must be turned upon itself (C), so as to become reversed, the surface of the cloth which was next the skin being turned outward, and vice versa. It is difficult to describe the manoeuvre, and it is a ittle difficult at first to execute it neatly and well ; but when practised, it becomes perfectly simple. This is by far the most useful form of bandage, and a person who can put it on well, will have but little difficulty in accomplishing the other varieties. For the purpose of retaining dressings upon the head, nothing answers better than a close-fitting calico cap ; a handkerchief will often serve every purpose, or the split cloth may be used ; applied as seen in the engraving, by the upper tails being brought beneath the under ones, and fas- tened under the chin, the under tails being cairied to the back of the head. When it is desirable to retain the head in vne position, it may be done by bands attached to a cap, and fastened as required to a band going round the chest. When tor this purpose, or to fix a broken rib, such a band is requir- ed, it ought to be from eight to ten inches wide, made of toler« ably strong double calico, and sewed firmly round the body. To retain a pad or poultice in the aimpit, a good sized handkerchief answers better than any bandage, the middle being placed at the armpit, the ends crossed, at the side of the neck opposite, carried under the corresponding armpit, crossed and brought and tied on the shoulder. For the groin and parts adjacent, the spica, or figure of 8 bandage, is also used. A roller eight yards long is taken, the end secured by one or two turns round the pelvis (hips), and then the band- age is brought down across the front of the thigh, carried evenly between the legs, and again brought up and carried round the pelvis : this being repeated at each turn till the roller is exhausted. As a general rule, leg bandages, habit- oally worn, ought to be put on before the individual gets out of bed in the morning. A bandage which gives pain after its application, without obvious cause, ought to be taken off, and be reapplied. If there is reason to suspect inflammatory swelling beneath, it will be well to try the use of cold water before disturbing matters. There is some little management required in taking off a roller, as well as putting it on. As each successive turn is unrolled, it should be gathered in a bunch in the hand, and not, as is often done, three or four yards of bandage at full length pulled round the limb every tiino. 301 CLASSIFICATION OF MEDICINES, Tub medicines wanted for common use are very few: although snch ao immense variety is to be found in apothecary shops. They are all arrang- ed under different heads, according to their most conspicuous effects upon the system. Under each head will be mentioned those deemed most im- portant in common use. Remember that in taking medicine of any particular kind, the system becomes habituated to it, and requires an increased dote ; therefore, medi- cines of similar nature ought often, when practicable, be substituted for the f^e previously taken. The doses stated are for adults— the ratio of doses for children will be found under Tabular list of Medicines. rTJR GATIVES.— Medicines which Open the Boiuels. Saline Purgatives, (or Sa Its.)— Epsom salts, Glauber salts, Roohelle salts. Dose of each one ounce, (about one tablespoonful) given dissolved in a glass or cup of cold water, on an empty stomach, the morning being pre- ferable. Dose for children, about half the above quantities, or less, ac- cording to age. Seidlitz Powders. — The contents of one blue and one white paper, taken on an empty stomach, or the contents of two blue and two white papers may be taken ; directions go with the seidlitz powders ; for children about half do^es. Phosphate of Soda. — This is a tasteless salt, and on that account is well adapted to children, as it can be given in soup, or beef tea; dose from one to two teaspoonfuls. Castor Oil. — This is a standard article, the world over, almost. Dose from one to three tablespoonfuls for a grown person, and children in pro- portion to the age. To prevent castor oil from griping, let it be taken with a few drops of essence of peppermint or cinnamon and some loaf sugar ; or for grown persons it may be given in some cold coftee or le- monade. Senna Leaves. — A small handful (three drachms) steeped in half pint of water for an hour, (like tea,) a few caraway seeds, some orange or lemon peel, tamarinds or sassafras bark, added to the senna, prevents it, to a great extent, from griping. This is not a suitable purge for children. Sca'.nmony — In powder ; dose from three to ten grains, for grown per- sons. Jalap — In powder ; dose from ten to twenty grains. Gamboge — Dose from two to five grains, in powder. Rhubarb — The powdered root ; dose from ten to twenty grains. Cream of Tartar and Sulphur — Mix one tablespoonful of sulphur with two of cream of tartar, to be taken in a glass of cold water on an empty stomach ; or for children, take the above quantities of each, mix thorough- ly with syrup or molasses, and give one half in the course of the day ; the balance the next day, if needed. Aloes — Dose in powder, five to fifteen grains, in tincture, one to two tablespooufuls ; for children, half the dose. 802 Classification if Medicines. Calomel, is not often given alone as a purgative, except in cases of grest Irritability of the stomach ; five to ten grains, in a pill, will sometimes re- main on the stomach when nothing else will. Some other purge must always be given in twelve hours to carry ofl* the calomel, to prevent sali- t/i. Art ire or Brink Purgative — Talap, ten to twenty grains; cream of tar- tar, thirty grains, for a grown person. Manna, is a good purgative for children; dose from one lalf to two drachms, according to age. Castor Oil Mixture — Powdered gutn-arahic. a heaping teaspoonful, po* dered white Bugar, two teaspoonfnls; peppermint or cinnamon water, two ounces; mix these together, and add a tablespoonful or two of castor oil, or less, of course, for children. (The peppermint and cinnamon water is made by dropping a few drops of the eetenee into cold water.) Oil of Turpentine and Castor Oil— Take two drachms of turpentine, and six or eight drachms of castor oil ; mix them well together, for a dose. This combination is proper, when a prompt action on the bowels is re quired, as in affections of the brain, &c. Purging Draught — Take of Epsom salt, Glauber's salt, each two drachms; mint-water, an ounce and a half; antimonial wine, forty or fifty drops; tincture of senna, two drachms. Mix. This is a very valuable and effectual purgative for all acute diseases, and most common purposes. If a purgative which will operate quickly and actively be required, the following will be found useful : Compound Senna Tea — Take of senna leaves, one ounce ; manna, hall an ounce; cream of tartar, five drachms; cinnamon bark, half an ounce- boiling water, a pint and a half. Infuse for two hours. The dose is a wiceglassfu] every two or three hours. Pith of Rhubarb and Soap. — Take of powdered rhubarb, one drachm ; white soap, ten grains; with water enough to mix into a soft mass. Di- vide into fifteen pills; dose, two to four at bedtime, for a gentle pur- gative. Laxative Powder. — Take of pow r dered rhubarb, twenty grains ; calcined magnesia, ten grains; essence of cinnamon, ten drops. Mix. A good mixture in acidity of the stomach or bowels, when £. gentle purgative is needed. EMETICS, or Medicines that produce Vomiting. Ipecac, the powder; dose, from fifteen to twenty grains. Put the ipe- cac in half pint of warm water, and let the patient take about tour table- spoonfuls every five minutes, until vomiting is produced. Drinking freely of warm water, during the intervals, assists the effeois of the medicines For children, one-fourth to two-thirds the dose, according to the age. Syrup of Ipecac, for children, is the best : half a teaspoonful every ten or twenty minutes, or oftener, if necessary, will have the desired effect Wt 11 e of Ipecac, is given in doses from one to two teaspooufuls, every half hour. Tarler Emetic. — Dose, dissolve two grains in four ounces of hot water; a tablespoonful every ten minutes. It, is not safe for children. Antimonial Wiue — Two teaspooufuls every ten minutes White Vitriol, (Sulphate ot Zinc.)— Thirty grains dissolved in water, in cases where a speedy emetic is wanted, as in poisoning. Tickling the throat with a feather, will often produce vomiting at Dnce, ic cases of poisoning, &c Ground Mustard— A teaspoonful or two mixed in a gill of water, is an active emetic in cases requiring prompt vomiting. Classification of Medicines. 393 LAXATIVE AND PURGATIVE INJECTIONS. For Grown Persons. Take of common salt, a dessert-spoonful ; tepid water, or water-grueL, a pint; add a tablespoonful of sweet oil, or melted butter. A more active injection is made as follows ; Take a strong infusion (<>r tea) of senna, a pint; Glauber's salt, or Ep- som salt, an ounce and a half. Sometimes, to increase the purgative yffeot, a spoonful of oil of turpentine may be added. For Infants and Children. Injections may be made in the same way as for adults, diminishing the quantity of fluid, and keeping out a portion of the stimulating ingredient, whether salts or senna CARMINATIVES, or Medicines to Expel ftiud. For Grown Persons. Ten or fifteen drops of the Essence of Peppermint, on a small bit of sugar. AssafwtiJn Pill*, three at bed-time. Carminative Injection. — Take of infusion of senna, eight ounces; dis- solve in this infusion, assafoetida, a teaspoon ful and a half; add pepper- mint water, one ounce. To be mixed together, and thrown up, pretty warm. For Infants and Children. Sweetened Cinnamon or Aniseed Water, one or two teaspoonfula every half hour. Essence of Peppermint, from one to three drops, every half hour. A tea made of caraway, dill or fennel seeds; or calamus root, chewed and swallowed, as well as hartshorn, 10 drops in water, are all good medicines of tins class. „ DIURETICS, or Medicines that promote the flow of Urine, For Grown Persons. Take of cream of tartar, one drachm; borax, half a drachm. Mix. Dissolve in three ounces of tepid water ; this quantity to be taken three times a day. Sweet Spirits of Nitre — A teaspoonful in warm water, four or five times a day. Acetate of Potass — From twenty grains to a drachm three tinves a day. Nitrate of Potass, (saltpetre) — Thirty to sixty grains in a pint of gruel. This quantity to be used as a common drink in the twenty-four hours. Gil of Juniper — Four drops on white sugar, three times a day. Sjuill — One grain in powder, mixed with powdered cinnamon, three times a day ; or, two grains of squill, with ten grains of powdered nitre, to be mixed in sugar and water, or molasses, and repeated twice 01 three times a day. Diuretic Mixture. — Take of sweet spirits of nitre, one ounce; tincture of squill, two drachms. Mix. Dose, a teaspoonful five or six times a day, given in a teacupful of the following, namely : juniper berries, bruised. 394 Classification of Medicines. one ounce ; and cream of tartar, half an ounce ; infused in a pint of boil ing water. Infusion of Juniper Berries in Cider. — Take of bruised juniper berries, mustard seed, and ginger root, of each half an ounce; grated horse-rad- ish and parsley root, of each one ounce; and infuse them in a quart of hard cider. The dose is a wine-glassful, three or four times a day. This Infusion has been found useful in oases of general dropsy occurring in pa- tients very tnnch debilitated and unconnected with inflammation, or disorganization of any internal organ. When fever or indamma.ion is present, it would be improper. Carbonate of Potash — Half drachm in a pint of water. Dose, twe tablespoonfnls every two hours. Cream Tartar — One ounce in a gallon of water ; to be drank during the twenty-four hours. Oil of Turpentine — One to two teaspoonfuls, three times a day. For Infants and Children. Nitrate of Potass, (saltpetre) one drachm ; water, eight ounces. Dis- solve, and Bweeten with refined sugar. Dose, from a teaspoonful to a tablespoon fill every three hours, till the water flows freely. Street Spirits of Nitre, one teaspoonful; water, three ounces. To be mixed together, and a little syrup added. A table8poonful every two hours. A drink made by dissolving a drachm of cream of tartar in a quart of boiling water, and sweetening it with sugar, may be used, to increase tho irine. DIAPIIORETICS, or Medicines to produce Perspiration or Sweating. For Grown Persons. By regulating the doses of the following medicines, and the drink of the patient, as also the quantity of his bed-clothes, we can produce a perspira- tion mow or less copious. Antimonial Medicines are excellent diaphoretics. A grain of tartar emetic may be dissolved in five ounces of hot water; and a tablespoonful of this solution given every two hours, will generally occasion perspiration. Or James's powder, three or four grains, in honey, jelly, or marmalade, every three hours. Diaphoretic fever powdtr. — Take of nitre, powdered, one drachm ; tartar emetic, one grain ; gum-arabic, half a drachm ; for twelve powders ; ons to be taken every three hours. A mixture of narcotic and emetic medicines, makes an excellent sudo- rific or sweating medicine. Such are Dover's powder, and the diaphoretic draught, made by adding thirty drops of laudanum to forty drops of anti- menial wine, and the same quantity of sweet spirits of nitre, to be taker in an ounce of cinnamon or peppermint water. These combinations of opium should ho avoided when the skin is »erj hot and dry ; hut they may lie used in rheumatism and other feverisL iis orders, alter the violent excitement is in some degree removed. Camphor. — Two grains of camphor reduced to powder by the help of 9 little alcohol or whisky, and hull' a grain <>f opium, made into a oolus ; to oe repeated only once or twice at the interval of four hours. Diluted Acetate of Ammonia, (Spirit of Mindererus) from two drachm Classification of Medicines. 805 10 half an ounce, in an equal quantity of water, every tliree hours. (Spi- rit of mindererus can be made by dissolving a teaspoonful of carbonate of ammonia in a teacupful of vinegar.) Saline Mixture. — Take of the fresh juioe of lemons, one ounce and t half; and of the sub-carbonate of potassa, or chlorate of potash, twenty grains; then add, of white sugar, one or two drachms; of tartar emetic, one grain ; and of pure water, an ounce and a half, and the same quantity of cinnamon water. Dose, a tablespoonful every two hours. This is an excellent prescription in most cases of fever. Diminished doses of Ipecac may also be used to promote perspiration. For Infants and Children. Antimonial Wine — From four to ten drops, in a teaspoonful of tepid water, every two hours. Take of tartaric acid, one drachm; carbonate of potass, four scruples. Dissolve each of them separately in an ounce of water, add them together, and, when the effervescence is over, add, syrup, two drachms; cinnamon water, half an ounce; water, four ounces. Dose, a teaspoonful every two hours. Diaphoretic Mixture. — Take of sweet spirits of nitre, four drachms; water, two ounces; cinnamon water, two ounces; sugar, four drachma; tartar emetic, one grain. Mix. Dose, a teaspoonful every three or four hours. A tea made of Virginia snake root, or pleurisy root, or boneset, is good for sweating. E XP E C T O It A y T S , To bring Phlegm from the Lungs. Squill. — The powder of the dried root, one grain night aud morning, made into pills with powdered cinnamon and ginger. Or vinegar of squill, a small teaspoonful, with simple syrup, in a litle peppermint water tliree times a day. Ipecac. — One grain three times a day, made into lozenges. Sulphate of Zinc. — One grain, with powdered ginger, twice a day. The Steam of Hot Water and Bitter Herbs, such as hoarehound, sage, &c, inhaled into the lungs. Expectorant Mixture. — Take of mucilage of gum arabic, four ounces; syrup of squill, four drachms; tarter emetic, two grains; sweet spirits of nitre, three drachms. Mix. A teaspoonful to be taken every three hours. Brown Mixture. — Take of the powdered extract of liquorice and of powdered gum arabic, of each two drachms ; dissolve in four ounces of warm water; then add sweet spirits of nitre, two drachms; tartar emetic, one grain ; and laudanum, forty to sixty drops, or paregoric, one tea- ■poonful. Mix. The dose is a table-spoonful every four hours. This is a good prescription in cases of catarrh, towards the decline of the disease, when a troublesome cough still remains. Expectorant Pills. — Take of extract of henbane, eight grains; extract o belladonna, one grain ; powdered ipecac, four grains ; for eight pills Dose, one every three hours. 396 Classification of Medicines. A 11 S O It B E NT MEDICINES, (h Correctors of Acidity in the Stomach, and of Heartburn. For Grown Persons, Cirlmnate of Potass, or carbonate of soda, froiri ten to thirty grains, Ir water. Prewired Chalk, when the bowels are loose; from twenty grains to two drachms in cinnamon water, or milk. Calcined Magnesia, when the bowels are costive: to be taken in the same way. The above two articles meeting with an acid in the stomach form 9 neutral salt : that with chalk is binding; with magnesia laxative. Lime Water. — A small wine-glassful, with three table-spoonfuls of millr, three times a day For Infants and Children. Calcined Magnesia, or Prepared Chalk, m iy be given in milk or any liquid, or mixed with the food, in doses of from three to ten grains. AN OD YNES , Medicines to allay Pain, and procure Sleep. For Grown Persons. Opium. — One or two grains. Tt can he made into a pill without any addition. Opiate pills may be made also by taking equal weights of opium and powdered cinnamon, and forming them inro amass with simple syrup. This mass may he divided, so as to make the pills to contain each one grain of opium. Paregoric may be given as an anodyne; half to one teaspoonful. Anodyne Draught. — Take of laudanum, thirty drops; cinnamon water, one ounce. To be sweetened with dissolved jelly or syrup, aud taken at once. Or, sulphate of morphia, two grains; cinnamon water, four ounces sugar, one drachm. Dose, a teaspoonful every three hours. Anodyne Injection. — To one ounce of olive oil, and three of thin madt starch, add thirty, forty, or sixty drops of laudanum, and mix the whole well together. This injection is particularly useful in cases in which there is great irritation about the lower part of the bowel, bladder or urinary passages and in dysentery and diarrhoea, after proper evacuations. The relief obtained is sometimes almost instantaneous. When opium binds the bowels too much, Henhane in extract or tincture nr.ay be used in larger doses than opium ; three grains of the extract, or a drachm of the tincture. A strong tea made of hops, a few spoonfuls every two hours, is also good. For Infants and Children. Opiates are so hazardous, that we feel reluctant to sanction thfl nse ol any one of them internally, but from three to ten drops of paregoric, aocording to age, given at bed time, may he considered sate. For eternal use, Anodyne lUdsam, or the nurture of soap with opium, rubbed on the belly or along the spine, in the quantity of a table-spoonfu^ In many cases allays pain wry effectually. Classification of Medicines. 397 ASTRINGENTS, Or Medicines to lessen Discharges of Fluids. For Grown Persons. In Looseness nf the Bowels ; after being sure that they are cleared of a!] rritating matter, as much as possible. Astringent Drops. — Take of tincture of rhubarb, two teaspoonfuls; laud a nam, one teaspoonful. Mix them together. Thirty-six drops to be taken four times a day in a little water. Chalk Mixture. — Take of prepared chalk, one ounce ; refined sugar, hah an ounce; mucilage of gum arabic, two ounces. Mix together, and then gradutuiy add, of water, two pints and a half; cinnamon water, two ounces. Of tLis, a small cupful may be taken four times a day ; and if it ho thought necessary to increase its astringent power, ten drops of laudanum, or half a teaspoouful of the tincture of kino, may be added to each dose. Astringents, in discharges of Blood from the Lungs or Womb. Infuse a handful of dried Red Rose Leaves in a quart of boiling water for half an hour. Strain off the liquor, and add of diluted sulphuric acid, thirty drops; simple syrup, two ounces. A table-spoonful to be taken every two bours, when necessary, during a discharge of blood. Other measures at th* same time being employed for the cure of the disease. Astringents, to be thrown into the Vagina for the cure of Whites. Thirty grains of White Vitriol dissolved in a pint of water. Or, take of oak bark, two ounces; water, two pints. Boil to one pint; to which, when strained, add one drachm of alum. Inject half a pint up tha parts three times a day. ASTRINGENTS, to check Looseness of Children. Astringent Mixture. — Take of best Turkey rhubarb, twenty grains ; pre- pared chalk, one drachm; Dover's powder, ten grains; simple cinnamon water, Wf an ounce; spring water, two ounces and a half. Mix them carefully. Dose, from one to two teaspoonfuls every six hours. This is found particularly useful in some cases of habitual looseness. Stronger Astringent Mixture. — Take of tincture of catechu, two drachms ; prepared chalk, half an ounce; simple cinnamon water, one ounce ; spring water, five ounces. Mix them. Dose, from two teaspoonfuls to a table-spoonful every three or four hours. This may be rendered still more powerful in checking debilitating looseness, by the addition of a small proportion of laudanum to each dose. For Grown Persons. Nut Galls in powder. The dose from ten to twenty grains. Black-Berry Root. That of the running brier, called Dew Beiry, is the best. An ounce of it bruised and put in a pint of boiling water. Th dose about half a cupful, three or four times a day. Alum. Dose five to ten grains : also small doses of rhubarb. White Oak and Chestnut Bark, in substance or strong decoction, are powerful astringents. Gum Kino and Catechu come under this head. The dose of either is from five to ten grains. 398 Clasdfication of. Medicine. Lime Water, particularly when acid exists in tlie stomach, h.is a slmila. effect. The iloae is n half teaenpful, with an equal quantity of milk. Common & Ut. A table-spoonful has been recommended to stop bleed mg of the lungs. The <>ist- may be repeated. Charcoal in powder, in small doses has an astringent effect upon the bowels: also when applied tu bleeding parts — as the nose, gums. etc. Cold 1\'nic, in doses of two tablespoonfuls three times a day. Gentian Root and Quassia are among the strongest bitters. A very com- mon bitter tincture is made of two ounces of gentian, one ounce of orange- peel, and half an ounce of cascarilla bark in a quart of spirit or wine ; and it is a tonic. Dose, one tahlespoonful three times a day. Bitters, in general give tone to the system ; and among thoso most used are — Chamomile Flowers, Hops, Virginia Snake Root, fforehound, and Worm- vood, separately, or in combination made in strong tea, or added to wine or spirit, make agreeable and mild bitters. Charcoal in powder, in doses of a teaspoonful once in two hours, hat been found a valuable tonic. Nitric Acid. This is a most powerful tonic; especially in chronic affec- tions of the liver, etc It is generally given a teaspoonful in the course of a day, diluted in a quart or more of water, and sweetened to render It palatable. To be drank through a quill, to save the teeth. Iron has long been considered as a tonic, not only when in sr.bstance. but when it solution, as in the state of chalybeate waters. The filings of iron were once much used ; but a better form is the Bust of Iron, in dose* from five to ten grains three times a day. Green Vitriol. Dose from two to four grains, twice a day. Classification of Medicines. 39& Tincture of St'tl. Dose from fifteen to thirty drops, throe times a day. C-halybeate Waters owe their strengihenin^ qualities to iron, which is dissolved by the agency of fixed air. By putting a tow grains of the ruKl of iron in a bottJe, and having it filled with the common S,„ln Wat,,- as ii ■8 called, as val ndde a chalybeate drink may be had as from any of our springs, to whi?h so many resort. Ionics are rot to be given in high fevers, and the following rules should be observed in recovering from sickness: Let the die*, of the patient be accommodated to the state of the system. After recovering from violent disease — it should at lirst consist of the lightest vegetable matter, as rice, tapioca, arrow-root, and sago, also Irish potatoes. Then eggs, oysters, wild fowl, poultry, and finally beef and mutton, generally selecting the articles most agreeable. The patient should eat often and in small quantities, and solid food is generally pre- ferable, and should be prepared as plain as possible. WORM MEDICINES, Except Rochel'.*?, Epsom or Glauber Salts, almost any purgative may be nsed to expel worms. Take of calomel, four grains; powdered jalap, four grains; powdered aloes, three grains. To be mixed together and given in jelly, honey, or conserve of rosos, at bed time, followed next morning by a dose of castor oil. Five grains of aloes, with four of soda, taken at bed time, and followed next morning by a tea-cupful of strong infusion of senna-tea. A teaspoonful of common salt, taken in the morning, when the stomach is empty, will often expel worms. Two or three cloves of garlic may be swallowed in the morning for a length of time, or three grains of assajatula made into a pill. Injections made of senna-tea, with a teaspoonful of tincture of aloes, may be thrown up the bowels, to destroy the small white worms. A teaspoonful of oil of turpentine, given in syrup, will, in many case*, carry off the tape-worm. Pink-Root. — The dose is from five to ten grains of the powder, or an ounce of it boiled in a quart of water, of which one or two tablespoonfuls may be given every two or three hours. It is to be followed by a brisk purgative after it has been taken three or four days. Worm-Stcd Oil, extracted from the seed of the Jerusalem oak, in dosei of eight or ten drops, taken morning and night for three days, followed by a purgative. EYE- WATERS. When there is much inflammation, decociwn or tea of quince seeds, or in- fusion of the pith of sassafras, applied every three hours. When the inflam- mation is abated, twelve grains of the sulphate of zinc, dissolved in 6ix ounces of rose water, applied every three hours. Six to ten grains of acetate of zinc, in four ounces of rose water, applied every three hours. Twelve grains of sugar of lead, dissolved in six ounces of spring water, with the addition of a tablespoonful of distilled vinegar, is a stimulating eye- water. The quantity of sugar of lead may be increased if necessary. 400 Classification of Medicines. GARGLES. A eoon domestic gargle for sore throats is made by using vinegar, dilated with warm water, and sweetened with honey <>r sugar. Infusion of red rose leaves, acidulated with vinegar. Or a gargle may be made with port wine and a little vinegar, or strong gage tea, with t lie addition of alum and honey. Gargles should always be of such a degree of sharpness as to cause a temporary smarting of the throat. STIMULANTS. These are medicines which excite a general action ovei the whole sys- tem, but of short duration, which is exemplified in the effects of spirituous liquors. A rale respecting them, when they are required, is that they are to be frequently renewed, the quantity gradually increased, and the kind changed. The most common and the best are our much-abused intoxicat- ing liquors in the various shapes of spirituous liquors, wines, porter, ale, cider, &c. Those which are considered of the strictly medicinal kind are: Spirit or Oil of Turpentine. — The dose is thirty to sixty drops. Sulfuric Ether. — Dose from one to three teaspoouiuls, mixed in half a tea-cup of water. Spirit of Lavender. — Dose about a teaspoonful. Hartshorn, called Volatile Salts. — Dose from ten to fifteen grains, made Into a pill with syrup. Of the same nature is Spirits of Hartshorn. — Dose from one to two teaspoonfuls. Teas of Hops and oi>r garden herbs, as well as of those imported, are also of this class. Garlic and Onions are stimulants as commonly used. Opium, and its preparations of Laudanum and Paregoric, in small doses, are equal in stimulating power to spirituous liquors. BlisttTs are often u^-ed to stimulate the whole system. Articles to irritate the nose, as volatile alkali, hartshorn, snuff, assafoetida, burnt feathers, and any thing very offensive, are sometimes properly used to rouse a momentary action. Sudden burning, and irritating the skin by whipping, have often done good in rousing the system. All the stomachics and cordials, in common use, particularly the various essential oils of peppermint, cinnamon, &c. ; all our spices, as pepper, gin- ger, &c, are often used to rouse the whole system to action, and with very good effects. ANTISPASMODICS Are those stimulants which are supposed to remove spasm, era kind of cramp in parts of the body. Of these the most remarkable are — Opium and its preparations in large doses, depending on the urgency "A the case. Tincture of Valerian, and Tincture of Uyoscyamun ; dose, one half tc tWO teaspoonfuls, three times A day. Sulphuric Ether — Dose, a small tablespoonful. A*$afwtides. Red Precipitate Ointment, made by rubbing up one drachm of pow (flered precipitate with one ounce of hog's lard. Tar Ointment. Valuable for affections of the skin and scald head; i-made by melting together equal quantities of tar and suet. C A USTICS. These are frequently necessary to destroy the fungous of sores or proud flefilc, as it is vulgarly termed; and to stimulate them to greater action. That tuost commonly used is Burnt Alum. Tins is common alum deprived of its water, by keeping it on a hot iron until it ceases to boil ; it is then powdered and sprinkled on the sores. Powdered rhubarb is a good substitute. Lunar Ctvustic. This article, obtained from the druggists, is most osed by surgeons. Its application is very simple, the edge of it slightly moist- ened, the sores are to be gently touched with it. Nitric Acid. When diluted freely with water, it is very commonly applied as a wash to destroy the worms or maggots of sores in warm weather. MISCELLANEOUS RECIPES, Antimonial Wine. — To make this, put twenty grains of powdered tartai emetic in ten fluid ounces of sherry wine, and shake till dissolved : foi dose, see tabular list of Medicines. Hose Water. — Mix five drops of otto of rose with a tablespoonful of powdered white sugar, rubbing well until all the oil has been taken up in the sugar ; then dissolve the sugar in one quart of cold water, and strain through muslin. , Spermaceti Cerate. — Melt one ounce of spermaceti, three of white wax, and six ounces of sweet oil, or lard, in a vessel over a slow tire, mixing thoroughly. This makes a good healing application to sores, ulcers, burns, &c. Resin Cerate, (or Basilicon Ointment) — Resin, five ounces; lard, eight ounces ; yellow wax, two ounces. Melt and mix together, and while hot it may be strained through a coarse cloth ther atensils maybe effectually cured from offensive Bmells by rinsing them with charcoal powder, after the grosser impurities have been scoured off with sand and soap. Blue Vitriol. As much of it as any given quantity of water can dissolve, •s frequently applied to old sores. Although many remedies have been mentioned, do not understand me hs recommending them tor general use. Annexed is a list of snob as we thick ought to be iu every family, at least in every neighborhood, espe- cially in country places, also for steamers, ships, etc. Your great dependence for the cure <>f disease should be on the rnctl timph means; you should give a decided preference to local, instead of general remedies, in most cases. a LIST OF MEDIC1XES FOR A MEDIC J NE CHEST, For Ships, Families, etc. Powdered Jalap % Powdered Rhubarb 1 Magnesia, calcined 1 Tartar Emetic 1 .< Powdered Ipecac ).< Powdered Aloes 1 Laudanum 2 Paregoric 2 Blistering Plaster 2 Camphor 4 Columbo Root 4 Sugar Lead 1 White Vitriol 1 Blue Vitriol 1 Powdered Nut Galls 1 Spirit Nitre . . .4 Ether Sulphuric 4 Senna and Manna, each 8 Flowers of Sulphur 8 Chamomile Flowers 8 Powdered Peruvian Bark 8 Epsom Salts 2 pounds, and Cream of Tartar % pound. Oil of Turpentine, and Spirit of Hartshorn, each one bottle, (lastor Oil, and Olive Oil, each one bottle. Essence of Peppermint 2 Virginia Snake Root, % pound. Also a little Alum, Nitre, Borax and Basilicon Ointment. Tincture of Aloes 8 •ejitimonial Wine 2 Ouncu. ( lum Ammoniac 4 Gum Assafoetida 4 Balsom of Peru '2 Buchu Leaves 2 Oardamon Seed 2 Prepare '1 < 'balk 4 Powdered Cinnamon Bark 4 Esseuce of " 2 Extract of Colocynth 1 Syrup of Squills 4 " Ipecac 4 " Rhubarb 4 Dover's Powders 2 Gum Guaiacum 1 Carbonate of Ammonia, or Harts- horn 2 Tincture of Iodine 2 Gum Kino 1 Compound Spirits of Lavender. . . .4 Blue Mass, for li Blue Pills " 2 Powdered Gum Myrrh 2 Gum Opium, powdered, 2 drachms. Quassia 4 Rochelle Salts 8 Glauber Salts 4 Oil of Worm Seed # Quinine 1 Tincture of Hyoscyamus, or Hen- bane 4 Tincture of Valerian 4 Wine of Colchicum ... 4 Court Plaster, and Adhesive Plas- ter. Uva Ur.qi Leaves 4 406 O 9 : - a ° - 3 .: tl — ; o * s 5) II. oj t- w , - -3 m P* I p s «* £ o "= s 3 if o | a H l x M 2 -r S 9S& O « ej ^~ « ... S« Zw< 0/' Medicines, ii 5 gfe 1 O o S« •St* . | o £ a ■% c > -< s . a -• tfi2 o "s — t; > O SB t |^ '. s 2 >; 9) g r3 ? . . O P H • = ^ ■» ^ "> *.* of « rf 3 8-8 a rs - - O WW r^ O (M o o o 00 o U o vo w § g § g | g ^ fee £ tE c3 =J3 CO iH -^ N« M O O O OOO 00 1-1 O O £ *« 408 List of Medicine*, m O •5 a -s* B J.J J5 » »t ^co * g£ S g 2 g «•« «* a II ■ja jfl js — , — js — v- — -v~ — , — g ja x ~ « .a C ."§•11 S ? u - b .all"* t f * »5 ri I Is m ft O 8- m a g on c ft 1 BD ft o 03 S< a 5b u E "O is be t-, n3 'C B -B W) o o o 13 bo "0 tr -i eo to cm 1— 1 e>» Tf CD «# D O O o s 5 a a O o c 3 IN-* IS o IO fH Oi CO CM o CO s » e £ £ DJ O ft* 3 —' o _ d O © _~ o © CO CO CO T3 c O o o c " c *j -u +a ^ *J O CO o • a • •5 : o ; • c - a' %t i , ft. QJ 'ft o 02 <-> ft, © ® a a s a a ft -J xT J" fc t Their Doses and Dues. 409 e> u w jt* ~> w w Jf3 S 2 S? £ ZC-- . 9 '. 8 £ s sj te is s a II" ■- £ i_ a'* 3 3 o I— I B H — v— O — -^. is « " _ ■/ ~ . 5 « s *■" r s © g co . *-< 04 CO s =L d 0. O d d — -d © d CD d - •5 §« d d rt »■© ■_ L- U t_ U 60 •o TJ TJ * .;■ c* cm 03 co CO n i— i CN 3 O s O O © a a ^ ~ o 3 o O o o O ■" _2 o O «* co «? ,_! ,_, o ,_, o ■h\ rH »o r-t CN C3 -© © o rf ■S-SS- °5w 5 © ^^^= b 2^3 3 © © .• © p, gllil d - - ^~ ^ a C BS ~ a c s d d © © © r- -r 1 CO CO CO CD X © © o © « a fc'W MH 41) List of Medicine* I i ® T ft • C 0- jf S3 O. C c o of I — X O". s S o DC 05 * S . O © or 8 9 B - ^5 gOQ c _E [3 a 'OejgH 05 MC3 => 85 ■8-J -r - ^. 2 « -»j tt -- *!> 51 | S S CO (M SB 00 » g 2 S\5 5 C O O c © 2 fe « * <* 2 'S? * .= 3 a Hi The Movement Cure. 411 THE MOVEMENT CURE. This new curative treatment, so called, is nothing more than extending into minutiw the old principle of the " dumb-bells,' for giving greater strength to the muscles of the arms, and thereby taking oft' local irritation existing in the lungs, etc. While we can not admit the wonderful cures said to be per- formed by this treatment, still we have seen cases greatly benefited by it, and under favorable circumstances is worthy a fair trial, as it can be done in the patient's own room, either alone, or m some cases having a friend to assist. The following is about the plainest description that can be given for popular use. Active Movements. — The purpose of an active movement, is to convey to, and concentrate upon a selected point, the nutrition and energies of the system. Such a movement may accomplish a two-fold purpose, that of supplying a part, and of relieving another part more or less distant. The mode of effecting this purpose is as follows : — The person to receive the application, is placed in an easy uncon- strained position, sitting, lying, half lying, kneeling, or any convenient position that will suitably adjust all parts of the body to the purpose. The body is fixed either by the hands of an assistant, or by means of apparatus, so as to prevent as much as possible any motion of all parts of the body, except the acting part. The patient is in 6ome cases directed to move the free part in a particular direction, the effort to do so is resisted by the operator, with a force proportionate to the exertion made — very nicely graduated to the particular con- dition of the part, and of the system at large. The resistance is not uniform, but varies according to the varying action of muscles, as perceived by the operator. In other cases the operator acts while the patient resists. The action is the 6ame, but in one case the patient's acting muscles are short- ened ; in the other, lengthened. The operation is a sort of wrestle, in which a very limited portion of the organism ia engaged. The motion must be much slower than the natural movement of the part engaged, which fact strongly fixes the attention and concentrates the will. The act is repeated two Or three times with all the care and precision the operator can command, being cautious not to induce fatigue. A perfect rest in the lying position succeeds, of some ten or fifteen min- utes. The changes of matter induced by the movement continue for that length of time, producing an afflux of power and nutritive material to the part, provided the patient *12 Poison* and their Antidotes. remains quiet. If, however, other actions be engaged in, i< detracts from and diminishes the effect of the movement. If movements succeed each other rapidly, very much of the peculiar effects are lost and the operation becomes to a certain extent gymnastic. The effect of a movement if properly applied and received, is to transmit the available force of the system, together with the conditions for its production to the acting part : this part receives what the whole system by the process is made to con- tribute. Thus a lax, weak, bloodless region is reinforced with fresh supplies contributed by the whole system. Every portion of the body is, in turn, and at proper intervals, sub- jected to similar operations. Such as the fingers, arms, legs, feet, etc. The great point is to commence these manipulations gradu- ally, and end in the same way ; and always follow the partial movements by thorough friction with the hand or a rough towel, and afterwards wrap up the part in a flannel cloth; the under garments should always be flannel or woolen, also. POISONS AND THEIR ANTIDOTES. The effects produced by many poisonous substances, take place with such promptness, that but little time is allowed for the exhibition of remedies, and the patient is often destroyed before the physician arrives ; whereas, had the proper treat- ment been tininediately instituted, the fatal result might have been prevented. We shall in this place confine ourselves to a brief account of the leading effects produced by the introduction into the 6tomach of the various classes of poisons, the antidotes pro- posed for the principal articles of these classes, and the gene- ral medical treatment demanded in cases of poisoning. Poisons may be divided into the cotrosive or acrid (which destroy the parts to which applied), the narcotic (or stupify- iug), and those acting both as corrosives and narcotics. The symptoms resulting from the first class, or acrid poisons, in addition to the particular taste, of the article itself, are heat, irritation, or an extraordinary and sudden sensation of dryness, constriction (tightness) and roughness at the root of the tongue, and in the gullet; these are succeeded by vio- lent efforts to vomit, and sharp pains in the stomach and bowels; there is also great thirst, copious discharges by vomiting and stool, attended with much straining, ami followed by hiccup; a Beiisc of constriction across the diaphragm (or cliectj, and difficulty of breathing; pain is generally fell Poisons and then Antidotes. 413 about the kidneys, followed by strangury (difficulty in urinat- ing), convulsions at length come on, or cramps of the hands trembling of the limbs, extinction of the voice, repeated faint- ing, cold sweats, and usually a hard and irregular pulse. The narcotic poisons produce the following effects : stupor, numbness, a great inclination to sleep, coldness and stiffness of the extremities, a cold sweat of an offensive or greasy na- tuio, swelling of the neck and face, protrusion of the eyes, with a haggard cast of countenance, thickening of the tongue, frequent vertigo (giddiness), impaired or depraved vision, delirium, general debility, palpitation of the heart, the pulse at first full and strong, afterwards becomes unequal and inter- mittent ; there is also paralysis of the lower extremities, re- traction of the lips, general swelling of the body, and swelling of the veins. At the conclusion of the disease slight convul- sions and pain are sometimes present. The effects of the narcotico-acrid poisons, such as bella- donna, aconite, etc., are distinguished by a combination of several of the symptoms of both the foregoing classes. There is generally agitation, pain, acute cries, sometimes stupor, and convulsive motions of the muscles of the face, jaws and ex- tremities, and occasionally extreme stiffness of the limbs, ami contraction of the muscles of the chest ; the eyes are red and starting from their sockets, the pupils frequently dilated ; there is often great insensibility to external impressions ; the mouth is full of foam; the tongue and gums livid, or purple, with nausea, vomiting, frequent stools, etc. Often these symp- toms attack in paroxysms, and between them the patient is left comparatively easy for a few moments. It might appear easy, from an attention to the symptoms we have recited, to distinguish the nature of the poisonous article under the effects of which the patient is laboring; but nevertheless, nothing is generally more difficult. Substances very different in their nature, produce similar effects ; as, for example, cantharides (Spanish flies), certain acrid vegetable substances and the caustic minerals. The difficulty is in- creased by the circumstance, that articles of ordinary food, perfectly innoxious in themselves, so far as regards any poison- ous property, in certain conditions of the stomach, and in cer- tain constitutions, when eaten, sometimes cause the most alarming symptoms. Roasted cheese, fish, crabs, lobsters, clams, mushroons, or even apples and cherries, have been known f o produce the most alarming symptoms and cause a suspicion of poison having been taken. A variety, also, is frequently observed in the symptoms caused by the same 414 Poisons and their Antidotes. poison in different persons. Many circumstances may con duce to this, euch as The mode in which the article has been taken. "When swallowed in a liquid form, the effects of a poison are gene- i ally more prompt and marked than when it is taken in a solid state. If the article be taken on a full or empty stomach, its effect? will vary ; being much more rapid and certain in the lattei case than in the first. The circumstance of vomiting occurring immediately, or not until after a considerable time, will produce a difference in the effects of the poison. In the former case the article may be rejected from the stomach before it has had time tc f)roduce any injurious effects. Thus large doses of arsenic lave been taken intentionally as a poison, but in consequence of copious vomiting instantly following, the lives of the indi- viduals have been preserved. To distinguish cases of poisoning from accidental affections of the stomach, produced by other causes, demands a judicioi s and cautious examination of every circumstance relative to the character and disposition of the patient ; the possibility .-f his having taken poison ; the article of which he had last cat* n or drank ; the vessel in which it had been contained ; tl o patient's own confession, if able to speak, &c. The diseas -a and symptoms most likely to be mistaken for the effects »f poisons, are probably those produced by idiosyncrasy (pecul - arity of constitution) and indigestion, and cases of sudden an I unexpected illness. But the most striking cases of resemblant, o to the effects of poisons, probably occur in those who, aft* r being long accustomed to a particular species of food, for tL * fiist time use another kind. The treatment, in cases it poisoning, varies according to the individual articles taker. As a general rule, in those cases in which the corrosive an I acrid poisons have been swallowed, the indications of cure an,, First, to endeavor to discharge the poison as quickly ai possible from the stomach. Then endeavor to destroy its poisonous properties, by tho administration of antidotes. And afterwards to prevent oi subdue inflammation. The first indication is to be effected by the administration of an active emetic ; or, if vomiting has already occurred, it general by the copious administration of diluent drinks ; or wt may attempt to remove the article from the stomach, by an appropriate pump, if it can be; had. Arsenic. — This is an article very frequently made use oi *fl Poisons and their Antidotes. 415 destroy frte ; it is, also, often taken in mistake for other articles, nearly resembling it in their external appearance, either of food or medicine. Arsenic may be taken m such quantity aa merely to produce disorder of the stomach and system, without necessarily destroying life ; or it may be taken in such quan titles as to produce death at a later period than twenty-four hours ; or, lastly, the quantity may be such as to induce death within twenty-four hours. When taken in the slightest portion, the symptoms produced by arsenic, are uneasiness at the stomach, with a sense of heat. When the dose is some- what greater, but not so great as to produce death, violent vomiting is commonly the first symptom; although, in some instances, it is preceded by a sense of heat in the tongue and throat; in other eases, these sensations are not felt during the whole course of the disease. When the vomiting is immediate, and the poison has been taken on a full stomach, the patient seems to owe his escape to the poison being discharged before it has had time to act. The next symptom claiming attention is purging, sometimes of blood ; but purging is less frequent in the Blight eases, than in those where the degree of poisoning is greater. In the region of the stomach and bowels, pain is frequently felt : it is often, however, rather an unsupportable uneasiness and oppression than pain, properly speaking. A sense of coldness, especially of the extremities, with cold sweats, seems nearly always to be present, with general paleness of the face and surface ; and in some cases languor, iaintness and a tendency to sleep. In this degree of poison, convulsions are not fre- quently observed ; and thirst and fever are seldom present. In the second degree of poisoning from arsenic, when the patient lives a day or two, the first sensations are heat and thirst, vomiting, or inexpressible distress. The first is less frequent than the two others ; purging is not often present ; convulsions generally take place, however. In the third degree of poisoning, when death takes place within a few hours, the symptoms succeed each other rapidly, or occur at the same time; fainting and general debility almost invariably precede the vomiting, which occurs in most cases, as well as purging and griping, and death seems generally to proceed from exhaustion and rapid sinking of the vital powers. The indications in the treatment of poisoning from arsenic are : — To remove the poison. To protect the stomach and bowels from its effects ; and if the patient survive sufficiently long, to diminish inflammation. The removal of the poison is to be attempted by emetics 0/ 416 Poisons and their Antidotes. sulphate of /.ine, or if vomiting be present, by the aid oi diluent drinks, or a vegetable emetic (ipecac being the best.) Tartar emetic should neve?' be administered. But when vom- iting does not quickly ensue from these means, the urgency ol the case, demands a resort to more direct remedies. The stomach may be washed out by means ?f taking large dnnke of sweetened water, and then causing vomiting by tickling the throat with a feather, &c; in this manner, a quantity of linuid is to be used, so as to dilute or suspend the poison, anu by means of a stomach pump, when to be had, the whole maj be withdrawn. By tin's procedure, we may, in many cases, succeed in saving the life of the patient. The second indication may be effected by means of milk, lime-water, soap suds, and drinks sweetened with sugar or honey. Fatty or oily substances are of doubtful utility. In a case reported by Joseph Hume, life was saved by administering freely, after vomiting had ceased, retching and pain, however, remaining, the carbonate of magnesia twenty grains, with twenty drops of laudanum, in water ; one or two cases subsequently reported are in favor of this practice. The third indication is to subdue inflammation by the same remedies as in ordinary inflammation of the stomach. For arsenic we unfortunately possess no antidote, strictly speaking. A preparation of iron has been vaunted, but it is of doubtful efficacy; if either this or the stomach pump is used, it will be safest in medical hands. "White arsenic is not the only preparation of the metal by which poisoning occurs; the coloring substances known by the name of King's yellow and Scheele's green are both compounds of arsenic, and being frequently and culpably used in confectionery, have proved fatal. Similar symptoms occur and similar treatment is to be followed as after poisoning by white arsenic. "Whether in poisoning by arsenic, or by any other agent, the vomited matters should always be carefully preserved in a vessel by themselves, for medical inspection ; and if there is any sus- picion <>f foul play, some responsible person should place them under lock ind key. The chemist can detect the smallest amount of arsenie, even after years have elapsed. Corrosive Sublimate. — Besides the ordinary symptoms caused by corrosive poisons, the present article produces a peculiar sense of stricture and burning heat in the throat and gullet, increased when attempts are made to swaliow; there ia also dysentery, bloody vomiting, and sometimes diminished or even suppressed secretion of urine. The treatment of poisoning from this article is to administer an emetic, or if vomiting i« , Poisons and their Antidotes. 417 prssent, as large a quantity of the whites of eggs, well mixed with water, as the stomach can contain. By the experiments of Ornla, it is proved that albumen decomposes corrosive sublimate, forming a triple compound, consisting of albumen, muriatic acid, and calomel. Dr. Taddei, of Italy, has recom- mended wheat flour, starch, or gluten, mixed with water, as an antidote to corrosive sublimate ; hence, when the whites of eggs are not at hand, either of the latter should be employed as directed above. The plentiful use of mucilaginous drinks is also very proper as an accessary remedy. The antidotes to corrosive sublimate are, therefore, albumen (white of eggs) and vegetable gluten (Hour, starch, &c.) Tartar Emetic. — This substance, in large doses, is undoubt- edly a poison. It is by no means, however, so destructive as either of the foregoing. The remedies are, if vomiting be present, to wash the article from the stomach by large draughts of tepid drinks ; if vomiting be not present, to excite it by tickling the throat, and by the administration of large quan- tities of warm water, sweetened. If, notwithstanding these means, vomiting be not induced, we are to resort to antidotes. These are decoctions or infusions (teas) of any astringent vegetable substances. The following may be employed: a tea of Peruvian bark ; strong green or black tea ; a decoction of galls, of oak bark, or of any of the other astringent roots or barks. The above articles are named in the order of their efficacy. From the experiments of Berthollet, the Peruvian bark would appear most certainly efficacious, and when it can be procured, should invariably be preferred. When the vomiting is excessive, opium may be administered. The /Salts of Copper. — These, in certain doses, are all pois- onous. Verdigris, or the impure carbonate, is the one most commonly employed. The symptoms are the same as in the case of other corrosive poisons. We are to endeavor, when it has been taken, to get it out of the stomach by the same means as have already been mentioned. Sugar was once considered as the antidote for this poison. Subsequent exper- iments, however, have lessened the estimation in which it was at first held, and have pointed out albumen as the article most to be depended upon ; hence, the whites of eggs mixed with water are to be administered at first ; their operation being aided by the use of large quantities of sugar and water. Should inflammatory symptoms remain after the presumed ev-acuation of the poison, apply mu&tard or leeches to the 41 S Poisons and their Antidotes. atoma3h. For the removal of the spasmodic affections thai aie apt to remain, knidannm or opium will be roquired. Sulphate of Zinc. — When taken in an over-dose, vomiting ghoula be excited by copious draughts of warm water, emol- lient drinks of slippery elm, flax-seed tea, &c. Milk is the iproper antidote. Inflammation is to be prevented by the .ordinary means, and irritation allayed by opium. Muriate of Tin. — The treatment is the same as in the for- mer article: milk is also its proper antidote. Nitrate of Silver. — When accidentally taken in an over- dose, a solution of common salt in water is to be administered; at the same time, the patient should take plentifully of emol- lient and mucilaginous drinks. Nitrate of Bismuth. — The same general treatment as in the case of other corrosive poisons, with milk and mucilaginous drinks plentifully administered. The Salts of Lead, when taken in large quantities, produce poisonous effects, and when gradually introduced into the sys- tem, they produce a peculiar species of colic, which has been already treated of. When taken in an over-dose, the proper treatment is to endeavor as speedily as possible to empty the stomach by the ordinary means. The sulphate of soda, (Glau- ber's salts,) or of magnesia, (Epsom salts,) is the most effectual antidote for lead ; it should be given in strong solution ; at the same time, mucilaginous drinks and purgatives are to be ad- ministered. Sulphuric Acid. — Taken in au undiluted state, or in large quantities, it produces all the symptoms attendant upon vio- lent inflammation of the throat, gullet and stomach, or when concentrated, it may destroy at once the lining membrane of those parts. Large quantities of calcined magnesia in milk, syrup, mo- lasses, or as little water as possible, must be instantly admin- istered ; or, if not at hand, soap and water, chalk and water, or lime-water. The caustic must be neutralized, or the patient is inevitably lost. The subsequent treatment will depend upon the degree of inflammation present. Demulcent drinks barley-water, gum-water, whey, milk diet and injections o* thin gruel, will always be proper. Nitric Acid. — When taken in excess, the treatment is to give freely carbonate of soda, or magnesia, or calcined mag* nesia, or lime-water, and the other general treatment recora mended above. The Alkalies, such as potash, ammonia, caustic soda, sale Poisont and tfieir Antidotes. 410 ratus, &c. For these, when taken in excess, vinegar and lemon-juice are the most valuable remedies; they are to be aided by the plentiful use of mucilaginous drinks and emol- lient injections. The remaining treatment will depend upon the degree or inflammation. Barytes. — All the salts of this earth, except the sulphate, are poisonous in certain doses. When taken, vomiting is to be excited, and the plentiful use of a solution of sulphate if soda, (Glauber salts,) or magnesia, (Epsom salts,) commenced with early. These decompose the poison and produce the in- soluble sulphate, which of course is inert. Nitrate of Potash, (salt petre.) when taken in excess, is a poison producing inflammation of the stomach, &c. Treat- ment, vomiting, mucilaginous drinks, and mustard to the stomach, according to circumstances. Muriate of Ammonia. — The treatment is the same as that directed in the last case. Acrid Vegetable Poisons. — The treatment for poisoning from these is, to dislodge the article from the stomach as speedily as possible, by vomiting, and then to administer large quantities of mucilaginous drinks, emollient injections, &r. To overcome violent irritation and spasm of the stomach an I bowels, give frequent doses of opium and laudanum. Narcotic Poisons — Opium.— When opium or any of its preparations are taken in a large quantity, so as to act as a poison, the following symptoms are usually perceived within a short period : insensibility and incapacity of exercising mus- cular motion ; breathing scarcely perceptible, and a small and feeble pulse, which usually becomes full and slow. As the effects of the poison increase, the state of stupor becomes more complete ; swallowing is suspended ; the breathing is occa- sionally laborious ; the pupils are insensible to the application of light ; the countenance is livid or pale and death-like, ana the muscles of the limbs and trunk are in a state of relaxation ; vomiting sometimes supervenes ; death is often preceded by convulsions. In cases of recovery, a weakness will sometimes be left in the lower extremities, nearly approaching to paralysis, and the bladder will be unable to retain its con- tents. The following are the directions for treating a case of poi- soning from opium : Induce vomiting, if possible, with sulphate of zinc, sulphate of copper, (blue vitriol,) or tartar emetic. In endeavor- ing to induce vomiting, great quantities of watery fluids will Se improper, as they dissolve the opium and promote its ab- 4-2C Poisons and their Antidotes. sorption. The vomiting should, therefore, be accomplished without the administration of any more liquid than is neces sarv to dissolve the emetic. The operation of the emetic may be accelerated by tickling the throat with the finger, a feather, &c, but as one of the ef- fects of this poison upon the stomach is to render the latter insensihle to the impression of emetics, much time should not be lost in vainly waiting until they shall operate, when by the aid of the gum elastic tube and syringe, the contents cf the stomach maybe pumped out and fluids afterwards injected, so as entirely to wash out every portion of the poison. The pa- tient should not be allowed to remain quiet in one position, but should be moved about between two assistants ; stinging with nettles, or even the application of a cowskin has been proposed, and put in practice, under these circumstances, with good effect. Mustard plasters on the extremities should never be neglect- ed. The effusion of cold water is also a remedy of consid- erable efficacy in rousing the system from the state of stupoi in which it is thrown by the effects of narcotic poisons, par- ticularly the one under consideration ; large pitchers or buck- ets of water should be splashed from a height over the head and shoulders of the patient, or over his whole body, and per- severed in until the patient indicates a return to- a state of animation. Now administer alternately, water acidulated with any ve- getable acid, and a strong warm infusion of coffee. The experiments of Orfila have shown that the exhibition of vege- table acids previously to the evacuation of the opium, is highly improper, as they accelerate and aggravate the action of the poison ; after, however, the latter has been entirely discharged from the stomach, water acidulated with vinegar, lemon juice, or other vegetable acid, tends to diminish and correct its ef- fects upon the system, to which, also, the infusion or decoction of coffee is admirably adapted. In about ten or twelve hours, administer an injection, and let the arms and legs of the patient be well rubbed with the flesh-brush, soft coarse flannel, or some stimulating appli- cation. Dr. Beck states that he has known the most happy results at this particular juncture, and during the latter stage, from repeated injections of a strong watery solution of assa- foetida. So long as any of the opium is suspected to bt retained in the bowels, purgative injections should be con- tinued. The above treatment for poisoning from opium or its pre Poisons and their Antidotes. 421 parations, and acrid vegetable poisons, is adapted in al essential particulars, for poisoning from the various kinds of poisonous plants, herbs, &c. Iodine and Iodide of Potash. — Give freely of starch or wheaten flour and water, combined with ipecac and warm water. Creosote, is coagulated and rendered comparatively harm- less, by white of eggs, or if not to be had, starch or flour and water, given freely, with ipecac and warm water, sweetened. Green Vitriol, or Cojyperas. — Give freely of carbonate of soda and water, followed by ipecac and sweetened water, and then give cold coffee, to strengthen the system and quiet the nervous pain. Poisonous Fish. — Give an emetic of ipecac, and warm sweetened water, or tickle the throat to produce vomiting. Then give a purge of castor oil or Rochelle salts or Epsom salts, and if necessary, injections of soapsuds up the bowels. Afterwards give a drink of vinegar, sugar and water, frequent- ly. A dose of laudanum may also be needed to produce sleep. ERYSIPELAS. This disease is also called " St. Aathoni/s Fire" or " The Rose" and is an inflammatory affection of the skin alone, or of the skin and cellular tissue or soft substance beneath the skin. Like other inflammations, it varies in degree and extent, in different cases. When it affects merely tke external surface of the skin, in which case the latter is red, not sensibly swol- len, soft and without fluctuation, the disease is termed ery theraa. The cases to which the term erysipelas is more gene- rally applied, are marked by the same symptoms as above, but of a more intense grade ; there is greater redness, con- siderable swelling, a peculiar burning pain, and an effusion takes place beneath the skin, raising the latter in the form of blisters of various sizes ; ver} r generally there is effusion also in the subcutaneous cellular tissue. The most aggravated form of the disease is termed phlegmonous erysipelas ; in this both the skin and cellular membranes are inflamed, and ex- tensive collections of matter and sloughing of the cellular structure are quickly produced. Erysipelas usually affects the face and limbs ; less fre- quently, especially in adults, the surface of the chest and ab- domen. In a few instances, the disease has been known to pervade the entire surface of the body. The disease is confined to no particular sex or constitution. It is more common, however, in infants and young children, as 422 Ei~y*ipelas. well as in the aged, than in persons about the middle period of life. It likewise more frequently attacks females than males ; and persons of a sanguine and irritable temperament, and of luxurious and intemperate lives, are more liable to iti attacks than any others. Erysipelas is confined to very small spaces sometimes, in others it extends over the whole head and face, or occupief an entire limb. It not unfrequently commences at a point, and gradually extends in every direction, until it involves a very large portion of the skin. In other instances, in the part first attacked, the inflammation runs through its various stages and disappears, while it subsequently extends over a new surface to pursue the 6ame course. In this manner, it may travel gradually from the head to the feet. In other cases, again, the erysipelas may suddenly disappear from the part primarily affected, to reappear in another and remote part of the body. It occasionally happens, that when the dis- ease very suddenly disappears from the skin, some internal organ, and particularly the brain, in cases of erysipelas of tho face, suddenly present all the symptoms of inflammation. The part affected with erysipelas in its simplest form, pre- sents the ordinary symptoms of inflammation, namely, swell- ing, heat, and redness. The swelling, however, is softer, more irregular and diffused than in common inflammation; the heat is more intense, and the accompanying pain is a burning or smarting, similar to that from the application of mustard or scalding water, in place of being throbbing as in the latter ; the redness is brighter and more intense and disappears upon pressure, but returns the moment the pressure is re- moved. When erysipelas attacks a limb, in general the whole circumference of the latter becomes enlarged, and the skin presents a kind of smooth shining appearance, and a some- what doughy feel, as though a fluid was effused beneath it, which is, in fact, the case in most instances, when the disease is of any violence or extent. When the face is the seat of erysipelas, the features become deformed ; the mouth is often drawn towards one side ; the nose is enormously enlarged, and the eye-balls, becoming swollen, close up the eyes entirely. In a lew days, the period differing in different cases, vesi- cations, (blisters,) varying in size, arise upon different parts of the inflamed surface, especially towards its centre. They are of an irregular form, and tilled with a fluid, at first clear and watery, becoming subsequently straw-colored. The skin after a time, gives way, allowing the fluid of the blisters to escape, Tkich generally drying upon the skin, covers it with thic Erysipelas. 423 scales. About the eighth or ninth day of the disease, but ©ccaBionally much later, the redness of the affected surfacea changes to a brownish or yellow hue ; the vesicles entirely lubside, and the skin dries and scales off. In general, the disease is preceded and accompanied with fever, varying in its character according to the constitution, age, and general state of health of the patient. In the young, the robust, and those of full habits, we have a very decided attack of fever, and often of considerable intensity. When the face or scalp is the seat of erysipelas, there are often pain and oppression of the head, inclination to sleep, or delirium. The tongue becomes dry and brown ; the pulse rapid and feeble, with great loss of muscular strength. In other cases, the heart and nervous system are less affected, but we have pain in the stomach, foul tongue, a bad taste in the mouth, nausea and costiveness of the bowels. This disease is produced by the same causes as other inflam- mations. It may result from cold and various irritants applied to the skin, or it may be produced sympathetically from irri- tations seated in the stomach and bowels. Phlegmonous ery- sipelas very generally results from wounds, bruises, extensive ulcerations, or from the influence of cold. The treatment of this disease, when it is possible, should be entrusted to a good physician, but in many cases this is not the case. The following plan of domestic treatment is recom- mended : Always begin by giving an emetic, (vomit,) of ipecac ; then clear out the bowels by the following mixture : mix ten grains of calomel, ten of Dover's powders, ten of rhubarb ; divide into three parts, give one part every two hours ; to be followed by a seidlitz powder, if the bowels are not freely opened in ten hours. If this mixture is not to be had con- veniently, a dose or two of castor oil or Kochelle salts, 01 other good purgative will answer, giving at the same time nauseating doses of ipecac, (about half to one grain of the powder every two hours.) In weak or delicate persons these' nauseating doses can be dispensed with, after one vomit in the beginning. The local treatment is also of much importance ; the best application to the inflamed part is caustic, nitrate of silver. Erysipelas tending to spread, may be stopped by surround- ing the affected part entirely with a cauterized ring. The parts to be touched must, in the first place, be shaved, if cov- ered with hair, and the skin must always be thoroughly cleansed from its natural oily secretion, by washing with soap ana water. It must then be moistened all round, and the 424 Erysipelas. stick of caustic drawn slowly and gently over it, so aft to rcak« a line of demarcation at least a quarter of an inch broad ; but this line must he entire throughout — deficiency in one spot may permit the inflammation to extend by the outlet. It to not asserted that in every case this caustic line will inevitably stop the disease, but it will do so in the majority, if care be taken that it is efficiently done, and that it includes, without doubt, every portion of the affected skin. When the solution of caustic is to he used to quell the disease, it should be used of the strength of forty grains to two drachms of water. The inflamed surface must be gently cleansed by soap and warm water, and the solution applied all over it by means of a camel-hair brush or a feather. The practice now recommend- ed is perfectly safe, is very efficacious, both as a preventive against the extension, and as a cure of this formidable disease, and might be quite justifiably employed by an intelligent person in the absence of medical assistance. Flour is a very common and often a good and comfortable local remedy in mild cases of erysipelas ; hot fomentations, either of simple water or a decoction of poppy-heads or hops, applied continuously for many hours, by means of flannel, give much relief in some cases ; or a lotion composed of twenty grains of sugar of lead, a drachm of laudanum, and sixteen ounces of water, may be used slightly warm, and applied by means of linen cloths, with much advantage. A poultice of charcoal, slippery elm, and hops, frequently renewed, is ako a good remedy in mild cases. Erysipelas is the most formidable enemy which can gain a footing in a surgical hospital ; and for the same reason, when the disease occurs in private houses, caution should be ob- served* that persons suffering from wounds do not come into close contact with the affected ; and, indeed in any case, the same precaution should be adopted in erysipelas as in conta- gious diseases generally. This is doubly requisite in a house m which a confinement is expected, or has recently taken place, for there is an undoubted close connection be' «veen erysipelas and fatal childbed inflammation, and vudei such circumstances too much care can not be exercised Tellintj Disease* In, the Tongue. 425 Telling Diseases by the Tongue. — Much could be ■aid about this " unruly little member," but in the present case we are only taking it into consideration in a mcdica. point of view, in what is to be regarded both with reference to its own disorders, and to the indications it affords of disor- der in other parts of the system. The condition and appearance of the tongue, are indications almost aiways consulted by a physician in investigating a ease of disease, and most valuable guides they are at times, when experience T observation, etc., have given the power of reading them aright. When the appearances of the tongue, however, are admitted as evidence, consideration must always be given to the natural state of the organ in the individual, for some never have a clean tongue, while in others it scarcely becomes furred, even when considerable disorder is going on in the system. In chronic disorders, especially of the digestive organs, the most valuable indications are often afforded by the tongue, immediately after the night's sleep, before food has been taken. Persons who sleep with their mouths open, gener- ally have a dry tongue in consequence, but in most persons in health, the mouth should be pleasantly moist on awakening in the morning; if it is the reverse — if the tongue is dry, or clammy, or viscid, and covered with fur, there is usually dis- order of the digestive organs, permanent or temporary, from some indiscretion in food, and especially in the use of stimu- lants. In feverish conditions of the system generally, the tongue is liable to become dry. The appearance of the fur on the tongue varies greatly ; it may be thick and dirty-white, as it is in stomach and febrile disorders, and especially in sore- throat ; it may be a thin, creamy-looking white, as in inflam- matory disease within the abdomen ; or it may be yellow, as in biliary disorder. It may be patchy, as in scarlet fever ; or, the centre and sides of the tongue being preternaturally red, Ls in some forms of intestinal (bowel) irritation, may contrast with the white fur in other parts. Further, the tongue may be morbidly clean and red also in intestinal irritation, and in hemorrhage ; in the former case, perhaps, feeling sore, as if scalded. Again, partaking of the general debilitated condi- tion of the system, the tongue may be pale, when it is also asually broad md flat, indicating general want of tone and power in the muscular fibres. The motions of the tongue, moreover, xhei. it is protruded, give a clue to the state of the aervous system especially ; thus in paralysis, it is drawn to one side ; in delirium tremens and nervous affections, it is tremulous ; in the Iom stages of fever, it cannot be protruded 426 Syinjytoms of Diseases. at all. Persons, therefore, who bear physicians ask a patien to put out the tongue, should bear in mind that it means some thing more than " putting on professional airs." Symptoms of Diseases.— As it is of the very greatest mportance to ascertain at the beginning the nature of every disease, we give here a few of the leading symptoms of dis eases, as they ordinarily make their appearance. In obserr fngand forming deductions from symptoms, the first questions cught to be — clo they indicate an acute attack?- have they supervened suddenly ? and if so, to what can the attack be traced ? Has there been exposure to cold and wet, or to checked perspiration ? — those fruitful sources of. inflammatory and rheumatic affections. Has there been exposure to conta gion in any form, or to malaria of any kind, or is there anj prevailing epidemic? Can any violence, at no very distant date, account for the attack ? Careful consideration of the " history " of the affection will often throw much light upon its nature. Again, if the usual symptoms of fever indicate inflammatory affection, it is to be considered whether pain or uneasiness in any part, or disordered function of any organ, indicate that the disease has localized itself. If inflammatory symptoms are absent, the spasmodic character of pain, or the nervous character of the disorder, become questions for con- sideration. Should the symptoms of ailment be chronic, the same consideration of the history and of the hereditary ten- dencies ought to be entered into, and attention particularly directed to the fact of there having been progressive loss of flesh, habitual complaint of cold, unusual lassitude, alteration in the complexion, difference in sleeping, etc. By systematizing inquiries and observations, a much clearei idea will be gained of the state of an individual who is an object of care and solicitude, than by making them at ran- dom. Thus beginning at the Head, attention should be direct- ed to any unusual sensations complained of by the person, or any unusual manifestations apparent to others. These are: pain, giddiness, affection of the senses, confusion of thought, or impairment of mental power; flushings, twitchings, draw ing of the features to one side ; disturbed sleep ; moaning grating of the teeth ; sleeplessness, or too great sleepiness Passing downward to the Organs of Respiration (breaming) alterations in the character of the voice ; in the respiration as to the frequency or otherwise ; in the power of lying n any or every posture, are all matters tor observation; also any habitual cough, and its character "Whec tu«> Digestive Salivation. 427 Organs are disordered, the period of their chief disorder, as connected with taking food, is an important symptom: whether the uneasiness comes on quickly after a meal, or not for some hours; whether it is worse after long fasting, or the reverse; whether there is habitual vomiting, etc. With respect to the Bowels, the nature of the motion.- or Btools is to be inquired into, and especially the fact of thorough daily relief. In inquiry into the state of the urinary organs, the amount of the secretion, its nature as to color, or its ten- dency to deposit sediments immediately after being passed, or when it becomes cool, are principal objects. If the calls are too frequent, it is to be noticed whether this depends <>n in- creased quantity or on diminution, which causes irritation from greater concentration. In this way, by carefully and systematically considering a case, even an unprofessional per- son may acquire very considerable knowledge of its leading features, sufficient probably to enable him to refer to those articles in this work from which he will derive proper infor- mation ; in many cases, sufficient to open the eyes to a condi- tion of health that calls for the prompt submission to proper medical advice. "When this is determined on, the observation of symptoms, either in his own case or that o{' another, such as a child, wtfl enable any individual to furnish a physician, even at a first interview, with such a historv as will afford him much assistance in forming his opinion. That makes a work of this kind of great value to every family, in fact to every individual. Salivation* — It is to be hoped that the day for " dosing with mercury " for the many ills that flesh is heir to, haa past. The first symptoms of the constitution being affected by mercury, or of approaching salivation, is a sen^e of ful- ness and tenderness of the gums ; the teeth feei as it were elongated, and the person cannot bite any firm substance, such as crust, as well as usual ; coincident with these symp- toms, the breath acquires a peculiar fetor (bad odor), which, once smelled, cannot be forgotten, and the gums, if examined, are seen to be slightly swollen, and of rather a purple hue. Sometimes the face swells to an enormous size, and presents hideous appearance. There are some constitutions so suscep tible of the action of the medicine, that tho smallest dost cannot be taken without its producing free, or even violeu\ salivation. Unfortunately, but little can be done to cut short, or even alleviate greatly, a course of mercurial salivation • cold, of course, is to be avoided j rfca alum wa.cfa for the 428 Influenza. mouth, or tincture of myrrh, or camphorated spirit in water used to rinse the mouth, afford some relief. A lotion made with two teaspoonfulls of ether, or spirits nitre, to eight ounce* of water, is also serviceable, and diminishes the fetor ; a so- lution of common salt, in the same proportions, will have the same effect. A few leeches may be applied under the jaw. Seidlitz powders, or Epsom salts, largely diluted, may also be given with advantage, if the patient can swallow them, and is not in a very reduced state. A tablespoonful of a mixture of equal proportions of flowers of sulphur and cream of tartar, given once a day, on a fasting stomach, ia often beneficial. Also a wash of white-oak bark, (tea,) cold, used freely every two hours, is beneficial. Cold green tea, also, and strong coffee, cold, are good remedies. Influenza. — This disease consists of a peculiar feverish attack, accompanied with catarrhal affection of the air-tubes of the lungs, and great prostration of strength. It is not un- common to call various forms of cold and catarrh, influenza; but the true influenza is a very distinct disease, and sel- dom occurs but as an epidemic, attacking large numbers at once. The symptoms of influenza are those of general fever ; coining on suddenly, there is shivering, loss of appetite, per- haps vomiting, heat, and thirst, with cough, headache, and generally great depression and languor. The feverish symp- toms mav last from one day to ten, but their general duration is from three to five, or even seven days, the cough usually remaining a variable time after the acute symptoms are gone, according to exposure and circumstances, such as a predispo- sition to cough, etc* To the strong and healthy, influenza is but a trifling dis- ease. It certainly prostrates even them for a few days, and leaves them weak ; but it is in almost all cases perfectly de- void of danger — with ordinary care — and requires little or no medicine. A few days in bed, according to the severity of the case, with low diet, a gentle purgative and diluent, drinks such as flaxseed tea, lemonade, with gingers, tea, etc., and the feet in hot water, being all that is required. If the catarrhal symptoms are severe, treatment similar to what is recommended for catarrh or cold may be had re- course to. To the weakly and the aged, influenza is, on the other hand, a comparatively fatal disease ; ami, from the almost univer sal nature of its attack, carries off more, perhaps, of these classes than many more apparently severe and more dreaded Change of Climate, or Acclimation. 429 disorders. The attack of influenza, in the description of per Bons above mentioned, should be the signal for medical a* tendance. Weakening medicines, especially, must not be resorted to ; confinement to bed, and the use of warm teas, will be required ; broth, strong o* weak, must be allowed, ac- cording to circumstances; if the strength is deficient, wine may be requisite, and stimulant expectorant medicines, espe- cially in the aged, if the expectoration is abundant, viscid, and difficult to be got up. In such cases, the following will be found useful : — Take of carbonate of ammonia, thirty to forty grains ; tincture of squill, one drachm ; wine of ipecac, forty drops ; water or camphor julep, sufficient to make an eight ounce mixture, of which two tablespoonfuls, or one- eighth, may be given every few hours. If the cough is very irritating and troublesome, two drachms of paregoric may be added to the above, but the opium rather tends to check the free expectoration which is so desirable. Demulcent drinks, such as barley-water, etc., should not be neglected, and a mus- tard plaster or blister to the chest Avill do good. In severe forms of the disease, with difficult breathing, if the strength is much reduced and the appetite bad, two doses of decoction of Peruvian bark may be given during the day. Persons who greatly suffer from delicate chests, should be- ware of allowing the effects of influenza to hang about them ; as the debility and cough are very apt, if predisposition exists, to lay the foundation of consumption. The strong and healthy may trust to the domestic management of influenza ; but the weak and aged ought to have proper medical advice, if it is within reach. Many persons of frail constitution, who might have lived for years with proper care, have fallen vic- tims to effects of influenza, colds, etc. Change of Climate, or Acclimation.— It is a fact worthy of remark, that the air and its temperature are largely concerned in the process of acclimation ; the former is so much more rarified in hot than in cold climates, that in the vital process of respiration, a comparatively much smaller quantity is habitually consumed ; less oxygen is taken in, and the process of oxidation or combustion, which is continually going on within the body, is slower ; we reasonably conclude that by this process of combustion, the animal heat, in part at least, is maintained; but of course, in a hot climate, a less active condition is sufficient to keep up the average tempera- ture. The process of oxidation or combustion effected on the one hand by the oxygen inspired, is supported on the othei 43C Change nf C/nnatc, or Acclimation. by some of the elements — carbon and hydrogen — of the ford. It is evident, therefore, that if an individual who has bncome resident in a hot climate, makes a practice of consuming aa much nutriment as he used to do, without injury to health, in a cold one, he must take more than is requisite; conse- quently the blood becomes overcharged with a quantity of noxious matter, which the raritied air and inactive habits of warm countries do not tend to remove; and if the course be continued, an attack of illness, probably of a biliary nature, is the consequence. Even in temperate climates, the differ- ence between the consumption of oxygen, in winter and in summer, is considerable. How great must be the difference to those who permanently settle in tropical heats ! certainly sufficient to require much alteration in habits of living. The abundant animal diet, the fats and alcoholic drinks of the colder climes, all of which contain carbon and hydrogen in abundance, and assist materially in sustaining temperature,, must give place to the fruits, vegetables, etc., of warmer re- gions ; vice ve?'sa, on going from a warm or temperate coun- try to a colder — as the experience of all arctic travelers testi- fies — a larger proportion of animal diet, and that of a more fat or oily character, is requisite to maintain health and strength, and those only who are capable of consuming and digesting this full allowance, are fit for encountering the cold of the north. From what has been said, it is evident how important due regulation of the food is to safe and speedy acclimation ; it is the main element, and the most under man's control. Modem science and discovery will render him much assistance, but study of the natural products of the soil and of native habits is essential. The great increase of the functions of the skin which takes place on removal to a warm climate, requires attention. It renders the constitution more susceptible to the influences of a damp or chill air, such as frequently occurs in evening. The best" preservative is woollen clothing of some kind, be it ever so thin, worn next the skin. Persons who, from a warm climate, of which they are either natives, or to which they have become accustomed, come to reside in a variable or cold country, are peculiarly liable to affections of the chest or lungs, and not unfrequently become the subjects of consump tion, for the want of a little timely medical advice, which a work like this is intended to give. Such persons should by all means go more warmly clad than those who have been raised or acclimated to a northern country — putting on an extra flannel nnder-ihirt bj all means. Chilblain — tfervovsficss, or Nervous Diseases. 431 Chilblain.— This disease, though not. v-ery frequent, U auite troublesome; it is an inflammatory affection of tlio jldn, more particularly of the fingers or toes, caused by alter* nations of cold and heat, and is characterized rather l>v irri- tating and troublesome itching than by pain. Persons of tine ikin, scrofulous constitution, or languid circulation, are most dable to suffer from chilblains, and old people and children more than those of middle life. The sudden exposuiv of 1)19 skin when very cold to a high state of temperature, is gener- ally and justly considered to be an exciting cause of the af- fection ; but one quite as frequent is keeping the surface in 3 state of artificial warmth, by the use of sleeping-socks and hot applications in bed, or of fur-lined shoes and foot-warmere in the day time. All these applications keep the skin in a continual state of unnatural perspiration, weaken its tone, and. so render it more susceptible of the effects of cold when exposed to it. To prevent chilblains, in the predisposed, the feet ought to be regularly bathed with cold, or (in the case of the aged) tepid water, or salt water, every morning, and after- ward well rubbed with a rough towel, exercise being employ. ed to preserve the warmth of the extremities rather than artificial heat. When chilblains have formed, and the >kin ts unbroken, stimulating applications are requisite ; many different ones are used — spirit, 6uch as brandy, camphorated spirit, paregoric, or turpentine, will any of them be of service, applied by means of a piece of linen, or gently rubbed on. When the skin of a chilblain breaks, an ulcer is the conse- quence, which discharges a thin slimy fluid, and is often diffi- cult to heal. In this case, the inflammation should be subdu- ed, in the first place by means of a poultice, and afterward an ointment used, made with ten grains of sugar of lead, to the ounce of lard. Of course all friction or pressure from ooots or shoes must be guarded against. Frequently anoint- ing the parts with sweet oil or lard may be beneficial. Nervousness, or Nervous Diseases.— The term " Nervousness " is a kind of undefined expression, after a manner of speaking ; and yet, call it what we may, the disease is very prevalent. Females are much more liable to nervoua disorder than males, independent of hysterical affection, which constitutes one of the most marked phases of the malady, and many of the remarks on which apply to the pre- gent subject. In nervous disorders, there is usually great susceptibility to external influences, and at the same time mental emotions, 439 N&rvousness, or Nervous Diseases. whether of joy or grief, fancied or real, exert much influence over the body and its functions. The heart palpitates, tne hand trembles, the face flushes under the most trivial excite- ment. Much of this is undoubtedly due to constitutional timidity; but it is also notably increased in debilitated states of the constitution, and those who have never been what is called "nervous," are apt to become bo in some particular condition of impaired health. The affection is, indeed, very nearly akin to hypocondriasis (lowness of spirits); it is essen- tially a disorder of weakness, and is relieved by whatever in- creases, temporarily or permanently, the power of the ner- vous system. The temporary relief to nervous sensations which is afforded by alcoholic stimuli, is very apt to lead those who suffer from them to put too much trust in, and to resort too habitually to the use of those palliatives — a prac- tice which must be followed by pernicious consequences; sometimes, too, opiates are habitually made use of, and are nc less injurious. Undoubtedly, when properly employed, alcoholic stimuli, and even opium, are valuable in the treatment of nervous dis- ease, but they must never be substituted for more permanent means of invigoration. particularly regular and sufficient ex- ercise in the open air, on foot or horseback, good nourishing diet, with a sufficient amount of animal food, and attention to the bowels and the state of the skin. The producing cause, whether excessive mental exertion, sedentary employment, late hours, or excess of any kind, must of course be modified as much as possible. The shower bath is often recommended, and often useful in these affections, but some persons cannot bear the shock ; when this is the case, the cold or tepid bath down the back does much good, particularly if there be any tenderness <>f t lie spine on pressure, a fact which should al- ways be investigated in those who suffer much from nervous disease ; it very commonly exists and is overlooked. When the tenderness is at all marked, it will require special treat- ment by counter irritation, by the use of liniments, friction, etc. In 'addition to the regulation of the bowels, by propel purgatives, or by injections, quinine (one grain three times a day;, and the preparations of iron, are the most generally Useful remedies ; tincture of valerian may be used as a pal* •iative during an aggravated attack, but. should be sparingly resorted to; or tincture of valerian and hyoseyamus usrd to- gether in equal parts (one taaspoonfu) three times a day^ Wtf be tried. Fullness of Blood, or Plethora. 433 Fullness of Blood, or Plethora.— It is not unusual to sec what are called robust, strong, full-blooded persons, that look to be the picture of health, and yet they are any- thing but well ; being always exposed to danger from the too great fullness of the blood vessels, and richness of blood, individuals of the sanguine temperament, while leading a life of mental activity and anxiety, have greater powers of activ- ity than most others, but they, in many instances, border upon plethora, and if they become so placed that their former activity is eitl>er uncalled for or interfered with, provided there is not much mental anxiety, they quickly become ple- thoric ; the vessels are overloaded with rich blood, and instead of the former power of exertion, oppressive languor and inac- tivity succeed ; in fact, the whole of the functions, and the nervous system especially, are weighed down and clogged — there is mental sluggishness, heavy sleep, and inaptitude for exertion. This last symptom is too often mistaken for weak- ness ; the person laboring under the mistake resorts to addi- tional food and stimulants — it need scarcely be added, only to increase the evil. An individual in this condition, it may be said, is ripe for inflammation ; if cold be taken, it is very likely to light up inflammatory action somewhere, and once lighted up, the action is very liable to be of the severest kind. Should febrile disease of any kind — as for instance, small- pox, or erysipelas, or rheumatic fever, be excited in the con- stitution, the symptoms run high, and the case is very likely to become one of danger. For similar reasons, accidents are not well borne : at least their after effects are often such as to put life in danger. Persons who are in a plethoric condition, not unfrequently get relieved by some natural effort ; piles show themselves and bleed, or the nose bleeds, or spontaneous diarrhcea comes on, and instead of the individual being weakened, he feels stronger than before. The evil results of mistaking a state of oppression from plethora, of false debility for one of weak- ness, must be evident to all. Even the pulse is liable to de- ceive, and in these states of oppression to seem low and weak, • but it is essentially different from the pulse of debility. The latter, if the finger is pressed even slightly upon it, is extin guished at once ; but the pulse of oppression seems rather to resist the pressure, to become stronger, and to beat up against the finger, rather than to give way. As might be expected, plethoric individuals are often the subjects of apoplexy. A state of plethora must always be one, if not of danger, at least of hazard, and ought to be guarded against. 434 Old Age If a person suffering from plethora is threatened with an immediate attack, such as apoplexy, the condition cannot be too soon or too actively removed. Bleeding in some way, free purging, and low diet, are the immediate remedies; but in the absence of any threatened attack, it is not advisable to invoke the aid of these powerful agents; the system should be -educed gradually and steadily by the formation ot, and per- everance in, modes of living suited to counteract the ten- dency. When a man suffering from the effect of plethora gets rid of his unpleasant symptoms by a "coup," such as the loss of a basinful of blood, by a few calomel pills and black draughts, he is probably highly pleased to be so easily rid of his enemy, and by means which involve no self restraint or giving up of indulgences; so, trusting to the repetition of the same remedial measures, he puts no check upon himself, and when the plethora again reaches a certain height, he again bleeds and purges, and this goes on until he is overtaken some day with an apoplectic attack, or until he becomes the subject of organic disease. Persons who have a tendency to plethora, must have exer- cise — they must use up their blood and muscle in active mo- tion ; but in doing this, especially at first, they must bewaro of over-doing it. It will not do for a plethoric man to com- mence a new system of living for health, with violent oxer. tion — otherwise he might precipitate the very evil he dreads. Plethora, to be reduced, must be so steadily, but gradually ; active exercise, increased as the ability to take it increases, must be balanced with food proportioned to the amount taken, and animal food in very moderate proportion used. Earl} hours, and curtailment of the time devoted to sleep, is desira- ble. In most cases, tepid bathing is preferable to either iiot or cold, and, either by it or by sponging, the skin must bo kept active. The bowels require especial attention, and are better rather lax than otherwise ; any slight tendency to ple- thoric oppression being counteracted by acting upon them by proper purgatives, such as Epsom salts, or by seidlitz powders. If the kidneys are inactive, spirits nitre, twenty to forty drops three times a day, in a wineglass of water, or a teaspoonful of cream tartar in same quantity of water, about three ox four times a day, will be beneficial. Old Age.- 1 ' The youngest of us will be old some day, if we live long enough," sounds a little on the Hibernian order, bir the idea intended to be conveyed is not a bad one, and w should not forget the aged and the infirm. "With old age Old Age. ' 43> Increases the liability to such hereditary diseases as gout, gravel, rheumatism, apoplexy and paralysis, and in women especially, to cancer. Now the effects of excesses and dissipation in early life, which may have been unfelt during the vigor of manhood, too often add to the natural infirmities. Whatever may have been the previous modes of living, it is always a dangerous experiment to make material or sudden change in them ; after age has begun to tell upon the constitution, it should not be done, but for important reasons, and under medical advice. The weakened digestion of advanced life should be considered in the food, which, while it is nutritious, ought at the same time to be lightly cooked, and everything like hardening avoided. Where the teeth are deficient, meat should be well divided, either by mincing before cooking, or by the knife after. The meals should be light, nut at too long intervals. If the dinner be early, as it ought to be for the aged, who are not obliged to hurry off to business, supper, though a light one, should always be taken. The skin of old people is often most shamefully and disgustingly neglected, and no point in their management is more closely connected with their comfort and health ; it should frequently be spong- ed with tepid water, and well rubbed afterward with a rough towel, to promote reaction. It ought at the same time to be carefully protected by woollen clothing: old people are most injuriously susceptible of the changes of external, tempera- ture, particularly cold. Exercise by the old should be con- tinued as long as they are able to take it, but never extended to fatigue. Sleeplessness, so frequently and so loudly cora- f darned of by aged people, is, in some respects, natural; aa ite advances, nature would seem to require less of the soft restorer. It is not well to endeavor to overcome it by nar- cotic medicines. If possible, the time of sleep should, by habit, be kept to the early hours of the night; and, in sum- mer especially, the tedium of the early morning may be relieved by reading, knitting, sewing, or some other light em- ployment. In advanced life, the urinary organs require the greatest care ; the call to relieve them should never on any account be delayed ; on the slightest symptoms of derange ment, proper medical advice ought to be taken at once; it may prevent evils which too often render the latter year miserable. It is most important for old people to give them selves time to empty the bladder thoroughly / tUey do thi c with more difficulty than the young. The medicines pre- scribed for the aged should be, whenever it is possible, of a warm character, to cou»te?*%ct the tendency to Hatulenf: dis- 43G Flatulence. tension ; large doses of mercurials, neutral salts, and strong fmrgatives, are all to be avoided. Pills, especially if at all iard, are apt to pass through the bowels unchanged. When a mild purgative is required by an old person, none is more suitable than a moderate dose of infusion of senna, to which a little ginger, or a teaspoonful of Peruvian bark, or of gen tian root, is added. Six to eight drachms of the compound decoction of aloes answers well, if there is no great tendency to piles. "When the bowels are habitually constipated, injec- tion of a pint to a pint and a half of warm soap-water, must be given occasionally as required; this counteracts the great tendency to accumulation in the bowels. The doses of medi cine ought always to be diminished after the period of incipi- ent old age, as old persons do not bear the effects of medicines so well. Flatulence. — This is commonly the result of indigestion, but it is often also the effect of nervous disorder. In the former case, it is probably chiefly due to the extrication of gas from the badly -digested food-mass in a state of partial fer- mentation. In tiie latter, it is only possible to account for the enormous quantities of " wind" which are discharged by its formation (secretion J in the bowels. Toward the termi- nation of fever and other acute diseases, flatulent distention of the bowels, or " tympanitis," as it is called, is always an unfavorable symptom. Persons who suffer from flatulence require sedulously to avoid most kinds of vegetable food and fruits. Individual expe- rience, however, is the best guide on this head. When a se- vere attack of flatulence comes on, carminatives, such as chewing a piece of calamus or ginger root and swallowing the juice, a few drops of peppermint in water, or eating some peppermint drops, are generally resorted to, and often prove useful. A drink of water as warm as it can be taken, is often a very good and simple remedy. But in many cases, partic- ularly in nervous individuals, with pale tongues, the mineral acids will often be of more service — either twenty or thirty drops of dilute nitric acid in a wineglassful of infusion of orange peel, or some other warm bitter ; or, better still, aro- matic sulphuric acid, in ten drop doses, in a wineglassful of water. As preventatives, keeping the bowels well open, and the use of the flesh-brush over the stomach and bowels twice ;i day, and plenty of out-door exercise, are the best. Persons subject to this complaint should be careful to eat slowly and chew t/ieirfood well. Noises in the Ears — Weakness of the Bladder — Bile. 437 Noises In Hie Ears. — These are often compared to thfl jounds of " bells rinffing," " simmering of water in a kettle," "singing of insects,' "roaring of the sea," &c. They are often extremly troublesome, and may arise from many and different causes. Mere temporary derangement of the di- gestive organs will in some persons produce them. They are often indicative of determination of blood to the head, and when accompanied by symptoms of this tendencv, ought not to be neglected. Partial obstruction of the Eustachian tube by cold, or accumulation of wax in the external ear-passage, are apt to occasion these noises, and they are accompanied with some degree of deafness. Of course the remedy must vary with the cause. If the digestive organs are deranged, they must be regulated; if cold be the cause, the symptoms may be left to pass away with the temporary ailment. In some cases of chronic or continued noise in the ears, regu- larly bathing the head with cold water every morning will sometimes remove it, when other remedies fail. Weakness of the Bladder in Old Persons. — An inability to perfectly retain the urine, and a weakness of the bladder, is a frequent disorder of aged persons. It often commences with and is accompanied by imperfect cmptj'ing of the organs, either through carelessness or weakness. Sponging the lower parts of the abdomen, &c., &c, with vinegar and water, or sa_t water, may be of service. Some physicians recommend the use of the tincture of the ergot of rye in these cases, a teaspoonful three times a day, but as a general rule they should be placed under regular medical attendance. The same may be said of that very troublesome complaint of old age, catarrh of the bladder, in which large quantities of thick mucus are discharged. A tea made of uva Ursi, and Buchu leaves (in equal parts), taken in the quantity of a small wineglassful three times a day, with the addition of twenty drops of spirits of nitre, is beneficial in diseases of this kind. Bile. — This is secreted by the liver, is of a brownish-yellow ^olor, and has a very bitter taste. Its composition is complex, and it undoubtedly fills more than one important function in the body. Bile is separated by the liver from dark blood, which, passing through that gland, on its way to the heart, from the abdominal organs, is thus purified of noxious mat- ters, containing a large amount of carbon, before re-entering the general circulation. The separated bile is discharged into 438 Bl^ousness, or Biliary Derangement. the duodenum (top of the bowels), and mixing with the di gest.ed food, appears to assist in fitting certain of the cunstitu ents for absorbing into, and assimilation or transformation in the body. A large proportion of the constituents of bile are ■long with the food re-absorbed into the system, and are probably intended and adapted to support the processes 01 respiratory combustion in the lungs. It is chiefly the color* ng matter of the bile which is discharged from the bowels in health, which gives color to the discharges from the bowels. Biliousness, or Biliary Derangement — When persons feel unwell and do not know exactly what is the mutter, it generally turns out they have made up their minds tli at they are " bilious" ! It is true that biliary disorders are very common. In fact biliary derangement is so frequent an ailment in civilized life — its history is so intimately connected with the general principles of health, and the prevention, or at least alleviation, of the disorder is so much under indi- vidual control, that it has special claims upon our attention. It has been shown, under the subject of Bile, that in ordinary health there must be a certain balance maintained between the secretion and ultimate destination of the bile, the assimilation of food, and the functions of respiration ; that in the excreted bile the blood is freed from certain principles containing a large amount of carbon, which could not be retained in it without injury to health. That further, the bile having been separated from the blood by the liver, and thrown out into the general tract of the bowels, performs an important part in the function of assimilation (digestion") ; and that, lastly, a considerable proportion of the bile — with- out the coloring matter — is reabsorbed into the system, with the nutriment, in such a state as to fit it, or rather its carbon, for union with the oxygen which enters by the lungs, so that while heat is generated, the carbon, by taking the form of carbonic acid, is fitted for excretion by the lungs or skin. Upon these facts hinge the causes of one at least of the most prevalent biliary disorders, that which depends upon the introduction into the system of a proportion of carbon ali- ment tjo great to be removed by the oxygen obtainable through the lungs, and which has its ordinary termination in the attacks which are termed " bilious attacks," * k sick head- ache.-),"' ik bowel complaints," ''cholera morbus," &c, accordiug to the manner in which the patient is affected. The second form of biliary disorder depends upon torpidity or inactivity of the liver itself. The third form is the reverse Biliousness, or Biliary Derangement. 439 of the first; the gland itself may be sufficiently active, but tho blood does not afford sufficient material to work upon, and bile is deficient. This is most frequent in children. The first form of biliary disorder, that dependent upon the accumulation of carbon, or of the elements of bile in the blood, must evidently be owing to one of the following causes, or a combination of them ; either too much food, cspe *ially of a highly carbonized character, such as fats, oils, Augar, ^c, is habitually consumed, or the habits are too physically inactive to keep the functions of respiration, animal heat, and circulation, in healthy action, or the external atmosphere is so temporarily or permanently rarefied by heat that the individual cannot obtain the full supply of oxygen in respiration ; lastly, the excretory function of the skin (sweating, &c), may be impeded. Now, though it is Unquestionable that some persons have a much greater ten- dency to biliary disorder than others, it is also unquestiona- ble that all have it in their power in a great degree, if not entirely, to control or obviate that tendency, by attention to, and practical application of, the above principles. In those who suffer habitually from sick headaches — which depend generally upon the presence of bile in the stomach — and from other forms of biliary disorder, there is generally traceable great error in diet. Fats, as found in ham and bacon gene- rally, melted butter, pastry, meat, malt liquors or wine, and >ther highly carbonized articles of diet, are taken too freely, )r at least are too regularly indulged in, while at the same oinie very little active exercise is taken ; the blood becomes >verloaded with carbon; languor, sleepiness, headaches, giddi- ness, loss of appetite, furred tongue, depression of spirits are the consequences, and continue until at last the system is relieved, wholly or partially, by an excessive secretion of vitiated bile, which passes off either by vomiting or purging. That deficient exercise has much to "do with such a state of system, is evident from the much greater prevalence of such attacks among females, who take little exercise, than among men ; and indeed they would be still more prevalent among the former, were it not for the monthly sickness. Habitual neglect of the skin, also, by impeding the excretion of car- bonic acid from its extensive surface, undoubtedly assists the evil. From what has now been said it is evident how much the avoidance of biliary disorder is under individual control the question is in reality not one of medicine, but of diet and regimen / medicine certainly maybe required, but not by any ii.0 Sciatica. moans to the extent it is often used. Those who are habitu ally liable to biliary disorder ought most strictly to regulate the diet ; fats of all kinds (except, in some cases, bacon), must be avoided ; butter either entirely avoided, or used in very small proportion, and never when melted; animal food may be taken in moderation, but should never be consumed at night; much sugar, strong tea or coffee, malt liquor and wines, are all bad. In addition to plain meat, bread, well boiled vegetables, farinaceous preparations, such as rice, potatoes, Arc, and fruits, ripe or cooked, are the best articles of diet. Exercise regularly in the open air must be taken, and the skin kept clear and in an active state, by frequent bathing, friction, &c. If the bowels are confined, a pint of warm water, used as an injection, will be most suitable. It is much better not to trust to medicine. When, from any cause, the languor, sleepiness, furred tongue, &c, give notice of an impending bilious attack, eat sparingly of the mildest liet and take a purgative of some kind. Having thus cleared the system, it is better to trust to diet and regimen than to a repetition of the dose as a corrective of indulgence. There is reason to believe that an emetic of ipecac or warm water taken on the first approach of the disease, would break it up suddenly in most cases. Sciatica. — This is a kind of NeuraJ,gia, or Nervous Rheumatism, which affects the Sciotic nerve, the great nerve Df the lower extremities. This nerve, the largest in the body, passes down the back of the thigh to the ham, a little above which it divides into two main branches. The nerve some- times becomes the seat of severe neuralgic pain, felt down its entire course, or perhaps in the hip only, or sometimes in the foot and ankle ; the pain comes on in paroxysms, and is gen- erally increased by exercise ; in some cases pressure upon the course of the nerve causes pain. Sciatica is often attended with so much suffering, that it alfects the general health to a considerable degree ; moreover, it is frequently most difficult to get rid of. Leeches and cupping, m the lirst instance, down the course of the nerve, especially in phletoric, robust subjects, followed by blisters, are useful ; or heat and moisture may be used with advan- tage in the form of a bran poultice, followed twice or three rimes a day by the application of a liniment. Kerosene oil frequently applied is an excellent application, to be followed by laudanum and turpentine, well rubbed in, and then covered with flannel. 441 The bowels being cleared by a purgative, if there is no ten dency to fever, drachm doses of carbonate of in n, given three times in the twenty-four hours, often cures quickly ; or tur- pentine, in doses ot fifteen drops, given in milk, three times a day, may be tried ; or quinine, in two-grain doses, every eight hours. There is considerable uncertainty in the effect of remedies in Sciatica, even in skilful hands. In all cases of Sci atica, perfect rest of the limb is essential. Sulphur baths are also recommended. Gonorrhoea, As tm's book has been written for all classes, a short statement giving the symptoms, causes, treatment, &c., of the various forms of sexual, or (as they are usually called,) venereal diseases, is necessary. In the first place, it should be understood, that Gonorrhoea, or Clap, and the Venereal disease, are two entirely distinct diseases. A person, for instance, having Gonorrhoea cannot give another person the Venereal disease, nor can one having the Venereal disease give another the Gonorrhoea, or Clap. Neither can one disease change into the other ; but both dis- eases may exist in the same person at the same time, and both may be communicated at the same time, or only one, as may happen. The important point to consider is that they are two distinct diseases. This is very important, because Gonorrhoea is simply a local disease, while the Venereal disease, or Pox, is a constitutional disease, which poisons the nlood. This is an infectious disease ; it is seated ; n the uri- nary passage, from the orifice of which there is»..es a dis- charge of matter, attended, more or less, with pain and heat in making water. There is no outward sore or ulcer in Gonorrhoea ; neither is there any within the passage. If it were possible to take an inside view of the urinary passage, nothing would be seen there but redness and a little swell- ing, and the discharge, whether much or little, would be seen issuing from the red and swollen state of the membrane which lines it, just as matter is sometimes seen issuing from an inflamed eye. Venereal disease, on the contrary, is not seated in the urinary passage, but externally, on some part or other of the genital organs, and consists in one or more Lttle ulcers or sores, which do not heal like others, but con- tinue unhealed, and, at length, assume a peculiar character. Gonorrhoea consists in a discharge from the urinary pas- sage, attended, more- or less, with pain and heat in making water, without ulceration or sores ; whereas Venereal disease consists in external ulceration or sores, without discharge 442 from the urinary passage, and without pain or heat in making water. No one, it is presumed, after this can possibly mis- take these two diseases. A person having been exposed to this infectious maladj (Gonorrhoea), at some period within seven days, if lie should Lave taken the disorder (which we will suppose to be the first attack , will feel a little pain and heat in making water. This lead- him to make an examination, when he will find the orifice of the urinary passage looks a little redder than usual, its lips rather pouting or swollen, and on squeezing it, an uncommon dampness or thin mucous will be seen. In the course of a few hours, or by the next day, the pain and heat in making water will have increased, the discharge also increased and of a purulent or white creamy appearance. For some days these symptoms go on increasing in severity, the matter be coming of a yellowish color. Sometimes the pain and heal in making water will be exceedingly great, amounting to a sensation of absolute scalding; at this time the discharge generally turns to a greenish color, and instead of being about as thick as cream, is thin and watery. Under these circum- stances, there is also a painful sensation along the whole length of the urinary passage. Gonorrhoea always begins with pain and inflammation, more or less, .which after a time abates very much or entirely subsides. This is called the inflammatory stage of the disease. The degree of pain and inflammation is not the same in all cases ; the oftener a person has had the disease, as a general rule, the less will be the inflammation, so that persons who have had the disease several times may feel scarcely any pain, the only notice of it being the soiling of the clothes with matter. After a time this inflammation subsides, whether remedies have been used or not. In the commencement, the seat of gonorrhoea is just within the orifice of the urinary passage ; but the disease soon pro- gresses, until it reaches the neck of the bladder. How long a time it may occupy in its passage through the urinary canal, is uncertain, and differs in different individuals, and under different circumstances of constitution, mode of life, etc. The painful inflammatory symptoms, however, seem principally to attend the invasion of the disease, and most of all, its et' feet upon the first portion of the passage; when these aio subsided, we may consider it has advanced to its ordinary distance. After a time, or if there has been much pain, after this hai subsided, another stage of the disease commences. This stage 443 consists a-rrply of an infections discharge issuing from tho oritice, with little or no pain. This discharge is more or lesa In quantity in different persons, and is much increased by whatever may excite, or by irregularities of any kind. This, specially when the discharge is slight, and quite unattended with pain, is what is properly called " (fleer,"' and when once Buffered to commence, there is no telling how long it may continue, or how it is to terminate ; but let it ever he remem- bered that, as long . as this discharge continues, the disease may be communicated by infection. This, then, is the Second or Chronic Stage of Gonorrhoea. Sometimes there is great swelling of the foreskin and prepuce, which is not free from danger, as mortification sometimes takes place, on account of a kind of ligature being formed of the skin around the parts, called Phymosis when the skin cannot be brought back, and Pariphymosis when it cannot be brought forward. Swelling of the glands in the groin, which often takes place, is the result of inflammation. In every part of the body, there are certain little vessels, called absorbents; and these, in their course, run through absorbent glands, of which there are several in each groin. Now it happens that inflammation in the urinary passage id communicated through the medium of these vessels to tho glands in the groin, which become painful and enlarged in consequence. It is, however, worthy of remark, that in gon- orrhoea, glandular swellings seldom go on to form an actual bubo (which is an abscess in the groin), as they are apt to do in Venereal Disease, so that they are comparatively trifling; after a little while, they generally subside and disappear. Swelling of the testicle sometimes takes place, and generally the pain is great, and the necessity of rest and lying in bed is urgent. Much, however, may be done to prevent it, if early attended to, and therefore the symptoms which precede and lead to it should be noticed caretuliy. The first thing which precedes a swelling of the testicle, 'a a sense of pain running down the whole length of the urinary passage, accompanied with a feeling as if a drop or two of urine were remaining in the passage after making water. To this there succeeds a dull pain in the groin, going on to aft'ec the testicle, which presently feels heavy, and very tender to the touch ; or, the pain and tenderness of the testicle may set in at once, without any of these premonitory symptoms No time should be lest. It should be attacked instantly, in order, if possible, a - arrest the inflammation before tiiJy developed. I m Inflammation of the Bladder is sometimes caused by con orrhoea. It may be slight, causing merely the inconvenience of too frequent urinating, with difficulty of restraining it , or, the bladder may empty itself every five or ten minutes, passing only an ounce or two of highly-colored mice, with great pain, and followed by blood, the desire to urinate remaining unrelieved. It is then attended with fever. This affection oftener appears in a mild or sub-acute form, but may set in with great severity, and is then a most painful and har- assing addition to the gonorrhoea. The question is sometimes asked, " Does gonorrhoea ever nrear itself out?" It may possibly d<> so; but it is running a most terrible risk, for it may, in the meantime, produce gleet, and stricture of the urethra. It is a serious matter for a physician, in writing a book for the use of the masses — those who are not conversant with the many phrases used by medical men in their every day pro- fessional life, to attempt to give definite and complete directions for treating diseases of such a complex nature and dangerous tendency, as diseases peculiar to the sexual organs in both sexes. The reader may not — most likely will not — have a Medical Dictionary at hand to consult, as to the meaning of various words in common use by medical men in describing the treatment and remedies to be made use of — and under such circumstances is just as likely to take the wrong meaning as the right — and the consequence is, the disease is made worse instead of better, and finally, after much suffering — possibly some local injury that will follow the sufferer to the grave — he goes to a physician for treatment. Besides all this suffering and the risk of permanent injury, the expense — no trifling matter to most of people — would in all probability be as ten to one. *\Ve remember a case of this kind : A young man who held a very responsible position in a large city South, was so un- fortunate as to contract Gonorrhoea ; he was married, which made his case the more lamentable, and in.his etibrts to con- ceal his adulterous and unmanly conduct, he tried the reme- dies which he found recommended in some popular medical work ; the result was, that after long, weary weeks of sufl'ering — dirting, purging, and using a lot of medicine, better adapted to a sick horse than a sick man, and becoming fully satisfied that he could not cure himself — he gave up his lucrative and honorable position, and came to New York. Falling in with one of the medical sharks that infest all cities, he was cured 445 of his money to the tune of $150 ; but his disease, -was worse than ever, his body reduced almost to a skeleton, and his mind worked up to the verge of despair. In this unhappy con- dition he happened to think of the author, an old acquaintance of other years, and finding his way to my office, out of heart, out of money, he told me his sad story. In about one month I had him so that he was able to say he was once more a well man, and went back to his home a wiser, if not a better man — having lost nearly a year in business, spent his money, suffered much in body and mind, before he fi»undout that in diseases of this nature, a competent physician at the begin- ning is the cheapest and best investment a man can make. The same remark will apply to all advertised quack medi- cines for these diseases. One patient informed me when he first came to me for treatment, that he used over fifty bottles of " stuff," costing one dollar per bottle, and was worse than when he began. The only common sense plan to pursue is to avoid getting such diseases j but if you are unfortunate enough to contract these diseases, be sure to consult, as soon as possible, a com- pent, honest physician. A physician may be very competent and yet very dishonest — giving his patient plentifully of sweetened water — until he allays excitement and reduces the size of the patient's pocket. But some, yea, most of pa- tient?, will say, I do not want to bring myself into disgrace by consulting my family physician ; nor yet, one in my neighborhood — I don't want to be seen going there. Well, all this is true, and for that reason w r e offer our medical ser- vices to all who may meet with misfortune of this kind. You can w T rite me by mail, if too far away to call in person, and can rely on being treated by a competent medical man, with- out being compelled to run any risk of exposure, in the manner referred to above. Out of the thousands of cases I have treated and cured, I have not even seen one patient out of a hundred ; they simply write me a letter describing the symptoms of their disease, giving age, occupation, how long affected, condition of the bowels and all other particulars. I prepare medicines, in a concentrated form, so they can go safely by mail in most all cases : or, if desired, can be sent by express. You need not use your real name in writing to me, unless you desire it. You should always bear in mind, not to wait — but send at once. In regard to expense, I would say, to save time, send me five dollars, (and twenty-five cents for postage) in Registered Letter Post Office Money Order, or by express. In a great many cases this will be all the 44G expense necessary, as I send the medical treatment and the medicine bv mail as an ordinary letter package. Address letters to— M. Lafayette Byrn, M. D., P. C\ Box 4669, New York (Office, 40 Nassau St., Room 9). Letters addressed simply to " P. O. Box 4069, New York," will reach me safe- ly, it" you do not want to put on any name. It* you desire to see me in person, write to me a few days before coining, what hour you will call. The sooner treatment for these diseases is commenced the easier will be the cure — many cases can be cured in a few days. Persons having a friend that they think may need advice or medical treatment on this disease, would do well to for- ward him this book for perusal. Syphilis This, as we have before stated, id an entirely distinct disease from Gonorrhoea. It commences with minute erosive ulcers on some parts of the genital organs. These are termed chancres. As the chancres gra- dually spread and deepen, they secrete a virus, which, being absorbed, may occasion a constitutional taint or cachexy, called secondary or constitutional syphilis. The first stage of a chancre is called the vesicular. A small red point is first noticed, which soon becomes elevated into a pimple ; this is gradually changed into a vesicle or sac, containing a turbid humor covered by a 6cab, which is eventually detached, becoming an open ulcer. The time elapsing from the first appearance of the morbid point to the complete ulceration, may be a few hours, or several days. The second stage is that of ulceration. The sores are generally of a roundish form, involving the whole skin nnd the adjacent parts with an indurated (or hardened) base and edges. The size of the ulcerated surface varies from that of a pin's point to a dollar. Sometimes the centre and bor- ders of the chancre are elevated so as to form a fungous (proud fles?h) projection, constituting what is called the raised chancre. Chancres in close proximity cften become united into a single ulcer. This stage of ulceration may inst for several weeks or months. In some cases, it has contii.ued for years. The third stage is that of cicatrization (or healing.) TV hen a chancre is about to heal, it passes into the condition of S wound. The difference between an ulcer and a wound con- sists in the difference of the membrane secreting the humor which covers the two solutions of continuity. When thin cicatrizing membrane appears, the edges of the ulcer whieli are detached sink, and approach the base, to which they uuit<\ 447 l'hd ^equalities of tlie base, the indentations » f the borders, disaj \ ear, and are replaced by fleshy granulations (or healing points/, resembling those in suppurating (running) wounds. As the healing of the ulcer progresses, its circular form becomes changed and angular at several points of its circum- ference, because its edges are drawn inward, and in an unequal manner, by the membrane. The cicatrix (or scar) which suc- ceeds to chancre, like that of every solution of continuity with loss of substance, is shrivelled and depressed; sometimes, instead of being depressed, it is, on the contrary, elevated like a honeycomb. On the mucous membrane these mark* at length completely disappear. Once the healthy process commences, its progress is rapid, for it is now no longer that of a chancre, but a wound. Cic- atrization is not complete while there remains a single point of tho grayish base. This point may extend, become devel- oped, and the chancre itself be renewed ; or, to speak more correctly, become enlarged, and invade the cicatrized portion, and the adjacent integuments, which were not before attacked. But when the cicatrization has once covered the whole sur- face, a return is no longer possible; before another chancre can appear, there must be a new inoculation—another attack of the disease. The chancre, as described ia the preceding article, is called regular. When the sores extend irregularly, and progress rapidly over the surface, in the form of a malignant erysip- elas, they have been termed phagedenic. The term chancre signifies a gnawing, corroding affection ; but the disease is denominated phagedenic only when it is unusually erosive, irregular, and spreading. Another form is called gangrenous. It implies a destruc- tion or death of small portions of tissue beyond the boundaries wf the ulceration. The phagedenic and gangrenous varieties lo not depend on peculiar modification or virulence of the mginal affection, but on the morbid conditions and habits of the patients themselves, or upon the unfavorable circumstan- ces in which they are placed. Another variety has been denominated Mpthtritic or put- taceous. It is generally noticed in old and feeble persons. The ulcer is deeply colored, disposed to bleed, and the sur rounding tissues are thickened and indurated. The ulcer is coated with a false membrane, and bleeds if this is removed. This membrane or coating is, however, immediately repro- duced. In some cases, the ravages of the disorganizing pro* sess are terrible. The genital organs are rapidly destroyed 44S Syphilis, or Pox. and the adjacent parts often present a disgusting mass of cor- ruption. The indurated chancre is defined as a small, round callous ulcer. In the treatment of this disease, as we mentioned when treat- in- of gonorrhoea, also, we would by all means advise those who contract this terrible malady to seek the very best medical advice at once. It is too dangerous a disease ever to be treated by any but a skillful physician. In the treatment of a disease like this, it requires the best medical skill and the most care- ful watching of physician and patient, that the unfortunate sufferer may be saved from a physical condition, but better preferable to death itself. Remember one thing ! this disease never cures itself, nor runs out ! but being a poison in the blood, goes on from bad to worse, until checked bv scientific treat- ment and the proper medicines. No living being should ever attempt to treat a case of this kind, by following some directions found in a Sick Almanac, or popular medical book, if a com- petent physician can be found. Neither should you ever take a quack medicine, no matter whether it be advertised in a Pamphlet. Newspaper, Circular, or some pretended Popular Medical Advertiser, in the shape of a book. How often have I shuddered as I have seen some unhappy being come to my office, whose wasted form, shattered constitution and broken spirit, has revealed to me at a glance that thev had been using some advertised remedy, or had been following the directions iound in some stray volume, that pretended to cure all the world and the rest of mankind, by a few simple words of ad- vice. Bo not attempt to cure you? self; bu t trust to a physician of honesty, capacity and experience. Having treated success- fully thousands of cases of this disease in its various forms and stages, I can conscientiously offer you mv professional services. I can cure you if directions are followed. Do not delay, but write at once, giving your age, size, occupation, how Ion*: afiected, and all the particulars of your case ; •enclose $5.00 (and 25 cents for postage,) in a Registered Letter or get a 1 ost Office Money Order, or you can send money by Express Address, M. Lafayette Byrn, M. D., 1\ O. Box 4669 New York! (Ofhce 40 Nassau Street). Persons who have this disease should be careful that none of the poisonous matter from sores of this kind gets on towels, or any place where the peculiarly poisonous substance may get into the eye, nose, mouth, etc., of any person as it is very contagious, and may ruiu the sight, etc., in other persons than the patient. Gleet— Its Nature and Cure. 449 GLEET.— ITS NATURE AND CURE. A Gleet is almost always the consequence of a badly managed Gonorrhoea. Instead of following up the cure of that disease by the means which have been so particularly dwelt on proper, the discharge is suffered to go on from month to month, and the effect of this is to entail a permanent disordered condition of the parts affected, and which generally then goes under the name of Gleet, Weakness, &c. It is important to understand the nature of this malady as well as how to cure it, especially as a very serious error re- specting its infectious nature prevails with many. It is a very common thing to hear it said that a Gleet is not infectious; but this is very wrong, and often leads to great trouble. Vir- tuous and unsuspecting women are unintentionally involved in this complaint in consequence. A person who is about to marry, for instance, may not have had Gonorrhoea for six or nine months, or longer; but a slight discharge — so slight indeed that he has scarcely observed it — may have continued all this time. But he does not dream of its infectious nature until the saddest consequences show themselves. So, also, unfortunately, does a similar cause of unhappiness frequently occur in those that have been abroad or from their family for a length of time. Indeed, the consequences of this error are so very serious that it merits any pains and trouble to set the matter in its own true light, and perhaps I cannot do this better than by giving a case or two as related by Sir Astley Cooper. On this subject, Sir Astley observes — "Gonorrhoea, when neglected, sinks into a Gleet, and is known by the change of the color of the discharge, and the pain attending the inflam- matory stage ceasing. In this state is the discharge infectious or not ? I doubt myself whether a Gonorrhoea ever loses its power of causing infection as long as any discharge from the urethra remains, and I will give you my reasons for this opinion. A married gentleman went to Lisbon from this country, [England] and whilst at a distance from home, departed, as too many do, from the path of virtue. The Portuguese lady with whom he cohabited gave him the Clap. He returned to England, and, after the expiration of five months and three days, after first observing the Gonorrhoea, he called on me, and asked whether he might return home with safety to his wife. He said he had a little discharge, and wished to know, if, after having it five months and three days, it were possible for it to be infectious. I replied — 'Certainly not ; you may go 450 Gleet— Its Nature and Cure. home, there is no danger of you giving it to your wife.' lie went home, and unfortunately gavehis wife a severe Clap. I attended both the parties afterwards, and was extremely sorry for what I had done ; but I thought, at the time I gave the advice, that a Gleet was not infectious. But I think differently now — and believe that, after a continuance of several months, the discharge is injections." Another instance — " A gentleman from the north of Eng- land, who had been recently married, came to me and said that he had communicated a Gonorrhoea to his wife. Shocked at such an occurrence, I said, 'How could you think of acting in such a manner?' 'Why sir,' said he, 'for fourteen months prior to my marriage I had a Gonorrhoea; I made various at- tempts to get rid of it, and had a variety of advice about it, but a yellow discharge always continued. I was told by every- body that it was not infectious, and not till after such repeated assurances did I get married ; the consequence, however, is, that my wife has a severe pain in making water, and a copious discharge.' I visited her, and found her in this state; she was some time under treatment before she quite recovered. From what I have seen, I do hold that a medical man is not warranted in saying that a discharge of a gleety kind is not infectious." On these two cases thus faithfully related, then, every per- son may be able to form his own opinion on the infectious nature of a Gleet ; I think they are sufficient to make every reflecting, conscientious person take care how he gives advice in such a case, particularly if his patient is a married man. Indeed, it is from this error, or from a total indifference as to its consequence, that we have so many cases of Gonorrhoea — they are twenty to one compared with cases of Venereal. In fact the common women of the town pay no attention to a Gleet. Alter the first or inflammatory symtoms of a Gonorrhoea have subsided, they mix with society as though nothing ailed them. In the patients of the Hospital called the " Lock " in London, for instance, nothing is more common than to see the Venereal and the Gonorrhoea in the same female ; but it is the Venereal which brings them there. As to the Gonorrhoea, or Gleet, they will tell you they have had that a long time, and thought nothing of it, but having got the Venereal, in the form of chancres, they became alarmed, and anxious to be cured. So also, when the Venereal is cured, they seldom stop in the Hospital for tlie cure of the Gonorrhoea, or Gleet, but go out again promiscuously in the town and spread the Gonor- rhoea in every quarter. I do not however, after all, say that every Gleet is infectious The Treatment and Care of Gleet. 451 but, they are so generally, and there is no mark whatever by which it can be said that this one is infectious and that one is not — this can only be known by its' consequences. ll<>w serious therefore to say to any one, especially to a married man, or one about to marry, that a Gleet is not infections? But it is incumbent also to state, that there is a discharge from the urethra, in some measure resembling a Gleet, which is not infectious. A discharge of this harmless kind may proceed from two causes which may be easily understood. In the first place, it may proceed from a little abscess which occasionally forms in the urinary passage, and breaks; and the other is, a discharge proceeding from a Stricture. Now, the nature of these two causes of discharges must be understood, and then a supicions Gleety disorder will be easily detected ami distinguished from either of these. First — With regard to the discharge from the little abscesses above mentioned, it should be known, that, in the whole length of the urinary passage are situated here and there, lit- tle sacks' for the purpose of secreting a lubricating fluid ; these are called lacuna*. After a Gonorrhoea, these little lacnnse are sometimes affected with common inflammation, which funis into abscesses, and when these burst and their contents are discharged, the running ceases. Now, the circumstance by which these abscesses may be distinguished from a Gleet, is this : — the discharge from' these lacunae stops entirely for a week or two, and then, when another breaks, it comes on again suddenly, and again ceases as before ; but the discharge from an infectious Gleet never stops — it may increase, from excesses or irregularities of any kind ; and it may decrease, so as to become very trifling, but it never ceases altogether. This, therefore, affords a good rule for judging between Gleet and a discharge from these abscesses in the urinary passage. And next — With respect to the discharge arising from Stricture, this will be easily detected by considering the symptoms proper to Stricture. THE TREATMENT AND CUBE OF GLEET. A Gleet is often a very troublesome disease to manage. If there were no other reason for saying this, I might safely infer it from the numbers who have come to me with this complaint, having had it on them, more or less, for a length of time. These patients generally state that they have tried a great variety of means, and are quite disheartened. I cannot always learn particularly what these means have been, they 402 The Treatment and Cure of Gleet. have always failed. As remarked -when speaking of the treatment of Gonorrhoea &c, I would by ail means advise Patients not to trifle with an attempted Self-Cnre, by direc- tion of some medical book or the use of some patent medicine, but consult a reliable, capable, knowable Physician. If there are reasons why yon do not want to apply to a physician in your own neighborhood, or having tried such, and you remain as yet uncured, I shall be pleased to undertake your case — and am satisfied that we can speedily cure you. Give your age, occupation, how long affected, what you have used, and your present condition, enclosing $5.00 (and 25 cents for postage) and I will furnish a medical treatment and medicines. Send in Registered Letter. P. O. Money Order, or by Express, to M. Lafavette Bvrn, M. D. ; Post Office Box 4GG ( J, New York. (Office, No. 49 Nassau Street.) There is probably no disease of the Sexual System which so often disappoints the expectations of the physician, or discourages the patient as Gleet. When supposed to be en- tirely cured, a very slight dissipation or irregularity may pro- duce the symptoms afresh, unless it has been thoroughly cured. 3IastvwI»atioii. — In all ages of the world, of which we have any account, there has prevailed in the youth of both sexes a most destructive habit, by reason of which many lives are lost every year, besides in other instances the laying the foundation for disease and a debilitated condition, which the I best efforts of a life-time do not counteract. This habit ia known by the name of secret habits of youth, or masturba- tion, and is. one of the most prevalent and most universal of any that afflicts the human race. One reason why the vice or habit is so very destructive to youth, is from the fact that it is continued in secret from day to day, and from year to year, without a knowledge of its real consequences. There are very few parents who ever think to warn their children of the dangers of this habit, either by speaking to them, or putting into their hands a treatise on the subject, and even do all in their power to keep their children from getting hold of any books on the subject. This kind of false modesty had been the cause of many a blooming youth filling a premature grave ; and we hope to see the time when parents, teachers and guardians will treat those entrusted to their care with more confidence, and the exercise of better judgment. This habit, began in youth, is often continued many years It is not a/ways the result of initiation, or contracted by contact with those who indulge in the habit, but this is the cause in 453 most cases, and one bad boy will ruin twenty good ones. There are those who think their children can only contract had habits by contact, and among the rest the habit of mas- mrbation, and think if they can keep their families from /ieious company they are safe. Tin's is generally true, but there are exceptions to the rule; for no matter how strict a parent may be, the very innocence of a child makes him a ready tool for tbe designing, when they chance to fall into their company. This habit is oftener learned at school than elsewhere. Tbe following are some of tbe consequences of this des- tructive habit: Consumption is often induced by this habit, by debilitating the system, and causing tubercles to be devel- oped in the lungs. Loss of memory is among the most com- mon effects produced by it. Insanity is sometimes produced by this habit ; the unusual and unnatural excitement produ- ced by the very frequent repetition of the act, sooner or later reaches the brain, the great nervous centre, unless abstained from; and this weakness continues in a ratio with the extent to which the practice has been carried, until it no longer controls the body, and there is lowness of spirits, a dis- position to commit suicide, restlessness, discontented mind, and an exceedingly unhappy irritability of temper, causing the patient to make himself, and everybody around him, unhappy. An uneasy, aching pain, heaviness, and weakness across tbe back and loins, is a frequent symptom, especially in the morning. Palpitation of the heart, shortness of breath, and nervousness, also result from masturbation. A nervous, aching pain in the head, bones and muscles, resembling rheu- matism, is a frequent consequence. By weakening the general powers of the system, such persons have not the ordi- nary powers of resisting diseases, and for this reason when they expose themselves to an atmosphere tainted with ordin- ary epidemic or miasmatic poisons, they are more liable to the disease. Stricture, or narrowing of the urinal passage, is pro- duced by this habit. In females, the following diseases are produced : Whites, falling out of the hairs and eyebrows, bad breath, loss of the oatural voice, barrenness, falling of the womb, epileptic fits, alceration of the neck of the womb, hysterics, a desire for seclusion from society, etc. The most frequent disease pro- duced by masturbation in males, is called spermatorrhoea, of involuntary emission during sleep. These at first are rare, happening once in the course of two or three weeks, and takes place during a dream of a lascivious character. They ±54 Masturbation. soon becomes more frequent, and if accompanied by a dream, they do not wake the person, and, finally, they happen almost or quite without any sensation. Treatment. — In all cases, it should be borne in mind that the Ji/»t step to be taken for the cure of this malad y, is, at o?ice and forever to abandon the pernicious habit. There must be no indecision or trifling turn from the evil of your way. But in a large majority of cases, even when the habit has been abandoned, the effects on the general system, to a greater or less extent, still manifest themselves: and the suf- ferers will require the best medical skill. Such cases occur generally in the young of both sexes, who will not consult a physician in their own neighborhood, much less the family physician ; neither will they let their condition be known even to the most intimate friend or relative, but suffer on in body and mind for years, after pining away with dread and fear, whereas a statement of their case to a competent medi-. eal man would speedily result in their being cured. Under such circumstances, would it not be a blessing to such a one to hear of a physician at a distance to whom they could write and give a history of their sufferings, and receive, by return mail or express, medical treatment and medicines that would speedily restore them to health of body and mind, and lit them for the social and domestic pleasures of life ? Having made a specialty of treating cases of this kind for over twenty yeaks, and cured thousands of such cases, we feel assured of being able to give the proper medical treatment and medicines to cure those who will follow our directions, which any reasonable and sensible person can do without letting the most intimate friend know any thing about it. I use vegetable medicines, which will not injure the most delieate constitution in male or female. All the questions I require you to answer is, to give your age, sex, occupation, weight, height, how long you have been affected, and all your present symptoms. The plan often followed by quacks and unprincipled pretenders, of giving fifty or a hundred questions lor a patient to answer, is a vile piece of humbugging and fraud, as the whole thing is done to make patients believe that they are consulting a very learned and wise man. Such questions only confuse the mind and injure the patient instead of doing good. In writing to the author, inclose $5.00 (and 25 eents for postage), giving answers as above Btated, and direct to M. LAFAYETTE BYKN, M. D., (Ullice, 41) Nassau Street.) P. O. Box 4o'0',>, New York. Hysteric Fits. 455 Hysteric Fits, or Hysteria— la a peculiar affection, and is the source very often of much unhappiness. A lit of hysterics may assume different forms, but, generally, the female becomes apparently, of a sudden, partially insensible, t may be, falls down, but more generally 1ms sufficient warning to seat herself on a chair. The eyes are closed, the 2ids tremulous, the limbs are stretched out, and spasmodically and suddenly contracted, at intervals; or there is violent struggling, the chest heaves, the heart and vesseh of the neck beat violently, and the face is more or less Hushed frequently the patient puts the hand to the throat and neck, as if to dispel some uneasiness, and not uncommonly gives utterance to incoherent or disconnected sentences, generally in a peevish or distressed tone of voice. In most eases the power of supporting the body when seated, re- mains, unless it is worked off the chair in the struggles. At length the attack, having lasted for a longer or shorter period, from a few minutes to some hours, terminates, probably with a fit of sobbing and crying ; the patient recovers consciousnes, but is left exhausted and fatigued with the efforts and struggles, and, perhaps, falls into disturbed or heavy-snoring sleep. Such are the outward manifestations of a fit of hysteria ; but before it comes on, many patients complain of a sense of general oppression or uneasiness, with coldness or numbness of the limbs. Just previous to the accession, the character- istic hysteric " globus," or ball in the throat, is probably felt. It seems as if a ball commenced rolling upward in the bowels, generally from the lower left side, and as if it kept gradually ascending toward the throat, which it seems entirely to fill up, causing those sensations which induce hysteric patients bo often to carry the hand to, and pull at the forepart of the neck or throat. During the continuance of a fit of hysteria, little either need or should be done, beyond preventing the patient hurting herself during the struggling. Cold water dashed upon the face may be useful, or it may be poured in a stream upon the head for a few minutes at a time ; a mustard plaster on the lower part of the neck may be applied. If there is much flatulence, a half teaspoonful of essence of peppermint in a wine glass of water will give it relief. It must be remem- bered, that in most cases, the patient is sensible of what is going on around, and may, in the excited state of the nervous system, be painfully alive to any unguarded or unfavorable opinions uttered by those in attendance. For this reason, it ia not to be recommended that, as sometimes is done, severe and violent remedies should be proposed within hearing of the pa 456 Clergyman's Sort Throat. tient, with the view of frightening her out of the fit. Such a course has had the opposite effect, causing an aggravation of the symptoms. This is a different thing from threatening severe remedies while the patients are comparatively well. Snch a plan of treatment, it is well known, has often succeeded in putting a stop to the spread of hysteria (by imitation) through schools, or such like collections of young females. The exciting causes of hysteria are, remotely, whatever tends to exalt the influence of the nervous system. Among the moderately-fed and hard-working population in the coun try, hysteria is comparatively rare, but it is not unfrequentin servants who remove from the poor living of their own homes to the stimulating diet of a rich man's house. Most gene- rally, hysteria, although in some degree the result of consti- tutional tendency, is connected with debility, and irregularity of the usual conditions of female health — all these being ag- gravated by emotions of the mind, particularly those which are connected with the affections ; these, too, when in direct excitement, as well as inordinate physical exertion, which produces exhaustion of the nervous system, must be ranked as amid the most general directly originating causes of the hys- terical lit itself. But little can be done for this disease during the " tit ;" about the best thing to be done is to give an emetic or vomit of Ipecac, or if nothing better, drinking every lew minutes of warm water, until vomiting occuis. Also injections of warm water or soap suds up the bowels, to produce an evacuation, is advisable. The attack is to be prevented by keeping the bowels open, avoiding overloading the stomach, and plenty of exercise — doing a good day's washing occasionally or scrubbing tho lioors being of more use, a great deal, than medicine. Clergyman's Sore Throat.— So called from the fact that it is oftener witnessed in ministers of the Gospel than others. It is a peculiar affection of the throat and organs ot voice, to which public speakers are liable. According toJUr. Macready, actors who have to assume feigned tones, are more liable to it from that cause. The seat of the disease is the mucous follicles (little lumps) scattered over the membranes of the throat, larynx (vocal box) etc., being extended to the latter from the former. The commencement of the diseaso is insidious; it -begins with an uneasy sensation, a?, if there was something in the throat which required to be hawked up or swallowed down ; at the same time the mucous se- cation is viscid (toughj. As the larynx becomes affected Frost-litten Parts — Common Cold. 457 the voice is changed, becomes hoarse, unequal in tone, or quite extinguished ; there may be slight pain about the parts, hut not much cough in the earlier stage of the disease. All the symptoms become aggravated by cold, by vicissitudes of temperature, or by exertion of the voice in reading, speaking, &c. The above sources of aggravation are of course to be guard ed against, and the general health attended to ; but the cure of the disease, which consists chiefly in the repeated application cf a strong solution of lunar caustic to the parts affected, must only be entrusted to a physician. Dr. Green, of New York, has the credit of first accurately describing the disease, and of prescribing the treatment above mentioned, which is very successful. But when you do not have the opportunity of having that done, I would state that Medicated Inhalation, as recommended under the head of " Catarrh in the Head," is very beneficial in this disease, assisted by gargles of tar- water, strong green tea, cold water, &c, and the external ap- plication of kerosine oil to the throat till it produces pimples on the skin, to be applied and re-applied if necessary. The Btooping position required by ministers who read their ser- mons instead of preaching them, is one great cause of this difficulty. The best plan is to do like Christ, the Saviour, did while on earth going about doing good, " preach from the heart" instead of talking from paper — it will be better for both soul and body, for preacher and for people. Frost-bitten Parts. — Usually it is the ears, toes, nose and fingers. In such cases, as in warming the body to avoid aching, the restoration to heat must be very gradual ; a limb has been frozen perfectly still', and by being rubbed in show, afterwards in cold water, and very slowly warmed, its life has been preserved. The sudden application of heat never fails to occasion inflammation, and mortification quickly fol- lows. When the heat has been gradually restored, and action and sensation perceived, the part should be rubbed with spir- its (gin, whisky, or Bay rum), the patient be put to bed and kept comfortable, perspiration excited by warm drinks, and perfect rest enjoined until the effects subside. Bathing the teet in cold water night and morning, and afterward rubbing with a coarse towel or flesh-brush, will harden the feet agniiist the effects of cold. Common Cold. — "What is best to do for a common cold?" is a question often asked, and as it is one of the meet prevalent ailments to which frail man is subject, we propose 458 Common Cold. Answering the question in a common-sense way. Tlie inhabi- tants of every climate are liable to take, cold at different sea sons of the year, particularly when the changes of the atmosphere are sudden. The persons most subject to this disease are those of a delicate and irritable constitution, and whose employments expose them to sudden transitions from A eat to cold. A cold is attended with a weight or uneasiness in the head fullness and oppression at the chest, a sense of distension an stopping up of the nose, followed by a secretion of thin mucou from the nose, watering of the eyes, soreness of the throat, cough, with expectoration of mucous, cold shiverings, suc- ceeded by flushes of heat, and pain in different parts of the body — very frequently the chest This disease is not generally attended with danger when appearing in a mild form, and early precautions are used. If the symptoms should be highly inflammatory, and the consti- tution of the patient delicate and irritable, the most vigilant attention is demanded in order to arrest the progress of the disease ; otherwise the most serious consequences may ensue. It is by such neglect that two-thirds of the cases of consump- tion and other pulmonary affections in this country, arise. When a person finds himself much indisposed from ex- posure to cold, he should at once confine himself to the house ; use a spare, mild diet; drink barley water with lemon juice in it, or any other warm diluent, or mucilaginous drinks, and particularly avoid eating or drinking anything stimulating. Previous to going to bed, put the feet in warm water for a few minutes, then wipe dry and rub them well with a flesh-brash or rough towel, put on the stockings again, and get into bed at once (between blankets being the best in cold weather) ; then from half to one teaspoon ful of paregoric, and about an equal quantity of syrup of ipecac should be taken in half a cup full of warm tea of any kind. The following morning take a dose of Rochelle salts or Seidlitz powder, or seme other good purgative. The mucilaginous drinks should be taken through the day. Repeat the paregoric two or three nighta if necessary. Any good liniment or a mustard plaster ap plied to the chest (front and back) and also the neck will DC of service. A violent lit of tickling cough may be relieved at once by taking a lard pill or gargling with a spoonful of melted lard, or sweet oil. The course of treatment above ad vised will cure the great majority of common colds, whei strictly followed. To avoid taking fresh <■<>/l food or of stimulants. Milk, and the various farinaciotu preparations with -which it is usually combined, such ai arrow-root, sago, rice, bread, &c, is perhaps the most gene- rally useful article of diet in convalescence ; next come the broths made from fowl, mutton, veal, or beef, alone, or mixed with crackers or bread ; next in succession, are eggs lightly boiled ; and lastly, solid meats, of which tender mutton is probably the best, are to be permitted. Ripe fruits in their season, if not contra-indicated by the nature of the previous disease, and if they do not occasion flatulence or diarrhoea, are both grateful and serviceable. The patient must be careful not to overload the stomach on any account. In whatever form nourishment is given to the convalescent, it should be in small quantity at a time, but as frequently re- peated as the natural appetite requires. The atmospheric purity of the chambers occupied by persons recovering from sickness requires great attention, and the temperature ought to be kept as nearly as possible about 58° Fahr. Lastly •when convalescence has reached a certain point, there is no remedy which so surely promotes perfect recovery and con- firms health as change of air; but care must be taken that in 6o doing there must not be injudicious exposure during un- suitable weather. Falling out of the Hair, or Baldness.— Those who lose this great natural ornament before the " head is whitened over with the frost of many winters," feel the loss very keenly, as well they may, for the hair is not only orna- mental but useful. Falling of the hair occurs from weak- ness, either of the body generally, or of the hair-bulbs, or " follicles," themselves. Various local stimulant application* are used in such cases, of which Balsam of Peru — a drachm stirred well into an ounce of simple cerate when melted — is said to be a good application. Baldness, or loss or deficiency of the hair on parts usually covered by it, is sometimes seen in infants. It frequently occurs in adults of the male sex, even in the prime of life, and almost universally, in a greater or less degree in old age. The direct occasion of baldness is defect in the hair follicles from which the hair is developed ; and this defect may arise from diseases affecting the skin itself, from acute genera* difc- ease, as fever; or chronic constitutional disease, such as con- sumption ; it may also arise from constitutional peculiarity, or the diminished circulation of blood, such as occurs in ad vanced life. Some families appear to be peculiarly liable to Falling out of the Hair, or Baldness ■ ■ 4G5 become the subjects of harness, even in early life ; those who perspire much about the head are often bald. Generally, however, whatever occasions a diminished supply of blood tc the scalp or skin, gives the hair a tendency to shed, and the treatment must be directed to stimulating the skin as much as possible by proper and timely applications. After acute dis- ease, if the hair falls off, shaving the part two or three times in succession will probably strengthen the growth. In other cases, much covering upon the head, which causes perspira- tion, and consequently weakens the skin, must be avoided; and the head should be well washed with cold water every morning, and afterward rubbed and brushed to promote reac- tion. Various applications are recommended to prevent or cure baldness ; they are all stimulant. Those of which can- tharides, or Spanish blistering flies, form an ingredient, are generally most serviceable. A drachm of the tincture of can- tharides, rubbed up with an ounce of lard, will form a suffi- ciently stimulating ointment. The infusion of the leaves of the Asarum Europceum, a plant which occurs wild in the woods in England, is a very efficacious stimulant to the hair follicles ; the infusion may be used as a lotion to the scalp. Falling oft' of the hair, which is occasioned by eruptive dis- ease, or which is accompanied with inflammation of the skin, of course requires a different and more soothing treatment. In the baldness of narly life, the hair drops off without the previous change of cdor which occurs hi age ; in the latter case, of course, no treatment is either likely to be resorted to or to be of service. Still everybody must try, so let thein try. SCROFULA, OR KING'S EVIL. The children most commonly attacked with scrofulous die eases, are those of a soft tine skin, fair hair, and delicate complexion ; but it is sometimes seen in those of a more robue* make and darker complexion. Children having a tendency to rickets, as indicated by a large belly, large joints, and pro- minent forehead, very generally possess the scrofulous habit Those who reside in damp, uncomfortable dwellings, exposed to many privations, who are badly clothed, who live on scant} and unwholesome food, deprived of exercise in the open air ±Q6 Scrofula. and who are inattentive to cleanliness, are those who are most subject to the disease. The countries where scrofula is most prevalent, are those of a cool, moist atmosphere, where the seasons are variable, and the weather unsteady. Seasons and weather, which remain cold and wet for a considerable time, often prove the occasion for an attack of scrofula. This disease is hereditary from parent to child ; and families, the members of which have a tendency to scrofula, ought to be particularly careful as to the manner in which they bring up their children. Since the malady is not always in active operation, it becomes a matter of great importance to know whether it can be kept from appearing and committing its destructive ravages ; whether any management in early life, or in more advanced years, will protect the lively child or the beautiful youth from the dargerous enemy which has attacked his fellows, and whether an early and assiduous care may not counteract the hereditary constitution of scrofulous families. Children who show any predisposition to scrofula, should be brought up on plain, but nourishing and easily digestible food ; such as good broth, with a moderate allowance of solid meat ; but pastry, heavy puddings, and the like, should be avoided. Their clothing should be warm, and they should use much active exercise in the open air when the weather is tem- perate and dry ; they should use the sponge salt-bath, and, in the prqper season, sea-bathing. The disease most commonly first shows itself between the third and seventh year of a child's age ; but it may arise at any period before the age of puberty, (about twelve years of age,) after which it rarely makes its first appearance, at least txternalhj. The attacks of scrofula usually begin some time in winter or spring, and get better or disappear in summer or autumn. Ihe first appearance of the disease is the occurrence of small round tumors under the skin of the neck, about the ear, or below the chin, without any pain or discoloring. In some cases, the joints of the elbow or ankle are the parts first affect- ed. In this case, the swelling surrounds the whole joint, and impedes its motion. After some time, the tumors acquire a larger size, the skin which covers them becomes more purple and they inflame, come to a head, and break into little holes, from which a mixed pus-like fluid, intermixed with curdy- looking matter, at first proceeds, which soon changes into a thin watery discharge. These ulcers spread unequally in va- rious directions ; 6ome of them heal, but other tumors form, followed by other ulcers. In this way, the disease continues Scrofula. 407 a number of years, and at last the ulcers heal np, leaving behind them very disagreeable scars, which are often the cause of great deformity. In some scrofulous habit?, the eyes and eye-lids are the principal seat of the disease, shown by the in- cessant inflammation of the ball, and the raw and painful state of the lids of the eyes. Diseased spine is also much connected with a scrofulous constitution. Many internal parts are sub- ject to disease in scrofulous habits. The mesenteric glands, (situated along the inside of the back-bone) through which the fluid destined for the nourishment of the body has to pass, become obstructed, inflamed, or break; the consequence of which is, a swelling of the belly, while the rest, of the body ie wasting; hectic fever, disordered bowels, and gradual decay. The lungs of scrofulous persons have, almost universally, tu- bercles or little whitish knots in them, which inflame and breal , and are the commencement of fatal consumption. Water i 1 the head, which carries off so many children of the same fan - ily, is believed to be connected, very generally, with scrofi - lous taint. It is certainly proper, as far as we can, to prevent the tumoi q from coining to a suppuration or head; and for this purpose, we are to endeavor to promote their dispersion by the prudei t use of gentle friction with any mild liniment, or the dry hand, aided by proper diet, with occasional purgatives ; taking caie to avoid all exposure to cold and moisture, and to keep ti.e swelled parts covered with flannel. Flannel should be worn for under-clothing at all seasons of the year. When we find our attempts to promote a resolution (or scattering) of the tumors to be unavailing, we must apply to them flaxseed poultices ; and at the same time give nourishing diet to invigorate the system, and bring it to a head. It becomes a matter of importance how to treat the abscesses when matter is formed ; whether to let them break, or to open them with the lancet. Whichever way they are opened, there is a probability of a long-con- tinued discharge ; but by allowing the matter to be discharged by a lancet, a small and effectual opening can be made ; whereas the matter, if the swelling be left to itself, will per- haps break, and discharge at several different places ; and nothing will be gained, with respect to the continuance of the after-discharge, or the prevention of unseemly scars. When the ulcers remain open and spread, a variety of applications will be necessary. Sometimes a stimulant dressing is required, as the ointment of verdigris, (ten grains to the tablespoonful of ard,) or basilicon ointment ; at other times, simple dressing, £ lard, or cerate, is all that can be borne. Sometimes a do- 46 S Abscess. gree of inflammation will suggest the propriety of a poultice, but tin's must not be continued long, lest we induce a relaxa- tion of the parts around. We must vary our treatment also, by the application of different washes, astringent or cooling, as sulphate of zinc, (one teaspoonful to a pint of water), or sugar of lead, in the same proportions. Under every treat- ment, scrofulous ulcers are apt to disappoint our hopes, and continue open for a tedious time ; and at length, in many cases, without any perceptible cause, they suddenly put on a healthy action, and heal up, not to break out any more. The constitutional treatment, during this period, should be as invigorating and as little stimulating as possible; a good, wholesome, but light diet, pure air, and active exercise are necessary ; a residence in the country, and sea-bathing are useful auxiliaries. Iodine in its various preparations, (see list of " Medicines, their doses and uses,") especially that of the iodide of iron, also iron itself, with tonics generally, and, above all, the use of codliver oil, are the principal remedies. From five to ten drops of tincture of iodine, mixed with a tablespoonful or two of codliver oil, tjiree times a day, is about the best prepara- tion, given in syrup. In some countries there is considerable importance attached to the contagiousness of scrofula. It cannot be considered contagious in the ordinary acceptation of the word, but it must be always advisable, especially for those predisposed to the disease, to avoid close contact with the affected. Hay-Asthma, or summer Bronchitis— Hay-Fc- v<2i\ — This disease is so called on account of its occurring during hay-time, or summer, and is thought to be caused by the odor of new-mown hay ; but it may be caused by other strong odors. It does not differ very much from the ordinary asthma, except perhaps there is not so much difficulty of breathing, and the attacks last longer in the hay-asthma ; the lining membrane of the nose is also much more inflamed and the throat irritated in the latter disease. The best thing to do is to remain within doors and keep quiet for a few days ; take a few doses of Rochelle salts or rhubarb, also a teaspoonful of paregoric at bed-time for two or three nights, and live on light diet. A dose or two ot quinine (one grain) may be beneficial, night and morning. Stricture of the Urethra ot Urinal Passage. 4G0 Stream flows fully and easily enough when once started, may 6e added. It is very common to have this hesitating or wait- ing longer than natural, then a full stream, then again the dribbling away afterwards. The remedy for Stricture is Bougies ; they are to be intro- duced up the urinary passage, commencing with a small one, and using a larger one from time to time, until the Stricture is dilated, and the passage becomes of its natural size again. This treatment should never be attempted by any but a med- ical man, as it is of too delicate a nature to be undertaken by any other. Stricture of the Urethra or Urinal Passage— Jonsists in chronic inflammation, usually following gonorr- hoea and gleet, causing a narrowing of the passage, and thereby interfering with the voiding of the urine. The disease is caused also by masturbation, and anything that produces a chronic irritation in the passage. The diseased condition exists during the early or first stage of stricture, only as a soft, swollen or puffy state of the delicate skin lining the passage In the next or second stage of stricture, an important change has taken place. That portion of the passage which was before in a merely tumefied or swollen condition, has now Required a certain firmness ; it resembles a band encircling the passage, narrowing it at this point, and actually reducing ts capacity. It now offers a decided impediment to the urine, and if a moderate sized instrument (Bougie) is introduced, an evident resistance is met; though with a gentle pressure it yields, and the instrument pretty easily passes on. In a still more advanced or third stage, the dilatable condi- tion has disappeared ; the stricture has become firm, or cal- lous, as it is commonly called ; the contraction is unyielding, and an instrument meets an abrupt positive resistance, the calibre of the passage being frequently so diminished as hardly to allow the urine to pass at all, or even an instrument of the smallest possible size. There is no natural cure for Stricture. When it once begins, it is sure to go on increasing, either rapidly or slowly. Fortu- nately, however, we have the means of curing it by art. Among the very early symptoms of a Stricture, theie is one in which great confidence may be placed. It relates to the manner in which the last few drops of urine pass, which is by dribbling away. This is a symptom of great value in deter- mining any doubtful case of Stricture. Another early symp- tom of stricture is a scattering of the stream of urine in making water, or splitting into two or three small streams. A certain hesitation in commencing to urinate, although tins 470 Albuminuria. Album in aria, or Bri flit's Disease of the Kid. lieys. — This disease is an affection of the Kidneys, and waa first described by Dr. Bright, of England. Its most distin- guishing symptom is the presence ol the serum (or warery Sortion) of the blood in the urine, so that when the latter uid is heated to near boiling, the albumen becomes coag- ulated, like the white of an egg, causing merely a cloudi- oess if in small proportion, but sometimes existing in such ■juantity as to form a nearly solid mass. This condition of the urine is always to be looked upon seriously. It some- times comes on slowly, more particularly in those addicted to the excessive use of ardent spirits ; or it may be the immedi- ate consequence of seveie cold and repressed perspiration; it is not an unfrequent sequel to scarlet fever. The sudden development of this condition of urine is accompanied with feverish symptoms and dropsical swelling of the face, with stiffness of the eyelids, swelling of the extremities, and if it proceed far, of the trunk of the body also. It ought at once to be submitted to the treatment of a physician. In the absence of this assistance, should sudden swelling, as above described, come on, and with it symptoms of general fever, a portion of the urine may be heated in a metal spoon to Doiling ; if it becomes thick or cloudy, and if it is not cleared by the addition of a few drops of vinegar, it may safely be concluded that the kidneys are suffering. Blood, according to the strength of the patient, may be taken from the loina by cupping, the patient confined to bed, and a bath of the temperature of 90° taken for half on hour, once in twenty four hours. A diaphoretic (or sweating) mixture, is to b given, and the bowels purged with cream tartar and jalap, or some other good purgative. The diet must be kept low as long as fever continues. The case ought not to be trusted to domestic treatment further than is unavoidable . Poison-Vine Eruption. — -This Vine, a species ot Sumach, and one or two other plants, cause by contact is some persons an inflamed eruption, or small blisters, which is in some cases very painful. The hands and face are its most common localities, but it may appear on any other part of the person. The treatment of this complaint is simple. Apply a mix- ture of one teaspoonful of sugar of lead, dissolved in half a hit of cold water, every two hours, with a camel's hah rush, or soft linen mop. Fluid extract of Virginia snake- root is said to be almost ;i specific, applied over the affected ts freely and frequently. When nothing better can be iad 5 :»i>i»ly sweet oil or common lard. Advice to the Young of loth Sexes. 471 ADVICE TO THE YOUNG OF BOTH SEXES. THE PHYSIOLOGY AND PHILOSOPHY OV RIGHT LIVING There is a right way of doing everything, in physical life as in the vegetable kingdom, the selection of proper Seed and Soil is indispensable to the production of a perfect plant, bo in the animal is the enlightened and judicious blending of the sexes a sine qua non to the production of a being repre- senting all the excellence of its species. This is an axiom the most unassailable; and hence the vital necessity of accepting it in all its integrity, and of never transgressing it in any re- spect upon the exalted plane of human existence. The sentiment of love, in its highest and most divine accep- tation, can obtain between the sexes only. Although far from antagonistic to that of friendship or affection, it differs widely from it ; inasmuch as it has more important ends to attain, and can never exist between individuals of the same sex. Friendship or affection for one another, may characterize the intercourse of men, or of women ; but love, in its truest sense, never. This latter is the golden link which unites us at once to our opposites and to heaven, and that culminates in that holy and mysterious compact which results in the propagation of our species, and the accomplishment of our mission in this direction. While in pursuit of the study of this question, however, we must be careful not to confound or confuse the love under con- sideration, with the mere animal passion that so often steals its guise to gratify the cravings of lust, and that so constantly betrays the youth of both sexes into excesses that terminate, on one side at least, in years of misery or shame. And here we would address ourselves more especially to the inexperi- enced maiden whose guileless heart is too often open to the deceitful blandishments of some cruel suitor, who has but one object to attain, or to the sincere and ardent professions of some thoughtless youth, who, without pausing to analyze the motives which actuate him or the stability of his intentions, accomplishes her ruin, and leaves her to learn, alas ! too late, that, save before the altar, no woman is justifiable in placing her character and happiness in the keeping of any man. In such instances, deceit and sincerity being alike at fault, the only safe course for the maiden who would escape the Scylla of the one or the Charybdis of the other, is to keep watch and ward on the battlements of her prudence and virtue, and, no matter how impassioned and sincere the pleadings of any in- 4:72 Advice to the Young of loth Sexes. dividual upon whom she may have bestowed her affections, preserve both intact, as the only means of retaining his love and respect, should he be a true man, and of keeping herself unsullied in the eyes of society, and of the world generally. Although delicate and difficult the task? of whispering some truths into the ears of a young maiden arrived at the years of discretion, yet, so necessary to her well being and happiness in every possible relation is it that she should be made thoroughly aware of the untoward influences which so constantly obtrude themselves into even the purest atmos- phere, we venture, although with some hesitancy, to assume the serious undertaking. And here we may observe, in the first place, that the primary elements of all that makes life worth a single hour's purchase, are to be found in a thorough recognition of what we owe to the Creator, to ourselves, and to society ; and the possession of a mind free from the taint which disfigures some of the literature of the day, and from those low desires and loose ideas, which, with scarce a single exception, result from its perusal. Nothing can be more dan- gerous to the youthful mind than even a passing glance at the works of any of those authors who appeal to the animal pas- sions in a manner so insidious and ruinous, and who, before a young maiden is aware of it, destroy all her sense of deli- cacy, and often, alas! betray her into those dreadful excesses which, although kept the profoundest secret from every living 6011I save herself, invariably end in the total loss of innocent purity and the utter destruction of all physical beauty. We need not be more explicit upon this subject, but may summon on the witness-stand in proof of what we here state, the sallow and lifeless features, the dim eyes, and desponding gait, which are significant to the astute medical man, and which are to be encountered so frequently in what is termed the very best so- ciety. Any violation of the laws of the Creator in this, as in every other connection, is sure to be visited upon the aggres- sor; and when we come to consider that the first offence in the particular relation now alluded to, leads quickly to anoth- er, and yet another, until transgressions crowd upuii each other thick and fast, and seize upon the whole being, we shall be able to perceive at once how vital the necessity for every young maiden to eschew with prayerful diligence the source of such terrible dangers, and to be in a position to feel within herself at the period when she may be called upon to give her hand at the altar to some one worthy all the love and af- fection that could be bestowed upon him, that she enters the marriage state as pure in mind and body as the veriest child. Advice to the Young of both Sexes. 473 and that in this relation, not a cloud or a regret can obscure the sunshine of her after years. In the observance of the course which is here suggested or implied, lies the corner-stone of all the bliss that attends upon the sacred compact into which two young souls enter fur life. And here we would observe, that, in this direction, a serious and solemn duty devolves upon mothers, to instruct at the proper moment, their daughters, as to the dangers that beset them, both mentally and physically, at a certain age. In this relation there should be no false delicacy felt. The truth must be told, and in a manner the most unmistakable. A life of happiness or of misery hangs on the issue, and there should therefore be no mincing of the matter. The crime of self- abuse, if we must say it, is not confined to the sterner sex only. Some of the most fearful examples of it amongst females are to be met with terrible frequency, and of a character so hope- less as to embarrass all medical interference, and to seal the doom of those who had so fallen from their natural birthright and high estate. The necessity, then, of the strictest caution on the part of mothers in the selection of books or playmates for their chil- dren becomes obvious at a glance. The child is the marble from which the woman is sculptured ; and if the youthful block is disfigured, fractured or broken, where may we find the moral, mental or physical chisel that shall obliterate or remove the defects? An eminent physician has justly observed on this head : — " We now approach a part of our subject which we would gladly omit, did not constant experience admonish us of our duty to speak of it v\ no uncertain tone. We refer to the dis- astrous consequences v.n soul and body to which young girls expose themselves, by exciting and indulging the morbid passion. "The results of the constant nervous excitement which this habit produces are bodily weakness, loss of memory, low spi- rits, distressing nervousness, a capricious appetite, dislike of company and of study, and, finally, paralysis, imbecility, or insanity. Let it not be supposed that there are many who suffer thus severely ; but, on the other hand, let it be clearly understood that any indulgence whatever in these evil courses, is attended with bad effects, especially because they create impure desires and thoughts, which will prepare the girl to be a willing victim to the arts of profligacy. There is no more solemn duty resting on those who have the charge of young females than to protect them against this vice. 474 Advice to the Young of Ijh Sexes. "But, it is exclaimed, is it not dangerous to tell them any- thing about it ? .Such a course is unnecessary. Teach them that any indecent language, any impure thought, is degrading and hurtful. See that the servants, nurses and companions with whom they associate, are not debased ; and recommend scrupulous cleanliness. "If the habit is discovered, do not scold or whip the child. It is often a result of disease, and induced by a disagreebie itching. Sometimes this is connected with a disorder of the womb, and very frequently with worms in the bowels. Let the case be submitted to a judicious, skillful medical adviser, and the girl will yet be saved. But do not shut your eyes, and refuse to see this fact when it exists." We have it on high authority that modesty is the chief quality in the adornment of woman ; and in no case is it more grateful and becoming than on that of a young maiden who has arrived at that important and interesting period when she may be wooed, and won, and made a wife. What the age of puberty is, has been made a careful study by medical men. In the temperate zone, fourteen years and six months is the average period of its first appearance in healthy girls. If it occurs six months earlier or later, then there is probably some- thing wrong. There is sometimes a wider deviation from the age stated here than this, and without any serious meaning; but at no time is such a deviation to be neglected. In a vast majority of cases it is owing to some defect in ^constitution, health or formation, and should be seen to and corrected at once, otherwise years of hopeless misery may be the result. "Mothers, teachers," observes the author just quoted, "it is with you this responsibility rests. The thousands of miserable wives who owe their wretchedness to the absence of proper attention at the turning point of their lives, warn you how serious is the responsibility." The foundation of old age, observes a celebrated author, is laid in childhood, but the health of middle life depends upon puberty. This maxim is invaluable. The two years which change the girl into the woman, frequently seal forever her happiness or misery in this life. They decide whether she is to become a healthy, cheerful wife and mother, or the re- verse — to whom " marriage is a curse, children an affliction, and life a burden." It is not a favorable symptom to experience any indication of puberty before the usual average time, as it betokens a weak- ly and excitable frame. Let us therefore enumerate the prin- ciple causes which incline to hasten it unduly. Idleness of Advice to the Young of both Sexes. 475 body, highly-seasoned food, stimulants, such as beer, wine, liquors; and in some degree, coffee, tea and irregular habits of sleep. The mental causes are, however, still more potent in tending to premature development. What stimulates the emotions, leads to unnaturally early sexual life. Late hours, children's parties, sensational novels, questionable pictorial illustrations, love stories, the drama, the ball-room, talks of love and marriage, &c, all hasten the event which transforms the girl into a woman. During the two short years, then, that transform " the awk- ward and angular girl of fourteen " into the graceful maiden of "sweet sixteen," the utmost caution is to be observed in every relation, moral and physical. The magic wand of the fairy is at work, and a new creature, as it were, is being re- leased from her chrysalis state, with sentiments and responsi- bilities that must be kept well in hand. The transformation goes on uutil at last the system acquires the requisite strength, and furnishes itself with reserved forces, when the monthly periods commence. A writer of great judgment and experience on this subject, asserts that one of the most frequent causes of disease about the age of puberty, is starvation. He avers that mauy a girl is starved to death, from the fact of food of an improper qual- ity being given to her, or from the circumstance of sustenance being administered to her in insufficient quantities, or at im- proper hours. Hence, from the want of proper nourishment, the system becomes enfeebled and subject to attacks of disease, and especially to those of consumption. The food at such pe- riods should be abundant, varied, and simply prepared. Good fresh milk should be used daily, while tea and coffee should be thrown aside totally. Fat meats and vegetable oils, so gen- erally disliked by girls at this age, are exactly what they re- quire at this juncture of their lives. All kinds of exercise propertoa young lady, and especially those which lead into the pure open air and sunshine, are also beneficial at this momentous crisis ; and a particular kind is to be recommended for those whose chests are narrow, whose shoulders stoop, and who have a hereditary predisposition to consumption. Let her stand erect, throw the shoulders well back, and the hands behind ; then let her slowly inhale pure air to the full capacity of the lungs, and retain it a few seconds by an increased effort; then it may be slowly exhaled. After one or two natural inspirations, let her repeat the act, and so on for ten or fifteen minutes, twice daily. At first the monthly loss of blood exhausts the system. 476 Advice to the Young of both Sexes. Therefore, plenty of food, plenty of rest, plenty of sleep, are required. That ancient prejudice in favor ut* earl}* rising should be discarded now, and the girl should retire early, and, if she will, sleep late. Hard study, care, or anxiety, should be spared her. With thoroughly healthy girls, what is usually termed the monthly period, continues to recur at regular intervals, from twenty-five to thirty days apart. This is true of something like three out of every four. In others, a long interval, oeca- sionally six months, occurs between the first and second sick- ness. This latter, if the general health is perfect, need excite no apprehension ; but under the slightest mental or physical derangement the case must at once receive intelligent treat- ment. Perfectly healthy young women have, on the other hand, been known to have been unwell every sixteen days, while others again experienced this change every thirty-five or thirty-six days only. At this critical period, the seeds of hereditary and constitu- tional diseases manifest themselves. They draw fresh malig- nancy from the new activity of the system. The first symptoms of tubercular consumption, of scrofula, of obstinate and disfiguring skin diseases, of hereditary insanity, of conge- nital epilepsy, of a hundred terrible maladies, which from birth have lurked in the child, biding the opportunity of attack, suddenly spring from their lairs, and hurry her to the grave or mad-house. If we ask why so many fair girls of eighteen or twenty are followed by weeping friends to an early tomb, the answer is, chiefly from diseases which have their origin at the period of puberty. From what has been now said it is impossible for any mother of ordinary good understanding to mistake for a moment the shoals and quicksands, both moral and physical, that surround her daughters, whether as mere girls, or grown-up maidens. A careful supervision of the company they keep and the books they read — their determined exclusion from the society of either men or women of lax conversation or morals, and the careful inculcation of self-respect, which can alone be based upon proper pride and purity, will go far to obviate the dan- gers that beset their path, and so ground them, ultimately, in the principles of virtue and a correct demeanor, as to put evil thoughts to flight on their first approach. While a handsome person and excellent acquirements are always desirable on the part of any individual who pays his addresses to a young maiden, yet there are other and more im- portant considerations which ought to overshadow mere physi- Advice to the Young of oo'.h Sexes. 477 eal beauty or mental attainments; and these are a high sense of honor, and a thorough and practical conception of the duty we owe to God and man. These latter constitute the imper- ishable part of our nature when properly moulded, and are the staff upon which we can lean with confidence when our mere physical being loses all its brightness, and totters to its fall. Hence the necessity of warning the young and untutored heart against mere outward appearance, and "directing it to- wards a recognition of those attributes and features on the part of the sterner sex, upon which a life of true happiness can alone be founded. This is a matter of such paramount importance, that we feel the necessity of impressing it, to the utmost of our ability, up- on those who have arrived at the years of understanding, and whose hearts may yet be free or partially so; and who maybe induced to pause ere they commit their happiness for life to the hands of those who may not only be unworthy of a wo- man's love, but who seek to obtain it under the false pretences of a comely exterior or the adventitious matter ot dress, while every fibre of their nature may be selfish beyond measure, and set only upon the momentary gratification of a passion that when once satisfied turns aside from the hapless and unsus- pecting object that has inspired it, and leaves her to mourn in the silence of her lonely chamber, the fate she might have avoided, but that is now beyond repair. How warm soever her feelings and sentiments, every step taken in the paths of courtship by a marriageable maiden should be well observed and guarded. In her conversation or conduct there should be nothing of thoughtless levity, or any- thing that could warrant a familiarity on the part of her suitor which might not be taken in the presence of some dear friend or relative. To observe a proper and well-considered course in this relation, is to secure the increasing admiration of the being upon whom she has bestowed her affections, if he be worthy her love. There is, therefore, nothing so desirable as firmness and cau- tion on the part of a young maiden in her conduct towards her accepted lover ; and both can be observed without wounding his susceptibility, or impressing him with the idea of either prudery or coldness on her part. Let us glance for a moment at the fact of so many beauti- ful and warm hearted maidens whose happiness has been wrecked, even in this city, through the fiendish machinations of perfidious suitors. Scarce a house of ill-fame in our midst but has one or more inmates of this character — poor, thought- 478 Advice to the Young of both Sexes. less, and confiding creatures, that would sooner had thought an angel of light capable of deceit than those who had be- trayed and ruined them. But they would not be warned, or had not been advised until the die was cast. Although the mental and physical tendencies of mere girls may vary in no small degree, we are of the firm belief, that, under even the most unfavorable circumstances, both may, through judicious and proper treatment, be brought to har- monize with the great objects of creation. In view of the ac- complishment of this vast desideratum, then, the early inculcation of proper religious principles, and the ensample of healthy conversation' and moral excellence in the family circle, are of paramount importance. And this is quite com- patible with the freedom necessary to the happiness and well-being of even the lighrest heart and most joyous disposi- tion. There is not an innocent amusement or pleasure incident to the life of a young girl, that may not be height- ened and sanctified, in a measure, through the adroit and loving guidance of a mother of sound observation and an or- dinarily well-trained mind. Mothers and guardians should therefore bestir themselves, if they would do a noble and abiding work in this connection ; and never relax their vigi- lance until those under their charge have attained the age of maturity and understanding, in the fullest sense. Here the parent plays a most important part, and must, if she would see her daughter a happy wife and mother, train her in all the paths of virtue and correct thought. The surveillance may be gentle and loving, but it must, at the same time, be constant and inflexible. Every rock and shoal must be point- ed out, and dwelt upon with force and clearness, and the guiding lights of self-respect, purity of speech, and careful demeanor, held constantly aloft and in full view. Conse- quently both mother and daughter should understand each other upon an issue so vital; the younger and more inexperi- enced looking, with full confidence, for counsel and advice to her truest friend and rightful preceptor, and forming no acquaintance or friendship, with a view to matrimony, without her sanction and approval. In this relation the quick wit and keen eye of the sober and thoughtful matron will be seldom at fault. She will be able to determine with something like unerring accuracy, and speedily, the character of the suitor who may seek to win the affections of her child, and who must not be judged on mere external appearance, or be taken at his own estimate. Here an honest heart, industrious habits, and a good record, are of Advice to iJte Young of both Sexes. 4.79 the last importance, and more desirable than gold itself. In saying so much on this head, however, it is not to be supposed that mere worldly wealth is to be disregarded as an element in any compact between two hearts that would become one, and spend together a life of usefulness and independence. The vital necessity, then, of worthy male companionship, in the first instance, for any young girl whatever, must be ob- vious to even the most commonplace intelligence. If those who surround her are pure and good, and the uncompromising enemies of the free-love taint and principles which are now so r^pe in certain quarters, her selection of a proper companion for life will be the less difficult, as fewer chances present them- selves for bestowing her affections unworthily. . Let us then hope that all those most deeply concerned will ponder well the facts we have laid before them on this all-im- portant subject, and let no mother relax for a single moment the vigilance that should wall out from her daughters the dangerous books and companionship to which we have made such distinct reference. In addition, let every young maiden who is approaching the interesting and critical period already named, look well to her footsteps, and beware of allowing her affections to be captured by a pleasing exterior only on the part of one of the opposite sex. However agreeable an attractive face and form, these do not comprise all that is ne- cessary to the most abiding and exalted manhood, and are not unfrequently a delusion and a snare. There is no absolute manliness without manly principles ; and no true happiness without moral rectitude and a proper sense of our duty to- wards heaven. These are the attributes and sentiments that tend to make earth a paradise, and that survive all mere phy- sical excellence, inasmuch as they belong to our immortal part. Let them therefore be sought after assiduously by both mother and daughter in the person of any suitor for the hand of the latter ; and let there be no uncertain sound in the premises. The license accorded to boys when compared with that allow- ed to girls of the same age, ought to engender in them a chivalrous respect for the gentler sex, and never urge them into anything savoring of egotism or tyranny. The apparent superiority is but simply the result of greater physical strength, and the freedom with which the one sex is permitted to move through the world compared with that accorded to the other. There is in reality no mental superiority in the one over the other; for in this respect it has been shown that the impress of man has not been left mentally on the age more than that of 4S0 Advice to the Yomture and beautiful maiden, or preserve his health and man- lood intact until both, at a ripe old age, declined in the natural order of things. It may be laid down as an axiom, then, that no true love can exist between a good and pure woman and the man who renders his person disgusting to her, and who in a measure emasculates himself through the constant use of intoxicating liquors; and when we come to dwell on the fact, that the prostration of his high mission and manhood arises from the indulgence of a loathsome vice, whose inception is to be traced to the first fatal and seductive glass that is thoughtlessly raised to his lips, surely the individu- Husband and Wife. 4S7 al who is yet free from the taint of this curse, or the man who is its partial victim only, should, if these few lines happen to meet his eye, never approach — or dash from him forever — the cup that has been so fraught with some of the direst crimes, heartaches, and miseries, known to the human fam- ily. When, therefore, it is a fact beyond contradiction, that a persistent use of stimulants of any description tends to generate morbid and adventitious sexual desires, that are succeeded by a reaction the most depressing, inconvenient, and dangerous, and that frequently result in permanent injury, what shall we say in denunciation of the habitual use of those fiery potations that not only lead to rags and beggary, but corrupt the blood, disfigure the features, and trail the last particle of manliood in the dust ? HUSBAND AND WIFE. THEIR DUTIES AND RELATIONS TO EACH OTHER. A CHAPTER FOE THE NEWLY MAREIKD, OK THOSE CONTEMPLATING MARRIAGE. It should not, then be forgotten by the newly fledged husband, that in the first moments of his matrimonial life, he must not suppose for a single instant the ears or the eyes of his wife are less chaste and pure than they were before she had become his in the sight of God and man. Here is a point of vital importance, and one upon which such grave issues hang that we place it in the very first rank of our present observations. Save in one instance alone, the conduct and consideration evinced towards the maiden must be mainly observed towards the wife ; for through this manifestation of respect and delicacy, the freshness and novelty of courtship may be continued for an indefinite period. Let the wife be preserved by the husband a beautiful mystery in part — let the natural veil of modesty which shrouds every pure woman be never ruthlessly torn apart, or her sense of propriety be blunted by coarse or indelicate remarks. As we nave already descanted somewhat diffusely upon the rule of conduct to be observed on the part of the youth as well as on that of the maiden who intended to become one at the altar, so now that 483 Husband and Wife. we presume them to be man and wife, we would be equally explicit as to how they should comport themselves as such. In addition, then, to what we have already just said, we would observe that in the first moments of wedded life the constant and unreasoning abuse of the privileges of a husband can not but result in evil consequences to both parties, inasmuch as it tends to render commonplace that which is intended by an allwise Creator to be otherwise, and is the brightest "and holiest link that unites the sexes. This privilege once famili- arized through constant and inordinate indulgence, loses all its charms, while the abuse which robs it of them, not only tends to injure the young wife physically, but the husband also. In this relation, the tide must flow and ebb according to the promptings of a law that none can fail to comprehend, and whose operations must not be accelerated if they are to be an unfailing source of delight, and to influence us through long years with undiminished powers. The reaction which inva- riably attends any continuous excesses of this character is so painful, humiliating and dangerous, as not unfrequently to lead to the most serious misunderstandings between the parties most concerned, and destroy that sweet confidence which should obtain between them. Again, the evil consequences of such excesses to the infant yet unborn are at times frightfnl to contemplate. A weakly and diseased frame, and, fre- quently, mind, are the dreadful results, while the health of the mother suffers commensurately. The young husband also pays his share of the penalty ; as the natural excitement which is the true key to all the pleasures that attend the sex- ual relations when indulged in upon the true basis, dies out under the enervating influences of satiety until the bond between man and wife becomes so relaxed in this relation as to be almost worthless. And let it be clearly comprehended here, that as this bond becomes weakened or vitiated between the young persons, so wanes their love and esteem for eacli other, until in time they come to look upon their union with apathy if not disfavor, and then are opened up all the ap- proaches to misery the most abject and heartrending. And if the most fitting place for the husband, after the labors of the day are over, is his own fireside, with his yonno- wife by his side, she, " the partner of his joys and woes," must endeavor to surround his home with every possible attraction; and light it up with a cheerful face and all the nameless charms that make it "the only spot on earth " to him. To this end, she must be always neat in her person, if at all within the range of possibility, for there is nothing more Husband and Wife. 489 pleasurable to a husband than a sense of the purity of the personal habits of his wife, and the comeliness of her attire when she presents herself before him. This latter involves neither labor nor very extraordinary expense. The bath, and, if needs be, the simplest fabrics, shaped, if necessary, beneath her own supple fingers, will meet all the necessities of. the case. These are attractions of such virtue and potency that they always operate like a magnet, and not unfrequently draw a husband away from the evil influences that tempt him to re- gard his home as a place of temporary sojourn only. "We have paid some attention to the subject, and can vouch for the fact, that, in ninety-nine cases out of one hundred, a pure, industrious, and cheerful wife, who meets her husband with a bright and warm smile on the threshold of her dwelling, spends the majority of her evenings in his society, without a fear for the future. But there are other observances, also, which ought to be regarded with the most profound caution by the newly-mar- ried who desire to spend their days in comfort and happiness together ; and one is the manner of their intercourse with such of the opposite sex as either the husband or wife may come into friendly contact with. Every properly constituted man or woman is more or less of a jealous disposition ; for without this sentitnent, active or latent to some extent, there can be no true love. Censure it as you may — call it mean and petty, if you will — but the fact obtains, nevertheless. Who that is conversant with the press in any degree, but can bear evidence to the fact that scarcely a newspaper is published without some painful recital, bearing upon this point, meeting the eye. To avoid the devastating influences, or approach of the " green- eyed monster," should be a leading feature of the wife's pru- dence, as well as of that of the husband ; for so unreasoning and sensitive are our natures in this direction, that when they are once aroused to suspicion, they seldom or never recover their wonted tone of confidence. And yet the accused party may be virtually innocent of the crime laid to his or her charge, although there are generally some grounds for censure on the score of thoughtlessness or that lightness or trifling which is so liable to be misinterpreted by certain individuals. Above all things, then, and especially on the part of the wife, no matter what the purity of her soul or intentions, she is al- ways to be circumspect with regard to her conduct or inter- course, in company or otherwise, with any of the opposite sex. Caution and decorum in this connection is of the first importance ; for not only might any thoughtless familiarity, 490 Husband and Wife. or any laxness of self-respect on this head be wholly misinter- preted by her husband, but, how innocent soever, be likely to fare no better at the hands of the individual towards whom she might have comported herself with unconscious levity. There is, therefore, nothing for it but the strictest prudence and an unswerving adherence to such a line of conduct as might be pursued with safety in the presence of her husband towards any gentleman of her acquaintance. Nor must there be any innocent secret confidences with any male friend, no matter how laudable the object, outside the sanction and re- cognition of her rightful counsellor and protector. The truer and prouder the husband, the more sensitive and jealous of his honor, and of his claims upon all the consideration to which he regards himself entitled on the part of the woman of his love — the wife of his bosom. As a general rule, then, no matter how intimate her gentle- men friends may be with her husband, or how frequently they may find a welcome beneath her roof, there must still be ob- served towards them that chaste and prudent course of conduct which they will not be slow to respect, or to attribute to the right cause, and which may be indulged in without the slightest shadow of acerbity or detriment to even the most generous hospitality. But it must not be presumed that the husband is not equally bound to be strictly observant on his part, also, as to how he comports himself in the opposite direction. The usages of society, we are well aware, allows him a greater latitude in this sphere than it accords to his wife ; but then there are proper limits set to it likewise; and the moment lie trans- gresses them he also becomes rightfully the subject of censure, and is an aggressor against the peace and happiness of the being he vowed to protect and cherish with all the love and affection of which he is capable. Yet, while the wife admits that civilized usages permit him to move with greater freedom among females than is accorded to her in her intercourse with males, she can determine, with the quick eye and intuition of her sex, when he transgresses the bounds of decorum, in her pre- sence, or fails in the allegiance due to her alone, and treasures the wrong within her soul of souls. In this it is impossible for a husband to deceive with continuous success the percep- tions and intuitions of the partner of his bed. There is about her that which fathoms and apprehends the most trifling approach to infidelity or immorality on the part of the man she loves. No matter how silent or uncomplaining she may appear to be, she feels, from certain unexplaiuable indices Husband and Wife. 491 perhaps, that all is not right ; and thus the canker sets in, that, if she loves with all her soul and might, gradually destroys all that makes life worth an hour's purchase, saps her life- blood, and hurries her to an early grave. These are truths which admit of no contradiction, and such being the case, the husband, in his turn, should, in his inter- course with the opposite sex, be just as careful and sparing of the feelings of his wife as she is of his. As in the unmarried state, so in the married, the selection of proper associates and friends is a matter of vital importance. !N"o man or woman who is careless in this relation can fail to suffer from the circumstance. It therefore behooves the young husband to exclude from his house or fireside such per- sons of their acquaintance as are of loose or questionable habits, and who, beneath the mask of a pleasing exterior, conceal a heart given to deceit or lewdness. It is impossible not to suffer from frequent contact with such people ; and for a husband to introduce any of them into his household is to thrust an indignity upon his wife, and subject her to influences the most unholy. In the same way the wife must be cautious and circumspect in relation to the choice ot lady friends and acquaintances ; and above all things, before taking them to her bosom, she must be thoroughly satisfied of their uprightness, and purity of thought and action. The very attire even must not be over- looked in the selection ; for where a young or an old woman is gaudily or expensively dressed, when there is not the am- plest means to sustain the folly, they are to be invariably regarded as undesirable companions — while, should they even be possessed of adequate wealth, they may be generally set down as light, frivolous people, of contracted minds and un- healthy tendencies. There is no difficulty at all in recognizing those upon whom the young wife may properly rely for womanly aid and sympathy, when such are necessary. The chaste matron, of silvery locks, with her sweet, pure daughter, who has been brought up to feel her dependence upon heaven and her duty towards the whole human family, are ot the class whose society should be cherished and prized by the in- teresting creature who may soon become a mother. Those of erratic ideas and disquieting influences ought to be studiously avoided ; as their presence in any household is undesirable, from the fact that frequent contact with such persons often so blunt the sensibilities and confuse the sense of right and wrong, that domestic misunderstandings soon obtain, and the happiness that should attend a well-ordered, family marred, perhaps, forever. 492 Husband and Wife. To succeed, then, in the marriage state, it may be laid down as a general rule, that the habits of both wife and husband shall be frugal, and their tastes congenial, to a great extent. If possessed of any antagonistic elements, their first and constant care should be to endeavor to harmonize them on the basis of love and chivalry — the husband yielding a point on the grounds of the one, and the wife moving forward a step to meet him under the promptings of the other. And to this end all disputations, how trifling soever, ought to be es- chewed with the greatest care. Out of mole-hills such as these, very frequently real mountains arise, and to the fatal disruption of all domestic ties. "While making these observations, however, it must not be presumed that we ignore the culture of the mind or of the taste. On the contrary, the interests of both may be attended to with excellent results, if the manner of improving them be clearly understood. There is scarce an object in art or nature that does not afford a text to the sincere inquirer after truth ; and as all knowledge lies in understanding the one and the other in the profoundest sense, this may be approached, to some extent, by those in even the most restricted circumstan- ces, if they only begin at the right point and pursue their studies systematically. To the accomplishment of this end, all trashy novels and exciting romances should be scattered to the winds; and pleasant, instructive books adopted in their stead, whenever a moment can properly be devoted to reading. There is nothing which so unfits a maiden or a young wife for her duties as the study of such characters as are presented in the sensational yellow-covered literature of the day. These are considerations of the gravest importance. The young wife, to whom we now T address ourselves more particu- larly, can not over-estimate their desirability. The moment she steps across her own threshold, she should, therefore, sur- vey all the circumstances of the case, and begin her wedded life on the only true basis, if a future of usefulness and happiness is her aim. Good habits, like evil ones, grow upon one; so that the first move beneath her own root should be taken with caution, and in the right direction. Another important desideratum relative to newly-married people is, the cultivation of each other's society when at all possible, and the constant study of each other's excellencies. These latter traits of character must be kept persistently in the foreground , and be made, so far as practicable, to cover whatever defects may, at times, peep out on the part of either Husband and Wife. 493 the wife or the husband. To err is human, and we cannot, therefore, expect absolute perfection in ourselves or in others, so that by taking an occasional peep into our own hearts we shall be prepared, in a measure, to make allowances for whatever slight defects may be apparent in those who are near and dear to us. One of the strongest bonds of union between man and wife is that of mutual admiration of each other's society, a similarity of tastes and intellectual pursuits, and a desire to minister to each other's edification and amusement. No day or hour should pass without the culti- vation of the warmest sentiments in this connection, tor although the circumstances of business may separate the husband from the wife for many hours daily, yet the magnet- ism of true love and affection can go forth on its subtle mission, and apprise both that their hearts beat in union, and that they are looking forward alike to the happy evening hour which shall re-unite them. A cultivation of such thoughts and the indulgence of such sweet anticipations will tend to cheer both during their hours of separation, and give the keenest zest to the moment when they shall again meet in a fond and welcome embrace. Living in this happy rela- tion, life glides swiftly and sweetly away, in the bright anticipation of an eternal day of joy, that shall dawn upon us on the shores of immortality. To the newly married, or those who are contemplating marriage, who may need any medical advice, we shall be pleased to give the benefit of our professional services. You may not be fully satisfied as to your physical or physiologi- cal condition ; may not know whether you ought to get mar- ried ; or there my be something in relation to your intended partner through the journey of life, on which you are not fully satisfied in your own mind ; may wish to know what will be the result in the future, of such a union in matrimony. Such an one may be as dear to you as your own life, and yet it might be the very worst step you could take to marry the one you so much love. In fact, there are a great many things on which persons often want professional advice and counsel, and about which they would not consult a physician in their own neighborhood ; to such we can give satisfactory advice in all matters of this kind. "Write out the particulars of the case in full, enclose a stamp for reply, and. we will give you our opinion. Address the author, M. LAFAYETTE BYRN, M. D,, Ofiice, 49 Nassau st. P. O. Box, 4,669 New York. 49i INDEX Page Abscess, oommon 261 u Mannnary 264 " Lumbar 265 Abstinence 42 After-Birth, delivery of 176 After-Paius 179 Age, Old 434 Ague and Fever 204 Ague, Brow 226 Air, Atmospheric 26 Air, Night 28 Air, Sea 29 Albumen 45 Albuminaria 451 Anger 65 Angina Pectoris 328 Animal Fat 4T Ankles, Weak 122 Anodynes 396 Antidotes for Poisons 412 Anti-spasmodics 400 Anxiety of Mind 66 Apoplexy 196 Apple Tea 138 Appetite 41 Arm, Fracture of 277 Artificial Nursing 82 Asthma 246 Astringents 397 Attendants on the Sick 383 Bacon 48 Baking 53 Bandages 386 Bandaging the Bowels 157 Barbers' Itch 193 Barley 50 " Water 138 Barrenness 203 Bathing 73 Beds 62 Bed Rooms 63 Bed Clothes 63 Beef. 47 Beef Tea. 188 P** Bees, Stings of . . 270 Bile 437 Bilious Fever 206 " Colic...". 348 44 Headache 226 44 Diseases 438 Biliousness 438 Bites of Venomous Snakes 219 Bites of Mad Dog 199 Bitters , 398 Bladder, Stone in '. 800 44 Inflammation of 326 44 Weakness of 437 Bleeding Piles 268 44 from the Nose 97 Blind Piles 268 Blisters, Dressing 385 Blood, Spitting of 234 44 Vomiting of . . . . 242 Bloody Flux 357 44 Urine 363 Boiled Eggs 137 Boil 263 Boil, Gum 264 Bones, Broken 273 Boston Cracker Toast 187 Bowels, Care of 67 44 Looseness of 105, 352 44 Bandaging of. 157 • 4 First operations from. 180 44 Inflammation of 321 44 Costiveness of 349 Brain, Inflammation of 194 44 Water on the 134 Bread 5J Breakfast 54 Breast, Sore 184 44 Gathered 264 Bright's Disease 451 Broiling 53 Broken Bones 278 Bronchitis 122 Broth, Mutton 131 44 Veal... 41 Index. 405 Page Brow Ague 226 Bruises 286 Bunions 192 Burns 248 Butter 46 44 MUk 56 Cabbage 52 Calf Foot Jelly 45, 137 Cancer 293 Candies 84 Canker of the Mouth 97 Carbonic Acid Gas, Inhaling.. .213 Carbuncle 266 Carminatives . . . ., 393 Carrying Infants 86 Catarrh in the Head 231 Caustics 402 Cellars 80 Cessation of the Menses 146 Cheese 46 Change of Climate 429 Chicken Pox 181 Chicken Soup 48 Chilblain 431 Children, Diseases of 94 " Management of 70 44 Physical Education of. 69 Child, Duties relative to 175 44 Washing the 179 44 Dressing the 180 Chills and Fever 204 Choke Damp 212 Choking 118, 299 Cholera 354 44 Morbus 360 44 Infantum, 118 Chronic Rheumatism 254 Clap 441 Clergyman's Sore Throat 456 Climate 30 44 Change of. . .429 Clothing 81, 73 44 Woollen 33 44 Cotton 33 44 Linen 33 Cleanliness 57 Coffee 56 Cold in the Head 316 Cold, Common 457 Colds and Snuffles 102 Collar Bone, Fracture of 281 44 Dislocation of ....286 Oolie 844 Colic from Indigestion 844 44 Bilious 843 44 Flatulent 316 44 in Children 106 Consumption 888 Contusions 286 Convalescence 402 Convulsions 1 u7 Cookery 53 Corn Bread 50 Corns 192 Corsets 34 Costiveness in Children 115 44 in Adults 349 Cough, Hooping 114 44 Common 459 Courses 139 44 Retention of 141 44 Suppression of 143 44 Deficient and Painful.. 144 Cramps 154, 158, 216 44 from drinking cold water.218 Cravat 34 Crying 69 Crabs 49 Croup, Membranous 98 44 Spasmodic 101 44 Crowing 101 Cupping 886 Currant Water 188 Custard 136 Cuts 288 Damp, Choke 213 Dance, St. Vitus' .207 Deafness 295 Death, apparent, from inhaling Carbonic Acid Gas 213 Defects of Vision 312 Delirium Tremens 195 Delivery, Diseases after 181 44 of the After-Birth ... 176 Demulcents 401 Derangements of the Lochia. . .186 Diabetes 361 Diaphoretics 894 Diarrhoea 105, 352 Diet (see Appetite and Cookery.) 44 for Children 76 «• 44 (sick) 186 Difficult Teething 94 Dinner 54 Diphtheria 865 Diseases of Children 94 400 Index. Page Diseases of Females 139 44 the Ear 116,295 " Heart 329 44 Pregnancy 150 41 after Delivery 181 Dislocations 282 44 of the Wrist 384 M 44 Elbow 284 44 " Shoulder 284 44 " Lower Jaw 285 44 44 Collar Bone... 286 Diuretics 393 Dizziness of the Head 225 Doses of Medicines 383, 406 Dreaming 64 Dress, Head 33 Dressing Blisters 885 Dressing the Child 180 Dropsy 244 Drowning 211 Drinks 55, IS Duties relative to the Child. . . .17*5 Dysentery 119, 857 Dvspepsia, or Indigestion.. 134, 340 11 Bread 136 Ear, Diseases of 116, 295 44 Foreign Substances in. .116,295 Ears, Noises in 437 Ear-ache 116 Education of Children 69 Eggs 46 41 Boiled 137 Elbow, Dislocation of 284 Emetics 892 Enlarged Veins 308 Ephemeral Fever 185 Epileptic Fits 208 Eruptions, various 102 Erysipelas 421 Examination of the Passage . . .161 Excoriations 104 Exercise. 38, 74, 86 Expectorants 395 Exposure 90 External Parts, Soreness of.. ..182 44 Violence 217 Eyes, Diseases of 103, 309, 810 Eye Waters 399 Fainting 182 44 Fits 206 Fat, Animal .47 Falling of the Womb 148 44 44 Fundament 106 Pagt Fallinc out of the Hair 464 False Pains 162 Fear 65 Feet, Care of 63 Felon 293 Females, Diseases of 139 Fever, Scarlet 126 «* Bilious 206 « 4 and Ague 204 44 Ephemeral 185 " Typhus 2-35 44 Typhoid 235 44 Yellow 240 " Puking 344 44 Milk 183 First operations from the Bowels. 180 First Stage of Labor 1 63 Fish 48 Fits, Fainting 206 44 Epileptic 208 44 Apoplectic 196 Flatulent Colic 346 Flatulence 436 Flooding 181 Flux, Bloody ...357 Fluor Abus 147 Food 43 Food, Vegetable 48 Food, Animal 44 Foreign bodies in the Nose 121 44 " Ear 116 44 44 Gullet . . . .299 41 44 Eyes 809 Fore-Arm, Fractures of 277 Fourth Stage of Labor 174 Fractures 278 Fracture of Collar Bone 281 Arm 277 < 4 Knee Pan 279 44 Ribs 276 44 Lower Jaw 275 44 Fore Arm 277 44 Thigh 278 44 Leg 280 Friction 41 Frost-bitten Parts 457 Frying 53 Fullness of Blood 433 Fundament, Falling of. 106 Gargles 40C Garters 87 Gathered Breast 2W Giddiness of the Head 92t Int Page Ginger Bread 51 Gleet 449 Gonorrhoea ,441 Gout 255 Crawl 300 Great Flow of Urine 361 Grief 65 Growing in of Toe Nail 313 Gruel, Oaten Meal 50, 137 " Indian Meal 137 " Sweet Cora 137 Gullet, Foreign Bodies in 299 Guiu Boil 204 Gums, [nflamed 95 Hair, Care of. 66 " Falling out of. .464 Ham 48 Hanging 213 Hay-Asthma 454 " Fever 454 Head Dress 33 " Scald 110 " Sore 109 " Giddiness in 225 " Dizziness in 225 " Cold in the 316 " Catarrh iu the 231 Headache 226 " Sick 226 " Bilious 226 " Nervous 226 Hysteric 226 " Rheumatic 226 Health, How to Preserve 25 Heart-Burn 341, 151 " Diseases 329 " Palpitation of 157, 332 Heart and Lungs 7 Heat, Prickly 129 Hemorrhage, Uterine 145 " from the Langs. . . 234 " " Stomach.242 " « Nose,... 97 Hernia 228 " Strangulated 304 Hiccup or Hiccough 224 Hooping Cough 114 Hope 64 Hornet, Sting of 270 Hunger 42 Hydrophobia 199 Hysteric Headache 226 " Fits 454 Pag* Hypochondria 223 Indian Corn . 50 " " Bread 50 " Meal Gruel 137 indolent Ulcers 307 Incontinence of Urine 120 Indigestion 134, 340 Infants, Nourishment of 76 Infection, Propagation of Dis- eases by .459 InHammation of the Lungs.125, 318 " " Brain ......194 " " Tonsils 313 " " Larynx 315 " " Top of Wind Pipe ....315 " •" Stomach, (acute)... 320 " " Stomach, (chronic. 321 " " Bowels 321 " " Liver (acute) 323 " " Liver, chronic... 324 " " Bladder 328 " " Kidneys 325 Inflammatory Rheumatism 251 Influenza 428 Injections 3d4 " Purgative 393 Insects, Venomous Bites of 219 '• Poisonous Stings of. 270 Intermittent Fever 204 Irritable Ulcers 306 Isinglass Jelly 136 Itch 136 " Barbers' 193 Itching of i\e outer Parts 153 Jaundice 842 Jaw, Lower Dislocation of 2S5 " Fracture of 275 Jelly, Calves- Feet 45, 137 " Orange 136 " Biscuit... 136 " Sago 136 " Tapioca, 136 " Isinglass 136 " Rice 133 " Moss 137 Joints, Wounds o* 291 Joy 64 Kidneys, Inflamm«>ion of 325 King's Evil „^ .251 498 Index. Page Cnee Pan, Fracture of. 279 Labor 158 * Natural 158 •« Signs of 162 u First Stage of 163 " Second " 168 » Third " 170 " Fourth " 174 Lacing, Tight 34 Lamb 47 Larynx, Inflammation of. 315 Leg, Swelled 187 " Fracture of 280 Lemonade 136 Lightning, Stroke of. 215 Liver, Diseases of 323 " Inflammation of (acute).. 323 " " (chronic). 324 List9 of Medicines 383 Lobsters 49 Local Irritating Remedies 401 Lochia, its derangements 186 Lock Law 202 Looseness of the Bowels. 352- .105 Long-sightedness 312 Love 65 I>ower Jaw, Fracture of 275 11 " Dislocation of 285 Lowness of Spirits 223 Lower Limbs, Swelling of 157 Lumbar Abscess 265 Lungs, Inflammation of 125, 318 Mad Dog 199 Maize 50 Malignant Sore Throat 117 Mammary, Abscess 264 Marshes 28 Masturbation 452 Meals 53 Meats, salted 49 Meats, unhealthy sickness from .267 " broiled 187 Measles 110 •Medicines, their Doses and Uses 383 Medicines, Classification of 391 " to Expel Wind 393 " " promote flow of Urine 393 u " produce Perspira- tion 39A ■ " bring Phlegm from' the Lungs 395 Pag* Medicines for acidity in the Stomach 396 " to allay Pain S9e " " lessen Discharges. .397 " " check Looseness ..397 ii <• " Vomiting... 898 " " strengthen the sys- tem 398 u for Worms 399 " • " Spasms 400 Medicines, proper time to give. 3^3 Medicines, Doses of 406 " for Medicine Chest . . . 405 Menstruation 1 39 " Profuse 145 Menses 130 " Retention of. 141 '• Suppression of. 143 " Deficient 144 " Painful 144 " Cessation of 146 Milk 45 * Toast 137 " Sago 187 " Porridge 138 " Fever 183 " Leg 187 " Sickness 344 Midwifery 15S Mind, Anxiety of 66 Miscarriage 154 Miscellaneous Recipes 402 Monthly Turns 139 Morning Sickness 151 Mortification 297 Moss Jelly 137 Mouth, Canker of 97 Movement Cure 41 1 Mucilage, Sago 138 Mumps 327 Mussel 49 Mutton 47 " Broth 138 Neck, Wry 808 Nervousness 431 Neuralgia 220 Nervous Headache 226 Nettle Rash 133 Night Air. 28 Nightmare 64 Nipples, the 157 " Sore 183 Index. 499 Page Nose, Foreign Boilios in 121 Noises in the Ears 437 Nourishment of Infauts 70 Nurses, Qualifications of 383 Nursing, Artificial 82 Oaten Meal 50 " Gruel 137 Dintments 401 OKI Age 434 Orange Jelly 136 Out of Joint 2S2 Outer Parts, Itching of 153 Oysters 49 Oyster Soup 138 Pain in the Breast 328 Pains, False 102 Pain and Difficulty in Urinating. 153 Palpitation of the Heart. ..157, 332 Palsy 197 " Lead ....198 « Shaking 198 Panado 51, 136 Paralysis 197 Passage, Examination of 161 Passions, the 64 Pastry 51 Phthisic 246 Piles 152, 268 " Bleeding 268 " Blind 268 Pimples in the Face 188 Plasters 402 Plethora 433 Pleurisy 320 Pneumonia 318 Poisons and their Antidotes 412 Poison-Vine Eruption 452 Porridge, Milk 138 Pork 48 Potatoes 52 " Roasted 137 Poultry 48 Poultices 386 Pox ; 446 Prickly Heat 129 Pregnancy, its Signs & Diseases. 149 Preservation of the Sight 67 Propagation of Diseases 459 Proper Time for Sleep 61 Profuse Menstruation 1 45 Puddings 51 " Starch 136 Paking Fever 344 Pagt Purgatives 391 Purging and Vomiting 360 Putting to Bed 178 Qualifications of Attendants on the Sick 383 Quantity of Sleep 61 Bash, Nettle 133 Recipes, Miscellaneous 402 Remittent Fever 206 Retention of the Menses 141 " " Urine 368 Rheumatism 251 " Inflammatory 251 v Chronic .254 Ribs, Fracture of 276 Rickets 121 Rice 50 " Caudle 136 " Jelly 136 " Pudding 137 Riding 40 " Carriage 88 Ring Worm or Tetter 130 River Sickness 344 Roasting 53 Rowing 40 Rupture 228 " Strangulated 304 Rye 50 Sago 52 " Jelly 136 " Milk 137 " Mucilage 138 Salted Meats 49 Salivation 427 Sausages 48 Scald Head 110 Scalds 248 Scarlet Fever 126 Sciatica 440 Scrofula 258 Scurvy 334 Second Stage of Labor 168 Secret Habits of Youth 452 Sea Air 29 Sea Sickness 221 Shaking Palsy 198 Shingles 188 Short Sightedness 312 Shoulder, Dislocation of 284 Sick Children, Diet for 136 Sick Headache 22£ Sickness, Morning .151 hidex.. Page Sickness from Unhealthy Meats. 267 u Milk 344 " Swamp 844 " River 344 Signs of Labor 162 Sisrns of Pregnancy 149 Sight, Short and Long 312 " Weak 312 " Preservation of 67 Skin, Eruptions of 102 Sleep 61, 74 " Quantity of 61 " Proper Time for 61 " to Promote 61 Slows 344 Small-Pox 189 Snake Bite 211) Sn allies and Colds 102 Soap 58 | Sore Eves 103, 310 j " Head 109 " Nipples 183 " Throat— Malignant 117 " Breast 184 " Throat 313 " " Clergyman's 456 Sores 305 " Running 305 Soup 49 " Chicken 48 " Oyster 138 " Beef 49 , " Veal 48 | " Mutton 49 SourCrout 52 Sourness of the Stomach 341 Spasms, or Convulsions 107 Spitting of Blood 234 Spirits, Lo^ness of 223 Sprains 287 Sr. Vitus' Dance 207 Stammering 125 Starch Pudding 136 Sterility 203 Stewing 53 Stiff Joints 344 Stimulants 400 Sting of Bees, Wasps, &c 270 Stomach (see Appetite and Cooking.) Stomach, Cramps in the. . .158, 218 " Sourness of the 341 " Wind in the 104 Pag* Stomach, Inflammation of 820 Stone in the Bladder 303 Stranguary 153, 365 Strangulated LTernia 304 Strictures 450 Stroke of Lightning 215 Stye 310 Summer Bronchitis 454 Sun Stroke 198 Supper 55 Suppression of Menses 143 " Urine 364 Swamp Sickness 344 Sweet Meats 84 Swelling of the Lower Limbs.. .157 Swelled' Leg 187 Swimming 40 Swimming in the LTead 225 Symptoms of Diseases 426 Syphilis 446 Table of Medicines 406 Tamarind Water 138 Tapioca Jelly 136 Tea 56 " Beef 138 " Apple 138 Telling Diseases by the Tongue. 425 Teething, Difficult 94 Tetanus 202 Tetter, or Ring Worm 130 Third Stage of Labor 17C Throat, Sore 117, 313 " Foreign Bodies in 299 Thigh, Fracture of 27S Thrush 96 Tight Lacing 84 Tires 844 Toast Water 55 " Milk 137 " Boston Cracker 137 Toe Nail, Growing in of 313 Tonics 398 Tongue, the 69 " Telling Diseases by 425 Tonsils, Inflammation of ,313 Toothache 95 Trembles , 844 Trusses „ ... 223 Turns, Monthly 13G Typhoid Fever 235 Typhus Fever 235 Ulcers 305 " in Weakened Parts 806 Index, 501 Page Dicers, Irritable 806 " Running 305 " Indolent 307 Unhealthy Moats, Sickness from.267 Urinating, Painful ...153 Urinate, frequent desire to 365 Urine, great flow of 361 " Bloody 363 " Retention of 363 " Suppression of. 364 • " Incontinence of 120 Uterine, or Womb Diseases 147 Vaccination 132 Varicose Vein3. .308 Varicocele, 222 Various Diseases 188 Veal 48 " Broth 48 Veins, Varicose 308 " Enlarged 308 Vision, Defects of. 312 Venomous Insects, Bites of 219 Venison 48 Ventilation 30 Vomiting and Purging 3G0 of Blood 242 Walking 89, 89 Warts 191 Wasp, Sting ef. 270 Pfgt Water, Tamarind 138 " Currant 138 " Apple 13£ " On the Brain 134 " Brash 342 Weaning 91 Weak Ankles 122 " Sight 312 Weakness of the Bladder 437 Weed... 165 Wen 307 Whey 55 Whitlow 292 Whites 147 Wine Whey 138 Wind in the Stomach 104 Windpipe, Inflammation of. ...315 Womb, Falling of 148 " Diseases of 147 Worms H3 Worms in the Face .188 Worm Medicines 399 Wounds 288 " of the Joints ...291 Wrist. Dislocation of 284 Wry Neck 80? Yellow Fever 84C IN D EX TO Ankle-joint and Foot 15 Advice to the Young of both Sexes 471 Advice to Young Men 4S3 Conjugal Irregularities 258 Counsels to a Young Woman.. 477 Courtship 477 Conjugal Duties 487 Bye, Muscles of 19 Eye Appendages 18 Eye, Transverse section of 17 Eye, Posterior Segment of 17 Eve, Longitudinal Section of. . . 16 Eye Ball r 16 Excesses in Marriage 255 Female Breast 20 Husband and Wife, Duties and Relations of 487 Morbid Passions of 473 ntestine, Small 23 mpotence 259 mportant Counsels 471 nteinperance 486 eaiousy 4S9 Sidney, Section of 15 Lovers, Important Counsel to . .433 ADDITIONS. Mesenteric Circulation 23 Milk Ducts 20 Mammary Glands 20 Meibomian Glands 18 Marriage Excesses 256 Maidens, Advice to 471 Maidenhood, Dangers of 472 Marital Errors 438 Nerves of the Face and Head:. . 22 Nose, Septum of Nerves 19 Nervous Debility 255 Newly Married, a Chapter for. .487 Ovaries, Anatomy of 100 Parotid Gland 23 Physiology and Philosophy of Bight Living 471 Puberty 474 Parental Duties 481 Skin, Structure of. 21 Sweat Gland 21 Skin, Section of 21 Skin, Pores and Papillae of 21 Secret Habits 256 Urinary Bladder 15 Womb, Anatomy of 160 Youthful Indiscretions 482 MAGNETO-ELECTRICITY, \Te live in an age of -wonders and extraordinary philosophical and scientific investiga- tions. Electro-Magxetism is achieving astounding revelations in the physical world; few Physicians even, of the present day have any just conception of the laws by which man has health and a vigorous existence. This grand and subtle principle is Magxeto- ELECTRlcrrr — a part of the same agent that sets the physical world in action, and keeps them in systematic and harmonious workings. 'According to experiments made by eminent medical men, the influence of electricity on animals, in augmeuting.the force of the contractions and expansions of the muscles, and in altering the morbid, and re-establishing the natural secretions, can not be doubted; thus showing this to be one of the most powerful agents that is used in the healing art. "Can it be safely used by any but physicians?' is a question that is often asked. By means of the Magneto-Electric Machine we now offer to the public, every family or individual can safely and systematically use Magneto-Electricity, and cure diseases there- by, that cannot be by any other known means. The WONDERS of Electricity in the cure of various diseases, are becoming better known every day. The people have long wanted a good and cheap Magnetic-Machine, and one free from danger and one not liable to get out of repair. In this Magneto-Electric Machine you have the thing so much desired. Instead of depleting the system by blood-letting, purgatives. &c, thus draining away the vitality, afford nutriment to the nervous system, repair and increase the nervous influ- ence and bring back the vigor of health. To do this, apply Magneto-Electricity by means of this machine; it is harmless, healthful and pleasant. It produces galvanic electricity by simply turning a crank. It requires no battery, no solutions, and no frictions, but develops electricity by what is called the inductive influ- ence of a permanent magnet, and it gives a current of the same character of the Electro- magnetic machines which require a battery to actuate them. The machine is small and convenient, being enclosed in a brass-covered box, and with good care will last a life-time. There is a " Book of Directions " for operating the machine, and everything complete for treating the various forms of diseases, that goes gratis with each machine. Men and women are making money with these machines, by traveling and applying ' Medical Electricity " to those who are sick. It is a paying business in the hands of any person of ordinary capacity. The force and current of electricity can be so regulated by this machine as to make it perfectly safe to use, even on children. LIST OF DISEASES TREATED BY THIS MACHINE. Asphyxia (when persons appear dead), Apoplexy, Asthma, Loss of Voice. Dropsy, Reten- tion or Suppression of Menses, Affections of the Liver, Fever and Ague, Bronchitis, Billi- ous Complaints, Barrenness, Impotence, St. Vitus' Dance, Costiveiiess, Turn of Life in Females, Colic, Catarrh, Genital Debility, Delirium Tremens, Dyspepsia, Dullness of Hearing.. Epileptic. Fits, Headache, Locked Jaw, Neuralgia, Paralysis, Females in Con- finement, Rheumatism, Sore Throat, Loss of the Sense of Touch. Diseases of females, Croup, Toothache, and, in short, nearly all Chronic Diseases, and diseases that other remedies fail to cure, should bo treated with this machine. It is sent safely by express everywhere, and each machine warranted. Price for ma- chine and book of directions, all complete, £12.00. Kemit in Post Office Money Order, by Express, or in Registered Letter, at my risk; it will bo sent C. O. D. when desired, to parties giving good references, Address, ,M. LAFAYETTE BYRN, M. D., (Office 49 Nassau Street.) P. 0. Box 4669,- New York. 3477 X288 > -^ ^ x 0o . ^ ^ o A ' *' >- "(-• **L» ^ ^ 4? ■%