^n0 m % %'-& '.*& > ,.•<■. #■*•■» € h >. /*v*# £ «#l * - V *■: *Gt 17. . *___£. < NATIONAL LIBRARY OF MEDICINE Bethesda, Maryland Gift of James Harvey Young In memory of his parents William Harvey and Blanche DeBra Young J* '7/ -r *'■ IN THE MEDICAL COMPANION, OR FAMILY PHYSICIAN? TREATING OF THE DISEASES OF THE UNITED STATES, WITH THEIR SYMPTOMS, CAUSES, CURE, AND MEANS OF PREVENTION*. COMMON CASES IN SURGERY, AS FRACTURES, DISLOCATIONS, &c THE MANAGEMENT AND DISEASES OF WO^VLE-X &XB CTHIaDUT&X. A DISPENSATORY, FOR PREPARING FAMILY MEDICINES, AND A GLOSSARY EXPLAINING TECHNICAL TERMS. TO WHICH ARE ADDED, A BRIEF ANATOMY AND PHYSIOLOGY OF THE HUMAN BODY, SHEWING, ON RATIONAL PRINCIPLES, THE CAUSE AND CURE OF DISEASES: AN ESSAY ON HYGIEINE, 6R THE ART OF PRESERVING HEALTH, WITHOUT THE AID OF MEDICINE: POINTING OUT THE VIRTUES AND DOSES OF OUR MEDICINAL PLANTS. ALSO, THE NURSE'S GUIDE. THE SEVENTH EDITION, REVISED, ENLARGED, AND VERY CONSIDERABLY iMPROVEDi BY JAMES EWELL, PHYSICIAN IN WASHINGTONTTORMERLY OF SAVANNAH. '• I have alwkVs thought it a greater happiness to discover a certain method of curing, even the iliirhnst JisSbe, than to accumulate the largest fortune; and whoever compass^ th-.- form- cr, I esteem notomy happier, but wiser and better too." SYDENHAM, WASHINGTON: PRINTED FOR THE PROPRIETORS 1827. rnrcE five dollars- DISTRICT OF COLUMBIA, to wit. f&SgSf^ BE IT REMEMBERED, That on the eighth clay of November*, IfMMK^H 'n the vear °f our ^ord one thousand eight hundred and Iwenty- BjrWWfli two, and of the Independence of the United States of America, ^BmBBm> the forty-seventh, CORDELIA B. EWELL and OLIVIA F. EWELL, of the said district, have deposited in the Office of the Clerk of the District Court for the District of Columbia, the Title of a Book, the right whereof, they claim as proprietors, in the words following, to wit: "The Medical Companion, or Family Physician; treating of the diseases of the United States, with their symptoms, causes, cure; and means of prevention; common cases in surgery, as fractures, dislocations, &c. The management and diseases of women and children: a dispensatory for preparing family medicines, and a glossary explaining technical terms. To which are added, a brief anato- my and physiology of the human body, showing on rational principles, the cau- ses and cure of diseases: an essay on Hygieine, or the art of preserving health without the aid of medicine: an American Materia Medica, pointing out the virtues and doses of our medicinal plants. Also, the Nm-se's Guide—The sixth edition, revised, enlarged, and very considerably improved, By James Ewell, physician in Washington, formerly of Savannah. "I have always thought it a greater happiness to discover a certain method of curing even the slightest dis- ease, than to accumulate the largest fortune: and whoever compasses the for- mer, I esteem not only happier, but wiser and better too.—Sydenham." In conformity to the Act of the Congress of the United States, entitled, "An Act for the encouragement of learning by securing the copies of maps, charts, and books, to the authors and proprietors of such copies, during the times therein mentioned."—And also to the Act, entitled, "An Act supplementary to the act, entitled An Act 'for the encouragement of learning, by securing the copies of maps, charts, and books, to the authors and proprietors of such copies during the times therein mentioned,' and extending the benefits there- of to the arts of designing, engraving, and etching historical and other prints." In testimony whereof, I have hereunto set my hand, and affixed the public beal of my office, the day and year aforesaid. EDM. I. LEE. Glerk of the District Court for the District of Colunibiet. RECOMMENDATIONS. In testimony of the merits of this work, the following commendations,by some of the most distinguished med- ical characters of the United States, are inserted; to- gether with the letters of their excellencies, Thomas Jefferson, and G. Hyde de Neuville—also, a review by Professor Mitchill, of New-York. Baltimore, Nov. 18, 1822. BEAR SIR, I have been truly gratified in the perusal of the Sixth Edition of your "Medical Companion, or Family Physician." The improvements made in this new impression of your work, compared with the former editions, are indeed extensive and impor- tant. Independent of your having enlarged considerably on dis- eases o-enerally, you have introduced additional matter, which "■reatly enhances its value. The introduction of the Nurse's Guide, as also the treatise you have given on the management of female complaints, will have the most happy effects, in correcting the gross errors daily committed by ignorant persons, and thereby save many valuable lives. I do not hesitate to say, that this new edition of your Medical Companion, is decidedly the best popular treatise on medicine, that has ever been published; and considering it, as I verily do, a safe and useful guide for heads of families, as well as for young prac- titioners of mfthcine, I take much pleasure in recommending it to the attention of our fellow citizens, both in town and country. I will only add, if your book meets with that encouragement, to which it is justly entitled, you will very soon be called upon, by the public, for another edition. I am, dear sir, with much respect, Your friend and servant, COUN MACKENZIE, M. D. Dr. James Ewell. It RECOMMENDATIONS. Baltimore, JVov. \Sth 18 2i DEAR SIR, When the Medical Companion was first published, I considered it greatly superior to every work of that character I had read. I have now read the Sixth Edition, and am much gratified in hav- ing it in my power to say, that in this Edition you have so enhanc- ed the value of the work, as to claim my unqualified approbation. Doctor Rush, during my residence in his house, often spoke of his intention to publish a medical work for the use of families, adapt- ed to the climate of the United States. As he reserved it for the last act of his labours, for the benefit of mankind, unhappily he did not live to accomplish his design. In the work novv presented to the public, you have fulfilled the patriotic intentions of the great and good Rush, to the utmost ex- tent, and I sincerely hope your reward may be as it deserves, ample. I am, dear sir, very truly, yours, ASHTON ALEXANDER, M. D. Dr. James Ewcll. Philadelphia, August 13, 1816. DEAR SIR, I have looked over, with spme care, the copy of the Third Edi-* tion of the "Medical Companion," which you did me the favour to. present to me. By the additions and revisions given to this new impression of the work, it is not only enlarged,but exceedingly improved. After stating so much, I need hardly repeat an opinion, which I publicly expressed on a former occasion, that I consider it, as indis- putably, the most useful popular treatise on medicine with which 1 am acquainted. Compared with the European Books of the same nature, it has, especially in relation to the treatment of the diseases of oui own country, a very decided superiority. I trust that the success of this literary enterprize maybe equal to your very generous and benevolent disposition. With great respect, I am, dear sir. yours Stc. N. CHAPMAN, M. I) Professor of the Tnst'tules and Practice of Medicine, and Clinical Practice, in the University of Pennsylvania RECOMMENDATION*.- v" Philadelphia, Aug. IStli, 1816. PEAR SIR, I have derived much satisfaction from a perusal of the Third Edi- tion of your "Medical Companion." The additions and improvements which it contains, as compared with the two first editions of the work, are extensive and important. To families in the country, remote, not only from medical aid, but from places where common medicinal articles are to be pro- cured, your Materia Medica alone, disclosing to them the healing resources of their ov»n farms and forests, v ill be of high value. Nor, provided they be true to their best interests, and avail themselves of the advantages placed at their disposal, will your rules and direc- tions for the preservation of health, be less useful to them. In addition to these two important branches, now introduced into the Medical Companion for the first time, it contains a large amount of new miscellaneous matter, which carmot fail to be interestn.b to the reader. On the whole, if I be not greatly mistaken in my estimation of the character of your work, it is well calculated to prove extensive- ly useful, and to place you in the midst of the permanent benefac- tors of your country. That you may receive, in reputation and wealth, your full reward, is the sincere wish of Dear sir, your very humble And obedient servant, CH. CALDWELL, 31. D, JYoiv Professor of Materia Medica and Physiology in the Transylvania University. Br. James Eicell. Philadelphia, December 31, 1807. DEAR SIR, I have read your book entitled "The Medical Companion," with pleasure, and think it worthy the attention of the citizens of the United States. „ „ _ W. SIIIPPEN, M. D Professor of Anatomy. Dr. James Eicell. Philadelphia, December 31, 1807. pEAR *->!*, 1 have carefully perused your work, "The Medical Companion," and take much pleasure in expressing my entire approbation of the plan, and of the utility with which you have conducted your inqui- ries.' Your book cannot fail to be a very acceptable present to the public in general, and especially to our. own countrymen. I really in of opiili'in. that you are entitled to much praise for the pains, VI RECOMMENDATIONS. which you have taken in furnishing us with a work, the want of which has long been experienced among us. Your friend, &.c. B. S. BARTON, M. D. Professor of Materia Medica, JYatural History and Botany. Dr* James Ewell. December 28, 1807. I have read ;' The medical Companion," by Dr. James Ewell, with satisfaction. It is a book containing a variety of matter in a small compass. The practice which he recommends in diseases, is modern and judicious, and the work cannot fail of being useful in all families in the United States. JAMES WOODHOUSE, M. D. Professor of Chemistry in the University of Pennsylvania. Dr. James Ewell. DEAR SIR, I have looked over your "Medical Companion," with pleasure. The arrangement of the various parts is judicious, the language plain and perspicuous, and the sentiments happily condensed; the modes of treatment grow out of the most improved state of our sci- ence, and may serve as a safe and useful guide to every family cut off from the services of able physicians. Accept the homage of my regard. JOHN B. DAYIDGE, M. D. Professor of Anatomy, Surgery, fyc. in the College of Medicine of Maryland. Baltimore, Feb. 19, 1808. Dr. James Ewell. DEAR SIR, We have perused your "Medical Companion" with much satis- faction, and strongly recommend it to the attention of those fami- lies who cannot with convenience procure medical aid. We think it the best publication we have ever read on the domestic treatment of diseases, more especially as it regards those of our climate. We are very respectfully, sir, your most obedient servants, BROWN & MACKENZIE Baltimore, March 4, 1S08. Dr. James Ewell.. RECOMMENDATIONS. vii SIR, I have read your book on Domestic Medicine with pleasure. The practice recommended in it is judicious, and being from the pen of a native physician, has great advantage over the publications of European authors. JOHN SHAW, M. D. Professor of Chemistry in the College of Medicine of Maryland. Dr. James Ewell. Charleston, May 7, 1808. DEAR SIR, Your "Medical Companion" contains much useful knowledge in a small compass, and is particularly adapted to these states. Fami- lies remote from medical aid, will find their account in possessing a book which describes diseases so plainly, and prescribes for them *o judiciously, as bid fair to save valuable lives, which otherwise might be lost. Your most obedient servant, DAYID RAMSAY, M. D. Dr. James Ewell. Charleston, S. C. May 12, 1808. DEAR SIR, The perusal of your "Medical Companion" has given me the grea-- fest satisfaction. Such a publication has been much wanted, andl think the plan and execution of your work must answer the mos,t Valuable purposes. Yours very truly, ALEX. BARRON, M. D. Dr. James Ewell. Charleston, May 14, 1808. DEA.R SIR, I have, with great pleasure, perused your "Family Physician." I find it to be a well digested r-ompend of the most modern and ap- proved modes of treatinc: diseases, especially those to which our country is most exposed.—You have subjoined a dispensatory, ju- diciously calculated to obviate those errors which too frequently ensue from tbe exhibition of medicine, where the aid of the practi- tioner cannot be obtained. Yours, &c. PHILIP G. PRIOI^EAtt Dr. James Ewell. , VU1 K E C O M M E X D A T r O K S. Washington, March 1, 1808. ^in, I return you my thanks for the copy of" The Medical Companion" you have been so kind as to send me. >"•' ivist particularly express my sense of the favourable sentiments expressed towards me in the beginning of the work; especially too, wh re it recalls, to my recol- lection the memory of your respectable fn'her, who w&s the friend and companion of my youth, and for whom I retained through life an affectionate attachment. The plan of your work is certainly excellent, and its execution, as far as lam a judge, worthy of the plan. Tt brings within a moderate compass whatever is useful, lev- els it to ordinary comprehension, and as a manual, will bd a valua- ble possession to every family. I pray you accept my salutations and assurances of esteem and respect. TH. JEFFERSON. Dr. Ewell. * Washington, July 3, 1819. SIR, I had the honour to thank you viva voce after my having received your book, I owe you new thanks after perusing it. Such a work would be useful, very useful, in every country, but it mav be said it is necessary in the United States, and you have ac- quired true titles to the gratitude of your fellow-citizens, and spe- rially that of the families who happen to be distant from medical aid. bv pointing them out the surest and, at the same timo^ the simplest rules to be followed in case of sickness. I, above all, offer up my prayers, thatyour wise hints to ladies may not be laid aside^ and that mothers of families impress them into their minds. Consumption, that inexorable enemy of youth and beauty, is in- deed, in most instances, but the mournful result of an imprudent fashion, and it cannot be too often repeated to young ladies who do not fear to show themselves at assemblies in winter, id light dresses, that which a great physician answered to one of his friends who told him, I am well, I have only got a cold: "Colds, said he, take away more people than the plague." Agree, Sir, with my sincere acknowledgments, thfc assurance of my truly distinguished consideration. G. HYDE DE NEUYILLE. Dr. James Ewell. The following Revieio is from that celebrated work} the Neio York Medical Repository. Manuals of health, or popular publications on medicine, have be- come so frequent as to have excited the censure of sqfrne^ grave and oracular members of the profession. They consider their publish RECOMMENDATIONS. It Ing brethren as unnecessarily divulging the arcana of the art, as depreciating its credit and estimation^ and as teaching the common massof readers to know as much as themselves. Thi§ communi- cative disposition they conceive to be carried to a very faulty ex- treme. For when the secrets of the healing faculty are promulgat- ed by its members, with such consummate knowledge and success^ what is left for distinguishing the regularly initiated from those who are without the pale? The propagation of the Esculapian myste- ries is viewed to be faulty on another account; in as much as in di* minishing the importance, it lessens the profits of the practisers, and thus, for the gratification and emolument of one tell-tale author, the whole fraternity is disparaged; Let us, however, do justice to those sons of physic who are thus accused Of faithlessness, In uttering abroad those matters which ought to be viewed as under the restriction of closed doors. Contrast their conduct with that of another class of medical personages, who forever deal in ndstrumsj and are incessantly boasting of their won- der-Working powers; who assure the credulous world they can cure every possible disease of mind and body; but with a cunning equal to their effrontery, permit no mortal to becomp acquainted with their remedies. Compare the conduct of him who withholds nothing from his fellow citizens, with that of him who keeps every thing to him- self. There can scarcely be a stronger exhibition 01 generous com- munication On the one part, and of selfish concealment on the other. Whatever may be pleaded in behalf of the persons who refuse to make a magnanimous publication for the good of mankind^ of such valuable means of cttre as they may possess, 0^ who secure the pro- fits of them under the statute of patents, there certainly is a charac- ter of greater disinterestedness and philanthropy, and a temper of a brighter mould and finish in him, who, without fee or price, offers to his fellow creatures all he knows that will be beneficial to them. We know it has been said, that a smattering in the knowledge of the animal economy, and of diseases, multiplies the number of pa- tients, and encourages the practice of physic. Books on such sub- jects, addressed to the people at large, are peculiarly calculated to alarm their fears whenever they are unwell, and therefore, impel them to seek assistance from those on whose skill they rely. It has been surmised too, that the disciples of Buchan, Willich, and their coadjutors, have often been led, from superficial and conceited knowledge, to become prescribersto others, and have, by their blun- ders, rendered the attendance of the regular physician more heedful than ever. Hence it has been argued, that publications of this kind fail to promote the plausible object of their composition^ and in re- ality, produce a mischievous, and not a beneficial effect. It has even been urged against them, that they are of no service to any per- son but the writer, who may diffuse his fame and increase his wealth in proportion to the circulation of his book and the consequent dis*' 'urbane<■ it works in society. 2 X R ECO M MENDATIONS. Whatever may be the merits of this controversy among those who are toiling night and day in the service of the infirm and dis- abled, or in the compilation of volumes, for our own parts, as review- ers, we feel favourable to the general distribution of knowledge. "N e are not attached to monopolies of any kind, and less than any, to that which confines to a particular order, the information which will teach man how to prevent sickness and pain, and to remove these ills when they invade. He who publishes wholesome precepts and directions, cannot be denied the merit of good intention; and it would be hard to refuse him the additional credit of having done substantial good to those who have followed his advice. Having in- dulged these prefatory reflections, we advance to the consideration of the work before us. The author has prefixed to it a dedication to the President of the tinted States, a preface explanatory of his design, and a number of recommendatory epistles from his friends. Then follows a chapter of preliminary observations, of which we were inclined to offer an extract for the gratification of our readers; but our limits forbade. ^ The body of the work is devoted to the consideration of the prin- cipal diseases which assail the human frame at different times of life. They begin with fevers, and end with rickets; without, however, observing any strict method or nosological arrangement. Each section stands by itself, and has little or no connexion with the pre- ceding or subsequent matter.—But a table of contents and index are two ajoodkeys to the subjects discussed. The diseases are severally considered in short and generally ap- propriate terms. After a definition, the observations are mostly comprised under the head of symptoms, causes, treatment, and regi- men; to which, in some instances, are added paragraphs onpreven- tion. And it is but justice to observe, that the author has manifest- ed a careful and discriminating mind in condensing so much valua- ble instruction into such a moderate compass. The sententious and, at the same time, intelligible manner of conveying his directions, is at once calculated to give the reader a clear idea of his meaning, and favourable opinion of his understanding. Besides the observations that are strictly medical, the work con- tains a variety of directions upon surgical subjects. To render his compilation more generally useful and acceptable, the author has annexed to it a dispensatory. This consists of two parts: the first comprehends a table of medicines for family use, wi'li their doses and qualities annexed; and the second contains a collection of recipes for the principal part of the compound medi- cines recommended in the course of the work. And this part of the publication is executed in a manner that justifies the opinion w4 hinted before, of Dr. Ewell's sagacity and skill. THOMAS raYFER&Otf, PRESIDENT OF THE UNITED STATES. I ^Efc leave to present tl\is Book to My. Jefferson, i\ot because lie is President of 1801, but becauseiie was tl\e patriot of inl- and still more, because, through the wlvole of a long and glorious life, lie bas been the *' uliilosoulier and friend of liis country, witli all the ingenuity of the former, exposing the misrepresentations of illiberal foreign- ers*, and with all the ardour of tbe*\atter, fanning the tire of American science, and "watering tlie roots of that sacred olive which sl\edslier ueaceful blessings over our land. To w\\ovn, then, with equal.urouriet$, could 1 dedicate a Book, designed at least, to uromote l\ealtl\ and longevity*\ And tf n ( 7 xn whom am 1 so hound by the tenderest ties of affection and gratitude, as to Mi. Jefferson'* Tbe early classmate and constant friend of my deceased father, an&xiistrumcntally tbe oi£ho¥ of, my tjKquaii\tv\i\cc with the first characters in the state of Georgia*, among wliom, with peculiar uleasure^ "I- would mention the honourable names of Milledge, Troup, Bullock, andBlournoy. Tivat you n%ay long direct the councils of a united and wise ueoule, steadily uur suing health, "peace, and competence, the main ■pillars of individual and national hopui- ness, is the fervent -prayer, of your Bxcel- \eucy5s much Obliged and Very grateful servant, JAMBS W^lAi, -* TQ t/m\!l \:> mamUbUA, m avl Vuc oh&tal\oui> ©lout Vip^ttu'me'vvt^ % Wous- ol uo hfc1^0^ ^° '^ S cau &xA\jeale*9 wiva a/Yuxtav •haohtidu^ V)a\* uumWU W>lVmomv ol wav a«4>otiou anA. tAfrhccfe) tWu to Vue a\>tWauw*A» "\naW\Amv... wt wvuaui, altmdW auavVtle^cl WaAauAuavvt., Ww buXAvwA. avX cuxJUeb VuVo u&ue/valiou am caVacau^ aui tvA/nceA t\\a^ Vu V&a^ a* WOl as in umvy, ue mau W fcaUvvi tuVvufrteA, m Vue altouwtae, ol tue ulauebt autwA ol u\> cowvdtu. ^SjuaUAve/v*. mtuemauUi>t awvm.. aAva-wceA hu&vAcaooa^ot inAWvauav mWmtWc&uux&'U ^oJLeA, uhou mv(v'\uai^wuc& \yu -ucu a'hfcn^ow. ^S^oie <\fw«8v, ani WAIaiokvi- ^ovxvmmto wWXi- m l*U AaAe*! Wnti> ol aaucu/v awA a\!>mau^ &W/ycA. wnu ^veatt au& vvauVeA tue, >^aVala vvvcto'tu. a/vt wtv\)L/t uftoUutA, v\\ luvw vvwUv- twtt^ %ss\ almvnvMuA xu VjLtvv, ftitemVu. Vvv^ tut mlU, atotnatucu ol tut uaUAion aa\^ o^ "atact. «3ut ut«Att n> twtt twit to tut how/.. tut haWvot v. tutt tnut to tut tatohv/t*., °^ ^ v»X\o!>t vilt ^ wuote Wtuut. vvmcst avX^ uai> tatn atvottA to tutvt caui>t. Vtom tut Uuo^ ol out ttwJtutVou to tut "toitbt-wt aau ^ awA wuobt it%- •oitti) eutvtV/t uvm to tut aUUxvAAilion ol tut fcCCOTvA lalutt ol uvi> couuWi* vwvvJl uot \*t lov aotttn- noa mav,ectt& tu iuoi>t. Vu wuobt i>o\>tv tvxvvitu av»tv%!> tut av^htutovlvou ol hovwtv aua tut Ytavat^L. ol uouot. t3uat uout tilt aui utavtumau tt 'a!tti)LtvtA^ auA ucu\ uaduvwU coutvnutato uou^teuuViu- t& tut hwwu. auA Wtwtut wvmv ol *Aout ovtAvtut auA atuoteA itimut- eWmt* tDvutvL. TCa>Wa\eu* JWvufct \<6W\. PREFACE. ON the important subject of domestic medicine, many books hate been written, which, though excellent in other respects, have greatly failed of usefulness to Americans; because they treat of diseases which, existing in very foreign climates and constitutions, must widely difTef from ours. The book now offered to the public has, therefore, the great advantage of having been written by a native American, of long and successful practice in the southern states, and who, for years past, has turned much of his attention to the composition of it. The professed object of this book is to treat in the most clear and concise manner, almost every disease to which the human body is subject, to give their common names and surest symptoms, to point out the causes whence they originate, and the most approved method of treatment—and, lastly, to prescribe the suitable regi- men and means of prevention. V A publication like this cannot but be exceedingly use- ful to all, but especially to those who live in the country, or who go to sea, where regular and timely assistance cannot always be obtained. XVI PREFACE. Among the many and great services, to be rendered by such a book, we may fairly state its tendency to pre- vent that dangerous officiousness of ignorant persons, and, that equally pernicious neglect of the patient, at the onset of the disease, whereby so many lives arc lost. These, with many other evils resulting from the want ot such a work, constituted the motives which first led the author to offer this publication to his countrymen. It is not for him to determine, whether it be happily executed or not; but, whatever may be the general opinion as to its merit, he has the high satisfaction to know, that it not only flows from the purest, motives, but. also contains a faithful relation of facts, collected principally from his own experience, and, in part, selected from authors of the greatest celebrity. !He has not hesitated, occasionally, to use the language of his favourite authors, where he found it sufficiently clear and familiar for his purpose; and he hopes this ac- knowledgment will be received in place of frequent refer- ence and quotation. The reader will ftnd, in the latter part of the work, a table of such medicines most commonly called for in fam- ilies, with an adaption of the doses to the age of the pa- tient, together with directions to prepare and administer them. And as it is impossible entirely to banish technical phrases when writing on medicine, the reader is pre- sented with a Glossary, explaining the medical and scien- tific terms unavoidably employd in this work- PREFACE. XVli The Author, animated by the extraordinary success of the "Medical Companion," has greatly improved and enlarged it, by a synopsis of the anatomy and physiology of the human body; essays on air, food, exercise, sleep, evacuations, and passions; and a Materia Medica. Thus imprbved, the Medical Companion not only treats of the art of preserving health, and curing disease, but also inculcates a familiar knowledge of the human system, in all its parts, and the laws that govern its economy. It is obvious, that by due attention to the non-naturals, by which is to be understood the means of preserving health, we may go far to protect this fabric from injury or disease. To inculcate this truth more universally and successively, the disquisitions contained in this work, are enlivened with appropriate illustrations, calculated to make impressions on the mind of the read- er, as lasting as they are important. Not the least valuable portion of this work is the ' Materia Medica, pointing out those precious simples wherewith God has graciously stored our meadows, fields, and woods, for the healing of our diseases, and rendering us happily independent of foreign medicines, which, while they are sometimes hard to be obtained, are frequently adulterated, and always costly. To conclude—The author having added much new and important matter to this seventh edition, it will, un- questionably, be found much more valuable than any of the former; because, he has laboured to correct in this, all the errors and imperfections that have hitherto ap- peared, has enlarged upon the treatment of most diseases, 3 XV 111 PHK1ACL. and has introduced several others, particularly that scourge of the South and West, the malignant fever, sometimes denominated the Cold Plague, which were not previously noticed, though highly important to be well known and understood. In the present state of the science of medicine, daily improving by experience, and adding rapidly to the number of valuable remedies, he felt it incumbent upon him to enlarge considerably on the treatment of the dis- eases generally, as well as to make other additions. Which a work of this nature required, in order to ib increased usefulness. In a familiar style he has pointed out the modus operandi of the different remedies; has given the prognostics of diseases; has noticed more particularly the circumstances whence the disorders originate, for the purpose of guard- •* ing against occurrences; has distinguished those cases which yield readily to the employment of simple means, from those which require the regular attendance of a medical practitioner; and has detailed the means for checking or retarding the progress of such cases. On the management and diseases of women, he has en deavoured, with the aid of the most distinguished author on this subject, to give such a description of the com- plaints to which they are liable, with instructions for their treatment, plain enough, to be understood by the at- tendants or the patients themselves; and which he sin- cerely hopes will in a measure have the tendency to cor- rect the errors and misconduct of unskilful midwives, and to prevent unnecessary interference in young practition PREFACE. XIX eis. To all which has been added a general sketch of the diseases of infancy and childhood. With a view of correcting the gross errors of nurses, whereby so many valuable lives have been lost, there is introduced the "Nurse's Guide," describing the prepa- rations of such aliments as are most proper for the sick, which, as a family assistant, will unquestionably be a val- uable acquisition. Desirous that nothing should be omitted, which would in the least add to the value of the work, he has greatly improved the Dispensatory: which is now arranged in a manner that will not in the least perplex the reader; hav- ing endeavoured to render each formula or prescription, as concise and clear as possible, both as to the mode of preparing and the intention of employing it by short prac- tical remarks under each class or head. He has likewise given a detailed Index, so that in all cases of disease, the reader may be directed without trou-; ble or embarrassment to the appropriate remedies. And that the bulk of the volume might not be too large, he has expunged many of the illustrations under the head of Hy- gieine, being of little importance compared with the mat- ter now introduced. The author cannot but think a work of this nature will be exceedingly useful to the student, whose theoretical knowledge has only prepared him to commence the ar- duous duties of his profession; for, it will not be tie-died, that the most experienced practitioner occasionally feels the want of a guide in his practice. It is worthy to be noticed, when the first edition of the Medical Companion XX PUEiAci; was presented to the public, Professor Barton, with his usual liberality and philanthropy, enjoined upon his pu- pils to procure a copy of the work before they entered up- on the duties of their profession, observing at the same time, that he himself had profited by it in practice, by refreshing his memory of what he had read in more vo- luminous works. To every family, more especially those in remote sit- uations, the possession of this book must unquestionably, be of incalculable value; for, conducted by such a guide, it will not be presumptuous to say that any person of tol- erable capacity, and reasonable attention, may be ena- bled to practise with safety and advantage, in those casts of simple diseases most incident to our climate. How far the Author has accomplished his wishes in these important respects the reader is left to judge from the high testimonials, prefixed to the work, from some vof the most distinguished physicians in our country. He will only add, from the time and attention he has devoted, in making the improvements now introduced, he cannot but flatter himself, the "Medical Companion'* will not fail to be acceptable to his fellow-citizens; and under this pleasing impression, he submits it to tjieir gen- erous patronage. CSMBRiLI* INDEX. ABDOMEN, description of 71 Abortion, observations on 532 < ---------prevention of - 535 Abscess common - - 4 17 Absorbents, class of - 810 ----------mixture, doses of SOI ----------• how prepared - 810 Abstemious living, good ef- ] fccts of - 109 1 Acid, nitric, tonic, - 827, 82S ---- muriatic, useful in nerv- vous fever, - - - 25 2 . vegetable anti-scorbutic 4-23 Acute rheumatism, - - 3.3.3 Acidity, or heartburn, 392, 522 Adams, John, his death and character noticed - - 37 2 Admonitory hints to ladies, 493 Advice to masters, - - 45 j ------ to parents, - - (if)2 Adulterated wines, to detect 7 15 After pains, - - -' - 559 Afterbirth,caution respecting 545 -------s—-: mode of extracting 553 Agaric, stops bleeding, - 6.39 Agrimony, useful in jaundice, ib. I Ague and Fever, - - - 1218 Air, its influence on the blood, 88 | ---on the body, - - 90 i ■---necessity forits renewal 93,9 7 ---confined, bad effect* of 93 ij ---warm, relaxes the body, 100 Ij -— damp,checks perspiration 101 ij —— the most wholesome - ib. I —— impure, how restored 99, 2ii2 jj Air and temperature,how to be Ij regulated in sickness - 75 7 'j Alder, black, anti-septic - 63J) Aloetic pills, how prepared 800 Alteratives, class of - - 827 Alterative diet drink - - 823 Alum, doses of 796 -----curd, how prepared 839 ---— whey, how prepared, 77 7 -----root, useful in cancers 640 Alvine discharge, nature of 280 Americans, patriotism of 198 Anatomical description of the human body, concise and interesting - - 49 An'asarcous swellings - 407 Ancle,dislocation of - - 466 Angelica, good aromatic, 64U Anger, its ill effects on mind and body 1,53; melancholy instances of 155; advanta- ges of repressing 156; won- derful effects of music in subduing - - - ' - 157 Animation suspended, how re- stored - - 434, 435, 590 Animal heat depends on the circulation of the blood, 69. —-------.--- depression of, how to be restored 234, 255 Anodyr.es class of - - 8 16 Anodyne liniment, to prepare 83 J ---- sudorific drops,doses of SO I --------how prcpaied, - 809 Anti-bilious pills, how prepar. 805 Anli-dy^entevic mixture, SOI, 3-22 Antimonial wine.dose&of 796 how prepared - - 830 run do; i and solution - 80S X\ll lil.NKHAl. INDKX. Antiphon promised to do upon s»uls what Hippocrates did on bodies - - - - 116 Antipathy to certain remedies, consequences- of - 40, 764 Anus, imperforate - - 611 ----Falling down of - - 1 U"> Aperient medicines, impor- tance of in fevers 23 2. 801 Aperient and diaphoretic pills 805 Apoplexy, or apoplectic fits 378 Appetites, three kinds of 105, 766 Apparent death, to resuscitate 434 Apparel, observations on - 189 Apple, Peru a valuable plant 641 Apple water - - - - 778 Apthae, or thrush - - 620 Arbutus, useful in gravel - 641 Ardent spirits, utility of 112, | -------------abuse of des- tructive to body and soul 173 \ristides, his goodness - 165! Arms, description of - - 51 > -----dislocation of - 465 -----fracture of - - 469 Armstrong.Dr. remarks on use of stimulants in fevers, - 254, \rria, her imincible love - 127 ' Arrow root, very nutritious 641 ! Arsenic solution, doses of 796 ------ how prepared - 830 j Art of piewrving health - 87 Arteries.their u-e explained 54! Asarabacca. u«eful in whoop- ing-cough, - - - - 641 j \«cnride«. worm - 585 ) Ascites, or dropsy of belly 40 1 [ Askew, his '-insular recovery 143 I Asthma,treatmentof - - 390 j Astorgas dines on tlie heart of { his mistress. - - - J 35 Astringe;it«, rlat, conversion of - 49 —■----punishment of - 209 itheni:u><. religion* instruc- tions of the - - -n: Atmosphere, component parts -r . - ' - - ' ~ - 91 Avarice, injurious to health 16.5 -------fatal instances of 16<} -------Hippocrates'advice 167 Avens, anti-septic - - 641 Azote, or corrupted air - 91 B. BACK-BONE use of Backach-brake, for cough Baker, Professor, praise due Balm, useful in fevers Balsamic medicines in con- sumptions when useful Balsam, capivi, doses of ----remedy for gonorrhas —Turlington's, how prepared 829 Barberry, useful in dysentery 642 Bark Peruvian, caution in the 221 220 824 ib. 829 770 586 51 6 12 639 64-2 358 72-2 114 use of - — jacket, how prepared — cold infusion of — decoction of tincture of 638 20 Barley water, how prepared Barrenness, observations oh Barton, Professor, his noble efforts to serve his fellow citizens ------ his unbounded liber- ality - - V - ------asserts the efficacy of oak bark in gangrene, 700; of poke weed in rheuma- tism, 708; of thorn apple in epilepsy, 8tc. 726; of to- bacco to dislodge worms - 732 Bastard ipecacuanha - - 6 1-2 Bashfulness, evidence ofvirtue 185 Bat.!,, cold, when proper - 43 ----warm, efficacy of 44, 58 ----regulation of - - 267 Bayous, agency of, in produ- cing malignant J ever 11th blank page Bavheiry, useful in jaundice 642 Bearherry, useful in gravel *! 12 Beaufort,* his dread of death 150 iteuuiy, wonderful effects of 493 Bearing down of the womb 575 Bed-room, oh serrations* on 1«>2 iUEN'EKAL INDKX. XX111 Beech drops, useful in cancers 6 13 Beef tea, how prepared, Boer, recipes for Beggar, anecdote of - Benne, useful in dysentery and yields a good sallad oil Bethroot, useful in hemorrha- ges - Bigelow, professor, honoura- ble mention of - - ------ testifies to the vir- tues of Gillenia Bile, the manner in which it is secreted, and use of Bilious fever, treatment of - •----------its fatality in Washington - - - 231 -----------prevention of 230 Bind weed, purgative - - 643 Byrd, colonel, celebrates the bastard ipecacuanha - 684 Bites, of musquitoes - - 437 -----of venomous animals, 433 .----of mad-dogs, - - 439 830 43 77 680 115 643 639 672 76 225 Blood-letting, rules to be ob- served - 224, 245, 265 486 Blood root, cure for polypus 644 Blood wort, checks bleeding 645 Bloody flux - - - 369 Blossoms, grog, cure of -«425 Blotches, or eruptions 424,616 Borrhaave, Dr. verifies that religion conduces to health 208 ---,----------his singular 152 4 17 161 Bitters, how prepared, ------ dangerous effects of Bittersweet, good for cutane- • ous disorders, &.c. - - 643 Blackb err j, remedy in dysen- tery, - - - - ib. Black snake root, useful in fevers - 748 Bladder, description of - 75 distended,- cause of mode of treating epilepsy Boils or tumours Bolea, captain, his singular mode of taking revenge - Bonaveuture, his admiration of a beautiful woman - 135 Borjes of the human ma- chine, description of Boneset, remedy in agues - Bowman's-root, good emetic I Box-wood, excellent tonic - Brain, seat of - -----inflammation of 51 646 ib. ib 59 302 6t3 654 Breasts, anatomy o( - -------inflammation of -------swelling of, infants 60^ -------cancer of - 449 retroverted womb, inflammation of Bleeding, at the nose piles - from wounds ■topical - 5 24 - 829 - 351 - 367 - 454 473,764 Blistering plaster, how pre- pared - 838 Blistering plaster, substitutes for. (See crowfoot, cuckoo- pi ut, me ze-reon,garlic, horse radish.) Blood, circulation of - 66 -----, how it is recruited - 75 •-----, spitting of - - 352 Bkood-Ietting, how performed 47'i Bread soup, how prepared - 774 pudding, how prepared 77C Breath, how to preserve its sweetness - Breeding sickness Brooinrape, useful in cancers Brown, Professor, his remedy for tetanus - Buboes, management of Buckthorn, good purgative - Burch, capt. cured of abscess of liver by onions - Burdock, purifies blood, Burleigh, Lord his just: •emark on religion Burnet saxifrage, useful in asthma, Burns or scalds, Butterfly weed, remedy in cold and pleurisy - Butternut, excellent cathartic Button snake root, useful in gangrene- 334 5°2 546 3S"> 421 "(.'.'■ 647 - 2If; 6 1? 412 647 ib. P hlv c. Caldwell.Professor, the man- ner he preserved the health of his son - --------remarks on worm's, deserveshighcsterm Calico tree, remedy for itch Calimus, good aromatic Calomel. do<-es of Calves1 feet jelly, how made -----------broth, how made Camomile, stomachic. Camphorated pewders, doses -------- how prepared -------mixture -------- liniment ------■- spirits Cancer, treatment of -------of the womb - Cancer root, astringent Candleberry mvrt!e,cnieiic - Caraway, evcellent aromatic Carroll. Airs, cured of bilious fever bv porter Carrol I, Charles, his death and character - Carbonic acid, or fixed air Carrot, wild, diuretic - ----— poultices how prepar. ------corrects foetid ulcers Cartwrighf, Dr. thanks due to him for his essays on mag- lignant fever, - - 479 ■----■-----his manner of ad- ministering doses of med- icine to his patients 12th blank page. Cartilages, description of - 5 2 Castor Oil, doses of - - 797 j -------- how made - - 650 | Cataplasm, of mustard - S.39 ■-------• of common salt - ib. --------of alum - - ib. Catarrh, or cold - - 28 2 Cat gut, or goats rue, remedy for wor.ns - 630 Cathartics, class of - - 801 Cathartic mixture, doses of 801 --------how prepared - 805 <;r.\r.R.u. tndia. Catheter, manner of introdu- cing - - - - Caustic alkali, doses of --------how prepared. Caution to parents, -------to masters Celandine,useful in cutaneous !! I 102 630 R.lii 648 6 19 797 771 77> 649 801 309 819 S3 2 S30 119 5 SO 6 19 ib. 6 19 229 321 9 I 6/.0 840 650 366 797 S31 60 2 ■15 affections, - - - 650 Cellular membrane,use of - 59 Centaury, good stomachic, - 651 Chalk, prepared, doses of - 797 Chapman,professor,his great zeal in diffusing knowledge 63s* -------treatmentofepidemic 302 -------attests t'ue efficacy of seneca in obstructions of the menses 659; and of bal- sam capivi, in gonorrhoea Chancres - - - - Chalybeate wine, how prep. Charcoal powder, how prep. poultice, how made Charity, godlike act - Charlemagrie,nohleness of - Cheerfulness consistent witJi religion, - Cherry tree, wild, substitute for Peruvian hark - Cheselden, Dr. on anatomy Chev ne, Dr.h's node of treat- ing delirium - - Chesterfield, Lord,on dress - Chieh'-n pox - Chicken water, how made - duckweed, red, remedy for hydrophobia, Chilblains, • - Child, position of in the womb Child-bed, management of ----■ diseases of Children, management of - Chills and fevers,vulgar mode of treating - - - Chin, or whooping cough - Chlorosis, or green sickness Chocolate,properties of Cholera infantum -------morbus Chordee - Chorea. ■>:■ *>t. Aritus's datice 41 t 421 82 d S3 2 840 755 126 205 651 5H 761 189 77 1 651 4 11 518 553 5 58 589 758 63 1 503 113 627 400 112 636 GENERAL INDEX. XXV Chremes, story of, a lesson to the intemperate - - 106 Christian, his consolation - 147 Chyle, how conveyed - - 75 Cider, when wholesome - 112 Cinquefoil, useful in bowel complaints - - - 652 Circulation of the blood, how performed - - - 68 Clap, or gonorrhoea - - 412 Cleanliness promotes health and preserves beauty - 192 --------, its importance in sickness - 45, 595, 759 Cleavers, good for the gravel 652 Clinias, calmed by music - 156 Clothing of infants - - 591 Club-foot, management of -» 611 Clysters, or glysters, - - 836 Cocum, used in rheumatism 652 Cock-up-hat, useful in yaws ib. Coffee, properties of - - 118 Cohush, for rheumatism - 652 Cold, or catarrh - - 282 ---- remarks on the popular remedies - 283 ----of foot bathing - - 283 ---- of cold drinks - - 283 ---- of full vomiting - - 285 ---- of steaming the head - 287 ---- inhaling vapour of hot water - - - - 239 ---- prevention of - 292 ---- importance of avoiding the exciting causes - - 295 ---- exposure to intense 116,294 Coldness of the extremities in fevers - 234, 255, 268 Cold water,its operation upon the stomach - 233 --------, the impression it makes when externally ap- plied - - - - 283 Cold bath, when beneficial - 43 Cold washing of infants - 595 Cold plague, its fatality, let- ter respecting - - 477 Colliquative sweats - - 360 Colic, treatment of - - 397 Colic pains, in children - 622 Collection and preservation of vegetable substances - 752 Colts-foot, useful in coughs 653 Columbo, Amer'n, good tonic ib. Comfrey, astringent - - ib. Common ulcers - - -150 Conception, signs of - - 515 Conscience, the effects of, Sec. 149 Congestion, signs of - - 23 t Conclusion and general re- marks - 768 Contagion,how to be arrested 262 Consumption - 354 -----------use of refrige- rating medicines in - 356 -----------of balsamic do. 358 -----------of inhalation & fumigation - - - 359 -----------of sedatives - 360 -----------of exercise - 362 Convulsions in children - 623 ---------in pregnancy - 528 ---------- in labour - 552 ----------hysterical - 377 Corday, Charlotte, interest- ing history of - - 183 Cordial mixture - - 817 Coriander, good aromatic - 653 Cornaro, by temperance re- stores a constitution im- paired by dissipation - 108 Corns, treatment of - - 446 Cosmetics, observations on - 494 Costiveness, remarks on - 396 ----------dangerous effects of, in pregnancy - - 518 ----------of infants - 621 Cough, management of - 296 ------symptomatic - - 297 ------danger of using pa- tent medicines in - - 299 -----mixture,how prepared 814 Countenance, prognostic of disease - - - - 271 Cow parsnip, useful in epilep. 654 Cow pox, or vaccine disease 341 Cox, professor, praise due to 639 Craik, Dr. and Mrs their death and character - 705 Cranes-bill, powerful styptic 654 XXVI GEN Kit Al, INTIKX. ramp, in pregnancy of the stomach — of the legs 3S5„ 527 3s J ib. 398 Darwin, Dr. cites a case in which pride was effectually cured - - - -1*1 his remedy toe or- - 334 Crawford, Wm. H. Hon. tes- tifies to the efficacy of onions in croup - - 701 Crawford, Dr. his treatment of a hypocondriac - - 3S3 Cream of tartar, doses of - 797 Crnvs-wort, useful in fevers 656 Croup or hives - 632 Crow-foot, excites blisters - 656 Cruelty, instances of - 155 Cuckold, useful in jaundice 656 Cnckow pint, used externally for blistering - . - - 65ti Cucumber root,useful in drop- sies - 657 Cullen, Dr. celebrates horse- radish in hoarseness - 68 2 Cupping, how performed - 473 Cure-all, excellent tonic - 657 Currant wine, how to make 657 Currie, Dr. his improvement in the treatment of nervous fever - - - - 249 Custard apple, a good pur- gative - -------.pudding, how made Cutaneous eruptions - Cuthush, Dr. his successful practice in the epidemic, hears testimony of the ef- ficacy of acids in scurvy, tistl; of tobaceo in dropsy 733 Cutler, Rev. Dr. deserving high commendations - 639 ----------------testifies to the efficacy of emetic weed and skunk cabbage in asth- ma, - - - 661. 722 D. Dandelion. u>cful in visceral obstructions - - 658 Darwin, Dr. eives an account of a parsimonious surgeon killins himself - - 149 rect bad breath Davidge, professor, his reme- dy for croup Daviess, colonel, his dying words Deadly night-shade, useful in rheumatism, - Deafness, treatment of Death, overmuch feared by some - Deer berry, useful in asthma 658 Delirium, treatment of 570, 760 Delivery, or child-birth Denman, Dr. his mode of preventing convulsions - ------------' his remarks on (3 33 - 198 697 332 149 539 530 5 19 624 831 658 65 7 776 424 302 preternatural labour. Dentition, on teething, - Detergent, gargles Devil's list, vermifuge, &c. Dewberry, useful in dysentery ib. Dexter, professor, entitled to praise, - 6.59 Diabetes, or incontinence of urine, - 363 Diaphragm, use of, 71 Diaphoretics, class of, 806 -------------drops, 801,SO7 Diarrhoea, or looseness, 401 Diet, for a healthy state, 110 ---- for tbe sick, - 766 ——mode of preparing, 769 Difficulty of urine, - 361,5.\j Digestion, how performed, 7 2,71 Dill, good aromatic, Directions for preserving vegetable substances Diseases of pregnancy, ---------of childbed prognostic* of 658 752 5 21 55* 273 Dislocations, observations on 4<;-2 Dislocation of the jaw 46.3 ---------of the shoulder, 46 1 --------of the elbow, 465 ----of the wrist or finger ib. of the thigh ib. I GENERAL INDEX. XXV11 Dislocation of the knees and ancles - Dispensatory, - Dispositions of children, Drspepsia, - Piuretics, class of Diuretic infusion and pills - Dock water,purifies the blood Dog-wood, best substitute for the Peruvian bark - Domestic remedies for whoop- ing cough - ----—— ——— for rheu- matism, - Dorsey, professor, his reme- dy for sore eyes ——— notice of his death and character - - - Doses of medicines, table of Dover's powders,howprepr'd -------------- doses of Dragon's claw, useful in fevers Dragon's root,usedforblisters Drastic purges - Dressing of infants - Dress, love of, natural ■ neglect of, improper ------advantages of wear- ing flannel Dropsy of the belly - ■------ of the cellular mem brane, or anarsarca ------ of the head - ------ of the ovarium of the fallopian tubes Drowned persons, how to be treated - Drunkards reclaimed, instan- ces of - ---------ludicrous descrip- tion of - Drunkenness, its horrid con- sequences - Dysentery, treatment of E. Ear, description of - ---- noise in, prognostic of disease - Ear-ach - 466 803 602 393 811 812 658 659 815 830 316 305 796 809 802 659 ib. 805 591 187 189 190 404 407 630 583 5S5 434 174 432 *7* 369 Eccymosis - Effervescing draught - Egg soup, how made - Eginardus, anecdote of Elder, common, aperient -----wine, how made Elecampane, expectorant - Elegy on the death of Col. Jesse Ewell - -----on a deluded girl Elixir paragoric, doses of - how prepared Elixir vitriol, doses of Elm, American, remedy in dysentery Emetic weed, excellent eme- tic and remedy for asthma Emetics, rules for their ex- hibition - Emissions, involuntary Empirics, cause of increase cures on which 474 808 774 126 659 660 ib. 403 719 798 829 797 - 660 661 803 417 39 their fame is built Enthusiasm, source of delu- sion - Envy, nature of -----baneful effects of -----antidote against Epicurus, his dread of death Epidemic, or typhoid pneu- monia - - - - Epilepsy, or epileptic fits - Epispastics - Ergot, hastens delivery Eructations - Eruptionsofthe skin, 424,572 Erysipelas, or St. Anthony's fire, - - - 350, Ether, vitriolic, doses of Essence of peppermint, ditto Evacuations, importance of alvine,prognos- 61 277 332 tic of diseases Evergreen, diuretic Excretory vessels, use of - Excoriations, or galling Exercise, promotes health - --------absolute necessityof mode of prcscrib- 40 200 163 164 165 149 300 374 493 (Hi 3 393 615 618 797 ib. 123 2S0 664 55 609 113 116 ing, in sickness - S23 XXV111 GENERA Expectorants, rules for their exhibition - - - si3 Eye, description of - - 60 ---- inflammation of - 315 Eye-water, how prepared - 832 F. Face, painful affection of - 339 Fainting Fits - 376 ■-----in pregnant and lying in women - - 523, 553 Falling of the fundament - 445 ------of the palate - 813 ------of the navel strings 552 ------ of the womb * - 575 Fallopian tubes, their use - 79 False conception - - 582 —— - pains - 527 Fanaticism, dangerous con- sequences of - - - 201 Fashion, its excess disgusting 188 Fear, its origin - - - 148 -----turns the hair gray - ib. ——-produces insanity - 149 —— - superstitious founda- tion of - 152, 602 Feather beds, necessity of airing - - - - 122 Febrifuge mixture and pow- ders - - - 802, 808 Feeding of children - - 593 Feeling, one of the senses - 68 Feet, description of - - 52 Fennel, sweet, aromatic - 664 Fern, male and female, useful in coughs, and remedy for tape-worm - ib. Tever, in general 215 ----- bilious or remittent - 225 -----hectic, or consumption 854 -----inflammatory - 264 •----intermittent, or ng;e 218 -----malignant, or yellow 477 -----miliary - 348 —---milk,in lvinginwomen 560 -----nervous, or tophus - 241 -----puerperal 572 ----scarlet - 318 Fibres, description of - 55 L. INDEX. Fig-tree, a mild rnustir - 665 Finger, dislocation and frac- ture of - - - - 465 Flag, blue, active cathartic 665 ---------sweet, aromatic 6t>6 Flannel, wearing of, promotes health, - - - -190 Flatulence, in infants - 622 ---------in adults 393, 397 Flax-seed sirup, how made 666 Flea-bane, promotes uriuc - ib. Flies, potato, equal to Spanish 712 ----------how collected - ib. Flower-de-luce, cathartic - 666 Fluor albus, or whites - 510 Flour, caudle, how prepared 773 Flowers, pernicious effects of 100 •Flux, or dysentery - - 369 Flux-root, remedy in colds - 666 Food, how received into the stomach and digested - 74 ----, rules to be observed in taking - 104, 109, 766 Fox-glove, a most valuable medicine in inflammatory complaints - 667 PVactures of the limbs - 460 -------- of the small bones 470 —■----- of the ribs - 471 French apple, cures epilepsy 670 Fro si-wort, useful in kings'ev. ib. Frozen limbs, management of 294 Fumitory, useful in eruptions 670 I Galen, how he became con- verted - - - 49 Galling, of infants' - - 609 Gall bladder, use of - 77 | Gamboge, doses of - - 798 j Gaming, a horid practice - 175 j-------melancholy occur- rence of - - - 178 ■-----— good advice on - 177 Gangrene, or mortification - 459 Garget, useful in rheumatism 670 Gargles, how prepared - L33 Garlic, excites blisters - (>71 Gentian, stomachic - ib. GENERAL INDEX, XXIX frillenia, common, emetic - 672 Ginseng, demulcent and sub- stitute for tobacco - 672 ------manner of prepar- ing for exportation - 673 Glands, their use - - 55 Gleet, treatment of - - 416 Glossary - - - 841 C-lyste-, or clyster, simple and en.oilient - - 836 ------common, - - ib. ------ stimulating, - ib. ■ ■ ai."d\ne, - - ib. ------turpentine, - ib. ------- r.r. rishing, - 837 ------mole of administering ib. Golden thread, a tonic bitter 674 Gonorrhoea, - - 4L8 Goose grass, useful in gravel complaints, j- - 674 Gout, - .409 ------doctor, anecdote of ib. Gratitude, the most exalted virtue, - 203 Gravel, - - - 364 Greene, General, his death and character, - - 305 Green sickness - - 503 Grief, injurious to health 144 ———, deep, cause of insani- ty and death, - - 145 ------, its best remedy, 147 Gripes, in infants, - 622 Grog blossoms, - - 425 Ground Holly, useful in gravel, 674 Ground Pine, useful in rheu- matism, &.c. - - 674 Ground Pink, remedy for worms, - - - 675 Guinea pepper, - - ib. ■ worm, Gun shot wounds, - 457 Gum pills, - - - 817 H. Hamilton,honorable Paul, his description of button snake root, - - - 64 7 ■ ■ of the pleurisy root, 707 ------of the squirrel ear, 724 ------his mode of adminis- tering the May apple, 691 ----- Archibald, lieut. his death and character, 648 Harriet, her unhappy fate, 132 Hartshorn, spirits, doses of 798 Hare lip, management of 610 Hart's tongue, remedy in di- arrhoea, - - - 675 Harvey, his sublime sentiments, 50 Hatred, destructive to mind and body, - - 158 Head, description of - 59 -----injuries of - 466 -----water in the - 630 Head-ach - - 329 Hearing, difficulty of - 332 Heart, description and use of 66 -----, grand organ of circu- lation - 67 Heart-burn 392 Hearts'-case, useful in cuta- neous affections - 675 Heart snake root, an emetic and diaphoretic - ib. Hectic fever - - 354 Hellebore, remedy in cuta- neous diseases - - GIG Hemlock, usefui in many ob- stinate cases - - 677 Hemorrhoids or piles - 367 Hemorrhoidal ointment - 83& Henbane, useful in convulsions 678 Herb bennet, good for ague 67-9 ---- trinity, for eruptions ib. Hernia, or ruptures - 443 Hiccough - 389 Hill, Dr. his effrontery - 719 Hippocrates,his desire to cure covetousness - - 1^5 Hip joint, rheumatic affec- tion of 338 Hives, or croup - - 632 j Hoar-hound, good for coughs 68'- ! Hoarseness - - 29C Hog-bed,promotesthemenses 679 i Holwell, Col. his account of 1 the black-hole in Calcutta 94 f ' XXX GINKRAL INDEX. Hooded widow herb, antidote to canine madness Hope, the source of human happiness -------its great influence on the state and disorders of the body -----ill-grounded - Hop beer, how made Hops, anodyne and anti-sep. Horse-radish, stimulant Hosack, Dr. a distinguished botanist - Hospital, a cheap plan re- commended to planters - -------ought to be establish- ed in our sea port towns - Houseleek. useful in burns &. stings of insects Hunger, painful sensation of explained Hunter, Dr. slept comfortably under snow Husbands, affection of some ------cruelty of some Hydrophobia Iiydro-cephalus, or water in the head Hygieine, or the art of pre- serving health Ilvpocondriac disease Hypocondriacs, ludicrous ca- ses of - - Hypoerisy Hyssop, useful in asthma, Stc. Hysteric fits 679 i3e 139 141 680 ib. ib. 639 46 47 683 74 118 129 173 489 630 381 882 200 683 377 ----physic, safe emetic ----tobacco, good for colic ----turnip, good for coughs Indigent sick, often neglected Indigestion or dyspepsia Indigo weed, emetic and ca- thartic Indolence, source of disease Infants, management of diseases of Infection, how to arrest Inflammation of the brain ------ of the lungs -------■---- liver stomach intestines kidneys bladder breasts ■ womb eyes ----■ pleura throat 094 >K ib. .755 393 6S4 115 589 605 262 302 321 322 325 326 327 329 564 567 315 318 306 611 ib. 770 209 186 390 Idleness the bane of virtue 115 Ice-plant, useful in fits - 683 Imagination,force of 139, 521 Imperforated anus ■-------vajrina Imperial drink Impiety, consequences of - impudence, disgusting Incubus, or night mare Indian hemp good for rheu- matism - - 683 Inflammable air, how to cor- rect - Inflammatory fever Influenza - Infusion of roses ------of oak bark ------of galls ------of Peruvian bark - ------of Colombo ------of gentian - Ingenhouz, Dr. his remarks on the properties of plants Inhalations - 289, Injections for gonorrhoea - Injuries of the head, &.c. Intemperance, vice of miserable refuge from misfortune reclaimation from Intermittent, or ague and fever Intestines, use of - Intoxication, symptoms of -------how to treat Inversion of the womb Ipecacuanha American,emetk ------- doses of - 98 264 282 821 ib. ib. 824 825 ib. 99 359 834 466 168 172 174 218 72 432 433 50 2 t;s i 798 i *. GENERAL INDEX. Iron,carbonate of, useful inTic Douloureaux - - 340 Iron filings, how exhibited 825 Issues - 475 Itch - - - 426 — lotion, how prepared 831 rves,Professor, attests the vir- tues of blood-root, in cer- tain cases - - 645 Ivy - 685 Jalap, doses of - 798 Jamestown, or Jimson weed, useful in many complaints 685 Jaundice, or yellow gum, 429 ------infantile - - 615 Jealousy, horrid effects of 135 Jefferson,President, his death and character - - 872 Jerusalem oak, vermifuge 685 Joan, queen of Naples, mur- ders her husband - 136 Jones, Hon. Dr. asserts the ef- ficacy of cotton in scalds 442 Joy,excessive, often fatal 122,143 Juniper an excellent diuretic 685 K Kidneys, use of - 78 ------inflammation of - 327 Kingston, Sir Win. his cruel mode of taking revenge 159 King's evil - - 423 Knee, dislocation of - 466 L. Labour - - - 534 Laborious labour - - 546 Lacedemonians, politeness of 186 Laceration of the parts - 561 Lafiteau, Father, first discov- erer of ginseng, in Amer- ica 673 Lambkill, for itch -686 Las*ii»tde,prognostic in rcvers 277 Lavaler's remarks on females 128 XXXI - 798 - 829 Laudanum, doses of ■■— how prepared Lavender thrift, for sore throat 686 Laurel, for diarrhoea - ib. Laxative medicines - 805 Leeches, mode of applying and preserving, and check- ing the discharge of blood 764 Legs, description of - 51 ----fractures of - - 467 Lemonade, how prepared - 770 Lemon tree, anti-septic - 686 ----how to preserve the juice ib. Lettuce, garden, an excellent anodyne - - 687 ----wild, a powerful diuretic 688 Lichen, useful in coughs ib. Life-root, remedy for gravel ib. Ligaments, description and use of - - 52 Lightning, to recover persons apparently killed by - 435 Lime water, how prepared 830 ------doses of - 802 Lime-kiln, dangerous effects of 98 Lind, Dr. on the influence of the mind over the body 140 Liver, description and use of 76 ----inflammation of - 322 Lobelia, useful in venereal 689 Lochial discharge - - 559 Lockjaw - 386 Longings - 236,522 Looseness,orcholerainfantum 627 ------in pregnancy - 523 Love defined - - 125 ----influence of - 126,127 ——- propitious, conducive to health - - - 130 —— disappointed 131,132 Lover,false,adetestable char- acter - - - 137 Louisa, affecting history of 130 Low spirits - - 881 Lumbago - - 338 Luesvenerea,oreonfirmedpox 4 3 8 Lungs,deseripfionand use of 66 -----inflammation of - 321 Lying-in-women, diseases oi 558 xx xii GENERAL INDEX. M. Madder,useful in visceral ob- structions - - 689 Mac Pheeters, Dr. celebrates black mustard, as emetic in malignant fever, 8th blank page. M'Bride, Dr. finds blood root useful in hydrothorax - 6 15 Magnesia, doses of Magnolia, good in rheumatism 690 Maiden hair, useful in coughs 000 Malignant fever - - 447 -------letter from Louisiana to the author respecting 447 ------- Cartwright's essays on, noticed - - 478 ------ symptoms of - 479 -------three distinct stages of tb. -------treatment of 480, and 5th blank page. -------animal and vegetable putrefaction, agency of in producing, 4th and 5th blank page. -------bayous,do. 14th do. ------prevention of, 15th do. Malignantorputrid sore throat 609 Mallow, useful in dysentery and gravel 691 Mandrake, an excellent pur- gative - - - 691 Manna, doses of - - 798 Marsh, trefoil, tonic bitter - 691 Marsh mallow,goodemollient 692 Marsh rosemary, for sore throat - - - ib. Master-wort, tonic - 69 2 Materia Medica 637 May Apple, purgative ib. 1 Mayrant, Col. celebrates Samson snake root as a remedy for dyspepsia - 720 i May weed, stomachic - 692 ; Mease, Dr. deserving of high praise - 639 Measures and weights table of - - - 795 I Measles - - - 346 ! If Meconium, observation on - 592 Medicines, table and doses of 796 ----—approved manner of administering, 10th blank page Medicine Chest, plan of - 847 Medicine, the importance of possessing some knowledge of 38 ------necessary caution in the use of 42 ------subject to abuse - 38 ------the necessity of taking agreeably to directions - 762 Membrane, description of 55, 58 Menstruation - - 496 -------cessation of - 499 -------painful - - 501 -------suppression of - 502 -------profuse - - 507 Mercurial pills, how prep. - 82? ------solution - - ib. -------ointment - S3.s Mezereon, useful in venereal and cutaneous affections - 692 Midriff", description &. use of - 71 Miliary fever - - 3 IS -------eruptions - - 572 Milk fever - - 562 -------blotch - - 616 Milk, or silk weed, useful in gravel &c. - - 693 Milkwort,usefulin coughs and colds - - - 6 93 Mind or soul, observations on 64 Mindererus spirits, how prep. 808 Mint, allays vomiting - 693 Mineral Tonics - - 8 25 Miscarriage - - 532 Misleto, useful in fits - 694 Mite-hell, Professor, deserving high commendation - 639 Modesty, its great influence 1*3 Mole, or false conception 582 Moore, Dr. cites a case rela- tive to imagination - 521 Moorwort, remedy for toe itch 694 Mortification, or gangrene 459 Moschettoes, bite of - 437 Motherwort, useful in nervous affections - - 694 GENERAL INDEX. XXX111 694! ib.\ 695 i ib): 696 | - 778: - 696 j Mountain tea, promotes lien- s'rual discharge Mouthroot, tonic bitter Mugwort, good stomachic - Mulberry tree, an excellent purgative --------wine, how made - Mulled wine, to prepare Mullein, good for piles Mumps, treatment of - 314 Muscles, description of - 52 Mustard, excellent stimulant 696 -------"hey, how made - 777 Music, powerful effects of - 157 JMutton broth, how made - 775 N. Narcotics, observations on - 818 Navel-cord, or string, man- ner of tying - 542, 591 ---------presentation of - 552 Neapolitan, manifests un- bounded love for his wife 1 29 Nervous fever - - 241 --------head-ach - - 331 Nerves, description and use of 53Jen, Dr. Wm. father of ihe Penn. uiiiver.Mty S ip t \ e; - Si.aw, on.lessor, his death - Shivtriugs, in childbed Sid' one of the senses Sickness and vomiting of in" fants Si' am'sms, how prepared Siin. the lunctionsof explain Sleep, after dinner, whether advisable -----talking or walking in -----signs of, in fever Sleeplessness - 258, Slow fever Small-pox - Smell, one of the senses Smith, professor, discovers the utility of blood-root in polypus Snakes or serpents, bite of Snuffles of infants Soap wort, valuable in jaun- dice, Slc. Socrates, maxim of Solander, Dr. his advice to travellers in cold weather Solution of arsenic, doses of how prepared 475 510 ------of crude salammoniac -------of kali Somnambulism and somnil- 315. Sk. Soul, immortal Sorrel, antiscorbutic Southern wood, stomachic - South sea tea, diuretic Spaniards, their cruelty to the Indians Spanish woman, her extraor- diiiorv hope Speech. Messing of - 55, 56 Spence, Dr. attests the effi- — d'sea■ es of - -42 1 eacy of fox glove in con- ; e for'heis and wounds 722 ! sumption nk cabbage, useful in || Spikenard, good In gout .'iirna 'J». I Spirit of mindererus, how pre 305 | 241 I 703 ! 559 | 63! 621 83!) oquism - Sore, eyes - -----mpples -----throat 30 6, brutally mur'e ied - 154 proper manner of treat- lusr - 45 S'-ive traHp abominable 96 S'^n, most reliving cordial 119 ----- how to be . egulated i 'i infants - - 59S ----- ' ''W-k of too much or t;u ht.e - - -111 pareu -----of turpentine, mode of administering -----of lavender, doses of - Shilling of \ loorl - Sphvn, description of -------enl&iL'em^nt of Snlecv ort useful in eou:rhs, 12* ib. 2 77 5 20 2 11 344 63 644 433 614 722 106 116 796 830 831 833 122 608 56.1 309 64 723 ib. ib. 155 111 61 667 723 808 820 799 352 324 nr "W GENERAL INDEX. XXXV11 - 382 590 806 818 437 724 71 Spotted fever - - 241 Sprains and bruises - 461 Spruce laurel, useful in vene- real - 724 Squirrel ear, antidote for the bites of serpents - ib. Star grass, an intense bitter ib. Stevenson,Dr. his remarks on bowel complaints - 369 ------his mode of treating a hypocondriac Stillborn infants, mode of re covering Stimulant purgative pills Stimulants, how to exhibit - Stings of inse< ts Stink weed, for cutaneous eruptions, &c. Stomach, description & use of Stools, prognostic in diseases 280 St. Anthony's fire - - 350 Strangury - - 364,523 Straw berry, cooling St laxative 724 Stroke of the sun - - 302 Structure of human machine 49 Sumach, common, anti-vene- real - 725 Sulphur, doses of - 799 Sudorific drops, or bolus - 809 Sundew removes freckles 7 25 Superstitio-',sourceof delusion 200 Suppression of urine 364,5231 Sutures, mode of applying 456 ! Sf. Vitus's dance - 636 Swallow wort, good for cold 725 Swallowing of pins - 441 Sweating, immoderate - 2 20 Swelled leg - - - 563 Swellingof feet in pregnancy 5 25 Table of weights 8c measures 795 Tali aferro,Hon. John,his rem- edy for whitlow - 447 Tansy, vermifuge - - 725 Tape worm - - 586 Tapioca jelly, how made - 771 Tartar emetic, doses of - 800 Tartar on the teeth,how to re- move and prevent - 334 Tar water, how prepared - 831 Taste, one of the senses - 63 Tea,properties of . 112 Teeth, management of - 334 Teething - - - 624 Temperance,promotes health 107 [171, 175 Tendons,description & use of 53 Tetany or lock jaw - 386 Tetter or ring-worm - 427 Thatcher, Dr. deserves praise 639 Theodosius, emperor, his an- ger subdued by music - 157 Thighs, description of - 51 ------dislocation of - 465 ------fracture of - 467 Thomas,Dr.attests the effica- cy of cayenneinputrid sore throat - - - 311 of charcoal to stop ■of head in infants ■ of breasts in do. - of scrotum in do. Su ine pox Swooning or fainting Sympathy T.» 606 ib. . 607 348 ■ 558 ro,76 Table of medicines for family use - - ". T9G bleeding of the nose Thorax or breast, description of - - - Thorn apple, remedy in mania, epilepsy, &c. ■---- case of a child swallow- ing the seed Thoroughwort, useful in fevers Throat root, for sore throat - Throat, sore Thyme, good aromatic Thrush, or sore mouth - Tic douloureaux —----symptoms of treatment of Tincture of steel, doses of --- of myrrh, ----of rhubarb 800, ---- of bark ----of eolumbo ----of foxglove 352 63 726 729 730 306 729 620 339 ib. ib. 800 629 829 lb. ib. ib. AX.XVU) GENERAL INDEX. 829 ib. ib. 427 771 731 735 64 278 610 S2.3 826 735 616 473 ----of canthandes ----, rheumatic, ----of laudanum Tinea, or scald head Toast water,haw made - Tobacco, for colic, dropsy, &c. Toeitch,goodfor toe or ground itch Tongue, description St use of ——— appearance of, an im- portant prognostic Tongue-tied how remedied - Tonics, class of Tonic powders, and pills Tooth-ach Tooth-ach-trce, for rheuma- tism and venereal Tooth rash Topical bloodletting Touchwood, excellent styptic 735 Tourniquet,how to apply 454 Travellersinwinter,cautionto 118 Treacle posset, how made 773 Trefoil water.emet. Sc cathar. 735 Troup, Hon. G. M. his deafness cured - 5->- Tulip bearing poplar, tonic 7 >6 Turmeric, diaphoretic - ib. Turlington's balsam,how prep. 829 Timer'* cerate - - 838 Twins,or plurality of children 550 Typhus fever, treatment of 241 Typhoid pneumonia, or epi demic U. Ulceration of the navel Ulcers, common, ■----ill-conditioned Ureter, description fy use of Urethra, description of Urine, prognostic in fever ----difficulty in voiding 364,523 ----incontinence of - "'63 ----suppression of - 56G Unicorn roo*. useful in cholic 736 Uterus, description of " 7b V. Vaccine disease Vagina, or neck of the womb —■- — protrusion of Valerian, wild, useful in ner- vous disorders Vanity, effects of ------ cure of Vapours, or low spirits Vegetable substances,howcol- lected and preserved Vegetation of plants, corrects impur^air Veins, their use Venereal disea e ----■.---------prevention of Venesection, or bleeding how performed Vine, grape, cultivation of - Violet rattle-snake soot^ re- medy for scrofulous tumors , sweet, mild laxative 736 17* isl 381 09 54 412 122 - V - 300 607 4.30 680 78 79 279 341 S 574 -* i Virgins1 bower, useful in cu- taneous affections Virginia, or black snake root, promotes perspiration Volatile sal ammoniac, mode of administering - -----liniment, how prep'd Vitriol, white, doses of •> Vitriolic solution, doses of 802, ------------how prepared Vitalain - Voltaire, his conversion Vomiting and purging,or cho- lera morbus Vomiting, in infants W. Wakefulness, or inability to sleep - Wake robin, for blistering - Walnut, white, cathartic. Warm bath, virtues of 4 t, 58, ----------how to be regu- lated Warm St discutient liniments !-----plaster Warts and corns Washing of infants Washington, Gen. his death and charactf r ----------, Mrs. L. her mi- raculous recovery Water cresses, :u.ti-scorbutic 737 7 IS ib> ib. ib. 819 831 8O0 82 2 822 91 210 400 621 230 749 750 267 267 831 83 2 446 595 307 238 750 eiENEUAL INDEX. XXXIX Water trefoil, anti-scorbutic Water, impure,how to correct Water gruel, how made Watery head ----- rupture Wayne, Gen. his death Weakness of the stomach - Weaning Weems, Dr. his prescription --------- his death W t-Iis, dry, danger of V. hitlow White swelling Whiles, or sexual weakness White gum - - - White caudle, how made White bryony, purgative White, wood, tonic Whooping cough Willow, astringent and tonic Wistar, Dr. attests the effica- cy of nitric acid in liver complaints ---.-----his death and cha- racter - - - Wine, excellent preventive & remedy of diseases —:— use of, is economy ----abuse of, injurious ----receipts for making - ---— adulteration of, how to detect - cautions in administer- 750 111 772 630 613 410 393 598 398 ib. 98 446 431 510 616 773 750 ib. 634 750 ing in fevers t—— whey, how prepared Winterberry, tonic 324 305 737 ib. 738 740 745 253 777 751 Wintergreen, for itch - 751 Womb, or uterus, descrip. of 78 ------falling down of - 576 ------inversion of - 562 ■------cancer of - 580 i-----polvpus in the - 578 ------inflammation of - 567 ------hemorrhage from - 558 Wood betony, good in rheu- matism - 751 Woodhouse, Professor, his death - - - 702 Worms - - 585, 629 Worm-seed, vermifuge - 751 Worm-wood, stomachic " ib. Wounds - - - 454 Wlists, dislocation of - 465 Yarrow, astringent, remedy for bruises and cancers - 751 Yeast, utility of, in nervous fevers - 247 -----corrects foetid ulcers 680 -----receipt for making - 681 Yellow fever -. - 477 prevention of, 15th blank page. Yellow gum Z. - 615 Zimmerman, Dr. his judi- cious mode of treating re- ligious melancholy - 2o; £ PRELIMINARY OBSERVATIONS Contemplating the numberless diseases to which man is liable, and which may cause him to drag out a protracted life of distress, or suddenly cut him off in the bloom of his exist- ence, and amidst his usefulness, we must adore the Divine excellence which has given us in medicine the means of coun- teracting their dreadful effects. As might have been expected, the attention to an art, rising in importance over all others, has ever kept pace with the general progress of intellectual improvement, commanding for it the respect and encouragement of every enlightened people. With the Greeks, especially, the wisest and most polished of all the ancient nations, medicine was held in the highest estimation. Its votaries were cherished and revered by them while living, and in some instances, carrying their enthusiasm so far as to deify them after death. It is not indeed easy to conceive a more noble character, than a great and amiable practitioner of medicine, who has expanded his mind to the utmost extent by the brilliant attainments of science, and mel- lowed the dispositions of his heart by the habitual exercise of benevolence towards the afflicted objects of his care. How exemplary are Physicians of this description! Such was Hippocrates, the father of medicine. Such was the pious, the enlightened Sydenham. Such was the benevolent Jones, of Savannah. Such was the enlightened Rush: and such are many others who have emulated their virtues and rivalled their fame; among whom, I have the high satisfaction to enumerate of my particular friends, the late Drs. Craik, of Alexandria. Meems, of Georgetown, Steveuson, of Baltimore, and Pi; Chapman, of Philapelphia. 6 38 PRELIMINARY OBSERVATION-. But unhappily, all those who profess our art do not rcsomblr those bright examples. Medicine, more than any other good thing, is subject to abuse and debasement, b\ the sordid and mischievous "tricks and devices" of empiricism, hike noxious weeds impostors rise up at first, from the rank soil of their own effrontery; but they owe much of their subsequent growth to the protection which they derive from the want, of that information widely diffused, which would at once detect, and "laugh into scorn" their idle claims, and arraign to conviction their dangerous tendencies. They live but by tolerance. The slightest examination of their pretensions would drive the herd iuto their holes and hiding places, and consign their widely sdrcadfumc to utter oblivion. It is strange, that so little popular curiosity prevails wifb regard to medicine, particularly when the v public mind is so actively alive to subjects certainly of less moment. Talk to the generality of mankind about property, and you would sup- pose they were all lawyers, they reason so sensibly on the various points of mcum ct tuum: but touch them-about that which is of more worth than all property, I mean health, and they are silent as mutes. Did not experience evince the fact,, we should think it. impossible that in things of such h;gli con- cern, men could be so preposterously dccYived! so careful ol the dross, and yet so negligent of the gold. What can be more deeply interesting than the investigation of that beautiful organization which has,, emphatically, been pronounced "God's master work?" What more; impmtant than acquiring the knowledge of preserving this adiri ablemecrmn- isin? And what more pleasant and useful tlu.n to investigate thf medical plants of our extensive country, whereby we may remedy those painful maladies which assail the human frame? Half the attention and the time-devoted to the minor politics arising out of our party tlisscn.-.ions, assisted by very little of that overboiling zeal given to the acquisition of property, would, if appropriated to medical studies, enable any person of tolerable capacity to [.i\i, lise with safety and advantage h those cases of simple disease which are nu)>t common to our climate, and to determine between the "arrant quack" and the modest, w* 11-euucuted, and judicious physician. It *: PRELIMINARY OBSERVATIONS. 39 Assuredly, some care might be profitably directed to medi- cine. Why will not the intelligent citizens who are scattered Ihroughout the country, dedicate a part of their "liberal leisure" to it? Of all the sciences it is the most inviting, and that which opens the largest treasures to its cultivators. No one can lend his mind to it without receiving "usurious interest." Medicine is the digest of human knowledge. It is the great reservoir into which every stream of science pours its tribute, which in return spreads its fertilizing water over every field that, brings forth its "ripe and abundant harvest." The want of a popular medical education, we have remark- ed, promotes the success of empirics. To what else can the amazing increase of these creatures be ascribed? Would they dare to quit the shades of their native insignificance, if they thought they were to encounter the blaze of criticism, or to be inspected and scrutinized by the torch of truth? No: the ter- rors of such a process, were it practised, would exterminate the race, or leave to them only a "beggarly account of empty boxes." Wre repeat, that empirics are nurtured and sustained exclu- sively by the prejudices of mankind in their favour, arising from their inability to judge rightly of their merits. For, can it be presumed that any one acquainted with the subject, would repose the slightest confidence in' the nostrums of the most stupid, illiterate, dishonest, and vagrant of society, who are confessedly destitute of oven the elements, the mere alphabet of medicine. Who can believe, that these nostrums, as generally asserted by their proprietors, are applicable equally to a variety of dis- eases, opposite to each other as the poles, and that too, under every difference of age, constitution, temperament, habit, season, and climate? Is it to be credited, that skill can be possessed in a profes- sion the most complex, without any preparatory devotion to it? Reason and experience combine to assert the impossibility. The powers of eloquence or poetry may be an inheritance; hut medicine is not intuitive. Whoever acquires it, that is, tliat thorough ktundedge of it, wiiich confers u surpassing skill" must undergo a slow, toilsome and arduous probation. 40 PRELIMINARY OBSERVATIONS. Its temple is raised on the summit of the loftiest eminence, and the path which leads to it winds in tedious tortuosity, narrow, intricate, and perplexed; but strewed, at its different Btagcs, with flowers to tempt, and hung at its termination with fruits to reward. Few, very few, have ever reached it. The majority of those who set out on the enterprise become soon discouraged, and either linger by the way, or are lost in its mazes. The energies of genius, assisted by unwearied diligence, cau only hope to surmount the difficulties and to gain the prize. But candour must still allow that the empiric strengthens; in some degree, his credit with the public, by sometimes per- forming great and imposing cures. Such instances, however, of occasional success, bring with them no solid claims to con- fidence. They are indeed calculated to excite distrust when properly viewed. Their cures, which are admitted to be few are alone registered and promulgated. Nothing is ever said of the failures or tlie deaths produced. No regular and impartial account is kept, nor any sinking adjustment of balances: but, what /••ii -\ he. the fatality of a practice conducted in a way so ra*h and indiscriminate, without the »-uidc of either principle or experience? The nostrums employed are uniformly com- pose d of higredients of the greatest activity, priucipjdly of the miiurul p(>;:-ou!<, as arsenic, corroswe suMimate, calomel. &.c. and which can never be neutral in their operations. Whenever administered they assume a side in the pending contest, and exert all their might either for the patient or the disease, till 6ne or the other yields. The preceding is a faithful picture of empiricism—of its swaggering pretensions, of its danger, and its uncertainties; a plain and unvarnished tale, in which naught is extenuate or set down in malice. But with the too prevalent inclination for nostrums, we re- gret the strange aversion that exists, and which proceeds from the same neglect of medicine, to some of the most efficacious remedies. Tartar is denounced as a certain destroyer of the stomach; mercury, because it lodges in the bones; arsenic, as rnncoroualy poisonous, 6cc. kc. Thus are those powerful PRELIMINARY OBSERVATIONS. 4i and salutary agents, when in the hands of a judicious physician, stigmafised by the false views of vulgar prejudice. It has been wisely and truly declared by high authority, "that all medi- cines in large doses are poisons, and that poisons in small doses are the best medicines." This is no paradox. The efficacy of a remedy must be proportioned to its force, provided it be administered with discretion, and its operation properly re- strained. On the contrary,' the weakest medicine becomes poisonous when given in an undue quantity. In the use of medicines we should be careful to adapt them to the nature of the disease, and the condition of the patient's system at the time, for the salutary properties of a remedy are not positive, but entirely relative to the peculiar circumstances of the case. A remedy, therefore, may do harm, or prove beneficial, according to the degree of judgment exercised in its employ- ment. This position might easily be illustrated and enforced by a variety of examples. We shall mention, however, only a few most pertinent. What then is more sanative in its effects than the Peruvian bark in the treatment of intermittent fever, or gangrene; or more deleterious if given in an excited system? Where is there a readier cleanser of a foul stomach than emetics? yet in inflammations of that organ, nothing would prove so perni- cious. The same remark applies to cathartics, "nature's sca- vengers of a gorged alimentary canal." With regard to our lancet: what could we do without it? How quell those dreadful insurrections of acute disease which every where ravage our country? But indispensable as it is in such cases, yet there is, perhaps, no remedy, which is more mischievous when wrongly applied. W ho has not experienced the soothing restorative operation of opium, that divine medicine, which has not with too much force been called, umagnum Dei donum," tlic great gift of God; and who has not known its demonical influence when impru- dently employed? In this way we might proceed through every class of the Materia Medica, deriving proofs to fortify our statement, and 42 PRELIMINARY OBSERVATIONS. to warn us of the danger of abusing remedies. Enough, how- ever, has been said. We trust the admonition will not be ne- glected. To apply, as we have indicated, the various medicines of which we are possessed, is the secret of successful practice, and constitutes the wide difference between the discriminating physician and empiric. The practice of the one is governed by principles slowly and cautiously deduced from the contributions of long experi- ence and diversified observations; that of the other is the result of daring experiment, sanctioned only by the chances and calculations of the lottery. I i the revolutions of the wheel, and amidst a thousand blanks, a prize may come out! Thus, an important cure by an empiric, like an enormous prize, seizes public attention, and is sounded abroad by the "clarion of fame," while the evidence of the murderous prac- tice, like the blanks of the lottery, is hushed in silence or buried in forgetfulncss. It may be proper to observe here, that, in using all active medicines, we should begin with the smallest doses, increasing them gradually, until the quantity suited to the strenglh ol the constitution be discovered. For there are instances of constitutions on which one-fourth, and even one-tenth, of what would not affect others, will act powerfully. As the system speedily accommodates itself to the action of medicines, we should never continue one medicine too long at a time. When wx find it is losing its eflicacv, it sliould he changed for some other of the same class, and after a short interval the patient may, if he choose, return to his first medicine. By thus varying the remedies, as the system be- comes accustomed to their action, we shall be enabled to cure diseases which otherwise would not have yielded; as obstinate jntermittents, wherein I have frequently employed the bark without effect: but on changing it for either the solution of arsenic, or vitriolic piiis, *a cure has generally * taken place, and when it did not, by exciting a slight mercurial action in the system and immediately following ii with one '* Vid. Dispensatorv. PRELIMINARY OBSERVATIONS. 34 M- the other of the above medicines, I have pretty constantly succeeded. On this account medicines should never be made loo free with, as preventives of disease', unless there be evi- dently a morbid predisposition lurking in the system: for, by thus wantonly familiarising ourselves to medicine when there exists no necessity for it, we shall stand a very good chance to be disappointed of its proper effects, in the season of our need. Bitters, those especially made with spirits, like other cor- dials, have no doubt their use at times, as in damp weather, which hangs so heavily on the springs of life: but to use tlxem, or mint slings, or drams, as some do every morning, even the brightest,'when dumb nature herself is smiling, and every bird and beast are uttering their artless joy, is a species of suicide. It is a most wicked attempt to substitute artificial joys in place of those most pure and natural. Such an impious fighting against God and Nature, generally ends as might be expected. The wretched self destroyers seldom live out half their days. For the same delightful exhilaration, produced by one antifog- malic last year, requires two this year, and in that increase, till the habit of intemperate drinking is confirmed. How melan- choly is it that rational beings should act so madly, and that the all bountiful Creator cannot intrust us with his good things, without our shameful abuse of them! Thus it is, that men turn into poisons those pleasant beverages given for cordials, to raise their depressed spirits, to invigorate their flaccid nerves, and to enable nature to repel the various attacks of a humid or infected atmosphere. Among the many remedies of disease, none perhaps holds a higher place than the bath, in its different forms. The cold bath, by its sudden shock, is peculiarly fitted to invigorate the system, and to re-animate its circulations and secretions. Hence its acknowledged reputation in all cases of weak and relaxed habits, particularly those of the studious and sedentary. It ought however to be remembered, that, like every other remedy, it belongs but to one set of diseases. In affections of the viscera, obstructions and inflammations, it is hurtful. If after leaving the bath, the patient do not feel a kindly glow on 44 PRELIMINARY OBSERVATION*. the surface, he has good cause to (ear that the angel of health was not there before him uto move tlie waters." On going into the plunging bath, as it is called, it were better to dash in at once head foremost. The shock in this way is more instanta- neous, and the distribution of the blood more salutary than when it is driven, as by wetting the feet first, from the extre- mities to the head. It is on thisjprinciple that the shower bath possesses advantages superior to the plunging. Immediately on coming out of the bath the body should be rubbed dry with flannel or coarse cloths, and moderate exercise taken. Besides the advantages of frequent cold bathing, its partial use is no less salutary in all cases of local action. In periodical headache, and indeed in most complaints of the head, the affusion of cold water, though a simple, is a very effectual remedy. If persons subject to the quinsy and sore throat, instead of muffling their necks, would bathe them two or three times a day in cold water, they would find their account in it. When the healthy resort to the cold bath, on account of its purifying and pleasant effects, they may continue in it for some time: but to strengthen and give elasticity to the solids, every thing depends upon the sudden shock.—The time of day for bathing is a matter of indifference, provided it be not immediately after a full meal, or when the body is warm and in a state of free perspiration. The warm bath, about the temperature of the blood, has nearly all the advantages of the cold bath, without being liable to so many objections. Some indeed tell us, that it wreakens the body, but so far from doing so, it may justly be considered as one of the most powerful and universal restoratives with which we are acquainted. Instead of heating, it cools the body, diminishes the pulse, and takes oft its unnatural quick- ness, according to the length of time the bath is continued. Hence tepid baths are of great service, when the body has been overheated, from whatever cause, whether by severe bodily or mental exercise. In all these cases, its happily composing and recuperative virtues seem to be owing to itn tendency to promote perspirationvand to relax spa9m. PRELIMINARY OBSERVATIONS. 45 Warm bathing can hardly be sufficiently commended, for its sovereign effects in promoting cleanliness, and consequently fo3P curing all diseases of obstructed perspiration from foul skin. It is much to be lamented that so many poor children should become the victims of their parents' laziness, and neglect of the most sweet and healthful virtue, cleanliness. For would they devote a little of their mispent time, and money, to the more de- cent clothing and frequent washing of their children, there could be no doubt that the little innocents would enjoy ten thousand times more comfort than they can possibly have while covered with filth, and tortured with scald heads, blotches, itch, and ver- min. In fine, having seen the fatal termination of so many dis- eases, in my opinion easily curable by the bath, I cannot dis- miss this important subject without earnestly recommending it to every gentleman to provide for his family the convenience of bathing, as not only one of the greatest luxuries, but the best preservatives of health in these warm climates. It is essential to health, luxuriously, to refresh the person by bathing and washing off the impurities of the skin; and equal care Should be taken to remove all filth out of the chambers of the sick, and frequently to change their linen and bed-clothes, which, when saturated with foetid perspirable matter, must prove extremely unpleasant and hurtful to the patient. And here I cannot but breathe the most fervent wish that the agriculturists of the south and west would be persuaded to insist more rigorously on cleanliness in the persons of their slaves. That the constitution of the African is more firm than ours, and better fitted to sustain the toils of warm climates, is very certain; but it is equally true that nis daily labours, with the sudden chan- ges of weather, often put his constitution, good as it may be, to trials which loudly call for every aid that humanity can possibly afford him. Of these aids, next to plenty of wholesome food., cleanliness is one of the greatest. It is, indeed, a medicine both Of body and mind. The poorest slave, however degraded his condition may be, has still left a portion of mind, which can nev- er be totally insensible to his outward appearance. Cover him with rags and filth, and you not only injure his body by ob- structing perspiration and corrupting the fluids, but you attack it> PRELIMINARY OBSERVATIONS. him in his mind. Knowing that he appears vile and loathsome t* others, he becomes much more so to himself; and this idea em- bitters reflection, depresses his spirits, and in conjunction with other causes, often brings on diseases which press him to an un- timely grave. Whereas, by ordering him frequently to bathe, and by affording him three changes of apparel, of which one might always be clean, he would be greatly refreshed and com- forted, both in mind and body. Thinking his appearance decent in the eyes of others, he becomes well pleased with himself, and looking on his new Iwbit, however clveap and simple, as an evi- dence of his master's affection and value for him, he feels at oner the touch of an honest pride in himself, and of friendship for his master, which lightens his task and sweetens all his toils. But, if cleanliness be of such importance to the healthful, how much more so to the sick slave. When sinking under the heat and burden ofhis labours, can it be good policy to suffer him to be put, like a mere animal, into a narrow dirty cabin; there left, with scarcely a child to hand him "a cup of cold water," with no food but dry bread, and breathing the foetid atmosphere of a sultry, filthy, habitation! In such circumstances, what but a miracle can save him from destruction ? Having been frequently an eye witness of such scenes, of which the owner himself was, perhaps, ignorant, I feel it my duty to advise him, not only for humanity, but interest sake, to erect for his slaves, especially if he have many, a cheap, coarse kind of building as an hospital. This building should he fixed on some spot, enjoying, in the highest degree, the double ad- vantage of good water and air. It ought to consist of but one large room, quite open to the top, well aired by doors and windows, and with a plank floor, that it may be frequently wash- ed and kept perfectly clean. Some good-tempered, notable, old woman of the family, sliould be appointed to attend the sick and supply the proper nourishment. In this cheap and simple way many a valuable slave might, we are certain, be saved to his owner, which alone were an ample reward, without counting the present comfort of such humanity, or the futurr blessings of Him, who has promised, that every act of love, orea to the poorest slave, shall be remembered as if dom- tr, 6 PRELIMINARY OBSERVATIONS. $ himself. To the truly wonderful effects of this regimen, em- bracing cleanliness, fresh air, good nursing and diet, I, myself, can bear the most public and unequivocal testimony. In the year 1805, when the Summer and Autumnal fever raged with uncommon violence and mortality in Savannah, having considerable practice among the shipping, I was induced, chiefly from motives of humanity, to open a private hospital for seamen- And though I had usually from twenty to thirty patients during the sickly season, I lost but one of all who had been taken into the hospital at an early stage of the disease. This extraordinary success, I ascribe in a great measure to the virtues of the regi- men above recommended. And in support of the plan recom- mended, I will venture to assert, that hardly an instance can be quoted, of the recovery of seamen, when left neglected, or badly attended, in the confined boarding-rooms, or steerages of the ships, where they were attacked. The very happy result, of the little hospital system above stated, cannot but excite the most earnest wish for a similar establishment, in Savannah, on a much larger scale. Such an institution could not fail to prove a great blessing to the state, hut more so to the town, where numbers of useful citizens, especially seamen, are annually swept off. It affords me pleasure to state, that since the appearance of this friendly hint, in the first edition of this work, the humane citizens of Savannah, have actually established a public hospital, and have found it abundantly productive of the good effects predicted. Fortunate would it be, if similar institutions were erected in all our seaports. In addition to the ,-ofter whispers of humanity, gratitude now lifts her louder voice; for surely our gallant sailors, principally the objects of such hospitals, have given glorious proofs in the late awTful contest, that they de- serve every mark of attention that a great nation in the pleni* Mide of munificence can bestow. * OF THE STRUCTURE OF THE HUMAN MACHINE. How poor, how rich, how abject, how august; How complicate, how wonderful is man! How passing wonder He who made him such! Who center'd in our make such strange extreme?} From different natures, marvellously mixed! An heir of glory! a frail child of dust! Helpless immortal! insect infinite! A worm! a God!—I tremble at myself, And in myself am lost. Yopng. ■"/ am fearfully and wonderfully made, 0 Lord," exclaimed David, on surveying the admirable mechanism of his own frame. Indeed, so complicated and curious is the structure of the human frame, that no person, who contemplates it, can possibly avoid joining with the pious Psalmist. That illustrious physician of antiquity, Galen, is reported in his youth to have been a Sceptic, but on witnessing a dissection, and examining the meehanism of the human body, the divine wisdom and design running through all its parts, he was struck with such a sense of the great Architect, that he immediately became a convert, and during his life devoted himself to the worship of the Deity with all the fervour becoming an enlighten* cd and grateful mind. Having himself happily caught the first spark of Divine light from a survey of this wonderful machine, he earnestly recommends to others the study of it as the noblest employment of the faculties, and one of the suresfrguides to ra- tioned devotion. His thoughts on this subject, though emanating f5ft OP TUB STRUCTIRW OF from a heathen, are well worth the attention of all Christians.— "Those treatises," says he, "which display the excellencies of the great Creator, compose one of the noblest and most ac- ceptable hymns. To acquaint ourselves witli his sublime per- fections, and point out to others his infinite tower, his unerring wisdom, and his boundless benignity—this is a more substantia) act of devotion, than to slay hecatombs of victims at his altar, 01 lrindle mountains of spices into incense." Now, as one object of the "Medical Companion" is to trea* of the art of preserving this divine piece of workmanship in a healthy state, nothing can impress us more forcibly than the absolute necessity of being made acquainted with its parts, and the laws that govern them, without some knowledge thereof, it appears no more possible to take the right care of it, or to keep it in good order, than to perpetuate the regular motion of a clock, or time-piece, without a familiar acquaintance with its jmechanism. The study of Anatomy, as it leads to the knowledge of na- ture, needs not, says the illustrious Cheselden, many tedious descriptions, nor minute dissections, what is most worth know- ing being soonest learned, and least subject to difficulty; while dividing and describing the parts more than the knowledge of their uses requires, perplex the learners, and make the science tedious, dry, and difficult. Upon this principle, the following anatomical description of the human bodv is conducted; and to render it perfectly intelli- gible to the uninformed readers, technical terms have, as much as possible, been avoided. "When a master builder," says the celebrated I lervey, whose sublime sentiments on this theme are at once so elegant and appropriate, that I have taken the liberty frequently to use them, . "undertakes to erect a magnificent edifice, he begins with the \les, decorated, but more solid parts, those which are to support. pr to contain the rest." This order we w .11 follow in considering the structure of the human frame. The Bones are the hardest and most solid parts of the hunu-u kcto, cast into a variety of moulds, enlarge dor contracted inf\a mie'v of si/.s. yrl calculated from their strength, to THE HUMAN MACHINE. 6l mpport the whole body. The manner of their articulation ifl truly admirable, and remarkably various; yet never varied with- out demonstrating some wise design and answering some valuable end. They contain marrowr, which makes them less brittle, and are covered with a membrane, or thin substance like a blad- der, called periosteum, except on the skull, where it is called pericranium, which is exquisitely sensible in an inflamed state, being plentifully supplied with nerves and blood-vessels. Its use is to sustain the vessels which enter the substance of the bones with their nourishment. The head, designed for the residence of the brain, is framed in exact conformity to this important purpose, ample to receive it; strong to uphold it; and firm to defend it. The Ribs, turned into a regular arch, are gently moveable for the act of respiration. They form a secure lodgment for the lungs and the heart. The Back-bone is intended not only to strengthen the body, and sustain its most capacious store-rooms; but also to bring down that appendage of the brain, which is usually termed Spinal marrow. The Arms, pendent on either side, are so exactly proportioned to each other, that the equilibrium of the structure may not be disconcerted. These being the guards which defend, and the ministers which serve the whole body, are fitted for the most diversified and extensive operations; firm with bone, yet not weighty with flesh; and capable of performing with singular expedition and ease, all manner of useful motions. To these are annexed the hands, and all terminated by the fingers; which are not, like the arms, of the same length, and of equal bigness, * but consisting of various little bones, and a multitude of muscles, • what shape can they not assume? what service can they not perform? The Thighs and Legs are alike substantial and stately columns; articulated in such a manner, that they administer most commo- diously to the act of walking, yet obstruct not the easy posture of sitting. The legs swell out, towards the top, with a gentle Hrqiection; and are wrought off, towards the bottom, with neat 52 OP THE STRUCTURE OF diminutions, ^"hich variation lessens their bulk, and at the same time increase?, their beauty. The Feet compose the firmest and neatest pedestal; infinitely beyond all that statuary or architecture can accomplish; capable of altering their form, and extending their size, as different cir- cumstances require. Besides performing the office of a pedestal, they contain a set of the neatest springs, which help to place the body in a variety of graceful attitudes, and qualify it for a multiplicity of advantageous motions. The undermost part of the heel, and the extremity of the sole, are shod with a tough, insensible, sinewy substance. This we may call a natural san- dal. It never wears out, never wants repair, and always prevents that undue compression of the vessels, which the weight of the body, in walking or standing, might otherwise occasion. While many animals creep on the ground, while all of them arc prone in their posture or their aspect, the attitude of man is erect, by far the most graceful, with an air of dignity, and bespeaking superiority; and by far the most commodious, fitting us for the prosecution of every grand scheme, and facilitating the success of all our extensive designs. It is likewise attended with the greatest safety; being, if not less than any other posi- tion exposed to dangers, more happily contrived to repel op avoid them. The Cartilages approach much to the nature of hones, being smooth and elastic. In them there is no sensible cavity to contain marrow, nor are they covered with any membrane to render them sensible as the bones are. They serve to make the bones, whose extremities they cover, move freely m their joints. They also contribute, in a great measure, to the formation of several parts, as the wind-pipe, nose, ears, and breast. The Ligaments are tough, compact substances, more flexible than cartilages. They have no conspicuous cavities, neither1 have they any sensibility, lest they should suffer upon the motion of the joint. They serve to unite the several limbs, and prevent their parting from each other, as happen in dislocations. \The ^Muscles are distinct portions of soft, red, flesh, with stfong tendinous heads and tails designed for insertion. They ar« composed of the slenderest fibres, yet indued with incrcdi- THE HU MAN MACHINE. 5$ ble .strength; fashioned after a variety of patterns, but all in the highest taste for elegance, conveniency and usefulness. These, with their tendons annexed, constitute the instruments of motion. The former, contracting their substance, operate somewhat like the pulley in mechanics. The latter, resembling the cord are fastened to a bone, or some portion of flesh; and, following the muscular contraction, actuate the part into which they are inserted. This, and all their functions, they exercise, not like a sluggish beast of burden, but quick as lightning. A nerve or more in each muscle sets them at wrork, diftusing the power of sensation through the body, or, returning upon an impression from without, giving all needful intelligence to the soul; so that flesh and nerves are the principal constituents of a muscle. Inwardly they supply the several movements of the active machine: Outwardly they render its appearance plump, well proportioned, and graceful. The strength of the muscles is astonishing in all persons, but especially in cases of frenzy, and in certain extraordinary cha- racters, who, by the use of a few muscles only,-will easily raife a weight much greater than that of their own bodies. The Tendons, although much smaller than the body of the muscle, are composed of the same number of fibres. They are not capable of contraction, but serve like ropes to pull when the fleshy fibres act, for the commodiousness and firmness of inser- tion, and the direction of motion. The use of the tendons is to avoid a large quantity of .flesh neajr the joint, to prevent clumsiness in particular places,, and for the better admitting of that friction, which, in less compact parts would have been injurious. The JYervcs are surprisingly minute, white cords, derived from the brain, running to every part of the body. They perform two distinct offices; conveying sensation from all parts of the body to the brain, and carrying the commands of the will from that seat to all the different parts of the body. Most of the muscles of the body producing motion are in the guidance of our will; some of them, however, entirely independent of it,"as those of the heart and vessels which carry on the circulation of the blood; 54 OF THE STRUCTURE OF and some are partly under the direction of our will, and partly indencndent of it, as in respiration. But all the muscle, the involuntary, as well as the voluntary, av; enabled to act only by their communication with the brain; for when that is cut off by the destruction of the connecting nerve, whatever impression is made on the part can no longer be felt; the orders of the will o that part can no longer be obeyed, and the part itself can no longer move. The Arteries are strong clastic tubes, which arise from the henrt, and thence, striking out, as they go into numberless smal- ler canals or branches, distribute the blood to every part of the body. These being wide at their origin, lesse.i'ng as they branch themselves, check the rapid motion of the blood. To sustain this shock, they arc indued with uncommon strength; by perfonning this sen ice they oblige the crimson current to pass into the narrowest defiles, and distribute itself into all quarters. The blood thrown from the heart dilates the arteries," and their own elastic force contracts them; by which means they vibrate, in proper places, very perceivably against the finger; bring ad- vices of the utmost importance to the physician; and very much assist him both in discovering the nature of diseases, and pre- scribing for their cures. The larger arteries, w herevcr the body is formed for bending, are situated on die bending side; lest, being stretched to an improper length by the inflection, their dimensions should be lessened, and the circulating fluid retard- ed. They are not, like several of the considerable veins, laid so near the surface as to be protrusive of the skin; but are de- posited at a proper depth in the flesh. This situation renders them more secure from external injuries. The Vei)is are tubes or vessels accompanying the arteries, and are appointed to receive the blood from their extremities, and rcconvey it to the heart. Small at their rise, and enlarging as they advance, they are void of any pulsation. In these, the pressure of the circulating fluid is not near so forcible as in the arteries; for which reason their texture is considerably slighter. In many places they have valves, because the slow motion of the blood in the reins, and their weaker contractilo power, un- THE HUMAN MACHINE. 55 assisted by a force adequate to that of the heart, have great need of such an invention to insure its return to the heart. The Secretory vessels are minute tubes in the different organs sewing to separate and strain off the different fluids from the general mass of blood. The Excretory vessels, tubes also belonging to the different or- gans, carry off the humours that are separated. The Glands, commonly called Kernels, are small bodies of finely interwoven vessels, whose office it is to secrete or sepa- rate fluids from the blood for particular uses, as spittle in the mouth, bile in the liver, milk in the breast, &c. Glands, when obstructed, become large and indurated, from which scirrhus and cancers are produced. The Membranes are thin tunicles or fine webs like a bladder, appointed to enwrap the fleshy parts; to form a connexion be- tween some; to line the cavities, and make a separation between others. The Fibres are simple threadlike bodies, serving to form other parts; hence some are very hard, as the boney ones; and others soft, as the flesh} parts. The Skin, like a curious surtout, exactly fitted, envelopes the whole, formed of the most delicate net-work; whose meshes are minute, and whose threads are multiplied even to a prodigy.— The me.-dies are so minute that nothing discernible to the eye passes them; though they discharge every moment uivriads of superfluous incumbrances from the body. The steam arising from the warm business transacted within, is carried ott by these real, though imperceptible, funnels; which constitutes what we usually call insensible perspiration. A single grain of sand, ac- cording to Mr. Lewenhouk, will cover no less than one hundred and twenty-five thousand of these funnels, or what has been prettily styled "cutaneous chimneys." The threads are so mul- tiplied, that the point of the smallest needle cannot pierce any single part without causing an uneasv sensation, and an effusion of blood; consequently without wounding, even by so small a puncture, both a nerve and a blood-vessel. The outermost covering of the body is that soft whitish tegu- ment which rises in the pustle of a blister, and is called scarf 56 OF THE STRUCTURE OF skin. The next, or true skin, is thai reddish and exquisitely tender part which appeal's when the blister is broken, and the dead skin taken oil'. The first is void of sense, and intended to screen the second, not only from the stroke of injuries, but even from the impressions of the air, which, mild as it may feel to the sheathed, would be too rough and sharp for the naked nerves. The natural colour of the cuticle is white. The apparent black or brown colour in the African or Indian, is entirely ow- ing to tlie mueuous substance under it. The skin unites in itself two very essential functions. It is the organ of the sense of the touch, and the channel of perspi- ration. For this purpose, innumerable nerves and vessels are dispersed throughout the skin, which are in the continual act of feeling, and at the same time, of secreting and volatilizing noxious particles. Ithns been proved b)r accurate experiments, that the healthy individual daily and insensibly perspires up- wards of three pounds weight of superfluous and impure hu- mours. It may therefore, be confidently asserted, that no part of the body is provided with so many important organs, by which it is connected with almost every operation performed in animal life, as the skin. By this organization, we are placed in immediate connexion with the surrounding atmosphere, which particularly affects us through the skin, and exerts its influence on our health. We farther feel, directly through that medium, the qualities of the air, heat, cold, pressure, and rarefaction. Important as the skin is to external life, it is no less so to the internal economy of the body, -where it appears to be peculiar- ly designed to preserve the grand equilibrium of the different systems, by which the human frame is supported in its vital, animal and sexual functions. If any stagnation, accumulation, or irregularity arise in the fluids, the skin is the great and ever ready conductor, through which the superfluous particles are separated, the noxious volatilized, and the fluids, stagnating in their course, effectually attenuated; a canal being at the same time opened for the removal of those humours, which, if they could get access to the vital parts, such as the heart and brain, would cause inevitable destruction. By the proper exercise of THE HUMAN MACHINE. 57 this organ, many diseases may be suppressed in their early stages; and those which have already taken place, may be most effectually removed. No disease whatever can be healed with- out the co-operation of the skin. The nature and constitution of this organ most certainly determine either our hope or ap_ prehension for the safety of the patient. In the most dangerous inflammatory diseases, when the prospect of recovery is gloomy? a beneficial change of the skin is the only effort by which na- ture, almost overcome, relieves herself, arid ejects the poison in a surprising manner, frequently in the course of one night. The greatest art of a physician, indeed, consists in the proper man- agement of this extensive organ, and in regulating its activity, where occasion requires. To mention only one circumstance; it is well known to those who have experienced the beneficial effects of a simple blister, that its stimulous, like a charm, has frequently relieved the most excruciating pains and spasms in the internal parts. When the sensibility of the surface is impaired; when the myriads of orifices designed for the continual purification of our fluids, are obstructed, if not closed; when the subtle ner- vous texture is nearly deprived of its energy, so that it becomes an impenetrable coat of mail, is there any reason to wonder that we are so often harrasscd by a sense of constraint and anxiety, and that this uneasiness, in many cases, terminates in gloom and melancholy? Ask the Hypocondriacr whether a certain degree of the cold, paleness, and spasmodic sensation in the skin, does not always precede his most violent fits of imbecility; and whe- ther his feelings be not most comfortable when the surface of his body is vigorous, warm, and perspires freely? In short, the degrees of insensible perspiration are to him the surest barom- eter of his state of mind. If our skin be disorganized, the free inlets and outlets of the electric, magnetic, and other matters, which affect us at the change of the weather, are inactive.—. Thus the origin of extreme sensibility, towards the various at- mospheric revolutions, is no longer a mystery; for, in a healthy surface of the body, no inconvenience w ill follow from such changes. If we farther advert to those acrimonious fluids. 5* •» THE.STRUCTURE OF which, in consequence of an imperfect state of perspiration. are retained ia tlie body, and which affect the most sensible nerves and membranes, we shall the better comprehend how cramps and spasms, the torturing pains of Ihe gout and rheuma- tism, and the great variety of cutaneous diseases, have of late become so obstmate and general. The just proportion of the fluids, and the circulation of the blood, are also determiu-d, in no small deg/ce, by '.he skin; so that, if these fluid-become languid, the whole momentum of the blood is repelled towards the interior parts. Thus a continual plethora, or fulness of the blood, is occasioned; the head and breast are generally oppress- ed; and the external parts, especially the lower extremities, feel chilly and languid. May we not infer, from what has been advanced, that the use of baths is too much neglected, and ought to be universally in- troduced? Bathing is considered an excellent remedy for alleviating both mental and bodily affections. It is not merely a cleanser of the skin, enlivening and rendering it more fit for performing its of- fices; it also refreshes'the mind, and spreads over'die whole system a sensation of ease, activity, and pleasantness. It like- wise removes stagnation in the larger, as well as in the smaller vessels, gives an uniform, free circulation to the blood, and pre- serves that wonderful harmony in our interior organs, on the disposition of which our'health and comfort so much depend. A person fatigued or distressed in body and mind, w ill de- rive more refreshment from the luxury of a tepid bath, and may drown his disquietude in it more effectually, than by indulging in copious libations to Bacchus. There subsists so intimate a relation between our interior and exterior vessels, that almost every error or irregular;iy in the organs within, shows itself first on the surface of the body, par- ticularly on the face. How often are we struck w'th the coun- tenance of a person who thinks himself in perfect health, but whose illness, the result of some morbid cause, concealed in the body, justifies, in a few days, the serious apprehensions we entertained at our last'interview? Nature has wisely ordained. T H E H U M A N M A C H I N K . 59 that the first appearance of internal irregularities should be in- dicated by the countenance; but to what do we generally apply this index? We refuse to avail ourselves of her beneficent in- timation; and the continued use of pernicious substances, instead of promoting the object we have in view, ultimately tarnishes and impairs that beauty which we meant to adorn and preserve. The secret venom circling in her veins, Works through her skin, and bursts in bloating stains, Her cheeks their freshness lose, and wonted grace, And an unusual paleness spreads her face. Granville.. We imagine it in our power to improve the skin, without at- tending to the purity of the fluids, though it is indebted to them for its very existence; and yet we should smile at a person, who should attempt to cleanse an impure tongue by constantly scrap- ing it, when a disordered stomach was the real cause of that impurity. The Cellular Membrane, so called from its numerous cells, adheres very closely to the skin, running between the muscles in general, and between their several fibres in particular; and communicating with the membrane which lines the inside of the breast and belly. All its cells communicate with each other throughout the whole body, so that from any one part the whole. may be filled with air, as is evident in beasts, from the butchers blowing up their lean meat with air when newly killed, and in emphysema, wliere the air from a broken rib, getting into one of the cells, forces its way into all the rest, distending the body to a frightful size; as also, in general dropsy, wherein all the cells, filled with water, may, by puncture, be emptied in the course of a night. In health this membrane is filled with an oily substance, giving an agreeable rotundity to the limbs. It is also the seat of biles, and contributes to keep the inner part6 warm and pliant; aud, by filling the interstices of the muscles, renders the surface of the body smooth and plump. The Head, that majestic dome, being the seat of the brain, in which the soul is supposed to reside, resenlbles the General's tent in an army, or the Momr%h?s in a city. It has a eommuhi- * GO OF THE STRUCTURE OF cation established with all, even the most remote parts of the system; having outlets and avenues, for the ready despatch of couriers to all quarters, and for the reception of speedy intelli- gence on every interesting occasion. It is furnished with lodg- ments wherein to post sentinels of various characters, and ap- point to various offices, to expedite their operations, whether employed in reconnoitering what passes without, or examining what claims admittance within. The whole turns upon a curious pivot, most nicely contrived to afford the largest and freest cir- cumvolutions. This stately capitol is screened from heat, de- fended from cold, and, at the same time, beautified by a copious growth of hair. The Great Creator, profusely gracious to mankind, has made us a>i inestimable present of the senses to be the inlets of inn;!:! :ra!>le. pleasures, and the means of administering the most valuable comforts. High in the head, bright and conspicuous as a star in the brow of evening, is placed the eye. In this ele- vated situation, like a centinel posted in his watch tower, it r.o:n!"aiid:-, the mos' enlarged prospect. Consisting only of sim- ple fluids, enclosed in thin lunicles, it conveys to our apprehen- sion all the graces of blooming nature, and all the glories of the viable Heavens. How prodigiously wonderful, that an image of the highest mountains, and a transcript of the most diversified landscapes, shall enter the small circlet of the pupil! How surprisingly artful, that the rays of light, like, an inimitable pencil, should paint on the optic nerves, paint in an instant of time, paint in the truest colours, and excatest lineaments, every species of external objects. The Eye is so tender, that a slight'accident, scarce perceiva- ble'by some other parts of the body, proves very injurious to its delicate frame. It is guarded, therefore, with the most soli- citous care; with a care evidently proportioned to its nice tex- ture, and extensive usefulness. It is entrenched deep in the head and barricaded on every side with a strong fortification of bones. The wisdom and goodness of the Creator appear in the aston- ishing apparatus of n.u ■/■ hs with which the eye is furnished, to produce all the necessary and convenient motions in the situation THE HUMAN MACHINE. 61 where it is placed. The eye-brows serve to defend this deli- cate organ from too strong a light; and as the incursion of the smallest fly would incommode the polished surface, it is farther defended by two substantial curtains (eye-lids) hung on a most slender cartilaginous rod, which secure it from floating dust and from every troublesome annoyance. In sleep, when there is no occasion to exercise the sense, but an absolute necessity to pro- tect the organ, these curtains spontaneously close, and never fail to lie shut. On the inside of these curtains or eye-lids, lie glands, which secrete a limpid fluid, that lubricates the eye-ball, as often as we wink, or, as it were, oils its wheels, and fits it for a course of unwearied activity. The Ear consists of an outward porch and inner chambers, with tools of the most admirable contrivance, and finished work- manship. The porch is that cartilaginous substance, standing somewhat prominent from the head, covered with a tight expan- sion of the skin, and wrought into irregular bends and hollows; which, like circling hills, or surrounding rocky shores, collect the wandering undulations of the air, transmit them with vigor- ous impulse, to the finely stretched membrane of the tympanum, or drum of the ear. The avenue, or narrow entry, is secured, from the insinuating attempts of little insects, by a morass of bitter and viscous matter, disgustful to their taste, and embar- rassing to their feet. The hammer and the anvil, the stirrup and the drum; the winding labyrinth&,and the winding galleries; these and other pieces of mechanism, instrumental to the power of hear- ing, are, beyond description, curious. Amazingly nice must be the formation, and inconceivably ex- act the tension of the auditory nerves, since they correspond with the smallest tremours of the atmosphere, and easily distin- guish their most subtle variations. With the gentle gales that fan us, or even with the ruder blasts that assault us, these deli- cate strings are but little affected. Whereas, they are perfect unisons with those fine, those significant agitations of the air which the acutest is unable to discern. These living chords tuned by the touch of an Almighty hand, and diffused through 68 OF THE STRUCTURE OF the echoing aisles, and sonorous cells, receive the impression* of sound and propagate them to the brain. These give exis- tence to the charms of music, and reciprocate the rational civ tertainments of discourse. The eye perceives only the objects before it; whereas the ear warns us of transactions above us, bo hind us, all around us. The eye is useless amidst the gloom of light, and cannot carry its observation through the bolted door or the closed window-shutter^ but the ear admits intelligence through the darkest medium^ and the minutest cranny. Hence, when, we cannot sec a friend, because of* an interposing parti- tion, yet, by the friendly aid of this organ, wc can learn that lie is in the adjoining room by his voice, or that he is near by liis steps. The eye is upon duty only in our waking hours; but the ear is always expanded, and always accessible; a courier which never tires, a centry ever in his box. To secure a re- source, in case any misfortune should disable one of the hearing oi- s* eing organs, our alt gracious Maker, has given us duplicates of each. As there are tremulous concussions impressed upon the air, discernible only by the instruments of hearing; Iherc are also odoriferous particles wafted by the same aerial vehicle, which are perceivable only by the smell. The Aostrils are wide at the bottom, that a large quantity o_" effluvia may enter; narrow at tlie top, that when entered, they may close their ranks, and act with greater vigour. Fine, be- yond all imagination, arc the streams exhaled from fief id or fra- grant bodies. The very best microscopes, which discover thousands and tens of thousands of animalcules in a drop of pu- frified water, cannot bring one individual among afl these evau- escent legions fo our sight. They sail in numberless squadrons close to our eyes, close by our cars; yet are so am; zingly at- tenuated, that they elude the search of both. Nevertheless, so judiciously are the olfactory nets'laid, and so artfully their mesh- es seized, that they catch these vanishing fugitives. They catch the roaming perfumes, which'fly off from the opening ho ttey-suckle, and take in the stationed sweets which hover round the expanded rose. They imbibe aft the balmy fragrance ol THE HUMAN MACHINE. 63 springy all the aromatic exhalations of autumn, and enable us to banquet even on the invisible dainties of nature. Furnished with these several organs, ***** not a breeze Flies ofer tlie meadows, not a cloud imbibes The setting sun's effulgence, not a strain From all the tenants of the warbling shade ,'lscends, but whence our sensesmn partake Fresh pleasure, Akenside, Anotlier capacity for frequent pleasure, our bountiful Creator nas bestowed in the power of taste; by means of which the food, that supports our body, feasts our palate; first treats us with a pleasing regale, then distributes its beneficial recruits. The ra- zor, whetted with oil, becomes more exquisitely keen; so the saliva, flowing upon the tongue, and moistening its nerves, quick- ens them into the liveliest acts of sensation. This sense is cir- cumstanced in a manner peculiarly benign and wise; so as to be a standing, though silent plea for temperance. The sight, smell, and taste, are not only so many separate sources of delight, but a joint security to our health. They are # the vigilant and cbcewrale iuspectors which examine our food, and inquire into its properties, pleasant or disagreeable, wholesome or noxious. For the discharge of their offices, they are excel- lently qualified, and most commodiously situated; so that nothing can get admission through the mouth, till it has undergone the scrutiny and obtained the pasport of each. To all these, as a most necessary and advantageous supple- ment, is added the sense of feeling; which renders the assem- blage complete. While other senses have a particular place of residence, this is diffused throughout the whole body. In the palms of the hands, on the tips of the fingers, and indeed through all the extreme parts of the flesh, it is most quick and lively.— The whole army of Xerxes drawn out in battle array, with his millions of supernumery attendants, were bat like a few glean- ers straggling in the field, if compared, either in number or ordel*^ G4 OF THE STRICTURE OP with' tliose nervous detachmnnts, which pervade the lexfureaf the skin and minister to the act of feeling. The crowning gift, improving the satisfaction, and augment- ing the beneficial effects of all the senses, is speech. Speech makes me a gainer from the eyes and ears of other people; from the ideas they conceive, and the observat ions they make. And what an admirable instrument for articulating the voice, and mod- ifying it into speech is the tongue! The tongue has neither bone nor joint; yet fashions itself, with the utmost volubility, into every shape and every posture, to express sentiment, or consti- tute harmony. This little collection of muscular fibres, under the conducting skill of the Creator, is the artificer of our words. By this we communicate the secrets of the breast, and make our very thoughts audible. By this we instruct the ignorant, and comfort the distressed; we glorify God, and edify each other. Who would not bless for this the gift of speech, And in tlie tongue's beneficence be rich? But still, what is this mansion of flesh, though so exquisitely Wrought, compared with the noble and immortal inhabitant, which resides within? + ***** a j>]Mi intellectual being, Those thoughts, which icander through eternity." The Mind, or Soul, of much higher character than that of the perishable frame with which it is at present connected, has neither nerves, nor the nervous Jluids. These are only its agents, in this its imprisoned state. When the " silver cord" is broken, which connects mind and matter together, vitality ceases. The body then, with all its artful and numerous vessels, fibres and nerves, and other exquisite machinery, undergoes decomposi- tion, and is turned into its original elements; but the immortal soul, having shaken off this coil, is destined for a new resi- dence; to flourish in eternal youth; to outlive the wreck of elements and the crush of worlds. It is embodied even in its THE HUMAN MACHINE. 65 Residence in another world. " Thou fool," says the Philosopher and Apostle, " that seed which thou sowest is not quickened ex- cept it die.—" And that which thou sowest is not that body which shall be, but God giveth it a body as it hath pleased him, and to every seed its own body. So also is the resurrection of the dead. The body is sowrn in the earth in dishonour, it is raised in glory; it is sown in weakness, it is raised in power; it is sown a natural body, it is raised a spiritual.—Behold I show you a mystery. We shall not all sleep, but we shall all be changed. In a moment, in the twinkling of an eye, at the last trump; for the trumpet shall sonnd, and the dead shall be raised incorrupti- ble, and we shall be changed. For this corruptible must put on incorruption, and this mortal must put on immortality." Man, therefore, is not what he will hereafter be. What we discover of him here below, is only the gross foldage, under which he crawls upon the earth, and which he must shortly cast off. The animal body has np other relation than to this earth. The spiritual body will have enjoyments which " ear hath not lieard, nor hath it entered into the heart of man to conceive." New senses will be disclosed, multiplying perfections in an almost infinite de- gree. Man's sphere will be aggrandised, and he will become equal to superior intelligences. Revelation informs us it will be so; and the parable of the seed is the most expressive and phi- losophic emblem of this wonderful pre-ordination. The senses, as they are brought into subjection to the soul, will no longer rule over her. Separated from flesh and blood, there will remain in her none of those earthly affections resulting from them. Transported into the regions of light, the human under- standing will present no ideas to the will, but those of the highest good. It will then have no other than lawful desires, and God will be their constant and ultimate end. It will love him from gratitude; fear him from a principle of love; and adore him as the supremely amiable being, the eternal source of life, perfec- tion, and happiness. The Thorax, or breast, is situated between the belly and neck. The front part is commonly called the breast; the posterior part the back; and the latteral parts the right and left sides. b6 OF Till. SIR l iTURK OF Before we take notice of the internal parts, it mn\ be proper to speak of the mamma1, or breasts. These are two glandular bodies, of a round oval liiairc, most remarkable in women. The period of their growing full in the female, is about the age of fourteen or fifteen, and that ot their decreasing, fifty. The breasts are composed of a vast multitude of minute vessels to secrete the milk from the blood. These "vessels, as they approach the nipple, fall into, and form eight or ten larger pipes, connected together with admirable skill, that, in case of any obstruction or accident in any one or more of thenij the milk might not be obstructed. The swelling of the breasts, during the time of gestation, is owing to the consent between them and the womb. The cavity of the breast is lined by a fine smooth membrane, named pleura, and contains those two grand organs, the heart and lungs. The Lungs are divided into two larger portions, called lobes; the one on the right, and the other onihe left side. The vessels which enter the lungs, arc the trachea, or wind* pipe, by which we draw in the air; the pulmonary artery, which comes from the right ventricle of the heart; and the pulmonary vein, whose trunk opens into the left ventricle of the heart:— Each of these divides into two branches. The lungs differ from every other part of the body in this re- spect; the wind-pipe, in its minutest ramifications, passes through all parts of its substance, terminating every where in air vesicles, for the grand purpose of respiration, which keeps it in a contin- ued state of action and re-action. Heme, when the lungs are diseased, their motion is not only increased by the respiration be- ing quickened, but they suffer violent concussion by the means of coughing. This circumstance renders disorders of the lunga more peculiarly difficult to cure. The Heart is a strong, active, indefatigable, muscular body, of a conical figure, included in an exceedingly strong membra- nous bag, called the pericardium, or heart-purse, and situated in the cavity of the chest. It has two separate cavities, called ven- tricles, on! of which issue the two large arteries of the human THE HUMAN MACHINE. G? l>ody, one called pulmonary, or artery of the lungs, the other aorta, or large artery of the body, from which all the other arte- ries go oil', as branches of a tree from its trunk, dividing them- selves into minute ramifications in their progress. Near the mouths of these two ventricles arc two other hollows, which, from their similitude to dog's ears, are called auricles, into which the veins, returning from all parts of the body with the blood, empty themselves, through two large trunks or channels. It has two motions, called systole and diastole; the former is when it contracts itself, and thereby forces the blood into the arteries.— The diastole is when it relaxes itself, and receives the blood from the veins. The ventricles of the heart are each capable of re- ceiving an ounce of blood or more, and therefore, being- full in their diastole, we may suppose that they throw out at least one ounce of blood each systole. The heart contracts about four thousand times in an hour, more or less, according to the different temperaments, sexes, and ages; and, therefore, there pass through the heart every hour, four thousand ounces, or two hundred and fifty pounds weight of bloOd. Now the common opinion is, that the whole mass of blood docs not exceed twenty-live pounds, and, therefore, according to this allowance, a quantity of blood equal to the whole mass, passes through the heart ten times in an hour, that i.->, about an ounce every second. If the heart contract eighty times in a minute, then twenty-five pounds weight of blood pass through its ventricles once in live minutes, or twelve times ■in ail hour. The farther the blood moves from the heart, its ve- locity decreases as the artery divides into more branches, so, much so, that the blood moves 5233 limes slower in some capil- lary arteries than if does in the aorta or great artery. The blood is received from the arteries into the veins, where it still moves more slowly as it returns to the heart again. The arteries ar° OF THE STRICTURE O 1 the brain; and forms those subtile spiritous dews, which impart sense to every nerve, and communicate motion to every limb.— Part flows downward; rolls the recking current through all the lower quarters; and dispenses the nutrimental stores, even to the meanest member, and the minutest vessel. Observe, how the stately Thames, and the lordly Potomac re- fresh the forest and groves; wrater the towns which crowd their banks; and make the meadows they intersect, laugh and sing.— So, only with an incomparably richer fluid, and with infinitely more numerous streams, this human river laves the several regions of the body, transfusing vigour, and propagating health through the whole. The living flood never discontinues its interchange- able tide; but, night and day, whether we sleep or wake, still perseveres to sally briskly through the arteries, and return softly through the veins. Such astonishing expedients arc used to elaborate the chyle, to blend it with the blood, and to distribute both through the body, that the animal constitution is perfectly maintained. In youth, its bulk is increased; in age, its decays are repaired; and it is kept in tenantable condition for the soul during the space of seventy or eighty years. The doctrine taught by the immortal Harvey, the discoverer of the circulation of the blood, is, that all tlie veins of the body falling into two trunks, viz. the ascending .and descending cava, empty themselves into the right auricle of the heart. The right auricle unloads into the right ventricle of the heart, which ■throws the blood through the pulmonary artery, into the lungs,by its two iranche:-., which go to the right and left lobes. From the lungs the blood is brought back by the pulmonary veins, into the left auricle, and thence it passes into the left ven- tricle, from which it is distributed through the body by the aorta, or large artery and its brandies. These terminate in the veins of the body, which collect the blood and bring it back to the heart, l>y the two cava, or large veins. In other words, the blood is conveyed from the left ventricle of the heart, by the aorta and its branches, to the minutest and most remote parts of the body, and then, passing from the extremities THE HUMAN MACHINE. 69 of the smallest arteries into the incipient veins, circulates through them into their larger branches, and so on into the right auricle of the heart, thence into the right ventricle, whence it is forced, with the fresh supplies that it receives from the chyle in passing through the subclavian vein, into the pulmonary artery, and, af- ter circulating through, and being acted upon by the lungs, in its passage through them, is returned by the pulmonary vein, into the left auricle and thence into the left ventricle, and so on, the same round, until death concludes the progress. There is in the consideration of the organs performing the circulation of the blood, an air of grandeur that seizes forcibly on the mind, and penetrates it with the highest admiration. We perceive that the blood, every time it is returned to the right ventricle of the heart, is directly dispersed through the lungs, and immediately reconveyed to the heart, before it is per- mitted to begin a new circulation. In the study of nature through- out all her work, however complex the machine, the utility of each part ever claims the admiration of the speculative mind. The observation is beautifully illustrated on the present occa- sion, and " I believe it will be admitted by every one," says the ingenious author of the Medical Extracts, " that the blood, after having performed one round, throughout the animal economy, undergoes some new and important change in its transit through the lungs, especially requisite to support a second circulation. This change is certainly the oxygenation of the blood, and we should expect if oxygen be the natural stimulus to the heart and arteries, that their pulsation would be in proportion as the blood had access to this principle." That animal heat depends upon the action of the arteries, and the circulation of the blood in general, is very natural to imagine; because whatever increases the velocity of the circulation, wdiether exercise, friction, or disease, also increases the internal heat; whereas fainting, hemorrhage, and whatever produces a weak and languid circulation, also diminish the heat of the body. When a ligature is put around an artery, so as to prevent the blood from being carried to any particular limb, that limb be- comes colder than it was, and does not recover its natural heat, 10 70 OF THE STRUCTURE OF until, by removal of the ligature, or the expansion of the branch iw. which go off from above the ligature, the usual quantity of blood is circulated through the limb. With a new-bora infant, the first thing is to infuse into its nos- trils "the breath of life;" for until the lungs be expanded, and the venal or purple blood changed into arterial or crimson, in that organ, the heart does not contract, nor the arteries vibrate; like a clock not wound up, though sound in all its parts, remain- ing entirely at rest. In the clock, if wre wind it up, the main- spring applying its powers, all the wheels are immediately put into motion, and it marks its hours and minutes; so, likewise, in the animal machine, the blood in the lungs having imbibed the. vital principle from the air, the heart acquires its actions, the brain its energy, the nerves their sensibility, and the other sub- ordinate springs of life presently resume their respective func- tions. No organ can be severely affected without affecting the heart, and disturbing its functions; nor can the heart be in the smallest degree affected, without disturbing every function of the animal economy. But the heart is not only affected by what injures the body, but also by what ruffles the mind. Rage occasions frequent and for- cible contractions; sorrow, slow and languid ones; and there are instances of violent passions suspending the contractions of the heart altogether, and occasioning death. The heart is not only affected by whatever hurts the body or mind of the person, to whom it belongs, but also by what hurts the bodies or minds of others. But#the extent of this kind of sympathy differs greatly in different persons. In some it embraces children, friends, re- lations, countrymen, and in a certain degree, the whole human race; in others, it seems to be entirely confined within the limits of their own bodies, or at most, reaches with a blunted sensibilP" ty, no farther than to those whom they conceive to be their own offspring. While the blood is in circulation, various liquors are separated from it by a process called secretion, all these secre- tions being necessary for the health and preservation of animal •life. When it is taken from the vein by the usual mode of bleed- THE HUMAN MACHINE. 71 big, and left to itself, it soon congeals, and appears to be com- posed of two distinct parts, Called crassamentum, or solid, and serum, or liquid. In a mass of healthy human blood, about one half is crassamentum, which hath the red colour to itself. The serum in a healthy state is almost colourless; at other times it is yellowish, or of a greenish hue, while the top of the crassamen- tum has different degrees of firmness, and puts on different ap- pearances, with respect to colour, according to the constitution and health of the subject, from which it is taken. A due pro- portion of the respective parts of the blood is necessary to per- fect health. The Diaphragm, or Midriff, is a large, thin, broad muscle, that divides the breast from the belly. The uses of the midriff are, first, to assist in respiration; for, hi taking in the breath, it js pressed downwards, and in expira- tion, it rises upwrards into the cavity of the breast; secondly, to assist the necessary motions of the stomach, intestines, liver and spleen; and for assisting the expulsion of the faeces, the urine, the foetus in parturition, and of the secundines or after birth.— It marks our passions by its irregular actions, as sighing, yawn- ing, coughing, laughing. It is affected by spasms as in hiccough. The Abdomen, or Belly, lies between the breast and pelvis which is formed by the juncture of the haunch bones. The belly contains many of the principal parts of the human body, as the stomach, the intestines, liver, spleen, pancreas, kid- neys, bladder, &c. On its inside, it is lined with a membrane called peritoneum, which is capable of a very great extension; and afterwards can contract itself to its ordinary size, as we see in pregnancy, dropsy, corpulency, and repletion. The Stomach may be considered a dilatation of the oesophagus or gullet, as it is a continuation of the same tube. Its figure near- ly resembles the pouch of a bag-pipe, and has two orifices, the one above from the gullet, through which it receives the crude aliment, the other below, whereby it conveys the partially di- gested food or chyle into the duodenum. Before the food enters the gullet, it must of necessity pass over ihe orifice of the wind-pipe; consequently must he in very immi- 73 OF THE STRUCTURE OF nent danger of falling upon the lungs, which would, if not entire- ly obstruct the breath, yet occasion violent coughing, and great inconveniencies To obviate this evil, the all-foreseeing Con- triver has placed a moveable lid, or hung a cartilaginous draw- bridge; which, when any of the smallest particle of food advances to enter the stomach is pulled down, and shut close; but the very moment the morsel is swallowed, it is set loose and stands open. By this two-fold artifice, the important passage is always barred and made sure against any noxious approaches; yet is always left free for the necessary accession of air, and commodious for the purpose of respiration. When the malster prepares his grain for the transmutation of the brew-house, he suffers it to lie several hours steeping in the cistern, before it is fit to be spread upon the floor, or dried on the kiln. The meat and drink likewise must remain a consider- able time in the stomach before they are of a proper consistence and temperature, either for the tender coats, or the delicate ope- ration of the bowels. For which purpose that great receiver is made strong to bear, capacious to hold, and so curiously contri- ved, as to lay a temporary embargo upon its contents. Here they are lodged in the very centre of warmth, and concocted by the most kindly combination of heat and humidity. Here they are saturated with other fermenting or diluting juices; and are knead- ed, as it were, by the motion of the stomach, and compression of the neighbouring parts. So that every the minutest fragment is separated; the whole is reduced to a tenuity abundantly finer than the exactest grinding could effect; and all is worked up into the smoothest, most nicely mixed pulp imaginable. From hence it is dislodged by a gentle acting force, and passes by a gradual tran- sition, into the cavity of the intestines. The Intestines form one continued canal from the stomach to the anus, which is usually five or six times the length of the in- dividual. It is curiously convoluted in the abdomen, and is ex- tremely irritable. Although one entire tube, anatomists have di- vided it into the small and great intestines. The small intestines are called duodenum, jejunum,and ilium; the larger arc the caecum, colon, and rectum. THE human machine. 73 The duodenum, so called, because it is generally twelve inches long in adults, is the widest and shortest of the small intestines. At a short distance from where it joins the stomach, it receives two ducts, the one from the liver, bringing the bile, and the oth- er from the pancreas, or sweet bread, bringing its liquor to com- plete the digestion of the food. The second gut is the Jejunum, so called, from its being usually found empty, its numerous lacteal vessels having absorbed the chyle. The Ilium is the third and last of the small'intestines. The great length of the small guts is evidently for the convenience of a greater number of lacteals, that the chyle which misses their orifices in one place may not escape them in another. The Caecum, or blind gut, is a pouch, as it were, of the Co- lon, about three inches long, and called blind, from its being out of the direction of the passage of the food. The Colon is the greatest and widest of all the intestines, about eight or nine hands' breadth long, and by lying so contiguous to all the bowels, it communicates all the benefits of the injections thrown into it. When the Colon is affected, there is a sense of weight though the pain is not very acute; whereas in the small guts there is not any sense of weight, but an acute pain. Sometimes a pain in the colon attended with fever, the pain extending to the ribs, gives a suspicion of pleurisy, though the colon only is affected. The colon is narrower on the right side than elsewhere, whence colic pains arise more frequently, and are more severe in this part.— The excrements are long retained here, and often are much in- durated before they pass farther on. The Rectum, or straight gut, is about a hand's breadth and a half long. It begins where the last curvature of the colon ends, and is terminated at the fundament. At its termination it is sur- rounded by circular muscular fibres, called the sphincter ani, to retain the fasces. The intestines are not left to move at random in the cavity of the abdomen, but are artfully tied down by a membranous web, which prevents their circumvolutions from being entangled in each other, at the same time allowing a gentle, but animated motion. That part of it connected with the small intestines is 14 0 1 THE STRUCTURE Ol called mesentery, the other part fastened to tire colon, mesocolon: All the intestines have in their inner membrane an almost infinite number of very small glands, whose office it is to discharge into the intestines a liquor for tlve attenuation of the chyle, for lubri- cating the intestines, and in the large guts to soften the tiee.es, that they may be evacuated without pain. The intestinal canal serves to complete the first digestion, strain off the chyle, and carry oft the faeces. Had the intestines been straiglit and slwrt, the food might have gone through them, without resigning a sufficient quantity of its nourishing particles. Therefore this grandest of all the vital ducts is artfully convolved, and greatly extended, to afford an opportunity of sifting more thoroughly whatever passes, and of detaining whatever may serve its purposes. Though the ali- mentary substance can never mistake its way, yet it may, through some accidental impediment, attempt to return backward. In this case a valve intervenes, and renders what would be extreme- ly pernicious almost impracticable. Upon a survey of the use of the stomach and intestines, we cannot avoid being struck with wonder at its apparent simplicity answering so many salutary purposes. As soon as we take our food, it is received into a place in all points calculated to render it fit for yielding its nutritious contents. At first, the food taken into the stomach, retaining its peculiar properties, irritates the coat of that organ, and occasions a contraction of its two orifices. The food thus confined, then undergoes a constant agitation by means of the abdominal muscles, and of the diaphragm, and by the motion of the fibres of the stomach itself. By these move- ments, every part of the food is exposed to the action of a fluid secreted in the stomach, called the gastric juice, which gradually dissolves and attenuates the food, and prepares it for its passage into and farther change m the intestines. The painful sensation of hunger, which is the irritation of the gastric juice on the coat of the stomach, or a sensation of a de- fective supply of chyle in the arterial s)stem, being removed by the food, we soon feel a mild and undescribable delight, first, from the stimulus of the aliment; and secondly, from the distension of this, and the increased action of other parts THE HUMAN MACHINE. 75 The aliment having remained during two or more hours in the stomach, is converted first into a greyish pulp, which is called chyle. This fluid passes out of the right orifice, the fibres of which relax to allow it to escape; while the grosser and less al- tered particles remain in the stomach till they acquire a sufficient fluidity to pass into the intestinal canal. As the digested food enters the duodrmum, it stimulates the common duct of the gall- bladder, from which it receives a full supply of bile and of saliva, secreted from the pancreas. The Chyle, drawn off by all the secretory orifices, is carried along millions of the finest ducts, and lodged in several commo- dious cells. As a traveller, by taking proper refreshments on the road, is better qualified to pursue his journey; so the chyle, di- verted to those little inns, is mixed with a thin, diluting watery substance, which renders it more apt to flow, and more fit for use. Hence it is conveyed to one common receptacle, and mounts through a perpendicular tube. When provision or ammunition is transmitted to an army, it generally passes under an escort ofable troops. As this is the immediate support and principal nourish- ment of the whole system, its conveyance is guarded with pecu- liar caution. The perpendicular vessel that conveys it, not hav- ing sufficient force of its own, is laid contiguous to the great ar- tery, whose strong pulsation drives on the creeping fluid, enables it to overcome the steep ascent, and unload its precious treasure at the very door of the heart. Here it enters the trunk of a large vein, secured by a valve, admirably constructed to prevent the refluent blood in case it should offer to return, and opening a free, safe, and easy avenue to introduce this milk, this manna of nature. The Blood, through every stage of its simple circuit, having sustained great expenses; being laid under contribution by every gland in the whole system; and having supplied myriads of the capillary vessels with matter for insensible perspiration, must be very much impovcrislied; but is most opportunely recruited by this accession of chyle. Besides the uses above specified, appropriated to the stomach and intestines, there is another very considerable bestowed, par- ~6 OF THE STRUCTURE O I ticularly on the former, by which impressions arc diffused to al- most every part of the machine, and from which all the sensible parts receive very peculiar and extraordinary advantages; namely, conveying action to different parts, and feeling the effect from these sympathetically and instantaneously. For instance, a glass of wine or brandy, received into the stomach of a person ex- hausted with fatigue and ready to faint, gives instantaneous spirits and fresh vigour. This must proceed from the affection of the nerves of the stomach, and their sympathy with the rest of the body, as there is not time for the liquor to be conveyed into the blood in the usual manner. The Stomach universally sympathises with other parts of the body. A blow on the head occasions vomiting. A disordered stomach often excites a head-ache. The head-ache, which is apt to come after drinking too much wine, or other strong liquors, certainly proceeds from the stomach, and sometimes is diminished or entirely removed by a dram. A stomach disordered by indi- gestion is often accompanied with flushings in the face, palpita- tions at the heart, difficult breathing, dejection of spirits, uncom- mon sensibility, and with giddiness. The Omentum, or Caul, is a fine membrane like net-work, lard- ed with fat. It is situated under the peritoneum, and immediate- ly above the intestines, on the surface, resembling an apron tucked up. It serves to lubricate the intestines, that they may the easier perform their peristaltic motion, to cherish and defend them from cold, and to assist in the formation of the bile. It serves also to temper the acrimony of the humours, and probably, to give nou- rishment to the body, as all the other fat is supposed to do, when it is incapable of being nourished any other way. The Liver, situated immediately below the diaphragm or mid- riff, on the right side, reaches as far back almost as the spine, or back-bone, and rests upon the right kidney. It is the largest gland in the body, and is divided into two unequal parts, called lobes. Except for the vessels, which are very numerous, the liver would be very soft, and like a piece of congealed blood. The great use of the liver is to secrete the bile. It is the scat of various disorders, inflammation, abscess, scirrluis, &o. and in THE HUMAN MACHINE. 77 most of them, the countenance hath a pale colour, or a yellowish one with a green cast. There is one circumstance not much at- tended to with respect to the situation of the liver; its large or right lobe occupies the whole half of the belly, where it lies from the spine to the inside of the ribs, laying over the upper part of the kidneys. Now this position of the liver is not often considered, for when one has a pain in the small of the back, it is said to be in the kidneys; but if it be a little higher up in the back, it is seldom, if ever, thought to be in the liver, though it most undoubtedly may, as its posterior edge lays on that part, on the right side. The Gall Bladder, or receptacle of bile, is fixed to the under side of the liver. Punctual as a porter in his lodge, it waits, ready to pour its acrimonious, but salutary juices on the aliment^ as it advances from the stomach; which dissolve its remaining viscidities, support the peristaltic motion of the intestines, and greatly assist in completing the digestion. Such is the importance of the bile in our constitution, and the ill consequence of an error in it, that every aid is desirable, by which our knowledge of its nature can be promoted. When there is a defect of bile, it disposes the body to various diseases; as melancholy, indigestion, and obstruction of the viscera, &c. When there is a redundancy of bile, or it offends the stomach by its acrimony, it causes chilliness, shivering, and great anxiety.— It is certain, that in fevers the bile is not only plentifully gene- rated, but peccant in its quality; and if not duly evacuated, must be productive of many disagreeable symptoms; hence the im- portance of a soluble belly in febrile disorders. The Pancreas, or Sweet Bread, a large gland, situated near the stomach, serves to secrete a liquor like the saliva, which is dis- charged, by a short duct into tlie duodenum. The Spleen is situated under the cartilages of the left short ribs. In its natural and sound state, it is about six or seven inches long, about three in breadth, and one in thickness. It often be- comes scirrhous and considerably enlarged in persons who have been frequently attacked with intermittent fever. Its use is not pjecisely known'. 11 <■• 78 OF THE STRUCTURE OT The Kidneys are two oval bodies, situated in the loins, conti- guous to the two last short ribs; the right under the liver, and the left under the spleen. They separate the urine from the blood. The Ureters are tubes about the size of goose quills, and about a foot long; rising from the kidneys, and entering the bladder near its neck. They form to themselves, as it were, valves, so that, upon the contraction of the bladder, the urine is ejected through the urethra, its proper passage. The Bladder is a membranous and fleshy sack or bag, capable of contraction and dilatation, situated in the lower part of the belly. Around its neck, which is longer in men than in women, there goes a small sphincter muscle, to contract the orifice, that the urine may not be involuntarily discharged. The use of the bladder is to receive the urine, perpetually secreted into it from the kidney^ The Uterus, or Womb, between the urinary bladder and the rectum, or straight gut, is placed, by Divine Wisdom, in a situ- ation of great security, called the pelvis or basin, being guarded on all sides by the strong bones that form the basis of the trunk. In figure, it very much resembles a pear, its broadest extremity, which is called its bottom, is uppermost, and its small part, the neck, is downwards. The womb, when impregnated, hath a very small cavity, but becomes larger as pregnancy advances, and, in the time of delivery, has its mouth wonderfully dilated, so as to give passage to the child. About the age of puberiy, the blood vessels of the uterus be- come distended, and secrete monthly a fluid called menses, cata- menia, and vulgarly, flowers, courses. The Vagina, or Neck of the Womb, extends from the mouth of the uterus to the pudendum or external parts. In women it enlarges, and, like the uterus, in the time of birth, dilates very much. Just within the vagina is the orifice of the urethra, which is shorter, wider, and straighter than in men. Besides the womb and vagina, there are two other contrivances supposed to perform particular functions, hen wc consider the extensive contrivance and delicate me- chaniim—what plans of geomeiry have been laid; what opera- tions of chemistry are performed; in a word, what miracles of art and elegance are executed, in order to furnish us with the necessary recruits and the several deliglits of life—is there not THE HUMAN MACHINE. 83 abundant reason to cry out with the inspired writer, uHow dear arc thy counsels unto me, O God!" thy counsels of creating wisdom! Thou hast not been sparing, but even lavish of thy indulgent de- signs! Thou hast omitted no expedient which might establish my ease, enlarge my comforts, and promote, yea complete, my bodily happiness! and is not this a most endearing obligation to glorify tlie blessed Goo with our bodies, as well as with our spirits? The mechanism of our body; the connexion and subserviency of all its parts to a common purpose; the exquisite contrivance of its organs, consisting of such various minute vessels, inter- woven with wonderful art, have led anatomists, in all ages, to acknowledge an infinite, wise and powerful Maker. Among the most precious remains of antiquity, are those commentaries of Galen, written on the uses of the several parts of the human bo- dy, as hymns and offerings of praise to the great Creator. Is it, indeed, otherwise conceivable how such consistency and harmony could have taken place in the different parts of our wonderful frame? How they could haye been so exactly fitted to each other, and to the exterior objects which have an evident relation to them, and the system they compose?, Could the bones, whicli in all amount to four hundred, and the muscles still more numerous, and each so well disposed for motion, be adjusted without a superior knowledge in mechanics? The eye, so ad- mirably adapted to light, and appropriated to vision, was it form- ed without a knowledge of optics? or the ear without the sci- ence of sounds? Even our inclinations and passions, those sources of so much apparent ill, are by the Deity providentially rendered the means of our preservation, both as individuals and a race; and the selfish and social affections, like centripetal and centri- fugal forces, conduct us with proper force, to the end intended by our Maker to be produced by them. Yet the love of life and all its enjoyments, the fear of death and all its dreadful har- bingers, and the social affections and all their endearments, would not have been sufficient security for our carrying on the vital mo- tions with that constancy and uniformity necessary to the preser- vation of life, if thus engaged these motions had depended upon our will and choice. Reason would have deliberated concerning 5i Ol THL STRICTURE OF thehi with too much slowness, and volition would have executed often with a dangerous and fatal caprice. For, if the heart had been subject to the souls authority, as much as the voluntary muscles are; if its motions could have been suspended or stop- ped with the same facility, death would then have cost us no painful pang; and, whenever the body was tortured with disease, and the. mind in anguish from grief or disappointment, a remedy so casilj applied might have been too frequently resorted to, and yet more unfortunate beings might have rushed uncalled into the presence of Him who stationed us for tho wisest reasons here on earth.— The preservation of life, therefore, greatly depends on our vital- motions bciiiic entirely subject to the wise government of the Au- thor of our lives, who charges I Iemseli with the immediate care of ihem and of us. All this, when attentively considered, must a licet us with a sense of (ion's goodness; who, respecting the imbecility of man's nature, hath been pleased, by appetites and passions, to excite him to acts of self-preservation; where the violence of these might have been hurtful j no less than the slow- ness and instability of reason, hath taken our safety under his more immediate direction. To attribute contrh iinces like these, and e\en understanding itself, to unintelligent causes, rather than to the all wise Parent of Nature, seems an incomprehensible perversion of reason and philosophy. That mind must be strong- ly prepossessed and bewildered with false science, which rather seeks for the cause of these involuntary motions in dead matter, organization, chance, necessity, something that, without know- ledge or power, acts wisely and powerfully, than in the great fountain of power, wisdom, and animation. If chance could be supposed to produce a regular determinate action, yet it is beyond the highest degree of credulity, to sup- pose it could continue (his regularity for any time. But we find it remains through life, independent of our will; and the same in- cessant vital actions have been carried on from the commence- ment of the world. It is thus that the sun's influence upon tlie earth hath ever been regular. The production of trees, plants, and herbs ever uniform. Every seed produces now the same fruit it ever did. Every species of animal life is still the same. THE HUMAN MACHINE. gjj Could chance continue this regular arrangement? Could any thing continue it, but the hand of an Omnipotent Creator? The human body is exalted to a most intimate and personal union with the eternal Son of God. He who deeorated the heaven with stars, and crowded the stars with lustre; He vouch- safed to be made flesh, and was found in fashion as a man. Nay, this is even now the apparel of that divine and adorable person. He is clothed with our nature; he wears our very limbs; and appears in the dress of humanity, even at the right hand of God, and at the head of all the heavenly hosts. What think you of another privilege mentioned by the Apostle? " Your bodies are the temple of the Holy Ghost." Not your souls only, but your very bodies are the shrine in which the high and holy one, that inhabiteth eternity, condescends to dwell. He, who sitteth between the cherubim and walketh in the circuit of the skies, is pleased to sanctify these earthly tenements for his own habitation. And is not this a much grander embellishment, than all their matchless contrivance and masterly workmanship? Nor must I omit the dignity—the transcendant dignity, which is reserved for these systems of flesh at the resurrection of the just. They will-then be refined and improved into the most perfect state, and the most beauteous form; surpassing whatever is re- splendent and amiable in the most ornamental appearances of material nature. They will be purer than the unspotted firma- ment; brighter than the lustre of the stars; and, which exceeds all parallel, which comprehends all perfection, they will be made like unto Christ's glorious body; like that incomparably glorious body which the blessed Jesus wears in his celestial kingdom, and on his triumphant throne. When we add all these magnificent prerogatives which are re- vealed in Scripture, to all those inimitable niceties which are dis- played by anatomists, what thankfulness, what admiration can equal such a profusion of favours? Say why was man so eminently rais'd Amid the vast creation, why ordain'd Through life and death to dart his piercing eye, 12 86 of the structure of, kc. With thoughts beyond the limit of his frame? But that the Omnipotent might send him forth, In sight of mortal and immortal powers, As on a boundless theatre, to run • The great carreer of justice; to exalt His generous aim to all diviner deeds; To chase each partial purpose from his breast, And through the tossing tide of chance and pain, To hold his course unfaltering, while the voice Of Truth and Virtue up the steep ascent Of nature, call him to his high reward, The applauding smile of Heaven.—Akensidb. ON HYGIEINS; OR, THE ART OF PRESERVING HEALTH. Reason's whole pleasure, all the joys of sens*, Lie in three words—Health, Peace, and Competence. But Health, consists of temperance alone, And Peace, 0 Virtue, Peace is all tny own.—Pope. In the preceding chapter I have treated of the structure of the Human Body. I shall now show, that by due attention to the " Non-naturals," air, food, exercise, sleep, evacuations, and passions, we may go far to preserve this fabric in good health from the cra- dle to the grave. Nay, so wonderful is the body in its resources, its powers of renovation; and so sovereign are the virtues of the Non-naturals, that thousands are the instances of persons who, after having their health apparently ruined by an abuse of them) have, on returning to a wise and temperate use, entirely reco- vered their health, and attained to a most active and happy old age. Hence the reason mankind are so often sick, is because they so often err in the use of these the appointed preservatives of life and health. 88 ON HYGIEINE, OR THE ART To inculcate this truth more universally, 1 have introduced these disquisitions on the art of preserving health, and, to render them more acceptable to my readers, have enlivened them with appropriate illustrations, hoping thereby to make impressions as» lasting as they are important. OF AIR. Tnou cheerful guardian of the ruling year, Whether thou wanton'st on the Western gale, Or shak'st the rigid pinions of the North, Diffuses life and vigour through the tracts Of air, through earth and ocean's deep domain. Without thy cheerful active energy No rapture swells the breast; no poet sijogs; No more the Maids of Helicon delight. Come then with me, 01 Goddess heavenly gay!. Begin the song; and let it sweetly flow, And let it sweetly teach thy wholesome laws; " How best the fickle fabric to support Of mortal man: in healthy body how A healthful mind the longest to maintain."—Armstrong. As soon as an infant enters the world, the air rushes into its lungs, the circulation of the blood through that organ commences, and its life from that moment depends " on the breath that is in its nostrils," which is incessantly taken in and thrown out of the lungs. While the child remained in the womb, it required no external air, because it existed in the blood which was received from its mother through the umbilical cord, or navel string- But as soon as the infant is born, the air is inhaled, and the circula- tion is determined through the lungs, which ever after continues in that way—and hence the necessity of breathing, which can never cease but with life. Since, then, air is the main instrument of vitality, both to man and all creatures, it certainly must be a most pleasing and profita- ble study to acquire correct ideas of this great element OF PRESERVING HEALTH. 89 By the unlettered part of mankind, the vast atmosphere which surrounds our globe, to the depth of two and thirty miles, is supposed to be one simple, colourless, invisible mass, without any essentia! difference of qualities, and without weight. But it is a gross mistake; for instead of being a simple uniform element, it is composed of several parts, some of which are widely different from each other. We have, too, numberless proofs of its weight; like other bodies falling to tlie earth, and becoming more dense as it approaches its centre. Every one knows that air on the tops of high mountains is much thinner than it is below in the val- leys, but the weight of air is susceptible of demonstration by positive experiment. Having exhausted a thin glass flask, and suspended it at one end of a balance, which being nicely counterpoised by wreights jn the other scale; this done, admit the air into the flask, into which it will rush with a noise, and though the flask was balanced before, it will now, upon admission of the air, preponderate. If the flask hold a qaurt, it will be found that the weight of the air it now contains is about seventeen grains, so that a quart of air weighs about seventeen grains. We will mention another experiment, easily put into practice, Some w*ater being poured into a saucer, burn a bit of paper in a tea-cup, which by rarifying, will exhaust and make a vacuum in the cup. Then while the paper is yet burning, turn it hastily down, paper and all, into the saucer, and the air without will press the water up from the saucer into the cup. The water will stand within the cup in a column; and if the cup were thirty-two feet high, and the air within it perfectly exhausted, the water would rise to that height in it, as we have said before. This satisfactorily accounts for the rising of water in pumps, or the standing of the quicksilver in the barometer. If further proof be necessary to show the weight of that great ocean of air, which constantly surrounds us, let a man take a thick glass tube, such as is put over lamps, and place it upright on a table having a small hole in it for an air pump. Then let him place bis hand closely over the top of the tube, while a friend with the 90 ON HYGIEINE, OR THE ART pump extracts the air, and he shall find that as the air on the in- side is removed, the air on the outside will'press his hand down with much violence. Nor will he be surprised at this pressure of the air, when he comes to learn that a column or pillar of air, of only one inch diameter, and thirty-two miles high, which is the depth of the atmosphere from its top above the clouds to the ground, weighs about fourteen pounds. If the hand of the person, which covers the top of the tube, measure ten inches square, the pres- sure on it will be about one hundred and forty pounds—sufficient in all conscience to crush every bone in the hand. By the same token, a square foot of such a column of air would weigh near two thousand pounds, and as a common sized man measures about fourteen square feet, it is a fact, as curious as it is awful, that every such person bears constantly on his body a weight of four-" teen tons, or twenty-eight thousand pounds of air. Some per- sons may doubt this from the conclusion that such a weight would crush every man to pieces. So it would, if it were to press sole- ly on any particular part. But this conclusion instantly falls to the ground, when it is recollected, that this pressure of the air is uniform and equal all around him, the air pressing as strongly from below as from above; from one side as from another; thus causing the various pressures most exactly and admirably to counterpoise each other; of this we see a wonderful instance in the case of fishes in the ocean. One of these animals at a great depth under water, would be crushed to atoms, if all that heavy element pressed only on his back. But the God who made him has so kindly attended to his safety, as to cause the water that surrounds him from below to press upwards as strongly as that from above to press downwards. There is another reason why our bodies are not so sensible of the tremendous weight of air, which thirty-two miles deep presses upon us; it is simply this, all bodies are full of air; and the air within pressing against that wdthout, preserves even the most delicate bodies uninjured. A bladder, or even a bag of oiled paper, if filled with water, remains perfectly unhurt, though a hundred fathoms below the surface of the sea; because the water within furnishes a full re- sistance to the water without. But take away this resistance. O F P R E S G R V I N G II E A L T H . 91 lVom within, and you shall find that the slightest pressure will bring the two sides together. According to the late discoveries in Chymistry, the atmos- phere consists of three different species of air—namely, pure, respirable, or dephlogisticated air; azotic, or phlogisticated air; and fixed, Or carbonic acid air. The proportion of the first, namely, pure or vital air, consists, according to the French Chymists, who have given it the name of Oxygen, of 27 or 28 in the hundred parts; the second, the Azote of the French, of 72 or 73 in the hundred; and the third, namely, the Carbonic acid air, of about one part only in the hun- dred. Oxygen is much better adapted to the respiration of animals than common atmospheric air. If two animals be enclosed in vessels, one of which contains pure Oxygen and the other com- mon atmospheric air, in proportions equal to the size of the ani- mals, the former in the Oxygen will be found to live six or seven times as long as the latter in common air. It is properly this Oxygen which we inspire, and which is the grand support of animal life. Persons apparently dead, or in a state of suffoca- tion, have been instantly restored to life, by its influence; and from the corresponding testimony of several respectable physi- cians, it appears to have been employed with advantage in many obstinate diseases. The celebrated Ingenhouz, therefore, gave it the name of vital air.. It promotes combustion in a very high degree. A candle will burn in it from six to seven times longer than in common air, with a much greater degree of heat, and a more brilliant flame. Bodies in a glowing state are immediately inflamed, when put into Oxygen gas; and even metals, which are not very fusible, are melted in it with the greatest facility. Azote, by others called phlogisticated, mephitic, corrupted,1 or suffocative air is absolutely unrespirable, and not miscible with water. It arises from the change which atmospherical air under- goes in every process of combustion, putrefaction and respiration, ^-feether produced b\ nature or art &2 0> HYGIEINE, OR THE ART Azote enters into no combination with water, but may be ren- dered less hurtful by shaking it with that fluid. This accountn in some measure for the salubrity of the sea-air. It greatly pro- motes the growth of plants, and readily accumulates in apart- ments filled with people, or containing articles fresh painted with oil colours, or in which strongly fragrant flowers are kept with- out having any accession of fresh air. We should be extremely cautious in entering such places, as diseases of the breast and lungs are too frequently the consequence of neglect or ignorance The Carbonic acid air, or fixed air, is miscible with water, but in its pure state is equally unrespirable as the Azote. It derives its origin, partly from the vinous fermentation of vegetables and some animal substances, and partly from the mild alkaline salts and earths combined with acid. Much of this air abounds in mines, where it frequently distresses the workmen by its suffo- cating effect. It is also observed in most mineral waters, where a stratum of it sometimes floats upon the surface of the well.— These waters, as well as fermented liquors which contain a con- siderable portion of fixed air, receive from it that well known pungency so agreeable to the palate. Hence flat and spoiled beer or wine, may be corrected and restored to its former brisk- ness, by the addition of fixed air evolved from chalk and vitriolic acid; or by mixing it with new beer, or wine in a state of fer- mentation. As this species of air quickly extinguishes fire, animals cannot live in it. These three aerial bodies, though blended together, arrange themselves, in some degree, according to their specific gravities; that is, the proportion of azotic air, which is the lighter body of the three, will be found most in the upper part, the oxygen air in the middle, and the fixed air will be found most in the lower part of the apartment. This occasions a circulation in the air, the rarified air will ascend, the fixed air sink, and the colder and purer air rush into the apartment through every crevice. To render the circulation of the air plain to sense, if the air of a room be heated by a fire, whilst the air in the i?ext room is cold, OF PRESERVING HEALTH. 93 and the door between opened, the hot air of one room being rari- fied, will pass through the upper part of the opening of the door into the cold room; and on the contrary, the cold air of the other room being heavier, will pass into the former through the lower part of the opening. This may be proved by applying a candle at the upper and lower openings between the two rooms. The di- rection of the flame of the candle will point out the contrary currents of air. It is for this reason, that when a fire is lighted in a chimney, a strong current of air enters the room, which may be felt by applying the hand near the key-hole, or other small openings if the door and windows be shut. A fire is said to purify a room; but this it does partly by drying the dampness of the room, and chiefly by promoting the circulation of the air. The fire does pot perform such service by purifying the bad air, but by re- moving it, and substituting that which is fresh and wholesome. Hence it appears that those persons are mistaken, who are over anxious to keep air from the apartments of convalescent per- sons, studiously stopping, by list, linings, and sand bags, all the smallest openings tlvat admit fresh air. Unless the air were constantly renewed, persons would be ex- posed to the most fatal accidents in large assemblies or crowded rooms. A rout was lately given at a celebrated bathing-place, or spring. The room was small and the company very numerous. They had not been long seated at the card tahles, before a young gen- tleman and lady, both in delicate health fell into a swoon. The doors and windows were immediately thrown open, to afford fresh air, which quickly dissipated the alarm, by reviving the young invalids. A physician present, telling one of his medical companions how severely he himself had suffered from the air of that vile oven, and that he had made up his mind to wrrite a bitter phillippic against Routs, was archiy answered by his friend:— " Let them alone doctor, how otherwise should twenty-six physi- cians subsist in this place?" A further illustration: Take a room thirty feet by twenty-five, and tliirty feet h:gh, capable of containing one hundred persons. Vow, since each person consumes about five cubic lect of air in an hour, that is. deprives -iurha quantity of air of its OA\ire!i. or vital 18 94 ON HYGIEINE, OR THL ART principle, it would follow, that, as such a room could contain onlv twenty-two thousand five hui.dred cubic fc<-t of air, unless the air was constantly renewed, it would be rendered completely mephitic or noxious in about four hours and a half, and it is pro- bable that the greater part of the company would he seriously incommoded, or even perish long before that time. The following affecting narrative is a melancholy confirmation of tips fact. In the summer of 1756, the British settlement of Calcutta, in India, was attacked by the natives under the viceroy Rajah Doulah, a young man of the most violent passions, and without the least sense of honour or humanity. After a most ob- stinate resistance, the little garrison surrendered themselves pri- soners of war, on a solemn promise from the Rajah of the most honourable treatment. But no sooner had the monster got them in his power, than, utterly regardless, of that due to honour, hu- manity, and a brave enemy, he barbarously drove them all into a dark shallow vault under ground, called the black hole, only eigh- teen feet square. The number of the unfortunate men, thus cru- elly immured, was one hundred and forty-six, with their gallant commander, Colonel Hoi well, the historian of the following trage- dy. The humane reader may form some idea of one hundred and forty-six poor fellows, many of them badly wounded and bleeding, and all worn out with the fatigue, and covered with the dust and sweat of a hard day's fighting, crammed together, on a hot sultry evening, into a small dirty hole, eighteen feet square, with only two little windows, and those obstructed by strong iron bars. A profuse sweat quickly broke out on every individual, attended with an insatiable thirst, which became the more intolerable as the body was drained of its moisture. It was in vain they strip- ped off their clothes, or fanned themselves with their hats. A difficulty in breathing was next observed, and every one panted for breath. Colonel Holwell, wdio was placed at one of the win- dows, called to the sergeant of the guard, and after striving in excite his compassion by drawing a pathetic picture of their sufferings, promised him a thousand rupees in the morning, pro- vided he could find means to remove some of his people into another place of confinement. The sergeant, allured by the pro OK PRESERVING HEALTH. 95 mise of so mighty a reward, assured him he would use his utmost endeavours, and retired for that purpose. What must have been the impatience, at this time, of these un- fortunate objects? In a few moments the sergeant returned, with the woful tidings, that the viceroy was asleep, and no man durst disturb his repose! The despair of the prisoners now became outrageous. They endeavoured to force open the door, that they might rush on the swords of the monsters, by whom they were surrounded, and who derided their sufferings; but all their efforts proved ineffec- tual. They then used execrations and abuse to provoke the guard to fire upon them. The captain of the guard was at length moved to compassion. He ordered his soldiers to bring some skins containing water, which by enraging the appetite, only served to increase the gen- eral agitation. There was no other way of conveying it through the windows, but by hats; and this mode proved ineffectual, from the eagerness of the wretched prisoners who struggled for it in fits of delirium. The cry of water! water! issued from every mouth. The consequence of this eagerness was, that very little fell to the lot even of those who stood nearest the window; and the most fortunate, instead of finding their thirst assuaged, grew more impatient. The confusion soon became general and horrid: all was cla* mour and contest; those who wrere at a distance, endeavoured to force their passage to the window, and the weak were pressed down to the ground, never to rise again. Colonel Holwell, observing now his dearest friends in the agonies of death, or dead, and inhumanly trampled on by the • living, finding himself wedged up so closely as to be deprived of all motion, begged, as the last mark of their regard, that they would for one moment remove the pressure; and allow him to retire from the window, and die in quiet. Even in such dreadful circumstances, which might be supposed io have levelled all distinction, the poor delirious wretches, ma- nifesting a respect to his rank and character, immediately gave way, and he forced his passage into the centre of the place, which was less crowded, because, by this time, about one thirtl 96 ON HYGIEINE, OR Til l, ART of the number had perished, while the rest still pressed to both whm\'Wh. He retired to a plal form at the farther end of the room, and lying down upon some of his dead friends, recommended his soui to the mercy of its Creator. He:-e his thirst grew insupportable; his difficulty in breathing increased; and he was seized with a strong palpitation at the heart. These violent symptoms, which he could not bear, urged him to make another etlbrt. He forced his way back to the window, and cried aloud, u Water! for God's sake, a little water!" He had been supposed already dead by his wretched compan- ions, but finding him still alive, they exhibited another extraor- dinary proof of regard to his person. "Give him water," they Cried; nor would one of them attempt to touch it, until he had drunk. He now breathed more freely, and the palpitation ceased; but finding himself still more thirsty after drinking, he abstained from water, and moistened his mouth, from time to time, by suck- ing the perspiration from his shirt sleeves, which tasted soft, pleasant, and refreshing. The miserable prisoners now began to perceive that it was air, and not water that they wanted. They dropt fast on all sides, and a strong steam arose from the bodies of the living and the dead, as pungent and volatile as hartshorn. Colonel Hoi well, being weary of life retired once more to the platform, and stretched himself by the Rev. Mr. Bellamy, who together with his son, a young lieutenant, lay dead, locked in each other's arms. In this situation he was soon deprived of sense, and seemed to all appearance dead, when he was removed by his surviving friends to one of the windows, where the fresh air brought him J^ack to life. The Rajah being at last informed that the greater part of the prisoners were suffocated, enquired if the chief were alive, and being answered in the affirmative, sent an order for their release, when no more than twenty-three survived, of one hun- dred and forty-six, who entered into this prison. How many melancholy instances of a similar kind have occur- red on board vessels engaged in that most abominable and diabo- lical traffic, the slave trade. OF PRESERVING HEALTH. 97 iVIy soul is sick with every day's report Of wrong and outrage with which earth is filled: There is no yielding flesh in man's hard heart, It does not feel for man. The nat'ral bond, Of brotherhood is sever'd, as the flax That falls asunder at the touch of fire. He finds his fellow guilty of a skin Not coloured like his own; and having power To enforce the wrong, for such a worthy cause, Dooms and devotes him as a lawful prey. Thus man devotes his brother; And, worse than all, and most to be deplored, As human nature's broadest, foulest blot, Chains him, and tasks him, and exacts his sweat With stripes, that mercy with a bleeding heart Weeps when she sees inflicted on a beast. Then wdiat is man? and what man seeing this. And having human feelings, does not blush And hang his head, to think himself a man? I would not have a slave to till my ground, To carry me, to fan me while I sleep, And tremble when I wake, for all the wealth That sinews bought and sold have ever earned. Cowper. To mention no other fact, a strong proof of the necessity of the frequent renewal of air may be found in the records of the Dublin lying-in hospital. In this hospital two thousand nine hundred and forty-four in- fants out of seven thousand six hundred and fifty, died in the year 1782, within the first fortnight after their birth, which is nearly every third child! They almost all died in convulsions, or what the nurses call ninth day fits, because they came on nine days after their birth. Many of these children foamed at their mouths, their thumbs drawn into the palms of their hands, jaws locked; and faces swelled and blue, as though they were choked. The last circumstance led Dr. Clark to conclude that the rooms «vere too close and crowded. That benevolent physician con- 9S ON HYGIEINE, OR THE ART trived therefore air-pipes, by which die rooms were completely ventilated. The consequence was, a prodigious decrease in the mortality. It is almost unnecessary to mention the frequent and sudden deaths that have taken place from entering deep wells, cellars, and other confined places. Three poor men at Denton, Maryland, having nearly com- pleted a deep well, quitted their work to go home to keep ihe holy-days. However, before they left the well, they covered the mouth of it closely. Carbonic acid gas settled at the bottom of it. After some time the unlucky well-diggers returned, and opening the well, very unsuspiciously let themselves down to their work. Two out of the three perished at the bottom; the other not going down escaped. Lime-kilns, throwing off large quantities of fixed air, are ex- tremely dangerous. Two disorderly young women, after rambling a greater part of the night, crept, early in the morning, into a little hovel, contiguous to a lime-hiln, and fell asleep. The kiln being in high blast, diffused a portion of vapour through the crevices into the hovel; but trie poor wretches were too sound asleep 10 be awakened. After some hours, the man, who had the care of the kiln, coming to look after his work, finding these women asleep, endeavoured to awake them, but in vain! They were ta- ken immediately to the hospital. Tlie one first conveyed reco- vered, but the other perished. There is another species of mephitic air, which burns with a bright flame, and, if mixed with common air, instantly catches lire and explodes; hence it has received the name of "inflamma- ble air." Mines and coal-pits are frequently infested with this gas, which, being ten times lighter than common air, ascends to the upper region of the mine; and is called fire-damp. To discharge this, the miners are in the habit of crawling on their hands and feet, and, with a taper affixed to a long stick, set fire to it, whicli is succeeded by a terrible, and sometimes fatal explosion. This air is often generated in the stomach and bowels of animals both living and dead. Alighted candle held near, has often caused it to take fiv<' OF PRESERVING HEALTH. 99 Tlie inflammable woman of Coventry, as described by Mr. Wihner, appears to have reduced herself by dram drinking, to such a state, as to be capable of being set on fire, and burning away like a match: so eager, says the learned Dr. Beddoes, were tlie principles of which she was composed to combine with oxygen. The Russians and Germans are frequently exposed to fainting during their cold season, from the noxious air of their stoves, and want of due ventilation. As soon as a person is discovered 'in this state, without sense and motion, he is instantly carried into the open air, and being stript, is rubbed very briskly with snow, Or cold wrater, which generally recovers him, if breathing have not been suspended above an hour. Faintings, or suffocations from the fumes of charcoal, are commonly cured by cold water thrown on the patient. As the mass of atmospheric air is incessantly corrupted by the respiration of men and animals, by the burning of so many natu- ral and artificial fires, by the dissolution and putrefaction of in- numerable substances, and by various other phlogistic or dis-ox- ygenating processes, it would at length become altogether in- competent for its original designation, if the all benevolent Crea- tor had not provided effectual means for its improvement and ren- ovation. Amongst the most powerful of these is the vegetation of plants. For this very important discovery, we are indebted to Dr. Priestly, who was so fortunate as to make it after he had Long employed many fruitless attempts to correct impure air by artificial means. He found that air rendered deleterious by the breathing of animals, which had died in it, was again so com- pletely restored by the vegetation of plants, that after the lapse of some days, an animal could live in it with equal ease, and for tlie same length of time, as before. The ingenious philosopher, Dr. Ingenhouz, remarked, firstj lint most plants have the, property of correcting bad air within a few hours, when exposed to the light of the sun; but that, on the contrary, during tlie night, or in the shade, they corrupt the air: second, that plants from their own substance afford a very pure air, or oxygen, when exposed to the rays of the sim: but 100 ON HYGlEINi:, OR THE ART a very impure air, or azote, at night, or in the shade: third, thai not all parts of plants, but only the green stalks of leaves, pro- duce this beneficial effect: fourth, that the disengagement of pure or vital air does not commence until the sun lias been some time above the horizon, that it ceases altogether with the termination of day light; and that the disadvantage arising from the impure ex- halations of plants, during the night, is far exceeded by the great advantage they afford during the day; insomuch, that the im- pure air generated by a plant during the whole night, scarcely amounts to a hundredth part of the pure vital air, or oxygen, ex- haled from the same plant in two hours of a serene day. Thus, the atmosphere is constantly preserved in that state of purity, which is the most salutary both to animals and vegetables. As the vegetable kingdom is renewed in spring, and as vegeta- tion in general is most lively in that season, there can be little doubt, that the pure vital air is then most copiously evolved by means of the light and heat of the sun. Hence it follows that the air of spring is more wholesome than that of autumn, which is saturated with impure particles. The cold, however, and the frequent winds which prevail at a more advanced period. prove extremely efficacious in counteracting the baneful effects of corruption and putrefaction. All strongly scented bodies are more or less pernicious; not onlj those of a foetid, but even those of a fragrant smell. The latter, if too strong, are particularly dangerous, as a sense of disgust does not naturally incline us to avoid them. Hence people who carry large nosegays in the hot days of summer, or sleep in rooms decorated with flowers, are apt to feel themselves affected with head-achs, vertigoes, fainting fits, and even apoplexies, have been produced in persons of a plethoric habit. The smell of roses, how pleasing soever to most persons, is not only odious, but alomst deadly to others. Warm Air relaxes the body, and occasions a quicker circula- tion of the fluids: hence the tender and infirm sutler severely in hoi weather; bene e arise hysteric and hypocondriaic complaints, convulsions, and diarrhoeas. OF PRESERVING HEALTH. 101 Cold renders bodies more compact, the appetite stronger, and digestion easier and quicker. On the contrary, the resistance of the fluid parts becomes so great, that even the increased powers of the solids cannot overcome it, if the cold be too violent. In winter the blood is much disposed to inflammations; hence stitches in the side, inflammatory sore throats, rheumatism, &c. In persons who take little exercise, the fluids are apt to stagnate, and the solids to chill during the winter. Upon the whole, how- ever, the effects of cold weather may be rendered less hurtful, and even salutary to the body, if proper exercise be not neglected. Damp or Moist Air suddenly relaxes and debilitates, retarding the circulation, checking the perspiration, and depressing the spirits. If damp air be accompanied with cold, it tends, by ob- structing the perspiration, to throw the retained humours on the breast, throat, stomach, bowels, &c. occasioning sore throats, pleurisies, sick stomach, diarrhoeas, &x. If damp air be accom- panied with heat, it is still worse, by opening the pores, through which the moisture penetrates in the body, and predisposes every part of it to putrefaction and dissolution. This accounts for the great mortality prevalent during the hot season at Batavia, and some of the West India islands. Dry and Cool Air, from its elasticity, promotes, in an extraor- dinary manner, the serenity and alertness of mind and body; and is, therefore, most agreeable and salubrious, both to the healthy and infirm. Too sudden a transition from warm to cold air, or the reverse, is pernicious. But none have ever complained on leaving, how- ever suddenly, the sickly air df the town, for the dry, pure, temperate air of the country. After all, the surest sign of good air in any place, is the longevity of its inhabitants. The most certain marks, by which to distinguish whether the air in rooms be damp or not, are the following: The wralls or tapestry change their colour; bread acquires a mouldy surface; sponges in the rooms retain their moisture; loaf-sugar turns soft; iron rusts; brass and copper acquire a green colour, and wooden furniture moulders and crumbles to pieces. H KI2" ON HYGIEINE, OU T IIE Alii In cities the sitting rooms ought, if possible, to be above thr ground floor, or on the second story, well ventilated by conve- nient doors and windows. And as to the bed-rooms, they ought assuredly to be in the most elevated stories of the house, that they may be as far removed as possible from that mass of azote, or deadly air which is so copiously generated in large towns, and whicli naturally settles near the ground. Dr. Caldwell, lecturing on this subject, states that it was on this principle he was induced, contrary to the remonstrances of his family and friends, to keep his son in the third story of his house, during a very sickly season in Philadelphia, and adds that he could not avoid being sensibly struck with its happy effects in preserving his health. And I am convinced the excellent health my family enjoyed, during eight or nine years' residence in Savannah, was greatly owing to sleeping in large well aired chambers, three stories from the ground. The airing of apartments should not be neglected, even in win- ter, as fires alone are not sufficient to carry off' the corrupted air. If possible, wre should not sit through the day in a room in which we have slept; as the bed clothes, and particularly feather beds, very slowly part with the exhalations they have imbibed during the night It farther deserves to be remarked, that all damp va- pours are prejudicial; hence, keeping wet clothes in dwellim; looms should by all means be carefully avoided. r- OF V R E S E R V I N G H E A L T H . 103 or FOOD. for this the watchful appetite was given. Daily with fresh materials to repair This unavoidable expense of life, This necessary waste of flesh and blood. Hence the concoctive powers, with various art Subdue the cruder aliments to chyle; The chyle to blood: the foamy purple tide To liquors, which througli finer arteries To different parts their winding course pursue; To try new changes, and new forms put on, Or for the public, or some private use. Armstrokg Nature not only points out tha food fit for infancy, but kindly prepares it When the babe, just born into this cold world, is applied to its mothers bosom, it is first agreeably affected by warmth; next it is delighted with the odour of the milk; then gratified by the flavour of it; afterwards the appetites of hunger aud of thirst afford pleasure by the possession of their objects, and by the subsequent digestion of the aliment; and lastly, the sense of touch is delighted by the softness and smoothness of the milky fountain, whicli the innocent embraces with its hands, presses, with its lips, and watches with its eyes. Satisfied, it smiles at the enjoyment of such a variety of pleasures. It feels an animal attraction, which is love; a gratification when the ob- ject is present, a desire wdien it is absent, which constitutes the purest source of human felicity, the cordial drop in the other- wise vapid cup of life, overpaying the fond mother for all her solicitudes and cares. Lo! at the couch where infant beauty sleeps, Her silent watch the mournful mother keeps; She, while the lovely babe unconscious lies, Smiles on her slumb'ring child with pensive eyes, Aud weaves a song of melancholy joy. Campbell. A mother who abandons the fruit of her womb, as soon as it i;$ iiorn, to the sole care of an hireling, hardly deserves that tender appellation. Nothing can be so preposterous and unnatural, as a *•' IUTi ON HYGIEINE, OR THE ART mother abandoning the care of her child. If we search Nairn-** throughout, we cannot fincLa parallel. Every other animal is th< nurse of its own offspring, which thrives accordingly. Connubial fair! whom no fond transport warms, To lull your infant in maternal arms; Who, blest in vain with tumid bosom, hear His tender wailing with unfeeling ear; The soothing kiss, and milky rill deny To the sweet pouting lip, and glisfning eye! Ah! what avails the cradle's damask roof, The eider bolster, and embroider'd woof! Oft hears the gilded coach, unpity'd plains, And many a tear the tassell'd cushion stains! No voice so sweet attunes his cares to rest, So soft no pillow, as his mother's breast! Darwin. It is in infancy and early age, that the foundation is laid for the many diseases arising from indigestion, found in almost every family. If children be fed immoderately, the first passages be- come too much distended, and the stomach, by degrees, acquire- an unnatural craving for food, w hich must be satisfied, whatever be the consequence. These excessive supplies are not only unneces* sary, but produce the most serious and fatal disorders.—There is a certain relation subsisting between what is taken in, and what is lost by the body. If we eat and drink much, we like- wise lose much, without gaining any more by it than we might do by moderate meals. Eating too much retards the growth, and eventually diminishes the digestive power of the stomach. Nature is easily satisfied, and is always best provided if we do not obtrude upon her more than she is accustomed to. If we have, for some time taken little nourishment, nature be- comes so habituated to it, that wre feel indisposed as soon as the usual measure is transgressed; and both the stomach and its di- gestive powers are thereby impaired. It would be impossible to lay down fixed rules, whereby to determine the salubrity or insalubrity of aliments, with respect to the individual. Experience is, indeed, our chief guide upon this subject; for, such is the peculiarity of constitutions, that, the same artich - OT PRESERVING HEALTH. 105 which wiil nourish and perfectly agree with one person, woul&!v prove highly pernicious to another. Let us, therefore, in the se- lection of our food, adopt that which long and careful observation iias confirmed to be salutary, and avoid those things, however tempting to the p date, which we know to be injurious. There are, however, articles of diet obviously improper to every one; which, though they may not manifest their ill effects immediately, yet, nevertheless, undermine and break down by gradual operation, the vigour of our systems, and entail upon us, with certainty, a train of chronic disorders, of all others the most troublesome and difficult to cure. The articles of this descrip- tion are all high-seasoned dishes, and those which are composed of a great variety of ingredients. People in health require no excitement to the relish of good and wholesome meat; and to those in the opposite state, the luxuries of the table arc poison. The sad effects of luxury are these; We drink our poison, and we eat disease. Not so, O Temperance bland; when ruled by thee, The brute's obedient, and tlie man is free: Soft are his slumbers, balmy is his rest, His veins not boiling from the midnight feast ?Tis to thy rules, bright Temperance! we owe All pleasures which from strength and health can flow; Vigour of body, purity of mind, Unclouded reason, sentiments refined; Unniix1d, untainted joys, without remorse, The intemperate sensualist's never-failing curse. Dodd. There are three kinds of appetite: first, the natural appetite— whicli is equally stimulated and satisfied with the most simple dish, as with the most palatable; second, the artificial appetite, or that excited by bitters, spirits, pickles, and other condiments, which remain only as long as the operation of these stimulants continues; third, the habitual appetite, or that by which we ac- custom ourselves to take victuals at certain hours, and frequently without any appetite." Longing for a particular food is likewise a kind of false appetite. By the true and healthy appetite alone, can we ascertain the quantify of aliment proper for the individual. If, in that state, ' »U0 O N II Y G I E I X I;, O R T II E All I- we no longer relish a common dish, it is a certain evidence of its disagreeing with our digestive organs. If, after dinner, we feel ourselves as cheerful as before it, we may be assured that wi have taken a proper meal; for, if the proper measure be exceed- ed, torper will ensue, with indigestion, and a variety of unplea- sant complaints. When the tired glutton labours through a treat, He finds no relish in flic sweetest meat. Then hear what blessings Temperance can bring, Those blessings, only, form my cause to sing; First Health—the stomach cramm'd from every dish,, A tomb of roast and boil'd, of flesh and fish, Where bile and wind, and phlegm and acid jar, And all the man is one intestine war, Remembers well the school-boy's simple fare, The temperate sleeps, and spirits li^lit as air. Pore. A decent, well-furnished and hospitable table, is very commend able in those who can afford it. It speaks the greatness of theii, minds, the goodness of tlieir natures, and gains the blessing of the poor and needy, wliere they are charitably allowed to come in for a share; but, when feasting runs into excessive luxury and vain expense, it reproaches the author of it with prodigality and folly; for no money can be so truly said to be thrown away, as that which is superfluously spent upon the belly. It was a maxim of Socrates, " that we ought to eat and drink to live, and not to live in order to eat and drink." Temperance is the preservation of the dominion of soul over sense, of reason over passion. The want of it destroys health, fortune and con- science. Chremes, of Greece, though a young man, was very infirm and sickly, through a course of luxury and intemperance; and sub- ject to those strange sorts of fits which arc called trances. In one of these, he thought that a philosopher came to sup with him; Wbo out of all the dishes served up at the tabic, would only eat of one, and'that the most simple; yet his conversation was sprightly, his knowledge great, his countenance cheerful, and his const it u- vin'n strong, When the philosopher took his leave, he. invilnt OF PRESERVING HEALTH. 107 Chremes to sup with him at a house in the neighbourhood; which also took place in his imagination; and he thought he was receiv- ed with the most polite and affectionate tokens of friendship; but was greatly surprised, when supper came up, to find nothing but milk and honey, and a few roots dressed up in the plainest man- ner, to which cheerfulness and good sense were the only sauces. As Chremes was unused to this kind of diet, and could not eaty the philosopher ordered another table to be spread more to his laste; and immediately there succeeded a banquet composed of the most artificial dishes that luxury could invent, with great plenty and variety of the richest and most intoxicating wanes.— These, too, were accompanied by damsels of the most bewitch- ing beauty. And now Chremes gave a loose to all his appetites; and every thing he tasted raided extacies beyond what he had ever known. During the repast the damsels sung and danced to entertain him. Their charms enchanted the enraptured guest, already heated with what he had drunk. His senses w'ere lost in cxtatic confusion. Every thing around him seemed Elysium, and he was upon the point of indulging the most boundless free- dom: when lo! on a sudden, their beauty, which was hut a visor, fell off, and discovered to his view forms the most hideous and forbidding imaginable. Lust, revenge, folly, murder, meagre poverty, and frantic despair, now appeared in tlieir most odious shapes, and the place instantly became the direct scene of misery and desolation. How often did Chremes wish himself far distant from such diabolical company! and how dread the fatal conse- quences which threatened him on every side! His blood ran chill to his heart; his knees smote against each other with fear; and joy and rapture were turned into astonishment and horror.— When the philosopher perceived that this scene had made a suf- ficient impression on his guest he tlms addressed him: "Know Chremes, it is I, it is Esculapius, who has thus entertained yon; and what you have here beheld is the true image of the deceitful- ness aud misery inseparable from luxury aud intemperance- Would you be happy, be temperate. Temperance is the parem Of health, virtue, wisdom, plenty, and of every thing that car* " render you happy in this world, or the world to come. It is, in- d-eed, the true luxury of life; for without it life cannot he enjoy- IOfci ON HYGIEINE, OR THE A R I cd." This said, he disappeared; and Chremes awaking, ami m structed by the vision, altered his course of life, became frugal. temperate, industrious: and by that means so mended his health and estate, that he lived without pain to a very old age; and was esteemed one of the richest, best, and wisest men in Greece. Such is the beautiful moral drawn by the pen of elegant and instructive fiction; with which, if there be any mind so insensible as not to be properly affected, let us only turn to that striking reality presented to us in the case of Lewis Comaro. This gentleman was a Yenitian of noble extraction, and memorable for having lived to an extreme old age; for he was above a hundred years old at the time of his death, wdiich happened at Padua, in the year 1505. Amongst other little performances, he left behind him a piece en- titled, "Of the advantages of a temperate life," of wdiich we will here give our readers some account; not only because it will very well illustrate the life and character of the author, but may pos- sibly be of use to those who take the summum bonum, or chief good of life, to consist in good eating. He was moved, it seems, to compose this little piece at the request, and for the benefit of some ingenuous young men, for whom he had a regard; and who, having long since lost their parents, and seeing him, then eighty- one years old, in a fine florid state of health, were desirous to know of him, what had enabled him to preserve, as he did, a sound mind, in a sound body, to so extreme on age. He describes to them, therefore, his whole manner of living, and the regimen he had always pursued, and was then pursuing. 1 le tells them that, when he was young, he was very intemperate; that his in- temperance had brought upon him many and grievous disorders; that, from the thirty-fifth to the fortieth year of his age, he spent his nights and days in the utmost anxiety and pain; and that in short, his life was grown a burthen to him. The physicians, however, as he relates, notwithstanding all the vain and fruitless efforts which they had made to restore his health, told him that there was one method still remaining which had never been tried, but which, if they could but prevail with him to use w ith persc- verence, might free him, in time, from all his complaints; and that was a temperate and regular way of living. They added, moreover,' that unless he resolved to apply instantly to it, his case would OF PRESERVING HEALTH. 109 soon become desperate, and there would be no hopes at all of his recovery. Upon this, he immediately prepared himself for his new regimen; and now began to eat and drink nothing but what was proper for one in his weak habit of body: but this was at first very disagreeable to him. He often wTanted to live again in his old manner; and did, indeed, indulge himself in a freedom of* diet sometimes, without the knowledge of his physician; but, as he informs us, much to his own detriment and uneasiness. Driven, in the mean time, by the necessity of the thing, and re- solutely exerting all the powers of his understanding, he at last grew confirmed in a settled and uninterrupted course of temper- ance; by virtue of which, as he assures us, all his disorders had left him in less than*a year: and he had been a firm and healthy man, from thenceforward, till the time in which he wrote his treatise. Some sensualists, as it appears, had objected to his abstemi- ' ous manner of living; and in order to evince the reasonableness of their own, had urged that it was not worth while to mortify one's appetites at such a rate for the sake of being old, since all that was life, after the age of sixty-five, could not properly be called a living life, but a dead life. "Now," says he, "to show these gentlemen how much they are mistaken, I will briefly run over the satisfactions and pleasures which I myself enjoy in this eighty-third year of my age. In the first place, 1 am always well, and so active, withal, that I can, with ease, mount a horse upon a flat, or walk upon the tops of very high mountains. In the next place, I am always cheerful, pleasant, perfectly con- tented, and free from all perturbation, and every uneasy thought I have none of that fastidium vitce, that satiety of life, so often to be met with in persons of my age. I take a view of palaces, gardens, antiquities, public buildings, temples, fortifications_, and endeavour to let nothing escape me which may afford the least amusement to a rational mind. Nor are these pleasures at all blunted by the usual imperfections of great age; for I enjoy all my senses in perfect vigour; my taste especially, in so high a de- gree, that I have a better relish for the plainest food now, than- 1 had for the choicest delicacies formerly, when immersed in a life of luxury " .1") J10 ON HYGIEINE, OR THE ART As a principal rule of diet, we ought to take food w ith art easy and serene mind, and to eat slowly. The stomach suffering in this case a very gradual distension, as the food has sufficient time to be duly prepared by mastication. To eat of one dish only seems most conformable to nature, and is doubtless, the means of procuring the most healthy fluids. The diet ought not only to be such as is best adapted to the constitution, but likewise to be taken at regular periods; for long fasting is hurtful at any stage of life. All great and sudden changes of diet are universally dangerous, jiarticularly from a rich and full diet to a low and sparing one. When, therefore, a change becomes necessary, it ought always to be made by de- grees. When a person has suffered so much from extreme hunger^ much food must not be given him at once. By full feeding, thousands long starved at sea have been destroyed at once. Such persons should be supplied with liquid food, and that spar- ingly. As soon as the food has entered the stomach, the important of- fice of digestion begins. The vigour of the organs exerted on this occasion, ought certainly not to be abridged by violent ex- ercise; but muscular and robust people feel no inconvenience from gentle motion about one hour after the heaviest meal. But as the whole process of digestion is of much longer duration than is generally imagined, the afternoon hours cannot be em- ployed so advantageously to health in any labour requiring strong exertions. In violent exercise, or an increased state of perspiration, the fluids are propelled to the external parts, and withdrawn from the stomach, where they are indispensable to assist the proper concoction. Exclusiye of the quantity and quality of food, great attention is due to the kind of it in particular constitutions. Animal food in general is more nourishing than vegetable, and, when fresh, is likewise more easy of digestion. On this account, it general- ly agrees best with delicate and weak constitutions. But the flesh of young animals, with a proportionate quantity rtf well boiled and wholesome vegetables, is the best diet adapted OF PRESERVING HEALTlt. Ill fo our system. In summer it is advisable to increase the propor- tion of vegetable food, and to make use of ripe fruit. With re- gard to our food, however, in quantity and quality, it should be proportioned to our exercise. The labourer, who is perpetually toiling from morning till night, could not subsist on food appro- priated to those who pursue not the severer exercises of the body. His diet must be of the courser kind; such as salted meats or fish, cheese, corn bread,potatoes, onions and peas, and these in pretty large quantities. On the whole, it will be found to be the safest, both in health and sickness, to regulate our diet With simplicity; ever bearing in mind that a preference is to be given to such articles as our personal knowledge has demonstrated to be the most congenial to our constitutions and habits. In our aliment, an essential part is drink, the use of which i6 Indispensable to the digestion of food. Water, the basis of our drinks, should be carefully obtained in its highest purity. The best water is that which is pure, light, and without any particular colour, taste, or smell. Where water cannot be obtained pure from springs, wells, rivers, 01 lakes, care should be taken to deprive it of its pernicious quali- ties, by boiling and filtering, but most effectually by distillation. Any putrid substances in tlie water may be corrected by the ad- dition of an acid. Thus half an ounce of alum, in pOwder, will make twelve gallons of corrupted water pure and transparent in wo hours, without imparting a sensible degree of astringency. Charcoal powder has also been found of great efficacy in check- ing the putrid tendency of water. To the same purpose, vinegar ind other strong acids, are Well adapted. Whatever kind of drink is used, it ought to be taken always in a moderate quantity. Too much drink, even of water, inno- cent as it is, tends to Oppress and weaken the stomach, Of Course "to generate acidities and flatulence. Some advise us never to drink without eating something, but he who drinks only when nature requires it, has no occasion to e;it every time he drinks. Persons, on the contrary, once accus- ;<>med to drink more than is necessary, or to make use of hot, 112 ON HYGIEINE, ORT HEART stimulating, and intoxicating liquors, would do well always to eat some bread, or other solid food, along with them. An undue proportion of drink renders the mass of blood too thin and watery, and occasions a general debility of the body. On the other hand, too little drink renders the blood thick and viscid, and weakens the digestive powers. Light and well fer- mented beer, is a wholesome, and, at the same time, diluent spe- cies of nourishment Cider, when properly fermented and pure, is also a pleasant and wholesome liquor. On the contrary, when it is new or tart, we cannot recommend it as a salubrious beverage. Wine, when pure, and used in moderation, certainly conduces to health, especially in weak and languid habits. See Vine, Mat Med. Ardent Spirits, when properly diluted, arc likewise an excel- lent beverage and antiseptic. These liquors are of considera- ble service in preventing the bad effects of a moist and cold at- mosphere, pestilential vapours, damp military camps, unclean oc- cupations, and, occasionally too, of a temporary abstinence from food. But as the infusion of too great a quantity of oil immediately extinguishes the lamp, the light of reason, and the lamp of life itself, are frequently suffocated, and put out forever, by an im- prudent use of either wine or spirits. Tea is considered by some as being highly injurious, while others have either asserted its innocence, or even ascribed to it extraordinary virtues. When taken in a large quantity, or very strong, and at a late hour, it often produces watchfulness; but if used in moderation, it greatly relieves an oppressed stomach, and pains of the head. It ought, however, to be made of a moderate strength, otherwise it certainly affects the nerves. IIypocondriac and hysteric people are much deceived in their opinions of the efficacy of tea; for all the evils arising from weak stomachs and flatulency, of which they complain, are certainly increased by tea, especially if taken in large and strong quantities. The cold stomach which they propose to warm by it, is a mere phantom Of PRESERVING H EALTH. 113 of the brain; for this sensation of cold, is nothing but relaxation, which, instead of being removed by hot liquors, is assuredly in- creased by them. Coffee promotes digestion, and exhilarates the animal spirits; but an excessive use of it, like tea, affects the nerves, occasions watchfulness, and trembling of the hands. As possessing excel- lent antispasmodic virtues, it is a favourite beverage with the hypocondriac and hysteric. Chocolate is nutritious and wholesome, if taken in small quan- tity; but to the corpulent and weak, particularly those with whom a vegetable diet disagrees, it is generally hurtful. OF EXERCISE. s # * # * # By health the peasant's toil Is well repaid, if exercise were pain Indeed, and temperance pain. By arts like these Laconia nursed of old her hardy sons; And Rome's unconquered legions urged their way Unhurt, through every toil in every clime. Toil and be strong. By toil the flaccid nerve? Grow firm, and gain a more compacted tone; The greener juices are by toil subdu'd, Mellowed, and subtilis'd; the vapid old Expell'd, and all the rancour of the blood. Begin with gentle toils, and, as your nerves Grow firm, to hardier by just steps aspire. The prudent, even in'every moderate walk, At first but saunter, and by slow degrees, Increase their pace. This doctrine of the wise, Well knows the master of the flying steed. Armstrokc. It was a common saying among the ancients, that acute dis- eases are from heaven and chronic from ourselves. To die, says Dr. Johnson, is the fate of man; but to die with lingering an- guish, is generally his own folly. Inactivity never fails to in- 114 O N H Y G I 1, I N E , 0 R t H E A R T duce an universal relaxation of the contractile fibres. When these fibres are relaxed neither the digestion, the circulation, nor the peristaltic motion can be duly performed. It is absolutely impossible to enjoy health where the perspira- tion also is not duly carried on; and that can never be the case, where exercise is neglected. Indolence often originates from a mistaken education in which .* pleasure or flattery is made the immediate motive of action, and not future advantage, or what is termed duty. This observation is of great value to tliose who attend to tlie education of their own children. I have seen, says Dr. Darwin, one or two young married ladies of fortune, who perpetually became uneasy, and believed themselves ill, a week after their arrival in the country, and continued so uniformly during their stay; yet, on their re- turn to London or Bath, immediately lost all their complaints. I was led to ascribe this to their being surrounded in infancy with menial attendants, who had flattered them into the exertions they then used; and that, in riper years, they became torpid for want of this stimulus, and could not amiise themselves by any voluntary employment; requiring ever after either to be amused by other people, or to be flattered into activity. Dr. Johnson says, "Whenever chance brings within my obser* vation a knot of young ladies, busy at their needles, I consider myself as in the school of virtue; and though 1 have no extraor- dinary skill in plain work or embroidery, I look upon their ope- rations with as much satisfaction as their governess, because I regard them as providing a security against the most dangerous ensnarers of the soul, by enabling themselves to exclude idleness from their solitary moments, i».nd with idleness, jts attendant train of passions, fancies, chimeras, fears, sorrows and desires." If sedentary employments be intermixed with a due quantity of exercise, they will never injure health. Weak fibres are the constant companions df itiaelhuly. No- thing but daily exercise in the open air can brace and stiengthen the powers of the stomach, and prevent an endkss train of dis- eases, which proceed from a relaxed state of that organ. W< seldom bear the active and labourious complain of nervous dis pases: which are reserved for the sons of idh-i:^". OP PRESERVING HEALTH. Hq ****** jjow happy he whose toil Has o'er his languid powerless limbs diffused A pleasing lassitude. He not in vain Invokes the gentle deity of dreams. By toil subdued, the warrior and the hind Sleep fast and deep.—Their active functions soon With generous streams their subtile tubes supply Ere morn, the tonic irritable nerves Feel the fresh impulse, and awake the soul. Armstrong. Idleness is a servile, weak and degenerate habit; that of thq mind being worse than that of the body. A gentleman states, that, as he was sitting with some friends before the door of the Capitol, a beggar presented himself, who with sighs, tears and lamentable gestures, expressed his misera- ble poverty, saying withal, that "he had about him a private disorder, which shame prevented him from discovering to the eyes of men. They, pitying the case of the poor man, gave each of them something, and he departed. One amongst theni sent his servant after him, to enquire what his privato infirmity might be, which he was loth to discover? The servant overtook him; and desired that satisfaction; and having diligently viewed his face, breast, arms, &c. and finding all his limbs in good plight, "I see nothing," said he, "whereof you have any such reason to complain." "Alas!" said the beggar, "the disease that afflicts me is far different from what you conceive of, and is such as you cannot see. It is an evil that has crept over my whole body; passing through the very veins and marrow of me, in such a manner, that no one member of my body is able to take proper exercise, or do any work. This disease by some is called idleness." The servant having left him, returned with this account; which not a little amused his master and friends. As idleness is the rust and bane of all human virtues, so, on the contrary, industry and diligence in business are conquerors of all difficulties; sweetening labour and pains, and giving satis- faction as well as profit, in the accomplishment of what is under- taken. When meu work at their play, and play with their work. 116 ON HYGIEINE, OR THE ART they invert the order of nature, as well as the Divine command, and must expect in the sequel to come home by Weeping Cross, because they have laboured in vain, and played the fool with themselves in neglecting to secure to themselves a comfortable subsistence. Among the Athenians and ancient Romans, there was a law exacting an account from every man how lie maintain- ed himself and family; and if unable to give a satisfactory answer, £ he was immediately banished with reproach, as a vermin that devoured what he had no right to, in being an unprofitable excres- cence, contributing nothing towards the tranquility of the public. A gentleman possessed of an estate of about two hundred pounds per annum, in land, kept the whole a great while in his own hands; but finding, nothwithstanding all his care and indus- try, that he still run behind hand, and at length obliged to sell half his estate to pay his debts, let the rest to a farmer by lease for twenty-one years, at an annual rent. His tenant thriving, and: coming before the expiration of the lease, to pay his rent, he asked his landlord, " if he would sell the land he rented of him?" " Why," said he " wouldst thou buy it?" " Yes," said the far- mer, " if you will part with it." " That is very strange," said she landlord. "Prithee tell me how it is, that I could not live upon twice so much being my own, and you upon half of it, though you pay rent for it, are able in less than twenty years to Imy it?" "O Sir," said the farmer, "a few words make the difference. When any thing was to be done, you said, 'Go and do it,' and lay in bed or took your pleasure; but I always said, 'Come, let us go and do it,' and both assisted and saw my business done myself." To show the absolute necessity of exercise in cold climates, *\ e cannot omit relating the botanical excursion of Sir Joseph Bank's, Dr. Solander, and others, on the heights of Terra-del-Fuc- go. Dr. Solander, who had more than once crossed the moun- tains dividing Sweden from Norway, well knowing that extreme (•old produced a torpor and sleepiness almost irresistible, conjured the company to keep always in motion, whatever pain it liii^h' cost them, and whatever relief they might be promised by rest: i; Whoever sits down," said he, "will sleep, and wlweveir sleeps v-W OF PRESERVING HEALTH. 117 wake no more." Thus at once admonished and alarmed, they set forward, but while they were still upon the naked rock, and before they got among the bushes, the cold wras so intense, as to pro- duce the effects that had been most dreaded. Dr. Solander, him- self, was the first who found the inclination, against which he had warned others, irresistible; and insisted upon being suffered to lie down. Sir Joseph Banks entreated and remonstrated with him in vain; down he lay upon the ground, though it was co- vered with snow; and it was with great difficulty that his friends kept him from sleeping. One of his black servants also began to linger. Partly by persuasion, and partly by force, the com- pany made them go forward. Soon, however, they both de- clared, "they would go no farther." Sir Joseph Banks had re- course again to expostulation, but this produced no effect. When the black was told that if he did not go on, he would in a short time be frozen to death, he answered that he desired nothing so much as to lie down and die. The Doctor did not so explicitly renounce his life; saying, he could go on, but that he must first take "some sleep," though he had before told the company, that "to sleep, was to perish." Both in a few minutes fell into a profound sleep. After considerable exertions they happily suc- ceeded in waking the Doctor, who had almost lost the use of his limbs, and the muscles were so shrunk, that his shoes fell from his feet; but every attempt to relieve the unfortunate black proved unsuccessful. Since we have touched upon the subject of cold, we cannot forbear inserting the observations of the immortal Darwin. Animal bodies resist the power of cold probably by their ex- ertions: but if these increased exertions be too violent, so as to exhaust the power of the brain, the animal will probably sooner perish. Thus the moderate quantity of wine or spirit, repeated at proper intervals of time, might be of service to those who are long exposed to excessive cold, both by increasing the ac- tion of the capillary vessels, and thus producing heat, and per- haps by increasing in some degree the secretion of sensorial power in the brain. But the contrary must happen when taken immediately, and not at due intervals. A well attested story was once related to me of two men, who set out on foot to travel in 16 118 ON HYGIEINE, OH 1 11 E A R T the snow, one of wdiom drank two or three glasses of brandy before they began their journey, the other contented himself with his usual diet and potation: the one perished, in spite of every assistance his companion could afford him, and the other per- formed his journey with safety. In this case the power of the brain was exhausted by the unnecessary motions of incipient in- toxication by the stimulus of the brandy, as well as by the c\e, tions of walking, whicli so weakened the dram-drinker, that the cold sooner destroyed him; not having power to produce suffi- cient muscular or arterial action, and in consequence sufficient heat to supply the great expenditure of it Hence the capilla- ries or smaller vessels of the skin, first ceased to act, and became pale and empty; next those w hich arc immediately associated with them, as the extremities of the pulmonary artery, as hap- pens on going into the cold bath. By the continued inaction of these parts of the vascular system, the blood becomes accumu- lated in the internal arteries, and the brain is supposed to be af- fected by its compression; because these patients are said to sleep, or to become apoplectic, before tfiey die. Travellers, benighted in deep snow, might frequently save themselves by lying down on the dry ground, and suffering them selves to be entirely covered with the snow, except a small hole for air. The ground being usually at the 40th degree of cold, that is, ei-ht degrees above freezing, and the snow in contact with tlieir clothes, thawing and contracting into the snow next to it, would form above them a close, dry cover let, that would per- fectly exclude the external cold, and place them in a situation almost as warm as a bed! My reverend and worthy friend, Dr. Andrew Hunter, of Wash- ington, overcome with the fatigues of a long day's march, during tlie revolutionary war, threw himself down with the rest of the arm;, on the cold frozen ground. II is only cover was a blanket and a saddle his pillow. Instantly his wearied senses were lock- ed up in sleep so sound, that he never felt the cold snow, which presently began to fall in heavy flakes upon him. Next morn- ing when he awoke, he was astonished at his situation—a heavy fall of snow a loot deep had completely covered him, through which the heat of his breath, melting the snow as it fell, had -*< OF PRESERVING HEALTH. 119 formed a nice opening. Having raised his head, and seeing his comrades still asleep, he laid himself down to enjoy a little longer his singular bed, which he declared was very pleasant. If these facts were more generally known, they might save the lives of many valuable citizens. OF SLEEP. The shades descend, and midnight o'er the world Expands her sable wings. Great Nature droops Through all her works. Now happy lie whose toil lias o'er his languid powerless limbs difiVcd A pleasing lassitude: he not in vain Invokes the gentle Doily of dreams. His powers the most voluptuously dissolve In soft repose: on him the balmy dews Of sleep with double nutriment descend. Armstrong. " Tired Nature's sweet restorer, balmy sleep," cannot be dis- pensed with. It introduces a most welcome vacation, both for the soul and tlie body. The exercises of the brain and the la- bours of the hands, are at once discontinued; so that the weary limbs repair their exhausted vigour, while the pensive thoughts drop their load of sorrows, and the busy ones rest from the fa- tigue of application. Most reviving cordial! equally beneficial to our animal and intellectual powers. Since sleep is so absolutely necessary, so inestimably valuable, observe what a fine apparatus Almighty Goodness has made to accommodate us with the balmy blessing. With how kind a pre- caution he removes whatever might obstruct its access, or im- pede its influence! He draws around us the curtain of darkness, which inclines to drowsiness, and conceals every object that might too strongly agitate the senses. He conveys peace into our apartments, and imposes silence on the whole creation. May we not discern in this gracious disposition of things, the tender 1 -U O N H Y G I V. I N E , O R T H E A R T cares of an affectionate Mother, who hushes every noise, and ex- cludes every disturbance, where she has laid the child of her lOve to rest? So, by such soothing circumstances, and gentle working opiates, He giveth to his beloved, sleep. No sooner does the njorning dawn, and day-light enter the room, than this strange enchantment vanishes. The man awakes, and finds himself possessed of all the valuable endowments which for several hours were suspended or lost. His sinewrs are bra- ced, and fit for action. His senses are alert and keen. The ro- mantic visionary heightens into the master of reason, and'the frozen or benumed affections melt into tenderness, and glow with benevolence. ■**##♦## 0 sacmi rcst! Sweet pleasing sleep! of all the powers the best; O peace of mind! repairer of decay! Whose balms renew the limbs to labours of the day, Care shuns thy soft approach, and sullen flies away. Dryden. If sleep do not pay the accustomed visit, the whole frame of man will in a short time be thrown into disorder; his appetite cease, his spirits dejected, and his mind, abridged of its slumber- ing visions, begin to adopt waking dreams. It is in vain that all light is excluded, all sound removed, and books of entertainment read, the restless and busy mind still retains its former activity, and Reason, that wishes to lay down the reins, in spite of her- self, is obliged to maintain them. This is strongly instanced by Shakspcare, in the soliloquy of King Henry. How many thousands of my poorest subjects Are at this hour asleep! Oh! gentle sleep, Nature's soft nurse, how hare I frighted thee, That thou no more wilt weigh my eye-lids down, And steep my senses in forgetfulness? Why, rather, sleep, ly'st thou on smoky cribs, Upon uneasy pallets stretching thee, And hush'd with buzzing night-flies to thy slumbers. Than in the perfum'd chambers of the grfeat, OF PRESERVING HEALTH. 121 And lull'd with sounds of sweetest melody? O thou dull god, why ly'st thou with the vile In loathsome beds, and leav'st the kingly couch, A watch-case or a common larum bell? Wilt thou upon the high and giddy mast Seal up the ship-boy's eyes, and rock his brains In cradle of the wild imperious surge; And in the visitation of the winds, Who take the ruffian billows by the top, Curling their monstrous heads, and hanging them With deaf'ning clamours in the slipp'ry shrouds, That, with the hurley, death itself awakes? Canst thou, O partial sleep! give thy repose To the wet sea-boy, in an hour so rude; And, in the calmest, and most stillest night, With all appliances and means to boot, Deny it to a King? Then, happy low, lie downl Uneasy lies the head that wears a cnown. Excess of sleep is not less prejudicial to health than the wan-. of it. The whole body sinking gradually into a complete state of inactivity, the solid parts become relaxed, the blood circulates slowly, and remains particularly long in the head; perspiration is disordered, the body increases in fat, and rendered incapable of being the medium of mental exertion, the memory is enfeebled, and the unhappy sleeper falls into ar lethargic state, by Avhich his sensibility is, in a great measure, destroyed. Sleep, immediately after supper, is apt to occasion the night- mare, or a stagnation of the blood, which, by its pressure, produ- ces the sensation or idea of this troublesome bed-fellow. It is principally the nervous, the debilitated, and those of an impaired digestion, who are visited by such terrific dreams. The proper duration of sleep, in youth and adults, is usually settled at six or seven hours; in children and the aged, from eight to nine hours. The more bodily weakness we feel, the more we may indulge in sleep; provided it be refreshing. If people in a state of health be perfectly cheerful in mind and body. when they awake, this is the most certain criterion that they have 122 ON HYGIEINi:, OR THE ART slept sufficiently. Though weakly persons may have a disposi- tion to sleep during the day, they ought not to sleep long, since it tends to increase their languor and relaxation. Whether to sleep after dinner be advisable, must be decided by a variety of concurrent circumstances; age, climate, and the like. However, a sleep after dinner ought never to exceed a half, or one hour at most; and it is also much better sitting, than lying horizontally; for, in the latter case, we are subject to determinations of the blood towards the head, and consequently to head-acb, and risk- apoplexy. In the evening we should eat light food, and not re- tire to rest till two or three hours after supper. The mind ought to be serene and cheerful previous to going to rest, and we should then avoid gloomy thoughts; so that wc may as much as possible guard against dreams, which always interfere with the refreshing influences of sleep. Sleep, accompanied either with talking or walking, called somniloquism and somnambulism, is a transient paroxysm and de- lirium. When they are induced by an increase of stimuli, whe- ther corporeal or mental, blood-letting, gentle cathartics, vegeta- ble diet, with moderate exercise, are the best remedies; but when they arise from a diminution of customary stimuli, a glass or two of wine, a draught of porter, or a dose of laudanum at bed-time, and a change of air, will generally succeed. The Feather-beds, in which we usually sleep, are certainly not as healthy as mattresses in summer. But, as many individuals have not sufficient resolution to use these, they ought to be particular in having their feather-beds frequently shaken and aired. Farther, it is highly improper to sleep in beds overloaded with clothes; they heat the blood more than is consistent with health, and produce an immoderate and enervating perspiration, which still more weakens the organs al- ready relaxed by sleep. The custom of sleeping with the cur- tains drawn close, is pernicious to health, because the copious exhalations, which then take place, cannot be properly dissi- pated, and are consequently re-absorbed. It is also very impru- dent to cover the head with the bed-clothes. The old and abom- inable custom of warming the bed, likewise deserves to be con- demned; as it has a direct tendency to produce debility. 0 1' PRESERVING HEALTH. 125 A .spacious and lofty room should always be chosen, if practi- cable, lor a bed-chamber, and attention paid to the admission «f Lreshair, even during the night, in warm weather. Lastly, no i audle or fire should be kept burning during the night in a bed-room. ON EVACUATIONS. By subtle fluids pour'd through subtle tubes The natural, vital, functions are performed; By these the stubborn aliments are tamed, Tlie toiling heart distributes life and strength, These the still crumbling frame rebuild. Armstroj;*.- The evacuations of the body, from its superfluous, impure, aud noxious particles, are no less necessary than its nourishment. The same power which changes and assimilates our food and drink, likewise affects the due and timely evacuation of the se- cretions. It is an object of the first consequence, that nothing remain in the body which ought to be evacuated; and that no- thing be ejected, wdiich may be of use to its preservation. How many persons do we find who complain of bad health, notwith- standing every attention they pay to air, aliment, exercise, and sleep; while others enjoy a good state of health, though totally careless with regard to these particulars, and all owing to a differ- ence in the state of evacuations. If these be disordered, the most rigorous observance of dietetic rules is insufficient to insure our health; while on the contrary, most of those rules may be neglected, for some time, without any injurious consequences, if the evacuations be regular. Nature removes not only noxious matter, or such as is in a state of corruption, but likewise the useful fluids, if they become superabundant; for instance, the milk, semen, and blood. In such cases, therefore, these must be considered as objects of evacuation, equally natural and salu- tary. Nature expels all crude and acrid substances by those three grand emunctories, the kidneys, bowels, and skin, and accord. t24 ON HYGIEINE, OR I II E A R T mgly as they are disordered, diseases of different degrees of ma- lignity and duration will necessarily ensue. Nature also fre- quently relieves herself by more unusual channels; such are the bleeding of the nose, in plethoric young men; the hemorrhoids, with which persons of a middle age are sometimes troubled; the various ulcers common to those whose fluids are in an impure state; tlie excretions of saliva, and the expectoration of others, &c. By a premature suppression of the troublesome, but salu- tary efforts of nature, great mischief may be produced to the in^ dividual. Many persons perspire much under the arm-pits; others in the hands or feet; others again are subject to eruptions in the face, or different parts of the body: such canals, however, if nature be once accustomed to eject by them certain ill humours, cannot be suddenly stopped without considerable danger—cleanliness, in the strictest sense of the word, is almost the only safe remedy to counteract their fatal effects. OF THE PASSIONS. Passions, like aliments, though born to fight, Yet mix'd and soften'd, in his work unite. Love, Hope, and Joy, fair Pleasure's smiling train, Hate, Fear, and Grief, the family of Pain; These mix'd with art, and in due bounds confin'd, Make, and maintain the balance of the mind. The lights and shades, whose well accorded strife, Gives all tlie strength and colour of our life. Port. Passions are the active forces of the soul: They arc its highest powers, brought into movement and exertion. Like wind and fire, which are instrumental in carrying on many of the benefi- cent operations of nature, where they rise to undue violence, or deviate from their proper course, their path is marked with ruin: so are the passions either useful or destructive, according to their direction and degree. OF PRESERVING HEALTH, 126 Yes, yes, dear stoic! hide it as you can, The sphere of pleasure is the sphere of man: This warms our wishes, animates our toil, And forms alike a Newton, oraHoyle; Gives all the soul to all the soul regards, Whet her she deals in planets, or in cards. Cawthqrv. OP LOVE. Lovi: is a passion by no-rule confinXl, The great first mover of the human mind; Spring of our fate! it lifts the climbing will, Or sinks the soften'd soul in seas of ill; Science, truth, virtue, sweetness, glory, grace. All are love's influence, and adorn his race, Love too, gives fear, despair, grief, anger, strifet And all the unnumber'd woes which tempest life. Hu.l. ' Love, the most universal and grateful passion of the heart, is not only conducive to health, but contributes greatly to the hap- piness of every society in which it is introduced. A warm and reciprocal affection, between two virtuous lovers, may be consi- dered the sweetest, charm of life. Where friendship full exerts her softest power, Perfect esteem enlivened by desire Ineffable, and sympathy of soul; Thought meeting thought, and will preventing will? With boundless confidence: for nought but love Can answer love, and render bliss secure. * * # # wnat js the world to them, Its pomp, its pleasure, and its nonsense all! Something than beauty dearer, should they look Or on the mind, or mind-illumin'd face; Truth, goodness, honour, harmony, and love. The richest bounty of indulgent Heaven, 17 126 ON HYGIEINE. OR T LIE A U I Meantime a smilingpffspring rises round, And mingles both their grades. By degress, ,, The human blossom blows; and every day, Soft as it rolls along, show's some new charm, The father's lustre, and the mother's bloom. Thomson. Love arises from a desire of what is'beautiful and, fair, and is defined to be an action of the mind, desiring that which is good. No one loves before he is delighted with the object, let it be what it wilL, by which means it becomes phasing in our eyes, and be- gets a value and esteem in our affections. This amiable -passion in many respects is very wonderful and unaccountable; it is o such power in its operation that it has often taken the .diadem from kings and queens, and made them stoop to those of obscure birth and mean fortune. It wrests the sword out of the conquer- or's hand, and makes him a captive to his slave. It has such a variely of snares to entangle the most wary, that few have atone time or other escaped them. E-inardus was Secretary of State to Charlemain, and having ; placed his affections much higher than his condition admitted, made love to one of his daughters, who seeing this man of a brave ^ spirit, and a suitable grace, thought him not too low for her sor- ing merit had so eminently raised him above his birth. She him, and gave him free access, so far as Jo suffer him to laugh and sport in her chamber on evenings, which ought to have been kept as a sanctuary where reliques are preserved. It happened On a winter's night, Eginardus, ever hasty in his approaches, biu negligent about returning, had somewhat too long continued .* visit- and in the mean time a snow had fallen, wind, troubled them both. He feared to be betrayed by his feet, and the lady was unwilling that such prints should be found at her door. Be- ing much perplexed, she did an act for her lover, very umisua, for the daughter of one of the greatest men upon earth. >..<■ took the gentleman upon her shoulders, and earned him all th« len-th of the court to his chamber, he never setting a foot to the gro°und, so that the next day no impression might be seen of his footing. It happened that Charlemain watched at his study this nio-ht, and hearing a noise, opened the window and perceived this 01 PRESERVING HEALTH. 127 pretty prank, at which he could not tell whether it were best to b e angry of to laugh. The next day, in a great assembly of Lords, and in the presence of his daughter and Eginardus, he asked, what punishment that servant was worthy of, who made use of a king's daughter as a mule, and caused himself to be carried on her shoulders in the midst of winter, through night, snow, and all the sharpness of the season. Every one gave his opinion, and not one but condemned that insolent man to death. The princess and secretary changed colour, thinking nothing remain- ed for them but to be flayed alive. But the Emperor, looking on his secretary with a smooth brow, said, " Eginardus, hadst thou loved the princess my daughter, thou oughtest to have come to her father, the disposer of her liberty; thou art worthy of death, but I give thee two lives at present; take thy fair portress in mar- riage, fear God, and love one another." Though the female be the weaker sex, yet some have so re- paid the weakness of their nature by an incredible strength of affection, that they have often times performed as great things as wc could expect from the courage and constancy of the most generous amongst men. They have despised death, in whatever shape, and made all sorts of difficulties give way before its in- vincible force, which seemed proud to show itself most strong, in the greatest extremity of their husbands. Arria, the wife of Cecinna Partus, understanding that her hus- band was condemned to die, and that he was permitted to choose the manner of his death, went to him, and having exhorted him to depart this life courageously, and bidding him farewell, gave herself a stab into the breast with a knife she had hid for that purpose under her clothes; then drawing the knife out of the wound, and reaching it to Paetus, she said, " Yulnus quod feci, Pate, non dolet, sed quod tu facies:'' The wound I have made, Pielus, smarts not; but tliat only which thou art about to give thyself' AVhereupon Martial wrote the following epigram. When Arria to her husband gave the knife, Which made tlie wound whereby she lost her life, " This wound, dear Paetus, grieves me not," quoth she. *' But that which thou must give thyself grieves me." % 128 ON HYG1EINF, OR THE ART Happy they! the happiest of their kind, Whom gentler stars ujiite, and in one fate Their hearts, their fortunes, and their beings blend 'Tis not the coarser tie of human laws Unnat'ral oft, and foreign to the mind, That binds their peace, but harmony itself Attuning all their passibns into Love. Thomson "It is this," says Lavater, "which has sweetened every bitter of my life; this has alone supported me, when the sorrows of a wounded heart wanted vent. When my best endeavours were rejected, when the sacred impulse of conscious truth was ridicul- ed, hissed at and despised, the tear of sorrow was ever wiped away by the gentle', tender, and affectionate address of a female mind, who has an aspect like that, of unpractised virginity, which felt, and was enabled to efface each emotion, each passion in the most concealed feature of her husband's countenance, and by en- dearing means, without what the world would call beauty, always shone forth in countenance heavenly as an angel." Serene (w virgin modesty she shines, And unobserved the glorious orb declines. Oh blest with temper, whose unclouded ray Can make tomorrow cheerful as to day: {She who ne'er answers till a husband cools, Or if she rules him, never shows she rules; Charms by accepting, by submitting sways, Yet has lier humor most wlien she obeys. PorE. How delightful that sentiment, which, even in advanced life, inspires a passion perhaps more profound than it excites even in youth; a passion which collects into the soul all that time has robbed from the senses, and stripping life, in its last stages, of all gloom, unsociability and indifference, secures us the happi- ness of meeting death in those arms which sustained our youth, and entwined us in the ardent embraces of love. O the sweet powerful influences of love ! It is this that unites the interests as well as the hearts ofiovers, and gives to each the joys and felicities of the other. And it is this which indue-*' OF PRESERVING HEALTH. 129 the delicate lady to forget belt- r d?ys, and to smile in poverty, and toil with the husband whom she loves. What charm then under Heaven can excel this noble passioni No pleasures are comparable to those that affect the heart, and there are none that affect it with such exquisite delight, as loving and being beloved by a worthy object. Ask the husband who is blest with an amiable wife, and he will tell you that the most delicious feeling his heart ever experienced were those of virtuous love. Go gentle gales and bear my sighs along? The birds shall cease to tune their evening song; The winds to breathe, the waving woods to move, And streams to murmur, ere / cease to love. PorE. Some angry poets spit all their venom against loving husbands; but it no way depreciates virtue. Virtue, the strength and beauty of the soul, It pleases and it lasts; a happiness That even above the smiles and frowns of fate Exalts great nature's favourite;—a wealth That ne'er encumbers, nor to baser hands Can be transferred; it is the only good Man justly boasts of, or can call his own. Armstrong. A Neapolitan, being at work in a field bordering upon the sea side, his wife being some distance from him, was seized by some corsairs of Tunis, and carried on board their vessel. Miss- ing his wife, aud seeing a ship at anchor, he soon conjectured wdiat the matter was, and throwing himself into the sea, swam to the ship, telling the captain, "He was come to take the same fate with his wife, for though he understood the hardship and misery' he must undergo in slavery, his love had conquered all difficulties, he neither could nor wrould live but with her." The Turks, admiring the man's unaccountable affection, at their re- turn told it to the King of Tunis, who pleasing himself with so singular an example of love and constancy, gave them both their liberties. A ** 130 ON II \ G I E I N 1.. OR 1 H E A IIT Bless'd is the maid, and worthy, to be blessed, Whose soul, entire by him she loves possessed, Feels every vanity in fondness lost, And asks no power hut that of pleasing most:. Her's is the bliss, in just return, to prove The honest warmth of undissembledlovc; For her inconstant man might cease to range, And gratitude forbid desire to change. Love is a vice only in vicious hearts. Fire, though thepurei»i of all substances, will yet emit unwholesome and noxious va- pours when it is fed by tainted matter; so love, if it grow in a vicious mind, produces nothing but shameful desires and crimi- nal designs, and is followed with pain, vexation and misery. But let it rise in an, upright heart, and be kindled by an objee adorned with virtue; it is safe from censure. Love, studious how to please, improves our parts With polished manners, and adorned witli arts. It kindles all the soul with Honour's lire; Curbs and restrains extravagant desire, And to be chaste and kind does still conspire. \ just heroic passion that can find, No room in any base degenerate mind. Drydkv In propitious love the heartbeats with joy; vivacity cheers the countenance, the eye is brilliant, society is courted, and all the benevolent affections are indulged. But disappointed love. on the other hand, is extremely detrimental. It depresses the spirits, enfeebles digesi ion, takes away the appetite, banishes sleep, and not unfrequently produces insanity. History affords many instances of mental derangement from disappointed love.__ The following affecting cases deserve to be mentioned. A German lady, of great beauty and accomplishments, having married a Hessian officer ordered to America, and not being able , to acquire any tidings of him in her own country, came over to England. Here, she could only learn the destiny of her husband from those ships which had either transported troops to the eon- OF PRESERVING HEALTH. 131 ment or were bringing back the wounded. Day after day she wandered on the beach at Portsmouth, and hour after hour she wearied her eyes, bedewed with tears, in the vain expectation "! of seeing him. She was observed at the same spot, ere it was $ light, and watched each motion of the waves until the setting sun.—Then her haunted imagination presented him mangled with wounds, and the smallest gust of wind seemed to threaten her with an eternal separation. After eight months spent in this anxious manner, she learned that a vessel bringing some wounded Hessian officers had arrived. She kept at some distance, for ] fear of giving too great a shock to her husband's feelings, should he be among them. He was landed with others: she followed '-jj to the tavern. When she entered the room, he burst intq^i flood , i of tears. A lady wras supporting him in her arms. What words or painter could represent the tragedy that followed! He had married in America, and this person was also his wife. He ii> treated for "pardon," was past reproach, for in a few minutes aficr he sunk into the arms of death. The lady, whose melan- choly history we are recording, rushed from the room, and leaving her clothes and money at her lodging, wandered, she knew not whether, vowing, "that she would never enter house more, or trust man." She stopped at last near Bristol, and ■' begged the refreshment of a little milk. There was something ^o attractive in her whole appearance, as soon produced her whatever she requesteafi' She was young, and extremely beau- ,J tiful; her manners graceful and elegant, and her countenance ia- J| {cresting to the last degree. She was alone, a stranger, and in extreme distress; she asked only for a little milk, but uttered uo complaint, and used no art to excite compassion. Her dress aid accent bore visible marks that she was a foreigner of supe- rior birth. All the day she was seen wandering in search of a *9 place to lay her wretched head; she scooped towards night a lodging for'^herself in an old hay stack. Multitudes soon flocked around her, in this new habitation, attracted by the no- v. volly of the circumstance, her singular beauty, but, above all, ihe suddenness of her arrival. French and Italian were spoken to her, but she appeared not to understand these languages; how- ■wer, when she was accosted in German, she evidently appeared 132 OX HYGIEINE, OR THE ART confused, the emotion was too great to be suppressed, she ut- tered some faint exclamations in that tongue, and then, as if hur- ried into an imprudence, she attempted to be also without know- ledge of this language. Various conjectures were instantly formed, but what seemed passing strange, was, her acceptance of no food, except bread or milk, and that only from the hands of females. On the men she looked with anger and disdain, but sweetly smiled, as she accepted any present from the other sex. The neighbouring ladies remonstrated with her on the danger of so exposed a situation, but in vain; for neither prayers nor me- naces could induce her to sleep in a house. Beneath a stack Louisa's dwelling rose, Here the fair maniac bore four winter's snows, Here long she shiver'd, stiffening in the blast, And lightnings round her head their horrors cast, Dishevell'd, lo! her beauteous tresses fly, And the wild glance now fills the staring eye, The balls fierce glaring in their orbits move, Bright spheres, wdiere beam'd the sparkling fires of love. It may gratify the reader lo learn, that it has been ascertained since her death, that this fair sufferer was the natural daughter of the Emperor Francis of Germany. (■■■ In W----, a small village in Saxony, there lived a poftf, but honest and upright curate, who for many years had enjoyed without alloy, the tranquil pleasures of domestic happiness. He had a wife, and an only child, a daughter. Content in the sphere wherein they were placed, and unacquainted with the turbulent passions of the fashionable world, their days flowed quietly on in an uniform course of undisturbed felicity. The mother and daughter took a joint care of all the domestic concerns, and strove by every act of attention and love, to diminish the burden which the duties of the good old man imposed on him. Harriet, this was the name of his daughter, was in the strict sense of the word, the child after his own heart. He was unhappy if she were absent even for a few hours; she was, therefore, his con- stant attendant.—She was about eighteen years old, but had not • P PRESERVING HEALTH, 133 yet experienced the inquietudes of that passion, which often exhibits itself in very early life in the great world; and her prh> ciples and mode of thinking were too noble and good to inspire her parents with even the slightest apprehensions as to the wan- derings of her heart. But hear her history. Far different from the condition of the Americans, the Saxons are obliged, in time of peace, to receive the king's cavalry, which are quartered in different villages, where it is maintained at the expense of the poor peasantry. Most of the soldiers are riotous young men, who, by virtue of their profession and uniform, obtain entrance into the houses of all the peasantry, and even to the curates, to the great eorruption of the innocent and virtuous manners of the country people. One of them, a handsome, but giddy young man, was quartered at W----, where he soon made the acquaintance of the good old parson. The young soldier had more culture of mind than is usually met with in such a class of men. He pleased the curate, who often invited him to the parsonage, and listened with pleasure to the histories of his battles, and warlike achieve- ments. The tender-hearted Harriet found great entertainment in the oompany of the young warrior, and, like Othello's mistress, the story of his life, the battles, sieges, fortunes that he had passed, the hair-breadth 'scapes, the moving accidents by flood and field, won her heart.—Love had taken possession of her bosom, before she was aware of its approach. She blushed when he took her by the hand, and was unhappy when he left her. The s»oldier could not resist the beautiful girl, for his heart was formed for love. They therefore soon came to an exphnation, of their mutual passion, which, for the present, they agreed to conceal from their parents, for fear that prudential motives would cause them to oppose it. They bound themselves to each other, how- ever, by an oath, whicli, at the same time that it showed the strength of their affection, exhibited the most romantic turn of mind. They promised to marry as soon as he could attain the rank of sergeant-major, and agreed that the one should destroy the otluir, who first failed in tlie engagement. Thus matters stood, when, contrary to the wishes of the lovers, a lawyer from a neighbouring town applied to the father of H*rr*et for the 18 134 ON HYGIEINE, OR THE ART hand of his daughter. He was well received, and his view.?, promoted by the old people1; but when his intention was declar- ed to the unfortunate girl, she fell into the arms of her father, as if struck with lightning, and, on her recovery, wept bitterly, entreating them not to encourage the addresses of this new lover. Her parents, being ignorant of the true; cause of her aversion, thought that time would soon overcome it, and therefore gave their solemn promise to the lawyer to second his wishes. Har- riet, however, resisted every argument, and remained true to her promise; but her parents, at length growing tired of her oppo- sition, determined to employ their authority, which at last pre- vailed. The young soldier soon received the intelligence, and instantly formed his desperate resolution, for without his lovely Harriet he could not live. A short time before the marriage- day, a dance was given in W----, in honour of the pair. To this he resorted, unable any longer to resist the desire of seeing once more his beloved. He concealed himself among tlie spec- tators until he saw her dance; which roused him to a state of fu- ry. He ran home, took a pair of loaded pistols, and waited Un- til the party broke up. It was a dark night, but he discerned the unhappy bride intended, and her bridegroom, walking hand in hand. He stepped up to her, and in a low voice, requested that she would indulge him with a moment's conversation. She dis- engaged her arm from that of the lawyer, intreated him to walk on, assuring him she would immediately return: but, alas' she was to return no more! A pistol was heard, and when her trembling friends reached the place, they found her weltering in blood, at the feet of her murderer. "Now art thou mine again,1* cried the soldier, in tones of horrid joy, and fled, but not to es- cape. He delivered himself to the officers of justice, and beg- ged to be instantly executed, whicli event, indeed soon followed. Learn parents, from this story, the danger of interfering with your children's affections in so serious an affair as marr-nge: for, as Shakspeare observes: Marriage is sure a matter of more worth Than to be subject for attorneyship, For what is wedlock, forced, but a hell. WF PRESERVING HEAT11 135 An age of discord and continual strife? Whereas the contrary bringeth forth bliss, Afid is a pattern of celestial peace. The most dangerous effect of love is jealousy. It is the most vain, idle, foolish, and turbulent disease that ever assaulted and o; pressed the mind of mankind. Of all the diseases of the mind, it ,s that Jdi most things serve for aliment and fewest for remedy. Eonaventur, sitting at a table, and looking earnestly upon a beautiful woman present, was asked by her husband, why he so gazed? He answered: "That he admired the excellency of the Creator by contemplating tlie beauty of the creature; and that if mortals were so amiable, how lovely should we be at the resur- rection." This was an example, saith Boschier, that was rather to be admired than imitated; suitable to the golden age, and not this present iron age of the world, wherein jealousy may be com- pared to the Indian arrows, so envenomed, that if they prick the skin it is very dangerous; but if they draw blood, it is irrecover- ably death: the first motions that rise from this root of bitterness have their evil effects; but wdiere the disease is improved, it empoisons all our comforts, and throws us headlong into the most tragical resolutions. ""■& \ The Marquis of Astorgas, of the family of Osorio, indulged himself in an illicit intercourse with a most beautiful young wo- man. His wife, on being informed of his intrigue, went imme- diately to the house where her husband's mistress lived, and murdered her in the most cruel manner. She tore her heart from her bosom, and took it home, ordering it to be hashed and served up to her husband for dinner. After he had eaten of it, she asked him if it were good? and, . on his answering yes, she said, she wras not in the least surprised, for if was the heart of his mistress, whom he so dearly loved. At the same time, she drew from a cupboard the bleeding head of his murdered favorite, and rolled it on the table at which this unhappy lover was sitting w ith his friends. His wife immediately departed, and took refuge in a convent where she soon afterwards went mad with rage and jealousy. 136 ON HYtflElNE, OR TUB ART Earth has no rage like love to hatred lurn'd, Nor hell a fury like a woman scorn'd. Dryden. The power of beauty is universally acknowledged, having been the object of love and admiration in all times and among all nations. But, alas! what is beauty without the graces of virtuei In Italy there grows an herb called the Basilisco; it is sweet- scented enough, but, withal, has this strange property, that being laid under a stone in a moist place, in a few days it pro- duces a scorpion. Thus, though the woman, in her first crea- tion, was intended as a help for uian, the partner of his joys and Cares, the sweet perfume and relish of his days throughout his whole pilgrimage: yet there are some so far degenerated from tlieir primitive institution, though otherwise of exterior beauty and perfection enough, that they have proved more intolerable than scorpions, not only tormenting the life, but hastening the death of their too indulgent husbands. Not that my verse would blemish all the fair, But yet, if some be bad, 'tis wisdom to beware; And better shun the bait, than struggle in the snare. Dryden. Joan, grand-child to Robert, king of Naples, succeeded her grand-father in the kingdom of Naples and Sicily; a woman of beautiful person, and rare endowments of nature. She was first married to her cousin Andrew, a prince of royal extraction and of sweet disposition; but being lasciviously disposed, she grew weary of him, and caused him to be strangled in the night and then threw out his corpse into the garden, wdiere it lay some days unburied. It is said her husband, on seeing her twisting a thick string of silk and silver, asked for what purpose she made it; she answered, "to hang you in!" which he then little believed; the rather, because those who intend such mischief use not to speak of it before-hand; but it seems she was as good as her word. OF PRESERVING HEALTH. 137 O fairest of creation! last and best Of all God's works! creature in whom excelled Whatever can to sight or thought be formed, Holy, divine, good, amiable, or sweet! How art thou lost. Milton. Love is never more abused than by those men who do not de- sign to marry. It will generally be found, that libertines will single out from among the herd of females, a raw, innocent, young creature, who thinks all the world as sincere as herself, to whom they design to make their addresses. They take every opportunity to be in tlieir company, and pretend to zeal in love, when it is nothing but lust that fires them. When men's desires and lusts once sated are, For oaths and promises they little care. The female, who yields her virtue to the brutal desires of a false lover, degrades herself in his estimation by the infidelity she commits, and the surrender of so precious a jewel inspires a remorse and shame, when she ceases to be beloved, that consti- tutes the bitterest woe of life. It is surely matter of wonder, that these destroyers of innocence, though dead to all the higher sentiments of virtue and honour, are not restrained by compassion and humanity. To bring sor- row, confusion, and infamy into a family; to wound the heart of a tender parent, and stain the life of a poor deluded young wo- man, with a dishonour which never can be wiped off, are cir- cumstances one would think sufficient to check the most violent passion, in a heart the least susceptible of feeling. 13S ON HYGIEINE, OR THE ART OP HOPE. "Hope springs immortal in the human breast* Man never is, but always to be bleit. 0 Happiness, our being's end andaim, Good, Pleasure, Ea9C, Contend, whateVr thy namr: That something still, which prompts the eternal >i0h, For which wo bear to /ut», or d;\re to die." (>n n HorE is the anticipation of joy, or the presentiment of an ex- pected good. It is attended with all the favourable effects of a fortunate event, without possessing any of its physical advan- tages; because the expectation of happiness does not affect us so excessively as its enjoyment. Besides, it is not liable to tliose interruptions, from which no human pleasure is exempt; it is employed principally with ideal or imaginary objects, and gene- rally keeps within the bounds of moderation; lastly, the sense of happiness contained in hope, far exceeds th'fe satisfaction re- ceived from immediate enjoyment,•consequently it has a more be- neficial influence on health, than good fortune realized. Although hope is in itself only ideal, and presents its flattering images to the fancy in a borrowed light, yet it is nevertheless the only ge- nuine source of human happiness. With thee, sweet Hope! resides the hcaveuly light, That pours remotest rapture on the sight: Thine is the charm of life's bewilder'd way, That calls each slumb'rh.g passion into play. Wak'd by thy touch, I see the sister band, On tiptoe watching, start at thy command, And fly where'er thy mandate bids them steer, To Pleasure's path, or Glory's bright career. Cami>i:ell. The poet Hesiod tells us, that the miseries and calamities of mankind were included in a great tun; that Pandora took off the I OF PRESERVING HEALTH. 139 \\(\ 0f it, sent them abroad, and they spread themselves in great quantities over all lands and seas; but at this time, Hope only did remain behind, and flewr not all abroad, But underneath the utmost brim and ledge it still abode. And this is that which is our principal antidote, which keep* our hearts from bursting under the pressure of evils; and that il uttering mirror that gives us a prospect of greater good. Hence some call it the manna from Heaven, that comforts us in all ex- tremities; others the pleasant and honest flatterer, that caresses- fiie unhappy with expectation of happiness in the bosom of fu- • turity. A very notable case of the influence of Hope on the human body, and jts maladies, is recorded in the history of the long siege of Breda, in 1625, by a physician, eye witness of the fact. That City, from a long siege, suffered all the miseries that fa- ■*. tigue, bad provisions, and distress of mind could bring on its in- habitants. Among other misfortunes the scurvy made its appear- '*':, ancc, and carried off great numbers. This, added to other cala- mities, induced the garrison to incline towards a surrender of the place, when the Prince of Orange, anxious to prevent its loss, and unable to relieve the garrison, contrived to introduce let' tcrs addressed to the men, promising them the most speedy assistance. These were accompanied with newly discovered medicines against the scurvy, of a most extraordinary price, but , still more extraordinary efficacy. To each physician were given three small vials, filled with drops of such sovereign power, that four drojis were sufficient to impart a healing virtue to a gallon of liqiwr. We now, says the physician, wdio was one of the eye- witnesses of this curious fact, began to display our wonder- working balsams. Nor were even the commanders let into the. » BfCrel of the cheat upon the soldiers. All who had the scurvy crowded around us to take their doses. Cheerfulness again ap- pears in every countenance, and the universal faith prevails in the sovereign virtues of the remedy. The effect of this delusion w as truly astonishing. Many who had not moved their limbs for a month before, were seen walking the streets erect and perfect- 140 ON HYGIEINE, OR THE ART ly cared. Many who declared they had been rendered worse hy all former remedies, recovered in a few days, to their inexpres- sible joy, and the no less general surprise, by their taking, what we affirm to be, their gracious Prince's cure. "This curious relation," adds Dr. Lind, "would hardly per- haps gain ■credit, were it not in every respect consonant to the most accurate observations, and best attested description of that disease. It is given us by an eye-witness, an author of great candour and veracity, wdio as he informs us, wrote down every day the state ofhis patients, and seems more to be surprised with their unexpected recovery, than he probably would have been, had he been acquainted with the nature of this surprising malady. An important lesson in physic," adds this excellent writer, " is hence to be learned; the wonderful influence of the passions of the mind on the state and disorders of the body. This is too often overlooked in the cure of disorders, many of which are sometimes attempted by the sole mechanical operation of drugs, without calling in to our assistance the strong powers of the imagi- nation, or the concurring influences of the soul. Hence it is, that the same remedy will not always produce the same effect, even in the same person; and that common remedies often prove wonder- fully successful in the hands of men not of the faculty, which do not answer the purpose in a timorous and distrustful patient." Primeval Hope, the Aonian muses say, When Man and Nature mourn'd their first decay; When every form of death, and every wo, Shot from malignant stars to earth below; When Murder bared her arm, and rampant War Yok'd the red dragons of her iron car; When Peace and Mercy banish'd from the plain, Sprung on the viewless winds to Heav'u again; All, all forsook the friendless guilty mind, But hope, the charmer, linger'd still behind. Campbell. A certain Rhodian, for his over freedom in speech, was ens', by a tyrant into a cage, and there kept as a wild beast, to his great pain and shame: for his hands were cut off, his nostrils slit, and his face deformed by several wounds upon it. In thf* OF PRESERVING HEALTH. 141 extremity, he was advised by some of his friends to shorten his life by a voluntary abstinence from all food. But he rejected their counsel with great indignation; and told them, " WThil« a man is alive, all things are to be hoped for by him." Cease, every joy, to glimmer on my mind, But leave—oh! leave the light of Hope behind! What though my winged hours of bliss have been, ^Like angel-visits, few and far between! Her musing mood shall every pang appease, And charm when pleasures lose the power to please! Campbell. But Hope ill-grounded does often trick and bubble the owner, as it did the Spanish woman that, coming with three of her sons a begging to a French shoemaker that lived in Spain, he said to her one day, " Good woman, I will ease thee of some part of thy charge; for if thou leave one of thy sons with me I will breed him up in my trade, and make him capable of living like a man, and to be helpful to his parents also." " God forbid," said the woman, " that I should cast away my child to a stranger, and bring him up to so pitiful a mechanic trade as a shoemaker, since I live in hopes that the eldest will be Viceroy of Naples, the se* oond of Mexico, and the youngest of Sardinia. Hope, Fortune's cheating lottery! Where, for one prize, a hundred blanks there be Fond archer, Hope! who tak'st thy aim so far. That still, or short or wide, thy arrows are. Thin empty cloud! which th' eye deceives With shapes that our own fancy gives: A cloud, which gilt and painted, now appears, But must drop presently in tears. Brother of Fear! more gaily clad! The merrier fool o' the two, but quite as mad. Dryden. 13 I li-2 on* hyi.ieim;, or the arc or joy. Pir.AsruF.s air ever in our hands or eves, And when, in act, they cease, in prospect, rise. Freseut to grasp, and future still to find, The whole employ of body and of mind. All spread their charms, but charm not all alike, On diff'rent seizes, diff'rent objects strike; Hence diff'rent Passions, more or less inflame, As strong or weak, the organs of the frame; And hence one master pamsion in tlie breast, Like Aaron's serpent, swallows up the rest. Pore. The consideration of some present good, and which particu- larly belongs to us, begets in the soul that delight which wre call joy; for as soon as our understanding observes that we are pos- sessed of the good we desired, the imagination presently makes some impression in the brain, from whence proceeds a motion of the sensitive soul, and of the spirits, that excites the passion of joy. By it the activity of the whole machine is enlivened; the ac- tion of the heart and arteries is increased; the circulation of .all the fluids is more vigorous and uniform; preventing the formation of disease, and facilitating the cure of such as are formed. There are several degrees of joy, as various circumstances may intervene; and so may wc distinguish various differences of the passion itself; for there is no pleasure or good that may not be mixed with some ill or inconvenience. Our extremest plea- sure has still some air of groaning and complaining in it, unless it be discreetly moderated. It proves fatal to us when it grows into excess. Ptolemeus Philadclphus had received the sacred volumes of the law of God, newly brought out of Judea; and while he held them with great reverence in his hands, praising God upon that account, all that were present made a joyful exclamation; and the king himself was so overjoyed, that he broke out into tears. Na- ture having so ordered it, that the expression of sorrow should also be the follower of extraordinary joys. ".-'■ i wm OT PRESERVING HEALTH. l45 Askew, a wealthy and facetious farmer of Cornwall, wTas af- flicted with a most alarming imposthumation, of which he ap- peared to be on the very point of suffocation. Concluding, from his agonies, that he had but a few moments to live, his servants, an ungrateful crew to such a generous master, began to plunder. One seized his gold watch, another laid violent hands on his plate, and the third, more daring still, broke his bureau, and began to finger his gold. A monkey, who was present, seeing what they were about, and thinking he might as well take a hand in the game, laid hold of his master's wig, and with his gold-headed cane, made him a low bow, and began to walk about the room as a man of great consequence. The stately steppings and self- ' assumed dignity of Jacko, so tickled the fancy of Mr. Askew, as to excite a most immoderate fit of laughter. The imposthu- mation burst, the purulent matter was thrown up—and, to the eternal confusion of his servants, Mr. Askew perfectly recover- ed his health. Philemon, a comic poet, beholding an ass eating some figs that . a boy had laid down; when the boy returned, " Go now," said he, " and fetch the ass some drink;" the old man was so tickled with the fancy of his own jest, that he died laughing. In the same manner, and much upon the same occasion, died Crysippus. Diagoras, the Rhodian, when he saw his three sons all victo- rious in the Olympic games, and crowned the same day, he was extremely pleased; but when his sons came and embraced their aged father, and each put their triumphal wreath upon his head, he was so overcome with joy and delight, that he fell into their arms, and died. If we have anticipated any joyful event, the body is gradually prepared to undergo the emotions connected with it. For this reason wc ought to fortify ourselves with the necessary share of firmness, to meet joyful as well as disastrous tidings. 144 ON HYGIEINE, Oil THE ART OF GRIEF. it is the great art of life to manage well The restless mind. For ever on pursuit Of knowledge bent, it starves the grosser powoU Quite unemployed, against its own repose It turns its fatal edge, and sharper pangs Than what the body knows, embitter life. Chiefly were solitude, the nurse of care, To sickly musing gives .the pensive mind, Ther$ madness enters; and the dim-eyed fiend, Sour melancholy, night and day provokes Her own eternal wound. * * * * ' Armstrong. Grief, like a poison, corrodes the powers of the mind and body; it enfeebles the whole nervous system; the heart beats slower; the circulation of the blood, and other fluids, become more inert; the appetite and digestion become vitiated, and thus arise obstructions and other distressing complaints. Tears are the anodynes of grief, and ought, therefore, not to be restrained. They have a tendency to prevent the danger to be • apprehended from grief, by diminishing the spasmodic motions in the breast and head; and by restoring regularity in respiration, as well as in the circulation of the blood. A widow lady was left in narrow circumstances with a boy and girl, two beautiful and lovely children, the one six, and the other seven years of age. As her circumstances allowed her to keep but one maid servant, these two children were the sole attention, employment, and consolation of her life. She fed them, dressed them, slept with them, and taught them herself. They were both snatched from her by the gangrenous sore throat, in one week; so that she lost at once all that employed her, as well as all that was dear to her. For the first three or four days after their death, when any friend visited her, she sat upright with her eyes wide open, without shedding tears, and affected to'speak of indifferent things. Afterwards she began to weep much, and for some weeks talked to her friends of nothing else but her dear children; but did not for many years, even to her dying hour, get quite over a gloom which was left upon her countenance. "U"^#t OF PRESERVING HEALTH. 145 When any cause of deep grief is presented to the mind it fre- quently gains such a force as almost totally to exclude all thoughts, except those that are connected wdth it. Hence the whole ima- gination is, by degrees, obscured, and the most usual conse- quences of it are the deepest melancholy, succeeded by insani- ty—and sometimes, that speedier dissolution, "a broken heart." When the Turks came to raise the siege of Buda, there was amongst the German captains a nobleman called Rayschachius, whose son, a valiant young gentleman, having got out of the ar- my without his father's knowledge, he behaved so gallantly in tight against the enemy, in the sight of his father and of the ar- my, that he was highly commended of all men, and especially of his father, who did not know he was his son; yet before he could clear himself he was compassed in by the enemy, and, va- liantly fighting, was slain. Rayschachius, exceedingly moved • by the death of a brave man, ignorant how near it touched him- self, turning about to the other captains, said "This worthy gen- tleman, whosoever he he, deserves eternal commendation, and to be honourably buried by the wdiole army." As the rest of the captains were with like compassion approving his speech, the dead body of the unfortunate son was presented to the most mi- serable father, which caused all who were present to shed tears; but such a sudden and inward grief surprised the aged father, and struck so to his heart, that after he had stood awhile speechless, with his eyes fixed, he fell down dead. The melioration of grief by time, and its being at length even attended by pleasure, depends on our retaining any distinct idea of the last object, and forgetting for a time the idea of the loss of it. This pleasure of grief is beautifully described by Akenside. * * * Ask the faithful youth " Why the cold urn of her whom long he lov'd So often fills his arms: so often draws His lonely footsteps at the silent hour To pay the mournful tribute of his tears? Oh! he will tell thee, that the wealth of worlds .Should ne'er seduce his bosom to foifego 146 OX IIYlilEINE, OR THE AIM That sacred hour; when stealing from the noise Of care and envy, swreet remembrance sooths With Virtue's kindest looks, his aching breast, And turns his tears to rapture. Whilst the great genius of physic, Hippocrates, drove away maladies by his precepts, and almost snatched bodies out of the hands of death, one Antiphon arose in Greece, wdio, envious of his glory, promised to do upon souls what the other did on bodies; and proposed the sublime invention, which Plutarch calls the art of curing grief, where we may truly say, he used more vani- ty, promises, and show of words than he wrought effects. Cer- tainly it were to be wished that all ages which arc abundant in misery should likewise produce great comforts to soften the cala- mities of human life. O! canst thou minister to a mind diseased, Pluck from the memory a rooted sorrow, Rase out the written troubles of the brain; And, with some sweet oblivious antidote, Cleanse the stuff'd bosom of that pcrilous'Stuff Which weighs upon the heart? Shakspeare. In the Pagan religion, the power of dying was the great conso- lation in irremediable distress. Seneca says, "No one need be unhappy, unless by his own fault."—And the author of Tclemachus begins his work by saying, that Calypso could not console herself for the loss of Ulysses, and found herself unhappy in being im- mortal. But to the Christian this one suggestion, I know that my Redeemer liveth affords a richer cordial to the fainting soul, than all the volumes of Heathen Philosophy. Many are the sayings of the wise In ancient and in modern books cnroU'd, Extolling patience as the truest fortitude. And to the bearing well of all calamities, All chances incident to man's frail life. Many arc the consolatary writs form'd With studied argument and persuasion; But with th' afflicted in his pangs such sound* gF PRESERVING HEALTH. 147 Little prevail, or rather seem a tune Harsh and of dissonant mood from his complaint: 1J uless he feel within Some source of consolation from above, Secret refreshings, that repair his strength, And fainting spirits uphold. Milton. In the midst of all distresses, there remains to every sincere Christian, that mixture of pure and genuine consolation, which springs from the promises and hopes of a future life. Consider what a singular distinction this makes in your situation, beyond ' the state of those who, under the various troubles of life, are left without hope; without any thing to look up to, but a train of unknown causes and accidents, in which they see no light or com- fort. Thank the Father of Mercies, that into all the evil' he sends, he infuses joyful hope, that the sufferings of the present time are not worthy to be compared with the glory tliat shall be revealed in the end to tlie virtuous and good. Have we sustained the great- est of all losses? It is his gain that he yet liveth, that this life is hut the threshold, the portal, the entrance to a better place, and that his happiness is as complete as our misery is great. Let us turn our eyes from earth to heaven, from the perishable body to that which endureth forever; and even whilst we are heavy with affliction, let us smile with our eyes turned upwards, and say, "It is thy will, I submit. He is happy. I would not wish him back to a troublesome world. I soon shall follow after him. The mortal hath put on immortality—.We shall then meet, never to be sepa- rated more." Think, then, ye mourning parents, nor complain For breathless children, as ye weep in vain. Why should you be in lamentations drown'd, While your young babes with victory are crown'd, Uefore the sword was drawn, or cruel strife Had shed its venom on the ills of life? Perhaps Almighty God foresaw some vile, Some tempting evil that should them beguile; Of sore adversity, a dreadful storm, Or of dire wickedness, a monstrous form. 148 ON HYGIEINE, OR THE ARl How then in words which nothing can avail. Against that kind precaution dare you rail? Remember, that of them you're not bereav'd, But from "the coming evil they are sav'd." OF FEAR. Timorous self-love, with sick'ning fancy's aid. Presents the danger that you dread the most, And ever galls you in your tender part. Hence, some for love, and some for jealousy, Have lost their reason: some for fear of want, Want all their lives; and others every day, For fear of dying suffer worse than death. Is there an evil worse than fear itself? And what avails that indulgent Heaven From mortal eyes has wrapt the woes to come,. If wc, ingenious to torment ourselves, Grow pale at hideous fictions of our own? Armstrong. Fcar has its origin in the apprehension of danger, and is kindly placed in man as a sentinel for self-preservation. But, like every other passion the excess of it is pernicious. O Fear, I know thee by my throbbing heart; Thy withering power inspir'd each mournful line: Though gentle Pity claim her mingled part, Yet all the thunders of the scene are thine. Collins. Don Diego Osorius, a Spaniard of a noble family, being m love with a young lady of the court, had prevailed with her for a private conference under the shady boughs of a tree, that grew within the gardens of the kiyg of Spain: but, by the unfortunate barking of a little dog, their privacy was betray ed, and the young gentleman seized by some of the king's guard, was imprisoned. It was a capital crime to be found in that place, and, therefore he was condemned to die. He was so terrified at the hearing of his sentence, that-one and the same night saw the same person young, and all turned grey as in age. The jailor, moved at the OF PRESERVING HEALTH. 149 sight, related the accident to king Ferdinand, as a prodigy; who, thereupon, pardoned him; saying, "He had been sufficiently pun- ished for his fault, seeing he had exchanged the flower of his youth into the hoary hairs of age." I knew a surgeon, says Dr. Darwin, who was always rather of a parsimonious disposition, had a large house, with a fortune of forty thousand pounds left him; and in a few weeks became insane from the fear of poverty; lamenting that he would die in a jail or a work-house. He had left off a laborious country practice and the daily perception of profit in his books; he also now saw greater expenses going on in his new house than he had been ac- customed to observe, and did not so distinctly see the source of supply; which seems to have occasioned the maniacal hallucina- tion. The fear of hell, continues he, has also, in some instances, been attended with fatal effects. In this kind of madness, the poor patients frequently commit suicide; although they believe they run headlong into the very hell which they dread! It is said of Epicurus, a profane teacher, that never was a school hoy more afraid of a rod, than he was of tlie thoughts of a God and death. No man more feared the things which he taught should be despised, than himself. For whatever there is in the air, there is certainly an elastical power in the conscience, that will bear itself up, notwithstanding all the weight that is laid upon it. Conscience, the torturer of the soul, unseen, Does fiercely brandish a sharp scourge within. Severe decrees may keep our tongues in awe, But to our thoughts what edict can give law? Even you, yourself, to your own breast shall tell \ our erimesj and your own conscience be your hell. Dryden. The wretched state of Richard the Third, after he had mur- dered his nephews, is thus described by Sir Thomas Moore: "I have heard," siidi he, ■<■ by credible reports, that after this abom- inable (\ca\ he never had quiet in his mind, and never thought himself safe. When he went abroad his eyes^ whirled about 2.0 150 ON hygieine, OR the art his body Was privily fenced, his hand ever on his dagger, bin countenance and manner like one who was ever ready to strike: he took no rest in the night, lay long waking and nmsinr, sore wearied with care and watching, and rather slumbered than slept, troubled with fearful dreams: he sometimes started suddenly up, leaped out of his bed, and ran about the chamber: his restless heart was continually tossed and tumbled with flic tedious im- pression and stormy remembrance of his horrid and abominable deeds." Conscience, what art thofl? thou mysterious pow'r, That dost inhabit us without our leave, And art within ourselves another self, A master self, that loves to domineer, And treat the monarch frankly as the sla\c; How dost thou light a torch to distant deeds, Make the past, present, and the future frown: How, ever and anon, awake the soul, As with a peal of thunder, to strange horrors! SlIAKSI'IiARE. The rich Cardinal of Winchester, Henry Beaufort, who pro- cured the death of the good Duke of Gloucester, was soon after Struck with an incurable disease; and, understanding by his phy- sicians, that he could not live, he expressed himself thus; " by, will not death be hired? Will money do nothing? Must I die who have such great riches? If the whole realm of England would save my life, I am able, either by policy to get it, or by riches to buy it." But the king of terrors is not to be bribed by gold. It is a pleasure to him to mix the brains of princes and politicians with common dust; and how loath soever he was to depart, yet grim death would sieze upon him. How shocking must thy summons be, O death! To him that is at ease in his possessions; Who, counting on long years of pleasure here, Is quite unfumish'd for tbe world to come ? In that dread moment, how the frantic soul Haves round the walls of her clay tenement, OF preserving health. 151 Rushes to each avenue, and shrieks for help, But shrieks in vain. ****** *********** The foe* Like a staunch murderer, steady to his purpose, Pursues him close through every lane of life, Nor misses once the track, but presses on, Till forc'd at last to the tremendous verge. At once he sinks to everlasting ruin, Flair. The best remedy against this torturing state of the mind is a good conscience, which is to the soul what health is to the body. It preserves a constant ease and serenity within us, and more than countervails all the calamities and afflictions that can befal us. When the mind has been under the influence of sudden sue-. prise, oi' vehement attention to some interesting object, it ha§ frequently suspended, and even entirely cured, ague and fever, asthma, and other chronic diseases, An officer, of great courage, who had contracted the asthma by long service in India, declares, that during a most severe at- tack of that complaint, when he could scarcely breathe in an erect posture, and without power to move, as he thought, six yards to save his life, the alarm guns were fired for the whole line to turn out, because the Mahrattas broke into the camp. Knowing that certain death would be his portion if he remained in his tent, he sprung out with an alacrity that amazed his attend- ants, instantly mounted his horse, and with great ease drew his sword, which the day before he could not move from its scabbard^ though he liad used his whole strength in the attempt. From the instant of the alarm, the debility left him, together with the asthma, nor did the disorder return for some time after. I have frequently observed, says the ingenious author of the Medical Extracts, delicate hysterical women, who, for many months, had seldom enjoyed one day's health, suddenly relieved from every complaint, when a favourite child was attacked with a disease, in which danger was apprehended: and they continued in appearance, to be in perfect health during the whole course of the illness, and exhibited an unusual alertness in discharging their duty as nurses an/1 parents. But when they understood that the 152 ON HYGIEINE. OR Till' ART danger was over, their former complaint gradually returned, tu their great surprise; for from the health they had lately enjoyed, and from so considerable a time, they believed themselves per- fectly cured. A very remarkable instance of the influence the mind has upon disorders of the body, occurred to the celebrated Boerhaave. A person fell down in an epileptic fit in the sight of other patients. The effect of this operated so strongly that great numbers of them became immediately affected hi the same manner. The opinion of the great physician above mentioned was requested on this occasion. He judiciously reflected, that, as these fits were originally produced by an impression on the mind, that the most proper means of cure would be to eradicate these impres- sions by others still more powerful He therefore directed actual cauteries to be prepared, and kept hot, in readiness to be applied to the person who should next be affected. Tlie consequence ivas, not one'percon was seized. Through a most criminal inattention to children in the nursery, a foundation is sometimes laid in their tender minds for those superstitious terrors, from which not all their efforts in subse- quent life can entirely relieve them. I allude to those dismal stories about Witches, Spirits, Hobgoblins, Raw-head and bloody- bones, wherewith silly nurses, especially poor blacks, are so fond of frightening infants. Considering the importance of deep im- pressions made during those tender years, parents cannot too strictly forbid every thing of this sort; neither can they ever exceed in their generous labours to illuminate the minds of their children with lofty ideas of their Creator, and that mighty power which he will never fail to exert in their favor, if they will but. be good. Timorous persons are more readily infected by contagious dis- orders, than those possessed of fortitude. Hence it is we find nurses most frequently escape contagion, while persons of a fear- ful disposition contract the disease on entering the chamber of the sick only once or twice. Persons under a violent fit of fear, should be treated like those who suffer from any other spasmodic contraction. Tea, a littlo If OF PRESERVING HEALTH. \5Q wine, or spirits and water may be given to them; vinegar, laven- der-drops, or spirits of hartshorn may be held to the nostrils; warm bathiug of the feet, and emollient injections may be of ad- vantage; but above all, the mind ought to be duly composed.->- Exccssive bashfulness borders on fear; it may be corrected by social intercourse with persons of a cheerful disposition. OF ANGER. When reason, like a skilful charioteer, Can break the fiery passions to the bit, And, spite of their licentious sallies, keep The radiant track of glory; passions, then, Are aids and ornaments. ****** Yo0ifc. Resentment of wrong is a useful principle in human nature; and for the wisest purposes was implanted in our frame. It is the necessary guard of private rights; and the great restraint on the insolence of the violent, who,df no resistence were made, would trample on the gentle and peaceable. But in the fulness of self- estimation, we are too apt to forget what we are. We are rig- orous to offences, as if we did not daily intreat Heaven for mer- cy. It is a vice that few persons are able to conceal; for if it do not betray itself by external signs, such as sudden paleness of the countenance, and trembling of the joints, it is more impetuous within. Pale and trembling Anger rushes in, With falfring speech, and eyes that wildly stajre; Fierce as the tiger, madder than the seas, Desperate, and arm'd with more than human strength, He whom Anger stings, drops, if he dies, At once, and rushes apoplectic down; Or a fierce fever hurries him to hell. Armstrong. Those who feel the approach of anger in their mind, should & much as posiible, divert tlieir attention from the object of pro- 154 o\ hygieine. or the art vocation, and remain silent. They should never use loud oadis, violent upbraidings, or strong expressions of countenance, or gesticulations of the arms, or clenched fists; as these, by their former associations with anger, will contribute to increase it. I have been told, says Dr. Darwin, of a sergeant or corporal, who began moderately to cane his soldiers, when they were awkward in their exercise; but being addicted to swearing and coarse lan- guage, he used soon to enrage himself by his own expressions of anger, till, toward the end, he was liable to beat, the delinquents unmercifully. Is this not applicable to some of us, in the treat- ment of our slaves? A gentleman in New-Castle county, Delaware, was so enraged with a neighbouring slave, for perse\ ering, contrary to his or- ders, to visit a female servant in his family, that he bought him of his master at a high price, for the express purpose of getting satisfaction; that is, to give him a severe flogging, and then to sell him to a negro-buyer. What with the bitter curses and blows he inflicted upon the poor fellow, tied hands and feet, his anger rose at length to a flame he could not control, and, by the time the master had lost the power to inflict, the poor slave had lost the power to suffer—having literally expired under his cruel hands. A sea captain, in Charleston, South Carolina, navigated his vessel with the help of three slaves. On some provocation from one of them, he laid hold of the offender, who was so alarmed at his master's looks, that he jerked away from him. Roused to fury by such an act of treason, as this appeared to him, the master eaught up abroad axe, and with the looks and voice of a demon, ordered his other slaves "to seize the d----d villain." Fright- ened out of their wits, they seized their fellow-servant, and the master black with rage, and regardless of his prayers and sup- plications, had him dragged to a bjock, and in a most barbarous manner struck off his head. Although the laws of the land did not sentence these inhuman masters to death, yet neither of them long survived their infernal acts. The gnawings of a blood-stained conscience soon brought them down to the aravc. I of preserving health. \5j Cruelly is the extreme of all vices, an offence to God, abhor- rence to nature, the grief of good men, and a pleasure only to devils and monsters divested of humanity. Justice may take away a man's life, to punish his offences, and to deter others by his example, from the commission of the same crimes; but to do it by racks and other torments, favours little of humanity, less of Christianity. How many millions of men have the Spaniards butchered in South America? Bartholomew Casa affirms, that in forty-five years they destroyed about ten millions of human souls; an un- accountable way of converting these poor savages to Christianity. These millions were butchered outright, and if we add those who died labouring in the mines, doing the drudgery of asses, ox'ii, and- mules, to what a vast number would they amount? Some of them carry burdens upon their backs of a hundred and sixty pounds weight, above three hundred miles. How many of these poor wretches have perished by water as well as by land, by diving fathoms deep, fishing for pearl, who stay there sometimes half an hour under water, panting and drawing the same breath all the while, and are fed on purpose with course biscuit and dry things, to make them long winded. And if what is reported be true, they hunt the poor Indians with dogs to make themselves sport. There is a story of Hathir Cacica, a stout Indian, wdio, being to die, was persuaded by a Franciscan friar to turn Christian, and then he should go to heaven; Cacica asked him "Whether there were any Spaniards in heaven?" "Yes," says the friar, "it is full of them." "Stay, then," said the In- dian, "I had rather go to hell than have any more of their com- pany." A young gentleman in Augusta, Georgia, going to a party in the neighborhood, in a gig, had not got out of the street, before his horse balked. The youth, leaping from his gig, and angrily catching his horse by the bridle, led him oft*. Having mounted his gig, he cracked his whip for a second start; but his horse had not gone many steps, before he unfortunately fell back again.— F raping from the gig in a violent rage, he struck his horse over the head with a loaded whip, and then attempted to lead him off once more. Frighted by such violence*, the animal, in place of 156 on hygieine, or the art moving fonvard, drew back. Enraged by such obstinacy, the young man repeated his blows with the whip until it broke, which rather increased the perturbation of his mind. By this time, finding himself surrounded by unwelcome spectators ofhis brutal conduct, he became more furious; and snatching a large club, continued his unmerciful blows, until he brought the horse to the ground; when, after a few struggles, his blood and brains flowing copiously, the poor annimal expired. As anger is a short madness, so paticne^ is a recollection of all requisite virtues, that enables us to withstand the assaults of the former, and to behave ourselves like sober and prudent men. When Xenocrates came one time to the house of Plato to risit him, he prayed him, "that he would beat his servant for him, in regard he himself was not at present so fit to do it, be- eause he was in a passion." Another time he said to one of his servants, *'that he would beat him sufficiently, but that he was angry." • Forgiveness of injuries, and a merciful disposition towards those who have offended us, are not only infallible marks of a great and noble mind, but are our indispensable duties as reason- able creatures, and peculiarly so as Christians. Sir Waiter Raleigh, a man of known courage and honour, being very injuriously treated by a hot-headed, rash youth, who next proceeded to challenge him, and, on his refusal to accept, spit upon him, and that too in public, the knight, taking out his handkerchief, with great calmness, made him only this reply: *'Young man, if I could as easily wipe away your blood from my conscience, as I can this injury from my face, I would this moment take away your life." The consequence was, that the youth, struck with a sudden and strong sense of his misbeha- viour, fell upon his knees, and begged forgiveness. Clinias, the Pythagorean, was a person very different both in his life and manners from other men. If it chanced at any time that he was influenced with anger, he would take his harp, play upon and sing to it; saying, as oft as he was asked the cause of his so doing, "that by this means he found himself reduced to the temper of his former mildness." * OF PRESERVING HEALTH. 157 There is a charm, a power that sways the breast, Bids every passion revel or be still; Inspires with rage, or ah" your cares dissolves; Can soothe distraction, and almost despair. That power is Music. * * * Armstrong. So great is the empire of music over all the faculties of human nature, and so loud have been the ingenious in celebrating its power and praises, that they have left nothing scarcely in hea- ven, not at all in tlie air, sea, or on the earth, but what, in excess of fancy or merit, they have subjected to its dominion for the better. Music exalts each joy, allays each grief, Expels diseases, softens every pain, Subdues the rage of poison, and the plague; And hence the wise of ancient days ador'd One power of Physic—Melody and Song. Armstrong. While the physician prescribes draughts for curing bodily dis- eases, an able musician might prescribe an air for rooting out a vicious passion. When the tyrant Eugenius raised that perilous war in the East, and money grew short with the emperor Theodosius, he deter- mined to raise subsidies, and to gather from all parts more than before he had ever done. The citizens of Antioch bore this ex- action with so ill a will, that, after they had uttered many out- rageous words against the emperor, they pulled down his statues and those also of the empress his wife. A while afterwards, wdien the heat of their fury was past, they began to repent them- selves of their folly, and considered into what danger they had cast themselves and their city. Then did they curse their rash- ness, confess their fault, implore the goodness of God, and with tears, "that it would please him to calm the emperor's heart." Their supplications and prayers were solemnly sung, with sor- rowful tunes and lamenting voices. Their bishop, Flavianus, employed himself valiantly, in this needful time, in behalf of the city; made a journey to Theodosius, and did his utmost to appease him: but finding himself rejected, and knowing that the emperor was devising some grievous punishment; and on the 21 158 ON HYGIEINE, or the art other side, not having the boldness to speak again, and yet much troubled in his thoughts because of his people, then came this device into his head. At such time as the emperor sat at meat, certain yuing boys were wont to sing musically unto him. Fla- vianus wrought so, that he obtained of those that had charge of the boys, that they would suffer them to sing the supplications and prayer of the city of Antioch. Theodosius, listening to that grave music, was so moved with it, and so touched with compas- sion, that having then the cup in his hand, he with his warm tears watered the wine that wras in it, and forgetting all his con- ceived displeasure against the Antiochans, freely pardoned them and their city. "Man may most justly tuneful strains admire, His soul is music, and his breast a lyre; A lyre which, while its various notes agree, Enjoys the sweet of its own harmony. What ravishes the soul? What charms the ear? 'Tis music, though a various dress it wear. Beauty is music too, though in disguise, Too fine to touch the ear, it strikes the eyes, And thro' 'em to the soul, the silent stroke conveys." OF HATRED. Interval Malice, only pining Hale, And Envy grieving at another's state; When these are in the human bosom nurst, Can peace reside in dwellings so accurst? Hamilton. Hatred is a Fury that never sleeps; ulcerates the soul; and tortures it throughout. Hence it never fails to injure the body. As admiration, the first of the passions, rises in the soul before she has considered whether the thing represented to her be good, or convenient to her, or not; so, after she has judged it to be good, there is raised in her most agreeable and complacent of all OF PRESERVING HEALTH. 159 passions, Love; and when she hath conceived the same to be evil, she is quickly moved to Hatred, which is nothing but the soul'* aversion to that which threatens pain or grief, and may be defined to be "a commotion produced by the spirits, that incite the soul to be willing to be separated from objects represented to her as ungrateful and hurtful;" which definition only respects pure na- ture; but through the corruption of men and manners, it may be said to arise from an imbibed prejudice, or envy aggravated by continuance, and heightened by a malicious intention of malignan- cy, and injuring the persons to whom we have a disaffection, and that too without any reason but what proceeds from a self-con- tracted wickedness. Anger is sometimes, allowable, and when excessive, is still called but the vice of men; but hatred is said to be the sin of devils, being not confined at home, but roves abroad, seeking wdiom it may devour. "Cruel revenge, which still we find, The weakest frailty of a feeble mind. Degenerous passion, and for man too base, It seats its empire in the savage race." A certain Italian, having his enemy in his power, told him there was no possible way for him to save his life, unless he would immediately deny and renounce his saviour. The timor- ous wretch, in hope of mercy, did it; when the other, forthwith, stabbed him to the heart, saying that now he had a full revenge, for he had killed at once both his body and soul. In the reign of Edward VI. upon the alteration of religion, there was an insurrection in Cornwall and divers other counties, wherein many were taken and executed by martial lawr. The chief leaders were sent to London, and their executed. The se- dition being thus suppressed, it is memorable what cruel revenge or sport Sir William Kingston, provost-martial, made by virtue of his olliee, upon men in misery. One Boyer, mayor of Bodmin in Cornwall, had been amongst the rebels, not willingly, but enfor- ced. To him tbe provost sent word that he would come and dine with him, for wbuni the mayor made great provision. A little before dinner, ihe provost took tlie mayor aside, and whis- pered him in the car, "That an execution must that day be done lt)U ON HYGIEINE, OR THE ART in the town, and therefore required that a gallows should be set up against dinner should be over." The mayor failed not of his charge. Presently after dinner, tbe provost, taking the mayor by the hand; desired him to lead him to the place were the gal- lows was; which, when he beheld, he asked the mayor, "If he thought it to be strong enough?" "Yes," said the mayor, "doubt- less, it is." "Well, then," said the provost, "get you up speedily, for it is provided for you." "I hope," answered the mayor "you mean not as you speak!" "In faith," said the provost, "there is no remedy, for you have been a busy rebel:" and so, without re- spite or defence, he was hanged. Near the said place dwelt a miller, who had been a busy actor in that rebellion, who, fearing tlie approach of the marshal, told a sturdy fellow, his servant, that he had occasion to go from home, and, therefore, if any came to inquire for the miller, he should not speak of him, but say he was the miller, and had been so for three years be- fore. So, the provost came, and called for the miller, when out comes the servant, and said, "he was the man." The pro- vost demanded, how long he had kept the mill? "These three years," answered the servant. Then the provost commanded his men to lay hold of him, and hang him on the next tree. At this the fellow cried out, "that he was not the miller, but the miller's man." "Nay, Sir, said the provost, "I will take you at your word. If thou beest the miller thou art a busy knave; if thou art not, thou art a false lying knave; and, howsoever, thou canst never do thy master better service than to hang for him;11 and so, without more ado, he was despatched. Revenge is but a frailty, incident To craz'd and sickly minds; the poor content Of little souls, unable to surmount An injury, two weak to bear affront. Dryden. Revenge is a great sign of cowardice, when an enemy is at one's mercy. There is more bravery and disdain in slighting a private enemy, and despising revenge, than in cutting his throat: nottliata man should be insensible of an injury or affront, but that he should not carry his resentments too far, where a gentle revenge is suffi- cient. Excellent was the advice that was given to the Romans by the ambassadors of some cities in Etruria. '-That since they were OF PRESERVING HEATH. 161 men, they should not resent any thing beyond human nature; and that in mortal bodies they should not carry immortal feuds." Light injuries are made none by disregarding them; which, if re- venged, grow grievous and burthensome, and live to hurt us, when they might die to secure us. It is princely lo disdain a wrong; and they say, princes, when ambassadors have offered indecencies, used not to chide, but deny them audience; as if si- lence were the royal way to revenge a wrong. When the Duke of Alva was in Brussels, about the beginning of the tumults in the Netherlands, he had sat down before Hulst, in Flanders; and there was a provost-marshal in his army who was a favourite of his, and this provost had put some to death by secret commission from the duke. There was one captain Bolea in the army, wdio wras an intimate friend of the provost's; and one evening late he went to the captain's tent, and brought wdth him a confessor and an executioner, as it was his custom. He told the captain he was come to execute his excellency's commission and martial law upon bim. The captain started up suddenly, his hair standing upright, and being struck with amaze- ment, asked him, "Wherein have I offended the duke?" The provost answered, "Sir, I am not to expostulate the business with you, but to execute my commission; therefore, I pray pre- pare yourself, for there is your ghostly father and executioner." So he fell on his knees before the priest, and having done, and the hangman going to put the halter about his neck, the provost threw it away, and breaking into a laughter, told him, "there was no such thing, and that he had done this to try his courage, how he would bear the terror of death." The captain, looking ghastly at him, said, "Then, Sir, get you out of my tent, for you have done me a very ill office." The next morning, the said captain Bolea, though a young man of about thirty, had his hair all turned grey, to the admiration of all the wrorld, and the duke of Alva himself, who questioned him about it; but he would confess nothing. The next year the duke was recalled, and in his journey to the court of Spain, he was to pass by Saragossa, and this captain Bolea and the provost went along with him as his domestics. Tbe duke being to repose some days in Sa- ragossa, the young old captain Bolea told him, "that there 162 ON HYGIEINE, OR TUB ART was a thing in that town worthy to be aeen by his excellency, which was a casa de loco, a bedlam house, such a one as there was not the like in Christendom." "Well," said the duke, "go and tell the warden, I will be there to-morrow in the afternoon." The captain having obtained this, went to the warden, and told him the duke's intention; and that the chief occasion that moved him to it was, that he had an unruly provost about him, who was subject often times to fits of frenzy; and, because he wished him well, he had tried divers means to cure him, but all would not do; therefore, he would try whether keeping him close in bedlam for some days would do him any good. The next day the duke came with a great train of captains after him, amongst whom was the said provost, very shining and fine. Being entered into the house about the duke's person, captain Bolea told the warden, pointing at the provost, "thct's tlie man:" the warden took him aside into a dark lobby, where he had placed some of his men, who muffled him in his cloak, seized upon his sword, and hurried him into a dungeon. The provost had lain there two nights and a day; and afterwards it happened that a gentleman, coming out of curiosity to see the house, peeped into a small grate where the provost was. The provost conjured him, as he was a Christian, to go and tell the duke of Alva his provost was there confined, nor could he imagine why. The gentleman did his errand; and the duke, being astonished, sent for the warden with his prisoner. The warden brought the provost in cuerpo, full of straws and feathers, madman-like, before the duke; who, at the sight of him, burst into laughter, asking the warden why he had made him prisoner? "Sir," said the warden, "it was by virtue of your excellency's commission, brought me by captain Bolea." Bolea stepped forth, and told the duke, "Sir, you have asked me oft how these hairs of mine grew so suddenly grey; I have not revealed it to any soul breathing; but novv I'll tell your excellency ;" and so related the passage in Flanders; and added— "I have been ever since beating my brains to know how to get an equal revenge of him, for making me old before my time." The duke was so well pleased with ihe story, and th;' wittiucss of the revenge, that he made them both friends. OF PRESERVING HEALTH. 163 OP ENVY. ****•##« Malicious Envy rode Upon a ravenous wolf, and still did chew Between his canker'd teeth, a ven'moua toad, That all the poison ran about his jaw: But inwardly, he chewed his own maw At neighbours' wealth, that made him ever sad: For death it was when any good he saw, And wept, that cause of weeping none he had, But when he heard of harm, he wax'd wond'rous glad. He hated all good works, and virtuous deeds, And him no less that any like did use; And who with gracious bread the hungry feeds, His alms for want of faith, he doth accuse; Bo every good to bad he doth abuse; And eke the verse of famous poet's wit, He does backbite, and spiteful poison spews From lep'rous mouth on all that ever writ: Such one, vile Envy was. Spencer. To repine at the superior happiness of others, is the nature of Envy. It arises from self-love or self interest, particularly in such individuals whom nature has denied certain qualifications of body or mind, which they cannot avoid seeing in others. It is almost the only vice which is practicable at all times, and in every place; the only passion which can never lie quiet for want of irritation; its effects are, therefore, every way discover- able, and its attempts always to be dreaded. Envy commands a secret band, With sword and poison in her hand, Around her haggard eye-balls roll, A thousand fiends possess her soul. Tbe artful, unsuspected spright, With fatal aim attacks by night. Her troops advance with silent treadj And stab the hero in his bed; Or shoot tbe wing'd malignant lie, And female honours pine or dit. CoTtoa. 104 ON HYGIEINE, OR THE ART Solomon emphatically styles "Envy, a rottenness of the bones,11 and we too often witness its baneful effects on those who cherish the fatal poison. It shows itself in horrors even on the face of young females, who, it might be supposed, could not possess so odious a passion. Observe an envious girl, while pleased with herself, appears quite beautiful and pleasing in her manners; but on the appearance of one of her sex, a school-mate, of supe- rior beauty and endowments, her countenance becomes strange- ly altered. In like manner the spirits become depressed; and, as the body cannot remain undisturbed, when the mind, to which it is so nearly attached, is in such misery, the person who is tor- mented with it cannot enjoy good health. For it is the passion of the damned; and, as it richly deserves punishment, it never escapes it. A French lady of quality that was well married, and lived in plenty, hearing her husband's brother had married a very hand- some lady with a great fortune, was mightily out of humour, in- somuch that she perfectly hated all that spoke in the commenda- tion of her new sister-in-law, and hearing her husband also com- mend her as a very beautiful woman, she bribed a servant in that lady's family to poison her; but he, discovering the design, and the lady being reproached for it by the husband, she poisoned herself and died. Envy's the worst of fiends, procurer of sad events, And only good when she herself torments. Cowley. Plutarch compares envious persons to cupping-glasses, which ever draw the worst humours of the body to them. Like flies, they resort only to the raw and corrupt parts of the body; or, if they light on a sound part, never leave blowing upon it till they have disposed it to putrefaction.- When Momus could find no fault with the face in the picture of Venus, he picked a quarrel with her slippers; and so malevolent persons, when they cannot blame the substance, will yet represent the circumstance of men's best actions with prejudice. The black shadow is stili observed to wait upon those that have been the most illustrious for virtue, or remarkable for some kind of perfection: and to excel in ei- ther has been an unpardonable crime. OF PRESERVING HEALTH. 165 "The man who envies, must behold with pain Another's joys, and sicken at his gain." When Aristides, so remarkable for his inviolable attachment to justice, was tried by the people at Athens, and condemned to banishment; a peasant, unacquainted with the person of Aristides, applied to him to vote against Aristides. " Has he done you any wrong," said Aristides, " that you are for punishing him in this manner?" " No," replied the countryman, "Idon'teven know him; but I am tired and angry with hearing every one call him the just." Mutius, a citizen of Rome, was noted to be of such an envious and malevolent disposition, that Publius, one day observing him to be very sad, said, " Either some great evil has happened to Mutius, or some great good to another." Medicines cannot cure a disease so odious. Education and im- provement of morals are its only antidotes. Envious persons commonly give too much importance to trifles; hence they ought to be instructed to employ themselves in more useful pursuits; to judge of things accoiding to their true value, and to accustom themselves to a philosophic calmness, learning how to overcome, or at least to moderate their selfishness; to counterbalance tlieir expectations with their deserts; and to equal or surpass others in their merits, rather than in their pretensions. OF AVARICE. And, oh! what man's condition can be worse Than his, whom plenty starves and blessings curse? Tlie beggars but a common fate deplore, The rich poor man 's emphatically poor. If cares and troubles, envy, grief, and fear, The bitter fruits be what fair riches bear, If a new poverty grows out of store, The old plain way, ye gods! let me be poor. Cowlet. This vile passion, which frowns at the approach of the stranger, clinches the hand against the poor, denies all encouragement of public good, and can pinch and starve wife and children, is hardly 166 ON HYl.IKI\8« OR THE ART more detestable in a moral point of view, than it is pernicious in a physical. It is true, that by his umvillingmsH to part with his money, the miser is generally a temperate, and even an abstemi- ous character, and so far bis vice is beneficial to his health; but, in many other respects, this detestable vice operates very hurt- fully to the health of him who is cursed with it. By the extreme eagerness to make money, by the distressing fears about keeping it, by the inconsolable grief for losing it; besides the heart-achs, the envies and jealousies, the sleepless nights, wearisome days, and numberless other ills which it inflicts on its slaves, it often ruins their health, and brings them down to the grave by some lingering disease, or more hoirible suicide. History tells us of illustrious villians; but there never was an illustrious miser in nature. Can wealth give happiness? Look round, and see What gay distress! what splendid misery! Whatever Fortune lavishly can pour, The mind annihilates, and calls for more. You.vg. To declaim against riches, is like a hungry man inveighing against wholesome food, and a naked man railing at warm cloth- ing; it is spending breath to no purpose, and one should sooner be stigmatised with the character of a fool or madman, than gain be- lief that the harangue is more than a copy of one's countenance, or like the fox cursing the grapes that were out ofhis reach; for there are so many good uses to which riches may be employed, that to inveigh against them is to saturize upon acts of piety, beneficence. and charity. But to be poor in tlie midst of riches is the most insupportable kind of poverty. In vain our fields and flocks increase our store, If our abundance makes us wish for more. Rose. A rich cotton planter in Georgia, in consequence of losing two cents in the pound on a crop of cotton, was seized with such a sadness of heart, that he took to his bed, and refusing to be shaved, shirted, or to take suitable nourishment, died miserable. He was a bachelor, and his estate, on appraisement, amounted In nearly one hundred thousand dollars! OF PRESERVING HE ALT H. . 16f In York county, Pennsylvania, a farmer so wealthy as to raise one hundred bushels of clover seed on his own lands, in conse- quence of losing five dollars per bushel on his clover seed, that is, only getting seven dollars in Baltimore, after he had been offered twelve for it at home, was struck with such a deadly heart anguish, that he went into a fit of despondence, and hung himself. After his death, silver to the amount of two hundred thousand dollars was found barrelled up in his cellar. Vain man! 'tis Heaven's prerogative To take, what it first design'd to give, Thy tributary breath: In awful expectation plac'd, Await thy doom, nor impious haste To pluck from God's right hand his instruments of death. Warton. Hippocrates, in his epistle to Crateva, the herbalist, gives him this advice for the cure of some rich patients, that if it were pos- sible he should cut up that weed of Covetousness by the roots, that there might be no remainder left, then he might be certain, that, togetber with tlieir bodies, he might cure all the diseases of their minds. The same great and learned philosopher wished a consultation of all the physicians in the world, that they might advise together upon the means how to cure covetousness. It is now above two thousand years ago since he had his desire; and after him a thousand and a thousand philosophers have employed their en- deavours to cure this insatiable dropsy. All of them have lost tlieir labours. The evil rather increases than declines under the multitude of remedies. There have been a number, in for- mer ages, sick of it; and this wide hospital of the world is as full of such patients as ever it was. 168 ON HYGIEINE, OR THE ART OF INTEMPERANCE. IIV curse not rcint—the vile excess we blame; More fruitful than the accumulated board, Of pain and misery. For the subtle draught Faster and Mirer >wells the vital tide; And with more active poison than the floods Of grosser crudity convey, pervades The far remote meanders of our frame. ****** * For know whate'er Beyond its natural fervour hurries on The sanguine tide; whether the frequent bowl, Hisjjh seasoned fare, or exercise to toil Protracted, spurs to its last stage tir'd life, And sows the temples with untimely snow. Armstrong. Temperance, by fortifying the mind and body, leads to hap- piness. Intemperance, by enervating them, ends in misery.— And those who desiroy a healthy constitution of body by intem- perance, do as manifestly kill themselves, as those who hang, poi- son, or drown themselves. A'irtue is no enemy to pleasure; but, on the contrary, is its most certain friend. Her office is to reg- ulate our desires, that we may enjoy every pleasure with mode- ration; and then our relish for them will continue. Pleasure, mv friend, on this side folly lies; It may be vig'rous, but it must be wise: And when our organs once that end attain, Each step beyond it is a step to pain. Cawthorx. Anacharsis, the Scythian, in order to deter young men from that voluptuousness ever attended with ill effects, applied his discourse to them in a parable, telling them that the vine of youthful grat- ification had three branches, producing three clusters. " On the > first," says he, "grows pleasure; on the second, sottishness; on the third, sadness." Struck by the powerful charm the gloom dissolves In empty air: Elysium opens round. A pleasing frenzy buoys the lightened soul, And sanguine hopes dispel your fleeting cares; And what are difficult, and what was dire, OF PRESERVING HEALTH. 169 Yields to your prowess and superior stars; The happiest you of all that e'er were mad, Or arc, or shall be, cquld this folly last. But soon your heaven is gone; a heavier gloom Shuts o'er your head; and, as the thund'ring stream Swoln o'er its banks with sudden mountain rain. Sinks from its tumult to a silent brook; So, when the frantic raptures in your breast Subside, you languish into mortal man: You sleep,—and waking, find yourself undone, For, prodigal of life, in one rash'night You fovisli'd more than might support three days. Jl heavy morning comes; your cares return With tenfold rage. Armstrong. Drinking is undoubtedly the most miserable refuge from mis- fortune. It is the most broken of all reeds. This solace is truly short-lived; wdien over, the spirits commonly sinking as much below their usual tone, as they had been before raised above it.— Hence a repetition of the dose becomes necessary, andevery fresh dose makes way for another, till the miserable man is ren- dered a slave to the bottle; and at length falls a sacrifice to what at first, perhaps, was taken only as a medicine. Unhappy man, whom sorrow thus and rage^ Two different ills, alternately engage. Who drinks, alas! but to forget; nor sees That melancholy, sloth, severe disease, Memory confused, and interrupted thought, Death's harbingers, lie latent in the draught, And in the flowers that wreathe the sparkling bowl, Fell adders hiss, and poisonous serpants roll. Prior. Were tlie pleasures of the palate lasting, says Cornaro, tlvert1 would be some excuse for inebriety; but it is so transitory, that there is scarce any distinguishing fietween the beginning and the ending; whereas, tlie diseases it produces are very durable. O'er the dread feast malignant Chemia scowls. And mingles poison in the nectar'd bowls; Fell gout peeps grinning" through the flimsy scene, And bloated dropsy pants behind unseen: 170 OV HYGIEINE, OR THE Alii Wrapp'd in his robe, white Lepra hides his staias, ..' And silent Frenzy, writhing,bites his chains: Darwin The story of Prometheus seems to have been invented by phy- sicians in those ancient times when all things were clothed in hie- roglyphic, or in fable. Promotheus was painted stealing fire from heaven, which might well represent the inflammable spirit produced by fermentation, that may be said to animate and enli- ren the man of clay: whence the conquest of Bacchus, and the heedless mirth and noise of his devotees. But tlie after punish- ment of those who steal this accursed fire, is a vulture gnawing tlie Uver; which well allegorises the poor inebriate, labouring under painful hepatic diseases. It is thus beautifully described by Darwin. So when Prometheus braved the Thunderer's ire, Stole from his blazing throne ethereal fire, And lantern'd in his breast, from realms of day, Bore the bright treasure to his man of clay:— High on cold Caucasus, by Vulcan bound, The lean, impatient vulture flutt'ring round; His writhing limbs in vain he twists and strains,. To break or loose the adamantine chains: The gluttonous bird, exulting in his pangs, Tears his swoln liver with remorseless fangs. Let those who have been enticed frequently to taste spiritu- ous liquors, till at length they begin to have a fondness for them, reflect a moment on the danger of their situation; and resolve to \ make a speedy and honorable retreat. Remember that custom soon changes into habit; that habit is a second nature, more stub- born than the first; and, of all things, most difficult to be sub- dued. Remember, that it is by little unsuspecting beginnings, that this unfortunate vice is generally contracted; and, when once oonfirmed, scarcely terminates buf with life! Learn, then, in time, to resist this bewitching spirit, whenever its tempts you. Then will you find yourself so perfectly easy without it, ; without one generous struggle? The present conflict, re- r, ember, is not for the fading laurel or tinselled wreath, for which others so earnestly contend, but for those more blooming, more substantial honors, which Health, the daughter of Temperance, r.ily can bestow. For it is thine, O Health! and thine alone, to diffuse through the human breast that genial warmth, that serene sunshine, which glows in the cheek, shines in the eye, and ani- mates tlie whole frame! But, if still you have no regard for, this blessing, let me remind you of an hereafter! ?'■ v" "To die—to sleep—to sleep! perchance to dream— Ay, there's the rub!" If death was nothing, and nought after deaths If, when men died, at once, they ceas'd to be, Returning to the barren womb of Nothing, Whence they sprung—then might the wretch That's weary of the world, and tired of fife, At once give each inquietude the slip, By stealing out of being when he pleased, And by what way; whether by hemp or steel, Death's thousand doors are open. Who could force The ill-pleased guest to sit out his full time, Or blame him if he goes? Sure, he does well That helps himself as timely as he can, When able. But if there's an hereafter, And that there is, Conscience uninfluinced; And suffer'd to speak out, tells every man; Then must it be an awful thing to die: More horrid yet to die by one's otm hand. Self-Murder! dreadful deed! our island's shame, That makes her the reproach of nejghb'ring states: Shall Nature, swerving from her earliest dictates, Self-preservation, fall bf her own act? * r Forbid it Heaven! Let not, upon disgust,. 17% 0 X H YG1KIX E, O R T II E \ R T OF Tbe shamqfess hand be foully crimson'd o'er With blood of Us own lord. Dreadful attempt! Just reeking from self-slaughter, in a rage. To i-ush into the presence of our Judge ; As if we challenged him to do his worst, And heeded not his wrath. Blair. It. is an invariable law of our present condition, that every pleasure, which is pursued to excess, converts itself to a poison. Could we expose to view the monuments of death, they would read a lecture on moderation much more powerful than any that the most eloquent writers can give. You would behold the graves, pe.jpled with the victims of intemperance. You would behold Miosc chambers of darkness, hung round, on every side, with the trophies of luxury, drunkenness, and sensuality. So numerous would you find those victims to iniquity, that it may be safely asserted, where war or pestilence have slain their thousands, intemperate pleasure has slain its ten thousands. By unhappy excesses, how many amiable dispositions have been corrupted or destroyed! how many rising capacities and powers have been suppressed! how many flattering hopes of pa- Jents and friends have been totally distinguished! Who, but must drop a tear over human nature, when he beholds that morning, which arose so bright, overcast with such untimely darkness; that "-ood humour, which once captivated ail hearts; that vivacity, which s'Kiikled in every company; those abilities which were fitted for adorning the highest station, all sacrificed at the shrine of low sensuality; and one who was formed for running the fair ^career of life in the midst of public esteem, cut oft' by his vices at the beginning ofhis course; or sunk for the whole of it, into in- significancy and contempt. Would you extend your narrow span. And make the most of life you can; Would you, when med'eines cannot save. Descend with ease into the grave; Calmly, retire like evening light. And cheerful bid tbe world good night: Let temperance constantly fireside Our best physician, friend, and guide! OF PRESERVING HEALTH. 173 The Father justly describes tlie nature of this beastly vice, when he saith of it, that "It is a flattering devil; a sweet poison; a delightful sin; which he that hath, possesseth not himself; and he that acts it, doth not only commit a sin, but is wholly con- verted into sin, being deserted ofhis reason, which is at once his counsellor and guardian." A young gentleman of the most respectable parentage, being rather intemperate, was urged by his parents to marry, thinking that might produce a change of his habits. He paid his addresses to a most amiable young lady, of a fair estate, to whom he was goon united in wredlock.—It was not many months after marriage, before he resumed his former habits, and what with drinking and gambling, he very soon exhausted the whole of her fortune. Ex- ecutions being out against him; he was compelled to keep at home, where he did nothing but get drunk and abuse his amia- ble wife. One night, filled with rage, he resolved to destroy her, and going at a late hour into the kitchen, where she had been constrained to retire from his abuse, he continued his opprobri- ous language to her, and notwithstanding she gave him only lov- ing and kind words, yet he struck her over the head with a large stick, which she bore patiently, although it much injured her face. He still continuing to rage at her, wearied, and in great fear, she rose up and went to the door. Here he followed her with a chopping-knife in his hand, with which he struck at her wrist, and cut her very much; no help being near but an old woman, who durst not interpose, fearing for her own life, who prayed her mistress to stay and be quiet, hoping all would be well, and so getting a napkin, bound up her hand with it. After this, still railing and raging at his wife, he struck her on the forehead with an iron cleaver, whereupon she fell down bleeding; but re- covering herself, upon her knees she prayed unto God for the pardon of her own and her husband's sins, praying God to for- give him as she did. But as she was thus praying, the infernal demon, her husband, split her skull open with the cleaver, so that she died immediately: for which he was apprehended, con- demned, and hanged. But so callous was the wretch, that even under tlie gallows he did not exhibit any marks of repentanoe.' 174 ON HYGIEINE, OR THE ART It is a lamentable fact, so great is the infatuation of this vice, that few, once deluded, have ever recovered their freedom. Some glorious instances, however, have occurred, which is sure- ly fine encouragement to others. We also have the pleasure lo find none are greater enemies to vice, than those who formerly were the slaves of it, and have been so fortunate as to break their chain and recover tlieir liberty. A medical gentleman in Virginia, who was married to a most amiable lady, by associating with dissipated characters, became at length intemperate himself. As soon as he acquired habits of intemperance, his disposition was altered, and from an affection- ate husband he proved very turbulent, and treated his wife so ill that she was constrained to separate from him. After living a disorderly life for some time, he was brought to a sense of re- flection, and with an entire change of mind and manners, he re- nounced all vicious habits, plead guilty before his amiable wife, who was ready to forgive, and they have since lived in the ut- most harmony. So sensible is he of the danger of using spirit- ous and vinous liquors to excess, that he will not taste them, lest he should be enticed to exceed the bounds of moderation; and whenever he sees a person so inclined, never fails to caution him against so insidious an enemy. A gentleman of Maryland, addicted to drunkenness, hearing a considerable uproar in his kitchen one night, felt the curiosity to step without noise to the door, to know what was the matter; when, behold, they were all indulging in the most unbounded roars of laughter, at a couple of his negro boys, who were mim- icking himself in his drunken fits!—as, how he reeled and stag- gered! how he looked and nodded, and hickupped and tumbled! The pictures which these children of nature drew of him, and which had filled the rest with such inexhaustible merriment, struck him with so salutary a disgust, that from that night he be- came perfectly a sober man, to the inexpressible joy ofhis wife and children. A very respectable gentleman in Philadelphia, had a wife who, by her fondness for strong drink, had almost broken his heart. At length he was advised, "as a desperate remedy in a desperate OF PRESERVING HEALTH. 175 disease," to place a barrel of spirits in her closet, and let her kill herself as soon as possible, since every persuasive means had been used in vain to break her of this beastly vice. At the sight of so extraordinary a visitant in her closet, she was struck with such horror at the idea of the dreadful design on which it was placed there, that she was immediately reclaimed, and recovered all the purity and lustre of her former character, to the infinite joy of her husband, children and numerous friends. O Temperance! support and attendant of other virtues! Pre- server and restorer of health! Maintainer of the dignity and li- berty of rational beings, from the wretched, inhuman slavery of Sensuality, Taste, Custom and Example! Brightener of the un- derstanding and memory! Sweetener of life and all it comforts! Companion of reason, and guardian of the passions! Bountiful rewarder of thy admirers and followers! how do thine excellen- cies extort the unwilling commendation of thine enemies! and with what rapturous delight can thy friends raise up a panegyric in thy praise I OF GAMZNG. The love of gaming is the worst of ills; With ceaseless storms the blacken'd soul it fills; Inveighs at Heaven, neglects the ties of blood; Destroys the power and will of doing good; Kills health, pawns honour, plunges in disgrace, And, what is still more dreadful—spoils her face. Yotjno. While gaming keeps within the bounds of innocent diversion, to recreate the body, or compose the mind, and is not tainted with covetousness or passion, the most strait-laced casuist will not censure or condemn it as a crime; but, when it breaks the limits of moderation, and transports men into heats, swear- ing, cursing, reproaching, and lying; or is taken up as a trade to live by, and pushed on by a covetous desire to enrich our- I/O ON HYGIEINE, OR THE ART selves by the loss and ruin of one's neighbour, it is absolutely unlawful, carefully to be avoided, and utterly abominated, as the certain procurer of repentance, sorrow, grief, disease, derision, beggary, and coutempt. To play sometimes to entertain com- pany, says the Marquis of Halifax, or to divert yourself, is not to be disallowed; but, to do it so often as to be called a game- ster, is to be avoided, next to the things that are most criminal. It has consequences of several kinds not to be endured; it will engage you into a habit of idleness and ill hours, draw you into had company, make you neglect your business, bring you to po- verty and disgrace, cause sleepless nights, and destroy health. What fool would trouble Fortune more, When she has been too kind before; Or tempt her to take back again What she had thrown away in vain, By idly venturing her good graces To be dispos'd of by umes-aces; Or settling it in trust, to uses Out of his power, on trays and deuces; To put it to the chance, and try, V th' ballot of a box and die, Whether his money be his own, And lose it if he be o'erthrown; As if he were betray'd, and set By his own stars to every cheat, Or wretchedly condemned by Fate To throw dice for his own estate. Butler. It is true, as it is lamentable, in the age we live, there are too many of all qualities and conditions excessively addicted to this abominable vice; by which many respectable families have been reduced from affluence to extreme poverty. But the evil does not stop here; it must be fresh in every memory, of the most diabolical acts having been perpetrated by persons who en- listed under the banners of a gambler, and squandered away their estate., Let the following melancholy catastrophe, which I have from the best authority not long since took place, prove a Warning to others. OF PRESERVING HEALTH. 177 Mr. A. S---, who had a very comfortable support was enti- ced to associate himself with gamblers, and in a short time lost all that he possessed, at cards and dice, which ought to have been treasured up for the subsistence of his family. Reflecting on the foolish manner in which he had thrown away his money, and be- holding his children cry about him for victuals, so diseased his mind that taking advantage of his wife's absence, he cut the throats of his three children, and then hung himself. His wife, on returning home, being so much affrighted at the sight of so barbarous a tragedy, fell dead upon the spot, An old ruined gamester in hopes to make a bubble or prey of a young gentleman that came to town with his pockets full of money, took him to a gaming house, and there, to encourage him to play, showed him several topping sparks that were born to no fortune, who by play had purchased great estates, and lived in pomp and splendour, by success in shaking their elbows.— " You show me," says the young gentleman, " the winners, but I pray what has become of the losers?" To which the old prig making no reply, a third person, overhearing their conversation, told the young gentleman, that since the other was silent and co-- founded with shame at the question, he would oblige him with an answer—" Many of the losers," saith he, ON UYGIEIXE, OR THE ART they have more lace. Some ladies put so much weight upon or.. naments, that if one could see into tlieir hearts, it would be found that even the thought of death was made less heavy to them, by the contemplation of their being laid out in state, and honourably attended to the grave. The man of letters is proud of the esteem the world gives him for his knowledge; but he might easily cure himself of that disease, by considering how much learning he wants. The military man is proud of some great action performed by him, when possibly it was more ow- ing to fortune than his own valour or conduct: and some are proud of their ignorance, and have as much reason to be so as any of the rest; for they being also compared w ith others in the same character and condition, will find their defects exceed their acquisitions. O, sons of earth! attempt ye still to rise, By mountains pil'd on mountains to the skies? Heavfen still with laughter the vain toil surveys, And buries madmen in the heaps they raise. Poi'E. A person of infinite wit, speaking, of what might precisely be called a proud and vain man, once said, "Wlien I see him, I feel something like the pleasure of seeing a happy couple; his self-loir and he live so happily togetlier." Pride was not made for men: a conscious sense Of guilt, and folly, and their consequence, Destroys the claim, and to beholders tells, Here nothing but the shape of Manhood dwells. I once saw, says Dr. Darwin, a handsome young man, who liad been so much flattered by his parents, that his vanity rose so near to insanity, that one might discern, by his perpetual atten- tion to himself, and the difficulty with which he arranged his conversation, that the idea of himself intruded itself at ever* comma, or pause of his discourse. I dreamt that, buried with my fellow clay. Close by a common beggar's side I lay; And as so mean an object shock'd my pride, Thus like a corpse of consequence I cried: OF PRESERVING HEALTH. 181 "Scoundrel, begone! and henceforth touch me not, More manners learn, and at a distance rot." "Scoundrel, then," with haughtier tone, cried he, -Proud lump of earth, I scorn thy words and thee; Here all are equal, now thy case is mine, This is my rotting place, and that is thine." Done The cure of vanity may be attempted by excess of flattery, which will at length appear ridiculous, or, by its familiarity, will cease to be desired. I remember, says Dr. Darwin, to have heard a story of a nobleman, in the court of France, who was so disagreeably vain in conversation, that tlie king was pleased to direct his cure, which was thus performed. Two gentlemen were directed always to attend him; one was to stand behind his chair, and the other at a respectful distance before him: whenever his lordship began to speak, one of them always pronounced, "Lord Gallimaufre is going to say the best thing in the world." And, as soon as his lordship had done speaking, the other attendant pronounced, "Lord Gallimaufre has spoken the best thing in the world." Till, in a few weeks, this noble lord was so disgusted with praise, that he ceased to be vain, and his majesty dismissed Jus keepers. OF MODESTY. Hail, Modesty! fair female honour hail! Beauty's chief ornament, without whose charms, Beauty disgusts, or gives but vulgar joys. Thou giu'sf the smile its grace; the heightened kiss Its balmy essence sweet! Armstrong. Modesty is to virtue, what a fine veil is to beauty. It is one Of the most distinguishing and attractive characteristics of the female sex. It comprises the beauties of the mind, as well as those of the body; and it not only heightens the desire of the male, but deters him from rudeness and improper behaviour. It ?4 182 ON HYGIEINE, OR 111K ART is, therefore, the interest of the men to cherish, and not to injure* by indelicacy, a quality from which they derive so much plea- sure and advantage. Naked in nothing should a woman be, But veil her very wit with modesty: Let man discover, let not her display, But yield her charms of mind without delay. Ybt.vo. I remember, says a female author of great distinction, the count M----, one of the most accomplished young men in Vi- enna, when I was there; he was passionately' in love with a girl of peerless beauty. She was the daughter of a man of great rank and influence at court; and, on these considerations, as well as in regard to her charms, she was followed by a multitude of suitors. She was lively and amiable, and treated them all with an affability which still kept them in her train, although it was gene- rally known that she had avowed a predilection for the count, and that preparations were making for their nuptials. The count was of a refined mind and delicate sensibility; and loved her for herself alone; for the virtues|which he believed dwelt in her beau- tiful form; and, like a lover of such perfections, he never approach- ed her without timidity; and when he touched her, a fire shot through his veins that warned him not to invade the vermillion sanctuary of her lips. Such were his feelings, when, one night, at his intended father-in-law's, a party of young people were met to celebrate a certain festival; several of the young lady's njected suitors being present. Forfeits were one of the pastimes, and all went on with a grateful merriment, till the count was com- manded, by some witty mademoiselle, to redeem his glove by saluting the cheek of his intended bride. The count blushed, trembled, advanced to his mistress, retreated, advanced again— and at last, with a tremor that shook every fibre in his frame, with a modest grace, he put the soft ringlets, which played upon her cheek, to his lips, and retired to demand his redeemed pledge, in evident confusion. His mistress gaily smiled, and the game went on. One of her rejected suitors, but wdio was of a mt i ry, unthinking disposition, was adjudged by the same indiscreet crier of the forfeits, to snatch a kiss from the lips of the object of h|s OF PRESERVING HEATH* 183 fcftecnt vows. A lively contest between the lady and gentleman lasted for a minute! but the lady yielded, though in the midst of a conclusive laugh; and the count had the mortification, the agony to see the lips, which his passionate and delicate love would not allow him to touch, kissed with roughness by another man, and one whom he despised. Without a word, he rose from his chair, and left the room, and the house—and never saw her more! Thus, by that good-natured kiss, the fair boast of Vienna lost a husband and her lover. Although I consider this act of the count as ridiculously fasti- dious, yet I cannot but think it may prove a good hint to my fair readers. Certainly the sensitive plant cannot shrink more coyly than should the lovely virgin from the slightest touch of the im- modest. "Learn, then, ye fair, to keep, the person sacred; ****** j^ tne pUre mm^ Be that array'd in modest dignity: Nor e'en its beauties flauntingly expose- Thus may ye keep the heart your charms have won." The attractive grace and powerful charm of Modesty cannot be better illustrated, than by relating the following interesting nar* rative. Charlotte Corday was tall and well-shaped, of the most grace- ful manners and modest demeanour. There was in her counte- nance, which was beautiful and engaging, and in all her move- ments a mixture of softness and dignity, which were evident in- dications of a heavenly mind. She came to Paris, and under a feigned pretext gained admission to that republican tyrant, Marat, in whose breast she plunged a dagger, acknowledged the deed, and justified it by asserting that it was a duty she owed her coun- try and mankind, to rid the world of such a monstert Her de- portment during her trial was modest and dignified.—There was a softness so engaging in her countenance, that it was difficult to conceive how she could have armed herself with sufficient intre- pidity to execute the deed. Her answers to the questions of the tribunal, were full of point and energy. She sometimes surprised the audience by her wit, and excited their admiration by her efo- lo4 ON H r G I E I N I., OR THE ART O V quence. Her face sometimes beamed with sublimity and was some- times covered with smiles. She retired while the jury deliberat- ed on their verdict; and when she again entered the tribunal. there was a majestic solemnity in her demeanour, which perfectly became her situation. She heard her sentence with attention and composure, and left the court with serenity, her mind being long before prepared even for the last scene. It is difficult to conceive the heroism which she displayed in the way to execution. There was such an air of chastened exultation thrown over her counte- nance, that she inspired sentiments of love, rather than pity. The spectators, as she passed, uncovered their heads before her, and others gave loud tokens of applause. She ascended the scaffold with undaunted firmness. When the executioner informed her that her feet must be tied to the fatal plank, she submitted with a smile. When he took off her handkerchief, the moment before she bent under the fatal stroke, she blushed deeply; and her head, which was held up to the multitude the moment after, exhibited the last impression of offended modesty. Such an instance of a young female, given up to destruction. and yet so tremblingly alive to modesty, that even in her last mo- ments she resents the slightest insult tO that, more than she dreads the executioner's axe, is a display of the charm, as well as the force of virtue triumphant over death, that deserves to be pre- served in everlasting remembrance. Its effects on the crowd beg- gared all description. Admiration held the gazing thousands mute. And though, while gazing on her cheeks yret divinely en- riched with the blush of deathless modesty, they shed their tears over her untimely fate, still their joy-glistening eyes seemed to thank her for such a proof of the divinity of virtue, and the birth- right to Heaven. One of the spectators, a young man, by the name of Lux, had his feelings wrought to such an adoration of her virtues, that he proposed, in a pamphlet published the day after, to erect a monument to her honour, and to inscribe it with these words:—GREATER THAN BRUTUS. He was in- stantly sentenced to the guillotine. He received the news with joy, and died exulting that he had the honour- of being offered up, at the same altar witli the immaculate Charlotte Corday. OF PRESERVING HEALTH. wz As lamp? burn silent, with unconscious light, So modest, ease, in beauty, shines most bright: Unaiming charms with edge resistless fall, And she who means no mischief, does it all. Hill. Plutarch observes, that as thistles, though noxious things in themselves, are usually signs of an excellent ground wherein they grow, so bashfulness, though many times a weakness and be- trayer of the mind, is yet generally an argument of a soul inge- nuously and virtuously inclined. We read of many, who, through modesty and fear, when they were to speak publicly, have been so disappointed, that they u ere forced to hold their tongue. Thus Cicero writes of Cario, that being to plead in a cause before the senate, he was not able to speak what he had premeditated. Also, Theophrastus being to speak before the people of Athens, was on a sudden so de- prived of memory, that he remained silent. The same happened to the famous Demosthenes in the presence of king Philip. Nor are we ignorant that the like misfortunes have befallen many ex* cellent persons in our times. Get that great gift and talent, Impudence; Accomplished mankind's highest excellence; 'Tis that alone prefers, alone makes great, Confers alone, wealth, titles, and estate; Gains place at court, can make a fool a pcerK An ass a bishop, can vil'st blockhead rear To wear red hats, and sit in porplfry chair; OldhaM1 When once men have bid adieu to modesty, there is nothing so unmanly, indecent, or reprehensible, but the brazen brow will venture upon; and nothing so high or great that his impudence does not pretend a title to. A gentleman being asked how it came to pass that he, being g man of extraordinary natural parts, and those improved by a uni- versity education, foreign travel, diligent study, and the know- ledge of most European languages; besides, being well born, and having many friends to recommend him, missed a considera- ble employment in the government, at a time when there were so many vacancies; The gentleman answcredr The- reason is plain; l°b ON HYGIEINE, OR THE ART 1 have too much modesty, and too little impudence, to be pre. ferred, where a higher value is put upon tlie latter than the for- mer. For he that has but impudence, To all things has a fair pretence; And put among his wants but shame, To all the world may lay his claim. Ht*DiBn.\« An Athenian, of decrepid age, came into the theatre at Athens, on a public night, when it was very much crowded. He went to that part of the house where his young countrymen wrere sitting, but instead of making room for him, they closed their ranks. By chance he came to a place where sat some young Lacedemo- nians of the first distinction, who, moved w ith the age of the man, in reverence to his years and hoary hairs, rose up, and pla- ced him in an honourable seat amongst them; which, when the people beheld, with a loud applause, they approved the modesty of another city. At which one of the Lacedemonians said, "It appears that the Athenians do understand what is to be done, but they neglect the practice of it." These young Lacedemonians were Heathens. How devoutly were it to be wished, that all young Christians would copy so fair an example, and learn to treat seniority with a respect equally amiable and endearing. OF DRESS. lv the rude verse that now detains your car, Should to one female heart conviction bear; Recal one genfler mind from Fashion's crew, To give to Nature what is Nature's due; Whilst others mount the arduous heights of fame, To wake your feelings be my nobler aim: Nor yet unblest, if, whilst I fail to move, The fond attcroptmy kind intention prove. R^jcoe. OFPESERVING HEALTH. 187 Plinv, one of the most celebrated naturalists of antiquity, pa- thetically laments, "that whilst Nature has given various clothing to the brute creation, and even fenced plants and trees with bark against the injuries of the cold and heat, she should have cast man into this world naked, unprovided against the inclemency of different climates and seasons." But, instead of agreeing with that philosopher, that JVature has, in this particular, acted more like a cruel step-mother, than a kind and indulgent parent to man, we cannot sufficiently extol her providence and wisdom. It was no more than consistent with equity to provide the irrational part of her works with clothing suitable to their circumstances; but man, whom she endued with the transcendant faculty of reason, she hath very wisely left to accommodate himself to the differ- ence of season and climate, and to clothe himself, accordingly, writh the fleeces and skins of animals, and the products of various plants and trees. JVature knows no other use of clothes but to keep the body warm. The shape God has given, is too often attempted to be mended by dress, and those who know no better, believe that mankind would be frights without its assistance. The bones of growing persons are so cartilaginous, that they readily yield to the slightest pressure, and easily assume the mould in which they are confined. Hence it is, that so many girls, in proportion to boys, are mis-shapen, A lady, whose girls were all mis-shapen, though her family was numerous, consulted the celebrated anatomist, Mr. Cline, on the pre\ ention. " To liave no stays—and to let the next girl run about lilcc the boys," was the excellent advice of this gentleman; which being complied with, none of the future children were afterwards marred by the ill-placed attention of the ignorant mother. It has been said, observes a celebrated female author, that the love of dims is natural to the sex; and we see no reason why any female should be offended with the assertion, press, however, must be subject to certain rules^ be consistent with the graces and with nature. By attending to these particulars is produced that agreeable exterior which pleases we know not why; which charms even without thai first and powerful attraction, heautv. \88 ON HIGIEIM:, OR THE ARl A beauty, carclcsly array'd, Enamours more, than if displayed. All woman's charms were given, And o'er tlie bosom's vestal white. The gauze appears a robe of light. That veils, yet opens Heaven." Fashion, in her various flights, frequently soars hey ond the reach of propriety. Good sense, taste, and delicacy, then make their appeal in vain. Her despotic and arbitrary sway levels and confounds. Where \s delicacy? where is policy? we men- tally exclaim, when we see the fair inconsiderate votary of fashion exposing, unseemly, that bosom which good men delight to ima- gine the abode of innocence and truth. Can the gaze of the vo- luptuous, the unlicensed admiration of the profligate, compensate the woman of sentiment and purity, for what she loses in the esti- mation of the moral and just? But delicacy apart what shall we say to the blind conceit of the robust, the coarse, tbe wanton fair one, who thus obtrudes the ravages of time upon the public eye? Nature having maintained a harmony between the figure of a woman and her years, it is decorous that the consistency should extend to the materials and fashion of her apparel. For youth to dress like age, is an instance of bad taste seldom seen. But age affecting the airy garment of youth, the transparent drapery of Cos, and the sportivencss of a girl, is an anachronism, as frequent as it is ridiculous. Virgin, bridal beauty, when she arrays herself with taste, obeys an end of her creation; that of increasing her charms in the byes of some virtuous lover, or the husband of her bosom. She is approved. But when the wrinkled fair, the hoary-lieaded mat- ron, attempts to equip herself for conquest, to awaken sentiments which, the bloom of her cheek gone, her rouge can never arouse; then we cannot but deride her folly. There is a mediocrity which bounds all things, and even fixes the standard wdiich divides virtue from bombast. ***•*#» Loveliness Needs not the foreign aid of ornament; But is, when unadom'd. adorn'd the most. f OF PRESERVING HEALTH. 189 It is worthy of remark, an unaffected beauty carries with it a respect and superiority that proceeds from the impulse of nature, and not from the artifice of those that have it. "Taste," says Dr. Knox, "requires a congruity between the in- ternal character, and the external appearance."—Another author, the discriminating Chesterfield, observed that "a prepossessing exterior is a perpetual letter of recommendation." Hence we see that the desire of exhibiting an amiable exterior is essentially requisite in women. It is to be received as an un- equivocal symbol of those qualities, which we seek in a wife; it indicates cleanliness, sweetness, a love of order, and universal propriety. What, then, is there to censure in a moderate consi- deration of dress? Nothing. We may blame, when we find ex- travagance, profusion, misappropriation; the tyranny of fashion; slavery to vanity; in short bad taste! Fashions like manners, still from courts descend, And what the great begin, the vulgar end. Honour's a mistress all mankind pursue; Yet most mistake the false one for the true: Lur'd by the trappings, dazzled by the paint, Wc worship oft the idol for the saint. Courted by all, by few the fair is won; Those lose who seek her, and those gain who shun5 Naked she flies to merit in distress, And leaves to courts the garnish of her dress. Although we cannot suppose prodigality in dress would recom- mend the wearers to persons of sense; yet we consider that a de- cent habit, proportioned to one's quality and business, is essenti- ally necessary. Philopaemon, commonly called the Great, was a person of a very mean aspect, and one that took no care to set himself off with decent apparel, by which means he was often affronted by such people as could not distinguish the man from his clothes. He sent notice to one of his friends in Megara that he would take a sup- per with him, who wrent immediately to market to provide an entertainment, and requested his wife, in the mean time, to right 25 190 ON HVGIE1N1. OR THE ART up the house that it might be fit to entertain so noble a guest,— Philopaemon, it seems, made greater haste than his attendants; and the wife of the house, by the meanness of his dress, taking him to be a servant, employed him in cleaving wood for the fire, which he was busy at when his friend returned from the market, who being astonished at the sight, said, "Why does my great friend Philopaemon dishonour himself and me, by stooping to so mean an office?" The great man, with a cheerful and smiling countenance, answrered, "I am taking penance for my homely face and bad apparel." Though we cannot hope entirely to escape the unpleasant sen- sations, or altogether to ward off the fatal effects, occasioned by the sudden changes of our climate; yet, considering properly the nature of clothing, we may avoid much of the danger. If ladies are subject to catch cold more frequently than men, it is not alone their delicacy of constitution, or their being more confined within doors; but the frequent changes they make in the quality and quantity of their garments, and sometimes, however fearful of a partial current of air, because they expose those parts of the body that a little before had been warmly clad. If a greater proportion of females fall victims to consumption, is it not because, losing sight more than men of its primary purpose, says Dr. Beddoes, they regulate their dress solely by fantastic ideas of elegance?" After the high encomiums bestowed upon flannel by so many 'respectable authors, both ancient and modern, and by persons who, from long experience, have ascertained its beneficial effects, it is surprising that any individual should be whimsical or hardy enough to dispute its general salubrity, merely with a view to establish its favourite hypothesis. It has been objected, that flannel worn next the skin is debili- tating, because it too much increases perspiration; but this is n$t founded on truth, since perspiration, as long as the skin remains dry, never can be hurtful. In answer to another objection against the wearing of flannel, it is certain that a flannel shirt may pre- serve the body as clean, and much cleaner, than linen, if as fre- quently changed. <*F PRESERVING HEALTH. 191 To cold phlegmatic temperaments; to all who lead a sedentary life; to individuals subject to catarrhs, or frequent colds, gout, diarrhoea, and partial congestions of the blood; to all nervous patients and convalescents from severe chronic disorders; to per- sons who are too susceptible of the impressions of the atmosphere; and, lastly, in such climates and pursuits of life, as are exposed to frequent and sudden changes of air, the wearing of flannel next to the skin is certainly a salutary dress. It will also be found a better preventive of contagion than any other; because while it encourages perspiration, it at the same time removes the inhaled poisonous particles. It is a mistaken notion that flannel is too warm a clothing for summer. I have never found the least incon- venience from wearing it during the hottest weather; but, on the contrary, have experienced the greatest advantage. A celebra- ted author's favourite recipe for health was, "to leave off flannel on mid-summer day, to resume it the day following." To keep an animal in health, beside the retaining of a due de- gree of animal heat, there must be a continual generation of new juices, and a perpetual discharge of the old. Without the due quantity of perspiration, which, with us, depends very much on our clothing, neither the vegetable nor animal can continue in health. A plant, whose perspiration is stopt, becomes sickly and dies. Even an egg, whose shell has been covered with a varnish, and the perspiration stopt, will produce no animal. Whilst treating on clothing, I would recommend it to every person to be careful in observing that the linen which they put on, and the sheets in which they sleep are properly dried. Due care should also be taken to change the stockings, and other cloth- ing, as speedily as possible after their becoming wet from expo- sure to rain or snow. Those wdio neglect these cautions will expose themselves either to rheumatism, fever, pleurisy, cough, consumption, or some other disease of a dangerous or even fatal aiature. 102 ON HYGIEINE, OR THE ART OF CLEANLINESS. The grand discharge, the effusion of the skin, Slowly impair'd, the languid maladies Creep on, and through the sick'ningfunctions steal; As. when the chilling east invades the spring, The delicate Narcissus pines away In hectic langour; and a slow disease Taints all the family of flowers, condemned To cruel heav'ns. But why, already prone To fade, should beauty cherish its own bane! 0 shame! Opity! nipt with pale quadrille, And midnight cares, tlie bloom of Albion dies. Armstrong. Cleanliness may be considered the grand secret of preserv- ing beauty, as well as promoting health; and therefore is appli- cable to all ages and sexes. It maintains the limbs in their pli- ancy; the skin in its softness; the complexion in its lustre; the eyes in their brightness; the teeth in their purity; and the constitution in its fairest vigour. The frequent use of tepid baths is not more grateful to the sense, than it is salutary to health, and to beauty. By such ablu- tion, all impurities are thrown off; cutaneous obstructions remov- ed; and, while the surface of the body is preserved in its origi- nal brightness, many threatening disorders are put to the rout. Indeed, so important is this regimen, that every family should make a bathing vessel as indispensable an article in the house as a table. Against the rigours of a damp, cold Heaven, To fortify their bodies, some frequent The gelid cistern; and, where nought forbids, I praise their dauntless heart. * With us, the man of no complaint demands The warm ablution, just enough to clear The sluices of the skin; enough to keep The body sacred from indecent soil. Still to be pure, ev'n did it not conduce, As much it does, to health, were greatly worth Your daily pains. 'Tis this adorns the rich; The want of this, is poverty's worst wo— OF PRESERVING HEALTH. 193 With this external virtue, age maintains A decent grace; without it, youth and charms Arc loathsome. This the venal graces know; So, doubtless, do your wives; for married sires As well as lovers, still pretend to taste; Nor is it less, all prudent wives can tell, To lose a husband's than a lover's heart. Armstrong. Cleanliness is certainly agreeable to our nature. It sooner at- tracts our regard than even finery itself, and often gains esteem where that fails.. It is an ornament to the highest, as well as the lowest situation, and can not be dispensed with in either. I had occasion, says the author of the Spectator, to go a few miles out of town, some days since, in a stage-coach, where I had for my fellowr-travellers, a dirty beau, and a pretty young quaker wroman. Having no inclination to talk much, I placed myself backward, with a design to survey them, and to pick a specula- tion out of my two companions. Their different figures were sufficient to draw my attention. The gentleman was dressed in a suit, the ground whereof had been black, as I perceived from some few spaces that had escaped the powder which was incor- porated with the greatest part of his coat; his periwig, which cost no small sum, was after so slovenly a manner cast over his shoulders, that it seemed not to have been combed since the year 1682; his linen, which was not much concealed, was daubed with plain Spanish, from the chin to the lowest button, and the diamond upon his finger, which naturally dreaded the water, put me in mind how it sparkled amidst the rubbish of the mine where it was first discovered. On the other hand, the pretty quaker appeared in all the ele- gance of cleanliness. Not a speck was to be found upon her. A clean, oval face, just edged about with little thin plaits of the purest cambric, received great advantage from the shade of her black hood; as did the whiteness of her arms from that sober coloured stuff in which she had clothed herself. The plainness of her dress wras very well suited to the simplicity of her phra- ses; all which, put together, gave me an exalted sense of both her good taste and her pure innocence. 194 ON HYGIEINE, OR THE ART This adventure occasioned my throwing together a tew hints upon cleanliness, which I shall consider as one of the half-virtues, as Aristotle calls them, and shall recommend under it the three following heads. As it is a mark of politeness; as it produce* regard; and as it bears analogy to purity of mind. First, it is a mark of politeness. It is universally agreed upon, that no one unadorned with this virtue, can go into company with- out giving a manifest offence. The easier or higher any one's fortune is, this duty arises proportionally. The different nations of the world are as much distinguished by their cleanliness, as by their arts and sciences. The more any country is civilized, the more they consult this part of politeness. We need but com- pare our ideas of a female Hottentot and an English beauty, to be satisfied of what has been advanced. In the next place, cleanliness may be said to be the foster-mother of love. Beauty, indeed, most commonly produces that passion in the mind, but cleanliness preserves it. An indifferent face and person, kept in perpetual neatness, has won many a heart from a pretty slattern. Age itself is not unamiable, while it is preserved clean and unsullied; like a piece of marble constantly kept clean and bright, we look on it with more pleasure than a new vessel that is cankered with rust. We might observe farther, that as cleanliness renders us agree- able to others, so it makes us easy to ourselves; that it is an ex- cellent preservative of health, and that several vices, destructive both to mind and body, are inconsistent with the habit of it.— We find, from experience, that through the prevalence of cus- tom, the most vicious actions lose their horror by being made familiar to us. On the contrary, those who live in the neigh- bourhood of good example, fly from the first appearance of what is shocking. It fares with us much after the same manner as to our ideas. Our senses, which are the inlets of all the images conveyed to the mind, can only transmit the impressions of such things as usually surround them. So that pure and unsullied thoughts are naturally suggested to tbe mind by those objects that perpetually encompass us, when they are beautiful and ele- gant in their kind. • OF PRESERVING HEALTH. 195 OF PATRIOTISM. Man, through all ages of revolving time, Unchanging man, in every varying clime, Deems his own land, of every land the pride, Belov'd by Heaven o'er all the world beside; His home a spot of earth supremely blest, A dearer, sweeter spot than all the rest Movtsomery. Patriotism, properly defined, is the love of the laws and of the commonwealth. It is a sentiment which makes us prefer the interest of the public to our own. At the very name of country, the wise and brave feel an enthusiasm which renders them in- vincible. Patriotism also contributes greatly to the promotion of good morals; and hence to health, and every other blessing, both pri- vate and public. Rome, Athens, and Lacedaemon, owed all their glory to patriotism; and their nothingness to their forgetfulness of their country, their laws, and morals. Happy if these awful lessons, read to us in the examples of the great republic of antiquity, could but avail to kindle among our- selves that divine patriotism which once exalted them to such glory among the nations. Among innumerable other blessings, health would then be promoted. For the noble virtues of the soul constituting patriotism, as magnanimity, disinterestedness, va- lour, and consciousness of doing our duty, would diffuse through the heart that habitual complacency and joy most friendly to health; which would be still further promoted by that simplicity of manners, and activity of life, which belongs to Republicans. Whereas, on the contrary, in proportion as national patriotism decays, health becomes enervated by luxury and other vices, which are sure to overspread a nation that has lost the animating fire of patriotism. 196 ON HYGIEINE, OR THE AIM John II. kiug of Portugal, who for the nobleness of h.s mind was worthy of a greater kingdom, when he heard there was a bird called the Pelican, that tears and wounds her breast with her bill, that with her own blood she may restore her young ones to life, when left as dead by the bitings of serpents, this excellent prince took care that the figure of this bird, engaged in this action, should be added to his other royal devices; that he might hereby show, that he was ready, upon occasion, to part with his own blood for the welfare and preservation of his peo- ple and country. Pity it is to conceal their names, whose minds have been, in this respect, as pious and princely as his, not fear- ing to redeem the lives of their fellow-citizens at the price of their own. Themistocles, the Athenian general, after his many famous exploits, was banished the country, and sought after to be slain. He chose, therefore, to put himself rather into the power of the Persian king, his enemy, than to expose himself to the malice of his fellow-citizens. He was by him received with great joy; insomuch, that the king in the midst ofhis sleep, was heard to cry out thrice aloud, "I have with me Themistocles, the Athe- nian." He also did him great honour, for he allotted him three cities for his table provisions, and two others for the furniture of his wardrobe and bed. While he remained in that court with such splendour and dignity, the Egyptians icbelled, encouraged, and also assisted by the Athenians. The Grecian navy had come as far as Cyprus and Cilicia; and Cimon, the Athenian admiral, rode master at sea. This caused the Persian king to levy sol- diers, and appoint commanders to repress them. lie also sent letters to Themistocles, then at Magnesia, importing that he hail oiven him the supreme command in that affair, and that he should now be mindful of his promise to him, and undertake this war against Greece. But Themistocles was no way moved with an- ger against his ungrateful countrymen, nor incited to wage war with them by the gift of all his honour and power; for, after having sacrificed, he called about him his friends, and, having embraced them, he drank a strong poison, and chose rather to close his own life, than to be an instrument of evil to his native country, which yet had deserved so ill at his hands. Thus died OF PRESERVING HEALTH. 197 Themistocles, in the sixty-fifth year of his age, most of which time he had spent in the management of the republic at home, or as the chief commander abroad. At the siege of Turin by the French army, in 1640, a sergeant of the Piedmontcse guards signalized himself by a singular ex- ample of patriotism; this sergeant guarded, with some soldiers, the subterraneous parts of a work of the citadel. The mine was charged, and nothing was wanting but wdiat is called a sausage or pudding, to blow up several companies of grenadiers who served in the work and posted themselves in it. The loss of the work would have accelerated the surrender of the place.— The sergeant, with great resolution, ordered the soldiers he com- manded lo retire, begging them to desire the king his master to protect his wife and children. He then set fire to the powder, and perished for his country. On the surrender of Lord Cornwallis, in the American war, the Loyalist of 22 guns, then in the Chesapeake, became a party in that disastrous event; her crew were conveyed to the Count de Grasse's fleet—of that fleet the Ardent, captured off Ply- mouth, made one, but was then in a very leaky condition. The Count being informed that the carpenter of the Loyalist was a man of talents, and perfectly acquainted with the nature of the chain pump, of which the French were ignorant, ordered him on board the Ville de Paris, and addressed him thus: " Sir, you are to go on board the Ardent directly; use your utmost skill, and save her from sinking, for which service you shall have a premi- um, and the encouragement due to the carpenter of an equal rate in the British navy; to this I pledge my honour; on refusal, you will, during your captivity, be fed on bread and water only."— The tar, surprised at being thus addressed in his own language, boldly answered; "Noble Count, I am your prisoner. It is in your power to confine me; but never let it be said that a British sailor forgot his duty to his king and country, and entered volun- tarily into the service of the enemy; your promises are no in- ducement for me, and your threats shall not force me to injure my country." 26 198 ON HVGIEINL, OR THE ART There is a land, of every land the pride, Belov'd by Heaven o'er all the world beside; Where brighter suns dispense serener light, And milder moons emparadise the night; A land of beauty, virtue, valour, truth, Time-tutor'd age, and love-exalted youth. "Where shall that land, that Spot of earth be found?" Art thou a man?—a patriot?—look round; 0 thou shalt find, howeVr thy footsteps roam, That land thy country', and that spot thy home! Montgomery. As Americans, we feel the love of country, not merely because it is the land wdiere we were born, but the land where we enjoy freedom, equal rights, and every blessing that can sweeten life, and gild it over with glory. Hence we need not have gone back to ancient times to show wdiat men have dared from patriotism. No, thank God! we have, in ourow-n country, and in our own days, names as bright as ever adorned the annals of time. The memory of my exulting reader is already flying before me to a liost of heroes, who even courted wounds and death for their country; to Lawrence, whose last words were "Don't give up the Ship!"—to Burrows, who, when desperately wounded on the deck, said, " / xoon't be carried below; prop me up, tlutt I may see my brave men at tlieir guns!"—to Lowry Donaldson, who cried, "My gallant countrymen, I die, but don't let the cause of freedom die with me!"—to Daviess, who, on the field of Tippecanoe, smi- ling in the arms of fate exclaimed, " Thank God, I die in tlie best of causes!"—to a common sailor, who, w bile below, dressing for a mortal wound, and hearing his companions on deck shouting for victory, snatched away the shattered stump of his arm, saying, " Let me go, doctor: I know I am dying, but I must give one huzza more'for my country!"—to Pike, Covington, Gibson, Wood, Holmes, Stoddard, Bcasley, Mead, Spencer, Wattles, Iloppuck, Jack, Bradford, Armistead, Yanhorn, Olmstead, Middleton, Woolfolk, Smith, M'Donough, Blaney, Legate, Yates, Jackson, O'Fling, of the army—to Allen, Ludlow, Wilmer, Funk, Babbit, Hamilton, Howell, Stansbury, Gamble, Cowell, William*, Brookes, Bush, Broome, of ike navy—to Davis, Allen, Lauder- OF PRESERVING HEALTH. 199 dale, Henderson, Graves, Hickman, Hart, M'Cracken, Hooper, Pace, Buel, Hamilton, Evans, Quarles, Brown, Belknap, Blakes- ley, Clagget, Clemm, Rosevelt, Poe, of the militia,—and a thou- sand other Martyrs of Liberty, who all rushed into the battle as if animated by the immortal Washington's injunction,— " Remember, tlutt you are going to fight for liberty!" and who all died rejoicing thaj; they had shed their blood to cement her Holy Fabric. " To live with fame tlie gods allow to many; but to die with equal lustre, is a gift which Heaven selects from all the choicest boons of fate, and with a sparing hand on few bestoies." OF RELIGION. Yet, though kind Heav'n points out th' unerring road. That leads through nature up to bliss and God; Spite of that God, and all his voice divine, Speaks to the heart, or teaches from the shrine, Man, feebly vain, and impotently wise, Disdains the manna sent him from the skies; Tasteless of all that virtue gives to please, For thought too active, and too mad for ease, From wish to wish in life's mad vortex tost, For ever struggling, and for ever lost; He scorns Religion, though her seraphs call, And lives in rapture, or not lives at all. Cawthobn. Some of my readers may perhaps be surprised, that in a hook which professes to treat of Health, I should so far forget the text as to introduce the subject of Religion.—But I trust they will cease to wonder wdien they consider that health is the phy- sical result of nicely balanced appetites and passions, and that there exists no power on earth, that can so attune these into har- mony, as Religion. Cast your eye around you, and say whence have sprung most of tlie diseases, both mental and corporal, hut from lack of this divine guardian of man, Religion. By this great «W ON HYGIEINE, OR THE AIM name, I do not mean that hypocrisy which consists in gloomy faces, nor that narrow bigotry which rests on particular forms; the one only shows that religion is very galling to their feelings; the other is but too often false and treacherous, deluding those who behold them, into the opinion of their superior sanctity and virtue. Nor can I entertain a more favourable opinion of those who make a profession of religion and exhibit too much levity. It is a maxim among politicians, " that those who know not how to dissemble, know not how to rule." But this will not hold in religion, where virtue is at all times to be the guide of our actions. There are some sectarians who arc so illiberal as to express a belief, that those only of their persuasion are in the right road to Heaven! Strange infatuation! Can this be consistent with the Scriptures or reason? The pure spirit of the gospel of Chris' breathes forth a holy religion, founded on meekness, charity. kindness, and brotherly love. Could we forbear dispufe, and practise love, We should agree as angels do above. Where love presides, not vice alone does find No entrance there, but virtues stay behind: Both faith and hope, and all the meaner train, Of mortal virtues, at the door remain. Love only enters as a native their, For, born in Heaven, it docs but .sojourn here Waller. It is of the utmost importance to guard against extremes of every kind in religion, lest by seeking to avoid one rock wc split upon another. It has been long the subject of remark, that Superstition and Enthusiasm are two capital sources of delu- sion. Superstition, on the one hand, attaching men with immo- derate zeal to the ritual and external points of religion, and en- thusiasm) on the other, directing their whole attention to internal emotions and mystical communications with the spiritual world; while neither the one nor the other has paid sufficient regard to the great moral duties of the Christian life. OFPESERVING HEALTH. 201 Blest is the man, as far as earth can bless, Whose measur'd passions reach no wild excess; \N ho, urg'd by Nature's voice, her gifts enjoys, Nor other means than Nature's force employs. Zimmerman. In mental illusion, Imagination, when she first begins to exer- cise her powers, seizes on some fact, of the real nature of which the mind has but an obscure idea, and for want of tracing it thro' all its connexions and dependencies, misleads reason into the darkest paths of error. The wild conjectures, and extravagant opinions wdiich have issued from this source, are innumerable.— The voice of the calm inquirer, Reason, is incapable of being heard amidst the tumult, and the favourite image is animated and enlarged by the glowing fire of the Passions. No powrer remains to control or regulate, much less to subdue, this mental ray, which inflames the whole soul, and exalts it into the fervour of Enthusiasm, hurries it into the extravagance of Superstition, or precipitates it into the furious frenzies of Fanaticism. The fire of fanaticism is so subtilely powerful, that it is capa- ble of inflaming the coldest minds. The rapidity of its progress certainly depends, in a great degree, on the nature of the mate- rials on which it acts; but, like every dangerous conflagration, its first appearances should be watched, and every means taken to extinguish its flame. In the course of my practice as a physician, says Dr. Zimmer- man, I was called upon to attend a young lady, whose natural disposition had been extremely cheerful, until a severe fit of sick- ness damped her spirits, and rendered her averse to all those lively pleasures which fascinate the youthful mind. The debility of her frame, and the change of her temper, were not sufficiently attended to in the early stages of her convalescence. The anxie- ty of her mind was visible in the altered features of her face; and she was frequently heard to express a melancholy regret, that she had consumed so many hours in the frivolous, though innocent, amusements of her age. Time increased, by almost impercepti- ble degrees, these symptoms of approaching melancholy; and at length exhibited themselves by penitential lamentations of the sin jr. 202 ON HYGIEINE, OR THE ART she had committed with respect to the most trilling actions of her life, and in which no shadow of offence could possibly be found At the time I was called in, this superstitious melancho- ly was attended with certain indications of mental derangement. The distemper clearly originated in the indisposition of the body, and the gloomy apprehensions which disease and pain had intro- duced into the mind during a period of many months. This or.cr lively, handsome, but now almost insane female, was daily attack- ed with such violent paroxysms of her complaint, that she lost all sense of her situation, and exclaimed, in horrid distractiou and deep despair, that her perdition was already accomplished, and that tlie fiends were waiting to receive her soul and plunge it into tlie bitterest torments of hell. Her constitution, however, still fortun- ately retained sufficient strength to enable me, by the power of medicine, gradually to change its temperament, and to reduce the violence of the fever which had been long preying on her life. Her mind became more calm in proportion as her nerves recover- ed their former tone; ami when her intellectual powers were in a condition to he acted on with effect, I successfully counteracted the baleful effects of Superstition by the wholesome infusion of real Religion, and restored, by degrees, a lovely, young, and v'u •uous woman to her family and herself. Oh! would mankind but make fair Truth tlieir guide, And force the helm from Prejudice and Pride, Were once these maxims fix'd that God's our friend, Virtue our good, and Happiness our end, How soon must reason o'er the world prevail, And Eerror, Fraud, and Superstition fail! None would hereafter, then, with groundless fear, Describe The Almighty cruel and severe; Predestinating some, without pretence, To Heaven; and some to hell for no offence. Inflicting endless pains for transient crime.*, And favouring sects or nations, men or times. Zl.M-MEr.IMA.V It is that fervent love of God and man, constituting the heart- gladdening religion of Christ, wdiich I mean. This teaches us to deny ourselves, and follow in the exercise of all virtue*, whci":i: OF PRESERVING HEALTH. 203 consists the life of religion, laying aside all idle quarrels, self-in- terest, and needless debates about circumstantials; for this reli- gion is not in words but in works; not in opinions but in assur- ances; not in speculation but in practice. It is this religion all men ought to love for their own sakes, because a holy life, which it teaches, gives a comfortable death and a happy eternity. He that alone would wise and mighty be, Commands that others love as well as he. Love as he lov'd—How can we soar so high? He can add wings when he commands to fly. Nor should we be with this command dismay'd; He that examples give will give his aid. For he took flesh, that when his precepts fail, His practice, as a pattern, may prevail. Wallek. The man who loves God, enjoys that first of felicities, the con- sciousness of having placed his affections on the only object that truly deserves them. O! how amiable is gratitude; especially when directed to the Supreme Benefactor. It is the most exalted principle that can actuate the heart of man. When a good man looks around him on this vast world, where beauty and goodness are reflected from every object, and where he beholds millions of creatures in their different ranks, enjoying the blessings of existence, he looks up to the Universal Fa- ther, and his heart glows within him. And in every comfort which sweetens his own life, he discerns the same indulgent hand. Thus it is that gratitude prepares a good man for the enjoyment of prosperity; for not only has he as full a relish as others of the innocent pleasures of life, but, moreover, in these he holds com- munion with God. In all that is good or fair he traces his hand. From the beauties of nature, from the improvements of art, from the blessings of public or private life, he raises his affections to the great Fountain of all happiness which surrounds him, and this widens the sphere of his enjoyments, by adding to the pleasures of sense, the far more exquisite joys of the heart. If this goodness of God is so admirably seen in the works of Nature, and ihe favours of Providence, with what a noble superi- ority does it even triumph in the ministry of redemption. Redemp- 204 OX HYLIEIXE. OR Till'. ART tion is the brightest mirror in which to contemplate the most lovely attributes of the Deity. Redemption! oh thou beauteous mystic plan, Thou salutary source of life to man! What tongue can speak thy comprehensive grace: What thought thy depths unfathomable trace? 0! blest Redeemer, from thy sacred throne, Where saints and angles sing thy triumphs won! From that exalted height of bliss supreme, Look down on those who bear thy sacred name; Restore their ways, inspire them by thy grace. Thy laws to follow, and thy steps to tract; Thy bright example to thy doctrine join, And by their morals prove their faith divine! BOYSE. Religion is so far from debarring us of any innocent pleasure 01 comfort of human life, that it purifies our enjoyments, and ren- ders them more gtateful and generous; and thus makes us habit- ually cheerful ThoU, Cheerfulness, by Heaven design'd To sway the movements of the mind; Whatever fretful passion springs, Whatever wayward fortune bring* To disarrange the power within, And strain the musical machine; Thou, goddess, thy attempering hand Doth each discordant string command. Refines the soft and swells the strong, And, joining Nature's general song, Through many a varying tone unfolds The harmony of human souls. Akenside. Cheerfulness is consistent witli every species of virtue and prac- tice of religion. It bears the same friendly regard to the mind as to the body; it banishes all anxious care and discontent, soothes and composes the passions, and keeps the soul in a perpetual calm. OF PRESERVING HEALTH. 205 Providence did not design this world should be filled wHl mur- murs and repinings, and that the heart of man should be involved in perpetual gloom and melancholy. What blessings Thy free bounty give* Let me not cast away; For God is paid when man receives; T' enjoy is to obey. Pon. As I was between sleeping and waking, says a sublime author, I perceived one of the most shocking figures imagination can frame, advancing towards me. She was dressed in black, her eyes deep sunk in her head, and her complexion pale and livid as the countenance of death. Her looks were filled with terror and unrelenting severity, and her hands armed with whips and scor- pions. As soon as she came near, with a horrid frown, and a voice that chilled my very blood, she bade me follow her. I obeyed, and she led me through rugged paths, beset with briers and thorns, and a deep solitary valley.—Wherever she passed, the fading verdure withered beneath her steps; her pestilential breath infected the air with malignant vapours, obscured the lus- tre of the sun, and involved the fair face of Heaven in universal gloom. Dismal howlings resounded through the forests; from every baleful tree the night raven croaked his dreadful note; and the prospect was filled with desolation and horror. In the midst of this tremendous scene, she addressed me in the following manner. "Retire with me, O rash, unthinking mortal, from the vain al- lurements of a deceitful world, and learn that pleasure was not de- signed the portion of human life. Man was born to mourn, and to be wretched; this is the condition of all below the stars, and whoever endeavours to oppose it, acts in contradiction to the will of Heaven. Fly then from the fatal enchantments of youth and so- cial delight, and here consecrate the solitary hours to lamentation and wo. Misery is the duty of all sublunary beings, and every enjoyment is an offence to the Deity, who is to be worshipped only by the mortification of every sense of pleasure, and the everlasting exercise of sighs and tears." 27 200 ON HYC, IE1XH, OR TIIK WIT This melancholy picture of life quite sunk my spirits, and seemed to annihilate every principle of happiness within me. I threw myself beneath a blasted yew, where the winds blew cold and dismal round my head, and dreadful apprehensions chilled my heart. Here I resolved to lie till the hand of death, which I impatiently invoked, should put an end to the miseries of a life so deplorahly wretched. In this sad situation, I espied on one hand of me a deep muddy river, whose heavy waves rolled on in slow and sullen murmurs, when I found myself suddenly surprised by the sight of the loveliest object I ever beheld. The most engaging charms of youth and beamy appeared in all her form; effulgent glories sparkled in her eyes, and their awful spiencour were softened by the gentlest looks of complacency and peace. At her approach, the frightful spectre, who had be- fore tormented me, vanished away, and with her all the horrors she had caused. The gloomy clouds brightened in cheerful sunshine; the groves recovered their verdure; and the whole re- gion looked gay and blooming as the garden of Eden. I was quite transported at the unexpected change, and reviving hope began to glad my thoughts, when, with a look of inexpressible sweetness, my beauteous deliverer thus uttered her divine in- structions: "My name is Religion. I am the offspring of Truth and Love, and the parent of Benevolence, Hope, and Joy. That mon- ster from wdiose power I have freed you, is called Superstition; she is the child of Discontent, and her followers are Fear and Sorrow. Thus, different as we are, she has often the insolence to assume my name and character, and seduces unhappy mortals to think us the same, till she at length drives them to the borders of despair; that dreadful abyss, into which you were just going to sink. "Look around, and survey the various beauties of the globe, which Heaven has destined for the seat of the human race, and consider whether a world thus exquisitely framed, could be meant for the abode of misery and pain. For what end has the lavish hand of Providence diffused such innumerable objects of deliuht, but that all might rejoice in the privilege of existence, and be filled OF PRESERVING HEATH. 207 with gratitude for the blessings he has sent, is virtue and obedi- ence; and to reject them merely as means of pleasure is pitiable ig- norance, or absurd perverseuess. Infinite goodness is the source of created existence; the proper tendency of every rational being, from the highest order of raptured seraphs, to the meanest rank of men, is to rise incessantly from lower degrees of happiness to higher. They have each faculties of assigned them for various orders of delight." "What!" cried I, "is this the language of Religion? Does she lead her votaries through flowery paths, and bid them pass an unlaborious life?" "The true enjoynwnts of a reasonable being," answered she, mildly, "do not consist in unbounded indulgence, or In.curious ease, the tumult of passions, the langour of indul- gence, or the flutter of light amusements. Those are often raised into the greatest transports of joy, who are subject to the greatest depressions of melancholy: on the contrary, Cheerfulness, though it does not give the mind such an exquisite gladness, prevents us from falling into depths of sorrow. Mirth is like a flash of light- ning, that breaks through a gloom of clouds, and glitters for a moment. Cheerfulness keeps up a kind of day light in the mind, and fills it with a steady and perpetual serenity." Repinings and secret murmurs of heart give imperceptible strokes to those delicate fibres of which we are composed and wear out the machine insensibly; not to mention the injury they do the blood, and those irregular disturbed motions which they raise in the vital functions. Whereas Cheerfidness bears the same friend- ly regard to the mind as to the body; it banishes all anxious care and discontent, soothes and composes the passions, and keeps the soul in a perpetual calm. To aim at a constant succession of high and vivid sensations of pleasure,is an idea of happiness altogether chimeiical. Calm and temperate enjoyment is the utmost that is allotted to man. Beyond this, we struggle in vain to raise our state; and, in fact, depress our joys, by endeavouring to heighten them. Look around you on the world; reflect on the different societies which have fallen .under your observation; and think who anion* them enjoys life to most advantage; whether they who, encircled by gay companions, are constantly fatiguing themselves in quest 208 ON HYGIEINE, OR THE ART of pleasure; or they to whom pleasure comes unsought, in the course of active, virtuous, and manly life. Religion or philosophy calls you not to renounce pleasure, but teaches you how to enjoy it. Instead of abridging it, we exhort you to pursue it with safety. We propose measures for securing its possession, and for prolonging its duration. Though she may appear to contract the bounds of enjoyment, you will upon reflec- tion find, that in truth she enlarges them: what is delightful in human enjoyment she readily allows, and not only allows, but heightens, by that grateful relish which a good conscience gives to every pleasure; an 1 not only heightens, but adds, when cor- recting the excess of some passions, she gives room for the growth of others. Amid the turbulence of riot and the. fumes of intoxication, unknown are the pleasures of generous friendship, heart-felt love and domestic society; unknown the conscious satisfaction which accompany honourable pursuits, and the justly acquired esteem of those who surround us. It was the daily practice of that eminent physician, I}r. Boer- haave, throughout his whole life, as soon as he arose in the morn- ing, which was generally very early, to retire for an hour to pri- vate prayer and meditation on some part of the Scriptures. He often told his friends, when they asked him how it was possible for him to go through so much fatigue, that it was this which gave him spirit and vigour in the business of the day. This, therefore, he recommended, as the best rule he could give: for nothing, he said, could tend more to the health of the body, than the tranquillity of the mind; and that he knew nothing which could support himself or his fellow-creatures, amidst the various distresses of life, but a well grounded confidence in the Supreme Being, upon the principles of Christianity. We have all of us experienced the effects which any indisposition of the body, even though slight, produces on external prosperity. Visit the gayest and most fortunate man on earth, only with sleep- less nights, disorder any single organ of the senses, corrode but one of his smallest nerves, and you shall presently see all his gaiety vanish; and you shall hear him complain that he is a mis- erable creature, and express his envy of the peasant and the cot- OF PRESERVING HEALTH. 209 tager. And can you believe that a disease in the soul is less fatal to enjoyment than a disease in the animal frame; or that a sound mind is not as essential as a sound body to the happiness of man? Let us rate sensual gratifications as high as we please, we shall be made to feel that the seat of enjoyment is in the soul. Ah! what is life? with ills encompass'd round, Amjdst our hopes, fate strikes the sudden wound: To-day the statesman of new honour dreams, To-morrow death destroys his airy schemes; Is mouldy treasure in thy chest confin'd? Think all that treasure thou must leave behind! Thy heir with smiles shall view thy blazon'd hearse, And all thy hoards with lavish hand disperse. Should certain fate th! impending blow delay, Thy mirth will sicken, and thy bloom decay; Then feeble age will all thy nerves disarm, No more thy blood its narrow channels warm. Gay. Let the affections of a man be once softened and dulcified with Divine love, and he is ever secure from the sudden apoplexies of the passionate, the poisonous cups of the drunkard—the murder- ing pistol of the duellist—the assassinating dagger of the jealous —the loathsome diseases of the harlot—and the wasting hectics of the gambler. Though it is an ill man's interest there should be no God, be- cause then there should be no punishment for sin, and though this interest passes into argument, yet it is never so conclusive as to pass into an entire satisfaction; for we cannot believe any person that has the use of his rational faculties, and gives himself the liberty of thinking, can deny the existence of a Deity, both as to creation and providence. Then, if every man believes there is a God, not to live in obedience to his precepts is to enhance ' one's guilt, and bring conscience as a witness to convict the offender of wilful transgressions. As for professed Atheists, or such as have pretended to be so, and durst presume to affront j their Deities, let others read the blackness of their sin in the exemplary punishment that attended it. A young gentleman of the City of Florence, in Italy, being accounted brave and dexterous at single sword, was to duel an- 210 OF 1'RKSl.RVIXG HEALTH. other young man called Forchehene. Th y were accompanied into the field by several of their acquaintance, where a friend saluted the former with his good wishes, saving, ' I |"av God give you victory over your antagonist." The insolent spark answered, "How can he fail to do otherwise?" Foiehcbeie overhearing them, replied, " These blasphemous words will ren- der me the executioner of Divine vengeance." To it they went with equal fury, when the combat, for some time, was very doubtful; but at length Forchehene made such a home-thrust into his adversary's mouth, that he fixed his tongue to his neck, the sword appearing above six inches on the other Vide; of which wound he died immediately, and had his death in tlie part that offended. Oh man! degenerate man! offend no more! Go, learn of brutes thy Maker to adore! Shall these through every tribe his bounty own, Of all his works ungrateful thou alone! Mark how the wretch his awful name blasphemes, His pity spares—his clemency reclaims! Observe his patience with the guilty strive, And bid the criminal repent and live; Recall the fugitive with gentle eye, Beseech the obstinate he would not die! Amazing tenderness—amazing most The soul on whom such mercy should be lost! Boyle. There are many wicked men who will speak unbecoming things of God, in a humour of bravado amidst company, but will trenv ble before him in solitude, and shudder at the approach of death. Man makes a death which nature never made, Then on the point of his own fancy falls, And feels a thousand deaths in fearing one. Young. Voltaire, a man who, after having long and too justly been considered the patron of infidelity, and after having shown him- self equally the enemy to every religious establishment, at length, to the astonishment of all serious minds, and at the close of a long i life of near eighty years, embraced the Christian religion. If a veteran in the cause of infidelity thus closes his life and his works, does it not greatly behoove those who have been ON HYG1EI N E, OR THE ART 2U deluded and misled by his writings, seriously to look to them- selves, and bring home this striking example to their hearts. 0 then, while penitence can fate disarm, Whi'c ling'ring justice yet withholds its arm; While heavenly patience grants the precious time, Let the lost sinner think him of his crime; Immediate, to the seat of mercy fly, Nor wait to-morrow—lest to-night he die. Boyle. If men, so prodigal in scattering imprecations and curses upon all they are displeased at, would take time to consider what they arc about before they disgorge them, they would certainly be a-ha ■ned of the folly of such a practice, because nobody is hurt by it hut themselves; for curses, like arrows shot against Heaven, fall upon the heads of those that throw them out, but can never injure the persons or things levelled at. Again, wdiat can be more foolish than for men, in common discourse, to make imprecations upon themselves, to confirm the truth of their assertions, which does no more than give a handle to their auditors' suspicion; for good men will be believed without them, and scorn to use them; and bad men can never gain credit, but disparage them- selves, by so frequently venting them; because, by such bitter asseverations, they seem to suspect their own reputations. It is also for want of consideration, and too easy a compliance with a scandalous and vicious custom, that men of sense, in other matters, upon very slight, and sometimes no occasion in the world, expose themselves to the wrath of Heaven, by calling upon God to damn them if what they say be false, when, at the same time, they know there is no truth in it, and wish they may perish eternally, if they don't do what they never intend when they speak it. What use of oaths, of promise, or of test? Wliere men regard no God but interest? What endless war would jealous nations tear, If none above did witness what they swear? Sad fate of unbelievers, and yet just, Among themselves to find so little trust! Were Scripture silent, Nature would proclaim, Without a God, our falsehood and our shajine. Boyie. 212 ON HYGIEINE, OR THE AIM Amongst all the nations, there are none so barbarous and cruel, none so utterly lost to all the sentiments of humanity and civility, but have embraced and continued amongst them the notion of a Deity, or some being entitled to their adoration. This is a prin- ciple so deeply engraven in the very nature of man, that no time, nor change, nor chance, hath ever been able to obliterate it; so that, rather than have nothing to worship, men have often been contented to adore as gods, even the works of their own hands. And, indeed, herein their ignorance and folly is chiefly to be la- mented, that they have still made choice of any thing, rather than the true God, to pay their homage and veneration. In the mean time, they shame some of us, in having been more zealous in their superstition, than wc arc in the true religion. The Athenians consulted the oracle of Apollo, demanding what rites they should make use of in matters of their religion. The answer was, "The rites of their ancestors." Returning thither again, they said, "The manner of their forefathers had been of- ten changed;" they, therefore, inquired, "what custom they should make choice of in so great a variety?" Apollo replied, "The best." First to the gods thy humble homage pay; The greatest this, and first of laws obey: Perform thy vows, observe thy plighted troth, And let religion bind thee to thy oath. The heroes next demand thy just regard, Renown'd on earth, and to the stars preferr'd, To light, and endless life, their virtue's sure reward. Due rites perform, and honours to the dead, To every wise, to every pious shade. With lowly duty to thy parents bow, And grace and favour to thy kindred show: For what concerns the rest of human kind. Choose out the man to virtue best inclin'd; Him to thy arms receive; him to thy bosom bind. Pythagoras. The great Lord Burleigh used to say, " I will never (rust any man not of sound religion; fort he that is false to God can never be true to man." OF PRESERVING HEALTH. 213 From the very respectful mention which I have so frequently made of religion, some of my readers may be charitable enough to conclude, that I am religious in a high degree. Would to God I were. From my soul I wish that my devotedness to re- ligion had all my life been equal to the exalted opinion which I entertained of it. But, though like most of the human race, I have too often neglected my duty in this respect, yet can I say, before my God, that I look upon religion as the only true glory and hapfriness of man; and though worlds were thrown into the opposite scale, yet would I not relinquish the joys, imperfect as they are, which I derive from it. And from this circumstance I have often been led to think, that if I derive so much comfort from the little religion which I possess, how truly enviable, how superlatively happy must they be, whose whole lives are devoted to her service, and whose hearts are perpetually'enjoy- ing those sublime pleasures which her unclouded smiles can impart. Arise, my soul, on winces seraphic rise, And praise th' Almighty Sov'reign of the skies; In whom alone essential glory shines, Which not the heaven of heav'ns, nor boundless space confines. While this immortal spark of heavenly flame Distends my breast, and animates my frame; To thee my ardent praises shall be borne On the first breeze that wakes the blushing morn: The latest star shall hear the pleasing sound, And nature in full choir shall join around. When full of thee my soul excursive flies Through air, earth, ocean, or thy regal skies; From world to world new wanders still I find, And all the Godhead flashes on my mind. When wing'd with whirlwinds, vice shaft* Jake its flight To the deep bosom of eternal night, To thee my soul shall endless praises pay; Join, men and angels, join th' exalted lay!—BLACKLOCK 29 ©F FEVERS IN GENERAL. UNDER this head are comprehended all fevers whatever, by which the human frame is affected; but, as they arise from a great variety of causes, and affect persons of very dissimilar constitutions, they must of course differ in their nature, and rev- quire a very distinct treatment. - Two very opposite states of the human body are supposed' to give rise to fevers, and to form their great and fundamental distinctions. The one is called the phlogistic diathesis, or in- flammatory disposition; wherein the heart is excited to rapid and. $ strenuous exertions, manifested by great strength in the action. of the vessels, while the blood itself exhibits a more florid hue and denser texture than usual. In the other, the brain and nervous system are more directly affected, their energy seems impaired, the force of the heart and vessels is diminished, the blood is of a looser texture, and the fluids tend to desolation. In the first state, when the inflammation originates from exr ternal causes, as wounds, contusions, or burns, the fever fol- lows the local affection, and is in proportion to the degree of inflammation in the part affected. Such fevers are called symp- tomatic. This is also the case in certain disorders of tlie lungs, and other viscera, which arise, not from external injuries, but from some vice in the part, which gradually brings on inflammation -16 of rr.VEKs in c.fm:k.vi.. and fever. If the local information be removed, the fever is re- moved also; if it cannot be subdued, but increase gradually, destroying the organization of the part, the patient dies some- times by the violence of the fever, and sometimes merely be- cause an or«ran essential to life is destroyed. Cold is found, by universal experience, to give a disposition to inflammatory disorders, and heat to those called putrid.* Du- ring the winter, and early in the spring, pleurisies, peripneu- monics, quinsies, rheumatisms and inflammatory fevers prevail. Towanb the end of summer, and particularly in autumn, fevers of a different nature, with dysenteries and putrid ulcerous sore throats, make their appearance. Although it is true in general, that cold occasions a disposi- tion to diseases of an inflammatory nature, and heat to those supposed putrescent, yet, persons who take violent exercise in sultry weather, or who accidentally fall asleep on the ground, ex- posed to the beams of the mid-day sun, are sometimes seized with fevers of a highly inflammatory and dangerous quality; the inflammation directly affecting the brain itself, or its mem- branes. The time, in which intermmittents and remittents are most prevalent, is the end of summer and beginning of autumn, when heat and moisture combine to hasten the corruption of animal and vegetable substances, and fill the atmosphere with miasmata. These considerations reduce it next to a cer- tainty, that something essentially connected with a marshy soil produces fever, and we can suppose nothing with so much proba- bility, as the effluvia of stagnant water and corrupting animal jnd vegetable substances. And if a.sudden stoppage of perspiration, from the cold of autumn, after the body is relaxed by the heat of summer, be * We continue this term in obedience to custom only. For it conveys a false view of what really happens in :ho»^ t' vers. Recent experiment and more accurate ob- sei'v.it;on, Inve d:ittr.«jpd, that putrefaction never takes place in a living body. T!i" ^rucesa which ^me i n: s ^n--soi in these malignant fevers, Las some oftlr .appearancesof putref.ictiuh; Uit it is, in fact, t'.U'lly distinct. OF FEVERS IN GENERAL. 217 sufficient of itsolf to produce fever in dry and well ventilated countries where there is no reason to think that marsh mias- mata prevail, we cannot be surprised to find them far more universal and more obstinate in low and marshy soils, where the first cause concurs with the second. A still more active source of fevers is the effluvia from the living human body, which, when long confined, becomes in the highest degree acrimonious, and gives rise to diseases the most dangerous and malignant. Whenever numbers of peo- ple are crowded together, the air must soon be deprived of its vital ingredient, by repeated respiration, hence this infectious matter will be formed, but with most rapidity in gaols, in hos- pitals, in the holds of ships, and in dirty dwellings, where its virulent tendency is hastened by nastiness, by unwholesome food, by desponding thoughts, or by the effluvia coming from bodies in a diseased state. It communicates its infection not only to those who approach the places in which it is generated, and the human body from which it flows, but also will remain long entangled in beds, blankets, and other articles, having been in contact with the patient's body, retaining its activity, and capable of infecting others at a considerable distance of time and place, if, unhappily, those contaminated materials are carried abroad. In this manner, one person who is not him- self infected, may infect another: the first person in such cases, being less predisposed to the disease than the seebnd. Although the infection arising from the living human body, is not perceived to act at a great distance from its direct source; yet it seems most probable that it does not immediately lose its virulency; but after it is diffused in the atmosphere, con- tinues in some degree to act in conjunction with the miasmata of marshes, with heat, obstructed perspiration, and the other causes of fever, and, according lo the various proportions of those causes, combined with the circumstances of season, cli- mate, and the constitution of the patient, the nature of the fever is determined. 21t> Intermittent," 01? INTERMITTENT, OR AGUE AND FEVER. • » Swii'TOMs. Is that fever which has, periodically, a clear jflL* intermission alternating with a return of its paroxysms. From the length of time between the fits, the species of the fever are distiiigeished and named. Thus, if the fit returns every day. it is termed a quotidian! if every third, a tertian; if every fourth, a quartan. The ague commences with weakness, fre- quent stretching, and yavvnin^s, succeeded by sensations of cold in the back and extremities, which increase, until the limbs as well as the body become agitated with frequent and violent shivering. This continues for some time, during which a vio- lent pain of the head and b+ick, and a sensation resembling a stricture across the stomach, frequently distress the patient; and the sense of coldness is so ^reat, that no endeavours to ob- tain warmth are of the lc;i-t avail. These symptoms, subsi- ding by degrees, give way finally to warm flushings, which in- crease, until redness and heat, much greater than natural, are extended over the whole body; the patient at length burning with such extreme heat, as to be now as solieitous for the re- freshing sensation of cold, as he was before anxious to mitigate r its violence. After these systoms have existed for sometime, they gradually decline; the thirst goes off, the skin is relaxed, and a moisture breaks out on the head, which soon becomes ge- neral and profuse; then it slowly abates, till it entirely ceases. Thisistne general progress of a regular paroxysm of a well formed intermittent; the patient is often left, apparently, fire of disease, until the next attack. Caise;-. The remote causes of ague Or autumnal fever are, first, the effluvia which arises from marshes or moist grounds acted on by heat. Secondly, co'd, especially when accompa-. nied by moisture, which will necessarily act with more certain- AGUE ANDK> FEVER. 219 iy, if a predisposition to theJJisease exists. This predisposition may be induced by living too sparingly, or on trashy food, ex- cessive fatigue, impeded perspiration, preceding disease, indul- gence in spirituous liquors, and in fine, by whatever tends to weaken the system and impoverish the blood. Hence the poor are more subject to the disease than the rich. For health consists of spirits and of blood, And these proceed from generous wine and food. pXpe. Treatment. In the cure of an ague, whether quotidian* tertian, or quartan, much the same plan may be followed, which is, as far as possible, to prevent the disease from beinv habitual; for the longer it continues, the more it weakens tf>e .constitution, and disposes the glandular viscera, as the liveV. spleen, he. to obstructions, and often prepares the habit of dropsies and other chronic diseases. So that although this disease be not very alarming in its appearance, yet, if injudicious- ly treated, or neglected, it often draws after it the most serious consequences; and hence merits particular attention. The cure of the disease therefore caHs for an emetic, or a dose of calomel and jalap, or salts, senna and manna, to free the bowels of their offending contents; and if the patient be of a full habit, with head-ache and flushed countenance, the pulse hard and quick, showing an inflammatory disposition, blood letting will be highly necessary. Having by these means prepared the system, strengthening remedies should next be employed. Of these, the Peruvian bark is the most celebrated, and may be used with sa^ty in the time of intermission, provided there exists no swelling or hark_ ness of the viscera. In that event the bark must be withheld, until these symptoms are rendered milder by the administration of gentle laxatives, blisters, and diaphoretic medicines, as the cathartic and saline mixtures,* whose good effects will be great- ly aided by diluent drinks and abstinence from solid food. •See Dispensatory. 220 IM'ER.lflNTENT, OR . As soon as the system is properly prepared for the use of the bark, it may then be jriven in such doses as the stomach will bear, and at such intervals, that six oreiirht doses may be ta- ken during the intermission: Should it disagree with the pa- tient in substance, aivc it in some other form, as the cold infu- ^ sion, decoction or tincture. Sec Dispensatory In the mean time, strict attention must be paid to the habit of body: for in vain shall we expect to cure intermittents, if the bowels%e not kept open and the skin moist. i When, therefore, the Peruvian bark produces costiveness, five or six grains of rhubarb, or some mild purgative, should be added to each dose; and in case of cold phlegmatic habits, with a dry skin, the addition often or fifteen grains ofVirginia 4 snake-root is peculiarly proper. ^ In some constitutions the bark produces severe and copious purging. . This debilitating effect may be prevented by adding five or six drops of laudanum to each dose. And when the patient is troubled with sourness on the stomach, flatulence and pain, take the bark in lime water, or conjoin with each dose, eight or ten grains of salt of tartar, or magnesia. * Notwithstanding every precaution, the bark will not some- times remain on the stomach, and with children it is often dif- ficult for them to swallow this medicine. With such patients it should be employed externally as directed below.t Some patients are subject to profuse sweats, from debility. I In such cases the bark should be united with a few grains of the rust of steel, or ten or fifteen drops of elixir vitriol, and ta- ken in wine. But when these evacuations proceed, as they often do, from an inperfect cure, accompanied with great and intense heat, during their prevalence, we must immediately resort to the preparatory remedies, as blood-letting, cathartic and diap- horetic. Sometimes the fever, will not yield to the bark, even t f Take apiece of Holland, cut in form of a waistcoat, and for the lininc:, getlium- hninsofan open texture. Between these t-1 oaths, from three to six ounces of hark must be closely quilted, anil then the waistcoat applied on the naked skin. Even- two or three days, it will be necessary lo rub the jacket bet wet n the hands. If i<> "jmetimes proper to unite snake-root with ihe bark, in proportion of ene otmcc of th former lo four of the latter. 4'' \ ^_______■__,____________________I AGUE AND FEVER. 221 when all the usual preparatory medicines have been employed. In such cases we may justly suspect the liver to be diseased, particularly if the countenance be either livid, or pale, or of a yellowish cast; and in that event, the use of the bark should be suspended until those obstructions be removed. For this purpose one of the mercurial pills* should be given night and morning, until ptyalism, that is, a soreness of the mouth with increased spitting, U produced, which will general- ly succeed; and when it fails, the nitric acid diluted, and given in its usual doses* may be depended on. After a ptyalism is effected, recourse must be had to one or other of the strength- ening remedies, to give tone to the system. From the tenor of these observations it follows, that the Peruvian bark is not a remedy to be employed in every case of intermittent fevers, but that much caution is necessary in the use of it, lest it be turned into abuse. For unless the system be properly prepared by suitable remedies, the administration of bark, or any otlier tonic, is an error fraught with the most terious mischief. The Peruvian bark being so costly and not always to be had pure, it must afford much pleasure to the benevolent, to learn that the black oak bark of America possesses the same virtues of the Peruvian, as has been verified by repeated experiments, not only in the cure of intermittents, but otlier diseases hitherto treated with the Peruvian bark alone. It may be taken in the same manner, only in rather larger doses. In substance it is most efficacious, and if well pulverised it will be found more palatable than the Peruvian bark, and not so apt to excite vomiting. Another mode in which this remedy may be employed to threat advantage, from its abundance in our country, is by bathing twice or thrice a day in a strong decoction of it; which to children, and patients whose stomacks will not retain medi- cine, will prove exceedingly beneficial. When the black pak 30 •See Dispensatory. 222 INTERMITTENT, OR bark is not convenient, the red oak bark, though less efficaci- ous, should be substituted, as I have often witnessed the hap- piest effects accruing to debilitated persons bathing in a strong decoction of it, about lukewarm, particularly in the last stage of fevers. Hence this remedy well deserves the attention of the planter. Professor Barton assures us that he has employed the bark of the Spanish oak in gangrene, with the happiest effect, and that he considered it, in powder, equal to the best Peruvian bark. See Oak. Materia Me icti. The common dog-wood bark, of our country, is also an ex- cellent substitute for Peruvian, particu arly in the cure of inter- mittents; so is the bark of the wild cherry-tree, and of the lyriadendron tulipifera, or American poplar, all of which may be given in the same forms and doses, as the Peruvian bark. See Materia Me Aca. The columbo root, an admirable corrector of bile, is a most useful medicine in this complaint, and will often be retained by the stomack, when the bark in every form has been rejected^ It is likewise an excellent remedy, joined with steel, as in the form of the tonic powders or pills,* for patients disposed to be dropsical, or who have a swelling and hardness of the spleen. called ague cake; especially if a purge or two have been pre- viously employed, and some mercurial action excited in the system, by one or two grains of calomel, taken every nighl and morning for a few weeks. Another valuable medicine in the cure of agues, and which has frequently succeeded when the bark failed, is white vitriol. But like other tonic medicines, it requires that the stomach and bowels should be freed of their morbid contents, before any good effects can result from its use. Therefore, some evacuating medicine is always necessary; after which, one of the vitriolic pills* may be gireii every three or four hours dur- ing t're intermission of fever, gradually repeating the dose, or increasing it, as the system becomes habituated to its action. • See Dispensatory. AGUE AND FBVEK 22 J Charcoal powder in doses, from a tea to a table spoonful »nven three or four times during the intermission, has often interrupted the expected paroxysm and cut short the disease. A scruple of the spider's web, it has been said, in many in- stances hath proved successful, given an hour before the fit of an ague and an hour after it. But among the remedies of intermittents none is more in- fallible than the solution of arsenic, which may be given with perfect safety to persons of every age, beginning with the smaller doses, and proportioning them to the age of the patient. Stimulants administered before the fit, by inducing a salu- tary change in the system, have frequently overcome the dis- ease. It is in this way that emetics are considered useful in the coming on of the fit, so is active exercise, and other stimulants. Cataplasms of mustard seed and garlic, or horse radish, ap- plied to the wrists and ankles an hour or two previous to the unexpected fit, will excite a degree of inflammation so great as to increase the heat as well as the circulation, and have often succeeded. I have frequently, in obstinate intermittents, prevented the recurrence of the fit, by giving a large dose of laudanum or aether about an hour before the expected paroxysm. But when an inflammatory disposition prevails in the system, this temedy should not be resorted to, as it may convert the inter- mittent into a continued fever. An emetic given previous to the return, while the perspira- tion is supported by the volatile alkali or Dover's powder* in their usual doses, with warm drinks, have also succeeded in obstinate cases. It should be observed, however, that when we attempt to prevent the paroxysm of an intermittent by sweating, this mode of relief must be continued till the period of the paroxysm is at an end; or at least till the time when the sweating stage would have otherwise commenced. Those means which excite terror, surprise and horror, by producing a train of new emotions will prevent the return of" * See Dispensatory. 224 INTERMITTENT, OK paroxysms. A man has been pushed into the water; fire ha•• been cried; the most distressing tidings invented and commu- nicated. All these remedies fill the mind with such dread as to counteract the impression of the cause; but in general they are dangerous, and when we wish to prevent the fit, we depend rather on tonics, the stimulants, and the sudorifics. Dr. Kellie, an ingenious surgeon of the British navy states, that many instances have occurred of the good effects of compression by tourniquets or bandages applied so as to obstruct the circulation in two of the extremities. The plan pursued by him was to apply the instrument on one thigh, and on one arm, of opposite sides, at the same time. In two mi- nutes after the application of the tourniquets, the shaking and other symptoms of the cold stage entirely ceased, a inild hot stage was immediately induced, and the patient found himself quite relieved. After suffering the instruments to remain on for about fifteen minutes, they were removed, and the cold symp- toms did not return. He further states, that, if the tourniquets be applied previous to the accession of the paroxysm, the cold stage will entirely be prevented; and that, where the cold stage of an ague is either thus shortened, or altogether pre- vented, the following hot stage will be rendered both milder and of shorter duration. As agues are liable to recur, one excellent mean of preven- tion, as well as cure, is to wear flannel next to the skin, and to exchange the situation where the disease was contracted, for anodier, even though not of a healthier air. This alone has often effected a cure. In like manner a change of medicines is as necessary as a change of air, that the body may not be- come habituated to any one mode of treatment. Therefore, it ought to be remembered, that neither bark nor any other tonic medicine, should be continued longer than a fortnight at a time, but should be changed for another article whose virtues a. e nearh the same. After a week or two, the former may be resumed, in case the disease should prove obstinate; and to bring about the necessary changes in the constitution, largo doses should be given. AGUE AND I EVER 225 REQIMEN. As to regimen in the cold fit, very little more is necessary than warm camomile tea. In the hot fit, the drink may be barley water, mint or balm tea, lemonade, toast and water, or cold spring water, taken often, but in small quanti- ties at a time. When the sweating begins, the drinks just enumerated may be enlivened with wine, and if the patient be able to take it, he may be allowed a little nourishment. Dur- ing the intermission, the diet should be as nutritious as the pa- tient's appetite and digestion will allow. Every thing that tends to keep up a gentle perspiration, and to give tone to the vessels is useful; hence moderate exercise is singularly proper, since nothing more conduces to these beneficial effects. The exercise should be of that kind to which the patient has been most accustomed; and taken in the open air, unless wet wea- ther, or a damp situation forbid. But the utmost care should be taken, that exercise be not pushed to fatigue, which, by in- ducing debility, carries thousands, particularly foreigners, to untimely graves. REMITTENT, OR BILIOUS FEVER. Symptoms. In this fever there is a remission or abate- ment of its violence, but not a total cessation. Like other fevers it commences with a sense of coldness and shivering, accompanied by violent pains in the head and back, great de- jection of spirits, sickness at the stomach, giddiness, loss of strength, and difficulty of breathing. The cold stage is suc- ceeded by a considerable degree of heat, the pulse, which in the cold fit was small and quick, becomes full, but abates not of its quickness. The pain of the head and back increases, and the nausea is augmented, frequently7 terminating in co-» pious vomitings of bile. These symptoms continuing, the skin which had hitherto been hot and dry, becomes moist. Soon after this, tlie symptoms abate, and sometimes cease en- tirely. The patient flatters himself with the hopes of health speedily returning; but, alas! these .dening illusions are soon dissipated by another attack, which comes on with increased 22b KEMl1TENI,OK violence. And if the fever be not opposed by means early employed and sufficiently powerful, a constant delirium and restlessness take place; die discharges become very offensive succeeded by twitchings of the tendons, profuse clammy sweats, and convulsions, whicli soon terminate in death. Causes. Remittents are produced from the same cause? which induce intermittents, but acting here in a more power- ful manner. Like these, they are most prevalent in die months of August, September, and October, when heat and moisture combine to hasten the corruption of animal and vegetable substances, impregnate the air witli noxious exhalations. Treatment. In the cure of this fever, all our eflbrts should be made to bring the remission to a complete intermis- sion; and this is to be effected by bleeding, cathartics, eme- tics and diluents, with such medicines as have a tendency to solicit the circulation of the fluids to tlie surface. Hence, on the commencement of the disease, bleeding will generally be found unnecessary, and should be often repeated, when there exists much pain in the, head, with a hard and quick pulse. But to evacuate the first passages of their impure contents is always necessary; and this is best done with calomel and jalap, or salts, senna and manna, and when circumstances do not prohibit the use of emetics, they may also be employed. The extent to which these means are to be carried, can only be di- rected by the symptoms present, the habit of body, and other considerations. It will in many cases be proper to exhibit an emetic at the very first attack, but this may sometimes be for- bidden, by great irritability of the stomach, or the appearance of inflammation. For frequently in diseases of the same ori- gin, and in persons, very nearly similar, with respect to age, sex, and temperament, one will frequently be accompanied with an inflammatory diathesis, whilst another will be more of the low, irritable species; and consequently the treatment must be varied, in proportion to the nature and violence of the dis- BILIOUS; FEVEK. 227 ♦jase. For among fevers, we see all the intermediate degrees and varieties, from common agues to those of the most violent and infectious kinds. If the patent be of a strong plethoric constitution, with a hard and quick pulse, a deep seated pain in the eyes, a burning heat at the stomach, and flushed countenance, indicative of a strong inflammatory disposition, bleeding is absolutely neces- sary, and should be repeated every ten or twelve hours, or oftener, until the inflammatory symptoms subside. The necessity of diligently evacuating the intestinal canal, must be obvious to every person. And it is not always by one or two brisk cathartics that this complaint is to be cured; but the operation must be continued until the whole of the bilious matter is evacuated, which may be known by the fa?ces changing their color, and putting on a natural appearance. When the irritating matter is thoroughly evacuated, mild laxa- tives, as the cathartic mixture* or castor oil, answer very well in the course of the disease to keep the body gently open; but in desperate cases calomel is most to be depended on. And if a ptyalism, or a slight salivation be excited by the calomel, the patient has no cause of alarm, but rather of joy, as this is a certain indication of recovery. Ho v desirable then must it be in high stages of bilious fever, to have this effect produced as early as possible, by giving calomel, and rubbing in mercu- rial ointment, and dressing the blisters with the same. Besides the aforesaid evacuants, glysters of warm soap-suds, or molasses and water, to which may be added a little vinegar, should be employed; as they are not only useful in removing from the larger intestines any offending matter present, but also in producing the good effects of fomentations. Attention having been paid to the state of the bowels, which is always necessary, because of the constant disposition to ac- cumulate bile, such medicines as tend to determine the fluids to the surface, are next to be regarded. Of this class are the diaphoretic drops, saline mixture, mindererus's spirit, febrifuge and Dover's powder.* Either of these may be exhibited in 'See. Uisnensatorv. 22^ RLiiirri'M, ok their usual doses, every two or three hours, but in desperate cases the antimonial powders with calomel, or colomel alone, in small doses, are most to be relied on. The warm bath admirably promotes insensible perspiration, by relaxing the skin, and taking off the stricture of the ves- sels; it consequetly should always, when practicable, be used, and if a bathing vessel cannot be procured, the extremities should he immersed in warm water at least once a day. The temperature of the bath, should be regulated by the feelings of the patient, and that whicli effects these most agreeably, should be preferred. The cold affusion, by throwing cold water over the patient. or sponging the body with vinegar and water, has been at- tended with the best effects in warm climates, particularly if the application be made during the height of the paroxysm, when the head is generally affected. After the inflammatory disposition has ceased, bark will add considerably to the cure; but if incautiously used at the outset, as it frequently is, will render every synitom more violent. However, if the patient suddenly becomes giddy, feeble and languid, the bark and wine must be had recourse to, and given freely on the remission; otherwise it will degenerate into a true nervous fever. But you must not mistake the debility which arises from oppression, requiring evacmints, for an exhausted state of the system; as in that case the use of tonic- would be but little better than butchery. Another medicine of great importance in this disease is thf colunibo root, which readily checks the vomiting, so frequent- ly an attendant, and supports the patient's strength during the use of such medicines as are requisite to abate the febrile heat. and to carry oft* the bile. After unloading the stomach and intestines, by two or three brisk purges, and diminishing the arterial action, by bleeding if requisite, a wine glass full of the infusion of columbo, 01 ten or fifteen grains of the powder may be given in a cup of mint tea, every two or three hours, either conjointlv or niter BILIOUS FEVER. ,22.1* uately, with some gentle opening medicine, as rhubarb, mag- nesia, cream of tartar, or salts, to remove the redundant bile by keeping the bowels open. Salts, though a nauseous medicine, may be rendered much less so by adding a little sugar, acidulated with lemon juice or sharp vinegar, as in the form of the cathartic mixture; and this is an excellent aperient, to be exhibited in small doses after the vitiated bile has been removed by calomel. A solution of salts in seltzer water, is a form still more agreeable. During this general treatment, particular symptoms will re- quire attention. The head-ache, for example, which so fre- quently accompanies this fever, is to be treated by applying to the head, cloths wrung out of cold water, or vinegar and wa- ter often repeated, until the malady is removed; besides which, a blister should be applied between the shoulders. As to the vomiting, that depending on the peculiarities of habit, is to be variously treated. In some I have found the saline mixture, or infusion of columbo, answer very well;,in others a spoonful or two of new milk, or equal parts of milk and lime water, given every hour, have had the happiest effects. A spoonful of sweet oil and molasses has proved beneficial, when vomiting is accompanied with a burning sensation at the pit of the stomach. To others, porter has afforded immediate relief. Never was there a more welcome or wonderful illustra- tion of this, than in the case of Mrs. Carroll, consort of Daniel Carroll, Esq. of Dudington. It was my good fortune to attend this very amiable lady under a most violent attack of the bilious fever, with incessant vomiting. All the usual remedies were employed, without any good effect, which excited considerable alarm. She being in a state of pregnancy, and recollecting that nature sometimes furnished a cure beyond the rules of our art, I asked her if there were any article of drink to which her appetite parti- cularly led her. " Yes, Sir, replied she, I have been craving to drink some good London porter for two days past, but I I would not mention it, being under the impression you would <&0 HhWITTENT, uR forbid my taking it." Learning that Dr. Thornton had som« of that description, I immediately obtained a few bottles, and giving her a glass of it, diluted with a little water, it acted like a charm, and in a few weeks, I had the very great satisfaction of seeing my fair patient perfectly restored to health. The warm bath, or local applications, such as flannels wrung out of a warm decoction of camomile flowers, or mint leaves stewed in spirits, or equal parts of sweet oil and laudanum rubbed on the stomach, have done much good; and when these fail, a large blister, or a cataplasm of mustard-seed, ought in- stantly to be applied over the region of this organ. When the stomach is in a very irritable state, the patient may frequently moisten his mouth and throat with cold water, but should drink as little as possible of any liquid. Wakefulness, or inability to sleep, will often yield to the warm bath and blisters, and when they fail, a glass or two of porter, or the camphorated julep may be given, which also fail- ing, a dose of laudanum is proper at bed-time, provided there exists no considerable inflammatory diathesis. The pain in the bowels is mostly relieved by the warm bath, ,r a moderate bleeding and emollient injections, to which occa- sionally may be added twenty or thirty drops of laudanum. If these produce not the desired effect, and the fundament be scalled from die evacuations, give glisters of milk and lime water, composed of half a pint of each. These failing, inject every hour with cold water, and apply cloths wrung out of it, to the belly. If a delirium come on in the first stage of the disease, it is to bo treated by bleeding, purging, and the means prescribed above for violent headache; but should it occur at a later pe- riod, the pulse weak and irregular, with a great propensity to deep, besides making cold applications to the head, the body should be frequently sponged with cold vinegar and water, or equal parts of vinegar and spirits. And should not the recol- lection in a W hours become more improved, and the pulse BILIOUS FEVEK. 231 fuller and more uniform from this mode of treatment, it will be proper to apply a blister to the head, and sinapisms or blisters to the extremities; besides which, wine or some cordial must be allowed; and if there be a cold sweat, or coldness of the extre- mities, flannels wrung out of hot spirits, or spirits of camphor. ought to be applied often around the arms, legs and thighs. On the decline of this fever, patients are sometimes troubled with night sweats, to relieve which, gentle exercise in fresh air, and the tonic powder or pills, (See Dispensatory) or bark and elixir vitriol will be proper. The unusual fatality of this fever in Washington, as well as in many sections of our country, during the last summer and fall, was sufficient to create alarm, and to induce the benevolent to solicit, through the medium of public prints, information, rela- tive to the most successful mode of treatment. Although the practice I pursued last autumn, did not mate- rially differ from that above recommended, yet, I arapursuaded a brief sketch of the improvement, accompanied with a few re- marks, will be gratify ing to most of my readers, particularly as I can state, an incontrovertible fact, not a patient who was governed by my prescriptions died during the sickly season; nor was there a case of the disease degenarating into the ner- vous, when early application was made. This extraordinary success was the more remarkable, as the number of my pa- tients were very considerable, in so much, that it was impracti- cable to visit all of them daily, and many were attended princi- pally by my students. Some of the indigent sick would doubt- less have followed the fate of many of the paupers who died, had I not been sensible that exhibiting medicines, without pay- ing due attention to reignien, would not have the desired effect, and knowing this fact, I felt it my duty to those for whom I pre- scibed, to have them supplied with nourishment suitable to the case. In most instances, the lancet was resorted to; and with some 232 REMIT TENT, OK patients of robust constitutions, and inflammatory dispositions, «t was used freely in the early stage of tlie disease. Aperient medicines, being of the greatest importance, were frequently administered, and I found their salutary effects evi- dently increased by conjoining such as determined to the sur- face. Twenty grains of calomel, united with a grain of tartar emetic, or six or eight grains of ipecacuanha, were administer- ed to an adult in the morning, and followed in a few hours by an ouuce of epsom salts, or an infusion of salts, senna and manna, in broken doses. When a preference was given to me- dicine in the form of pills, I directed two of the aperient and diaphoretic pills [See Dispeusatoru~\ to be given every two hours, or two of them, to be taken at bed-time and the dose re- peated every hour in the morning, until several copious evacua- tions were produced. With infants, calomel and ipecacuanha, in large doses, repeated occasionally, were often found suffi- cient. It should be observed with respect to aperient medicines, thouuh active in their operation, they do not weaken the pa- tient as generally supposed, for they take away the cause of, at least apparent, weakness, and we have often found patients in fevers taking bark and stimulants to support them under lliis apparent debility, who after the operation of some laxa- tive medicine, required neither. In the emplovment of this remedy, however, it is necessary to attend to the discharges. The nurses will often report frequent evacuations, and if ex- amined, these may be found mucous and insufficient, or a wa- tery fluid scarcely coloured. It is necessary that the stools should be truly feculent, and be continued while the discharges shall be dark and offensive. We therefore ought not to be go- verned by the number of evacuations; but by the effects, and the patient's feelings. If he be relieved after each stool, and the pulse becomes softer, the hand more moist, and the head ess loaded, he need not be apprehensive, however violent the discharge. On the contrary, if the pulse become smaller and BILIObri FLVEK. more frequent, the face sink, and faintness comes on, however little the discharge, it has been too much. In some cases, emetics were employed with very good ef- fects. Thev greatly contributed to relieve congestion in the liver, and were also useful in determining to the skin as well as carrying off the bile. When purgatives were not requisite, the febrifuge mixture. diaphoretic drops, or antimonial powders were administered in their usual doses, every two hours, with the view of promoting a gentle diaphoresis, and to assist their effects, the patient be- ing directed to take frequent small drinks of some tepid dilu- ting liquor. Medicines of this class, by exciting perspiration, will be found to produce most beneficial effects, in those cases where the vital energy is not diminished; but when considera- ble debility is present, they frequently fail of having the desired effect, and act on the bowels, producing a dangerous diarrhcea. When the fever manifested a disposition to yield, the infusion of columbo or camomile was given, particularly, after the im- mediate operation of laxatives; which had the effect of correct- ing the bile, restoring the tone of the stomach, and supporting the patient's strength. And so soon as there was an intermis- sion of fever, or symptoms of the disease assuming the typhoid state, the bark conjoined with Virginia snake-root, was given in such doses as the stomach would retain, which j together with the liberal use of porter and wine and nourishing diet, speedily arrested the disease. In some instances the nitric acid diluted (See Dispensatory) was employed as a tonic with considerable advantage, particu- larly in delicate habits; or when there were symptoms indica- ting the liver to be diseased. With others again the solution of arsenic in the usual doses was administered with the most hap- py effects. The warm bath, in every instance in which it was*employed, produced beneficial effects; and when this luxury could not be procured, sponging the body and extremities with vinegar and 234 KEM1TTENT, OR water, or equal parts of vinegar and spirits, afforded groat re- lief. A few cases occurred of patients of robust constitutions, who not only neglected the proper remedies at the commencement, but aggravated the disease by taking stimulating drinks or ac- tive exercise, were at length attacked with great jirostration of strength, accompanied with cold clammy sweats, coldness of extremities and impeded pulse. There symptoms indicated that considerable congestion had taken place, which would admit of no dclav. 1 directed the warm bath, and when this could not be immediately obtained, friction and flannels wrung out of hot spirits, in which red pepper and mustard seed had been infused were applied to the extremities, and renewed as often as they be- came the least cold. So soon as the natural warmth was resto- red, blood-letting with calomel and other aperient medicines were resorted to; and also blisters over the region of the liver and extremities.—It will frequently occur in such cases, that the action of the heart is so overpowered in the first instance, that the blood merely trickles or rather oozes from the punctured vessel for a considerable time, being much darker and thicker than natural. Yet when a few ounces have been drawn it n nally flows with freedom, and becomes finally of a brighter colour. The deficiency or irregularity of heat on the surface is among the first symptoms that indicate congestive diseases, and if the -kin can be restored every where to its natural warmth, a < tire may be expected. It is evident the warm bath, frictions of the skin, blood-letting, calomel with purgatives, and blisters are the chief expedients to diminish congestion; but unless these be very early resorted to, they will not succeed, so rapidly does the slage of collapse supervene. Recovery very generally succeeds if natural warmth be speedly restored, and an univer- sal perspiration excited. Upon this principle is to be explain- ed the repeated success of the practice pursued by some prac- titioners in the plague; for immediately after persons were perceived to be affectpd, and consequently while there was yei BILIOUS FEVER. 235 00 arterial excitement, they were subject to frictions by warm oil, in a close room, and over a brazier of hot coals, until a free perspiration took place. Some patients in the course of the disease, were afflicted with acid eructations and heartburn, but were relieved by mag- nesia, the absorbent mixture or mucilage of gum arable. These medicines were also useful in giving check to watery evacua- tions, which sometimes occurred on the exhibition of diaphore- tic medicines; others again, on the decline of fever were trou- bled with pain, arising from flatulency, which required occasion- ally a little mint water, ginger tea, tincture of assafoetida or spirits of lavender. This symptom, however, seldom came on when proper attention was paid to the discharge of the bowels. In a few cases the hiccough became exceedingly troublesome, but was relieved by taking in turns the syrup of damsons, a lump of loaf sugar moistened with brandy, tincture of assafaeti- da, or the camphorated mixture. When these failed, a catap- lasm of mustard seed and vinegar applied over the region of the stomach generally succeeded. Strangury was another spasmodic affection that required particular attention. Although the occurrence of this symptom was frequently the effects of blisters, (See suppression of urine) yet in some cases, it evidently was produced from a spasmodic irritation of the neck of the bladder. And when arising from this cause, the camphorated powders, the warm bath, or injec- tions of warm camomile tea or infusion of hops, with laudanum, proved to be the best remedies. Hemorrhages sometimes occurred, and when proceeded by head-ache, the pulse full and hard, indicating an inflammatory disposition, recourse was immediately had to blood-letting, fol- lowed by aperient and diaphoretic medicines; but when the dis- charge was attended with faintness, or happened at the conclu- sion of fever, the bark, elixir vitriol, or nitric acid, with cold drinks, were prescribed. Nitre in doses, of ten grains every hour or two, in a glass of cold water, as well as cold applica- 23G ia.MilTLN r, OK tions near the pans effected, were employed in both cascswith evident advantage. Longings for improper food and drink, with some patients, were exceeding 1, troublesome. On the decline of fever, when ibis symptom did not arise from the caprice of the moment, and the patient anxiously craved any particular food or drink, it w as allowed not only with impunity, but considerable ad- vantage. Those cases in which I was consulted after the typhoid state of fever had come on, as manifested by a disturbed state of the brain and nervous system; showing itself in frequent sighing?, wandering delirium, watchfulness or irregular and interrupted sleep ; characterized also in the more advanced stage of fever by a deranged state of the secretions and excretions, attended with a brown or black state of the tongue, and a cadaverous and offensive smell of the whole body, my attention was drawn to support the patient's strength by supplying him with nour- ishing diet, and giving stimulants both diffusable and perma- nent as recommended under the head of Nervous Fever. Attention was also paid to the state of the bowels, and their offensive contents were evacuated daily, not by active purges which in this exhausted state of the system would destroy the patient, but by injections, and the occasional use of small rloses of calcined magnesia alone, or conjoined with a few mains of rheubarb. I was no less attentive in having the offensive materials, which were constantly excreted by the skin, removed by wiping the body and extremities twice a day with a cloth wetted with equal parts of vinegar and spirits. Care was also taken to have the sheets and linen of the patient frequently changed. By perseverance in the means above stated, several persons, whom I was called to visit at the latter stage of the disease, re- covered under the most unpromising circumstances. One case particularly deserves to be noticed, in order to show the im propriety of giving up a patient while there i- life. BILIOUS iiVER. 237 Jfclrs. Lund Washington lingered under this disease, upwards of six weeks, before application was made to me, and learning she had been given up by her physicians as a hopeless case, I wa3 unwilling to attend ; but from the earnest solicitude of her son, Mr. Peter Washington, I consented, provided the medi- cqji gentlemen who attended her would meet me. From some aause or other, neither of the physicians appeared at the hour •appointed, and as there was no time to be lost, I took the liberty ©f prescribing in their absence. I found her in a state of ex- cessive debility, and on examining her mouth, the tongue was covered with small white blisters, and gnms with a foul sordes, accompanied with a cadaverous breath. Her bowels were in a very irritable state, and from the acuteness of pain she occa- sionally felt in them, caused her to scream out in a most lament- able manner. The state of her mouth readily induced me to ascribe the affection of her bowels to the swallowing of some putrid matter, and notwithstanding her extreme debilitated state, I deemed it necessary to direct a table spoonful of castor oil to be given, and its operation encouraged by injections of soap-suds. At the same time, her strength was supported by arrow-root, made palatable by a plentiful addition of wine and nutmeg. I directed, also, fresh charcoal powder to be given in doses of a spoonful every two or three hours, which pro- duced most beneficial effects, as distressing symptoms soon yield- ed. On further examination, I found one side of the hip and lower part of the back in a gangrenous state. To arrest this; poultices of charcoal and bark were frequently applied, and so soon as a bathing vessel could be procured, and a strong de- coction of red oak bark prepared, she was taken up in the sheet and bathed daily, from thirty to sixty minutes at a time. The number of blisters which had been applied, together .with the large ulcers in her back, occasioned great pain in bathing, as well as in moving her from one sheet to another: but novvith- standing this, as her stomach would not retain a sufficient quantity of either bark or nitric acid, I had the bath continued about three weeks, which, together with the most nutritious 32 238 KEMITTEXT, OK tliet anil a plentiful u-e of wine, porter, ami other stimulants her gt neral health was so tar improved as to require little or iu> attention except to the ulcers. These, after the mortiliud pari had sloughed oft', were very deep and extensive, exposing the boue, and requiring more attention lhau I ^as. able to give. ' therefore requested the surgical aid of Doctor Bailey Washing- ton, and by the skill and attention of this gentleman, tliose ill- conditioned ulcers were healed in a few weeks. And I am happy to add, this most amiable lady is now restored to perfect health, to the exceedingly great joy of her affectionate family and numerous friends. Reoimen. Witli respect to regimen, the food and drink should be varied, and adapted to the taste of the patient. !\a- ture, perhaps, generally takes care that no error shall be com- mitted in that way, during the continuance of this disease. The patient is seldom persuaded to swallow any thing but liquids, during the prevalence of the fever, and if by accident he should have an inclination for something more solid, arrow root, sago, corn, or rice, gruel, mush, panado, custards, roasted apples, oranges, grapes, or other mild ripe fruits are all that should be allowed. To allay the thirst, barley or rice water,apple water, tamarind water, molasses and water, toast and water, or cold spring water, lemonade, raspberry or currant jelly, dissolved in water, mint or balm tea, acidulated with lamon juice, or other •pleasant acids, may be given with great benefit, in frequent. but small quantities. These cooling drinks not only quench thirst, but also tend to excite perspiration. Washing the face and hands of the patient from time to time. with vinegar and water, is always refreshing. The room should be somewhat darkened, and kept moderately cool, by a constant succession of fresh air; taking care, however, that the current of the wind is not immediately directed on the patient. The covering of the bed ought to be such as is found most comfort- able, and the body kept, as nearly as possible, at rest. When tlje fever subsides, and the patient regains a desire for food, it BILIOUS FEVER. 239 will be best, i» addition to the mild articles of diet already men- tioned, to begin with puddings of various kinds, new-laid eggs, boiled soft, soups with vegetables, raw oysters, he. resuming his diet gradually, as he finds his health return. To keep up the tone of the system, a moderate use of genuine wine, or porter diluted, or brandy, or rum and water made weak, will be proper, at the same time paying due attention to air, cleanliness, and exercise. Thus have I detailed, in the clearest manner, according to my experience, the best curative means of this the most preva- lent and#dangerous of all our Southern maladies. It is how- ever much easier to prevent than cure diseases; and in order to the first, I will point out the general means which have been found conducive to this great end, and which constant experi- ence has sanctioned. Prevention.—To obviate the attack of summer and au.- tumual fevers, we should intercept their causes, or guard the habit as much as possible against their influence. Therefore, on visiting a warm climate where any epidemic prevails, the first step is to prepare the system, as much as pos- sible, for the unavoidable change it is about to undergo ; and this preparation consists in living temperately, and taking every other night, or oftener, one or two grains of calomel, or chewing rhubarb, or drinking molasses and water, or using sulphur in such doses as to increase the discharge by the bowels, without debilitating the system^f If there prevail a fulness of habit the loss of ten or twelve ounces of blood will also be a useful pre- caution. In the mean time, an imprudent exposure to the heat of the sun, or night air, should be strictly avoided. Hard drinking is another cause of disease, which should be carefully guarded against in warm climates, particularly by sea> men, who of all others are, perhaps, the most inattentive to health. The same admonition applies to their sleeping on deck during the night, and cold bathing when overheated, or in a state Of intoxication, which, by suddenly checking tht copious perspiration, seldom fails to bring on di«eas«" :4u REMITTENT, OK Cold moist air is a frequent cause of disease in warm cli- mates ; hence too much attention cannot be paid to comfortable fires, and suiting the dress to the changes of the weather. Flannel worn next to the skin is one of the chief preserva- tives of health. Many people, indeed, clamour against it as tending to debilitate, because it creates perspiration. But this is altogether a silly prejudice; as mild perspiration, or a soft skin, so far from being hurtful, is the- very habit of health. It preserves a proper medium of temperature, by absorbing the excessive moisture from the body during the day, and by pre- venting the effects of the cold damp air at night. Cleanliness, both in our persons and apartments, is so essen- tial to health, as to form a leading consideration in all our views to that first of blessings. The neglect of this not only- renders a man loathsome and offensive to himself, but gives rise to many of our most inveterate and fatal diseases. Among the various means used for the prevention of diseases, and for the preservation of health in general, none is perhaps more beneficial in warm climates, than good wine prudently used. It increases the circulation of the fluids, pro- motes both the secretions and excretions, and invigorates all the functions of the body. How much is it then to be lamented, that so valuable a cordial cannot always be got pure; from the avarice of selfish men, who at a low purchase tart or half-spoil- ed wines, and, to render them saleable, adulterate them with the most poisonous ingredients, so that they become the most insidious foes to health. The common red wines are most generally adulterated, and artificially coloured, as manifested by a red sediment in the glass, as well as in the bottle. But the most pernicious of all adulterations of wine, is that of sugar of lead, or lead itself which gives it a sweet taste: and therefore it ought to be re- membered, that every wine of a sweetish taste, accompanied with astringent qualities, may justly be suspected to be adulte- rated with that noxious mineral. [S>e Poison."] When genuine wine cannot be procured, good old spirits ar* BILIOUS PEVER. 241 *if considerable service, especially when taken in small quanti- ties, and much diluted. These pleasant preventatives, whether under the name of grog or toddy, must, in consequence of their gentle stimulant qualities, be peculiarly beneficial to persons whose lot is cast in low situations and moist air. But they should never forget, that no where is the great virtue of self- government more necessary than in their use. For, if in- dulged to excess, they seldom fail, whenever a pre-disposition to any particular disease lurks in the system, to rouse it to action. In like manner, we must have regard to a proper regulation of diet, which consists in preserving the happy mean between long fasting on the one hand, and immoderate eating on the ether. Vegetables are peculiarly adapted to warm climates, and consequently should constitute the chief part of our diet. Sweet oil, when pure, is perfectly wholesome; but rancid oil, gutter, fat, or meat the least tainted, must be wholly rejected. To those of weak habit and bad digestion, much benefit will Kesult from a glass of the infusion of columbo, or camomile, or cqld water, every morning, on an empty stomach. Such are the general- means for preserving health, and pre- venting diseases in a southern climate. The chief point is to avoid the exciting causes, and keep the bowels always moeTe- -ately lax, * NERVOUS FEVER. The fevers already described, and indeed all diseastes attended vVitli a considerable degree of morbid heat, affect in some measure the nervous system; but in this particular species, the nervous system is more immediately and more violently affecf> ed, than in any other. When a fever is once produced, froitj whatever cause, it seldom fails, by long continuance, to occasion all the symptoms which appear in the nervous or malignant fever. This fever has been described by different authors undef Various names; the typhus or nervous fever, the slow fever, the gaol fever, the hospital fever, the ship fever, the petechial fever, $\e putrid frver, and the mulignetnt fever. '2-i2. NEflVOUa FLVFJl. The first appellation it receives from its attacking flic bruin and from the effects it produces on the nervous system. The second, from the si nv and gradual manner in whicli it some- times comes on. The third, fourth, and fifth, from their being apt to arise in gaols, hospit; Is, and ships, when numbers of men are crowded together, and when sufficient care is not ta- ken to have such places well ventilated and cleansed. The sixth, from certain spots which sometimes appear on the skin of the patients, labouring under this disease. The seventh, from a putrid state, or tendency supposed to take place in the jhti •: and the last, from the dangerous nature and malignity of the fever: but they are all one and the same disease, various- ly modified, according to the violence of tlie symptoms, and the different constitutions of the patients. SvviPTOMS.—The symptoms are commonly more various in this, than in any otlier lever. It sometimes creeps on in such a slow, insiduous manner, that the patient will have suf- fered the disease to make considerable progress, before he thinks it necessary to use any remedies. On other occasions it comes on with a great degree of rapidity, and with many of the symptoms common to all fevers. Thus, it commences with alternate sensation^of heat and cold, a want of appetite, a nausea, and occasional vomiting. These are followed by some confusion of the head, a sense of weakness, dejection of spirits, tremor of the hands, and fre- quent sighing without knowing the cause. At this stage the pulse is irregular, sometimes a little quicker, at other times about the natural standard. In some a dull and heavy pain, with a sense of coldness, possesses the back part of the head; m others, a pain ill the orbit of one eye. These symptoms gradually increasing, the pulse becomes sms.'ler, and at the same time quicker, while the arteries of the temples and neck beat with additional force. The patient is generally more restless towards nitrht, the breathing is some- what difficult, and very little refreshment is obtained, from his short and disturbed slumbers. This gradual increase of symp- NERVOUS FEVER torn.-, withithe peculiar pale, sunk countenance attending fe- ver, will give the alarm, even when other nervous diseases with which the earlier symptoms have been confounded are present. In the progress of the disease, the sy stem is unequally affec- ted; for sometimes head-ache, restlessness, and uneasiness pre- vail in a high degree, while at the same time the tongue is clean and moist; and at other times, while there is no head- ache, or restlessness, the tongue will be dry and foul, and pro- fuse sweats will break out. Th:.; fever, moreover, is not only thus irregular, in affecting various parts of the body differ- ently, but it is also irregular in its exacerbations ; and these^ instead of taking place in the evening, will arise often in the morning. Again, sometimes the fever is very violent for^the first three or four days; it then diminishes for a time, and then perhaps increases again. After, or about the tenth day, the weakness increases considerably; the whole nervous system becomes affected with tremors and twitchings; the urine is commonly pale; the fingers are in constant motion; the tongue becomes dry, of a dark colour, and trembles when attempted to be put out; and sometimes the gums and lips are covered with a dark viscid substance. To these succeed stupor, cold clammy sweats, with a foetid smell, hiccough, and twitching of' the tendons, together with an involuntary discharge of the ex- crements. In every-malignant case, this fever tends fatally on or before the seventh day: but more frequently tliose who die, are carried off about the middle or towards the end of the second week. When the patient survives the twentieth day he usually reco- vers. When the fever terminates favorably before, or at the end of the second week, the crisis is generally obvious; but when that happens at a later period, particularly if after the third week, the favorable turn is less evident; and sometimes several days pass, during which the disease goes off so gradu- ally, that the most experienced are in doubts whether it abates or not. At length, however, it becomes evident by a warn moisture on the skin, by the dark-coloured gluey substance- 244 KEEVULS FEVLt... which adheres to the gums and lips, growing less tcnaciou*. and being mere easily n moved; by the stools regaining a na- tural colour; by the urine being made in greater quantity, and depositing a sediment; by a return of appetite, and by the pulse becoming slower than it was before the commencement of the disease. Deafness ensuing, tumours appearing behind the ears, a red rash, and an inflamed scab below the nose, 01 about the lips, are also considered favorable. The symptom* which point out the near approach of death, are a change ol voice, a wild stare, a constant inclination to uncover the brea-t, purple or liv id spots on the skin, laborious respiration, profuse evacuations by sweating or purging, much watchfulness, sink- ing of the pulse, great incohcrencyr of ideas, muttering', picking at the bed-clothes, considerable dilatation of the pupil of the eves, involuntary discharges by urine and stool, starting of the tendons, hiccough, and convulsions. If many of these symp- toms occur, little expectation of recovery can be entertained. Causf.s.—This fever is occasioned by impure ahr, and pu- trid animal and vegetable effluvia. Wc are therefore not sur- prised to find it often originate in gaols, ships, and dirty dwel- lings, where numbers are crowded together, and where it is not possible to have sufficient ventilation. Though human contagion, and the effluvia arising from putrid animal and vegetable substances, are the most frequent. and active causes of this disease, yet they cannot be considered as the only ones; for we sometimes meet with instances in a country neighborhood, of persons being seized with the disease in all its malignity; where it is not epidemic, nor can it be traced to any place where the human effluvia could be supposed to be confined in any uncommon degree. Hence nasliness, a moist atmosphere, much fatigue, cold, depressing passions, scanty diet, excessive study, too free use of" mercury, immoderate venery, profuse hemorrhage, or whatever weakens the nervous system, may be enumerated among tlie ■causes. NERVOUS FEVLR. 24i Treatment.—With regard to the cure, when the inflam- matory symptoms appear to run very high, the early use of the lancet will be required. It should be observed, however, if blood-letting be employed in all the various forms of typhus, without due regard to the period of the disease, the quantity of the blood drawn, the age, habit and constitution of the patient, it will often be followed by fatal consequences. On the con- trary, if it be cautiously used in the beginning of the inflam- matory typhus, it will be of the greatest utility, as it will render the other means more prompt and effectual, and thereby facili- tate the cure. When the lancet is resorted to, the blood should be taken away in small quantity, and from a small orifice. And as the rising of the pulse, under bleeding, is a certain indication of its propriety, so its sinking is as certain an indication of its im- propriety; hence we have a criterion to guide us in the operation. Towards the close of most acute fevers of severity, there is some tendency to a change in the constitution of the fluids; and this may occur so soon as the second or third day, in the' most malignant cases of typhus. The blood, when drawn in this state, loses its florid colour, and as it flows from the arm, exhibits a dirty, dark appearance, sometimes of a muddy blue, and sometimes of a deep black. It does not coagulate, but continues in a dissolved, state in the vessel, which induced the ancients to call it putrid. It is unquestionably very unfavora- ble, and indicates that depletion is improper. In general it will be safest to resort to the evacuation of the alimentary canal; therefore, on the first appearance of the symptoms, twenty or thirty grains of ipecacuanha, or four or rive grains of tartar emetic, may be dissolved in a pint or more of weak camomile tea; of which the patient may drink a gill every fifteen or twenty minutes, until it excites vomiting, which ought to be assisted by drinking freely of warm water: or should any costiveness prevail, give a dose of calomel alone, or conjoined with ipecacuanha, and in a few hours afterwards, .J4G NKRVUfr- 1T.VEK. some rhubarb, epsoin salts, or infusion of salts, srnna and man na, in broken doses to evacuate the bowels of their morbid contents. Through the whole course of the disease, the bow- els must be kept in a soluble state, cither by some of the above medicines or acid laxatives, as cream tartar and tamarinds, by fruits, or by clysters- Two or three stools daily may be safely borne, though if so great an evacuation should appear to de- bilitate, even this number should be curtailed. However, the patient should in no case be more than two days without ■* stool, for a great deal of feculent matter is produced in fever. although lfttle food is taken, and costiveness is apt to induce an increase of heat and affection of the head as delirium, Jsa\ In administering purgatives, care must be taken not to employ them in such doses as would operate very copiously, as great debility might thereby be produced. So long as the alvine evacuations continue of a dark colour or unnatual appearance, calomel should be given not only as an aperient, but also with a view of producing ptyalism. The alterative operation of this medicine, in the early stage of the disease, is a circum- stance highly to be desired, as it equalizes the circulation, and diminishes visceral congestions. In typhus proceeding from contagion, arid of a malignant nature, very few hours should be tost in these preparatory steps; for the disease often hasten^ with rapidity, and the worst symptoms sometimes occur, so ear- ly as the fifth day. In the early period of the simple typhus giving an emetic, and followed the next day by some active purgative medicine, have frequently cut short the fever at once; and when this desi- rable effect has not been produced, they have hardly ever fail- ed to shorten its duration, and to lessen its danger. Although medicines, which might excite profuse sweating, would be highly improper in this fever, yet those possessed of ■i mild, diaphoretic power, as Dover's powders, the camphorat- ed powders or mixture, [See Dispensatory] the spirits of nitre, \v, we may safely go on with it; but if, on the contrary, it produces restlessness, difficulty AERVOVS BEVER. 2oo of breathing, the tongue becoming drier, and the pulse more tense and rapid, its further use should he omitted until the in- flammatory fliathesis is removed. In habitual drunkards, the stage of collapse sometimes rapidly supervenes, and they should always have an earlier and a more liberal allowance of stimulous, than those who have lived in an abstemious man- ner, otherwise they will sink under the evacuations which may be indispensably necessary to remove the disordered con- dition of certain organs. By this general plan, a cure will, for the most part, be ef- fected; but in the progress of the disease, particular morbid symptoms will require especial treatment. Thus affections of the head, with stupor and delirium, will sometimes be re- lieved by frequently washing the temples with cold vinegar and water; and occasionally bathing the feet in warm water. But if these affections, notwithstanding, should continue, it will be necessary to shave the whole of the head, and apply cl<>ths wrung out of cold vinegar and water, which should be frequently renewed; and if the delirium be accompanied with wildness of the eyes, a blister must be applied to the head. Wliere there prevails any unusual coldness in the lower ex- tremities, recourse must immediately be had to the warm bath, or to some warm stimulating applications externally, as well as the exhibition of stimulants internally, in order to restore the circulation to the surface. The efficacy of the bath will be givatly increased in such cases by having it strongly impreg- nated with salt, and the patient should remain in it, till his skin become warm, and on being removed to his bed, he should be well rubbed all over with hot flan.iels, and bottles of hot water, or heated bricks with vinegar poured upon them and enveloped in flannel applied to his feet, legs, and under the armpits. When a bathing vessel cannot he procured, use, as an embrocation, a strong solution of table salt, in heated spir- its, which admirably recalls the languishing circulation to the surface. A depression of the animal beat will sometimes come on in ZaO NERVOUS FEVER. the collapse of typhus without any apparent cause. The pui-ie becomes very small, and the extremities very cold; and if some warm cordial, as mulled wine, hot toddy, or ginger tea, sweetened, with the addition of a little spirits, be not immedi- ately administered internally, and warm stimulating applica- tions applied externally, death will soon follow. Blisters, as well as sinapisms in such cases, have frequently been employ- ed, and are serviceable by their stimulating effects; but they should not be continued on long at a time; and when a blister is raised in this disease, the sore should be frequently washed with an infusion of red oak bark; and nothing ought to be ap- plied to the part which may tend to increase the discharge; for that, by debilitating the system, would prove injurious. If nausea or vomiting continue, apply flannels, wrung out o; hot spirits, in which red pepper or mustard seed has been steeped, to the stomach and lower extremities. These failing, give the saline or camphorated mixture, and apply a poultice of mint leaves ?or cloths moistened with laudanum and cam- phorated spirits to the stomach, and cataplasms of mustard seed and vinegar to the feet. A slight purging, attended with a gentle moisture of the skin, not unfrequently arises towards the close of this fever, and now and then assists in carrying it off: but where it docs not seem to produce a critical eflect, it ought to be stopped speedily as possible by giving charcoal or the absorbent mix- ture, with a few drops of laudanum, or by olysters of starch, or the decoction of red oak bark, containing in each a tea- spoonful of laudanum. When the purging is not considerable, wine or brandy mulled up with spice, or a free use of arrow root, with plenty of nutmeg, or rice milk with cinnamon boil- ed in it, is often sufficient. If purging be produced from swallowing putrid matter, give a small dose of castor oil or rhubarb and magnesia, and afterwards charcoal. [See Bilious Fever,] In the stage of excitement, a diarrhsea accompanied with bloody stools some- times occurs, indicative of either a preternatural fulness of NERVOUS FEVER. 257 Ihe liver, or inflammation of the mucous membrane of the bowels. In this case we must resort to the warm hath, muci- lageous drinks, and cvqcuants, as calomel, and castor oil. It not unfrequently occurs, that patients, kept in very close apartments, have, on the approach of the last stage, black, bloody stools, without any offensive odour. About the same time petechial or purple spots begin to show themselves upon the extremities, which at first are only few in number, and appear as if drops of black ink had been allowed tordry here and there upon the skin: hut becoming numerous, they soon spread over different parts of the body, and are generally ac- companied by discharges of blood from the nostrils, mouth, bladder or bowels. When tlvs;e symptoms are accompanied with a weak, quick, thready pulse, we may be sure the stage of collapse is at hand. In such cases, recourse must he had to the most powerful antiseptics, such as vegetable aud mine- ral acids, yeast, liquors in a state of fermentation, wine and bark, and aromatics with very small doses of laudanum. At this momentous crisis, bathing the patient frequently in spi- rits, or in a bath composed of equal parts of whiskey and decoction of red oak bark, with a free admission of air, will not fail to produce good effects. In addition to this mode of treatment, when the hemorrhage proceeds from the nose, mouth or ears, it is advisable to make use of local applications, as lints dipped in a solution of alum, or blue vitriol, or some powerful styptic. Miliary eruptions sometimes appear as the crisis to this fever, and ought, therefore, on no account to be checked by any kind of evacuations; nor should the patient, on the con- trary, be kept too warm with a view of forcing them out. Profuse sweats arc to be obviated by sponging the body and extremities daily with equal parts of vinegar and spirits; by being lightly covered with bed clothes; by admitting fresh air freely into the chamber, and by giving whatever he drinks, cool, and agreeably acidulated with lemon juice or elixir vitriol. -ios NERVOUS FEVER. If hiccoughs or starting of the tendons supervene, it will be necessary to give camphor and volatile sal-ammoniac in large doses, with the warmest cordials. In cases of retention of urine, the treatment must be varied according to circumstances. In some instances the kidn-ys become inflamed, and in this state very little urine is secreted, untii the healthy action of the vessels be restored by adminis- tering calomel and mild purgatives, swallowing freely of de- mulcent dunks, and, occasionally, using tbe warm bath. In the ow typhus, the kidkneys are rendered incapable of per- forming their functions from a loss of tone, and in such cases stimulants and tones, with cold applications over the region of the bladder, as cloths wrung out of spirits, or equal parts of vinegar and spirits, are the best remedies. When the bladder is over distended, or inflamed, indicated by acute pain aud some tumor, the catheter is indispensably necessary to draw off the water. In febrile complaints, it will be found that, where a small quantity of urine is secreted, the sediment is proportionally copious; and, on the contrary, where a large quantity is secreted, the sediment is proportionably scanty. If attention be paid to keeping the bowels open from the com- mencement of fever, a suppression of urine will hardly ever take place. ; In an advanced stage of the disease, it sometimes happens, that in addition to a profuse secretion of vicid saliva, little white ulcers, or apthse, appear in the mouth. In such cases the detergent gargle [Sec Dispensatory] should be frequently employed, and the nouth occasionally washed with a solution of alum in water, an ounce of the former to a pint of the latter, and this will quickly take away the stench that arises from them. The viscid phlegm, which collects about the tongue and teeth, may be wiped away with flannel, dipped in vinegar, or salt and water, or after washing the mouth with sharp vinegar or some austere acid, it may be scraped off with a knife, or a piece of whale-bone bent. From the wantof sleep, much rambling and low delirium some- NERVOUS FEVER. J25S times occur, which will require an opiate at early bed time. The most advisable way of giving it, to prevent any deleterious effects, is to conjoin laudanum, with the camphorated mixture, or the opium with a few grains of camphor, volatile sal-ammo- niac, or some mild diaphoretic, as Dover's powder. Opiates arc more admissible in this fever than in any other, and, as it is of the utmost consequence to procure rest, they should, w ith this view, be employed every evening, where there is no great delirium. In all fevers where we wish to procure sleep, and cannot have recourse to opium, on account of" delirium being present, a pillow of hops laid under the patient's head, has been used with singular advantage In case of watchfulness, the camphorated julep, or porter and water, will generally succeed. W hen, however, these means fail, and there is great prostration of strength, followed by st.mor, and a train of the most distressing symptoms, wine s! otild be exhibited in large quantities, and it will be found that tee patient will show a relish for this valuable cordial, alter refusing medicines and every kind of nourishment in a sol if I form. At first it is better relished mulled; but after- wards the patient will take it freely in its pure state, and in the quantity of one or two quarts a day, without intoxication- The quantify of wine should be regulated by the degree of de- bility present, the age of the patient, and the effects produced by it. The proper rule to be observed in the use of wine, is to give it until (he pulse fills, the d« iirium abates, and a greater de- gree of warmth returns to the extremities. And upon the smallest appearance of the stupor returning, the pulse quicken- ing, and sinking, for they usually go together, the wine must be resumed, and continued in that quantity which is found sufficient to keep up the pulse, and ward off the other bad symptoms. V hen wine cannot he had, rum or brandy diluted with milk or water swtMtviied. will answci: ;.r>d vvnh f io- patients is hetter renbhed. 1 lis friends ot tne sick should never bedis- 260 NERVOUS1 FEVER. heartened too soon, for here, if any where, we may say, "while there is life, there is hope." And I can truly aver, that I have often seen the patient raised, as it were, from tbe dead, by the determined use of generous wine aloue, especially old Madeira. As soon as the patient be able to take nourishment, such as panado, arrow-root, &c. the quantity of wine must be gradual- ly diminished.' For although it be absolutely necessary to take it so liberally, during the continuance of this fever, yet, as soon as that shall have left the patient, much caution be- comes necessary in the use of it; since the third part of what formerly had proved a salutary cordial and restorative, would in this state of convalescence, occasion a dangerous intoxi- cation. It sometimes happens at the close of tyhus that the patient is affected with a slight degree of mania or temporary aliena- tion of the mind. In such a case it will be necessary to sup- port the patient with a generous, nutritive diet; to keep him as quiet as possible; and to give him tonic medicines, as bark and elixir vitriol, nitric acid or tincture, or rust of steel, carefully avoiding evacuations. If the appetite does not readily return on the cessation of the fever, the mineral acids, or stomachic bitters, will be pro- per. Bathing daily in a strong decoction of red or black oak bark, will be found an excellent remedy in removing the irrita- bility and weakness which are left behind; and when there is no visceral obstruction, the shower bath w ill be attended with beneficial effects. Wc repeat, it is of the utmost importance throughout the whole course of the disease, fhat tbe most rigid attention be paid to cleanliness, and the communication with the external air kept up in different degrees day and night, according to the state of the atmosphere. None but those whose business it is to attend the sick, ought to be allowed to go near the pa- tient, except when there is little or no affection of the head. In such cases the presence of a friend may soothe the mind and AERVOUsi FEVER. 261 help to dispel gloomy ideas; hy comforting the patient with the hope of a speed) recovery, and diverting his thoughts from that anxiety and dread of danger which invariably attends this complaint. Regimen. In addition to the mild articles of diet cnumer- ated in the bilious fever, bread and milk, with a little water, sugar, and the pulp of u roasted apple, form a most grateful and nutiiti us food; and for the sake of variety, cider, porter, or any other drink which the patient covets, should always be allowed. It has been observed, that this fever often originates from corrupted air, and of course must be aggravated by it; great care should therefore be taken, to prevent the air from stag- nating in the patient's chamber. When that is small, and cannot be well ventilated, the patient should be carried into the open air, and allowed to sittherc two or three hours every day in mild weather. When this cannot be conveniently done, every means in our po,ver to ventilate the room should be employed. Strong scented herbs ought every day to be strewed about the room, and vinegar frequently sprinkled, about the bed clothes, and some evaporated, by pouring it on hot iron. The bed clothes ought to be h\ no greater quantity than is agreeable to his feelings, and when he can set up, with his clothes loosely put on, it is often a refreshing change of posture and situation. The patient should have his linen and bedding changed often, and the stools removed as early as possible; for nothing refreshes the sick more than cool air and cleanliness. In the early stage of this disease, when there is much pre- ternatural heat, washing the face and hands often in cold vi- negar and water, and wiping the body with wet cloths, will be highly refreshing; and in the more advanced stage of the disease, when there is less febrile heat, the vinegar should be united with an equal quantity of spirit, In all eases where Hie fever is unusually protracted, and leaves the patient inov 35 * * 262 NERVOUS FEVER. cessive weakness, the recovery is slow and precarious, and the greatest care is required to prevent any error in diet, du- ring the convalescence, as a very small degree of excess at this time, will produce very troublesome consequences. Food of easy dig stion, taken in small quantities and often repeated; gentle exercise when the weather is favorable; attention to prevent co-tiv-ness, by some mild laxative; and the use of bitters to assist digestion, or tho rust of steel, when there is any prevailing acid on the stomach, are the most certain means of re-instating wealth. Contagion. Having in the preceding chapter enumerated the different means for the prevention of diseases, I shall now point out such as are most suitable to arrest the progress of Contagion when commenced. When a contagious fever makes it appearance, the first precaution is to seperate the sick from the healthy, and thus to cut off, as much as possible, the intercourse b t een them. The next step should be, to purify both beds and clothes from every particle of filth. The chambers mus' be often fumigated, by burning good sharp vinegar or tar, and the floor washed daily with lie, or the solution of pot-ashes, or strong soap-suds^ A cloth wetted in lime water and hung up in the room, and replaced as often as it becomes dry, is also a great mean of purifying m ceted air. When a contagious disease originates on ship-board, quick- lime should always be added to the water whi h is used for common drink, in the proportion of one pound of qui- k-lime, to a hogshead of watei; but if tie water be impure, a larger quantity of lime w ill be necessary; and some of it shoul•'• be put Mso into the ship's well, to prevent the putrid and foul air arising thence. >Vhen these means are ineffectual to stop the progress of any contagious disorder, fumigation with the nitrous vapor, wili undoubtedly succeed; and tin i"« tli<>ti of [..epaing it, is fo put half an ounce of vitriolic acid into a cup, warm it over A NERVOUS FEVER. 263 a shovel of coals, adding to it, by little and little, about the same quantify ot powdered saltpetre, and stir, ing it occasion- ally with a slip of glass, as long as the vapor arises. rI he vessel is then to be carried about the room, the doors and windows being close shut, and put in every corner and place where it can be suspected there is any fo.d air; the fundi/, dion to be continued for one or two hours every day, or oftener, until the contagion shall be destroyed. If the vapor should irritate the lungs, so as to excite much coughing, fresh air should be admitted, by opening the door or windows of the room. However, after a little familiarity with it, this vapor will not offend the lungs, but on the contra- ry will prove highly grateful and refreshing. The vapor of muriatic acid has also been successfully em- ployed in purifying infected air, aud destroying contagion. It is made use of in the following manner. Put one po.nd of common salt into an earthen vessel, and pour over it, from time to time, a small quantity of sulphuric acil,ti:l the whole salt is moistened. If the air be foul, and p culiarly offe'^ive, apply a gentle heat under the vessel, to extricate a larger quantity of vapor; but in general, the simple addition of the acid to the salt will be found sufficient, unless the apartment be very large. On the first appearance of typhus or any infectious disorder in a gaol, hospital, boarding school, or any other place where many persons are crowded together, one of these gaseous fu- migations should be employed in every room, in addition to a free ventilation and the greatest cleanliness. An eminentphysician of the marine barracks of Brest, states, that previous to visiting the hospital, he was in the habit of in- troducing into his nostrils sponge cut into proper size and shape, and moistened with some essential od. He also kept in his mouth a piece of orange-peel; and in thi* simple method, he escaped several putrid and pestileriial diseases, w'dch in one year killed eleven physicians and one hundred and thir- teen students. • * ib4 INFLAMMATORY FKVKK. Where any one is apprehensive of having caught infection, which may be suspectcM by a bad taste of the mouth, and want of appetite, an emetic should be given towards the evening, and on the patient going to bed he may be allowed a little mul- led cider, or wine whey, with a small dose of the anooyne sudorific drops. (See Dispensatory.) The warm bath, if such a lux-iry can be commanded, would here be found exceedingly refreshing and beneficial.* INFLAMMATORY FEVER. When fever is attended with an inflammatory diathesis, or when actual inflammation affects any part during the exist- ence of fever, the patient is said to labor under one of an inflammatory kind; butaccording to the tlifferent parts in which the inflammation is seated, different denominations are given to the disorder. This disease, however, exists when there is no topical inflammation, and is distinguished by more consid- erable heat than usual, indicating an increased action of the arterial system. The fever continues for several days with nearly the same violence, the morning remissions being scarce- ly ever observable. Symptoms. A sense of lassitude and inactivity, succeeded by vertigo, chilliness and pains over the whole body, but more particularly in the head and back; which symptoms arc shortly followed by redness of th- face, throbbing of the tem- ples, great restlessness, intense heat, unquenchable thirst, op- pression of breathing and nausea. The skin is dry and *To this disease the philanthrophic Dr. Benjamin Rush, of Phila- delphia, fell a victim, in the year 1813; a man distinguished through- out a long and brilliant life, by his private and social virtues He was efficiently engaged in promoting the Independence of the United States in the war of the revolution; and contributed chiefly to the es- tablr-lmient of the Medical University of Pennsylvania, in which he filkv successively the most important chairs. His memory is cherish- ed wifi, ;he greatest respect, not t>nly by the members of the profes- sion ei which he was the ornament, but also by the people of the United States. * ■ INFLAMMATORY FEVER. 265 parched, the eyes inflamed, and incapable of bearing the light, the pulse tard and quick, beating from ninety to one hundred and thirty in a minute. The disease unusually goes through its course in about fourteen days, and terminates critically, either by a diaphore- sis, diarrhea, hemorrhage from the nose, or a deposite of copious sediment in the urine—otherwise it changes to a ty- phus. Causes. Sudden transitions from heat to cold, the applica- tion of cold to the body when warm, swallowing cold liquors when much heated by exercise; too free a use of spirituous liquors; violent passions of the mind; exposure to the rays of the sun; topical inflammations; the suppression of habitual evacuations, and the sudden repulsion of eruptions. Treatment. The symptoms which attend this fever indi- cate most strongly the necessity of having an early recourse to the lancet, which should be freely used. In repeating the operation we must, however, be governed by the effect it pro- duces on the pulse, and by the appearance the blood puts on after standing sometime. If the former continues full, strong, and tense, and the latter exhibits a buffy, sizy coat on its sur- face, the bleeding should be repeated by ail means. The pulse in this fever is apt to become fuller aud stronger after bleed- ing, whicli may easily be explained; for the plethora may be so great as to distend the vessels beyond their proper tone. In such cases, the vessels cannot act fully, and the pulse is con- tracted: but when the plethora is taken off by copious bleeding, and the vessels are allowed to contract properly, the pulse be- comes fuller, which shows that the remedy is proper. When the fever has been of several days' standing, and the head is much affected, either with severe pain or delirium, topical bleeding, by the application of three or four leeches to each temple is advisable, should the pulse not justify the u^e of the lancet. ft # 266 INFLAMMATORY 1 LV Lli. Applying linen cioth*. wetted in cold vinegar and water, to the forehead and temples, will ofien afford consi- erable relief. If nausea or sickness prevail at the commencement of* Hie disease, it should be relieved by a gentle emetic. But when the determination to the head is violen and the vessels have not been sufficiently depleted by blood-letting, the aperient and diaphoretic pills, or a dose of calomel, or infusion of salts, senna and manna, will be most proper. Cathartic medi- cine will not only relieve the head; but prevent determinations to the lungs and liver; and medicines of this class hh.>.dd be repeated every day or two during the continuance of much febrile action. Diaphoretics are remedies also of great utility in continued fever. Therefore, with a view to determine the circulation to the surface of the body, give the febrifuge p >wders or mix- ture the saline mixture, spirit of Mindererus, diaphoretic dr ps, Dover's, or aotiuioniai powders in their usual doses. [See Dispensatoru,] I iie warm bath will be found of consider- able elli:aey in enrourag.ng toe diaphoretic powers of ihose medicines. In m;:.ny cases it will b- sidlicient to ;tiduee per- spiration for th • patient to bathe his feet in warm water, to lie in Oed and drink plentifully of dilu nt liquors, as balm, ground ivy. or flaxseed tea. with the addition of a little nitre; but should these simple means not prove < fficacious, it will then be necessary to resort to more powerful agents. It ought to be remembered, in the whole of the inflammatory cases, wc should never have recourse to diaphoretics, till arte- rial action and general excitement are considerably red in ed by blood-letting, and aperient medicines. And, it should also be laid down as a general rule, in every species of inflammatory fever, to solicit ^perspiration rather by simple in ans, than to force it by any violent measures. When t'ie means employed have a tendency to allay heat, soften the skin, relieve delirium, and induce sleep, we may be assured of their propriety. But sweating, when excited in fevers by st mulanr, heating and inflammatory medicines, is almost sure to prove hurtful. It INFLAMMATORY FEVER. 267 likewise proves injurious win n *-xt 'ted by much external heat, or a load of bed-clothes: as also were, instead of relieving, if rather increases the frequency and hardness of the pulse, the anxiety and difficulty of breathing, the head-ache and delirium. When sweating is partial, and confim d to the superior parts of the body, it will be more likely to prove hurtful than sa.utary. Tbe torpid state of the vessels of the surface, renders it, sometimes, necessary to have recourse to artificial heat, in order to equalize the circulation and produce perspiration. Therefore, when neither the warm or vapor bath can be procured, hot bricks, after being dipped in water, or vinegar poured upon them, and surrounded with flannels, should be applied to the feet, between the tlrghs, the sides, or arm-pits, while tlie patient is moderately covered, so as to confine the steam 01 vapors. These means will verj generally and speedily cause a relaxation of the surface, and produce an abundant perspiration. In having recourse to the warm bath, it is worthy of re- mark, that the natural temperature of the human species is about ninety-eight degrees, but owing to the cooling process constantly taking place on the surface, it is here considerably lowciyand hence we feel the sensation of warmth, at several points below animal heat. It is this circumstance which ren- ders it difficult to adjust a precise standard, though, perhaps, we . ay not err by fixing it from ninetv to ninety-six degrees. However, it will be proper, from the different susceptiblities of persons, always to consult the feelings of the individual, and so to regulate the bath that it may impart a slight,but an agreeable sensation of wat'mth. But, though the application o* heat to the surface, in the mode which we have described, wiil very generally excite sweating, it does notdoso uniform- ly. There are cases att< tided by great heat of the surface, purticularly in the early stage of tbe nervous and scarletfever, which is aggrav: ted by all the means we have enumerated, as designed to create perspiration. And in diseases of this na- « 268 INFLAMMATORY FEVER. ture, the effusion of cold water will be found more effectual in removing the constitution of the cutaneous vessels, than warm applications. In the progress of this fever, it sometimes happens that particular p»rts of the body are much affected, and that there prevails either great oppression of breat. ing, or that violent pains in the head, stupor or delirium ensue. In all such cases the application of a blister near the part affected, will be pro- per, and relief will often be quickly procured by it. Where there is any unusual coldness of the extremities, with a sink- ing pulse, blisters to the inside of the legs will likewise prove highly serviceable. Their efficacy in such cases may be in- creased by the application of stimulating cataplasms, to the soles of the feet and palms of the hands. Blisters very pow- erfully restore the balance of the circulation, and diminish morbid congestions. In all cases of fever there is a fulness of the vessels; and we find the vessels of the eyes red, the face flushed, and {he eye-ball itself apparently enlarged; but congestion produces also irritation, and often a less degree of phrensy. The usual wanderings of the mind are more rapid, the voice quick, the temper irritable, unreasonable, and occa- sionally violent. In each state, blisters are indicated, and oft n produce the happiest effects; sleep frequently coming on as soon as the plaster begins to stimulate. The milder symp- toms of congestion yield frequently to purgatives; and when these have been freely used, blisters are often necessary. In this fever, as in most others, sleep is much interrupted; and from a want of this, delirium often arises. Opium here would be an uncertain medicine; for should it fail to procure rest, the delirium would be greatly increased by it. In such cases, a pillow of hops laid under the prtient's head, or a strong tea of this herb, will generally have the desired effect of procuring refreshing sleep. The camphorated powders or julep are of considerable utility in fevers, and in many in- stances have procured sleep. The calmness whicli camphor often seems to inspire^ the serenitv, and even the temporary INFLAMMATORY FEVER. 2f& ease, which are among its first effects, render it peculiarly va-. tuable. Hemorrhages sometimes occur in this fever, and at times are difficult to be restrained. If the pulse be full and hard; if much headache has preceded, the bleeding must be continued. But if it happen at the conclusion of fever, or be attended with faintness, antiseptics constitute the proper remedies. (See Bi- lious and Nervous Fevers.) Palpitation of the heart, is frequently a troublesome symp- tom in fevers. It is often produced by a redundancy of blood, as indicated by a florid countenance, in which case the lancet must be resorted to. It sometimes proceeds from the state of the stomach and bowels, and may then be relieved by evacu- ants; but it arises also, in many cases, from a diminution, or an irregular distribution of the nervous power; and shows that the degree of debility is considerable when stimulants will be required. In some instances, the fever is continued and kept up solely by debility. In such cases, the bark may beemployed, provided on using this medicine, the patient sleeps well, breathes easily, and does not find any increased heat; but if, on the contrary, it produces difficulty of breathing, and restlessness, its use should be omitted. If by a prudent and judicious use of the remedies pointed out, we can lessen the congestion in the head,, preserve the strength by the due regulation of temperature, and support it after the-first days by more nourishing diet, we shall find little occasion for administering bark or other tonics,, Cordials are however often necessary; and of these, wine is tlie. most efficacious. In this fever, partial evacuations, such as purging and sweat- ing, which have no tendency to prove critical, often arise* When these happen, we must put a stop to them by resorting to the means recommended in such cases, under the head of Bilious and Nervous fever. Critical evacuations may be distinguished from those which are not so, by attend- ing to the appearances which take place in other parts of the «v?tem. For instance, if a purging should arise, and the. 36 -70 INFLAMMATORY 1 LVMv. tongue continue foul, and the skin dry, without any abatement of heat and thirst, then we may regard it as by no means criti- cal; but if, on its taking place, the tongue becomes clean and moist, the pulse moderates, the febrile symptoms abate, and a gentle sweat is universally diffused over the skin, then a crisis .may be expected. When this fever does not yield to the remedies pointed out, and assume the symptoms of tyhus, it is then to he treated as advised under the head of Nervous Fever. Among the sequels of fever are cough, night sweats, an ir- ritable and irregular state of mind, a capricious, and often an inordinate appetite. These are, in general, marks of debility only, and disappear with returning strength. Bark and tonics are Usually employed for a time with little eflect. The constitu- tional powers are at last exerted, and the patient gstins in hours the strength which, with the most powerful tonics, it did not at- tain in days. The powers of digestion, however, do not return in the same proportion as the appetite, and relapses arc not un»- connnon from unlimited indulgence. Regimen. Throughout the whole course of the disease the patient is to abstain from solid food and animal broths. The diet should be chiefly gruel, barley, or rice water, arrow root, subacid fruits, water acidulated with lemon, the jelly, of currants, or similar sharp fruits. It may be drank warm or cold, as is most agreeable to the patient. His chamber is by uo means to be kept warm, either by fires or by being closely rdiut up, as is too generally the case; on the contrary, it should be of a proper temperature, by allowing the admission of cool air into it from time to time. His bed ought to be lightly co- vered with clothes. The patient may sit up a little each day, according to his strength, for this will lessen tbe fever, head ache and delirium; but when a salutary perspiration comes on» it should be indulged in bed. On his recovery, a strict attention should be paid to diet, scrupulously avoiding to everlead the stomach, and partaking INFLAMMATORY FEVER. 271 af such things as are light, nutritive, and easy of digehtion; all ign> of accumulation, and it depends on the comparison of the other symptoms, whether it be obstructions of the viscera, accumulated contents, or merely flatulency, and the prognostic must be re- gulated by comparing tlie symptoms of each disease. The mode of life will often lead- us to form some prognostic of an impending disorder. Late houra cannot be borne with impunity, except by a very few; and their principal effect is to induce obstructions in the abdominal viscera. If connected with drinking spirituous liquors, the eflect is usually felt in the liver. The sedentary student has reason to apprehend biliary accumulations, with costivt ness, and a train of hypocondriac symptoms. Excess in eating or drinking will equally lead us to foretel diseases of the stomach, often of the head, connected with the stomach; but retributive justice is frequently seen to punish former error with the greatest severity, in the feelings of the patient by loss of appetite. Almost every situation i-, apparently consistent with health, if free ahr be admitted; but its deficiency leads to a variety of diseases from debility, which may be easily foreseen,, and only can be avoided by a change. Changes of habits and situations are frequently the source of different diseases, which we can often prognosticate, and some times guard against. Abstemiousness, suddenly adopted after free living, and the contrary, are sources of disease, the former chiefly of complaints arising from insufficient stimulous, the latter from too great ex- citement. A sedentary, after an active Ufe, is often attended with languor, low spirits, and visceral accumulations; the con- trary, at first with languor and fatigue, soon followed by in creased tone and vigor. INFLAMMATORY FKVER. 27J The ciitical periods of life merit attention also in our prog-- uostics of various diseases. If scrofulous affections do not yield in i iu» early period of life, there is little prospect of cure. The same iiKiy be said of epileptic fits and of Saint Vitus's dance, though to the latter there are many exceptions. The critical period of the female life is that of the cessation rather than appearance of the catamenia, for unless hectic symptoms come on, the dis- charge, though at a much later period than usual, becomes regu- lar. The period of cessation, if not preceded by free, often copious discharges of the menses, prognosticates a less healthy old age. Prognostics in diseases are usually drawn from the vitals animal, or natural actions. The vital actions, which give the best information, are the states of the circulation and the res- piration. The first is chiefly known by the pulse. But be. fore we proceed further on this subject, it may be proper to describe its action. The pulse consists in the reciprocal con- traction and dilatation of the heart and arteries, by the former of which the blood is propelled through every part of the body. Much attention is required in feeling the pulse, since it often misleads, unless the practitioner is accustomed to its examina- tion. In estimating its strength or weakness, it is necessary to consider the sex, temperature, and age of the patient. The pulse in women is quicker than in men; in the sanguine than in the melancholic temperament; in youth than in age. Du- ring the first year of an infant, its pulse is from one hundred and eight to one hundred and twenty; during the second from nine- ty to one hundred and eight; the third from ninety to one hun- dred. It varies little till the seventh year, when it is about seventy-five; and in the following year scarcely exceeds seventy.. These numbers are subject to great variety. The pulse is quick- ened after a full meal, or taking any stimulous; after exercise or any agitation; it is also quicker when standing than sitting, and in the latter posture than when lying down. In hysteric pa- tients it is excited to an inconceivable rapidity by the slightest circumstances without portending danger. A fat person has ,;74 INFLAMMATORY FEVLR. naturally a weak pulse; but it beats also to a disadvantage be- neath a layer of fat. This circumstance should also be attend- ed to in our estimate. The size of the artery we can often es- timate, for we can feel, in thin persons, two-thirds of its circum- ference, and errors can scarcely arise from this source. A na- tural pulse is from 60 to 80, more strictly from 65 to 75. On feeling the pulse the artery should he first felt gently, and if any doubt arises whether the pulse is weak, it should be compres* sed strongly by three finders, and the two uppermost slowly raised. If the pulse is«strong, and seemingly weak only from compression, the blood, rapidly returning, will strike fully the finger below. If realy weak, it gradually recovers its formef force. A strong, firm pulse is consistent with high health, but if i| strikes the finger like a tense cord, it shows a tendency to dis- ease, and if with this hardness, it is increased in frequency, in- flammatory fever is present. A throbbing pulse which strikes the finger with apparent but not real firmness, will sometimes be mistaken for what is styled the hard pulse. But this has not the same firm resistance which we have described. It strikes sharply but not strongly, and the relaxation is as rapid as the pulse is transitory. When there is internal irritation, the throb- bing pulse will continue often to the last, showing, in every suc- ceeding moment, its peculiar character more strongly; but in the commencement of fevers it often so nearly resembles the strong pulse as to deceive. A small pulse will also be mis- taken for a weak one, unless by a practitioner of experience, but the lightness of its strokes depends on the small size, sometimes the depth of the artery. If a pulse is at 55 or 50, there is rea- son to apprehend some compression on the brain. A constant pulse of 90 in a minute, rising occasionally to 108, shows a considerable irritation in the system, and is not without dan- ger. If, in the early stages of fever, it rises to 120 in a female, wot peculiarly irritable, it portends considerable danger, either INFLAMMATORY l'EVER. 27« (rCfm debility or irritation. If, at any stage it excoeds 120 or4 considerably exceeds it, except for a short time, we have the greatest foundation for apprehension. An intermitting pulse is a mark of considerable debility, and prognosticates a dangerous disease. It is also a symptom of organic affections. This alarming view of the subject re- quires, however, some alleviation. An intermitting pulse is frequently owing to fullness of the stomach and bowels, and often arises from agitation of mind. It is also habitual, a cir- elimstance not uncommon. In such constitutions, the usual intermission, on the access •f fever, often disappears, and the first symptom of amend- ment is the return of the intermission, which at the end of the long fever may appear alarming, if not connected with other fevorable symptoms. In general, the favorable signs are pulses more soft, somewhat fuller, and in a slight degree more slow., The unfavorable signs are, more thready pulses, as if the arte- ry was smaller, pulsations quick, weak, and irregular. The state of the circulation is also known by the complexion. A sallowness, and a want of transparency show that the blood rs not carried to the extreme vessels; and even when the cheeks- •are flushed, if the skin round the lips and nose is of an opaque sallow whiteness, the conclusion will be the same, and strength of the constitution is sonsiderably impaired. The appearance of the eyes is equally indicatory of strength and weakness, and the character of the features is preserved in proportion tCf the remaining strength. Each appearance depends on the state of the circulation. Respiration is a vital action connected with the state of cir- culation, and of the greatest importance as a prognostic. Respiration slow, fall, and deep, shows the strength and all the vital organs to be unimpaired, and in every situation is highly favourable. The weak, slight and insufficient respiration is, in general, a mark of weakness; the .vffocptim. of obstruction;- the quick of considerable irritation, exciting rapid expiration. The stertorous shows insensibility, from compression on the s-vf* LMLV.VJMATORV LLV UK brain; the stridulous, inflammation of the trachia; thvralUiuz, accumulations of phlegm often unconquerable; and tlie inter- mi n eh t, attends the last efforts of expiring life. The animal actions, from which we may draw prognostics,. are, the senses, muscular action, and sleep. Violent delirium is a symptom of active inflammation in the brain, and is danger- ous only so far as it shows a violent acute disorder. The wandering delirium in fevers of a low kind, is a symptom of no grevt danger, unless it conies on early, and in a degree dis- pr.port v.eA to the state of the fever. In other complaints it wili excite serious apprehensions, and shows that the inequality of excitement depends on debility. If it persist after the ces- sation of the fever, unless evidently in consequence of debility, therein reason to suspect an organic injury in the brain, and more so if violent delirium has occurred in the early part of the complaint. Delirium, arising from want of sleep, is said not to be dangerous, but the want of sleep itself is generally owing to a languid inflammation of the brain. General rest- lessness is a symptom of the same kind. Of the external senses, and tlieir organs, the eye affords the most particular symptoms by which the event may be foretold. The sensation of black spots, which induces the patient to pick the clothes, as if he could remove them, is a symptom of debility, and is attributed to a partial palsy in the retina. It is certainly a highly dangerous symptom, though by no means a desperate one, ;»s it has been represented. A more dangerous svmptom is double vision. It is in general an early symptom of hydrocephalus. When the eye-lids fall, and can scarcely be elevated by the exertion of the will, it shows considerable we;»k ness, and when the patient sleeps without closing them, great insensibility. The latter symptom is, however, often owing to an irregular contraction of the muscles of the eyes, for in such cases the pupil is drawn up under the lid. The svmptom is not, however, on this account, less alarming. The clear natu- ral appearance of the eye is a favorable symptom; but too great brilliancy, or too quick motions of this organ, show INFLAMMATORY FEVER. 277 approaching delirium. A severe fixed look, without an object, is a similar symptom. The appearance of the eyelids some- times points out a weak state of the system, particularly when there is a blackness in the lower lid, towards the inner corner of the eye. A noise in the ears in fevers, is said to be a sign of approach- ing-delirium, though frequently a symptom of weakness only, and often occurs from this cause in weak and old people. If this noise occurs in the beginning of fevers^it is said to foretel a violent and a tedious disease. Hearing particularly acute is oft mi a precurser of delirium, and without fever, it is the eflect of strong excitement in the brain. Deafness in fevers is said to be a favorable symptom: we can at least observe that we have not found it unfavorable. Depraved taste is very common and offers no particular prognostic. La>situoe on the attack of fevers, in so great a degree as to produce fainting, is alw ays a very dangerous occurrence. If attended with a considerable wandering, the danger is greater. It is a favorable sign if, in the beginning of a fever, the patient can sit erect with his head elevated. And, if the patient can support himself in bed, and occasionally turn on his side, about the tenth or twelfth day, circumstances are favorable. Sleep, if calm and refreshing, is always a favorable symp- tom; but if interrupted, broken by terror, excited by dreadful images in dreams; if, instead of tranquil rest, the patient starts, catches, talks in a hurried manner, though not conscious of terror, it i» unfavorable. Deep sleep is itself a disease, and shows considerable oppression on the brain; yet, at the period of a crisis, if attended with a soft pulse, moderately slow, and a soft moist skin, it is salutary. After a crisis, the deepest, long continued sleep is not dangerous, if not attended with a stertor, (a sound like snoring) or with a pulse preternaturally slow. The natural actions which furnish prognostics, are digestion and its consequences, and the various excretions. In fever the appetite is at once destroyed; nor is it a favorable sign, in an acute disease, that it should remain or return too soon. 37 • « Z'S 1X1 I. VMM \1 DRY f EVKK The appearance of the tongue is of considerable importance as a prognostic. Whitness of its surface is a sign of fever; and if white and dry, it shows the fever to be more considera- ble. In the progress of a fever it becomes brown, a darker brown, and even black; and these colors are usually seen when the tongue is dry and hard. While the edges continue clean, and of their natural speckled appearance, there is little danger; and indeed fevers have terminated favorably, though the tongue has been, for many days, dark, dry, and even black. The tongue sometimes in the course of fever becomes suddenly • lean, and of a shining red. This, in general, shows that the fever will be of some continuance. The tongue sometimes deans slowly in elderly and debilitated constitutions. And, independent of fever, in such habits, tlie tongue is often black at the back part. A heavv load in the stomach is an unfavorable symptom, unless it arises from indigestible food, since it shows either an accumulation of viscid mucus, or a want of energy in the organ. When the irritability of the stomach is exhausted by excessive stimuli, the eflect is a heavy load. Vomiting is the connecting symptom between affections of the digestive organs, and those of the secretory ones. When violent and incessant, without previous accumulation of bile, it is an unfavorable symptom, as it generally arises from irritation on the brain. Even when from b le it is distressing, for the act of vomiting emulges the biliary duct, and the inverted motion of the duoderum carries the bilious fluid back into the stomach, thus furnishing new fuel for the flame. A frequent diarrhcea, independent of mucus inflammation, is dangerous, as it shows considerable debility, and a difficulty of retaining the food so long as is necessary for its assimila- tion. The other excretions, which have attracted attention as prog- nostics, are the perspiration; the urine and alvine evacuations. It is generally acknowledged, that the salutary perspiration is INFLAMMATORY FEVER. 279 not attended with heat, is not clammy to the touch, is generally diffused without any load, uneasiness, or anxiety. The sweat of an opposite kind does not relieve, but debilitate. Cold clammy sweats arise from a total relaxation of the exhajents, and are, in general, the preludes of death. The state of the urine has also afforded numerous prognos- tics, and the discrimination of its clouds, its sediment, he. have been peculiarly minute. The greater number of these appearances may be disregarded. Urine must be examined only after it has been made for some time. It should be poured into a glass while yet warm, and kept in air moderately cold. With such precaution, some useful lessons may, perhaps, be drawn from its appearance. The quantity of urine varies in different persons, and, in the same, at different periods. Hence, from this no conclusion can be drawn. In general, where it is remarkably deficient, it is at other times equally redundant; and this chiefly occurs in hys- terical constitutions. The excess is also at no time dangerous, unless the quality of the urine is changed, since it only depends on irregular action of the renal vessels. When the urine is in small quantityj its color is necessarily high; and at the conclu- sion of a gouty paroxysm, as well as of a paroxysm of an in termittent, it throws down a brick colored sediment. When highly red without depositing any sediment, it shows a violent, and probably a long fever. In general, a scum on the top, in the early period of fevers, seems to show considerable debility; and we have usually found such fevers slow and tedious. A cloud, suspended at first near the top, and afterwards falling lower till in succession it reaches the bottom of the glass, are favorable signs; and a suspended cloud, previous to the four- teenth day, shows that the disease will terminate at that period. If it appear after the fourteenth day, the disease terminates at the twenty-first, gradually lessening on the intervening days. The progress of the cloud in the urine, in cases of fever, is regular. It is at first suspended at the top, gradually falls. £80 INFLAMMATORY KHVEK- though for a day or two, often stationary ne;ir the middle of ihe gla>s, and at last reaches the bottom. It falls to the bottom often some days before it is accompanied by any sediment; but when a white or redish sediment also falls down, the crisis is nearly complete. The urine is sometimes turpid, if not at the moment of discharging it, very soon afterward-; and this, according to the authors of prognostics, is said to show an insidious disease. Frothy urine, or which long retains the air bubbles, is said to show a tedious disease, or a slow consuming fever. In bilious fevei*9, the urine is so.netimes of a green or black color, which shows a highly putrid slate. The black is more dangerou-, but unless highly foetid, we have frequently seen it without its %eing followed by a fatal event. In chronic diseases, red urine, depositing a copious, red, scaly, or branny Sediment, is a mark of considerable debility. A mucus and viscid sediment is usually alarming from the apprehensions which it excites of abscess in the bladder. Mucus is, however, light and equable, wholly free from foetor, and arises from an inflammation of the mucous membrane. It arises ;d o from any irritation of the neck of the bladder; and h a frequent Synrmto n of gravel and calculus. The nature of the ilfiir t'^-hur^s is of considerable impor- tance, and these should be frequently examined with attention- In acute diseases the discharge is often estimated by the num- ber of motions rather tBan their appearance, and we have been told there has been a free discharge from the bowels, when the stools had not the slightest feculence. Liquid, frothy, watery motions, with little color or smell, show, in general, a tediou9 fever, for in every fever there seems to be an obstinate retention of the f£eces, and motions of this kind show that the spasm is peculiarly violent. When the stools, in the beginning, are highly foetid and bilious, it has been accounted a dangerous symptom; but if the discharge be free and copious, they are rather favorable. Calomel w.ll, through the whole course of a fever, often bring oh sneh motions by its superior power on the f INFLAMMATORY PfiVER. 281 biliary secretion. Small, black, pitch-like motions, are always dangerous, and show equal weakness in the alimentary canal and the biliary system. On the contrary, hardened excrement brought off with little straining or cholic, is favorable. From the remarks which have been offered, it will appear that our prognostics of fever must be taken generally from the signs and degree of debility. This is obvious often to the sight. Every circumstance which regards a patient in a fever, will, by attentive observation at the bed-side, throw some light on this subject. The situation of the patient is dangerous, if the character of the countenance is soon lost; if the eyes apparently glare on vacancy; if the answers are rambling and incoherent; if slight* partial, involuntary contractions occur in the features; if the tongue trembles, or is soon dry and dark; if he soon declines turning on his sides, lies on his back, and sinks down on hi» bed; if the extremities are cold and benumbed; if the tendons are particularly tense, and occasionally start; and if he appears to pick off or remove any dark spots on the bed clothes, or wishes some supposed dark object to be removed; each of these symp- toms is a mark of debility; and the earlier they occur in fever, the greater is the danger. If, however, in a fever, the expression of the countenance i? unchanged; if the mind is steady and unruffled; the sleep, though short and interrupted, refreshing, and the patient is sensible of having slept; if the tongue is clean at the edges; the abdomen neither tense nor painful; if the patient lies on either side, and awakes without hurry or Confusion, we may prog- nosticate a safe termination. In the more usual cases of fevers, if the disease is properly managed in its earlier period, and the circumstances are on the whole favorable, there are few instances in which a salutary change does not take place on the tenth or fourteenth day. Where this is not observable, a gradual ^amendment takes place, which is clearly conspicuous on the seventeenth, and the fever has disappeared before the tweqrietb. »*■ • •& COLD, Or, in the language of the Nosologists, CATARRH is a disease of the inflammatory kind, which occurs more frequently on sudden changes of the weather, and attacks persons of all constitutions, but especially those of consumptive habits. It is also1 at times epidemic, when it is known by the name of influenza, and has been erroneously considered as depending upon a specific contagion for its cause. The influenza generally pays us a visit every six or seven years. The season of its visitation is the middle or latter end of autumn, after a long spell of dry weather. It would appear to be no respecter of persons, knocking equally at the door of the rich and the poor, and attacking the young no less than the aged. Symptoms. Its first symptoms are a stoppage of the nose, dull pain, with a sense of weight in the forehead; stiffness in the motion of the eyes, and soon after cough, hoarseness, an increased secretion of mucus from the nose, and tears from the eyes, attended with more or less fever, and sometimes sore throat. Cause. This disease is generally the effect of cold, which, by obstructing the perspiration, throws the redundant humors upon the nose, fauces', and lungs; or to those great physical changes which give rise to epidemics. Treatment. The treatment of this disease, as of all others of an inflammatory nature, consists of the antiphlogistic, or cooling remedies. Where it is slight, little else will be necessary than to pay attention to the state . f the bowels; live abstemiously, avoid cold, and whatever may increase the fever- ish habit. * COLD. 283 Bathing the feet in Iuke-warm water, or bran and water, a little hotter than milk just taken from the cow, at the same time that something warm, as a glass of hot toddy, punch, or mulled wine, is taken internally, forms a remedy upon which many people place their. sole reliance for the removal of their colds. But this, unquestionably, is a hazardous practice; for it maybe regarded as a general rule, in inflammatory diseases of what- ever description, that all attempts to excite perspiration by sti- mulating a\id heating drinks, w ill be uniformly injurious. Foot-bathing is certainly a simple, and often found to be a powerful assistant of the operation of other remedies, by equalizing the circulation and promoting perspiration. In this practice, however, much caution is necessary not to get fresh cold; the feet should be carefully and speedily wiped dry, and afterwards wrapped up in a warm dry flannel, or the patient t hould immediately go into a warm bed. When there exists any febrile action, the free use of cold wa- ter in the early stage of the disease, forms a safer and a much more efficacious remedy than the administration of warm or stimulating liquids. A glass or two of cold.water, taken upon going to bed, is a very common and sometimes a successful re- medy for cold. The impression of cold drink upon the stomach, indepen- dently of its general refrigerant operation, seems to have the effect of promoting the action of all the secretory and excretory vessels. Taking a draught of cold water every hour or two with ten or fifteen grains of nitre dissolved in it,, will be found a remedy as effectual as it is simple in almost every case of inflam- matory catarrh. Should it be observed that the nitre has a tendency to increase the cough, nauseating doses of tartar emetic should be added to each draught of cold water, wjiich promote expectoration as well as diaphoresis, without, at the same time, increasing arterial action. When recourse is had to this medicine, dissolve thiee grains of tartar emetic in a quart of pure cold water, of which solution a gill to a half pint 284 COLD. may be jriveii to an adult everv three or four hours, or at slich intervals as will produce a v t ry gentle nausea, without creating any considerable degree of uncomfortable sensation. The consent cf the stomach with every part of the animal system \> s'o generally acknowledged, that this organ-is now admitted to be the medium through whicli almost all medicines, taken inter- nally, produce their effects upon every part of the frame. Her.ee cold applied to this viscus must be attended with more speedy and certain effects than to any otlier part whatever. Itf operation in this case is simple; it produces its effects merely by the abstraction of the stimulous of heat. Although it will be admitted these two plans of cure, however Contradictory, have both occasionally succeeded; yet the cool mode of treatment, when employed with a due degree of cir- cumspection, is unquestionably the most advisable, for the sue- j cessful removal of the disease in its incipient state. Of all the improvements which have been made for many years, in the practice of medicine, the introduction of the use of exter- nal cold, in the treatment of acute diseases, may be regarded us one of the greatest importance. The theory upon which it is founded is rational, and the practice it has led to, has been attended with the most happy effects. In fevers, inflammations, and eruptive disorders, it has restored thousands that would otherwise have perished; but its free and extensive use in catarrh, is inadmissible, as by exposing the body afresh to a Tow temperature, the original mischief would be often spread wider, or the foundation would be laid for other diseases more formidable. However, upon the accession «f the symptoms indicating the commencement of the disease, the air which immediately surrounds the body, and which is inhaled in respi- < ration, should be as cold as is consistent with comfortable feel- ing, Perhaps a temperature from forty to fifty degrees, will be most salutary. An approximation to this may always be effected by the patient remaining, in cold weather, in a room warmed enly by a small fire; and in the milder months, by a A C0LJ1. 285 Ace exposure to tlie open air; in all cases carefully avoiding the causes winch operate in rendering the cold air injurious. The covering of the body, both day and night, should be as light as the external temperature will allow, and every thing taken in the stomach should be perfectly cold. By pursuing the refrigerating plan, the activity of the whole arterial sys- tem is diminished, the inflamed vessels are relieved from that redundancy of blood, and increased action, in which the dis- ease consists, and finally recover their wanted healthy tone without any morbid relaxation of their extremities. Where- as, the mode of treatment which admits of warm drinks, warm rooms, and warm air, when it operates in a manner the least dangerous, produces, by excessive excitement, such a relaxa- tion of the exhalents of the bronchia?, as to admit of a secretion of mucus, or pus, which, though it relieve the topical inflam- mation, by what is called expectoration, either lavs the foun- dation for chronic catarrh, or terminates in consumption. Full vomiting, at the commencement of the complaint, will seldom fail to prevent its further progress. The operation of an emetic, besides its more immediate, effect in evacuating the contents of the stomach, produces such a universal com- motion in the system, as to excite every minute fibre into a.o tion; and in this way it is that emetics prove salutary in the majority of complaints in which they are administered. They ex< itv anew and powerful action, which expels or overbal- ances the pre-existing weaker one. Thus they arrest the pro- gress of fever, and thus, if administered at the accession of catarrh, they will prevent the occurrence of the symptoms which would otherwise infallibly ensue. In three cases out of four, perhaps, if upon feeling a stuffing of the nose, dull pain in the head, sneezing, and other symptoms which mark the commencement of the complaint, a person has resolution to try the experiment, he will find a brisk emetic have the effect of completely restoring him to his natural feeling. Emetics will also prove beneficial, not only at the commencement, but at other periods of tin disease, particularly when the lungs arc oppressed with phlegm. 38 236 LOLU. Iii the treatment of this complaint, the indications which arisr to he fulfilled, may be red need to the follow ing heads:— To reduce inflammatory action in the early stngi—to pall ate urg nt symptoms—and to diminish irritation in tlie protracted stage. Wh-ii the disease is violent, aperient medicines, in conjunc- tion with bbo'1-1. tling in a larger or smaller quantity, should be resorted to, an.! repeated as the symptoms may require. A'tl«o igh the oceasiona use of tp' runts is indispensable, and should be had recourse to early in the complaint; jet very active purging is oft n found more prejudicial than service- able, by diminishing > xpect»ranon. I he saline aperients, as cp-om or glauber salts, in thv form of the cathartic mixture, [See Dispensatory) lave the advantage over others in febrile diseases, being sedative and cooling. Those, however, who have an aversion to salts, may substitute any other opening medicine, as castor oil, rhubarb, sulphur, and cream of tartar, or senna and manna. Hut the purgative which of all others is mos. powerfully febrifuge is calomel, which may always be administered with perfect safety, provided the patient guard properly against imprudent exposures to wet and cold at the time he is under its operation, and there is no peculiarity of temperament that militates against its use. When recourse is had to calomel, give it in the form of the aperient and dia- phoretic pills, [See Dispensatory] or conjoin therewith a few grains of ipecacuanha, or a small portion of tartar emetic; and in a few hours after swallowing the medicine, or, if it be taken at bed-time, on the next morning give a small dose of cp'-om salts or castor oil. In catarrh, the in pans which nature occasionally takes for its removal, or, in other words, the symptoms which mark its critie,,! or spontaneous termination, arc, principally, a copi- ous and equable flow of sweat, an increased secretion of mu- cus from the membrane of the trachea and bronchia, the pro- duction of a diarrhjea; and h nee, an indication for the use of diaphoretics, er.pzctomnts, and laxatives. Therefore, with rhe view of regulating aiwl promoting the salutary efforts ol COL*). 287 nature, it is advisable, during the interval of purging, if the skai remains obstinately dry, and there exists a general fever- ish disposition, to give the saline mixture, in the state of ef- fervescence spirit of Mindererus, the febrifuge mixture or drops, Dover's, antimonial, or febrifuge powders, [See Dispen- satory] or infusion of scneca root in their usual doses, with diluting liquors; as flaxseed, balm or ground ivy teas, weak wine whey, barley water, &c. in order to produce a de'tet mi- nation to the surface. When the cold chiefly occupies the head, it has been ad- vised, to suffer the whole head to ren ain, for a considerable time, in contact with the steam of water, as hot as the patient can bear. And this is to be done in fhe following manner:— While the patient sits up in bed, a vessel containing two or three qua'ts of water, may be placed immediately under and before his fV.ee. letting it rest on his la]), and a piece of flan- nel or thin blanket being put over the head, and extending under and around the pun; this will keep the steam in contact w ith the fare. neek. and head, and at the same time, will admit sufficient air for respiration. In cases of great stuffing up of the nose, and difficulty of breathing through the nostrils, this practice has frequently had the effect of removing these symp- toms in tbe course of a few hours; but it is seldom successful, where there is considerable pain and oppression at the fore- part of the head, in consequence of some inflammation occupy- ing the cavities communicating with the nostrils. In such cases, a pinch of snuff, united with cayenne pepper, has afford- ed some relief. But where the pain is extremely severe, the pa- tient will experience most relief from a blister applied to the back of the neck, or to one or both temples. When the mucus membrane of the nose is much affected, it should be washed frequently with a thick mucilage of gum- arabic, or pith of sassafras, [See Materia Medica] or smeared, from time to time, with a little tallow, thorn-apple, or simple ointment. [See Dispensatory.] An inflammation of the throat, producing soreness and dif- ficulty of swallowing, is an occasional symptom of this com- i88 t'OLU. plaint; and where it is slight, it will readily be removed by taking ihe nitre lozenges. [See Dispensatory] or se-all portions of nitre in the mouth, ami swallowing them as thev slowly dissolve. Where it is of a more severe nature, the application of onions to the IVei,[.Nrc Materia Medica] or the remedies ad- vised under the head ol sore throat must be resorted to. In ease of pain or oppression at the breast, after the inflam- matory action of the system is pretty weli subdued, the appli- cation of a blister as near as possible to the affected part should not be omitted. The most prominent symptom of coh! is cough, which being uniformly present, and often very distressing, is usually that to which the patient directs the chief part of his attention.— The medicines to be resorted to for the purpose ol alleviating cough, and producing expectoration, are murilagenous and sheathing drinks, as flaxseed tea, barley water, 6lc. or taking, now and then, a table spoonful of the flaxseed syrup, or a tea spjonful of equal parts ol sweet oil and honey, or a mixture composed of one part oil, and two of honey 01 syrup, or some of the more simple pectoral mixtures. [See Dispensatory.] After the inflammatory symptoms have abated, the pectoral mixtures combined with laudanum or paregoric, [See Dispen- satory] will afford the greatest relief; and where flit patient's rest is particularly disturbed in the night, an opiate at bed time will be highly necessary, but it should be combined with some diaphoretic, as in the form of the anodyne sudorific bolus or draught, [See Dispensatory] or by giving two parts of paregoric with one of antimonial wine in some warm tea. Barley, hoarhound, and sugar candies, liquorice, and vari- ous syrups of indigenous simples, are universally employed for the purpose of allaying the tickling which produces cough. The effect of all remedies of this kind, is to smear over the glottis or fauces, and, by thus sheathing them, rendering them less susceptible to the irritation. As they have the ad- vantage of being innocent, and are usually found to afford a temporary relief, they may, in every case, be resorted to with advantage, as palliatives. COLD; 289 Whenever a cold, either in consequence of its severity, or from its having been neglected in the first instance, runs out to a considerable length, it is usually kept up by a state of wimple irritation of the part, which supervenes upon the disap- pearance of the inflammation, and becomes as it were habitual, exciting the vessels to an increased secretion of mucus and producing cough by sympathy with the larynx. In this pro- tracted stage of the complaint, when the cough and spitting alone remain, it is absolutely necessary that the patient she-dd carefully guard against all unnecessary exposure to cold, and to defend jiarticularly the breast and feet; and when obliged to go into an air of low temperature, to increase J::s clothing, and hold a thin pocket handkerchief before his mouth and nose. The vessels are. in a state of relaxation or debility, when the cough is long protracted, and the consequence of any unusual application of cold is very generally a suppres- sion of their excretions, and a subsequent renewal of the inflammatory affection. And it is in this way that colds are often kept up for months, until they degenerate into a perma- nently morbid state of the lungs. In such cases the nitric lac ammoniac, [See Dispensatory] in doses of a table-spoonful in a cup of flaxseed tea, or sweetened water, every four hours, to adults, will be found a most valuable remedy. Benefit will also be derived from wearing a burgundy pitch, or some warm adhesive plaster, upon the breast, or between the shoulders. Should these means prove ineffectual, one or two grains of calomel, with double the quantity of powdered squills, taken by an adult at bed-time, and continued until a ptyalism is produced; and afterwards the nitric lac ammoniac, adminis- tered as above directed, may be depended upon. Another remedy which has succeeded in this state of the disease, is the tincture of digitalis, in doses of ten drops, three times a day, to adults, and its efficacy will be increased, by using the vapor bath. Inhaling the vapor of hot water is a remedy which lias rong been in use, in all inflammatory complaints of the chesty 2ijo 0<»LD. However, upon tlie first commencement of catarrh, it has had the effect of rend-ring the subsequent symptoms more severe- but at a more advanced period of the complain', if lends pow- erfully to arrest its progress, by increasing the secretion from the glands and vessels of the part, and thereby diminishing their inflammatory action. The vapor lias been found most ehVacjous when impregnated with vinegar or camphor, or in- fusions from emollient herbs. The inhaler, invented by Dr. Sludge, of England, is well adapted to render the process per- fectly convenient for children. But a common funnel will form a very good succedaneum for Ihe inhaler, when this can- not be conveniently procured, the broad part being inverted over a vessel containing the water, and the steam being received hy the mouth applied to the small end. Should a fun- nel not be at hand, a tea or coffee pot, may be substituted, and i lie operation continued from a quarter to a half hour. In this :nanuer the vapor bath may be received twice or thrice ;i t\:. -SI aiso by inspiring oxygen, or pure air. It is of importance, i'' tlie patient be in a debilitated state, to invigorate his constitu- tion by nutritious diet, regular exercise, and removing to a more salubrious air. A popular writer of considerable celeb- rity, Dr. White, states a case in which not only a loss of voice, but a partial palsy of the muscles of deglutition, producing an imperfect, and, at times, a total incapacity of swallowing, ensued upon the disappearance of a severe catarrh, attended with sore throat; and which did not go off for the space of a month. In this case, the patient was in the habit previous to an attempt of deglutition, to suffer a tea-spoonful of brandy to pass over the affected parts; after which, she immediately became capable of swallowing with ease, but again lost the power of doing so, after the effect of the stimulous had worn off. Should hoarseness occur in the inflammatory or early stage of the disease; inhaling watery vapors, bleeding, cold water, and demulcents constitute the proper remedies. Although fhe attendant symptoms of cold, in its incipient stage, seldom amount to such a degree of urgency as to demand the antiphlogistic mode of treatment in its more active forms; yet, if it be aggravated or rendered frequent in its return, by neglect or imprudence, it becomes a malady which not only combats, but often defeats the skill of the most experienced physician. And it should be remembered, when- ever the cough is frequent, the fever considerable, and the breathing intercepted by transient pains or tightness of the chest; unless the most powerful means, as bleeding, purging and blistering, with diluting drinks, be early employed, inflam- mation of the lungs will succeed, which, if not speedily removed, will inevitably terminate in consumption. I have now presented to my readers, in a manner familiar to every capacity, the most approved plan of cure of this de- structive complaint. Should it be adopted in the domestic management of colds, I shall not have wholly failed in my earnest endeavors to lessen some ef the dreadful ills; for, of ■592 (?0L1A. all the diseases incident to the human species, there is notie«o frequent i.i its occurrence—none winch excites so little atten- tion—and none, perhaps, when neglected, is so often fol.owed by fatal consequences, as that under the name of cold or cough. It is the rock upon which the health and lives of thousands have been wrecked. The frequency of this disease, from the sudden changes of weather to which our climate is subject, and the slight degree o! alarm generally excited by what is called "only catching a coid"' too often occasions that neglect, which gives rise to the most distressing maladies, such as quinsy, pleurisy, inflamma- tion of the lungs, rheumatism, Ate. Fully satisfied that numbers fall victims to the supposed insignificance of this insiduous enemy, 1 have thought it my duty thus to warn the inattentive. Regimex. A rigid attention to diet, is not to be looked for at the occurrence cf every slight attack of cold; but when the disease rises to such a degree as to produce a state of general febrile indisposition, it will be absolutely necessary for the patient to abstain from every thing of a stimulating nature. He should confine his diet to light things, of easy (ligation, as arrow-root, sago, tapioca, rice-milk, custards, jclli.s fruits, &.C. fee. Where the symptoms are so trifling as not to render an abstinence, from animal food requisite, those means of a more digestible nature should be chosen; and if the patient has been accustomed to the use of spirituous liquors, he sh >; Id substitute for them, porter, cider, or wine,' diluted with water. Every thing which either stimulates the glottis and fauces in deglutition, or pe v< s indigestible after bene; received i ave, with impunity, th. vc ssitudes of the atmosphere of our climate. It is in the power of every «>n<•. to render the apartments they occupy, cool and airy; ami there are none, eei'haps, who have it not in L'eir power, more »»r less, frequently, dtring the day, to breathe the < pen air without doors. In endeavoring, however, to habituate the system to two '.e;;r«es of tempera- ture, one caution is of the most essential importance to be at- tended to, namely; never to remain inactive, either in the open air, or in cool apartments, long enough to induce a continued and unpleasan sens;ition of actual cold. This, in all cases, would effectually counteract the design proposed; and by fre- quent repetition, would, in all probability, ultimately be suffi- cient to injure the strongest constitution. By attention to these precautions, those inflammatory dis- eases, for which cold only prepares the system, may be easily avoided. COUGH Is produced by the violent, and for the most part, involun- tary motion of the muscles of respiration. It proceeds from various causes, and is therefore as variously to be treated. The seat of every cough is generally in the breast, and the principle parts diseased, are the wind-pipe, and the ramifica- tions, which are irritated by inflammation, obstruction, or foreign bodies introduced; but the morbid irritation may be in the adjacent part, as the diaphram, the atomach, tbe pleura, the oesophagus, the liver, &c. Thus, coughs attend pleuri- sies, wounds about the neck, inflammation of the liver, acrid matter in the stomach, or in the duodenum. Spasmodic dis- .couuh. 297 orders are often attended with a cough tic lungs suffering, either by consent from the source of ti.c spasm, or becoming in their turn, the scat id* that which produced the spasm in some distant part. The mod frequent cause, however, is suppressed perspiration. Coughs are generally at first, dry; but at last, expectora- tion < nines on, and a hectic fever is the consequence. It sometimes happens, however, that a cough continues during along life, wii out inconvenience; and though it does not lead to consumption, induces at last, asthma, or dropsy of the bre;st. bo far as coughs are connected with the state of the lungs, they have already been considered under the head of cold, aud will be further noticed in treating of consumption, so that we shall here, chiefly notice the symptomatic coughs. The cure of the symptomatic coughs depends upon the re- inoval of the original disease; hence, the absolute necessity in all chronic coughs, of investigating tlie cause before we can expect to find the appropriate remedy. Sometimes, coughs have their origin in the stomach, af- flicting the lungs by sympathy, in which case, recourse must be had to emetics, aperients, stimulants, and tonics, with the view of cleansing and strengthening the organ primarily af- fected. Should the liver be the seat of the disease, calomel in small doses, together with the nitric lac ammoniac, [See Dispensa- tory] constitute the best remedies. It is very evident that coughs more frequently arise from hepatic affections than is generally suspected. The coughs of those who have long resided in warm climates, very gener- ally proceed from a diseased liver. And we are fully per- suaded those cases of hectics which have been cured by sali- Tation, originated from scirrhus of that viscus. Women, in the last months of pregnancy, arc sometimes afflicted with a troublesome cough, but which will readily yield to small bleedings, at the. same time keeping the bowels in a soluble state, and avoiding food indigestible and of a flat- ulent nature* 5&8 couun. With children, a cough is occasionally produced by teeth- ing, as well as by worms; ;n both of which cases, it is »o be cured by such medicines as arc adapted to those complaints. Coughs which attend the dyspeptic. < hlorotir, and hys- teric habits, are style! uervous. In ibis, as in other convul- sions, increased irritability, with a less evident stimulus, or sometimes with a stimulus which escapes observation, in- duces a violent degree of the complaint. It is supposed, cough of this kind proceeds from repelled eruption, gout, or the translation of some disease to the lungs. In such cases much benefit will be derived from the warm and vapor bath, and when tbe secretion of the chest is greatly lessened and debility aluue remains, we must endeavor to give tone to the system, by substituting the cold for the warm bath; by ad- ministering the cold infusion or decoction of bark; by tran- quility of mind; by moderate exercise, together with a nour- ishing and generous diet. It is necessary, however, to observe in having recourse to the cold bath, should the patient feel chilly and uncomfortable, instead of feeling a universal glow over the system and being invigorated, it must not be repeated until the visceral obstructions are removed. Neither will it be proper to continue the use of the bark or any otlier tonic if it be found to check expectoration, or produce a difficulty of breathing. In several instances of unconquerable coughs of this kind, which have come under my notice, calomel, united with squills, or given alone in small doses to produce ply hsm, has effected a cure. The operation of calomel in jfthe cure of obstinate coughs is, by producing a determination to the liver, and thus, by an increased secretion from that or- gan, securing more the vital parts and relieving tliose affect- ed; and by exciting a new and general action in the arterial system, which shall transcend or supersede the existing mor- bid action. When the cough is kept up entirely by irritation, arising from an increased secretion of mucus, under a weakened state of the lungs, a dose of paregoric at bed-time, will prove ex- ceedingly beneficial: so the occasional use of some of the ■0OUGJI. 29$ pectoral mixtures. [See Dispensatory.] In this state where in*'.minatory action has totally ceased, some of the balsamic medicines may also be employed with safety and advantage, and of these the tola is the most valuable. It is a very grateful medicine, in consequence of its fragrant smell, and having a warm sweetish taste. The dose of the tincture or sirup to adults is a tea spoonful, in some mucilage or sirup, three or four times a day. Dr. Hill's balsam of honey is nothing more than the tincture of tolu sweetened with honey. Tar united with bark, and formed in pills, have been administered in doses of six or eight three times a day, with very good effects. In like manner tar water, taken to the quantity of a quart daily, has been found useful in coughs of long contin- uance. In coughs of aged people, or in all cases whereflthe lungs are heavily oppressed, and expectoration difficult, gum am- moniac in doses of ten or fifteen grains dissolved in mint water or ginger tea, or administered in the shape of pills, or, which is preferable, given in the form of the nitric lac ammo niac, [See Dispensatory] will not fail to produce expectoration and abate the distre^Rng fatigue of cough. From the variety of causes which produce coughs, it must he evident, the mode of treatment should vary, and here we would earnestly entreat every one who values the preservation of health, never to trust for the cure of any complaint, more especially affections of this kind, to patent medicines. Let it be impressed upon their minds, that most of these advertised, as infallible remedies for the cure of colds and coughs, are either perfectly inert, or really hurtful. And even supposing the medicine employed to possess the virtues ascribed to it, by the proprietor, can it be applicable to all the various forms and stages of the complaint, for which it is recommended? If in one state of a disease, judiciously administered, it prove a successful remedy, in another it must of* consequence be in the highest degree injurious. [See Preliminary Obsei-vations.J By resorting to medicines of this description.they frequently lot slip the favorable opportunity, whenj by more rational »- " p 300 ritdumh;. means their hcp'*h might have been easily restored, and then eon p'aint ihus gaining ground, under tee use of an imlleetual wmedy. will often become inveterate in its nature, and set all human skill at defiance. How lamentable it is that so many valuable lives are yearly sacrificed by pusisting in the use of quack niedieints. It is to the credulity of tlie lower class of society, that they are most 1 cable to be taken in by the infamous venders of poison, snee they very generally prefer the use of a patent medicine to the advice of a practitioner. But how astonishi>>g it is to find this fatal prepossession extend further; for we have frequently observed persons of higher order, and who it was expected would hare had better understand1 ng, persist in their use, and become a sacrifice to the delusion. I EPIDEMIC. The attention of the medical gentlemen of our country, Wj- drawn to a disease, which, during the three last winters, pe- \»drd every state in the Union, and in most of them, ac- c>••rl;r»ic o the statements of the physicians, assumed every va-h-iy ol sisape, and required no little diversity of treatment. In *o;ne ]■!;•.'•< s. the lancet was us d freely; and in others, re- in dies log! y siiirulant were administoicd. In spite, how- ever, of the very d>^i-rent practice pursued, the disease con- ti ed its ravages, which, in many places, resembled those of the pl-guc,sweeping w ole families into the grave. Extreme debility appears to have been the characteristic fen: re >f the disease, for ail accounts agree, that in whatever form it commenced, there ensued a great, and sometimes, a viry u en ; r stratmn of strength. Tf is a'arming pestilence did not appear in the city of V rfchmgton, until the winter of the year, 18t b, and even then, not s . dr«t.net velv s '-v. many ot! er places. Most of the cases which I saw,- resembled very much the bilious pleurisy EPIDEM1G'. 301 ol oup country. They commenced with chill antl fever, ac- companied with |>ai" in the side and chest, with a dry skin and rather laborious respiration. But the cough was by no means so frequent and distressing, as in pleurisy or peripneu- mony. The eyes were wild and red, and the countenance uniformly indicated great anxiety and distress. In some in- stances the throat and head we're very much affected. The pulse was full, though soft and readily compressible; indeed it sometimes indicated so much action that a practitioner not conversant with its peculiarity of type, would be very apt to treat the complaint as an inflammatory affection. This coun- terfeit character, however, did not continue long, for in a very short period it assumed the typhoid form. Of the causes of the disease little has been ascertained. In common with other epidemics, its origin is involved in obscu- rity. As yet, we know only that it commences in cold weather, and is generally dissipated by the warmth of spring. In the treatment of those cases which came under my care, I generally commenced with an emetic, and if this had no ef- fect on the bowels, it was followed by a dose of salts, or an infusion of salts, senna and manna. During the operation of the cathartic, I sometimes found it necessary to support the patient, by having wine added to the gruel with which the medicine was to be worked offt As the cure of this formidable disease depended principally on exciting perspiration, 1 lost no time after the operation of the medicine, in having sudorifics administered; and of this class, I found nothing superior to the Seneka and Virginia snake-root. [See Materia Medica.] In the insipient stage of this disease, I directed a strong decoction of the former to be taken in doses of a tea cup full every hour or two, and as the disease advanced, or the pulse began to sink, the latter was administered in the same manner. In addition to this, mulled wine or cider highly spiced, or hot toddy, was given very freely in those cases which indicated great prostration ofpo *r. It was also my uniform practice, to have a blister aw *0 J02 FUKK.NaV. cd as speedily as possible on the breast or side, over the pain- ed part. If the head were most affected, the blister was put between the shoulders: and when the throat was complained of, a cataplasm of mustard or garlic [See Materia Medica] was applied around the neck. Flannels, wrung out of hot spirits, in which, mustard-seed or red pepper had been steeped, were constantly applied to the extremities, and assisted greatly in producing the desired effect. As the disease advanced, bark, conjoined with Virginia snake-root, proved a useful auxiliary in facilitating the cure. Dr. Cutbush pursued a very similar plan, in the treatment ofhis patients, with the same fortunate result. Many other practitioners bear testimony in favor of this mode of practice. The ingenious and learned professor Chapman, in his very interesting lecture on this epidemic which 1 had the pleasure of hearing, stated, that, in no in- stance, did any patient die under his care, after perspiration was induced. It was his practice also, to combine witb the diaphoretics, the most cordial stimulants; and of this class of remedies, he spoke highly of volatile alkali, in frequent and large doses. As malignant as thisj disease was, it appeared to pay some respect to persons. For the rich, or rather tliose who lived generously, were seldom attacked with it; while the poor, and the intemperate, in tliose places where its ravages were most destructive, hardly ever escaped. PHRENSY, OR INFLAMMATION OF THE BRAIN. Stmtoms. A deep seated headache redness of the eyes and face, violent throbbing or pulsation in the arteries of the neck nd temples, incapability of bearing light or noise, a constant jrtchinc or delirium, with picking the bed-clothes. The ,'lse, althou|Sf sometimes languid, is generally hard, tense, PHRENSY. $03 •tnd strong. The mind chiefly runs upon such subjects as have before made a deep impr ssion upon it, and sometimes, from a sudden silence, the patient becomes, all of a sudden, delirious and quite outrageous. An approaching phrensy is announced by intense continual watehings; or, if the patient sleeps, bis sleep is interrupted and troubled: he starts, and is affected with terrible dreams, soon forgetting what is said. If, at any time, he returns an answer to a question, his fierceness and anger seem to be in- creased; a pain is constantly felt in the back part of the head, and, as the disorder increase ., the eyes become more fixed and red, tears at the same time flowing from them. The tongue is dry, rough, and of a yellow or black colour, the face O: a deep red, and the pulse small, quick, and hard. Phrensy is distinguished from mania, by the sudden attack, the violent fever, pain in the head, and an evident exciting cause; and from that species of delirium which occurs in low fevers, unaccompanied with inflammation, by the appearance of the countenance and eyes; for, in true phrensy, the features are rather enlarged than shrunk, and the eyes protuberate and sparkle; whereas, in the delirium supervening to low fever, the face is pallid, the fe'atures are shrunk, and the eyes pearly. Causes. Exposure of the head to tlie scorching rays of the sun; to deep and long continued thinking; excessive drink- ing; suppression of usual evacuations; concussion of the brain* and whatever may increase the afHux of blood to the head. Treatment. Blood-letting is the "anchor of tope" in this disease, which should be employed copiously on its first attack, and repeated as the symptoms and strength of the patient will permit. Immediately after bleeding, a dose of calomel, followed by a large dose of salts, or some cooling purge must be given. Ice pounded and put into a bladder, or folds of cloth wet with vinegar or cold water, should constantly he. applied to the head and temples; and if the symptoms 304 PIIRKNS\. prove obstinate the head ought instantly to be shaved, and the whole of thv- scalp covered with a blister. When the pulse has been reduced by blood-letting from the arm, f tbe pain in the head continue severe, let cups or leeches be forthwith applied to tbe temples, forehead, and back of the head. Bathing the feet and legs in warm water, or wrapping them up in flannel wrung out of hot water, is also of great service, by producing a revulsion of blood from the head. With tuesaine view sinapisms should be employ-d. One of the antimonial or camphorated powders [See Dispen- satory j given every two hours, or large portions of nitre dis- solved into the patient's drink, will be useful. If the d'srase be occasioned by a sudden stoppage of evacu- ations, every means to restore them must be trh d. In all inflammatory affections of the head, a copious discharge from the intestines will be found highly beneficial, by diver- ting the humors from the head; and when we cannot employ purgatives, laxative clysters should be used. To assist also in diminishing the determination of the blood to the head, the patient should be kept as near the erect pos- ture as can easily be borne. In symptomatic phj&nsy, particular attention should be paid to the primary disease which has given rise to it, and the treatment ought to be varied according to the nature and progress of the disorder which has occasioned it. In its early or inflammatory stage, copious bleeding will be necessary^ but if it has been of some continuance, drawing blood from the t inph's, by means of leeches, or cupping with scarifica- tions will be preferable. The application of a blister to the neck or between the shoulders is not to be omitted, as it is well adapted, by keeping up a steady discharge, to lessen the accumulation. When tbe accumulation is removed, its eff ct, uustoadlness of mind, often continues. This is sometimes supposed to be. owing to remaining inflammation, and the violent evacuaUons are with little discrimination employed; a plan which increases instead of mitigating the disease; for it PHRENSY. 30S depends on flie too great previous excitement. We have found no mode of conduct particularly serviceable, except absolute rest of mind, with moderate exercise of body. The camphor, hark with valerian, and some other medicines of this tribe, with cold bathing, and gentle alvine evacuations, seem occasionally to have contributed to the relief; but from time alone a cure may be expected. Regimen. The diet should be of the lightest kind, as ripe fruits, with dilutent drinks, such as cold water, tamarinds and water, &c. freely used. The patient to be kept in a dark room, as cold and quiet as possible, avoiding all irritating causes, and breathing a current of fresh air.* •It was of this disease, generally termed a stroke of the sun, that the brave General Greene, an officer second only to Washington, died at Mulberry Grove, his country seat near Savannah. A true Republican, he delighted in exercise, particularly that of gardening, of which he was so fond as sometimes to continue it under the meri- dian blaze. It was in this garden that the last summons found him. His honorable friend, E. Telfair, Esq. had often cautioned him against imprudent exposure to the Georgia suns: but believing that he possessed the same nerves that sustained him in the hot field of Monmouth, he still pursued his favori e exercise: but while busily adorning the soil which his own valor had so gloriously defended, a sun-beam pierced his brain, and in a short time translated to heaven as noble a sfiirit as ever fought under the Standard of Liberty. *In 1818, the medical community lost, by this inexorable disease, John Syng Dorsey, M. D who, by his acquirements and peif'or- mances, had attained to very great distinction, as a physician and teacher. Having been adjunct professor of Surgery, with his venera- ble uncle, Dr. Physic, in the medical school of 1'hiladelphia, and filled with great brilliancy the chair of Materia Medica, he was unanimously elected to the chair of anatomy, as successor of professor Wistar; and, but a few days before his lamented death, had delivered, with great eclat, his introductory lecture to his intended course. The chair, to which he had been promoted, was long filled by Dr. Shippen and Dr Wistar; with what success and popularity, need not here be par- ticularised. The generous and benevolent Shippen has always been accounted one of the fathers, and Wistar not the least magnificent pillar of that Scientific Edifice, which has contributed a full share of glory to our nation.—The immediate predecessor of Dr Dorsty, was admired, not only for his professional qualities, but for his charming social virtues, and uniformly dignified, and polished hospitality. Hij> house was wide open as the benevolence of his heart; and his daily •ompanies comprised the learned of our country, and the enlightened visitors from Europe. On his death, he le<"t vacant the chair of anatomy to the University of Pennsylvania, and the presidency of the Ameri- QUINSY. OR INFLAMMATORY SOKE THROAT. Symptoms. Is distinguished by a sense of bent, pain and tightness in the fauces and throat, acco npanied by a difficulty of swallowing, particularly fluids. In general, the inflamma- tion begins in one tonsil, a gland on each side of the palate, t!ien spreads across the p.date, and then seizes the other ton- sil. When the inflammation possesses both s des^ tbe pain becomes very severe, and swallowing is perfumed with extreme difficulty; but if if attack the upper part of the wine pipe, it creates great danger of .suffocation. Causes. Cold, wet feet, theowing off the neckcloth, or drinungcold water when overheated. Treatment. Tlie same rules arc to be observed, in this as in all cases of disease highly inflammatory, such as bleed- ing, purging, and other cooling means. The extent to which these are. to be used, can only be ascertained by the violence of the disease and theconslitution of the patient; but from the danger of this complaint, they should be early and freely em- ployed, particularly if there exist any fever. Local applications have also their good effects, and in slight cases, are often sufficient to remove the inflammation. Re- oa.n Philosophical Society. To the former. Dr. Dorsey, one of his favorite pupils and hourly companions, was unanimously elected, and carried with him the confident expectation of every one, that it would not only be reputably sustained, but adorned by hfii various genius, attainments, and popular eloquence. To say nothing of the great dis- appointment which his vei y sudden death created in the University, extending alike to the trustees, faculty, and students, we should have left more than enough to fill up this passing tribute of a friend, in the recollections of the infinitely varied attractions of li -.private character. He was m.inly and generous; kind and benevolent; honorable and faithful; gay aie.l go'.d-natvtred; instructive and entertaining; and died, ». all like him, deeply and universally regreted. '&> * • INFLAMMATORY SORE THROAT. 307 ceiving the steals of warm water, <>r vinegar and water, through a funnel or spout of a tea-pot, will give great relief. Much benefit may be derived from the use of gargles, com- mencing wit.i the common, and after the inflammation is con. siderably abated, using the astringent gargle. [See Dispensa- tory.] At this stage of the disease gargles of port wine, or brandy and water, answer every purpose, to restore the tone of tie fibres, relaxed from overdistension. External applications are, ikewise, of great use. In slight cases it will be sufficient to have tbe neck rubbed twice or thrice a day with the volatile or camphorated liniment, [See Dispensatory] and a piece of flannel applied. Tlie embroca- tion will be rendered still more stimulating by adding a small portion of the tincture of cantharides. But in those cases where the inflammation is considerable, the early application of leeches, or a blister or cataplasm o: mustard around the neck, is most to be relied on; whicli, by exciting external inflamma- tion, will lessen the internal. Onions [See Meteria Medica] arc also excellent when applied externally in this disease. In addition to tliose remedies, the antimonial mixture or deco.-tion of rattlesnake root, [See Materia Medica] given in suc;. doses as will excite pcrspit atiwn, is much to be depended on, when the inflammatory symptoms run high, and before the febrile symptoms are any way violent, the timely exhibi- tion of an emetic often proves extremely useful, and some- times checks its complete formation. Slrmld these means prove ineffectual, and there appears a tend ncy to suppuration, it ought to be promoted by frequent- ly ! ok ing into tbe fauces the steams of warm water, or apply- ing waem poultices to the neck. As soon as a whitish tumor with fluctuation of matter is discovered, it should be opened by the lancet, and then the detergent gargle [See Dispensatory] should be used. If in consequence of the largeness of the tumor the patient cannot swa!1''.v. he must be supported by nourishing clysters of broth, gruel, or milk. *S08 QCI!S.«Y, OR If persons, as soon as they discover any uneasiness in the throat, were to use tbe nitrous lozenges, [See Dispensatory] orsmal portions of nitre as recommended under tbe h"ad of cold; bathe their feet in warm water; apply flannels moistened with one of the above liniments; and keep comfortably warm, this disease would seldom proceed to a great height. . Regimen. With respect to the regimen, it must be of the cooling kind, except the application of cold. Barley or rice water, flaxseed tea. and such like, rendered agreeable to the palate by the addition of jelly or honey, should bo often taken, although difficult to swallow: for the pain consequent on swal- lowing is more owing to the action of the inflamed parts, by which deglutition is performed, than by tbe passage of the liquid which is swallowed. Prevention. For the prevention of this disease, the directions should be adverted to, which have been given under the head of cold. Wliere it becomes habitual, an issue behind the neck docs often succeed in preventing its recurrence.* •Well knowing how deep an interest the world always takes in great mm, I trust it will not prove unacceptable to my countrymen, to iearn that the above malady, the Quinsy, was the messenger whereby God was pleased to introduce into his own presence, the soul of that purest of human beings, George Washington. On the afternoon of the 13th December, 1799, riding out to one of his farms, he was caught in a driving rain, which, soon turning into a snow storm deposited a considerable quantity of snow betwixt his era vat and neck Long accustomed to brave the inclemencies of weather, he paid no re ird to this circumstance; but having brushed off the snow on his return, he supped and went to bed, as usual. Some time before day, he was awakened with the sore throat, and difficult breath- ing, which constitute quinsy. A. faithful domestic, who always carried a lancet, was called up and bled him, but without affording any relief. About day break, my near relative and honored firecefitor^Docior James Craik. of Alexandria, the inseparable friend and /i/tysician of Washington, was sent for, who reached Moult Vernon about ten o'clock. Alarmed at the general's symptoms, he communicated his fears to Mrs. Washington, who immediately despatched ser- vants for Doctors Dick and Brown Noching was omitted that human ingenuity and skill could do for a life so dear, but all in vain, h ap- peared in the result, as the illin.triom sufferer previously declared, #!?* his hour -van come. PUTRID SORE THROAT. This is a contagious disease, and appears more generally in autumn, after a hot summer. It oftener attacks children, and persons of relaxed habits, than those of vigorous health. ■ Symptoms. It generally comes on with a sense of giddi- ness, such as precedes fainting, and a chilliness or shivering like that of an ague fit, soon followed by a great heat, inter- changeably^succeeding each otlier during some hours, till, at length, the heat becomes constant and intense. The patient then complains of an acute pain in the head, of heat and sore- ness in the throat, stiffness of the neck, anxiety and nausea, with vomiting and delirium. On < xamininir, the mouth and throat, the uvula and tonsils appear swelled, and are of a deep red, or shining crimson colgr; soon after covered vifh white or ash-colored spots, which, in a short time, become ulcerat- ed. The pain in swallowing is slight, in proportion to the de- gree of inflammation. The patient often complains of an of- fensive putrid smell, affecting the throat and nostrils, some- times occasioning nausea, before any ulcerations appear. On the third day, or thereabouts, a scarlet eruption is generally thrown out on the skin; first, on the face and neck, and then, over the whole body and extremities. From the first attack of the complaint, there is considerable fever, with a small, frequent, and irregular pulse; aud every evening, there appears a manifest exacerbation, and in the morning some slight remission, together with a debility and general loss of strength. In slighter kinds, the course is not very different from that To oblige Mrs. Washington, he continued to take medicines offered him, till the inflammation and swelling obstructed the power oi' swallowing; when he undressed himself and went to bed, as he said, "to die." About half an hour before he died, he desired his friends to leave him, that he might spend his last moments with God. Thus, after filling up life with glorious toils, he went to rest, "in a good old ;age ladened with riches aud honor." t "Let the poor witling argue all he can', "It is religion still that makes the man." 41 * 3^0 s PL'TRID euJK-E PUROA V. of the inflammatory species, though seemingly slight, with alternate chilis and heals pain in the head, Ate. till tlie debility appears, who every other had svmpt on immediately follows. Every sin throat should, therefore, be carefully examined. The put* id sore throat sometimes attends on measles which are of a mu gnam nature. In'a (lis• ase which runs its course generally in less than five, always in seven days, no prognostic is to be depended on; but a more florid appearance in the throat, and a more healthy aspect of tbe edges of the sores. Causes. The same which give rise to the nervous or pu- trid fever, afi bad air, damaged provisions, &c. 6tc. Treatment. The indications of cure are similar to those 'of tbe nervous or malignant f ver, as it is analogous in some essential circumstances to that disease: to which we must add the healing of the ulcers. Therefore, on the first attack of the putrid sore throat, an emetic may be given, w ich may be repeated <»n the nexi day. and followed by a mild cathartic. Afterwards it will be * necessary to recruit the patient with bark aud wine, or m.lk toddy. The ulcers in the throat demand early and constant atten- tion, as a loas of substance here cannot but threaten much danger to life, or injury to the parts, if the patient should survive: hence the use of gargles must be obvious to every one. When the disease is of a mild aspect, the common and astringent gargles, [.See Dispematory] frequently used, are often sufficient: but when the symptoms are urgent, the ten- dency to putrefaction great, the sloughs large, and the breath offensive, the detergent gargle must immediately be resorted to. Independently of gargling the throat, it is essential that some of the same liquid be injected into tbe fauces, with a small syringe. In young subjects, this method is the more necessary, as they do not know how to manage a gargle to any purpose,v did the soreness of the parjs permit them to do it. PUTRID SORE THROAT. 311 When the throat is painful, the application of a piece of flannel moistened with tbe volatile liniment spirits of camphor, or tincture of red p pper, to excite a slight degree of inflam- mation externally will be attended with good effect. But blisters, from tbe prevailing disposition to putrefaction, must be carefully avoided. According to Dr. Curri**, the affusion of cold water is also beneficial in this disease. It was his practice, after a copious afft.sion, to have his patient wiped dry and put into bed, and given about eight ounces of wine, if an adult, and so in pro- portion to children; which plan it appears was very success- ful, for in fifty out of sixty-two cases, where lie had adopted it at the commencement of the disease, be succeeded. Dr. Thomas states, that, when be was in the island of St. Christophers, in tbe year 1787, this disease prevailed a uni- versal epidemic among children, and a vast number of them fell martyrs to it, in spite of the utmost endeavors of the profession to save them; when at last the most happy effects wre derived from the use of a remedy, the basis of which was cayenne pepper. The medicine was prepared by infu- sing two table spoonfuls of this pepper and a tea-spoonful of salt in half a pint of boiling water, aduing thereto the same quantity of warm vinegar. After standing for about an hour, the liquor was strained through a fine cloth, and two table-spoonfuls were given every half hour. ■ The speedy and good effects produced by the use of this medicine, in every case in which it was tried, evidently points out the utility of giving warm ar >matics, which will bring on a timely separation of the sloughs, as well as other antisep- tics, to correct the tendency in the parts.to gang.*n\ Since the period above mentioned, many practitioners bear testimony in favor of caynne or red pepper, [See Materia Medica] in the putrid sore throat. Pepper-corns constantly bitten and the saliva swallowed, have been highly useful. The grand objects to be kept in view, in this malignant dis- ease, should be, to check or counteract the septic tendency which prevails, to wash off, from time to time, the acrid mat* :\X~2 limiD m;ki; jiiuoax. ter from the fauces, and to obviate debility. With this view, give bark in large doses every two hours in ginger tea, or a strong infusion of Virginia snake-root. These may be washed down with punch, miik toddy, porter or cider. It wih be necessary also to make a, liberal use of wine, which may be given to persons unaccustomed to it from one to three quarts within twenty-four hours. Even sleep is less necessary than wine ami bark, and should it continue above three hours, the patient must be awakened, for the loss ot time cannot be regained. The quantity of the wine and bark must be ngu- lated by tbe eflect. If we gam nothing in tbe firstihirty-six hours, wc may depend on a fatal event; if we lose ground in tw» nf}-four, hours, our hopes will be inconsiderable. In addition to th se remedies we would earnestly recommend bathing the patient frequently in a strong decoction of oak bark, with one fourth whiskey. This valuable remedy should always be resorted to with children, as it is often impractica- ble to prevail on them to take the bark in any form. It is :.lso advisable with such patients to administer this decoction in a clyster; or use as an injection two drachms of Peruvian bark with a gill of thin gruel or barley water, which should be r^given every three or four hours to young children; and about half an ounce, in a proportionate quantity of the liquid to those of eight or ten years of age. Should the first cluster come away too soon, from five to twenty drops of laudanum may be added to the subsequent ones. Should any particular symptoms arise during its progress which may tend to aggravate it, such as vomiting, diarrhsea, hemorrhage, or suppression of urine, the same remedies must be resorted to as advised under the head of .Nervous Fever. Regimes. Medicine will prove of little efficacy, if the animal powers be not supported by proper nourishment: the attendants must, therefore, constantly supply the patient with arrow root, sago, panado, gruel, otc. to which may be added such wine as is most agreeable to the palate. Hi;>e fruits^are peculiarly proper, and fermented liquors, as •i FALLING OF THE PALAT1J. eider, perry, &c. should constitute the chief part of the pa- tient's drink. But previous to taking any nourishment, gar- gles aud injections should be very carefully employed; for cleansing away the Sharp, acrid humor from the mouth and throat, to prevent as much as possible its being swallowed. The patient should be so placed in bis bed, that the discharge may freely run out at the corners of the mouth, and great at- tention should also be paid to cleanliness. The feelings of a tender parent, who views the progress of the disease on a beloved child, cannot b ut excite our tender- est sympathy. Too*often, from an ill-judged tenderness to the child, the parent will not suffer this dreadful disease to be checked by medicines. But it should be remembered, that although the pain is for a moment increased by these harsh, but necessary means, yet the quantity of pain must, on the whole, be much lessened, and besides, which is the sweetest consideration of all, a precious life thereby saved. Prevention. The same means as devised in the nervous fever, to correct infectious air, must strictly be attended to here, and especially with a view to prevent the progress of "*» this disease* FALLING OF THE PAIATF. Thb falling down, or elongation of the palate, is attended with a sense of tickling in the fauces, and soreness at the roots of the tongue. Treatment. Avoid speaking, and gargle the throat with the astring* nt gargle, [Sec liecipe -il] or when there is little or no inflammation, apply salt and pepper by means of the han- dle of a spoon. If fever accompany this affection, bleed and give cooling purgatives, using nothing but a vegetable diet. 313 ' %. MUMPS. A contagious disease, affecting the glands and muscles ol the neck externally. Symptoms. Slight fever, which subsides upon the appear- ance of a tumor under the jaw, near its extremities: some- times only on one side, but m ire fr^qtienty on both. It in- creases till the fourth day, and then declines gradually. Treatment. This disorder is often so slight as to require very little more than to use a spare diet, and keep a laxative state of tbe bowels. If, however, there be much fever and pain in the head, it will be necessary, in addition to the above, to bleed, blister behind the neck, and take freely of diluting dri ks, as flaxseed tea, barley or rice water. It has been usual to keep the neck warm, but this is im- proper. It will be found, generally, tliose who have been most neglected, have been soonest restored to health. There is a singular peculiarity now and then attending this complaint; for sometimes tie swelling of the neck sub- sides, the test cles of the male, and breasts of the female, are affected with hard and painful tumors, and frequently when one or other of these tumors has suddenly been repressed, a delirium of the milder sort occurs. In t'ds event, bleed mo- derately, apply a blister between the shoulders, give a doso of ealomel, and endeavor to reproduce the swelling by warm fomentations and stimulating liniments. When these tumors are painful, every precaution should be used to prevent suppuration from ensuing, by bleeding, ca- thartics, antimonial powders, r mixture, dilutent drinks, and by cooling; and diseutient applications, as cloths wet with lead water [See Dispensatory] and cold vime-ar and water. It is necessary, also, that the swelled testicle should be supported by a suspensory bag. SORE EYES, A disease so well known as to render all description of it unnecessary. Causes. External violence done to the eye-lids, or to the eye itself; extraneous bodies under the eyelids, as particles of dust and sand—acrid fluids or vapors—exposure of the eyes to a strong light, and night watching, especially sewing, reading or writing by candle light. Inflammation of the eyes may also he the consequence of bud humors in the system, or may accompany other diseases of (he eyes, and of the neighboring parts, such as the turning inward of the eye-lids, or styes growing on them. Treatment. When the disease is moderate, and the ex- citing cause no longer exists, the cure is perfectly easy, re- quiring little more than external application, such as washing the eyes frequently with warm milk and water, mixed with a little brandy, or using for a lotion, mucilage of sassafras, [»S'ee Materia Medica] simple rose water, or about eiglut grains of white vitriol dissolved in a gill of spring water. But in more severe affections, bleeding, blistering behind the ears*, on the temples, or nape of the neck, with gentle pur- gatives and the cooling regimen, will be found eminently use- ful. The greatest benefit will also result from vsoft linen bandages wet with cold water, applied to the eyes, and fre- quently renewed entil the heat and inflammation have sub- sided. Soon as this is affected, use the anodyne eye water. [See Dispen$< tory] or two or three drops of laudanum drop- ped into the eye, or bathe the eyes in cold water, or brandy and water, to restore the tone of the parts. In all inflammations of the eyes from common causes, the remedies above specified will generally succeed; only wc should be careful not to use any of the more stimulant appli- 316 sr fifteen drops of laudanum, or thirty fir- ps of paregoric, given about an hour before the evening exacerbation, alleviates the symptoms, ami if repeated for a few evenings, gradually increasing tbe dose, ensures the cure. II the pulse sinks and becomes languid, blister the extremi- tie-, and give six or eight grains of volatile salts every three hours with mulled wine. The bowels, in the course of the disease, must be kept moderately open, by emollient injections or mild laxatives, as castor oil, or the cathartic mixture. Tbe bastard pleurisy is often confounded with true pleurisy. It consists of a rheumatic inflammation of the intercostal mus- cles, often of tbe other muscles, of the breast or abdomen. The disease is distinguished by external soreness, and is re- lieved by bleeding, blistering and exhibiting the sencka-root in decoction. Regimen. In no disease is a strict abstinence more neces- sary than in this, since, in proportion to tbe nourishment taken, will be the increase of the blood, and consequently of fever. Nothing but diluent drinks, as toast and water, barley water, bran, or flaxseed tea, ought to be allowed, until tbe violence of the disease is subdued; and these liquids should be taken often, but in small quantities at a time and never cold. When nourishment is required, the lighter kinds only should be used, as arrow root, sago, panado, &c. After recovery, great care must be taken to prevent a relapse; the sparest diet should therefore be used; the inclemencies of the weather carefully guarded against; moderate exercise employed, and the chest protected from the action of cold, by wearing flannel next to the skin. In this state of convalescencv, a prudent use of wine with bark or columbo, will assist digestion, and give tone to the system generally. PERIPNEUMONIA OR INFLAMMATION OF THE LUNGS. Symptoms. Febrile affections, succeeded by difficulty of breathing, cough, and obtuse pain under the breast bone, or betwixt tbe shoulders, increased on inspiration. A sense of fulness and tightness across the chest—great anxiety about the heart, restlessness, loss of appetite and sleep—the pulse quick, sometimes hard, and seldom strong, or regularly full: the breath hot, the tongue covered with a yellowish mucus, and the urine turbid. From the obstruction to the free pas- sage of blood through the lungs, the veins of the neck are distended, the face swollen, with dark red colour about the eyes and cheeks. The pain in the chest is generally aggra- vated by the patient lying on the side most affected, and very often he can lie only on his back. Causes. Cold, obstructing perspiration and thus produc- ing a morbid determination to the lungs, or violent efforts, by over-distension, Tteatment. Such is the delicate structure of the lungs,, that they will not sustain inflammatory attacks many hours before their important functions are destroyed, or so much mischief produced, as to lay the foundation of consumption. The antiphlogistic plan, therefore, as advised in the pleu- risy, for the resolution of the disease, should be put into im- mediate operation, and not by degrees, as is often the case, by which many lives are lost, but should be caTrted to the utmost extent, particularly the taking away of blood in con- siderable quantities from the arm. We would remark, however, although the evacuating plan is indispensably necessary in the early stage of the disease, yet it should not be continued too long, for tbe truly salutary discharge is by expectorate.n; and if the strength is too far reduced, this will be prevented. INFLAMMATION OK THE LIVER, Is of two kinds, the acute and chronic; and consequently, requires variation in the mode of treatment. Symptoms. The acute is marked by a pungent pain of the right side, rising to the top of tbe shoulder, something like that of the pleurisy, attended with considerable lever, difficul- tly of breathing, dry cough, and often bilious vomiting. The chronic inflammation of the liver, is usually accompa- nied with a morbid complexion. The symptoms are some- times very obscure, and confined rather to the common marks of stomach complaints, as flatulence and frequent eructations. The appetite, in consequence, fails, and occasional uneasiness or pain is felt in the region of the liver extending to the right shoulder, the characteristic of the disease. An obscure fever prevails, which is generally worse at night, inducing langor, want of sleep, and much oppression. The patient has gene- rally clay-coloured stools, and high-coloured urine, depositing a red sediment, and ropy mucus. In the progress of the ma- lady, the countenance seems liv d and sunk, and the eyes of a dull white or yellowish hue. Inder these symptoms, the bo- dy becomes gradually emaciated, while, in the region of the liver, is felt a sense of fulness, with a slight swelling and dif- ficult breathing, attended with a hoarse, dry cough, particular- ly aggravated when the patient lies on the left side. As the disease advances, dropsical symptoms, accompanied with jaundice supe< vine, and under these complicated mala- dies, the sufferer sinks. Sometimes an ab cess opens exter- nally, whicli, if it do nottffecta cure, at least prolongs the life of tbe patient. Causes. Violent and repeated shocks from vomits—sudr den changes in the weather, but especially, cold nights after •INFLAMMATION OP THE LIVER. 323 Vfry hot days—sitting in a stream of air when overheated— drinking strong spirituous liquors, and using hot spicy ali- ment. Treatment. In this, as in all other cases of visceral in- flammation, the same means to take off inflammation, as ad- vised in the pleurisy, should be carefully observed. And as it is an object of the first importance, to prevent the forma- tion of matter, we should adopt these means as early as possi- ble, to produce resolution, the only salutary termination.— Scarcely any complaint requires such prompt and copious blood-letting, as acute inflammation of the liver. After the acute stage is over, we may consider the affection of a chro- nic nature, and the mode of treatment must be regulated ac- cordingly. In the chronic species of this disease, the cure depends principally upon mercury, which may be employed in the ear- ly stages of the complaint. Tbe mercury may be introduced in the system, either by taking one or two of the mercurial pills, night and morning, or by rubbing as frequently on the part affected, the ointment about the size of a nutmeg, con- tinuing the one or the other, until a ptyalism is produced, or the disease is subdued. During this course, the use of the tonic powders, or pills, [See Dispensatory] or bark and snake-root, when febrile symp- toms have abated, will greatly hasten the cure. The nitric acid, with patients who are scorbutic, or much debilitated, is far preferable to tbe calomel, on account of its antiscorbutic and tonic powers. It should be given t»the ex- tent of one or two drachms daily, diluted with water, in the proportion of one drachm of the acid to a quart of water. At first, if ought to be given in small doses, anil frequently re- peated, and tbe dose gradually increased, as circumstances require. This medicine, like calomel, must be continued un- til the mouth becomes affected, the salivary glands enlarged, and their secretion increased; and when this takes place, the 324 inflammation op the liver. disagreeable symptoms will be removed, and the patient, from being debilitated, becomes healthy, vigorous, and cheerful. My own experience of the efficacy of the nitric acid in chronic affections of the liver, induces me to spc^ik well of it; and I am happy to add, it was a favorite remedy of that cele- brated anatomist, and distinguished physician, professor Wistar, in this distressing disease, particularly when there was an enlargement of the liver. Obstructions and indurations of the spleen, bear some re- scmblance to a diseased liver, and are very prevalent in Jow, marshy and aguish situations. Tlieir treatment consists in the use of the same means recommended for the cure of this disease. Regimen. The food should be easy of digestion, such as veal, lamb, fowls, or fresh beef. Watercresses, garlic, and other pungent vegetables are useful. A change of climate, and moderate exercise in the open air of the country, is both agreeable to the patient, and very salutary.* ♦Of this formidable disease, died, on the 29th October, 1823, Charles Carroll, of Bellevue. Maryland This inestimable friend was expensively known, and wherever known, was justly es- teemed for his intelligence and moral excellence. Whatever of man- ly grace and virtue belongs to the human character, shone conspicu- ously in him .A.n affectionate husband and a kind parent, a generous friend and a polished gentleman; he stood among his fellows, a bright example of what a man should be. His philanthrophy prompted him to devote a considerable portion of his fortune, which was, at one time ample, to the alleviation of the distresses of his fellow men. In more than one instance, as the author is able to testify, individuals owed much of their prosperity and happiness in life to his unsought bounty. Soon after the late war, Mr. C. removed from this city, where he had resided several years, to Gennessee, New York. Early in the year 1822, he was induced to accept an office under the government of the United States, in Missouri. In that state, he contracted the disease, which, eighteen months afterwards, terminated fitally; and there, too, by a calamitous coincidence, Henby Carroll, (formerty pri- vate secretary to Mr. Clay, while minister at Ghent ) met with an un- timely and violent death. The memory of Mr. Carroll's worth is deeply engraven on the hearts of all who knew him, and his name will, hereafter, stand high in the annals of virtue and benevolence. INFLAMMATION OF THE STOMACH. Symptoms. Acute pain in the stomach, always increased upon swallowing even the mildest drinks. Inexpressible anx- iety, great internal heat, something like heart-burn, constant retching to vomit—and, as the disease advances, the pulse be- comes quick and intermitting—frequent hiccoughs, coldness of the extremities, and the patient is soon cut off. Causes. Acrid or hard and indigestible substances, strong emetics, or corrosive poisons taken into the stomach, or drinking extreme cold liquors, while the body is in a heated state. It may also be occasioned by external injury. Treatment. Unless the inflammation can be resolved inr ihe very beginning, it rapidly terminates in a mortification. Therefore, a violent pain in the region of the stomach, with sickness and fever, should always be very seriously attended to. Copious and repeated bleedings, not regarding the small- ness of the pulse, are absolutely necessary, and is almost the only thing that can be depended on. In no inflammation is the immediate use of the warm bath so necessary as in this, which attacks at once the "throne" of life. If a better bath- ing vessel cannot be had, a barrel or half hogshead, filled with warm water, about blood heat, will do. Let the patient be instantly put in it, covering the top with a blanket. Keep him in as long as he can bear it, and when taken out and wiped dry with warm cloths, he should immediately have a large blister or cataplasm over the stomach. The bowels must be kept open by the mpdest clysters, as water gruel, or weak broth, with the addition of a little salt petre, and sweet oil or sugar. These injections answer the purpose of inter- nal fomentations, and also nourish the patient, who is often anable to retain any food, or even drink, upon his stomach. *.* On the preceding page, the readc is requested to supply an omission which occurred rn the notice of Mr. Carroll. In the 5th line trom the bottom, after the word "coincidence," read, his amiable anil treecu}f.lishtd son, 15V. V'l o'2j* INFLAMMATION OF THE I VITSTINES. The erythematic inflammation of tne stomach often arises iu putrid diseases, aud comes on insidiously. It is evident, by the inflammation appearn.^ on tbe internal surface of the mouth. When, therefore, an inflammation of this kind affects the mouth and fauces in the bilious, typhus, or puerperal fe- vers, with a frequent vomiting, and an unusual sensibility in Wic stomach, *\e may suspect that tbe same affection extends downward. In such cases, or when tbe state of inflammation is approaching to gangrene, spirits of turpentine, in doses of a tea-spoonful, given alone or in a little water, upon the high authority of professor Chapman, will arrest the disease.— This medicine is to be repeated, more or less frequently, ac- cording to the urgency of the symptoms. When the disease is a little alleviated, the infusion of bark, with a few drops of any mineral acid, is borne with case, and is highly beneficial. Regimen. When the stomach will admit of nourishment, only that of the lightest kind should be allowed; barley wa- ter, and mucilage of gum-arabic, moderately warm, are the most suitable drinks. Every thing of a heating and irritat- ing nature, must be carefully avoided for some time after the attack. INFLAMMATION OB' THE INTESTINES. Symptoms. Tension of the belly—obstinate costiveness— great internal pain—external soreness, especially about the navel, and so severe as scarcely to bear the slightest touch- great debility—hard, small, and quick pulse. Causes. The same, generally, that induce the preceding disease. It may also be the sequel of other diseases, as rup- ture, colic, dysentery, worms, &c. Tuevtment. Whatever may b* the cause, we must en- deavor to bring about, as quick as possible, resolution, lesf INFLAMMATION OF »'HE KIDNEYS. 327 mortification be the consequence. The treatment of inflam- mation of the stomach will also be proper here, as copious bleedings, emollient clysters, frequently repeated, the warm bath, and immediately afterwards, a blister on the belly.— Cupping on the belly is also useful. Such is the nature of this complaint, that we cannot be too cautious in the administration of medicines or diluents by the mouth. But the frequent use of emollient injections will, in great treasure, supersede their necessity, and at the same time, act as fomentations to the parts. Fresh olive-oil, in the dose of a table-spoonful, is perhaps the only medicine that can be admitted with safety. When the violence of the disease shall have considerably abated, we may venture to give some ape- rient medicine by the mouth, as castor oil, not rancid, calo- mel, or cathartic mixture. In this stage of tbe disease, laudanum may be employed with great advantage, particularly by way of injection. , When the disease is combined with spasmodic colie, the application of cold to the abdomen, either by means of pound- ed ice, cloths wetted with very cold water, or cold water dash- ed from a pail immediately over the belly, has sometimes suc- ceeded, when all other means have failed, in removing the ob- struction; producing an increased action of the intestines, from sympathy with the external parts. . Regimen. After the disease is subdued, the diet should be, for some time, of the lightest kind, and not flatulent.— The patient must be kept quiet, avoiding cold, severe exercise, and all irritating causes. INFLAMMATION OF THE KIDNEYS. Acute pain and heat in the small of the back—great numb- ness along the thigb, aud not unfrequently, a retraction of one 328 INFLAMMATION OF TUB KIDNEYS. of the testicles—retching to vomit—voiding the urine in small quantities, sometimes very pale, and other times, of high red colour, attended with febrile affections. The patient gene- rally feels gnat uneasiness when he endeavors to walk or sit upright, and lies with most ease on the affected side. Causes. Excessive exertions, external injuries, violent strains, exposure to cold when heated., and calculous concre- tion in the kidneys. Treatment. Bleed copiously,' keep the bowels open with castor oil and emollient clysters, use the warm bath, or foment the part with a hot decoction of camomile or bitter herbs, or hot water alone; give mucilaginous and diluting li- quors, as flaxseed tea, barley water, and thin gruel, with the camphorated powders, [Sec Dispensatory] or small portions of nitre. A decoction of peach leaves [See Materia Medica] is also beneficial in this complaint. Flannel wetted with spirits, and hartshorn, or tincture of Spanish flies, may be applied to the small of the back, for the purpose of exciting some degree of inflammation of tbe external parts. After the inflamma- tion has somewhat abated, the exhibition of laudanum in its osual quantities, either by mouth or clysters, will add con- siderably to the cure. This disease is often removed by a moderate ptyalism. If the disease have been treated improperly, or neglected at the onset, and a suppuration take place, known by a discharge • of matter with the urine, use uva ursi, [See Materia Medica] or balsam capiva, twice or thrice a-day, for a week or two, and afterwards, take bark or steel. Regimen. The diet should consist of the most mucilagi- nous substances, as arrow root, sago, milk, buttermilk, cus- tards, flaxseed tea, barley, or rice water, &c. In the con- valescent state, moderate exercise in the open air is of great freTvicCi INFLAMMATION OF THE BLADDER. Symptoms. Acute pain at tbe bottom of the belly, whicAi is much increased by pressure—a frequent desire fofr, and dif- ficulty in making water, and frequent efforts to go to stool,, attended with febrile affections. Causes. Calculous concretions, suppression of urine from obstruction in the urcthra,Jtepanish flies taken internally, or applied to the skin, wounds, bruises, &c. Treatment. It must be treated as V\l preceding disease, excepting that, where there is an entire retention of urine, the patient should drink no more than absolutely necessary. Gum- iu rtbic kept in the mouth will sheath the inflamed parts without adding to the quantity of urine. If necessary, the catheter , must be introduced, though much care is required in the at- tempt, which often fails. After using the warm hath, a cata- plasm of mustard and vinegar applied to the perincenm or some rubefacient, to excite external inflammation, will be attended with good effects. The lovers of wine and cider should remember that those beverages, however jdeasant and exhilarating, have a tenden- cy to aggravate all diseases of the kidneys and bladder, esper dally when they originate from an acrid state of the fluids. HEADACH. If a foul stomach be the cause, give an emetic, after which, take columbo three times a-day. If from a plethoric habit, which is known by a heaviness of the head, and flushed face, bleed and give opening medicines. Jf from rheumatism, ap- ply a blister to the back part of the neck, or between the tfkooldcrs^ and at bed-time, bathe the fee.t in warm water, and 330 UK AD A (.II. i take the anodyne sudorific drang'it. [See Dispensatory.] t| from a weak habit, and where the pain returns at stated peri- ods, as in cases of intermittents, and confimd on one side of the head, as over an eye, the cure will generally depend upon the free use of bark and snakeroot, or the solution of arsenic, twice or thrice a-day, which seldom fails, especially if preced- ed by a brisk purge. In this, as well as other periodical pains laudanum exhibited in a pretty large dose an hour or two before the expected fit, will often prevent its coming on. ./Ether externally applied over the pain on a piece of linen, with a warm hand to confine it, will afford immediate relief in headachs attended with cold skin. Cayenne pepper mixed with snufT, by irritating tbe membranes of the nostrils, has al- so given much relief in cold or nervous headachs. It is not unfrequent that the partial or nervous headach, as it is termed, is produced from a decayed tooth, which, on dls- • .^ covery, should instantly be extracted. Symptomatic headach is a disease of so many organs, that it is difficult to ascertain the organ primarily affected. Hut when the real nature of the complaint is ascertained, the practice to be pursued, will, of course, be obvious. Wliere the causes arc beyond our reach, the disease may be mitigated at least by some of the remedies wc have pointed out, such as paying attention to the state of th* bowels, blistering, and keeping up a determination to the surface. The sympathy between the head and the stomach has been already noticed. It is the subject of such constant experience, that to enlarge on it would be superfluous. Headach attends fever of almost every kind. Every obstruction in the bowels; • every accumu!ation of sordes, or indigestible matter in the stomach produces the same disease; every obstruction to the regular evacuation of any gland, particularly those of the surface; every nervous affection, either from excessive ex- citability or exhaustion, lias a similar consequence. Repelled fluids from the surface produce very constantly a symptomatic headach. A cause of this kind is the repulsion of acrid matter from the surface, by the application of astrin- gent washes to cutaneous affections; by saturine or mercurial •HEADACH* * 331 applications as cosmetics, from which the head generally suf- fers, though the mischief is often more extensive, and apo- plexy or epileptic fits the frequent consequences. Repelled gout is a still more serious cause. We have not mentioned the mental causes, anxiety, fear, suspense and grief; for these seldom produce the complaint until the body, or, in general, the stomach, is affected. The headach of students is often a nervous affection merely.— Whatever be the action of the nervous fibres in intellectual operations, its excess is often a cause of pain; though in many instances, the headach of students is connected with obstruc- tions of the bowels, and very often with increased determina- tion to the head. The hysteric headach partakes of this ner- vous cause, particularly, when the pain feels as if a nail was fixed in the brain. Are we then to be surprised at its fre- quent occurrence? Is it not wonderful that the head is ever free from pain? In tbe nervous headach, which occurs more frequently than is generally suspected, I have found no remedy so effectual as genuine wine. It may be given during the paroxysm, to per. sons unaccustomed to it, from a half pint to a quart, without producing any other than the pleasing effect of mitigating the pain. It is also the best preventive of all nervous diseases, wl en used regularly and in moderation. [See Vine, Materia Medica.] When headach is accompanied with a coldness of the ex- tremities, bathing the feet in warm water, rubbing them with flour of mustard or tincture of cayenne pepper, and keeping up a general circulation to the surface by flannel next the skin, will often afford immediate relief. And in cases of great determination to the forehead as indicated by a flushed face and preternatural heat, the application of cloths wrung out of cold vinegar and water to the head and temples will be attended with good effects. Those subject to this complaint, should bathe their head every nioin^iii? in cold water, avoid full meals, lie with tbeir head high in bed; and always keep their feet warm, and the bowers m a regular state. EARACH, in frequenfly produced by living insects getting into Uif ear. The most effectual way to destroy them is to blow in the smoke of tobacco, or pour in warm sweet oil. If occa- sioned by cold, inject warm milk and water in the car, or drop in a little laudanum or volatile liniment. If this pro- duce uot the desired effect, foment the ear with steam of warm water, and apply a bag of camomile flowers, infused in boil- ing water, and laid on often, as warm as can bo borne. When the inflammation cannot bo discussed, a poultice of br«ad and milk or roasted onions may be applied to the ear, and frequently renewed till the abscess breaks; after whicli, it most be syringed twice or thrice a day, with Castile soap and we.fer. In this complaint, a blister behind the ear is highly aselul. DEAFNESS, Is occasioned by any thing injurious to the ear, as loud noise from the firing of cannon, violent colds, inflammation or ulceration of the membrane, bard wax, or by a debility or paralysis of the auditory nerves. It also frequently ensues in consequence of long protracted fever. Treatment. It is difficult to remove deafness, but when it is owing to a debility of some part of the organ, or arises in consequence of any nervous affection, stimulants dropped into the eat,often prove salutary. ^Ether dropped into the ear, seems to possess a two-fold ef- fect, one of dissolving the indurated wax, and the other of stimulating the torpid organ; bet it is liable to excite some de- gree of pain, unless it be freed from the sulphuric acid. No prescription for deafness from indurated wax ever acted more surprisingly—ncne, I am sure, more agreeably, to my feel- ings at least, than the following: TOOTHACIt. 33.3 In consequence of a violent attack of bilious fever, which degenerated into the nervous, my honorable friend, Colonel George M. Troup, of Georgia, was afflicted with a deafness for a year or two, so entire, that, in congress, when the mem- bers were on the floor, he was obliged to place himself close to the orator, and even then, frequently failed of the pleasure and profit ol hearing his reasonings. Suspecting indurated wax to be the cause of his deafness, I directed the cavities of both ears to be well syringed with warm and strong suds of Castile soap. This was done twice a day, the ears constantly filled in the interim with pellets of wool dipped in strong camphorated liniment, and sometimes plugs of camphor. In a few weeks, the nerves of hearing recovered their sensibili- ty, and, as the Colonel himself thought, more acutely, if pos- sible, than before. Salt water is a better menstruum for the wax, and may be employed, or some of the table salt finely powdered may be dropt in the ear. There is reason, however, for apprehend- ing one bad efTect from this remedy, viz: giving «uch a sus- ceptibility to the organ, that it is more liable in future to be affected by cold, and therefore, this remedy must be employed with caution. Deafness in old people is sometimes attended with noise in the ears, and is then generally owing to debility. Every evacuation increases it, and warm tonics, with a generous diet, are the best remedies. TOOTHACH, Is best removed by extracting the tooth; but if this cannot be effected, fill the cavity with a little cotton dipped in the toothach drops, Turlington's balsam, or any of the essentia) oils, or with pills of camphor and opium. The. nerve may sometimes be destroyed by a hot iron or knitting needle. A carious tooth is sometimes pained by ac- cidental colds, and in such cases, it would not be prudent to *4 334 IOOT1IACH. have it extracted. If the external aperture is smaller than the carious cavity, after clearing away the carious matter, the ac- cess of air may be impelled by stuffing of gold or silver leaf. When the nerve is accustomed to the external air, it will con- tinue carious for many years without pain, and be truly use- ful. When toothach is connected with rheumatism or gout, which sometimes happens, the remedies ol either should be employed. This unpitied, though often excruciating pain, is, in most cases, no more than the just punishment of our negh ct of the leeth. Surely, then, we ought to take some care of them, though it were but for the pleasure of having them sound.— But this care would he redoubled were we but daily to consi- der the advantage of good?, and clean teeth and sweet breath. Some women, indeed, are blessed with faces so nearly angelic that not the blackest teeth can entirely defeat" their charms, nor the vihst breath drive away tlieir lovers. But how dif- ferent would be tbe effect of both, if, through their ruby lips,;. opened with a smile, we were to see teeth of ivory, white as snow, pure as the fair owner's frame, and accompanied with breatli as sweet as that of infancy. Prevention. To prevent the toothach, and to preserve the teeth and breath perfectly sound and sweet, the tooth brush dipped in warm water, and then in charcoal tooth-powder, i Sec Dispensittory] should be used constantly every morning. The charcoal powd r, aa invention of the celebrated Darwin, is good for whitening the teeth, and admirable in correcting bad breatli. The tooth-|*ick anil tumbler of pure water should never be forgotten after every meal. If the calcareous crust or tartar upon the teeth adheres firmly, a fine powder of pumice stone may be used occasion ally. When the gums are spongy, they should be frequently pricked with a lancet, and gently rubbed with a powder coin- posed of equal parts of Peruvian bark and charcoal. Young persons who wish to carry their teeth with them RHEUMATISM. , 335 through life, must take care never to sip their tea scalding hot, nor to drink water freezing cold. Such extremes not only injure the tender coals of the stomach, but often ruin the teeth, and have caused many imprudent persons to pass a sleepless night, distracted wito pains of the teeth and jaws, RHEUMATISM. Symptoms. Wandering pains in the larger joints, and in the course of the muscles connected with them, increased on motion, and generally worse towards night. When, with fever, it is called acute or inflammatory rheumatism, and chronic, without. Causes. Sudden changes of weather—application of cold to the body when overheated, wearing of wet clothes. Treatment. In the inflammatory rheumatism, large and repeated bleedings are necessary, as indicated by the fullness of the pulse, especially on tbe first days, and when there is much pain. With this should be combined a free use of dilu- ent drinks, as flaxseed or balm tea, barley or rice water, with a little nitre dissolved in each draught, or the antimonial powders or ntixture in small doses, to excite slight perspira- tion, which should be kept up with,.great care, as in this relaxed state of the skin, the disease is liable to recur upon the least application of cold. In this disease, a very essential discharge is the perspira- tion; and if this be not produced, every medicine appears in- jurious. Of the diaphoretics, Dover's powder seems best adapted to this complaint; and it should be observed, when sweating is once begun, should not be intermitted, and when it has relieved, should be suffered very gradually to decline. The foxglove, exhibited in doses from ten to twentv drops overy fonr hours, will be found a remedy of considerable effi- 336 RHEUMATISM. cacy, particularly when an objection is made to the free use of the lancet. The blood root [See Materia Medica,] is also a useful auxiliary in this disease. Bleeding and blistering over the part affected, when the pain and inflammation continue violent, have likewise their good effects. After the inflammatory symptoms have in a great measure subsided, the anodyne sudorific draught or bolus, [See Dispen- satory] or audanum alone, may be administered at bed-time, with great advantage. During this general treatment, attention must be paid to the state of the bowels, which should bo kept open by emollient clysters or cooling medicines, as the cathartic mixture, or castor oil, exhibited in small and repeated doses. When the disease has fully attained its chronic state, it then forms a local affection, distinguished merely by stiffness, dis- tension, and considerable immobility in the joint. In this species of the disease, a different plan of cure must be followed. Large evacuations are to be avoided, and exter- nal stimulants of the warmest kind should be applied, as the oil of sassafras, spirits of turpentine, opodeldoc, or Hip tinc- ture of red pepper and mustard, and along with this, friction with a flesh brush or flannel over the afflicted joint is not to be omitted. If these means prove ineffectual to rouse the en- ergy of the part, add to an ounce or two of either of the above articles, one or two drachms of the tincture of Spanish flics* In addition to these remedies, the internal use of the rheu- matic tincture, [See Dispensatory] in doses of a table-spoonful, twice or thrice a-day in a cup of tea, is much to be depended upon. When these remedies prove ineffectual, we may suspect that some peculiar fault exists in the habit, which must be corrected before a cure can bf expected. If the patient be much debilitated, ef a srorbutic habit, give him the nitric acid diluted, or bark freely. And i'' the disease be in conse- quence of venereal taint, or taking cold from the use of mer- 1UIEUMATISM. 337 cury, let him take calomel in small doses, or one of tbe mer- curial pills night and morning until a p.yalisiu be produced. A strong decoction of sarsaparilla [See Materia Medica] is also a useful auxiliary, and sometimes a remedy of itself. In some cases of obstinate rheumatism, I have witnessed the happiest effects from taking, for some time, a fea spoonful of flour of sulphur nigbt and morning in milk or spirit and water. In others, again, I found nothing equal to the poke- berry bounce [See Materia Medica] in d< sesof a wine-glassful, morning, noon, and night. The cuckow pint, or wake robin [See Materia Medica] in the form of a conserve, with an equal part of sugar, is often highly useful. The seneka root and mczereron in tbe form of decoction, has also been exhibited with most happy effects. Another valuable medicine in chronic rheumatis o is the spirits of turpentine, in doses from twenty to sixty drops three times a day, which may either be given on sugar, in a little water, or incorporated with double the quantity of honey, by melting them together over a gentle heat. But it should be observed these active stimu ants are never to be employed when there is the least febrile action prevailing in tbe system. The solution of arsenic has in some instances, been exhi- bited with success in the chronic form of this complaint. Compressing the large arteries by means of a tourniquet or bandage, as mentioned under the head of intermittents, is another remedy which has been employed with advantage in severe rheumatic pains. In recent cases when the pain wanders from one part to the other, or whenever the joints are stiffened and rigid, and tbe pain upon motion severe, or where the musiles have become contracted, by the length and violence of the disorder, immers- ing the whole body in a warm bath, strongly impregnated with salt, or applying it topically, by pouring warm wat-r upon the limb from a kettle, or fomenting the part with a de- coction of mullein two or three times a day, will often, soothe the pain, and prove a useful auxiliary to the other means we employ. 338 RHEUMATISM. Warm bathing, and warm pumping, arc remedies of great utility in this disease; but as it requires painf •! muscular ex- ertion to use the warm bath, it is not often resorted to. The vapor bath, from its superior temperature, is better adapted to its chronic form. Two other forms of rheumatism ought here to be men- tioned, namely,the lumbago, and the sciatic. The first attacks the loins or lumbar region, with a most acute pain shooting to the joints of tlie thigh. This affection is nei lv related to the inflammatory rheumatism, and must he treated in tie same mann r, oniy instead of applying blisters over the affected part, tiiey should be applied on the inside of the thighs, and kept running for some time. The second, or sciatic, is a violent or fixed pain, attacking the hip joint, and partaking of the nature of the chronic rheumatism, is most successfully to be treated like that dis- ease. Regimen. In acute rheumatism, the patient must be kept on a cool spare diet; but no change whatever will be neces- sary in the patient's ordinary mode of living, in chronic rheu- matism. In this species, mustard and horse-radish [See Ma- teria Medica] used freely in their natural state, or united with food, will be found very heneficial. In all cases of both dis- eases, flannel, or fleecy hosiery, should be worn next to the skin, a flesh brush be used morning and night, and every pre- caution be taken to guard against exposure to cold and wet, and also to a moist or damp atmosphere. If the appetite is impaired, stomachic bitters, elixir vitriol or Some of the tonic medicines may be taken with advantage. Exercise, either of the whole body or of particular limbs, will be highly impor- tant. The want of exercise is apt to produce stiffness in the limbs. Pkevention. Cold bathing, and the use of flannel next the skin, are the most effectual means of preventing the recur- rence of both acute and chronic rheumatism. f TIC DOULOUREUX, OR PAINFUL AFFECTION OF THE FACE. Symptoms. A painful affection of the nerves, which mostly attacks the face. The most frequent seat of the affection is in the nerves over the cheek bone, just below the orbit of the eye, the nostrils, upper lip, and gums. The pain is often ex- cited by opening and moving the mouth, attended with ptyalism and convulsive agitation of the adjacent muscles. The only diseases likely to he confounded with this are, rheumatism oc- cupying the face and jaws and the toothach. It may, however, readily be distinguished from the former of them, by an at- tack of pain being readily excited, by the slightest touch, by the shortness of its continuance, and by its extreme severity and violence; and from the latter, by tbe rapidity of its succes- sion, and there being an entire freedom from pain at intervals. Treatment. A very great variety of medicines, given internally, as well as remedies applied externally, have been- tried for the alleviation and removal of this excruciating com- plaint, and even a division of the nerve has been resorted to; but although this operation has answered the purpose in a few Rases, still it has failed in many others. Electricity, blisters, topical bleeding, by means of leeches, stimulant and anodyne embrocations, and frictions with mer- curial ointment, have all been employed in rotation as exter- nal applications, whilst the solution of arsenic, large doses of the extract, as also powder of Peruvian bark, preparations of iron, opium, and the extracts of henbane, hemlock, and night- shade, have been administered internally in considerable doses. If appears that the nightshade (bella donna) has, in many cases, proved a powerful and very efficacious medicine, and may therefore be given with confidence. From two to three grains of tbe extracts have been administered every five or six hours to adults during the great severity of the pain, or from twenty 340 PAINFUL AFFECTION OF THE FACE. to forty drops of the tincture, lessening the dose very consid- erably as soon as ease was procured. It will always be most advisable to begin tbe use of this medicine in small doses, such as half a grain of the extract for an adult, repeated every four or six hours, increasing the quantity, by degrees, to about two grains, and we may, at the same time, make trial of it as an outward application to the cheek, by laying over it a piece of fine linen rag, moistened in a solution of the extract in water, in the proportion of six grains of the former, to two ounces of the latter, or it may be wetted in the tincture of night- shade. Tbe use or this medicine internally, is, howcver,often at- tended with distressing symptoms, when given in such doses as to produce a certain effect, as impaired vision, giddiness in the head, numbness, tightness at the chest, and a sense of suffoca- tion with dryness in the throat; but these soon cease again on greatly diminishing the dose, or wholly discontinuing the remedy. As persons unaccustomed to the use of so active a medicine, might be intimidated even by the probability of such unplea- sant consequences, we would recommend them to make a pre- vious trial of the carbonate of iron, in doses of one scruple, repeated three times a day, gradually increasing each dose to the extent of one drachm, if no decided benefit is derived by taking it in smaller quantities. This remedy has been em- ployed in several cases of the tic douloureux after a failure of very large doses of the extract of bark, the solution of arse- nic, and most of the other means usually resorted to, with an exception of nightshade, in all of which the complaint soon ceased, and has not again returned in any of them. In the treatment of this vry painful complaint, it has been advised to paralyze the nerve by the application of an oint- ment, consisting of two scruples of the superacetate of lead (sugar of had) mi.vd with a little lard, every morning on the cheek affected, about an hour b-fore the paroxysm is expected. Tbe experiment has been tried with success by Mr. <\stly Cooper, in a case which had previously resisted every other itiiudy, and even a division of the nerve by the knife. 341 VACCINE DISEASE* OR COW-POX. The vaccine discovery may be justly considered as one of the most extraordinary blessings bestowed on man, since it is incontestibly a certain security against the small-pox, a dis- ease distressing in its symptoms, formidable in its appearance, doubtful in event, and to which mankind are generally ex- posed. The comparative advantages which the kine-pox has over the small-pox are very great and striking. First, it is neither contagious nor communicable by effluvia; secondly, it excites no disposition to other complaints; thirdly, it can he communica- ted with safety to children at the earliest age, and almost in every situation; and fourthly, it is never fatal. What more can be required to produce a general conviction of its superior utility? The method of performing the inoculation is, to hold the lancet nearly at a right angle with the skin, in order that the infectious fluid may gravitate to the point of the instru- ment, which should be made to scratch the skin repeatedly, un- til it becomes slightly tinged with blood. The operator must be cautious not to make the wound deeper than necessary, as the inoculated part will be more liable to inflammation, which may destroy the specific action of the virus. The most certain method of securing the infection is, to inoculate with fresh fluid from the pustule; but as this is often impracticable, it is advisable to hold the infected lancetover the steam of boiling water to soften the hardened matter. Where the virus has been procured upon thread, make a small longitu- dinal incision in the arm, and insert in it the affected thread, and detain it there by court-plaster, until the disease be com- municated. Matter may also be procured from the scab. The mode of inoculating from it is the same as from the fluid, taking care, however, previously to moisten it with tepid water, and to use the matter of the inner side of the scab. The scab will frequently retain its virus for months, provided it be kepUn a close box. 45 342 VACCINE DISEASU, OR COW-POX. The first indication of the success of the operation is a small hiflae.it'dspot wiierethe |uiucture is made, which i» very disiin- g'.ishahje about the tlgrd. fourth, or iiiiii dav. This i mtinucs to increase in size, becomes i-ard, and a .small circular tumor is formed, rising a little above tin level of the skin. About the sixth or seventh day the centre of the tumor shows a disco- loured speck, owing to the formation of a small quaniWy of fluid, which continues to increase, and the pustule to fill, until about the tenth day. At this tiiiie it shows in perfection the characteristic features which distinguish it from the variolus pustule. Its shape is circular, or somewhat a little oval, but the margin is alweys well defined, and never rough and jagged. The edges rise above the level of the skin, but the centre is depressed, and has not that phrnpness which marks the small-pox pustule. As soon as the pustule contains any fluid, it may be open d for future inoculation. About two dav s before, and two after the eighth day, making a period of four (hivs, is the season when the matter is found in its greatest activ ity. At the eighth day, when the pustule is fully formed, the effects on the constitution begin to appear. The general in- disposition is commonly preceded by pain at the pustule and in the arn-pit, followed by headach, some shivering, loss of appetite, pain in the limbs, and a feverish increase of pulse. These continue with more or less violence for one or two days, and always subside spontaneously without leaving any unpleasant consequences. Dining the general indisposition, the pustule in the, arm, which bad been advancing to matura- tion in a regular uniform manner, becomes surrounded with a circehr inflamed margin, about an inch or an inch and a half broad, and this blush is an indication that the whole system is afiVeted; for the general indisposition, if it occur at all, al- ways aC'oears on or before the time when the efflorescence hc- e.oi.ies visible. Aft"; this period, the fluid in the pustule gradu- ally dries up, 'ho surrounding blush becomes fainter, and in a ■l-»y or two dies away imperceptibly, so that it is seldom to he VACCINE DISEASE, OR COW-I'OX. 343 distinguished after the thirteenth day from inoculation. The pustule now no longer increases in extent, but on its surface a hard thick seal), of a brown or mahogany colour is formed, which, if not removed, remains for nearly a fortnight until it spontaneously falls, leaving tlie skin beneath perfectly sound and uninjured. The above is the progress of the vaccine inoculation in the greater number of cases, from the time of insertion to that of drying up of the pustule, with only the variation of a day or two in the periods of the different changes. The successive alterations, that take place in the local affection, appear to be more constant and more necessary to the success of the inocu- lation than the general indisposition. With respect to the lat- ter the degree is very various—infants often pass through the disease without any perceptible illness—with children it is ex- tremely moderate—and even with adults, its severity is but for a few hours, and then never dangerous. v:< ry little medical care is necessary to conduct the patient through this disease with perfect safetv, especially when chil- dren are the patients. Adults may take a dose of salts on the eighth day, which will be particularly useful in plethoric hab- its. In general, no application to the inoculated part will be required, unless the inflammation increase, and the pustule become painful; then the part should be kept moist with cold vinegar and water, or lead water, till the pustule be dried up. To conclude, much attention and discrimination are necessary in the vaccine inoculation, to ascertain whether the infection have fully taken, and whether or not, the disorder be complete and genuine. The regularity, with which the local disease at • the place of inoculation runs through its several stages, seems to he the principal point to he attended to; for the presence of fever is certainly not necessary to constitute the disease, since the greater number of infants have no apparent indisposition. Therefore, when the vaccine inoculation is fVJIowed by no local disorder, or only a slight redness at the punctured part, for a-day or two, we can have no doubt that tlie operation has failed. When the pustule advances in very hasty and irregu- 344 SMALL-VOX. lar progress, when the inoculated puncture on the second or third day after insert ion, swells considerably, and is surround- ed with an extensive redness, the premature inflammation vcrv clearly indicates a failure in the operation, even when the inoculation has advanced for the first few days in a regu- lar manner, but, when about the sixth day, instead of exhibit- ing a well formed pustule and vesicle of fluid, the part runs into an irregular festering sore, the purpose of inoculation is equally defeated, and these varieties require it to be watched with an attentive and experienced eve. since they might readily lead to a fa's >, and perhaps fatal idea of security againstany subsequent exp isure to small-pox. The circumstance, however, which most strii.ingly distinguishes the genuine from the spurious dis- ease, is t he appearance of the pustule. I n tin- genuine, the pus- tule has a well-defined elevated margin, with an indentation in its centre, rcsemhi'm ; a button mould. The spurious is either pointed like a small common abscess, or is rugged and irregu- larly formed, like an ordinary sore. Every otlier symptom, almost occurs in each disease. SMALL-POX. It would seem unnecessary to take any notice of the small- pox, after having treated so largely of its mild and merciful substitute, the cow-pox; but as that dreadful disease does sometimes find its way on board of ships and into country neighborhoods, sweeping whole families in its progress, it may be very proper to subjoin the following history of its symptoms and treatment. Symptoms. A few days prior to the attack, the patient complains of languor and weariness, succeeded by cold shiver- in gs and transient glows of heat, immediately before the fever, widch is accompanied by violent pain of the head and loins, and frequently, with a sev re oppressive pain at the pit of the stomach. The patient is very drowsy, and sometimes deliri- pf MALL-VOX. 345 ous. About the third day, the eruption appears like flea bites, first on the face and limbs, and afterwards on the body. From this period, the pustules gradually increase, and on the fifth or sixth day, will begin to turn white on the tops. The throat, at this period, often becomes painful and inflamed; and some- times on the seventh day, the face is considerably swelled. In the confluent, the spots assume a crimson colour, and in- stead of rising, like the distinct kind, they remain flat and run into clusters, and during the first days of the eruption, much resembling the measles, but of a purple colour. The flow of saliva is constant in this form of the disease, and be- comes so viscid as to be discharged with the greatest diffi- culty. Treatment. The cure of small-pox depends on the gene- ral principle of the antiphlogistic plan, especially in a free admission of cold air, which may be carried much further in this than in any other disease. Bleeding in the first stage of the disease, or when the pulse is full, may be allowed, but the use of cooling purgatives, with acid and diluent drinks, are in- dispensable. When the eruption makes its appearance in clusters of a dark red colour, the disease is more of a putrid nature, and consequently, instead of bleeding, requires a liberal use of bark and wine to invigorate the constitution, as directed in the nervous fever. [See Oak, Materia Medica.] But besides this general treatment, there are some symp- toms which require particular attention. Thus, when con- vulsions or great restlessness prevail, exposure to cold air, and a dose of laudanum a e enjoined. Wliere perspiration is much impeded, or deglutition difficult, blisters may be applied to the breast and neck; and gargles, such as recommended for sore throats, frequently employed. If the perspiration be ob- structed, the antimonial mixture may be used. When this disease finds its way aboard of a vessel, or into a family, all those who have not had it, should immediately be inoculated with the variolus matter, if the vaccine fluid -annot be procured. 346 Ml". \SLE?. The benefits which result from inoc illation arc great, as wc have an opportunity to prepare the system by abstinence from animal food, and by taking one or two purges of calomel and jalap before tbe eruption takes place. But. if the subject be of a weak delicate habit, a restorative diet alone will be more proper. In every stage of the small-pox, the bowels should be kept open,either by mild purgatives or clysters. Rv.gimex. The diet is to consist of vegetable substances, as arrow root, panado, milk, rice, &c, and when the eruption is completed, a more nourishing diet may be allowed. If the disease be of a putrid kind, wine, cider, perry, porter, or milk toddy, may be given freely. In this, as in all diseases connected with putrescency, tlie advantages arising fro n cleanliness, as well as from frequent ventilation of the chambers, arc so obvious, that to insist on them is unnecessary. [See JYervous Fever.] MEASLES. Tins disease is the effect of a specific contagion, and at- tacks persons only once in life. Symptoms. Alternate heat and chills, with the usual symptoms of cold. On the fourth day from the attack, erup- tions like flea bites arise on the face and body, and in about four days more, those eruptions disappear with the fever. The vtnent. When the disease is very slight, little more is necessary, than to keep the patient's body open with the cathartic mixture. But should the febrile symptoms run high, with difficulty of breatlftng, bleed, blister the breast, and give Dover's, or antimonial powders, the febrifuge mixture, or diaphoretic drops. [See Dispensatory.] The cough being MEASLES. 347 usually troublesome, it will be proper to take freely of flax- se d sirup, or some of the pectoral mixtures. Breathing the steams of warm water will also be neel'id, in relieving the Cough as well as the eyes. The water should be pat in a ba- son, and t'c head covered with a flannel large enough to hang over its edges. After the eruption is completed, the anodyne sudorific draught, paregoric, or laudanum, will be serviceable at bed time, to allay the cough. If the spots sud- denly disappear, immerse in warm water, or bathe the legs and feet, and give freely of warm wine whey, until the erup- tions return. The consequences attendant on the measles, are often more to be dreaded than the immediate disease, for although a per- son may get through it, and appear for a time recovered, still pulmonary consumption frequently arises and destroys him. Another had consequence of the measles is, that the bowels are often by them in a very weak state, a diarrhoea remaining, which has sometimes proved fatal. An obstinate ophthalmia, or affection of the eyes, will also ensue, if proper attention be not paid in managing the disease. Most of these disagreeable symptoms may be prevented by blood letting, and administer- ing emetics, cathartics, and diaphoretics, in the first stage of the disease. Should the symptoms manifest a malignant kind of the dis- ease, and a putrid tendency prevail, we must then adopt a vc- ry different m'ide of teeatm°nt from what has been advised for the inflan-matnry. Th cure ^ uct be conducted on the plan recommended for the nervous fever, and putrid sore throat. Regimen. The diet should be low an'l proportioned to the degree of fever. BarW,or rice water, flaxseed tea, or other cooling mucilaginous d?in; >. with i^'lies, as arrow root, gruel, sago. ckc. will, in general, he a'l that is necessary, un- til the feverish svmptonis are evidenflv on the dedmc. Much caution is necessarv, that the ^tt'ent he not smhVnly expos- ed to eo!d ai". which rpidd repel fhe eruption, and produce fatal effect^. * 348 CHICKEN. OR SWINE-POX. In this disease, an eruption much resembling that of a very favorable small-pox. appears after a very slight fewr. This eruption soon proceeds to suppuration, in which state It re- mains but a little time, before the disease terminates by the drying up of the. pustules, which seldom haves scars behind. As to the treatment, medicine is very seldom necessary, it being generally sufficient that the patient be kept moderately cool, and supplied with the diluent drinks and light food.— Should there be fever, a cooling purge, and afterwards, the antimonial powders or mixtures, may be employed. MILIARY FEVER Is now considered to be symptomatic, only, because it never appears contagious or epidemic. It sometimes attends febrile affections, as well as those of an inflammatory as of a putrid nature, but it seldom occurs in any, unless a hot regimen and sweat precede. The symptoms which attend, are restlessness, frequent sighing, fetid sweat, pricking of the skin, and an eruption of red small distinct spots, at first, confined to the neck, breast, and arms, but soon spreads over the whole skin, except the face. When these eruptions make their appear- ance, they must be treated according to the rules laid down under their proper heads. SCARLET FEVER. Symptoms. Chilliness, followed by a burning dry heat— the pulse frequent, respiration irregular, a dejection of spi- rits, great prostration of strength, and often a stiffness of the neck. The face and neck is at first covered with red spota^ SCARLET FEVER. 34G which soon extend over the whole body. A sore throat e;cne- rally comes on about the second or third day, but sometimes is wholly absent; however, a redness of the fauces in every case is conspicuous. This fever is distinguished from the measles by the eruption being less distinct and more like a red coloured effusion, and by not being accompanied by catarrhal symptoms. It is distinguished from Saint Anthony's Fire by the fever being more considerable at night than the former, and the swelling being scarcely observable. It attacks more frequently young children; whereas, Saint Anthony's Fire is mostly confined to adults, and is not attended with scarlet hue on the throat. This fever is evidently infectious, generally epidemic, and appears most frequently at the end of summer. Treatment. Give an emetic on its attack, and on the following day administer some gentle cathartic medicine.— The bowels should be kept in a soluble state, and nitre given in the patient's drink. The heat must be repelled rather than encouraged. And this is to be effected by cold affusions, which should be steadily applied. It is not enough to sponge the body once or again, but the cold water must be dashed against the patient repeatedly till the heat is subdued, and the process must be repeated as fast as it returns. In this dis- ease, cold water is peculiarly applicable; the heat being con- siderable, the determination to the head violent, and the de- bility alarming. We know no disorder which represses so powerfully the constitutional energy. Bark and cordials would appear peculiarly useful in this complaint from its ten- dency to putrefaction; hut if these are early employed they will be found to increase both fever and delirium, to check the perspiration, and to impede sleep. Where this disease is attended with malignant symptoms, its tendency is to the putrid kind of fever, and must be treat- ed accordingly. [See Mrvous Fever, and Putrid Sore Throat.] Regimen. The diet should be light, the liquors cold and acidulated with vegetable and mineral acids. The stools should be frequently removed, tlie linen frequently changed, t ■ i 350 ST. ANTHONY'S FIRE. and the room kept airy. The nurses should carefully wash themselves, and frequently change their linen. With thesq precautions, there is little danger of infection^ ST. ANTHONY'S FIRE. Symptoms. An inflammation on some part of the skin, attended with pain and heat; and when extensive, there is con- siderable fever, accompanied with drowsiness. Causes. Imprudent exposure to cold when tbe body is heated—bard drinking—and sudden stoppage of any natural evacuations. Treatment. When slight, it requires only that the bow- els be kept gently open, by an infusion of peach leaves, [Set Materia Medica] small doses of cream of tartar and sulphur, or the cathartic mixture, with small portions of nitre in the patient's common drink; but when the attack is violent, and the head affected, then, in addition to the above, bleed, batbe the feet in warm water, apply a large blister between the shoulders, sinapisms to the extremities, and give the saline or antiraonial mixture [See Dispensatory] with diluent drinks. The best external applications are flour or starch* gently sprinkled by a puff on the part, or in case of dryness and much heat, fresh leaves of the thorn apple, or cabbage leaves, stripped of tbeir stems and softened in boiling water, and re- new ed every two or three hours. Cold applications, as cloths wetted with vinegar and water, with the addition of a small quantity of camphorated spirits, has also been employed with great benefit and relief to the feelings of the patient. If, in spite of those means, ulcerations should take place, apply bark poultices, frequently renewed, or cloths dipped in the camphorated spirits, with the usual means <*f preventing mortification. Should the inflammation assume a purple co- BLEEDING AT THE NOSE, 351 lour, or the swelling suddenly subside, attended with internal oppression, anxiety and weak pulse, apply blisters or sina- pisms to the extremities, and give wine or warm toddy freely, to throw out the eruptions to tbe skin; and then it is to be treated as the nervous fever. Regimen. The diet should he low, and the drink chiefly of rice an. barley water, acidulated with tamarinds or the Juice of lemons. Prevention. Avoid the extremes of heat or cold, ab- stain from spirituous liquors, and keep the bowels regularly open. BLEEDING AT THE NOSE. In feb'ile diseases, accompanied with pain in the head, flushed countenance, and redness of tbe eyes, bleeding from the nose in general is salutary, and ought not to be checked, unless the patient is likely to be too much exhausted by it.— However, when this discharge is too profuse, the patient Should have his bead raised and exposed to cool air. Beside which, cold acidulated drinks should be used, and the patient should rather immerse his head in very cold water, or have cloths dipped in cold vinegar and water frequently applied to the nostrils, face, and back of the neck. A piece of metal, as a key for example, applied cold to the naked back, is a fa- miliar remedy, and often succeeds. If these should not prove sufficient, a pledget of lint dipt in strong alum water, or a powder composed of flour and alum of equal quantity, should be introduced into the nostrils, with sufficient force to com- press the orifice of the ruptured vessels. In addition to these means, give a dose of epsom or glauber salts, to evacuate the bowels, and from ten to twenty grains of nitre every hour or two, in a glass of cold water. Immersing the feet rn Sxi SPITTING of blood. warm water while the coxl applications are continued to the head, will also be found beneficial. One of the most powerful styptics which we can use, says Dr. Thomas, is powder of charcoal. It may be applied by means of tents, first moistened with water, and then dipped in this powder; but in slight cases, it will answer by being ta- ken like snuff. After the bleeding has ceased, the patient must be careful not to remove the tents of clotted blood, but should allow them to come away of themselves. SPITTING OF BLOOD. Wuen there is a discharge from the mouth, of blood of a florid colour, brought up with more or less coughing, preced- ed by a sense of tightness, weight, and anxiety in the chest, and attended with a saltish taste of the spittle, it is in conse- quence of a ruptured vessel of the lungs. Causes. Plethora—violent exercise of the lungs—and frequently a faulty conformation of the chest. Treatment. The most important remedy in this alarm- ing complaint, is blood-letting, which should be actively cm- ployed, paying, at the same time, attention to the state of the bowels. Spitting of blood, however, is sometimes owing to the contraction of the chest with debility; and in this case, the lancet must not be so freely used. Sedatives, particularly those which repress the activity of the circulation, are highly, useful. Of these, the chief are nitre and fix;-love. Mitre, in doses often grains, given every hour, in the coldest water, and swallowed while dissolving, is much to be depended on in the early stage of this disorder.— The tincture of foxglove exhibited in small doses every hour or two, by retarding the action of the pulse, will also prove SPITTING- OF BLOOD. 355 a most useful auxiliary in suppressing pulmonic hemorrhages, particularly in those cases where an inflammatary diathesis prevails. Whenever there is fixed pain in the chest, a blister applied to the breast or back will do much service. According to Dr. Rush, two tea spoonfuls of common salt, dissolved in a sntall quantity of water, and exhibited every two hours or oftener, will check this disease, as well as he- morrhages from the stomach and uterus. Astringents are frequently «resorted to, as alum, kino, and sugar of lead, but they are of little utility, except in the pas- sive hamoptyses, and even in these, nitre is often found pre- ferable. If the cough be troublesome, it will be necessary to have recourse to demulcents and pectorals, as advised under the head of cold. Sometimes a spitting of blood is produced in consequence of suppressed evacuation; in this case, it is not dangerous, and only requires remedies to restore the cus- tomary discharge. A spitting of blood may readily be distinguished from a discharge of it from the stomach, as, in the latter, the quan- tity is usually more considerable, of a darker colour,' and is generally unattended by coughing. Regimen. Alow diet should be strictly observed, and the fcody kept as quiet as possible. Nothing should be taken warm: flaxseed tea, barley or rice water, acidulated with the juice of lemons or elixir vitriol, ought to be used as common drinks, and taken as cold as possible. Prevention. Carefully avoid all exertions whish detain or which hurry the blood in its passage through the lungs, as singing, loud speaking, running, or lifting great weights. Obviate costiveness, by the occasional use of mild aperients, and use a spare diet. On experiencing any pain in the chest, blister, bleed, and constantly* wear flannel next to tbe skin. Swinging, sailing, travelling in an easy carriage, and rid- ing on horseback, will be the most appropriate exercise. 4. 354 CONSUMPTION. Symptoms. Those which mark its first stage, are a slight lever, increased by the least exercise—a burning and dry- ness in the palms of the hands, more especially towards even- ing—rheumy eyes, upon waking from sleep—increase of urine—dryness of the skin, as also of the feet in the morning- occasional flushing in one, and sometimes both cheeks- hoarseness—slight or acute pain in the breast—fixed pain in one side, or shooting pains in both sides—headach—occasion- al sick and fainty fits—a deficiency of appetite—and a gene- ral indisposition to exercise, or motion of every kind* Tbe first appearance of this disease will vary in different cases; but the most constant symptoms which characterise it, are a cough and phlegm resembling matter, of which, at length, it becomes entirely composed. This disease often attacks insidiously, and is chiefly con- fined to the young, the fair, with light skins and blue eyes, florid complexions, contracted chest, and high shoulders. In constitutions disposed to hectic, the fingers are often long, and the nails bent; they grow rapidly, but seldom expand in breadth and bulk. From the age of twelve or fourteen, to tbat of about thirty-five, 'S the hectic period: more generally from sixteen to tweenty-four; and the tendency seems to re- turn about forty-five or fifty, especially in women at the peri- od of the cessation of the catamenia. At the age of fourteen or sixteen in each sex, while the genital organs are evolving, there is often a considerable debility and irritability. The debility in females is often formidable, and a slight cough is no uncommon attendant. The cough is either quite dry. or accompanied with an expectoration of a small quantity of a thin frothy matter, which differs from that of ti*ue catarrh, in being easily diffusible in otlier fluids. Sooner or later, the general health becomes impaired, and at length, the fatal hec- tic makes its appearance with little suspicion; all the symp- toms being referred to the great change that then takes place. CONSUMPTION. 355 No diagnosis can arise from the existence of fever, since in the chlorolic state, coldness, with occasional flushing, are not unfrequent. In general, however, the fever of phthisis attacks more pointedly in the evening; that of chlorosis in the morning. The appetite of hectic patients is best in the fore- noon; of chlorotic at night; and the latter can eat meat sup- pers frequently with impunity. It sometimes occurs that persons who have been improper- ly treated in the venereal disease, have symptoms which as- sume the form of consumption; but, in general, tie chest is free, while pains are more violent at night, and more fre- quently in the middle of the bones of either extremity, or deep seated in the head, than in the trunk. It has also seldom pro- ceeded so far as to mislead, without showing its nature by eruptions, or by an affection of the throat. From the state of mind, we may draw some distinction; for cheerful hope il- lumines every hour of the hectic; despair darkens each mo- ment of the syphilitic patient. Strange as it may appear, amidst all the horrors of this disease, the patient's hopes are seldom abandoned, and even increase, as the fatal termination advances. Causes. Obstructions and inflammation of the lungs, de- pending most frequently on the existence of small tubercles in the substance, which, coming to suppuration, burst and discharge a purulent matter. Sometimes, it is induced by a general affection of the system, and sometimes it is a conse- quence of other diseases, as cold, measles, small-pox, pleuri- sy, &c. &c. Treatment. This must be varied and adapted to each «tage and case of the disease. In the fi rst or inflammatory stage, moderate bleedings, twice or thrice a-week, according to the force of the pulse and habit of the patient, are essen- tial, aided by blisters to the breast and back, and employing, at the same time, a cooling regimen. In almost every species of the disease, blisters or issues are often a means of relieving the cough; for even when they have .356 tfONsuMrriofti no tendency to remove the stimulating cause producing cough, as when it arises from a tubercle, yet they diminish the effect of the stimulus. They are particularly useful in that period of the disease, when a catarrhal has a disposition to degener- ate into a phthisical affection; for in that modification of the disease, derivation from the lungs is of the utmost consequence. By this means, a change may often be affected in that state of suppuration which takes place from the internal mem- branes of the lungs, and the purulent discharge may thus be converted into the natural mucus. Among other remedies in consumption, the use of emetics is strongly rec nnmended. By the action of vomiting, the blood is propelled to the extreme vessels in everv part of the body, particularly to the extreme vessels of the surface. Thus, there is produced a derivation from the lungs, and a conse- quent; change in the state of separation at that part of the sys- tem; but they are chiefly useful in consumption, as obviating symptoms, particularly cough and difficulty of breathing, and by promoting expectoration. A considerable variety of medicines of the refrigerating kinds have been strongly recommended for combating con- sumption in its incipient state. They tend to diminish the impetus of circulation, and although they do not immediately remove a plethoric state, yet they perhaps tend to diminish the inflammatory diathesis even more effectually than the re- peated blood-lettings. The cooling neutrals through the whole course of the disease, are useful; particularly nitre, which may be advantageously taken in any period of the com- plaint. Demulcents are always indicated, and usually em- ployed in the manner we have recommended under the head of cold, to sheath the fauces and lessen the violence of cough. Gum-arabic held constantly in the mouth, will also be found extremely useful in relieving this distressing symptom. Of all the remedies which have of late been fashionable in consumption is the fox-glove, [See Materia Medica] but it does not seem to merit all the praises which has been given it lender proper management the fox-glove'produces a slowness of the pulse, not perhaps to be obtained frem any other medi- CONSUMPTION. 357 «»inc yet discovered. And it has been the opinion of some, that, by reducing it to the natural standard, from the employ- ment of digitalis, consumption may be overcome. But it should be observed, that the quicknessof pulso in this disease is merely symptomatic, and that the reduction of it, even he- low the natural standard, can have no effect either in remov- ing a tubercle, or in healing an ulcer in the lungs. Hence, on this ground, it is in vain to expect a radical cure from its isc* However, as a diminution of the celerity of the pulse will somewhat alleviate the hectic fever, it may, in certain cases, be employed with advantage. The most eligible mode of using the fox-glove is in a tincture, begiuuing with the dose of ten drops, and gradually increasing it to sixty to an adult, morning, noon, and night. In exhibiting this medicine, it should not, however, he given in such doses as to induce much sickness. Among other active medicines, recourse is frequently had to mercury, but unless consumption was excited by a vene- real taint, we have never witnessed benefit from this medicine. On the contrary, when mercurial salivation is produced in tbe genuine consumption, it has uniformly hastened the death of the patient. Iceland, liverwort, or moss, has been, of late, biglly extol- led as ajremedy in this complaint that readily allays cough, facilitates expectoration, abates hectic fever, and quiets tlie system without constipating the bowels. It is likewise said to strengthen the organs of digestion, without increasing the action of the heart and arteries. Indeed, the physicians oF Europe have spoken so loudly in its praise, that every patient ought certainly to give it a trial. The most approved method of using it, is in the form of decoction; one ounce of the herb to a quart of water, boiled for fifteen minutes over a slow fire, to wlfith two drachms of sliced liquorice root may be added about five minutes before it is taken off. A tea cupful of this decoction should be taken four times a-day. Another form is by boiling two drachms of the herb in a pint of milk for ten minutes, and taking it for breakfast aud s pp*r. If choco- late be preferred, it may be blended with it, by making the 47 ■ 3J8 Uw.NSiL VIMION. chocolate with a decoction of ihe moss, without the liquorice. as above directed. " Of all our indigenous plants, the Indian turnip [See Materia Medica] has the highest reputation as a remedy in consump- tion. It is evidently an active expectorant, and maybe use- ful in tbe latter stage of the disease. In the treatment 6f this disease, balsamic medicines are frequently resorted to. They are totally unsnited t© the in- flammatory state of any one of the complaints of the lungs, whether acute or chronic. Action having b en sufficiently , subdued by depletory measures, they may be safely and ad- vantageously administered in catarrhal consumptions and pro- tracted coughs; and will be found particularly useful when expectoration is checked from debility, and a want of irrita- bility of the glands. So opposite are tbe states of the lungs in catarrhal affections, that it requires essentially different substances to produce expectoration. It may be repressed or imperfectly performed, by a constriction of the lungs, and by the removal of which, an infinite degree of relief is often af- forded. It is also apparent that the lungs occasionally, from extreme debility, pour out an excessive discbarge, and that by direct stimulation of the exhalents, the effusion is abated and oppression removed. The advantages of the vegetable balsams, as they have been called, were supposed to consist in their power of promoting the healing of wounds and ulcers. At one time, man* of them were highly extolled in pulmonary consumptions; but each have had their day of fashion, and have each fallen into deserved neglect According to tbe testimony of Drs. Dun- can, Simmons, and otlier eminent physicians, gom-myrrh, ex- hibited in doses of twenty or thirty grains thrice a day, united with an equal quantity of nitre, has, in many instances, been employed with the best effects in this intractable disease. While, for csolvtog tubercles or healing ulcerations in the kings, many medicines have been taken internally, sunn* modes of rure have been recommended with the view of act- * ■ fag topically on tho diseased parks. In this way, different CONSUMPTION. 359 articles have been directed to be inhaled into the lungs, under the form of vapor. In an inflammatory state of the bron- chial glands, warm watery vapor maybe useful, and vinegar has occasionally been added; but it seems often to irritate the cough, and tbe more stimulant vapors are evidently injuri- ous, except wliere expectoration is difficult and deficient. In cases w here the accumulations of the chest arc owing to de- bility of the lungs, or arr retained by the vicidity and tenaci- ty of the matter, sulphuric aether is strongly recommended; and we are told, upon the high authority of Dr. Pearson, that its powers are improved by several substances whicli are solu- ble in it. Hemlock is particularly praised, half a drachm of whioh is to be digested in an ounce of aether, for several days, so as to form a saturated tincture. Of this, two or three tea? spoonfuls are to be put in a wine glass, to be held up to the mouth, and inspired till the whole is evaporated, and lepeated several times in the day. Similar in its effect to these inhalations, is the practice of smoking tobacco, the stramonium and other substances. With the same views, tar fumigations, according to a dis- tinguished Russian physician, Dr., Crichton, of Petersburg, have been employed, and, is said, with triumphant success. The mode he recommends for doing this, is, to put the tar in an earthen vessel over a lamp, or heated iron, so as to cause a volatilization till the air of the room is sufficiently impreg- nated, and this process is to he repeated three or four times a-day. Having stated the remedies which have been most highly. recommended in consumption, and from which, when proper-' ly adapted to the circumstances of the case, there is the best chance of recovery, we will conclude with aftw remarks on the means of obviating urgent symptoms. It is a fortunate circumstance, that even in those diseases where the prospect of recovery is the most faint, and where there is next to certainty of an approaching dissolution in no long time, we still have it in our power to protract the period ^ life, and to alleviate the distress of the patient. In many v« 360 CONSl.Mll'lON. cases of this terrible disease, it is all that we can reasonably expect to accomplish. Although colliquative sweats are not productive of pain, yet they tend very much to debilitate the patient, and by the loss of strength, the chance of roci very is verv much dimin- ished. Hence the ncccssdy, in suchcases, of giving some to- nic, as the elixir vitriol or infusion of baik. In every instance of consumption it is of importance to prevent costiveness, and it is always a desirable circumstance to keep tlie bowels in a soluble state which should be obtain.. ed rather by diet than medicines. But when diarrhuu occurs spontaneously, this should in like manner be restrained by shunning the uso of those articles which are observed to in- crease it, and by employing what are i'.,und to moderate ii. Of all the symptoms which require to be mitigated, there is none which more frequcutly demands attention, than the cough. For this purpose an almost infinite variety of aiti- des, either of the demulcent or sedative kind, [See Cold] may be employed with advantage. But of these substantives, af- ter the inflammatory symptoms have been subdued, none is so useful or so powerful as opium. This article, however, valuable as it is, cannot be considered free from inconveni- ence. There arc some individuals with whom, from peculi- arity of constitution, it always disagrees, producing confu- sion in the bead, vertigo, sickness at the stomach, and vari- ous other distressing symptoms. Hence recourse has been had to a variety of other sedatives, both with the view of al- laying inordinate action, and of procuring sleep. Of all the substitutes for opium, none, according to the testimony of one of the. most celebrated and distinguished physicians in Eng- land, Dr. Duncan, equals the preparations formed from the common garden lettuce. [See Materia Akdica*] It has been supposed, that by the continued use of opiates, they might allay irritation,,and contribute to the great object, the healing of the nicer. They have, however, failed in this view, though we cannot refuse their employment to lessen pain, aud keep up the calm serenity, the pleasing delirium. hi the midstof distress, and a state hopeless of relief. * CONSUMPTION;. 361 From what has been said of the principal remedies recom- mended in consumption, the reader will find but little encour- agement to indulge a hope of relief. He will probably ex- claim, is consumption then never cured? Whence can arise the confident promises which every newspaper offers, and which the most respectable authorities confirm? The decep- tion arises from two sources. Catarrhal complaints are, in many instances, confounded with consumptive, and the most experienced eye is occasionally deceived. In some cases also vomica} are completely evacuated by expectoration, and the wound heals. So insidious is the attack of consumption, that it has often been taken for catarrh, and on the contrary, so violent is often a catarrh, that it has been pronounced to be truly phthisical, by practitioners of judgment and experience; nor has the delusion been destroyed but by expectoration.— From such errors it is not to be w ondered that so many medi- cines should have gained credit in the cure of consumption. To say, however, that this disease is never cured, would cer- tainly appear rash; for instances have occurred in which a recovery has been perfected by nature; but they are so few, that they can scarcely inspire hope. Regimen. Perhaps a greater number of cures in con- sumption have been effected by regimen than by medicine, es- pecially if under this head be included, not merely diet, but air, exercise, aud similar circumstances. It has been but too common to prescribe the same diet in every stage of tbe disease, which has been attended with the most pernicmus effects, and has often hastened the death of the patient. While the Brunonian fed his patients to avoid • debility, the other practitioners carried, apparently, their anti- phlogistic system too far. In judging of that diet which is best suited to phthisical patients, due attention must always be paid to its effects upon the system. While a considerable discharge by blood-letting is requisite, it is certainly proper to avoid those articles which can furnish a large supply of rich chyle, even, although they should be, like milk> of the • 362 CONSUMPTION. very milder nature. But after suppuration t.ihes place, and there is a free discharge of purulent matter, the antiphlogis- tic plan should be pursued no further; on the contrary, a more nutricious diet is essentially necessary. The healing of tuberculous ulcers in the lungs, as well as of scrofulous sores at other parts, is only to be expected from recruiting and giving vigor to the system. In this state, of the disease, there- fore, a nutritious diet is naturally indicated; and indeed the evident marks of exhaustion point out the propriety of a due supply. Besides these particulars, a liberal and nutritious dttt is often manifested in this stage of the disease by the feel- ings of the patient, for it is, by no means, uncommon to ob- serve even a craving for animal food; and it may be remarked, that in very rare instances only are such calls of nature en- tirely to be neglected. The diet in the inflammatory state of consumption should. be light, and composed of articles that tend to correct acri- mony, and diminish inflammation, as milk, butter-milk, rice- milk, arrow root, sago, fruits of every kind, and vegetables. In the advanced stage of the disease, and when the pulse is weak, a more cordial and stimulating diet, and strengthening remedies are necessary. To prevent weakness, and other ill effects of an empty stomach, patients should take frequently of meat, with wine, porter, or toddy: raw oysters are thought to be peculiarly proper. With this cordial diet, tar pills, bark, and elixir vitriol, or an infusion of the inner bark of the wild-cherry tree, or hoarhound, and hitters of all kinds, have been exceedingly useful in this state of consumption. Air and situation are apparently objects of considerable im- portance, in a disease where medicine must confess the utility of her resources. Change of air is among the remedies con- stantly recommended; and to change is often professedly the only object. Exercise, when not carried to fatigue, in a dry country air, often does more good than medicine, and, consequently, should always be takem INCONTINENCE OF URINfi, 868 Long journies on horseback, are the most effectual modes of exercise, carefully avoiding night air, and the extreme heat of the day in summer. That exercise he not carried to fatigue, patients should travel only a few miles a-day at first, and gradually increase the distance as they increase their strength. Wheu exercise on horseback cannot be supported, sailing and swinging should be substituted, and no efforts to cheer the spirits, or innocently to amuse the mind, should be neglected. Great care should be taken to regulate the dress accoroS ing to the changes of the weather. The chest, in particular, should be defended from the cold, and the feet from the damp*, In the various stages of this disorder, the bowels ought to be kept moderately open by emollient clysters, or the mildest 9 laxatives, if the diet should not have the desired effeets. INCONTINENCE OF URINE. Symptoms. An involuntary evacuation of urine. Causes. A relaxation of the sphincter of the bladders- injuries received about the neck of the bladder—pressure of the womb in a state of pregnancy, &c. Treatment. When the disease proceeds from a relaxa* tion of the sphincter of the bladder, a large blister to the os sacrum or lowermost part of the back-hone, will be found- highly beneficial, and often effects a cure in one or two days.^ The cold bath, or dashing cold water upon the genitals^ and tonic medicines, as the nitric acid, lime water, hark, steel, and columbo, are peculiarly proper in obstinate cases of this kind. The tincture of cantharides, in doses often or twelve drops, every three or four hours, is said, by Dr. Morton, to be a specific in this complaint. Others recommend alum whey, made as strong as the stomach will-bear if. and direct 3o4 DH-TICII.TY OF l/KI.NE. a half pint to he taken night and morning. With others, tho blue vitriol, in doses of half a grain, given twice a-day, in any agreeable liquor, is most to be depended on. The occasional use of rhubarb, in small doses, to keep the bowels easy, tends greatly to alleviate the affection. When it Ls produced by an impregnated womb, little more can be done than observing a horizontal position as much as possible. DIFFICULTY OF URINE. When there are frequent uneasy urgings to void urine, and it is discharged with difficulty and pain, the disease is called a strangury; and when it is totally retained, is called a suppression ofurim. Causes. It arises from a variety of causes, as calculous concretions—obstructions in the uretlir.i—ihst'is—or the tincture of cantharides, taken internally too freely—wounds, bruises, tec. m Treatment. The cure must greatly depend on the cause. If the pulse be full and feverish, bleed and procure stools by emollient clysters and cooling laxatives, such as castor nil, or the cathartic mixture. [See Dispensatory.]— Much dependence is to be placed in the free use of demulcent drinks, as barley water, flaxseed tea, mucilage of gum-arabic, tdecoction of marsh-mallows, of parsley roots, or of water- melon seeds, especially if the affection be owing to the can- tharides, or any injury of the bladder. One of the camphor- ated powders, [-See Dispensatory] given every three or four hours, in the patient's common drink, often effects a cure.— Gr. at relief will he obtained from the warm bath, used often- er or scldomer as the case may require, or sitting in a tub of warm water, or from the frequent applications to the belly, of DIFFICULTY OF URINE. 365 •loths wrung out of hot vater, or bladders half filled with it. Opiates are very serviceable, but should never be used in the height of fever. A starch clyster, with laudanum, has very frequently given immediate relief. Cooling laxatives and diuretics, which oper:te without any stimulus, particularly the epsom or glauber salts, as in the form of the cathartic mixture, often relieve. As a diuretic, the following mixture is considered most salutary. Take, of sweet spirits of nitre, one ounce, laudanum and antimonial wine, each, two dracl ms, a table- spoonful of which may be given in some diluent drink, and half this quantity repeated every hour, if necessary. In the chronic stranguary, after other means have failed, the use of calomel in small doses, or mercurial ointment rub- bed into the thighs every night till a slight ptyalism ensues, has frequently effected a permanent cure. In such cases an affection of the prostrate gland may be suspected to have been the cause. Walking on a cold wet floor, perhaps dash- ing water against the legs and thighs, would, in obstinate cases, succeed in procuring a discharge of urine, as it has done the discharge of the faeces. When a suppression of urine arises from partial palsy, as frequently occurs in the old and debilitated constitutions, our best chance of success, in giving temporary relief, is to give the spirits of turpentine in pretty large doses, make use of general stimulants, and apply a large blister to the loins. When this complaint is in consequence of calculous concre- tions or gravel obstructing the urinary passages, which may be known by pain in the loins, sickness at the stomach, and sometimes a discharge of bloody urine, an infusion of wild carrot-seed sweetened with honev, as also the infusion of peach leaves, [See Materia Medica] have been found exceedingly beneficial. The infution of hops, .which is considered a sol- vent of the stone, administered in doses of a wine-glassful, and taken to the quantity of a pint daily, is said to be an ex- cellent remedy in calculous affections. The uva ursi, is like- 48 *ri6 DIFF1CI l.TY OF URINE. Wise celebrated as a remedy in cases of gravel, in doses of five griins with half a j^iin of opium, thrice a-day. A more pow- erful medicine, however, for gravel complaints, is tbe caustic alkdi, or soup-lees. [See Dispensatory.] b-1 being of an acrid nature, it ought always to be given in mucilaginous drinks, and commenced wit'i small doses, which should brgrad' ally increi's> (1 as far as the stomach can bear, and continued for a longtime, particularly if there should be an abatement in the svmptoms. When great pain attends a suppression of urine, and the bladder is full, which can be ascertained by feeling it above the os pubis, and on pressure creating pain in the neck of the bladder, or at the cud of the penis, it will be necessary to have recourse to the catheter, or a hollow bougie for drawing off the water. The larger sizes of each are more easily in- troduced than the smaller, as they are not so liable to stop in the corrugations and foldings of the urethra, which occurs in elderly men. It is easy to introduce the catheter into 'he fe- male bladder, since the, direction of the urethra is nearly straight; but in males there is greater difficulty. The cele- brated Heister directs the man to lie on his back, and the ope- rator to take the penis in his left hand as he stands on the pa- tient's leftside, reclining the penis towards the navel, then he is to introduce the catheter, thoroughly oiled, with its concave part to the belly, in the urethra, so far as the os pubis, and so thrusting it under the symphysis of those bones, and mov- ing tlie bands gently outwards, forces it into the bladder. In the following rases, this instrument cannot be used.— When the neck of the bladder is greatly inflamed—when a scirrbosiiy or preternatural tumor of the prostrate gland or stone obstructs the passage—when the uterus is remarkably prominent and pendulous over thepubes—or when t^e uterus is retroverted, in whicli state it drags the bladder upwards and back wards. When the application of blisters causes a difficulty of urine, wash tie blistered part frequently with warm milk and water, «r apply sweet, oil. in children, a suppression of nrine is of- HEMORRHOIDS, OR PILES. 36* len relieved by a poultice of raw onions or radishes applied to the bottom of tire belly. Regimen. During the violence of this complaint, the lightest diet only should be used, and mucilaginous drinks taken freely. Those who are often afflicted with it, ought rare. fufly to avoid aliment hard of digestion, flatulent, or of a heating nature. HEMORRHOIDS. OR FILES. When there is a discbarge of blood from the hemorrhoidal veins, it is called the open or bleeding piles; and when, instead •f this hemorrhage, there are painful tumors at the lower part of the rectum, it is called the blind piles. Causes. Costiveness—strong aloelic purges—much ri- ding—or sedentary habits. Treatment. If the patient be of a full hab:t, bleed, keep the bowels gently open with epsom salts, the cathartic mix- ture, cream of tartar and sulphur or molasses and water; and avoid violent exercise, high seasoned dishes, and every thing of a stimulating nature. Topical applications, as cloths wrung out of cold vinegar and water, or lead water, are also useful, and should not be omitted in either case. When the piles are of the bleeding sort, and will not readily yield to the above means, apply cloths dipped in charcoal powder, or in a strong solution of white vitriol or alum, frequently to the fundament, or anoint the part with the hemorrhoidal ointment [See Dispensatory] and endeavor to restore the tone of the ves- sels by the use of bark, elixir vitriol, nitric acid, or tincture or rust of steel. When the disorder assumes a chronic form in the more advanced periods of life, or when the piles do not bleed, they are generally attended with considerable pain, in whicli case, dossils of lint dipped in olive oil may be applied, or olive oil with an equal portion of laudanum, may be spread < 368 HEMORRHOIDS, OR PILES. on soft rags and retained by the T bandage. In addition to this mode of treatment, when the tumors are very painlul, it is necessary to^it over the steam of hot water, which seldom fails to produce immediate relief. The poke-weed [See Mate- ria Medica] has in some instances been employed with good effects. The balsam capivi, in doses of a tea spoonful night and morning is said to be useful in relieving the pain, and will sometimes effect a permanent cure. According to Dr. Thomas, tbe tincture of fox-glove, given in pretty large and frequent doses, is a remedy both for the external and internal piles. When the tumors will not yield to the external applications above recommended, anoint them night and morning wit" the m« rcurial ointment, to which may be added one-fourth opium. If the blind piles encompass the anus so as to prevent the discharges by stool, and prove otherwise troublesome, the largest may be removed by a ligature. If the distend vein is high and inflamed, it may be opened with a lancet. When from long continued piles a fistula is apprehended, Hard's paste is sometimes useful. It consists of a pound of elecam- pane root, with half as much black pepper, and a pound and a half of fennel seeds, made into a paste with honey. Per- haps the remedy of the honorable John Taliaferro, for whit- low, might he useful in this case. When the piles are apparently continued from relaxation, two drachms of the tincture of steel, with nearly the same quantity of laudanum and four ounc« s of barley water or thin starch may be injected as a clyster, morning and night. Prevention. Those who are subject to this distressing tomplaint, may he assured of preventing its recurrence, by keeping the bowels in a soluble state, with the occasional use •f sulphur at bed-time, by washing the fundament night and mnrnine: with the co'dest water, and by making use of a sponge absorbed with cold water, after obeying the calls of nature. 369 DYSENTERY, OR BLOODY FLLX. Symptoms. A discharge of mucus by stool often bloody — violent gripings—pain in the loins—a constant inclination to go to stool, without being able to void any thing; and some- times fever. Causes. Putrid air and aliment—green fruit—strong ca- thartics—obstructed perspiration, and whatever increases the natural irritability of the intestines. Treatment. To conduct the patient safely through this disease, the bowels should be evacuated by calomel, castor oil, or the cathartic mixture, and if the patient be of an inflamma- tory disposition, or there be febrile symptoms, blood-letting will also be required. After the acrid contents of the sto- mach and intestines have been evacuated^the anodyne sudor- ific bolus or draught [See Dispensatory] may be given at bed- time; and on tbe following day, if there be no evacuation of a natural appearance, one* or other of the above aperient medi- cines must be exhibited in small doses, until the desired effect is obtained. To produce a natural evacuation daily, is a circumstance of the greatest importance in this disease, and should, at all times, be kept in view. To neglect this, as my good old friend, Doctor Henry Stevenson, of Baltimore, used often to say, would be like "Locking t ve thief in the home, to do all the mischief he could." It is sometimes proper, instead of bleed- ing, to give an emetic in th'1 beginning of the disease, to per- sons of weak habits; but where there is a great degree of ir- ritability of the stomac's, or obstructions of the liver, vomiting will d<> more harm than good. It is my us a! 'Tactile, at the commencement of this com- plaint, to adm'i.ister to adults about a scruple of calomel, con- joined with five or six grains of ipecacuauha, or a grain of 370 DYSENTEKY, OR BLOODY PM'X. tartar emetic, and in a few Imurs afterwards, or if the medi- cine be taken at bed-time, on the next mornim;, to give a small dose of epsom salts or castor oil. With children, calomel, in large doses, united with a small portion of ipecacuanha, are the principal medicines I employ, as it is difficult to prevail on thrni to swallow either the salts or castor oil. This mode of practice, together with a plentiful exhibition of arrow rot, the occasional use>y the discharge. A soft pulse, and moist skin, are the chief signs of the good effects of the remedies employed, and of a certain amendment. When the disease is epidemic, after having premised the necessary evacuations, calomel is most to be depended on, in doses of four or five grains, combined with Dover's powder, the anodyne sudorific bolus, or with one or two grains of opi- um alone, exhibited every night. And when tbe calomel does not produce a natural evacuation, it is always proper to give a small dose of epsom salts, castor oil, or one or two wine glasses of the cathartic mixture, every morning, until the disease begins to yield. If acidity prevails in the stomach and intestines, as mark- ed by oppression, heat, sour belching, and vomiting, and ex- coriations about the fundament, besides a liberal use of mu- cilaginous and sheathing drinks, a wine-glassful of the absor. bent mixture, [.See Dispensatory] or a spoonful or two of new milk and lime water, should be givn every two or three hours. Frequent injections of cold water alone, or flaxseed tea, or barley water, with a table-spoonful of laudanum, are of in- finite service when the pain in the bowels and tenesmus are distressing. DYSENTERY, OR BLOODY FLl X. Sy\ In obstinate cases, or wheif there is the least apprehension of an inflammation of tbe bowels, the warm hath or local fo- mentation to the belly, and afterwards, a blister, are indis- pensable. At the close of the disease, or when it indicates symptoms of a putrid nature, the charcoal, coluv.ibo, hark, and wine, arc the appropriate remcdiis; and as a purge, rhu- barb may be employed. (hildren that have been very much emaciated by this disease, have been most wonderfully restor- ed to health, by bathing them night and morning in a strong decoction of oak bark [See Materia Medica,] impregnated with whiskey or common spirits, and by putting on them hark jackets as advised in the ague and fever. Doctor Mosely, a physician of great celebrity, states, that in chronic dysentery, unattended with fiver, there is not a more efficacious medicine than the vitriolic solution, [See Dis- pensatory] in doses of a table-spoonful every morning, with an opiate at bed-time. In preparing this solution, the proportion of either the vi- triol or alum may be increased or diminished according to cir- cumstances; that is, when evacuations are required, the quan- tity of alum may be diminished, or entirely omit'ed, :»nd vvlen great astringency is required, the quantity of alum is to be in- creased, and the vitriol diminished. A simple, though efficacious remedy in this disease, is a so- lution of common salt in vinegar or lemon juice, termed anti- dysenteric mixture. [.See Dispensatory.] This medicine has also been strongly recommended in bilious fever, or putrid sore throat, when the bowels are in an irritable state. Dew- berry is likewise a valuable medicine in this distressing dis- ease. [See Materia Medica.] Regimen. In the violence of this disease, the diet should consist only of arrow root, sago, panado, or gruel, and the drinks of a cooling and sheathing nature, as barley or rice water, flaxseed tea, or mucilage -of gum-arabic, or sassafras. [See Materia Medica.] But when the disease has existed some time, the diet should he m«re nourishing, particnlarly if tlie 372 DYSENTERY, OR BLOOHY FLUX. patient has been weakened by preceding disease, or is either of a tender or an adv anc< d age. Orange*, and w liatever rip* fruit the season affords, may he allowed. The room should be constantly fimigatcd with vinegar, and well ventilated. Tbe clothing, as well as the bedding, outfit to be often remwd, and all off oisiv • odors, particularly the faces, should be removed as speedily as possible. Prevention. The same means of prevention are hereto be usi'd, as under the head of bilious fever, and as this disease becomes infectious, by neglect of cleanliness, its further pro- gress through the medium of bad air, may he checked by at- tending to themoile of purifying that element prescribed under the head of nervous fever.* * It was this disease, which carried from che honors of this, to the glories of a better world, the illustrious ainhor ol the Declaration ot Independence, Thomas Jkfhkrson. His disorder assumed a ser.oua character on the 26th of June, 1826. The stienpth ol his constitution and his freedom from pain, for a short time, encouraged the hope that h s illness was merely temporary. He himself, however, felt the con- viction, that his last hour was approaching. He had ah eadv lived be- vond the limit"'ordinarily ass.gned inhuman existence, and, for some months past, he had looked forward to its termination, with a calm ness and equanimity worth v of Ins past life, nunc dimitais, dom.na, &C. "Lord now lettest'thou thy servant depart in peace, the beautiful eiaculation of the h.st and devour-'Hebrew, w*s his favorite quotation. On the 2d of July, "tlie complaint le»> him; hut his physician expressed fears that his strength might not prove sufficient to restore him trom the debilitated state to which he was reduced. Conscious thai he ,hould not recover, and free from pain, he calmly gave directions re- lative to his coffin and interment, which he requested might be at Mont.cello, without pomp or parade On Monday the following day, hemquired. with much solicitude, of those around him, what was the dav of them, nth? On being told that it was the Sd day of July, he eaLrlv exm^SSed his desireShat he might be permitted to live yet a nXwhile, to breathe the air ot the fiftieth Anniversary His desire was eratified. He was sustained up to the very moment when his wfshL were complete, and was then borne to that world, where the Trein heart meet their God. Of Mr. Jefferson's public virtues and services, X "were superfluous for the author to speak History has Sen chance of then. His excellent and amiable life, his warm and unvanineTtacl ment to hi, friends, his liberal aud unaffected hos- oTaS and Ms singular moderation and equanimity are ate known toaUandbvall, and held in pleasing but mournful remembrance. Sone was evxr more illustrious in life; none was ever more happy in dCOn the same day died the venerable compatriot of Mr. Jeftr«on. the Ex-President, John Adams. Mr. Adams telt the gradua . relief is obtained by the use of the bath, mild laxatives, and opium in more than usual doses. A small portion of opium, combined with the lead, [See Dispensatory] will generally ob- viate or correct its unpleasant operation. The good effects of nitrate of silver, commonly called lu- nar caustic, cave also been attested by eminent physicians, in doses from one-fourth, very gradually increased to a grain, twice f.~day, made into pills with bread. The flowers of zinc have likewise been highly spoken of, and are said to have , performed permanent cures, in doses of six or eight grains, morning and night. As there is incontrovertible evidence, that these medicines have succeeded in certain cases, they are all deserving of a fair trial, particularly in the treatment of a disease in which no plausible remedy should be left untried. FAINTING FITS. Symptoms. The pulse and respiration suddenly becomeb exceedingly feeble, insomuch, at times, as to create a fear of the total extinction of life. Causes. Fright—long fasting—large evacuations—debil- ity, &c. Treatment. The patient should be placed in a reclining posture, and every part of the clothing, which by its tight- ness is likely to interrupt the free circulation of blood, must be immediately loosened. The doors and windows of the room, especially if the weather be warm, should be kept open, and no more persons admitted than are necessary to give assis- tance; and these should not prevent the free access of the air to thp patient. Sprinkle the face with cold water or vinegar, and apply vo- latile, burnt linen, or feathers, to tlie nostrils; and that the stimulus may with more certainty be inhaled, the patient should be kept from breathing through the mouth, by holding ahand- kerchief forcibly against it, taking care, however, to leave the nostrils perfectly free. 377 HYSTERIC FITS. This disease more frequently occurs in the unmarried or barren women, and those who lead a sedentary life. It very seldom appears before the age of puberty, or after the age of thirty-five years. The time at which it most readily occurs,, is that of the menstrual period. Symptoms. Generally commences with universal lai.guor and coldness of the extremities. The colour of the face is va- riable, being sometimes flushed and sometimes pale. The pulse becomes unequal and obscure. The stomach is some- times affected with vomiting, the lungs with difficulty of breathr ing, and the heart with palpitations. A painful sensation is often felt, like that of a globe or a hall in the left side of the belly, advancing upwards, and producing the same uneast -ss in the stomach, from which it rises in the throat, occasion ig by its pressure, a sense of suffocation; when a degree of faint- ing comes on, certain convulsive motions take place, agita- ting the trunk of the body and limbs in various ways; «fter which, alternate fits of laughter and crying occur, and a re- mission then ensues. In some patients, a violent beating pain takes place in some part of the head, as if a nail was driving into it. Sharp pains, likewise, attack the loins, back, and bladder, and the patient makes an unusual quantity of urine as limpid as water; which is one of tbe most characteristic signs of the disease. The appearances which take place in this affection, are con- siderably varied in different persons, and even in the same persons at different times. It differs by having more or fewer of those circumstances above mentioned; by those circum- stances being more or less violent, and by the different dura- tion of the wliole fit. Causes. Excessive evacuations, particularly of the men ses, depressing passions, continued anxiety, violent excite- ment, sudden surprise, grief, indigestion, &c. 378 HYSTERIC HI':. Treatment. If the patient be young and of a plethoric habit, blood-letting will he required during the fit; but in deli- cate constitutions tiiis operation is not advisable. Volatilcs, singed feathers, and the like, should he applied to the nostrils: and if the patiqojjt can swallow, a tea-spoonful of scther, or tincture of assafoetida, or thirty or forty drops of laudanum, may he given, in a glass of cold water, and repeated in a cou- ple of hours, or sooner, if necessary. Clysters of gruel, to which may he added a tea-spoonful or two of laudanum, will also have a good effect. The feet and legs should, as soon as possible, he put in warm water, and well rubbed with the hand. Cold water sprinkled on the face, and tlie admission of the cool air in the room, are likewise proper auxiliaries. During the intermission of the fit, the nervous system should be strengthened to prevent a recurrence, by the tonic powders, pills, or drops, [^e Dispensatory] in tlieir usual doses, after having adm nistered some purgative medicine.— Upon the approach of any languor, the patient should instantly take a glass of wine, or a tea-spoonful of lavender, or ten or tvvdve drops of laudanum in a glass of cold water. WIi-mi hyste»'ic affections originate from a suppression or obstruction of the menses, these must be promoted by adopt- ing tlie means advised under those heads. Rbsiviev. \n attention to diet is highly proper for the rcnoval of this disease. \ milk airl vegetable diet duly per- sisted in, will have the most salutary effect, especially in san- guine, constitutions; but should vegeUb'es create flatulency and acidity in the stomach and bowels, in such cases animal food will be the most appropriate diet. The best drink after dinner is water with a little good wine, or a smaller quantity of old spirits. Tea should be prohibited altogether, or used sparingly.— Moderate exercise, particularly riding on horseback, is of the greatest service, as are likewise amusements and cheerful cbmpany. 3?9 PALSY, Is a disease consisting in a loss of the power of voluntary motion, but affecting certain parts of the body only, and by this it is distinguished from apoplexy. In the most violent degrees of palsy, the patient loses both the power of motion, and sense of feeling, either of one side, or the lower half of the body. Tbe first is termed hemiplegia, the latter paraple- gia. When it affects any particular parts only, as the tongue> the lip, eye-lid, &c, it is termed a local palsy. Symptoms. If this disease be not the effect of apoplexy, it is often preceded by universal torpor, giddiness, a sense of weight or uneasiness in tbe head, dulness of comprehension, loss of memory, and a sense of coldness in the part about to be affected; there is also, sometimes tremor, creeping, and pain in the part. Causes. Compression of the brain from any of the causes inducing apoplexy—certain poisons received into the body, as lead, arsenic, &c.—injuries done the spinal marrow___ It is also produced in consequence of extreme debility, and old age. Treatment. If palsy arises from the causes producing apoplexy, it must necessarily be treated in the manner recom- mended for the cure of that disease, by bleeding copiously in full habits, and keeping the bowels in a laxative state for ma- ny days. It will also be requisite to apply a large blister to the back of the neck, and when the discharge is lessened, others should be applied behind each ear. After congestion is removed by this mode of treatment, it will then be necessary to commence with the stimulating plan, in order to rouse the torpid vessels into action. When stimulauts are reported to, thry should be changed every e,git or ten days, mid sometimes alternated with gentle laxatives, to prevent returns of accumulation on the hrain. 380 PALSY. In sine instances this diseaso arises from diminished cu"i gy of the brain, and in such cases we must have recourse to stimulants, both internally and externally, without delay. In this state the essential oils and balsams arc frequently em- ployed with good effects. One of the most active and useful medicines of this class is the spirit of turpentine in doses from twenty to sixty drops thrice a-day. A table-spoonful of horse- r.i lish scrape:!, or the same quantity of mustard-seed, swal- lowed three or four times a-day, will have a good effect. The volatile alkali is also of infinite service in large doses. At the same time, external stimulants must be duly attended to, such as dry frictions over the part affected, with a flesh brush or rough cloths, and the flour of mustard, or flannels impreg- nated with the tincture of cayenne pepper, oil of turpentine, oil of sassafras, or volatile liniment, or some of the tincture of cantharides. Stimulating the part with nettles has produ- ced good effects, as well as electricity, particularly in local palsies. A seton in the neck, particularly if the patient is affected with giddiness, will afford considerable relief, and should nol be neglected. Cases of palsy have been cured by salivation. If the disease is in consequence of a curvature of the back bone, compressing the spinal marrow, a perpetual blister or issue over the part affected, or on each side of the diseased portion of the bone, is the only remedy. A local palsy, par- ticularly when it is confined to one muscle, will generally yield to t'tc application of a blister as near to the part affec- ted as possible. Regivien. In plethoric habits the diet should he of the lightest kind, but quite the contrary in debilitated habits. In S'irh *ases the diet should be warm and strengthening, sea sonud wi'di spices and aromatic ingredients, and the drink mn^t be generous wine, mustard whey, ginger tea, or brandy arvl water. Flannel wore next tlie skin is peculiarly proper, so -s regular exercise, when not carried to fatigue, or used in a cold damp air. 381 HYPOCHONDRIAC DISEASE, CCommonly called Vapors, or Low Spirits.J This complaint chiefly occurs in the male, and that at ad- vanced life; and it is confined, for the most part, to persons of a sedentary or studious disposition, especially such as have indulged grief or anxiety. Symptoms. Languor, listlessness, or want of resolution and activity, with respect to all undertakings—a disposition to seriousness, sadness, and timidity as to all future events— an apprehension of the worst or most unhappy state of them, and therefore often, on slight ground, a dread of great evil. Such persons are particularly attentive to the state of their own health, and to the smallest change of feeling in their bo- dies, from any unusual sensation, perhaps of the slightest kind, they apprehend great danger, and even death itself; and in respect to all their feelings and apprehensions, there is, for the most part, unfortunately, the most obstinate belief and persuasion. This diseased state of mind is sometimes attended with symptoms of indigestion, hysterical affections, and sometimes with melancholy; but these are merely effects. Causes. Indolence-—violent passions of the mind—sup- pression of customary evacuations—obstructions of some of the viscera, &c; but its immediate cause appears to be a loss of energy in the brain, or torpid state of the nervous system. It would appear, however, that these complaints proceed from an original affection of the stomach. Treatment. The cure of this disease seems to depend on exciting the nervous energy which is depressed, and that particularly by attending to the state of mind. sm HVFOCHONHRIAC DISEAHK. A constant state of motion should therefore be advised,"es pecially by riding on horsebsck. and making long journies which presents new objects to the view. Nothing is more pernicious in this disease, than idleness; but in avoiding it, all application to former studies are to be prevented. The present emoM-ms must he favored and indul- ged: and though an attempt should he made to withdraw the attention of such patients from themselves, yet their confi- dence ought first to be gained; and since the persuasion of tlieir o-vn opinion is strong, and the infallibility of their own fears and sensations rooted, however absurd these may be, they require a very nice management.* Raillery must never " Some hypochondriacs have fancied themselves miserably afflicted in one way, and some in another—somf'have insisted that they were tka pots; and some, that they were town clocks,—this, that he had a big belly, and that his iegs were glass—one that he was ex- tremely ill, and another that he was actually dying. But I have never heard of any of this blue-devil class, whose extravagance ever yet came up to the following, which was related to me by my noble-heart- ed old friend, the late Dr. Stevenson, of Baltimore, whose very name always sounds in my ears as the summary of every manly virtue. This Hypochondriac, who, by the bye, was a patient of Dr Steven- son, after ringing the change on every mad conceit that ever torment- ed a crazy brain, would have it at last that he was dead, actually dead. Dr. Stevenson having been sent for one morning in great haste, by the wife of his patient, hastened to his bed side, where he found him stretched out at full length, his hands across his breast, his great toes in contact, his eyes and mouth closely shut, and his looks cadaver- ous. "Well, sir, how do you do? how do you do this morning ?" asked Dr. Stevenson, in his blustering jocular way, approaching his bed. 'How do I do," replied the Hypochondriac, faintly—"a pretty ques- tion to ask a dead man." Dead!" replied the Doctor. "Yes, sir, dead, quite dead. I died last night about twelve o'clock." Quick as lightning. Dr. Stevenson caught his cue, which was to strike him on the string of his character; on which, the Doctor happily recollected he was very tender. Having gently put his hand on the forehead of the Hypochondriac, as if to ascertain whether it was cold, and also felt his pulse, he exclaimed, in doleful note, "Yes, the poor man is dead enough—it is all over with him, and now the sooner he c in be buried the better." Then stepping up to his wife, and whis- pering her not be frightened at the measures he was about to take, he called to the servant, "My boy, your poor master is dead, and the sooner he can be put in the ground the better. Run to Mr. C----m, fori know he always keeps New- England coffins by him, ready made and, do you hear, bring a coffin of the largest size, for your master makes a stout corpse, and having died last night, and the. weithet warm, he will scun begin to smell." HYPOCHthNWKIA« DISEASE. 883 be attempted. «From this supposed bodily affection, the mind should be diverted by employments suitable to the circumstan- ces and situation in life, and unattended with much emotion, anxiety, and fatigue. Company which engages attention, and Away went the servant, and soon returned with a proper coffin.-— The wife and family having got their lesson from the Doctor, gather- ad around him, and howled no little, while they were putting the bo- dy in the coffin. Presently, the pall-bearers, who were quickly pro- vided and let into the secret, started with the Hypochondriac for the ohurch-yard. They had not gone far before they were met by one of the towns-people who, having been properly drilled by the facetious Stevenson, cried out, "Ah Doctor! what poor soul have you got there?" "Poor Mr. B----" sighed the Doctor, "left us last night." "Great pity he had not left us twenty years ago," replied the other, '"for he was a bad man " Presently another of the towns-men met them with the same ques- tion. "And what poor soul have you got there, Doctor?"' "Poor Mr. B----," answered the Doctor again, "is dead." "Ah! indeed!" said the other. "And so the devil has got his own at last." "Oh villain!" exclaimed the man in the coffin, "if I was not dead, how 1 would pay you for that." Soon after this, while the pall-bearers were resting themselves near the church-yard, another one stepped up with the old question again, "what poor soul have you got there, Doctor?" Poor Mr. B----," he replied, "is gone." "Yes, and to h---11," said the other, "for if he is not gone there, I see not what use there is for such a place." Here the dead man burst- ing off the lid of the coffin, which had been purposely left loose, leapt eut, exclaiming, "Oh, you villain! I am gone to h—11, am I! Well, I have come back again to pay such ungrateful rascals as you are." A race was immediately commenced between the dead man and the liv- ing, to the petrifying consternation of many of the spectators, at sight of a corpse, bursting from the coffin, and in all the horrors of the winding sheet, racing through the streets. After having exercised himself into a copious perspiration by this fantastic chase, the Hypo- chondriac was brought home by Dr. Stevenson, freed of all his com- plaints. And by strengthening food, generous wine, cheertul compa- ny, and moderate exercise, was soon restored to perfect health. To demonstrate further, the happy effects of possessing quick wit, ''to shoot folly as it flies," I will cite another case of Hypochondriasm, which came under the care of that philanthropic and learned physi- cian, the late Doctor Crawford, of Baltimore, who, in everything amiable and good, was not unlike his intimate friend, Doctor Steven- son. A certain Hypochondriac, who, for a long time, fancied hi ro^elf dy- ing of a liver complaint, was advised by Dr. Crawford, to make a journey to the state of Ohio. After an excursion of three months, he returned home, apparently in good health: but upon receiving infor- mation of the death of a twin brother, who had actually died of a scho-rus liver, tie immediately took the staggers, and falling down, roared out that he was dead, and had, as he always expected, died of a liver complaint. Dr. Crawford being sent for, immediately attend- ed, and asked the Hypochondriac how he could be dead, seeing he 384 HYPOCHONDRIAC DISEASE. is at the same time of a cheerful kind, will ahvays be found of great service. The occasional reading of entertaining ho »ks, or playing at any game, in which some skill is requi- red, and where the stake is not an object of much anxiety, if not foo long protracted, will further assist in diverting the min'' from its*df. The symptoms of indigestion, and hysteric complaints, that so frequency attend this state of mind, although the effect, rat'iei than the cause, are objects of practice; inasmuch as they tend to aggravate and realize the false apprehensions of the patient. These secondary affections require the same mode of treatment recommended for indigestion and the hys- teric disease. The warm bath is peculiarly beneficial in this complaint, and when the s> stem becomes somewhat invigo- rated, the cold hath may be employed with advantage, provi- ded there ex:4s no obstructions in the bowels. From an acid acrimony generally prevailing in the stomach, the rust of steel, or filings of iron, in doses of ten grains thrice a-day, is the most salutary medicine of all the tonics. Magnesia and lime water are useful on the same account. Regimen. A proper diet constitutes an essential part in the 1i\ atment of this malady. In general, light animal food is what alone agrees with such patients; for there are few, if any, vegetables which do not prove flatulent in their bowels— Acids are particularly injurious. All malt liquors, except could talk. But still he would have it that he was actually dead. Whereupon, the sagacious Doctor exclaimed, "O yes, the gentleman is certainly dead, and it is more than probable, his liver was the death of him However, to ascertain the fact, I will hasten to cut him open before putrefaction takes place." And thereupon, getting a carving knife, and whetting it as a butcher would to open a dead call, he stepped up to him and began to open his waistcoat, when the Hy- pochondriac, horribly frightened, leaped up with the agility of a rab- bit and crying out. "Murder! Murder! Murder!" ran off with a speed that would have defied a score of Doctors to catch him. After running a considerable distance, until he was almost exhausted, he haitedrand not finding the Doctor at his heels, soon became compos- ed. From that period, this gentleman was never known to complain ofhis liver; nor had he, for better than twenty years afterwards, an- •vmotora of this disease. CRAMP. 385 porter, are apt to excite too high a fermentation in the sto- mach; and wines, for the most part, are liable to the same ob- jections. If an exception can be made in favor of any, it is" good old Madeira, when it can be obtained, which not oidy promotes digestion, and invigorates the concoctivc powers, but acts, immediately, as a generous and wholesome cordial. The use of spirituous liquors is not to be recomo ended as a habitual resource, though they may be taken occasionally, in a moderate quantity, diluted with water. Tea and coffee, though hurtful to people with bad digestion, are often useful, however, to the hypochondriac. Moderate exercise, we have already observed, is indispensable in the cure ol this com- plaint; and it cannot be taken any way with so much advan- tage as long journies, when convenient, accompanied v^th such circumstances, as may convert them into an agreeable amusement. CRAMP. A painftti spasm of the calf of the leg or muscles of the toes, and sometimes of the stomach. Causes. Sudden stretching of the, limbs— advanced preg- nancy—acidity—indigestion, irritation, and debility. Treatment. A cramp of the calf of the leg is best re- lieved by standing up, which simple act, by throwing the weight of the body on the toes, forcibly extends the muscles, and thus takes off the spasm. If the cramp arises from acid- ity or indigestion, give every night a pill composed of half a grain of opium, with six grains each, of rhubarb aud prepared chalk, and administer ten grains of the rust of steel, morn- ing and noon. A cramp of the stomach is best treated by an infusion of red pepper, [See Materia Medica,] or a large dose of aether or laudanum, accompanied with friction on the part, either by a 5iJ6 1LTAM, OR LOCKED JAW- desh brush or flannel. When these fail, a very copious bleed- ing will sometimes remove the spasm, after which the patient must be purged. The chief remedies of spasm are those which remove the irritating cause, if this cannot be ascertained, wc must en- deavor to lessen irritability by anodynes. A sudden terror, the apprehension of a severe operation, on the return of the fit and unexpected surprise, have succeeded. Dashing water in the face, touching a person with something cold, or throw- ing up a cold clyster, have from the same principles, been ef- fectual. Persons subject to the cramp in the leg may prevent it by wearing stockings in bed, and occasionally rubbing the part with camphorated oil. According to vulgar authority, sul- phur grasped in the hand, is good to cure, and carried in the pocket, to prevent cramp. TETANY, OR LOCKED JAW. Symptoms. A rigid and painful contraction of all or se- veral of the muscles. Its first symptoms is a stiffness in the back of the neck, increasing to pain, extending next to the root of the tongue, then shooting into the breast, and lastly seizing the back. Causes. Wounds of the head or extremities—and punc- tures of the slightest kind, as running a splinter under the nail, or into the toe or finger. It is equally induced from cold or moisture, particularly when sudden vicissitudes prevail, or sleeping on damp ground Treatment. On the first appearance of this disease, give one or two table-spoonfuls of laudanum* or six or eight grains ef opium every two hours until the symptoms abate, and then the dose should be gradually lessened. Between the doses, & TETANY, OR LOGKLti* JAW. 387 vjine uf spirits should be given very freely. The use of the warm bath will also assist the eflicacy of the opium. These remedies should be increased and carried to the utmost extent as the symptoms may indicate. If the opium cannot be swal- lowed, six times the quantity may be injected in clysters un- til the patient can swallow. This disease has oftentimes yielded to a salivation. And when there is time for the operation of mercury, it should he used both internally and externally. At the same time it is advisable to give opium, in more moderate doses. Dr. Brown, who is now one of the principal professors in the Transylvania University, communicated sometime since, through the medium of the New York Medical Repository, his success in the cure of tetanus with the tincture of cantha- rid<'6. When recourse is had to this remedy, give from twen- ty to thirty drops of the tincture every hour until it produces stranguary or a difficulty of urine. As soon as this occurs, it must be discontinued, and flaxseed or marshmallow tea or barley water, or some mucilaginous liquid drank freely, and some of it injected by way of clysters, to which may be oc- casionally added two tea-spoonfuls of laudanum. According to Dr. Nathaniel Miller, the solution of arsenic, in doses of ten drops, with an equal quantity of laudanum, and a large spoonful of spirits every half hour, has in several cases of tetanus succeeded admirably in performing a cure.__ When the symptoms abate, the dose must be diminished and the medicine gradually discontinued. Among the various remedies which have been recommended for the cure of tetanus, none has been employed with greater success than the cold hath. This is to be done by plunging the patient in the coldest water, or by pouring suddenly over his head and shoulders several tubs of cold water. The cold bath must be repeated every three or four hoars until a per- fect cure is effected. On the decline of the spasm, hark with wine and opiates at bed-time should he given until the patient's health is re- instated. *t 388 PALPITATION OP THE HEART. Spirits of turpentine and infusion of tobacco [See Materia Medica] have each been administered by way of injection with 'very happy effects in this alarming disease. In every stage of the disease, it is of importance to keep the bow-Is open, by, the usual stimulating purgatives or clysters. When local injuries have been the cause of this disease, the wound should be dilated and filled with common salt, Span- ish lies, or turpentine, and afterwards dressed with warm poultices until the wound be brought to a state of good di- gestion. If a wounded finger or toe be the cause of this hor- rible malady, it ought instantly to be cut off. PALPITATION Or THIS HEART. Symptoms. In this disease, the motion of the heart is performed with more rapidity, and generally with greater force than usual, which may not only be felt by the hand, but often be perceived by the eye, and even heard; there is fre- quently a difficulty of breathing, a purplish hue of the cheeks and lips, and a variety of anxious and painful sensations. It sometimes terminates in sudden death. Causes. A morbid enlargement of the heart itself, and of the large vessels—organic affections—an hereditary disposi- tion—plethora—debility, or a morbid condition of the sys- tem— mal-confirmation of the chest, and many of the causes inducing fainting. Treatment. This complaint is best relieved by keeping the mind and body at rest, avoiding every cause of irritation, and keeping up a proper equilibrium of the circulation. When the disease arises from plethora, and the action of the heart is violent, bleeding is indispensible, which should be followed by a cooling cathartic, and afterwards the exhibition of nitre every two or three hours, or the tincture of digitalis, in doses from ten to twenty drops thrice a-day, by lessening the a- tio.v of the arterial system will effect a cure. hiccup. 3$g When there is reason to believe this affection is in conse- quence of debility, the solution of arsenic in its usual doses, taken for some time, is a certain remedy. \Y hen the nervous system is affected, small (loses of pether, laudanum, or some cordial will be found vi rv serviceable. The feet should he kept dry and warm, frequently rubbed, and if not otherwise warm, with powdered mustard seed, or tincture of cayenne pepper. Those who are subject to a palpitation of the heart should carefully avoid violent exercise, irregular passions, costive- ness, and all circumstances that may tend to increase the ac- tion of the sanguiferous system. HICCUP. A spasmodic affection of the diaphragm, and sometimes of the stomach, is a troublesome, but not often a dangerous com- plaint. Causes. Debility, acidity, flatulence, cold drinks when the person is warm, repletion, worms, repelled gout, tec. Treatment. W7hen it arises, as is most frequently the case, from spasm induced by debilitating causes, the warm antispasmodics, as set her, laudanum, the camphorated mix- ture, hartshorn, tincture of assafoetida, or some of the essen- tial oils, will be useful. A t^a spoonful of vinegar, slowly swallowed, has frequently afforded relief. Preserved damsons have likewise been found of excellent use in this complaint. When acidity is discovered to be the cause, give the ah- ' sorbent mixture, or twenty drops of hartshorn, with a tea- spoonful of magnesia in a cup of mint tea, or a spoonful or two of milk and lime-water; and to prevent its recurrence take ten grains of the rust of steel thrice a-day. When occa- sioned by poisons or improper food, an emetic will be proper. In weak stomachs, oppressed with indigestible food, a glass of good wine or spirit and water often relieves. iEtherap- 51 £00 MGin mam;, asthma. plied cxiernaliy to the stomach on a soft linen rag with a warm hand to comine it, is a good rcmcily: *o is the applica- tion of an acrid cataplasm or blister in obstinate cases. Like other spasms, it is often stopped by strongly arresting the attention, whether by hope, fear, or terror. A sudden alarm has often succeeded in curing this affection after every oilier means had failed. On the same principle a deep con- tinued inspiration will often remove slighter degrees of thi* troublesome complaint. NIGHT MARE, Symptoms. An alarming oppression of weight about the breast, with dread of suffocation. Causes. Late and excessive suppers—great fatigue—drun* kenncss, or sleeping on the back. Treatment. If the patient be of a plethoric habit, bleed, pura;e, an ' use a spare diet. And when the disease is the consequence of debility and weak nerves, the tonic medi- cines, as steel, hark, or columbo in their usual doses, arc pro- per. A glass of brandy, at bed-time, will generally prevent the attack. Prevention. The patient should sleep on a hard bed, which invites to frequent changes of sides, eat light suppers, which, with due exercise, and cheerfulness during the day. form the best preventive remedies. ASTHMA, Is often hereditary. When attended with an expectoration of phlegm, if is trmed moist or humeral; and .when with little or none, dry or nervous asthma. ASTHMA. 891 Symptoms. It generally attacks at night with a sense of tightness across the breast, and impeded respiration. The p rson thus taken, if in a horizontal situation, is obliged im- mediately to get into an erect posture, and solicits a free and Cold air. In violent paroxysms, speaking is difficult and un- easy. Treatment. On the first attack of asthma, bleeding is serviceable, if the pain in the chest and difficulty of breathing he considerable; hut less so afterwards, since the disease has a natural tendency to take off the plethoric state of the sys- tem. Vomits frequently repeated have been found of considerable utility in this disease. When there is reason to apprehend a paroxysm in the course of the night, an emetic exhibited in the evening will generally prevent it; and when the fit conn's on in consequence of a loaded stomach; it will often afford immediate relief. As in otlier spasmodic affections, the most powerful anti- spasmodics, as laudanum and sether, should be resorted to. These may he given conjointly or separately, hut in large doses, to allay the violence of the fit, or to prevent its acces- sion. Thus, half a tea spoonful of laudanum, or one of setber, to be repeated in an hour, if necessary, in a glass of cold water, has frequently relieved the symptoms, or when taken at the approach of the fit, have suppressed it altogether. A cup of strong coffee has sometimes afforded great relief; and when the disease proceeds from the irritation of mucus, a table-spoonful or two of vinegar in a glass of cold water is a good remedy. The skunk cabbage and stramonium, or thorn apple, are considered most valuable antispasmodics, and exceedingly beneficial in this complaint. According to Dr. (hitler, the emetic weed, or Indian tobacco, [See Materia Medica] is a cer- tain remedy. And Dr. Thomas speaks highly of the efficacy ef the tincture of fox-glove, in doses of fifteen drops twico a- day, conjoined with a few drops of laudanum. 3f>2 IICART-BUUN. In every stage of this disease the bowels must be. attended to. The connexion of asthmatic paroxysm, with flatulence a»»d cnstiveness, plainly points out the importance of aperient medicines and those of the warm class, as aloes and rhu- barb. Expert>r tnfs arc frequently required in this disease. The powiler. or s rup of squills, or gum-ammoniac exhibitrd in rather larger doses than usual, will often bring on expectora- tion, in rases apparently desperate. Blisters near the back are singularly useful, and should be often repeated. Cataplasms of garlic or onions lo the feet are also valuable assistants. Rkgimen. A light diet, easily digestible and not flatulent, is always proper for asthmatic persons, and dining the fit, Co«d drinks and fresh air are proper. It will always he found serviceable or three days the best aperien's, as calomel, castor oil, salts, senna uid manna, and injections, with the warm bath, and blisters, were usrd, but without effect. Being much alarmed about h.;» situation, I stated t'.ie case to my very excellent friend, the ingeni- ous and learned Doctor John IVeems, who advised the immediate use of six g'-ain- of op'um, wi.h twenty of calomel, in a bolus, and one- t'. rd of that dose every two hours afterwards, if the first failed tooj)- rrate I expressed my fears that so large a dose of opium might do hirm "No sir," replied he, " 'tis small doses that do harm; give large doses, large enough to take off the spasms, and you save the pa- tient " I still retained my repugnance; however, recollecting his great medi- cal attainments, and the desperate case of my patient, I acceded to his advice, and scarcely was the second dose swallowed, before it be- gan to operate like a charm. The spasm was taken off the intestines; copious foetid evacuations succeeded, and our patient was presently restored. This is but one of many extraordinary cures performed by Doctor John Weems. The citizens of Georgetown and Washington, will lv.jg lament the early fate of this gentleman, of vrhom for ardent friendship, and medical sagacity, I can truly say—hi» equal I have seldom seen, his superior never. colic. 399 means are despaired of, the patient should be placed erect on the floor, and a pail of cold water thrown on his feet and legs; this, though apparently a droll remedy, yet certainly deserves to he tried in desperate cases, especially as we are assured from the best authority, that it has often succeeded: it acts, as is said, by occasioning an immediate evacuation of the bowels. For the vomiting which often occurs in this disease, com- mon garden mint, i^ppcrmint, [See Materia Medica] or any other spices boiled in spirits, and flannels wrung out of it, and laid hot on the pit of the stomach, arc excellent, especially if a little laudanum be added. If acrid bile be thrown up, the 6aline mixture, or infusion of columbo should be given; and when vomiting is attended with cold extremities, warm appli- cations to the feet, and a blister to the back, often relieves this symptom. It is also frequently removed by a blister on the pit of the stomach. In violent colics, attended with vomiting, it is always ad- visable to administer an anodyne injection, and if it be speedi- ly discharged, the clyBter should be repeated till the vomiting ceases. A dose of calomel and jalap, castor oil, or infusion of salts, senna and manna is then to be administered every two or three hours, until evacuations are procured. Regimen. Evacuations being once produced, mucilagi- nous drinks and light diet should be strictly adhered to, and the bowels kept moderately open by mild purgatives, giving opiates at bed-time if necessary, until the soreness and disten- sion of the belly go off, and no hardened faeces appear in the stool. Prevention. Those who are at times afflicted with pains in the belly, should keep the feet dry and warm; abstain from flatulent food, and attend carefully to the bowels, to prevent constipation. Those whose occupation subject them to the fumes of lead, should breakfast on fat broth before they begii their work, and frequently interpose oily purgatives. 400 CHOLERA MORBUS. OR VOMITING AND PUKilNG. Causes. It is generally occasioned by a redundancy and acrinitiiiy of the bile—indigesiible food, or such as becomes r.nicid or acid on the stomach—poisons—strong an id purges or vom ts—passions of the mind, or a sudden check of pers- piration. Treatment. Endeavor, as early as possible, to cxp°l the acrimonious matter whicli affects the alimentary cana', by large and repeated draughts of chicken water, href tea, bar- lev or rice water, or thin gruel, tvc. which .should a.so be given ft* cly in elysters. It is said, upon high authority, that frequent small doses of cold water, not exceeding a gill at a time, wil* check the purgin , cool the ardent heat of the sto- mach, and abate the thirst Cold water is the more efficacious as the climate, season, and constitution of the patient arc warm, for it cools, blunts acrimony, and restores the tone of the parts It should be repeated as oft n as the patient throws up what he drinks, and if fainting, with otlier svmptoms of weakness come on, a little wine should be added to each draught of water. After having cleansed the stomach and intestines, give a tea-spoonful of aether, or thirty or forty drops of laudanum, in mint water or tea, and repeat the dose every hour, or oftener as the frequency of the evacuations or the urgency of the pain may require. If the laudanum be rejected from the stomach, give a tea- spoonful of paregoric, or opium in pills of half a grain, re- prated every half hour at furthest, until the disease be check- ed; and at the same time, apply mint leaves stewed in spirits, to the pit of the stomach. In general, this mode of treatment is sufficient; but if the patient be of a plethoric habit, he ought to lose blood immedi- ately: and in case the pain continues violmt, be plared in the warm bath; should the bathing vessel not ln» at hand, pepper- diarrhcla, on looslnlss. 401 mint stewed in spirits, or cloths wrung out of hot spirits or decoction of camomile, hops, or lavender, ought to be applied to the stomach and belly, and often renewed. If acrid bile be the cause of this complaint, the columbo must be given every hour or oftener, in large doses; and, in case of great heat, a small quantity of nitre in the patient's drink will he proper. In warm climates ^his remedy is con* sidcred almost a specific; it soon abates the violent evacua- tions; and by continuing it a few days a cure is effected. A tea-spoonful of the columbo, finely powdered, in a glass of mint water, or a gill of the infusion may be repeated every hour or two, according to the urgency of the symptoms. In pr paring the infusion it is better to add one fourth ginger or some grateful aromatic, in cases unattended w ith fever. When the disease originates from food, either very acid or putrid, besides plentiful dilution with the ahov«- drinks, give castor oil, salts, or rhubarb; and if from poisons swallowed, the patient should drink largely of pure sweet oil, melted but- ter, or mucilaginous drinks, with small portions of salt of tartar. Regivien. As no disease more suddenly weakens the pa- tient, he should take freely of a liglit hut cordial and nourish- ing diet, occasionally assisting his appetite, if deficient, with elixir vitriol, tincture of bark, or infusion of columbo. If he cannot sleep well, an opiate at bed-time may be taken, un- til his strength and spirits return. DIARRHOEA, OR LOOSENESS. Symptoms. A purging without sickness or pain, succeed- ed by loss of appetite. Causes. Acid or putrid aliments; obstructed perspiration; acrid bile; drinking bad water; worms; violent passions; or a translation of morbid matter of other diseases to the bowels. 402 UIARRHCtA, Oil LOOSENESS. Treatment. If offending matter be lodged in the sto- mach, give an emetic, and an opiate at bed-time; and on the succeeding day, if the disease is not removed, a dose of rhu- barb or castor oil, followed by forty or fifty drops of lauda- num at night. In every case where the diarrhoea continues obstinate, an emetic should be premised. It relieves the stomach from ac- rimony, checks the increased peristaltic motion downward, and determines to the skin. After the emetic, it is necessary to procure some respite, and with this view opiates may be em- ployed with perfect safety. By lessening or stopping the peristaltic motion, wc relax any spasmodic stricture which may prevent the discharge of ofTcndins: matter, and the gen- tle laxatives afterwards required, will have a more salutary effect. Cy thus alternating the opiates and laxatives, we at last succeed in relieving the bowels from the irritation of of- fending matter, and moderately warm astringents will com- plete the cure. Opiates may sometimes be given in clysters, and in this way they affect the head in a less degree than when swallowed. If the disease be in consequence of cold, or the skin be dry, the antimonial mixture, or Dover's powder, exhibited in small doses during the day, and the anodyne sudorific bolus or draught [See Dispensatory] repeated at bed-time, with a flan- nel shirt, will generally effect a cure. When bile is indicated to be the cause, the columbo in de- coction or powder, will be found admirable; and if accompa- nied witli sour and debilitated stomach, the tonic powders or pills, [See Dispensatory] with exercise, are the best remedies. Where bad water is in fault, it should instantly be changed or corrected by wine, brandy, or porter; remembering, that in all cases of continued evacuation, laudanum may be given at night after the stomach and bowels have been cleared. When worms induce this disease, which may be known from the sliminess of the stools, and bad breath, such medi- cines as are calculated to destroy them must he employed, af- terwards a wine-glass full of lime-water, with an equal quan- tity of new milk, will be proper three times a-day. diarrhoea, or looseness. 403 In obstinate cases, no medicine is superior to the continued use of the vitriolic solution [See Dispensatory] with an opiate at bed-time. The nausea which this medicine produces is very disgusting, but from this circumstance much of its effica- cy is derived. Should a common dose fail to nauseate, it should be increased until that symptom is effected. The jelly of slippery elm, and the blackberry, [See Materia Medica] conjoined with a small portion of cinnamon, ginger, calamus, or some aromatic, are also valuable remedies. According to domestic practice, the efficacy of burnt cork is highly extolled in this troublesome complaint. A friend of mine, of Baltimore, informed me that he administered this medicine to three gentleman who had their bowels very much disordered by a change of water, and thflt it afforded them immediate relief. He also stated of having given it to a child afflicted with the dysentery, in its chronic form, with the most happy effects. He directs a bottle cork to be burnt to a coal; and after reducing it to a fine powder, it is to be moistened with spirits and then mixed with a little milk and a lump of sugar. Half of this mixture is to be given to an adult, and about one-third, to a child of two or three years of age, repeat- ing the dose, if necessary, in an hour. From the astringent properties of this medicine, it is proper to remark, it should never be employed in affection of tbe bowels, attended with fever. Regimen. The diet should consist of arrow root, sago, rice, milk, and the white meats. The drinks may be of the diluting kind, as already enumerated—genuine wine may al- so be allowed, if it does not turn sour on the stomach. Mod- erate exercise is peculiarly useful, and nothing facilitates the cure more than flannel next the skin.* "This was the "Angel in disguise," that opened the prison doors of this uneasy life, and gave happy freedom to my ever-revered father, Colonel Jesse Ewell, of Virginia My sister Charlotte celebrated his virtues in an Elegy, the following extracts from which I beg permis- sion of the reader to insert, as a small tribute of gratitude to the be$ nf parents, and but a faint portraiture of his worth. "Early he woo'd fair virtue for his guide. And rarely wandered from her guardian side; 404 DROPSY. A collection of water in some part of the body. Symptoms. In common dropsies the legs usually swell. and a pit remains for some time after pressing the flesh—the appetite abates—-the face is bloated—urine little—thirst great, with slow fever, shortness of breath, and lassitude. Causes. Excessive drinking—poor diet—protracted in- termittents —scirrhus tumors of the abdominal viscera, but particularly ot the liver, and in fine, whatever may occasion too free a secretion of the serous fluids in the cellular mem- brane, or any cavity of the body, and at the same time dimin- ish the action of the absorbent vessels. By him the needy never were denied, He sootli'd their sorrows, and their wants supplied. He mourn'd the contests of the neighboring poor, And opened wide his peace-restoring door; Where soon his wisdom taught tucir strifes to cease. Revived their loves, and sent them home in peace, Tne slaves whom Heaven to his care consigned. Ne'er felt the terrors of a slavish mind; Well fed, warm clad, to moderate labors prest, They loved their fetters, and their bondage blest. As friend—as father-—who his praise can tell.' Where first begin, or with due raptures swell? To check our wrong, his frowns were ever li^lit. And sweet his smiles whene'er we chose the r\\'\\*, And when at length the awful hour drew nigh, To waft his spirit to its native sky, Such in that moment, as in all the past, "() bless mv children, Heaven!" was still his last. Now 'scaped from earth, with God he dwells above, And shares with angels in their feasts of love. Then come, blest faith, come h isten to my aid, Lest grief profane disturb his happy shade; Teach me to bow submissive—and adore. The unerring counsels of eternal power, Which gives in love or still in love denies, And makes e'en "crosses blessings in disguise.*1 And thou,-fond memory, still my sire recall, Record his virtues, imitate them all— That joy-, like his mv mortal life may prove, And peace eternal crown mv s*"ite above." DROPSY. 405 Treatment. Like other diseases, the treatment must vary according fo circumstances. In ewvy form of dropsy, if there be a hard, foil, and quick pulse, blood-letting consti- tutes one of the principal remedies, and must be repeated once or twice a week, until the action of the arterial system is considerably diminished. Brisk purges, as calomel and jalap in full doses, are indis- pensable, and ought always to succeed bleeding, and be given as often as the patient's strength will admit, followed by Dover's powder, or the anodyne sudorific bolus or draught, at bed-time, [See Dispensatory.] The discharge from the intestines is unquestionably of the greatest importance in dropsy; and when obstructed perspira- tion is a cause, sudorifics are much to he depended upon. However this distinction must he made. If purgatives be ac- companied by violent colics, and weakness is the consequence, without producing a considerable discharge, the remedy must be discontinued; but if they operate without pain and incon- venience, the stools watery; and weakness does not follow, whatever the number of evacuations may be, the remedy is good. And if, on the employment of sudorifics, they tend to weaken the system, in general, too much, they should not he persisted in. Another remark to be attended to is, that in every species of dropsy attempted to be cured by internal means, however, tfiey may be relieved by different evacua- tions, unless the urinary organs continue their evacuating power, the cure will never he lasting. While feverish symptoms continue, nitre is extremely use- ful in this disease, in doses of ten grains four or five trues a- day, or in such quantities as the stomach may bear, but should not he continued longer than two weeks, if no good effects result from its use. Another valuable medicine for lessening the action of the pulse, and thereby increasing absorption, is the fox-glove, [See Materia Medica] which may be given in powder, decoction, or tincture. The latter is the most conve- nient form, and in doses of twenty or thirty drops in a wine- glass of mint water, may be taken twice or thrice a-day, until the water is removed, or the inflammatory disposition taken 5S 406 DROPSY. off. Tf this quantity do not induce sickness, or produce any evident goo- fleet, the dose must be gradually increased to forty or sixty drop*, or lar'her. Cream of t«rtar, from balf an ounce to an ounce, dissolved in a pint or mure of wate«, is a pleasant and useful drink, and this taken early in the morning has frequently succeeded in evacuating the water. As soon as ti.e acti »n of the pulse becomes lessened, it is nec< ssary to strengthen the system and increase the digestive powers, by the nitric acid or the exhibition of steel alone, or th tonic powders, pills or drops [See Dispensatory] thrice a- day liuring the intervals of purging. One of the ra «st frequent causes of dropsy is obstructed liver, and when this is suspected, mercurial friction must be resorted to, or a grain or two of calomel, conjoined with a few grains of powdered squills, given night and morning, until ptyalism is produced, and afterwards the nitric acid, and other tonics, constitute the proper remedy. The squill in every form, is a valuable medicine, and succeeds in the greater number of dropsical cases. United with cream of tar- tar and a small portion of jalap, it is highly useful as combin- ing a diuntic and purgative effect; and with the resin of jalap and gamboge, in pills, its utility is almost unrivalled. The ef- ficacy of this medicine is also highly extolled in dropsies, in doses from five to ten grains, with double the quantity of nitre. It should he observed, however, the squill seldom increases the discharge of urine to any degree, till raised to a nausea- ting dose. The juice of leeks, in doses of a table-spoonful twice a-day, is Suid to have performed surprising cures; at any rate, in this state of the disease the patient can hardly make too free a use of the acrid stimulating vegetables, as gallic, onions, horse radish, &c. T:ght bandages applied in the morning round the belly and limbs, hav their good effects in preventing the increase or re- turn of dropsi al swelling. Friction, with a flesh brush or flannel every morning from tbe extremities upwards, is of the DROPSY. 407 greatest service, particularly if the skin be previously moist- ened with a liniment, composed of equal parts of soap, spirit and vinegar; or with the volatile or camphorated liniment. Persons recovering from lingering diseases are very subject to anasarcous sweliings, particularly if they replenish their weak vessels too fast by full diet. Scarifications with a knife are much commended when the legs ami thighs are tnrbid with extravasatcd serum; and, in- deed, the water is speedily discharged this way; but the lips of the wound will close in two days, so as to admit of no dis- charge; and from a defect of heat in the constitution, the part »s apt to mortify. De. Fothergill, to obviate these difficulties, advises this operation to be performed with the common scari- ficator used in the cupping, and the instrument to be placed so as to make the wounds transversely. If the skin is thick, the lancet may be so set as to make deeper, and consequently wider incisions; thus a large quantity of water will often drain from the legs or thighs, without risque of inflammation, or deterring the patient from a repetition, if necessary. The punctures must be made in the most depending part of the leg; and their number and repetition depend on the circum- stances of each individual case. The application of glasses, either before or after scarifying, is unnecessary; but the in- strument must be gently pressed upon the skin, until a sur- face is formed sufficiently flat to admit the lancets in the scari- ficator to act equally. In all cases where the skin is so stretched as to threaten inflammation, rupture, or a gangrene, and when the breath is greatly impeded, these openings should be made without delay. Blisters are often employed in the same circumstances instead of scarifications, and are equally useful. An oblong blister may be applied just above the in- ner ancle, and continued until a thick, white, or purulent dis- charge is produced. After this period but little water ap- pears, and the sore should be healed. If necessary to be longer continued, blisters may be employed on the outside; and when these have acted sufficiently, we may return to the former surface, which will be now healed. Should a dark or 4rl)8 DKorsY. black spot appear, bathe the leg in a strong decoction of oak, and sprinkle the spot with s« me of tlie hark, or myrrh pow- d nd, or apply poultices of charcoal and bark, which will soon separate it. and arrest the n o tification. When the difficulty of breathing :s considerable, relief w 11 very gmeral y be obtained bv expectoration; aud for this | nr- pose, pretty large doses of gum ammoniac with the squill, or seneka infusion may be repeated as the occasion r quires. The infusion of garlic is nlten useful, and assafoetida, in the form of pills or tincture, relieves the difficulty of breatbing when it is connected, as is often the case, with wind in tbe stomach occasioning hysteric affections. Spasms often arise in particular parts, especially about the chest, frequently awaking the patient out of a sound refresh- ing sleep. In such cas-s, a grain of opium, with five of cam- phor, is >he most effectual remedy. When the duplication of the peritoncem is the seat of drop- sy, tapping is alone the remedy. Regimen. During the inflammatory disposition, or wheu there is a pretern iural heat on the skin, or mucb action in the pulse, the diet should be light and easy of digestion. In the other state, when the patient is weak and feeble, it should be of the most nourishing kind, with a liberal use of wine. The patient may, in general, drink in proportion to his incli- nation. Acid liquors, as lemonade, cider, the imperial drink, or wine, or gin and water mny be allowed; and thirst is often prevented by holding nitre in the mouth. Exercise is of the greatest importance when not carried te fatigue. In the lowest stage of the disease, swinging or riding in a carriage are m ist proper; but as soon as the patient's strengtii will admit of it, riding on horseback, will be found most beneficial. 409 GOUT. Is often hereditary, but generally indolence and luxury, the hated parents of tins disease, which righteous heaven has marked with such sev-rity, that, like the leprosy of Maamais, it is hardly ever curable.* But though art has not often succeeded to cure the gout, yet it has discovered a variety of means to shorten the fits, and render them much more tolerable. Symptoms. The gout mostly affects the joints, but the viscera are not exempt from its ravages. It sometimes comes on suddenly, passing from one part of the body to the other, in the twinkling of an eye; but generally is preceded by indi- gestion, flatulency, loss of appetite, unusual coldness of the feet and legs, with frequent numbness, sense of pricking, and cramp. These symptoms take place several days before the paroxysm comes on, but commonly the day preceding it, the appetite becomes greater than usual. The next morning, the patient is roused from his sleep, by an excruciating pain iu great toe, or bail of the foot, resembling the gnawing of & little dog. Treatment. No matter what part of the body this dis- ease first seizes, the lancet will be required in every case where there is an increased action of the pulse, to take off the inflammatory disposition. The extent to which the blood- letting must be carried, can only be ascertained by the vio- lence of the disease, and the sex and constitution of the patient *.\n English nobleman, after twenty years riotous living, awoke one morning in the torments ot" the gout. As he lay writhing with'pam, his servant ran up stairs to him with great joy in his countenance: "O! sir, good news! good news! there is a famous gout doctor below, who says he will venture his ears, he can cure your honor in less than a week" "Ah! that is good news indeed, Turn; well runmv good boy, and put up his carriage and horses, and treat the doctor like a prince." "O sir, the gentleman has no carrige and horses; I believe he walked a foot!" "VV ilk. a foot! what! cure the gout and walk a foot! go down Tom, go down, and instantly drive the rascal out of the house; set the dogs upon hnn, do \ )u hear? the lying varleti why it he could cure the gout he might ride in a richer carriage than his majesty." 410 UOUT. In this, as in all inflammatory fevers, the bowels ought to be kept open freely by laxative medicines, as castor oil, sulphur, cream of tartar, rhubarb, senna, jalap, or calomel. Indeed a fit of the gout may be oftentimes entirely, and almost in- stantaneously, removed by active purging. Even drastic purges need not be dreaded in this disease. Nitre, with diluting liquors, given in such quantities as to excite a gentle perspiration, are of great utility in the inflam- matory stage of the disease. After the action of the pulse is somewhat reduced by evacuations, blisters over the pained parts are greatly to be relied on. As soon as the inflammatory state of the gout has subsided, sti milants and tonic medicines, as bark and steel, are tlie best remedies. Laudanum, aether, good French brandy and ai o- matics, as calamus, ginger. Virginia snake root, and red pep- per, [See Materia Medica] in the form of teas, are all exceed- ingly useful in this feeble state of the disease, especially when it affects the stomach or bowels. Besides these internal reme- dies, friction on the stomach and bowels, or the application of cloths wrung out of hot spirits or water, over the pained parts, and sinapisms to the feet, should be employed whenever the gout attacks the head, lungs, bowels, or stomach. Gentlemen long in the habits of intimacy with this disease, should remember that it is of immense rudeness, and ready on the slightest provocation to quit the toes and knuckles, aud seize on the very stomach and bowels of its best friends. They should therefore be constantly on their guard, and keep alw iys by them a vial of aether or laudanum, or a case of good old French brandy;* the latter of which is admirable for chasing the gout from the stomach. The white hellebore [See Mateiia Medica] is highly extolled as a remedy in this distressing disease. *For lack of this ammunition, the gallant Wayne was cut off long before "his eye was dim, or his natural heat abated." Late in De- cember, 1796, he embarked at Detroit for Presque Isle, but not with- out his usual supply ot* brandy, which, however, was all lost, through his servant's caielessness in upsetting his case. On the passage he caught cold, which brought on a violent attack of the gout in the stomach; and, for want of his usual remedy, he suffered tbe moet excruciating ttOUT. 411 Regimen. The diet should be regulated according to the state of the patient. If feverish, and of a plethoric habit, the lightest diet ought to be used. If debilitated and of a re- laxed habit, generous diet should be allowed. Exercise, although painful at first, must be freely taken. Prevention. If the person be plethoric, and has been ac customed to drink freely of wine, and eat heartily, he should gradually diminish the quantity of the aliment; particularly every spring and fall, as the disease is more liable to recur at those seasons than at any other time. But in debilitating habits predisposed to the gout, a stimulating diet is most pro- per, assisted with the use of the rust of steel, bitters or bark. In every case, costiveness should be avoided; and flannel worn next to the skin is peculiarly proper. Nothing, however, prevents the disease, more than temperance and exercise.* torture until he reached Presque Isle, where he died early in January, 1797. His body was deposited in the centre of the fort, to show the children ot future days the grave of him who so bravely defended their liberties Filial piety has since removed it to his native state, where it now sleeps with the dust of his fathers. I am happy to acknowledge, that for this anecdote, I am indebted to the politeness of my worthy friend, Captain Hugh M'Call, of Savan- nah. •The story of the wealthy Mr. Palmer, in the reign of George I. though well known to many, is yet so apropos to our subject, that 1 cannot deny myself a wish to relate it. Young Mr. Palmer received from his father, what the London merchants call a plum, (i. e.) a round 100 000/. of which he contrived to make such "good use," that by the time he was forty years of age, he was torn to pieces by the gout. His physicians advised him to try the virtues of a sea voyage •with the soft balmy, air of Montpelier. He set out, but on his passage tip the Mediterranean, was captured by an Algerine corsair, who took him to Morrocco, and sold him for a slave. He was bought by a far- mer, who carried him into the country, and set him to hard labor, al- lowing him nothing better than brown bread and dates, and even of that hardly enough to support him. His only drink was water, and his only bed a plank. In a few weeks every gouty symptom disap- peared, and he recovered his health, with an uncommon portion of activity. These first of blessings continued with him all the time he was in oaptivity, (two years,) at the expiration of which, he was ransomed by his friends. On his return toEngland, he was hardly known by his acquaintances, so great was the change which temperance and exer- cise has wrought upon him. But alas! for the lack of fortitude, he soon relapsed into his old passion for the rich dishes, flowing glasses, and soft couches of epicurism. His system soon became bloated and relaxed: and bis ancient foe, the gout, returned, and killed him in a Short time; 412 v, VENEREAL DISEASE"! The venereal disease is of two species: the one, a local afTcfion of ihe genital organs, termed Gonorrhoea, or CUtpfa an I the o-her, a general or constitutional coniplaiat, termed Suphilis, or Pox. The Gonorrhaiat Of which we shall first treat, is an inflammation of the mucus m; mlirane, lining the urethra, in men, and the vagina, in women; seated in Mie male ab njt the fraemi n of the penis, and in the female a small distance up the vagina; but in its progress communicating to all the surrounding parts, and producing a variety of painful sensations. Symptoms. A discharge of mucus, at first white, but soiin turning of a yellow or greenish appearance—m acute or scalding pain in 'raking water, with most indecent erec- tions of the penis termed cordee, very painful, and sometimes followed by a discharge of blood. At times the inflammation spreads to the contiguous parts, occasioning stranguary, swelled testicle, swelling in the groins similar to buboes, or a contraction and thickening of the fore-skin, which, when drawn over the head or nut of the yard, is termed phymosfo andparaphymosis when retracted behind it. When these symptoms dance their attendance to the catas- trophe, the d5p may be said to flourish in its full bloom, and tlie patient finds himself fairly seated on the stool of repent- ance. The appearance of a clap in the female is pretty much the sr-me as in the male, allowing fo^the difference of the parts. The disease in them is always milder, insomuch, that at times there is n» other symptom but the discharge, which is often mistaken for the flour albus. They are, however, more sub- ject to excoriations of the parts than the men, and, indeed, when the inflammation is considerable, it often extends to the nrethra, and occasions great pain. .' \ VENEREAL DISEASE. 413 Treatment. In the general treatment of gonorrhoea, rest, together with abstinence from strong food, and every thing of a heating nature, is of the greatest consequence; and this alone, with little assistance from medicine, will complete the cure in a short period. As the disease is local, topical applications in the form of injections become necessary. The patient should, therefore, without delay, employ one of the injections, [See Dispensatory] which in irritable habits, must be a little weakened, and the strength gradually increased as tlie inflammation abates. In- deed, when the inflammation is very considerable, it is better, at first, to inject with sweet oil or mucilage of sassafras, [See Materia Medica] and in such cases the testicles ought to be suspended by a bandage, and the antiphlogistic regimen strictly adhered to, particularly in taking freely of mucilaginous drinks, as flaxseed tea, barley water, or the mucilage of gum- arabic, and obviating costiveness, by small and repeated doses of'cream of tartar. Whichsoever of the injections is used, it must be thrown up the urethra six or eight times a-day, im- mediately after making water, and with a syringe that works easily, that it may not hurt or inflame the parts. It should be observed, if astringent injections of full strength be used in the early period, they often prolong the disease, and occasion swelled testicles, strictures, and enlargement of tlv prostate glands; but after the inflammatory state is removed, they may be employed with safety, and will be found to facilitate the cure. Frequent bathing the part, and the greatest cleanliness are too important to be neglected; particularly washing un- der the glands, to prevent the accumulation of the fluids from the odoriferous glands, which produces irritation, inflamma- tion, and often ulcers. For the cliardee, which is more severe during the continu- ance of inflammation, and occurs mostly in the night, while the patient is warm in bed; take, on going to rest, a dose of laudanum, or souse theguilty member frequently in a vessel of cold water. Should a hemorrhage supervene, it may he re- moved by rest, and immersing the part often with cold vinegar 4.14 VKNEKBAL 1HSEASE. and water, or lead water, of tlie ordinary strength, of which flic | i' i' lit may thtovv a little up. Ai cording to ProlVhsor Chapman, no remedy succeeds bet- ter in the cure of gonorrhoea than balsam capivi. Idle com- mencts with this medicine on the \evy accession of the dis- ease, regardless of all the appearances of inflammation, such as scalding, chordee, tec. Tlie proper dos is about forty drops, more <;r .ess according to circumstances, to be repeated morning, noon, and night, fie d.n-ets it to be taken in a little win , or milk, or if it should act on the bowels or be offensive to the stomach in this way, he advises it to he exhibited, agree- ably to the following prescription. Take of balsam capivi and sweet spirits of nitre, of each half an ounce, the white of t one ^gg, or powdered arabic and white s: gar, each two di ti Inns, n ix, and then add laudanum, one drachm, and water three ounces; of this mixtui e, the dose is a table-spoonfnl three timts a-day. One camion he suggests, should always be en- joined on patients who arc desirous of a speedy cure—An en- tire, abstinence from every heating article of food or drink, and a state of complete repose. lie says, contrasted with the ordinary mode of treating if by injection, his plan has several advantages. It is more con- venient to the patient—it produces no swelled testicles—it occasions no strictures—it leaves no gleet—it is more prompt and certain in the cure. (Jf the efficacy of this remedy, com- ing from such unquestionable authority, there can be no doubt; but candor compels me to acknowledge I have never resorted to it, having uniformly succeeded in the cure of gonorrhoea b; injections, as above advised. When the inflammatory symptoms of gonorrhoea increasa to a violent degree, a swelling or inflammation of one or both terries sometimes supervenes. The same consequence if of.en produced by astringent injections imprudently exhibited. Fo sure cases the general remedies for allaying inflammation, as i»i"od letting, cooling cathartics, diluent drinks with small portions if ni're dissolved in them, become necessary. Be- sides which, the testicles must be suspended by a bandage VENEREAL DISEASE. 415 and kept constantly moistened with cloths wrung out of lead water, or cold vinegar and water, often renewed. The swel- ling of the glands in the groins, and of the spermatic chord itself, require a similar treatment. In these affections, a hori- zontal posture, and spare diet, are particularly enjoined. In case of much pain with little or no fever, an opiate may be given at b*'d-time. And if hardness remain after the pain, the patient should have mercurial ointment rubbed on the part, night and morning, and take freely of a strong decoction of sarsaparilla. But if a swelling without hardness follow, one or two vomits, succeeded by tonic medicines, with the use of the cold bath, will generally cure In case of phymosis, cold applications to the penis, as lead water or cold vinegar and water, and topical blee«! :>g with leeches, constitute the proper remedies. Besides whii h, soap- suds should be often injected with a syringe between the skin and the gland, to prevent the stagnation of matter, whose ex- treme acrimony might otherwise produce a mortification of the parts. When these means assisted by opiates fail, an operation becomes necessary; it is simple, and by no means dangerous. A sharp pointed knife,concealed^ and defended by a grooved directory, which must be previously introduced between the prepuce and glands, are the only instruments required. The point of the knife should pass through the prepuce at the bot- tom, and the section be made by drawing it towards the operator. Common dressings are sufficient; but linen or lint should be interposed between the glands and the prepuce, to prevent adhesions. Paraphimosis is the opposite disease, where the prepuce cannot be drawn over the head of the penis; and in this case, bathing the part frequently in milk and water or soap-suds, and taking some cooling laxative medicine, will generally ef- fect a cure. When the inflammation is considerable and long continued, a mixture of syphilitic infection may be suspected, requiring a mercurial course. Indeed, these affections fre- quently originate from chancres. Such arc the principal symptoms which attend gonorrhoea, 416 VENEREAL DISEASE. Its consequences, which induce a new state of disease, afW the original affection is removed, arc no less important. Glut. This is known by a.constant discharge of mucus matter, after the inflammatory sy ptoins have subsided, occasioned by the relaxation of the mucus glands, or stricture in the urethra. A discharge of this kind may also be occasioned By hard dr nking. violent exercise, or straining. A discharge of mucus, if not connected with a venereal taint, even when accompanied with inflammation, whicli have been excited by high living, or violent exercise, is not infec- tious. Treatment. Although this disease often yields with great facility to the common remedies, yet it is sometimes pe- culiarly distressing and obstinate. The remedies generally employed are astringent injections; the use of balsam capivi, in doses of thirty or forty drops thrice a-day, and tonics of every kind, particularly cold bath- ing, both partial and general. In obstinate cases, the uva ursi, [See Materia Medica.] as well as the tincture of rantharides, have often succeeded. None of the remedies should be con- tinued longer than eight or ten days, if they produce no salu- tary effects. They often in this time remove the complaint which recurs on their being discontinued, so that they should be employed long after the discharge has ceased. The tinc- ture of cantharid' s may be given conjointly with balsam capivi, or alone in common drink. This remedy must be cautiously employed, beginning with very small doses, about fifteen drops of the tincture, which may be gradually increased daily, as in the irritable state of these organs even a common dose may excite dangerous inflammation. The application of a blister to the sacrum, or blistering the urethra, in its course, has some- times succeeded. Upon high authority an obstinate gleet was cured by the injection of punch, a remedy suggested in a con- vivial moment; at another time by green tea; and again by a VENEREAL DISEASE. 417 decoction of red oak bark. An astringent injection of con- siderable efficacy in obstinate gleets, is prepared by dissolving twenty or thirty grains of alum in a half pint of water, which should be injected up the urethra, twice or thrice a-day. When an ulcer in the urethra is the cause, which lhay be suspected, if on pressing the penis slightly erected, between the finger and thumb, one part is found more sensible to the touch than another, tlie best remedy which has come under my notice in practice, is an injection composed of one or two grains of corrosive sublimate in a half pint of water, or m.de of sufficient strength to excite some degree of inflam ation in the partaffected. If a stricture be the cause, the introduction of a bougie is tbe only remedy. While the use of a bougie is continued, the discharge usually proceeds, but after three weeks or a month it should he omitted. If the running stops, the cure is usually effectual; if it continues, the remedy should not be repeated. In women, gleets are equally obstinate, but tlry generally pass under the appellation ol'f.uor albus, or whites. Seminal Weakness, Is another consequence of clap, when there has been fre- quent returns of it, and is known by an involuntary discharge of the semen. At the beginning of the disease there is a great inclination to erections, and the emission of tlie semen is at- tended with pleasure; but gradually the penis becomes lame, the testicles hang lower than usual, and unless they are other- wise suspended, become almost a burden to the possessor. Although veterans in the wars of Venus, are most liable te be complimented with this kind of gleet, yet it may originate from other causes, as.self-pollution, a sudden lift or strain, hot clysters, straining to stool, or the imprudent use of strong diuretics. Let the cause, however, he what it will, there is no drain which steals away the quintessence of life and strength more rapidly. Treatment. If the emission takes place on the slightest irritation, as heat, wine, &c. and is attended with some degree 418 VBLVEKEAL DISEASE. of spasm, it is a sign the patient is in a very rampant state, and can hardly get him a wife too soon. But if it oozes away insensibly, cold bathing, and tonic medicines, ;.s bark, steel, or balsam capivi in tlie usual doses, with a generous diet. ar» the best remedies. Costiveness should be carefully avoided- Obstruction of Urine, Is another formidable symptom, which sometimes succeeds gonon hoea. It is produced by certain changes of the pas- sage, from tumors seated high up in the urethra, or contrac- tion of the urinary canal. Treatment. When this affection arises from tumors, a cure may be attempted, by the use of the mercurial pills, [See Dispensatory] night and morning, and a decoction of sarsapa- ri la, or niczeieon; but it is often incurable. When spasmodic constriction of the passage is the cause, it will be removed by the warm bat'i or fomentations. The penis may also be rubbed with camphorated oil, [See Dispen- satory,] or equal parts of aether and laudanum. If this fail to take off the spanis, bleed, and give laudanum in large doses. FOX, Is the venereal disease in its confirmed state, manifested by chancres, buboes, or warts about the genitals. To th*sc suc- ceed ulcer in the throat, nose, and tongue, blotches on various parts of the body, with nocturnal pains, especially in the shin* bones and shoulders. The system is now filled with the horrid poison, which, unless mercifully arrested, will soon ulcerate the eyes, con- sume the nose, contract the body, and convert the loveliest form into sucb a mass of corruption, such a dunghill of stench, such a picture of ghastliness, as is sufficient to strike the guilty person with terror. A pallid youth, beneath a shade, A melancholy scene displayed; His mangled face, and loathsome stains, Proclaimed the poison in his veins; VBNBREAL BISEASE. 419 He raised his eyes,' he smote his breast, He wept aloud, and thus addressed: aForbear tlie harlot's false embrace, Though lewdness wear an ange&s face; Be wise by my experience taught, I diefhlas! for want of tlmight." €ott6nt. ELEGY. «ride I once maintaiu'd: « Or w here the youths that wbo'd me to their arms! (^r where the triumphs, which my beanty gaia'd? 420 fENEREAL DISEASE. Ah! say, insidious Demon! Monster! wheretf Wliat glory hast thou gaiuM by my defeat? Behold the miseries 1 am dnom'd to bear, Sucii as have brought me to my winding sheet.v Treatment. Happily for mankind, the Governor of the world, is »a father who ptlieth his children," and afflicts them not to kill, but to cure. In mercy he has appoinied a medicine for this dreadful malady. A medicine, which, when taken in sufficient quantity, quickl} flies to ail parts of the system, attacks the disease at every post, drives it from gland to gland, and with a fidelity and courage truly admirable, never gives it rest until it has completely expelled it from the body, and restored tlie paiient to former health and vigor. This wonderful medicine is Mercury, which requires only to be so managed as to obtain full possession of the system; not exceeding it by salivation, nor falling short of it by untimely purging. To hit this desirable point, let a table-spoonful of mercurial solution or one of the mercurial pills [See Dispensa- tory] be given night and morning, until the system is fully charged with the medicine, w dch may he known by a slight soreness of the mouth and gums, and foetid breath. This fortunate state of things, carefully supported a few weeks, will remove the disease. If the mercury affects the bowels, lessen the dose, or give it at longer intervals, or use the mercurial ointment; and if there is an increased secretion of the salivary glands, we should omit the mercury for a few days, and take a tea-spoon- ful ke bounce. [See Materia Medica.] In this disease, there are certain symptoms whicli require local treatment. Thus, a chancre, which is a small red pim- ple, terminating in ulcer, with hard edges, and generally situ- ated on some part of the prepuce, or the lore-skin of the penis, is best removed by the application of caustic; or, if recentj washing with spirits or brandy, a solution of alkali, [See Dis- pensatory] and applying dry lint to the sore, with cleanliness, will generally prove sufficient. When a bubo supervenes, whicli is known by pain and swelling in the groin, every attempt should be made to dis- perse it by rubbing in mercurial ointment on the inside of the thigh or calf of the leg; and the application of cloths, wrung out of lead water, or ice, if it can be procured, to the swell- ing, renpwed as often as they become warm. Besides which, the patient should he kept still, the bowels open, and the pain alleviafed by the use of opiates at bed-time. When a tendency to suppuration is discovered, instead of the former plan, warm poultices of fl ixseed, milk and bread, or mush and fat, must be applied and renewed three or four times a-day, until the tumor breaks. After which, one or two poultices may be continued, to accelerate the discharge of matter, for a day or two, when the sore must be kept clean 422 VENEREAL DISEASE. With soap-suds, and drc^s- ii night and morning with basil icon, Spread on lint, until the matter is niostiy discharged. The s-ire should then be dressed with lint dipt in a solution of al- kali, [See Dispensatory] once or twice in twenty-four hours, as may be indicated by the discharge of matter; and lastly, when there is no appearance of proud flesh, it may be healed with Turner's cerate, or any healing ointment Warts area frequent affection of the penis, and sometimes remain after the venereal virus is expelled. In whicu (use they may be removed by ligatures, or the application of caus- tic. Regimen. There is hardly any thing of more importance in the cure of this disease, than a proper regimen. Inatten- tion to this, not only procrastinates the cure, but often endan- gers tie paLient's life. In full habits, the diet should always be light and cooling. Exercise should never be carried to ex- cess, *nd the patient should wear flannel on using any prepa- ration of mercury. Cleanliness is of too much importance ever to he neglected. As soon as the disease makes its ap- parance, r!i° infected part should be frequently washed in milk and water, or soap-suds; and if from a neglect of clean- liness, venereal ulcers appear, tlie sores must be well cleansed, and dressed with dry lint night and morning. In obstinate cases the lint should be dipt in the solution of alkali. When t'ie patient is in delicate health, or much reduced, a nourishing diet, with wine, bark, and other tome medicines, are proper, with pure country air. Prevention. After a suspicious connexion, it becomes a pruticnt man to discharge his urine, as soon as possible, and wash well his polluted member, by drawing forward the fore- skin, and closing the end with his finger, that it may bo dis- tended, and retain for a few seconds the urine. The glands and penis should then be well washed with strong soap-suds or grog. In women, besides cleansing the external parts, some por- tion of tlie wash'should be injected up the vagina, by means of a female syringe. 423 Symptoms. An unusually ^weakened slate of the body—- pale anil bloated countenance—the breathing affected on the slightest exertion—the gums soft, swollen, and inclined to bleed on being rubbed, and sometimes putrid ulcers arc formed—the teeth become louse—the breath fcefh—bin. the urine high coloured. Tbe heart is subject to palpitation— the lower extremities to dropsical swellings—the body to pains of a pleuritic or rheumatic kind—besides which, blotches and ulcers break out in different parts of the skin, and often ter- minate in mortification. ' Causes. Cold moist air—vitiated or scanty diet—an in- dolent life, with luxurious indulgences— corrupted water or provisons-*atid whatever may weaken the body, or vitiate the humors. Treatment. Raw and fresh vegetables of every descrip- tion, particularly those of an acid kind; and frui's such as lemons, limes, oranges, sorrel, &.c. [See Materia Medico] fur- nish the most effectual remedies. But hm these are not at all times to be obtained, common vinegar, or nitrous vinegar, us. d freely, will completely answer the end. The nitrous vinegar is prepared by dissolving three or four ounces of nitre or salt pe- tre, in one quart of good vinegar; and of this solution, from oiv to two spoonfuls may be taken three or four times a-day. ac- cording to the advanced stage of the disease, anda^ frequent- ly, some of it may be used in bathing the limbs, where they are either stiffened, swelled, blotched, or ulcerated. Soda-dfc water or nitric acid, [See Dispensatory] will be foutid a uselV.l auxiliary, when the disease is inveterate. The belly most frequently will be kept open by this medi- cine, and when it is not, the exhibition of cream of tartar, '.;• tamarinds, will be highly beneficial. When the gums are en- larged, ulcerated and foetid, the mouth should be frequent iv washed with a decoction of red oak bark, in which, a little 424 ERUPTIONS OK TUB SK1V alum is dissolved, and the gums rubbed wit'i a powder com- posed of equal parts of finely pulverised charcoal and hark, and with which, the scorbutic ulcers may be dressed morning and night. These ulcers may be known by their soft and spongy edges. Regimen. So uncommonly salutary are vegetables in this disease, that whenever they can be had fres'i, they should, with ripe fruits and milk, constitute tnal debili y, and can only be removed by tonics, as the bark, hilt rs, solution of arsenic, nitric and, &c, and exercise. Attention -h hiU also be paid to a fre« quent change ol linen, .uia the skin occasionally dusted with starch. BRUPTI08J9 ©P 426 wotti pear suddenly, but seldom continue long, and are apt to dis- appear from one pari of the body, and appear again in an- other. T'ie itching is the greatest inconvenience, as it sometimes pr v-nts t .e pati upfront sleeping, but the disease is not dan- geous. tt ith respect to the cure, observing a cooling regimen and a laxative state of the bowls, is generally sufficient; hut if fever supervenes, it will be proper to bleed and give the anti- mom d solution in small doses, o determine the fluids to the surface. When the disease is of a chronic nature, and often returns, twenty drops of elixir vitriol, taken thrice a-day, in a cuo of camomile or ccntuary tea, or infusion of columbo, should he directed. To allav the itching, a solution of borax, in vinegar, an oun-e of the former, to half a pint of tbe latter, affords a good wash. ITCH. The itch consists of small watery pimples of a contagious natu e, which first appear between the fingers, and on the wrists, but in process of time, spreading over the wln.le body. exrep* the face, attended with a great degree of itchiness, es- pecially after b*ir of su'p oir, tak or Mir >e times a--Uy. Hie internal exhibition of sul- phur alone, or combined with cream of tartar, should always TETTER, OR RING-WORM> 42? precede or accompany the external applications. Dock root, tobacco, and Virginia snake root, [See Muterm Medica,] have sometimes cured when the above remedies faded. TETTER, OR EINa-WOEM, Is an eruption that attacks various parts ot Vm- skin, in a circle with an inflamed basis, which gradually spreaus, form- ing an extensive excoriation, some-times riioist, at oil cr Lines dry; and is attended with smarting and itching, succeeded by scurfy scales. Treatment. If the habit of body he not faulty, external applications alone, aiv often sufficient to leumvr tins af; ction. The saturated solution of borax, with vinegar or lemon juice, one drachm to an ounce of the acid, is an excellent rem- edy, without producing the least pain on its application. The itch lotion, when prepared with double its strength, is also equally good. Covering the eruption daily with ink, or the juice of black walnut, [See Materia Medica,] has often effect- ed a cure. Wliere the disease is inveterate, internal medicines must he exhibited and continued for some tinn. such as lime-water, flour of sulphur, the mercurial pills, or which is preferable to all of them in obstinate cases, the solution of arsenic. [See Dispensatory.] TINEA, OR SCALD HEAD. Symptoms. Th s disease consists of little ulcers at the roots of the hair, w' ich discharge a humor that dries into a white scab, r thick 'rales, and has an offensive smell. It is not only a verv troublesome complaint, hut contagious, and when united with a scrofulous constitution, found extremely difficult to be cured. 428 SGRdPULA, OR kING'S EUL. Treatment. When it is merely a complaint of the aki^, it may be successfully treated with tojncal applications. In the beginning of the affection, washing the sores well, night and morning, with strong soap-s.i »s, or a decoction of tobac- oo, or Uy applying an ointment, inadeol jiuison-weed, or pride of China, [See Materia J.enca.] will fnqueutly effeci a cure. But if tlie disorder prove obstinate, the head ought to be shaved, and after being well washed with soap-suds, covered with tar and suet, spread on a bladder. My \cvy ingenious friend, Or. Chapman, has assured me, when every other ap- plication failed in removing this disease, he always succeeded, by having the affected parts washed with the following lotion, tvvi e a-day:—Take liver of sulphur, three drachms—Spanish soap, one drachm—lime water, eight ounces—rectified spirits of wine, two drachms—mix. But in cases wliere topical applications are resisted, medi- cine should be given internally, as lime water, flour of sul- phur, or calomel, according to circumstances; and to hasteu the cure, the course of the fluids may, in the mean time, be in part diverted from the head, by blisters or sinapisms. SCROFULA, OR KING'S EVIL. This disease Is most frequent among the children of the poor, aud negroes, who are ill-fed, ill lodged and ill-clothed; it is also hereditary, but never contagious. It most commonly occurs in children from the third to the seventh year; fre- qui ntly, however, it discovers itself at a later period in hab- its peculiarly disposed to it. Symptoms. It is known by indolent hard tumors of the lymphatic gland, particularly those of the neck, behind the ears, or under the chin. The upper lip, and division of the nostrils are swelled, with a smooth skin, and hard belly. In the progress of the disease, these tumors degenerate into ulcers of ba I digestioo; the discharge of which consists of a white curdled matter, resembling somewhat the coagulant of JAUNDICE. 429 milk; and previous to their breaking, they acquire a sort of purple redness, and a softness to the touch. Treatment. As soon as the tumors are first discovered, endeavor to disperse them by sea bathing, or bathing in sail and water, one pound to three gallons of water, or cold water alone, or by frequent application of lead water. Warm fomen- tations and poultices of every kind do harm, as they seem only to hurry on a suppuration, which, if possible, should be prevented. A draught of sea water every morning is a useful drink. Peruvian bark and steel, used alternately every two weeks, or the nitric acid, will be of infinite service by giving tone to the system. The remedy, however, most to be depended upon in this disease, is the muriate of lime, given in doses of ten to eighty drops, gradually increased, three or four times a-day, diluted with water or tea. When a suppu- ration takes place, the solution of arsenic should be given *wice or thrice a-day. The best application to scrofulous ul- cers, is a powder composed of one pound of finely powdered hark, and one ounce of white lead in fine powder, mixed well together, or a fine powder of calamine-stone alone, and the ulcers covered with it daily, keeping it on by brown paper and a bandage. Where these are not to be obtained, the constant application of linen rags, moistened with a solution of one ounce of sugar of lead, in a pint of water, may answer every purpose. With respect to the diet, it should be nourishing and easily digestible, avoiding all viscid food. Moderate exercise, in a dry warm air, is exceedingly beneficial. JAUNDICE. Symptoms. Yellowness of the skin, but chiefly of tht eyes, the urine also yellow—inactivity—anxiety and uneasi- ness at the pit of the stomach—itchiness of the skin. Causes. Whatever obstruct* the passage of the bile, through its natural channel. 56 43M JAUNDICE. Treatment. The indications of cure are, to remove the obstniti ns. which, as it originates from different causes, Will require different modes ol tr atment. As viscid bile is the most comim n cause of this complaint, in lull habits, and where there are an) fev<-rish symptoms, beg n the cure with bleeding, afterwards give an emetic, and lit ii a «iay after, a dose of calomel and jalap, which shou'd bo often tepeated il necessary. Common soap in large quanti* ti s has bun ev ibited Willi mu< h su cess in this case, hut as v this is i - greeable to fake, the salt of tartar, which has the San e advantage, or soda, may he taken in doses of twenty or thirty grains, three or four times a-day, dissolved in the hou- gh •. ol < okumbo. If Ihen be any acute pain in the region of the liver, with a quokii'. ss ef th. pulse, bleed more freely, give one of the ni« rcurial pills, [See Dispensatory] night and mo* ning, until a ptvalMe is prod red, use the warm bath, and apply a blister over th pained part. In cases of much pain, three or four table-spin i fuls of olive oil should be swallowed, and if it do not succeed in quieting the pain, one or two tea spoonfuls of scth. i. 01 thir'y drops of laudanum must be given. The warm bath, or bags of hot salt applied to the right side, are like- wise ben« ficial. After the obstruction is removed, the colum- bo or nitric arm. tonic powders ..r pills, or dogwood, or cher- ry-tree bark. [See Materia Medica,] with porter and wine, are necessarv to restore the tone of the system. } Beoimen. The diet ought to be regulated according to the eonstitution of the patient. In ph-thoric or feverish habits, the diet should be low, and in cases of excessive debility it ihould be of the most nourishing kind. Vegetables, by crea- ting flatulency and acidity, are to be avoided. Mucilaginous drinks are peculiarly proper; and in many instances, sucking a new laid egg every morning, on an empty stomach, has suc- ceeded in curing this disease, when all other means failed. 431 WHITE SWELLING. Is distinguished by an acute pain, without anv external in- flammation, of a joint, attended with a gradual increase of its size. Though all the joints are occasionally subject to it, yet its most usual seat is in the knee. While swellings are gen- rally of a scrofulous nature, but sometimes they are produced by rheumatic affections, and sometimes follow strains that have been neglected, or badly treated. Treatment. As soon as an affection of this kind is dis- covered, the patient should remain in bed, and the limb kept perfectly at rest, without which, remedies cannot produce any good effect. The great object is to prevent the formation of matter, by the immediate application of leeches, or scarifications to the part affected, and by which, eight or teii ounces of bio d may be taken away, every other day, or oftener, according to cir- cumstances. The whole joint should then be kept continually wet and cold with the solution of crude sal-ammoniac, [See Dispensatory] by means of four or five folds of linen. Af- ter the local affection is somewhat abated, frictions with the volatile liniment, or a mixture of soft soap and spirits of cam- phor, to which may be added some tincture of cantharides, will have a good effect. With one or other of these liniments, the joint is lo be rubbed well twice a-day, and afterwards covered witli a piece of flannel that has been soaked in the same. If this should not produce good effects, the part must be rub- bed night and morning with mercurial ointment, in the quan- tity of two drachms at a time, and continued until the mouth is gently affected. The cure may then be completed by small blisters on each side of the joint, which should be kept run* ning for a length of time. If the disease in spite of these, remedies continue to advance, emollient poultices must be applied often, until various ah' 432 3BA-SI0KNESS.—INTOXICATION. scesses appear, and these should be opened as soon as they seem to point, afterwards to be treated as ulcers. In cases where the white swelling is evidently scrofulous, tonic medicines, as bark, steel, tec. and a nourishing diet, to correct the constitutional affection, with stimulating applica- tions to the joint, form the best remedies. SEA-SICKNESS. Symptoms. A most unpleasant giddiness, with great nausea and vomiting, occasioned by the motion of the vessel. The duration of this complaint is very uncertain. Generally, it lasts but a day or two, but in some cases it will continue a whole voyage. Treatment. Though time, perhaps, is the only cure, yet it will be greatly alleviated by keeping the bowels open. A tea-spoonful of sethcr, in a glass of water, relieves the con- vulsive affection of the stomach. High-seasoned food, and acidulated drinks, are peculiarly proper. But nothing will bo found more serviceable than exercise, cheerfulness, and fresh air. Persons should, therefore, never go below, but romp on the decks, cut capers in the shrouds, and divert their minds and move their bodies as much as possible. INTOXICATION. Symptoms. Like every other kind of frenzy, it comes on with a burning redness of the cheeks—a swelling of the jugu- lar veins, and fiery wildness of the, eyes. The tongue is con- siderably affected, but very differently in different stages of the disease. At first, only glib and voluble—then loud, and louder still—at length noisy and excessively disagreeable. The patient now is quite on his top-ropes, and nothing goes down with him, but the most ranting songs, roaring laughs, ripping oaths, and bluntest contradictions, accompanied with loud INTOXICATION. 433 thumping of the flst on the table, especially if politics be the topic of conversation. There is no complaint that affects pa- tients so differently—some it makes so ridiculously loving, as to hug and kiss one another—others it kindles into such rage and fury, that they will frequently throw the bottles and glasses at the heads of their best friends. And, indeed, so wonderful is its influence, that it is no uncommon thing, with it, to inspire cowaids with courage—to teach truth to liars, and to make persons naturally reserved, loquacious, and even boisterous. The memory now partakes of the general infirmity, being hardly able to connect the parts of a story begun. The tongue at length, as if about to lose its powers, begins to trip—then to stammer—and at last the utterance dies away generally in some idle half-finished threat or oath. Hiccups now ensue, with a silly grin of the mouth, which continues half open, from the falling of the lower jaw. The face puts on an air of great stupidity—the eyes turn heavy and sleepy, and the pa- tient begins to nod, witli his head bending forward, until, be- coming too heavy, he sinks under the table, and not unlre- quently, after a filthy vomiting, falls asleep among the dogs and cats. Treatment. In a fit of drunkenness, the patient should instantly be placed in an airy situation, the head and shoulders kept erect, and the neck-cloth and collar of the shirt unbound, and copiously bled, if his situation seems alarming. The next step is to provoke vomiting, by the most expeditious means, such as tickling the throat with a feather or the finger. Cold applications to the head, as cloths wrung out of cold water, or vinegar and water, often renewed, will have the happiest effect; so will plunging the body into cold water, for many instances have occurred of persons having fallen over- board in a drunken fit, and have been picked up sober. Therefore, it will be found an admirable mode of sobering those vagabonds, who, as a nuisance, infest the streets of every city, to take them to the nearest pump, and there i 434 TO RECOVER PERSONS APPARENTLY DROWNHD. deluge them with cod water. This will not onlv bring them to their sens< s. but send them off, urn! r fliat sense of scaine, which ever follows the commission of a crime so truiy igno minions. TO RECOVER PERSONS APPARENTLY DROWNED. As soon as the body is taken out of the water, it should in- stantly be nibbed dry, and wrapped in warm blankets, unless the cooling process should b" first necessary, in consequence of the patient being in a half frozen state. For, in th«t case, the body oi^ght to be rubbed with snow, or flannels wrung out of cold water or vinegar, before any degree of artificial warmth is applied. After which, the patient is to be placed on a bed or mattress, with the head elevated, and air is then in- stantly to be blown into the lings, by inserting the pipe of a pair of bellows into one nostril, or for want of that article, a tobacco pipe, a quill, or even a card folded in the form of a tube, while the mouth and opposite nostril are closed by an assistant, or covered with some wet paper. By thus forcing air into tbe lungs, and alternately expelling it by pressing the chest, respiration mav happily he restored. Volatile salts, or vin gar, s'.ould also frequently Ik applied to the nostr ls. Next the intestines are to be stimulated by injections of warm spiirs and water, or mulled wine.. It will be more effectual sti'l, if some warm spirits and water he introduced immediately nro the stomach, by means of a syringe and a long flexible tube. While using the internal stimulants, a hiadiler of warm wafer should be applied to the region of the stomach, and the legs and arms briskly rubbed with a warm hand, or with flannel, extending the friction gradually to the thighs, beilv, and chest. A* that critical period, when sneezing, slight twitehings.or gasping, in irk the first da v n of ret uning lif •, it will he pru- dent to moderate the stimulating powers. Wheu respiration H TO RECOVER PERSONS APPARENTLY DEAD. 435 and the power of swallowing are restored, the patient should b« kept moderately warm, and gentle perspiration encouraged by warm drinks. Should feverish symptoms ensue, moderate bleeding, to- gether with mild laxatives and cooling regimen, will complete the cure. TO RECOVER PERSONS Jlpparently Killed by Lightning, or Noxious Vapours. Treatment. Instantly throw cold water with some force, in large quantities, on the face and head, which should be often repeated for some time, and if convenient, the whole body may be plunged iiito cold water, and afterwards wiped dry, and warmth gradually applied. If the body and the extremi- ties feel cold, instead of the application of cold water, the warm bath, about the temperature of the blood, should be pre- pared as aoon as possible, and the patient immersed in it for twenty or thirty minutes, using frictions at the same time with the hand. As soon as the patient is taken out of the bath, his s1 in must be wiped dry, and wrapped up in warm flannel, and gentle stimulants employed to produce a reaction. The vital principle is not unfrequently suspended by the dehtereous fumes arising from fermenting liquors, from char- coal, cnk>. &r., from combustion, from metals in a state of fu- sion, particularly arsenic and mercury; as also, very often, from respiring the foul air of wells, privies, caverns, and mines. In such cases, the person should be freely exposed te pure and cool air, and supported, at the sane time, in a lean- ing posture. Volatile salts, or other stimulating ^distances, are then to be applied to the nose, and cold water made use of, as above directed. In places where a lighted caudle will not burn, animal life cannot be supported; and, therefore, in all cases, where wells, cist-poolR, or deep vaults, are to be opened, a large candle, lighted, ought to be let down very ■lowly to the bottom, before any person attempts to descend. 486 poison. If the candle is extinguished, means must be adopted to re- move the noxious air, before any one descends. To effect this, the following modes will answer. 1st. Let the leather- pipe of an engine be introduced to the bottom of the well, if empty, or the surface of the water, and affix a blacksmith's bellows to the other end, when, by well working this, the foul air may be expelled. 2dly. Carbonic acid gas may be bailed out with a bucket made of coarse cloth like a bag, with a round piece of board, nearly the diameter of tbe well at the bottom; let the bucket, thus made, down upon the water, so that the bottom may rest upon it, and let the bag fall upon the bottom; then draw it up, when it will be filled with foul air, which may be brought up to the surface, and emptied by turning out and shaking the bag. Sdly. Let down about a bushel of quick lime, dipping it into the water occasionally, to slack itj or, if there be no water in the well, throw down some for the purpose. 4thly. Pour down a large quantity of •oiling water repeatedly into the well. When by these means the circulation of the blood is in- creased, and the extremities become warm, bleeding will be proper, and must be often repeated, if the patient have fever, or complain of pain. Besides which, evacuations must be procured by purgative medicines and clysters, and the anti- phlogistic plan in every respect strictly pursued, until the fe- brile symptoms abate. After which, tonic medicines, with wine, in case of debility, arc of infinite service. POISON. Treatment. The cure of poisons swallowed, whether vegetable or mineral, requires either an immediate evacuation, er a counteraction of their effects. Therefore, as soon as possible, throw in an emetic, quick in its operation, as blue or white vitriol in a dose, from five to twenty grains, repeated in fifteen minutes, if necessary, and assisted by copious draughts of warm water. JJITE3 OE MUSQUITOES. 437 I'o remove the stupefaction which generally ensues after an imprudent dose of opium, acids of the vegetable class, as lime juice, or vinegar diluted with water, ought to be exhibited freely. But if the patient lay iu a deadly stupor, with cold extremities, the warm stimulating plan must be first adopted. Sinapisms or blisters ought instantly to be applied to the ex- tremities; or, as a more effectual remedy to produce reaction in the system, the legs and arms should be whipped well with rods, and the soles of the feet seared with a red hot iron. It appears, from incontestible experiments, that the white of an egg beat up with cold water is the best antidote against corrosive sublimate and the other mercurial preparations. The whites of twelve or fifteen eggs, are directed to he heat up and mixed with two pints of cold water, and a glass full taken every two or three minutes, so as to favor vomiting. In defect of eggs, milk and mucilaginous drinks may be used with great success. The same method may be pursued in case of arsenic or any metalic salt has been taken. A drink composed of equal parts of lime water, and sugar and water, should also be given wdien arsenic has been swallowed. Un- less these remedies are quickly resorted to, death will inevita- bly take place. Should fever supervene, the antiphlogistic treatment must be pursued. The application of tobacco will assist the operation of an emetic. [See Materia Medica.] For the poisonous effects of lead. See Vine. BITES OF MUSQUITOES. Musq.uito bites often degenerate into painful acrid ulcers, particularly on the legs, in consequence of scratching them. It is, therefore, proper, where these insects are troublesome, to wear loose linen buskins to guard the legs in the evening^ and when this has been neglected, apply oil, vinegar, lime juice, or camphorated spirits, to the part, to allay the itching and tingling occasioned by their bites. 57 438 BITEB OF VENOMOUS ANIMALS. Treatment. The bites of all venomous animals are qured by the same means, which arc very simple, if the reme- dies were always at hand. The caustic volatile alkali, or can de luce, is a certain antidote against the bites or stings of the most venomous sorpents or spiders. Lint wetted with either of these should instantly be applied to the injured part., and renewed as it becomes dry. A tea-spoonful of the same medicine must also be given to the patient in a little water, every hour, or oftener, as may be indicated by the symptoms. Lunar caustie possesses the same admirable virtue, and should always be employed, when the other medicines are not at hand. The best mode of using it, is to dissolve five or six grains of tho caustic in two or three ounces of water, and keep the affected parts moistened with it, as above directed. Some of the same ought also to be given internally, only in a more diluted state. When these remedies cannot be pro- cured, a cataplasm, made of quick-lime and soap, should be applied to the bitten part, and as much Cayenne, or red pep- per, mixed in spirits, swallowed every hour or two, as the stomach can possibly bear. The juice of plantain and hoar-hound, in doses of a table- spoonful every hour or two, is considered a good remedy against tbe bites of venomous serpents, as is also squirrel ear. [See Materia Medica.] As soon as a person is bitten by a poisonous animal, a tight ligature should be made above the injured part, until suitable remedies can be employed. When the toe or finger is bitten, cutting it off immediately will prevent mischief from the poi- son. It is also a fact that sucking the wound, immediately after heing bitten, will arrest the progress of the poison. This was lately verified in tho neighborhood of Augusta, in the case of a youth who was bitten by a rattlesnake, and the wound being instantly sucked by a man present prevented its mischievous effectsj nor did any injury rcsnlt to the operator, HYDROPHOBIA, OR BITE OF A MAD D06. 439 W ben this remedy is resorted to, it may be prudent for the operator to guard his mouth with sweet oil or milk, and not swallow the saliva. It should never be attempted by a person with a sore mouth or very bad teeth. BSS9S9 HYDROPHOBIA, OR THE BITE OF A MAD DOG. This disease is so dreadfully alarming at all times, that we eught, as the bestmeans of security, to endeavor to prevent it. Therefore, as the infection of a rabid animal is conveyed by his teeth into the wound, the sooner it is removed, the less chance is there for absorption. Consequently, the bitten part should immediately be washed, and where it can be cut out, this should be done deeper and more extensive, than the wound itself. Then apply a cupping glass, with previous scarification, and cauterize the wound with lunar caustic. If the wounded part cannot be excised from its situation, it must be well washed, and then be scarified, and a free discharge of blood promoted by a cupping glass. This being done, the hit- ten part is to be well cauterized with caustic, and a proper discbarge kept up for a considerable time. In addition to this treatment, we should^diligently employ mercury, both internally and externally, to excite a saliva- tion. Opium, in such doses as are given in tetany, has been said to produce beneficial effects. A strong solution of arsenic, in water, has been recom- mended as an excellent wash for wounds inflicted by rabid ani- mals; this having been found to possess the power of destroy- ing the poison, and thereby preventing hydrophobia from taking place. It is probable, the caustic volatile alkali, might prove an antidote against the poison of a rabid animal, as that of the most venomous serpents. I 440 GUINEA WORM. Tlie scull-can, chick-weed, and emetic weed, [See Muter in J'edica] are considered valuable remedies in this dreadful dis- . ease. The most certain remedy, however, is to cut out the ■ part; and tlos is certain at any period previous to the inflam- P mation. If th \e und is inflicted so deep that the bitten pari cannot be separated, a caustic must bo applied to what re- mains. GUINEA WORM. This disease is frequent among the new negroe9, and is pretty uniform in its appearance. The patent is at first sensible of an itching, and on exam- ining the part, a smull blister is generally to be perceived.—- Frequently, two or three of these blisters manifest themselves; and at times, the part has the ajipcarance of being stung with nettles. Beneath thes( blisters, or other affections, on raising the sk;n, there appears a small pierc of mucus, on removing w' i"!i, the head of a worm is to be seen. It is generally firmly fixed, ami requ »-es force to detach it from the parts beneath. W i en once separated with the forceps, it can he twisted round a lig^urp, or a piece of lint, and by this means, a portion of it, a font or two in length, may be extracted in the course of one day. In its appearance, it resembles what is called bobbin, or ( small tape, and is of the same size. It is transparent and mo st. and appears to contain something like a white liquid. As much of it as will come away without pulling, is daily to be extracted. It is always dangernns to use force, on account of the risk of breaking the worm. "When this accident bap- pens, it occasions the most acute pain, accompanied with sw-lling and inflammation of the neighboring parts; and these symptoms will often continue for two or three weeks. In this case, tf,P worm also lakes a different course, and soon throws itself into another part. 441 SWAILOWINCt OF PINS. Pins, an I otlier hard and sharp pointed substances, some ti nes pass into the gullet, and even into the stomach. It is too prevalent a practice, when any substance of this kind has passed into the stomach, to endeavor to hasten its passage through the bowels, by giving some opening medicine. Miik alone, or mixed with raw eggs, should be immediately taken, as by the coagulation which takes place, the substance may become so involved, as to prevent its doing injury to the stomach; and on the same principle, should opening medi- cines, which render the fseces thin, be avoided; as hy allow ing the faces to obtain some firmness, there will be the greater probability of the pointed parts of tlie substance being so s'leathed, as to prevent their injuring the intestines. It is but rare, however, that any serious injury is done to the stomach hy the point of the pin. CHILBLAINS. Symptoms. Are inflammatory swellings, chiefly affecting the heels, feet, anil toes, and sometimes the arms and hands, attended with great pain and degree of itching. Causes. This disease is owing to a weaker action of the small vessels most remote from the heart, occasioned by cold or dampness; and occurs most frequently among children, and people of delicate constitutions. Treatment. Where the parts are frost bitten by long ex- posure to the cold, they should he plunged into the coldest water, and afterwards rubbed with salt. When they are only benumbed, they may he rubbed with strong brine, or spirit of camphor, or opodeldoc. [See Dispensatory,] to which, a little laudanum may be added, if the pain or itching he very trou- blesome; but when they crack and iscJarge an acrid matter, poultices should be applied, but net for any length of time, as 412 3CALD5 AM) UriL.\S. their continuance is apt to produce fungous excrcsceuoes.r- The application of diachylon plaster to the part, if the ex- citing cause be avoided, will afterwards eflect a cure. SCALDS AND BURNS. The leading indication in affections of this kind, is to abate the pain; and this is effected by whatever induces insen- sibility of the part, as plunging it suddenly into cold water, wovenng it with ice or snow, or applying soft soap, brandy, laudanum, asthcr, or spirits of turpentine. Of these remedies, spirits of turpentine deserves the preference, especially where the skin is detached. A liniment prepared of bascilicon oint- ment and spirits of turpentine, and applied twice a-day to burns, when there is a loss of substance, alleviates the pain like a charm, and brings the sore to suppuration in a few days, which may afterwards be healed, by a liniment com- posed of equal parts of linseed oil and lime-water, or by the application of the simple saturine ointment, or Turner's ce- rate, [See Dispensatory] or what is preferable, an ointment made with the thorn apple. [See Materia Medica.] The application of cotton to a burn or scald, admirably alleviates the pain. My honorable and highly esteemed friend. Dr. James Jones, of Virginia, stated to me the case of a child which fell in a tub of scalding water, being most wonderfully relieved of pain, immediately on covering it with carded cot- ton. After a few days, he directed the sores to be dressed with the thorn apple ointment, which soon completed the cure. Blisters, which occur from burns, should be opened as soon as the irritation induced has subsided; and in order to prevent any bad effects from the admission of air, small punctures ought to be made, in preference to incisions. When fevers attend burns, mild laxatives become necessa- ry; and where the pain is violent, laudanum ought to be given in pretty large doses. Should the sores not heal kindly, as- tringent washes are necessary, aB recommended for indolent ulcers. 443 HERNIA, OR RtTPTTTRES. The term rupture, was adopted when it was supposed that the disease was always the consequence of a rupture of some of the parts, which form the cavity of the abdomen or belly. But anatomical examination has shown, that this disease, as it most commonly appears, takes place in consequence of the protrusion of some of the contents of the abdomen through openings, which are natural to the human body, and without any violent separation of the parts. It will not be necessary to describe, particularly, tho several kinds of ruptures which may occur. It will be sufficient to observe, that ruptures will generally appear in the groin, in the upper and fore part of the thigh, and at the navel. Those which appear, at first just above the groin, will, in general, if neglected, soon descend into the scrotum, in men, and into the labia pudendi, of women. The tumor, in this disease, is most commonly formed by a part of the intestinal canal, or of the omentum or caul, or of both. In those ruptures which are capable of easy reduction, as soon as a pressure is properly made, the protruded intestine generally slips up, all at once, with a kind of gurgling noise, and the tumor immediately subsides; where tbe turner has chiefly been formed by the omentum, it passes up more slow- ly, aud without that particular noise which accompanies the return of the intestine. In those cases of rupture, where stricture has taken place on the protruded parts, and the reduction is thereby rendered difficult, the belly becomes tense and painful, the pain of the belly, as well as of the tumor itself, being much increased on tlie least exertion, a total stoppage of discharge by stool takes place, and the patient is distressed by a sickness at tho sto- mach, which increases until there is almost constant .retching and, vomiting. To prevent these evils, it is only necessary that such a prcssnrc be kept on the opening through which the part pro- v 444 HERNIA, OR RUPTURE!?. trudod, as may prevent its again falling out. The pressure of the fingers shows bow effectually this may be done, and if. at the time this pressure is made, the patient but gently coughs, he will discover how forcible the protruding parts are driven outwards, and how necessary it is to guard against tlieir fu- ture propulsion. The ingenuity of artists has devised a mode, by spring trusses, of applying a constant and properly adapt- ed pressure, requiring little or no exertion, or even attention, of the patient himself. No person, therefore, in the situation just described, should suffer a day to pass, more than is abso- lutely unavoidable, without obtaining the comfort and securi- ty which will follow the application of a truss, since, if it be adopted at tbe first appearance of the disease, not only will tlie malady he stopt in its progress, but, if employed with con- stancy and steadiness, a radical cure may be gained. If it be discovered that the return of the rupture is become difficult, and that a stricture on the protruded part has per- haps taken place, the person should place himself on his back, inclining to the side opposite to that diseased, with the head low, anil the breech raised high, the knees being drawn up- wards, and a little outwards. Whilst lying in this posture, he should endeavor, hy such pressure as he has been accus- tomed to employ for its reduction, to return the protruded part. Should he not succeed in this attempt, he may lay on the part a piece of folded linen, dipped in cold water, and re- peat his attempts. If these be also unsuccessful, he may then be assured that a stricture has taken place, ami as his life de- pends on its speedy removal, no time should be lostin obtain- ing the' best surgical assistance that can be had. The umbilicial hernia, or the rupture of the navel, is most common to childhood, and is easily cured, if early attended to. The means to be adopted are simply these— the protruded parts are to be returned, which may be easily done, by slight pressure with the finger, and retained in their proper situa- tion, hy a conical piece of very soft, sponge, thoroughly clear- ed, by rubbing between the thumb and finger, of sand and minute shells, which may be lodged in its cavities. This h* * FALLING OF THE FUNDAMENT. 445 ing kept to the part, by the point of one finger, is to be se- Gured by several slips of strongly adhesive plaster, three inch- os in length, crossing each other in a stellated form. PROLAPSUS AKI. OR FALLING OF THE FUNDAMENT. It is occasioned by weakness of the part, wb.ich is aggra- vated hy costiveness, hemorrhoidal swellings, diarrhoeas, and particularly a tenesmus. Treatment. The cure is to be effected by reduction of the part as soon as possible, and retaining it in its natural position, by a compress, secured with a bandage. To effect its reduction, the patient should be laid on his face in bed, with his buttocks raised above the rest of his body, and while supporting the tumor with the palm of one hand, the part of the gut least protruded, is to be first introduced with the fore finger of the other. As soon as the bowels are returned, the bandage is to be applied. When the protruded parts become inflamed, from being exposed to the air, before a reduction be attempted, the inflammation is to be alleviated by blood-let- ting, and fomenting the part with a warm decoction of mul- lein. Persons who are subject to falling of the fundament, would do well to wash the part, immediately after evacuation, with a strong decoction of oak bark. Such remedies as tend to recover the tone of the parts most readily, are to be used, as cold bathing partially applied, and uijcctions of the decoction of bark, with the addition of a little laudanum, or starch, if there be an acrid discharge. With the same view, tonic medicines, as steel, columbo, or bark., should be taken thrice a-day. Persons subject to this disease might to use such diet as produces but little excrements, and 446 WARTS AN© CORNS___WHITLOW. those of a soft consistence, llye nms i a.id molasses, used ex- clusively ;.s a dietior a few weeks, lias been found to product a perfect cure. WARTS AND CORNS. When warts are attem'ed with inconvenience, they may b« removed eiti.er by ligature or caustic, ac ordingto the extent of their base. The caustics commonly used for this purpose, are crude sal-ammoniac, blue vitriol, lunar caustic, or tine ture of steel, applied every day. As corns are formed entirely from pressure, we must care- fully avoid the occasional cause, hy wearing wide shoes; and for their removal, they should be bathed for some time in warm water, and then pared off as much as possible, without giving pain; after whieh, apply over them a wafer or diacby- lon plaster, to defend them from the cold air. Another meth- od is to allow them to grow to some length, through a piece of perforated leather, properly secured by plaster, or any otlier means; and afterwards, to pick them out, or to cut round their root, by which they may, for the most part, be casjly turned out. WHITLOW, Is an inflammatory swelling of the fingers, confined gene- ral'y to the last joint, particularly under the nail, attended With a sense of most burning heat. Causes. It. is often induced by external violence, as the puncture of a pin, or contusion of the nail; but it most fre- quently takes place without any obvious cause. Titr.ATMF.NT. The moment that a sense of any preter- natural heat, or pain is felt, in order to effect resolution, ap- TUMORS, OR BOILS. M*j ply a blister, or let the finger be bathed, several times a-day, in a mixture composed of four ounces of spirits of caoiphor, half an ounce of laudanum, and two drachms of extract of lead. When tliose articles are not at hand, holding the hand in brandy, or sharp vinegar, or very hot water often repeated, and continued for some time, will likewise prevent suppura- tion. According to my honorable and worthy friend, John Ttiliaferro, Esq. of Virginia, the application of a plaster, composed of lime and soft soap, is a sovereign remedy. ■i £t . Should, however, these means fail to produce resolution, the best method is tn m«ke an early opening down to the bone, which w 11 occasion the patient much less pain, than al- lowing the matter gradually to make its own way to the sur- face; whicli, likewise, from the length of time required, is at- tended with more mischief to the parts. The wound is then to be brought to suppuration by emollient poultices, and af- terwards, treated as an ulcer. TUMORS, OR BOILS. Evert tumor terminates in one of th*1 following ways:— By an absorption of the substance into the circulation, by a conversion into pus, or degeneration into scinhus or cancer. Tlere are two plans for the treatment of tumors. Either by resolution or maturation. In the first, there is a dispersion of the swelling; and in the second, it is brought to maturity, and of course, a discharge takes place by spontaneous rup- ture, or by incision. Treatment. In the treatment of tumors, we must be regulated hy the nature and cond'tion of them. If, for example, they should appear on any part or the body, With only a slight degree of pain, tension, and inflammation, and no preceding indisposition, that may induce us to believe it to be the effort of Mature, to get rid of some noxious matter. 443 TUMORS, OR BOILS we should then endeavor to disperse the inflammation, by strictly observing a cooling rigimen, by bleeding, by mild cathartics, aud by topical remedies, as cloths wrung out of lead water, or satunne poultices, [See Dispensatory] often re- newed. But when they arise from bad habits of body, their suppu- ration in all cases should he promoted as soon as possible, by warm emollient poultices, as milk and bread, flaxseed, or mush and fat, renewed every three or four hours. WBen the suppuration is complete, if the matter do not make its own way, the tumor is to be opened with a lancet or caustic, and after applying one or two poultices, it should be dressed with basilicon, [See Dispensatory] spread very thin on lint, night and morning, until it ceases to discharge; after which, with Turner's cerate, or some healing ointment. If fungous or proud flesh appear, it must be destroyed by sprink- ling red precipitate, burnt alum, or rhubarb over it, or touch the protuberant part with blue vitriol or caustic. Atteutionjnust also be paid to the general state of the sys- tem, since, if tbat particular state on which the tumors de- pend, is notchanged, the patient may he harassed a consid- erable time hy their recurrence. Hence, in debilitated constitutions, the tonic.and strength- ening remedies, sueh as bark, sea bathing, &r.t should he em- ployed, and in*robust and .cross habits, sulphur, and cream of tartar, ought to be taken in doses of a tea-spoonful thrice a-day. A tumor on the gums is to be brought to suppuration, by applying roasted figs internally to the part, as warm as can be borne; and afterwards, the mouth is to be frequently wash- ed, either wiVhen extirpation cannot be accomplished, every attempt should be made to stop the progress of the com- plaint, by general and topical bloodletting, by a cooling diet, consisting principally of milk and vegetahl -s, and to keep the bowels open by the occasional use of mild cathartics. In the incipient scirrhus state, wearing a hare or rabbit skin over the part affected, is extremely useful; and when this cannot be procured, a mercurial plaster will he fout>d serviceable. Lead water, in this state, has likewise been employed with some success, by arresting the progress of the complaint. Every thing that tends to irritate, such as rub- bing, picking, or handling the affected part, should be avoid- ed. The clothing should be so regulated as not to press too 450 COMMON ULCERS. hard on the tumor, nor to keep it disagreeably w arm, ner leave it painfully cold. VI hen the cancer becomes ulcerated, various have been the applications, but those which give the least pain are the most eligible. The narrow leafed dock-root has proved an effectu- al cure of this malady, in many instances. The manner of applying it, is by boiling the root till it is quite soft, then batue the part affected, with ihe decoction, three times a-day, as hot as can be borne, using the root in form of poultice. Another remedy for this discafte, is the solution of arsenic. It is to be taken inwardly, thrice a-day, in its usual doses, [See Dispensatory] and to be applied externally in a diluted state. A drachm of the solution is first to be diluted with a quart of rain water, and made gradually stronger, till it be double of that strength. This mixture may be either applied en lint, or made into a poultice with the crumb of bread. The solution of kali on lint, has also been employed with some success in cancerous ulcers, beginning with it weak, and gradually increasing its strength. The charcoal powder [See Dispensatory] is an excellent ap- plication to cancerous sores, particularly when they have an offensive smell. It may be daily applied in powder on \i\rt, carefully observing not to expose the ulcer to the air on changing the dressing. Carrots [See Materia Medica] are also a good application to foetid ulcers. COMMON ULCERS. No disease occurs more frequently among the poor and uegroes, than ulcers of the legs; for this obvious reason, they are more exposed to accidents, and when they meet with a wound or contusion in the leg, the injured part inflames, and becomes an ulcer for want of proper care. Women with ob- structed menses are also subject to this disorder. COMMON UL6ER8. 45 J TJlcers receive various appellations, and require different modes of treatment, according to tlieir appearances, or the causes, and peculiarities of the constitution of the patient.__ Where the disease is local, topical remedies only are neces- sary; but when it is connected with any disorder of the consti- tution, medicines that affect the whole system, are absolutely necessary. When ulcers appear to have had any effect, either in carrying off, or preventing disorders to which the constitu- tion may have been liable, a cure should not be attempted, un- til an issue is made in some more convenient part, which should be made to discharge nearly as much as the ulcer.— [See Issues.] An ulcer not attended by any considerable degree of paia and inflammation, and which affords a discharge of mild mat- ter, of whitish consistence, the granulation firm, red, and of healthy appearance, is called the simple purulent ulcer, and is entirely a topical affection. This ulcer is the most simple that can occur, both in its symptoms and method of cure; and it is to the state of such a sore, that every other species must be reduced before a permanent cure can be effected. The causes of purulet t ulcers are, all woumhffthat do not unite without the formation of matter, and every external accident that terminates in suppuration, with an opening as a consequence of it. In 'he cure of this species of ulcers, first remove any inflam- mation whieh may attmd it, by emollient poultices, as hread and milk, renewed every three hours. As soon as the inflam- mation subsides, on,it the poultices, lest the granulations be rendered lax and flabbv, but keep the sore clean, and dnss with some mild ointment, such as Turner's, < r tie simple ce- rate. [Sec Dispensatory] spread very thin on soft lint, or apply dry lint, and upon tbat. a piece of linen spread with the oint- ment. I he thorn apple ointment [See Mutena Medica] is a most valuable application to heal sores. The frequency of dressing ulcers must depend on the quantity of matter dis- charged; but in general, they should ho dressed once in twen 452 COMMON ULCEUS. ty-four hours in winter, and twice in summer, and the greatest care should betaken, in renewing the dressings, not to expose the sore for auy time to the air. When the ulcer is filled up with sound flesh, tbe remaining part of the cure consists in the formation of a cicatrix. This is frequently the work of nature, but, in many cases, when every deficiency appears to be supplied, still a cure is tedious, the. surface of tlie sores re- maining raw, and discharging freely. In such cases, the sores should be washed twice a-day, with simple lime water, or with some of the astringent washes. [See Dispensatory.] Ulcers of the irritable kind, which yield a thin ichorous dis- charge, sometimes bloody, and give pain on being touched, are brought to a favourable state by warm fomentations, as decoctions of m irsh mallows, slippery elm, wormwood, cam- momile flowers, or hops, [See Materia Medica] and by poul- tices ol" the same ingredients, to winch may be added bruised flaxseed or oatm-.al. But so soon as the irritability of the ulcer is removed, these applications should be discontinued, and the common remedies for ulcers employed. However, there are cases of irritable u'cers being rendered more painful by the application of any thing warm, and when this happens, such fomentations are not to he employed.— There, the sweet oil or saturine poultices applied cold, will be found most beneficial. Indolent ulcers which are marked by a backwardness in forming granulations, and in tliose that are formed, a want of sufficient strengtii to bring about a complete cure, require stimulating applications, as lime water, solution of kali, blue vitriol, or any of the astringent washes. Lint dipped in either of those solutions, that may be found to agree best with the patient, should be applied twice in twenty-four hours to the sore, after being carefully cleansed with castile soap and water. The strength of the solution should be gradually in- creased every two or three days; for what at first gives con- siderable pain, will soon lose that effect. Tincture of myrrh, pure or diluted, according to the state of the ul or, is, in ma. I COMMON ULCERS. 455 Hy instances, a good application, and a decoetion of wfchiut leaves, is exceedingly useful in disposing foul ulcers to heal. In some superficial ulcers, attended with a thickening of the skin, and when there is an unusual coldness of the limbs, without any tendency to mortification, warm salt water has been used with the great st advantage. _, There is nothing of more importance, both in facilitating and ensuring a permanent cure of ulcers on the legs, foan compression, which, however, should never be employed un- til the inflammation has subsided. As soon as this desira- ble event shall have taken place, and the usual dressings are applied, the aff-cted part should be covem-d with several foldings of soft linen rags, and the whole secured upon he part witli a calico or flannel bandage, three inches in breadth, andiour or live)aids in length; or rather, as much as will support the limb from the foot to the knee. This bandage should be applied with as much firmness as tan he borne by t:e patient, and as mi): b evenn ss ,ts possi- ble, by passing it first round the leg at tbe ancle joint, then once •r twice round the foot, and afterwards up the limb in a spi- ral manner, until it reaches the knee, observing, that each turn of the bandage have its lower edge about an inch above the lower edge of the fold next below. If the compression should give pain and produce inflammation, the part that is effected should be moistened with col! water, poured from a tea-kettle or tea-pot, and repeated as often as the above symp tonis may indicate the necessity. Should any disease prevail, its removal must first be effect- ed. If the patient be weak, the diet should be nutritious, and tonic medicines, as bark, or the nitric acid, given in their usual di^es. But i", on the contrary, of a plethoric habit, he s'-ould observe a spare and cooling regimen, and take a tea- spoonful of cream of tartar and flour of sulphur thrice a day. In obstinate cases, small doses of calomel, until the system is affected with it, or the use of pake-berry bounce, will assist the cure. .VJ 454 WOUNDS. The cure of all wounds is eft'ei fed two ways, cither by ad- hesion or suppuration; anil previous to attempting either of these modes, the hemorrhage or further effusion of blood should be restrained, and any extraneous substance removed. Hemorrhages are to be restrained by the application of dos- sils of lint, or by the tourniquet, or pressure with the hand, above the wounded part, until a ligature can be applied. In dangerous hemorrhage, or bleeding in the extremities, we have known the curative operations wonderfully assisted by simply raising the limb as perpendicularly as possl%. In the erect posture, the gravity of the blood so checked its ve- locity as to enable the surgeon, with great care, to stop its effusion, which he had not been able to eff-ct while the limb was pendent, and its vessel distended with blood. Simple as this suggestion may appear, it is a new disco- very in the science of healing, for which, we are indebted te professor Physic, whose extraordinary skill in that noble art, has conciliated to him that very amiable title, "the American Hunter," and for safety of all surgical operations, has placed Phil ad Iphiaon the same high level as Edinburgh itself. When ligatures are necessary, in consequence of large arteries being wounded, the following rules are to be observ- ed in applying them. If you have no tourniquet, take a gar- ter or a cord, make a small linen cushion, about four or five inches long, three broad, and about two thick, or roll up a handkerchief hard, in a similar form, and lay it on the trunk of the artery above the wounded jiarf; put the garter or cord over the handkerchief, round the limb; tie a knot, leaving a proper space; and then twist the ligaturo with a piece of stick, until the hemorrhage js completely restrainrd; you are then to prepare a ligature, formed of two or three white waxed threads, proportioned to'the size of the vessel; after which, WOUNDS. 45.) slacken the bandage, in order, by its hemorrhage, to discover exactly the situation of the artery, and with a tenaculum, or a crooked needle, stick its point into the coat of the artery, and draw out the latter for an eighth of an inc!-, when a ligature, previously placed over the instrument in the manner of a ring, by one of the ends being put twice through the other, termed the surgeon's knot, is to be pulled over the point of the needle by an assistant; and wdien upon the vessel, its two ends should be drawn gently, until the sides of the latter are compiesscd. A second knot, if thcwtery is large, may be then made, after which, the instrument is to be removed, and the cuds of the thread or ligature cut off, at such a distance, that they may hang at least one or two inches without the edge of the wound. When a small artery is wounded, if it he divided, it re- tracts, and the hemorrhage presently ceases. If it is punc- tured, the wouhiI should be enlarged, and then the artery may be tied, if proper pressure proves ineffectual. Sand, dust, or small pieces of glass, tec, are best removed by washing the parts in warm water, either by means of a sponge, or of a syringe. In the third place, as the principal object, proceed to the employment of tliose means, which will probably heal the wound in the most easy and expeditious manner; for the long. er this is neglected, the less is the part disposed to heal.— Whenever the nature of the injury will admit of it, the divided parts should be immediately brought into contact, the irrita- tion excited by the wouud itself, will then generally be pro- ductive of a certain degree of inflammation, which will accom- plish a union in the course of a few days; however, in relaxed habits, with symptoms of debility, the application of some stimulants, as Turlington's balsam, spirit, or balsam of apple, will be required to produce that effect. The wound is then said to be healed by the first intention, and this mode of cure should always, when practicable, be attempted. TV means 456 wou.\i)<. of drawing and preserving divided parts in contact, are band ages, adhesive plasters, and sutures. With respect to the two firs', these should always be preferred to the latter, in wounds that do not penetrate to any considerable depth. The mode of applying adhesive plasters is by straps; one rhalf of which, is fastened on one side of the wound, and the other on the skin, on the other side of the wound, drawing it tight, and holding it firm until the warmth of tbe part secures it; but if the wound is deep, this contact of the sides must he made by sutures. ^ In forming sutures,'it should he observed, that one stitch, or suture, is sufficient for every inch of wound, and that the ligature or stitch, should always be carried near the bottom of the wound, and the threads passed from within, outwards.— Tims, a needle being put upon each end of the same thread, well waxed, and each of the needles inserted at the bottom of the sore, when pushed outwardly, about half an inch to an inch from the edge of the wound, according to its depth, will form one stitch, and the needle being withdrawn, the same thing is to be repeated, according to the extent of the wound. When all the stitches arc completed, the lips of the wound are to be pressed together, and supported in that position, until the ligatures are tied in the manner as already directed for making a surgeon's knot. It is of consequence to observe, that where the sutures or adhesive plasters have been neglected at first, they may be employed witli advantage during any stage of the sore, as the parts will unite at any time very readily; and it will expedite the cure very much, to bring the edges of the ulcer into con- tact, whenever it can he done. When the parts are brought together, in the manner directed, in order to prevent the ac- cess of air, it will be proper to cover them with lint, spread either with a thick mucilage of some mild gum, or some bland ointment, as the simple saturine, or thorn apple ointment; or, in debilitated or- relaxed habitj^ apply Turlington's balsam.— [See Dispensatory-] The first dressing of wounds should never be removed, un- .'v WOUNDS. 437 til the cure be completed, or until they appear to be covered with matter, unless the pain 111 the wound becomes severe, and is productive of much inflammation; and then the dress- ings should immediately be removed, and the parts gently rubbed with some olive oil, and a plaster of saturine cerate, spread on soft lint, applied. If this prove insufficient, and the inflammation is observed to rise still higher, a .separation of ihe lips, tie stitches tense, and the points where stitches pass, particularly inflamed, cut the ligatures, and thke away every thing that is like stricture upontMie wound. All hopes of procuring adhesion must now be a'blndoned, and tlie wound should he brought to a speedy and plentiful suppuration, by flaxseed, or milk and bread poultices, often renewed; and as soon as there is a full appearance of pus, with relief of the more violent symptoms of inflammation, the poultices should belaid aside, and the sore then treated as a simple ulcer. When the sutures or plasters have been applied, and the symptoms of pain and inflammation continue moderate, they may generally be removed about the fifth or sixth day, as a union will by tbat time be produced. Gun shot,* or lacerated and contused wounds, as marked by their ragged and unequal edges, arc the most dangerous of all others, from their disposition to gangrene. Hence, it is obvious, that in these wounds, the means to guard against mortification should he early employed. In the treatment of wounds of this description, three stages are to be observed in its progress, which may be termed the inflammatory, suppu- rant, and the incarnating. In the management of the first or inflammatory stage, especially if the patient complain of much pain, blood-letting should be had recourse to, and repeated •Speaking of gun-shot wounds reminds me of a most awful and me- lancholy event, which not long since took place in Charleston, S. C.— I mean the death ot the great physician and historian, Dr. David Ramsay. Th;s gentleman, whose urbanitv of manners, and extraordinary lite rary acquisitions, had rendered him the brightest ornament of science and society, was suddenly cut off amidst his usefulness to his family and country, by the pistol of a lunatic. The untimely t'.ite of so t:-a- ly amiable a man, and so distinguished a physician unci patriot, as Dr. Ramsay, will long be remembered vith the deepest regret. ■!•.") 8 WOUNDS. according to the violence of inflammation and strengthiof thepatunt; ami ii' possible, to procure leeclie-. these should be applied near the -edges of the sore. Emollients ar then to he used, as pledgets of mild ointments on the wonr , with poul- tices of bread and milk, or flaxseed laid^above, i«nd rem wed every three or four hours, in order to promote a speedy sup- puiation. which are the best means of preventing gangienc. When the pus is freely formed, a separation of the.....st injur- ed parts ftkes place, and as soon as they have come away, th^edges of the wouudj^iay be brought together by plasters or bandages, but no kind of suture should be employed; and the sore w ill then come to be treated as a simple ulcer. In the second or suppurant stage, the chief point is to check the excess of suppuration, and dispose the wound to heal.— This depends on a light nourishing diet, with wine, and the plentiful exhibition of bark and elixir vitriol. The third or incarnating stage is promoted, by placing the member in a proper position, to give a free discharge of mat- ter, assisted by pressure at the same time, and by opening every collection which appears, hy removing splinters, hones, or whatever causes irritation—and by healing with astringent dressing of lint, dipt in tbe solution of alkali, lime waiei, or any of the astringent washes, [See Dispensatory,] when the discharge is excessive. In the progress of wounds, certain constitutional symptoms arise, that demand particular attention, those are pain, inflam- mation, and convulsive affections. The first of these usually goes off in a short time, hy attending to the posture and ease of the wounled part, and moving any extraneous irritation; but when it continues very violent, and for a longer time than usual, it will be necessary, in the first place, to try the effects of laudanum, in doses of eight or ten drops every two or four hours; and when the inflammation is violent, to unload the vessels bv topical bleedings; which may be further aided by fomentations ami eiwdiient poultices. If these are not suffi- cient, and the pain still continues acute, it probably depends on a partial separation of nerves; to relieve which, a completf MORTIFICATION. 439 division of them should be made. The latter complaints are spasmodic, which vary in degree from tlie slightest convul- sive twitching, to the highest state of tlie spasm in the attack of the lockjaw. They arc frequently ihe effects of trifling injuries: a small scratch, for instance, whicli does not pene- trate to a greater depth than the skin, will sometimes induce fit m; and when they happen, as the consequence of large wounds, they do not make their appearance until the sore se* ins nearly healed. I pon the first symptoms of these affections, the patient should be immersed in a bath of warm'water, soap-suds, or a ley made with wood ashes, as long aS he can hear it, and opi- um, should be exhibited m pretty large doses, every two or three hours, as the symptoms may indicate. When this fails, the malady is to be treated by remedies prescribed for tetany. The constitutional treatment of wounds requires, during the inflamieatory stage, tho strictest attention to the cooling regi- men, a low spare diet, an occasional use of laxatives, aud the wounded part kept in such a situation as affords most relief. When suppuration is formed, a fuller diet will then be necessa- rv; and if the discharge of matter is excessive, bark and elixir vitriol must be employed. MORTIFICATION. The word mortification, in its present acceptation or mean- ing, is generally supposed to have place where the circulation is no longer performed through the diseased part, which gene- rally turns black, and becomes putrid, producing a separation of iie diseased surface from the sound flesh, like an eschar, in consequence of a caustic having been applied. In the incipi- ent stage of this disease, which is termed gangrene, there is generally a very high degree of inflammation, and a swelling of the parts affected, with some vesications, like those from scalds, hut of different colours, according to the extravasated 460 MORTIFICATION. fluid, with which they are replete; sometimes pellueid or yel- low, at other times black or brownish. While things are in this state, attempts should be made to prevent a sudden change to a mortification: but in order to effect this, it must be observed, that a tendency to mortify may be owing to very opposite causes. It must, therefore, be extremely obvious to every man of consideration, that there cannot he any thing properly a specific for a disease, wliere a plethora ot fulness is the cause in one subject, and inanition in another. »' Wefknow very well -jjiat all inflammations may t-rmiuatc in mortifications. It is also of importance to know, that where there is a languid circulation, as in o'd age. or inc.ses of excessive debility, from protracted fevers, the extrrniities not ouly threaten soon to become gangrenous, but the proge ss to mortification is often very rapid uikW such circumstances. for not only the vital heat is deficient, but tlr vessels them- seves are frequently diseased, and though duly distended with blood, are incapable of reacting on the c< ntaim d fluid, which, consequently, in time, must stagnate in the small vessels. Hence, it is obvious, that a mortification may proceed from a circulation that is too rapid, or too languid; and, conse- quently, the treatment must vary according to circumstances, and the cause of disease. In the first case, general blood-letting, diluent drinks, with nitre dissolved in them, and the cooling regimen in every res- pect, are indispensable for its cure. And in the second, a liberal use of cordials and invigorating medicines, as wine and bark, to raise and maintain the vital heat, and to check the progress of putrefaction, can alone be depended upon. When the mortification proceeds from too languid a circu- lation, or when there is much pain, opium or laudanum is one of the greatest cordials, and should be taken freely every three or four hours, but not in such doses as to produce its narcotic effects. The best external application to arrest tho course ef gan- M aJPRAINS AND URUl^ES. 461 ';i'ene or mortification, is to apply a blister over the gangre- nous part, sufficiently large to cover one or two inches of the sound flesh, and afterwards to dress the part with cataplasms, made of bark, charcoal powder, and yeast, to be renewed every three or four hours, or as often as they acquire a pu- trid smell. When the mortified parts begin to separate, remove no more at each dressing than comes away without pain or loss of blood; and as soon as the gangrene stops, and granulations •f good flesh appear, it is to be treatejLas a simple ulcer. SPRAINS AND BRUISES. In the treatment of sprains and bruises, tbe chief point is to give an instantaneous vigor to the solids, so as to prevent the increase of effusion. Hence, the part should be instantly plunged into cold water. After this, cloths wetted with vine- gar or lead water, to which, laudanum may he added, should be applied, and renewed as fast as they grow warm, until the pain and inflammation have somewhat subsided. The sprain- ed part may then be dressed two or three times a-day, with a bandage of brown paper, dipt in warm vinegar and spirits, or embrocated with opodeldoc or volatile liniment, [See Dis- pensatory] always observing to preserve the part in the easiest and most relaxed posture. In addition to this local treatment, if the patient be of a plethoric habit, or the injury very severe, blood-letting, cool- ing cathartics, and a light diet, are particularly enjoined.— When bruises have been neglected at the onset, or become painful, warm fomentations of bitter herbs, are extremely useful; and their good effects will be considerably aided by applying the ingredients themselves as a poultice to the part, as warm as can he borne, aud sprinkled with a little finely- powdered oamphor. After serious sprains, the patient often complains of weak- Co- .««*...* 162 DISLOCATIONS. ness and uneasiness in the injured par':-;. In such cases, a stream of cold water poured on the part at a considerable height, from the spout of a tea-kettle or pitch r, two or three times r.-day. completes the cure, especially if a flesh brush or flannel he vigorously used immediately 1: fore and after the application. Some assistance will likewise be obtained by the use of a bandage or roller, to confine the swelling when that symptom occurs. DISLOCATIONS. Dislocation is the removal, hy force, of an articulated « bone from its natural situation, which is easily knowe bv a degree of protuberance on one side, equalled by acorr...| tid- ing "hollow on tho oUrr; by comparing the join* ot one lum- ber injured with its fellow; by an inability to move the injured limb; aud by pain and tension in the part affected. In what- ever art a dislocation happens, it is «.f great importance to have it reduced as soon as possible, because, !>y here inflammation has taken place before the reduction is accomplished, it cannot be performed until that is over- come. For this purpose, we must adopt the antiphlogistic plan, such as bleeding, keeping the bowels in a laxative state, by the occasional use of the cathartic mixture, and using warm drinks, together with the cainp'orated powders, andtheanti- ni'Miial solution. [See Dispensatory] in their nsual doses, in order to promote perspiration. DISLOCATION OF THE JAW. The lower jaw may be luxated by yawning, blows, falls, chewing hard substances, or the like. Ties accident may be known to have taken place from the patient's being unable to shut his mouth, or eat any thing. The chin, likewise, either hangs down, or is wrested to one side; and the patiei.t is neither able to speak distinctly, nor to swallow without con- siderable difficulty. The common method of reducing a dislocated jaw is to place the. patient upon a lew stool, in such a manner that an assistant may hold the head firm, hy pressing it against his breast. The operator is then to p^sh his two thumbs, pro- tected with linen cloihs, that they may not bo. bitten w' u the jaw slips into its place, as far back into tlie patient's mouth 164 DISLOCATIONS. as he can, and theu, with his fingers applied to the outside oi the angle of the jaw, endeavor tojjring it forward, till it move a little from its situation. ,. He should then press it forcibly downwards, and backwards, by which means the elapsed heads of the jaw will immediately slip into their place. DISLOCATION OF THE SHOULDER. The humerus or upper bone of the arm is the most subject to dislocation of any in the, body, and may be luxated in va- rious directionsc The accident, however, happens most fre- quently downwards, aud very seldom directly upwards. This dislocation may be discovered by the patient's inability to raise his arm, as well as by violent pain in attempting it, and hy a depression of cavity on the top of the shoulder. When the dislocation is downward or forward, the arm is lengthened, and a ball or lump is perceived under the arm pit; but when it is backward, there appears a protuberance behind tlie shoulder, and the arm is thrown forward towards the breast. The usual method of reducing a dislocation of shoulder is to set the patient upon a low stool, and to cause an assistant to hold his body firm, while another lays hold of his arm a little above the elbow, and gradually extends it. The opera- tor then puts a napkin under the patient's arm and causes it to be tied behind his own neck. By this, while a sufficient extension is made, he lifts up the head of the bone, and with his bands directs it into its proper place. In young and del- icate persons an operator may generally reduce this disloca- tion by extending the arm with one hand and thrusting in the head of the bone with the other. In making the extension, the elbow ought always to be a little bent. If much difficulty occur in the operation, blood-letting, sometimes so far as to produce fainting becomes necessary. This remedy seldom fails to facilitate the reduction. 4G;i DISLOCATION OF THE ELBOW. g The bones of the fore-arm may! be dislocated in any direr- lion, but most commonly upwards and backwi-.rds. In this luxation, a protuberance may* be observed on that side oT t:,e arm towards which the bone is pushed, from o u oh cirri in- stance, joined to the patient's inability to herd his arm, a lu i tion at the elbow may be known. For reducing a dislocation at the elbow, two assists-, it* are for the most part necessary: one of them must lay hold of the arm above, and the other below the joint, and make a pretty strong extension, while the operator returns the bones into their proper place. The arm must afterwards be bent, and suspended for some time with a sling about the neck. Dislocations of the wrist and fingers are to be reduced in the same manner as those of the elbow, viz. by making an extension in different directions, and thrusting the head of the hone into its place. «——■*■—■ DISLOCATION OF THE THIGH. When the thigh-bone is dislocated forward and downward, the knee and foot are turned out and the limb is longer than the other; but when it is displaced backward, it is usually pushed upward at the same time, by which means the limb is shortened, and the foot is turned inward. When the thigh-hone is displaced forward and downward, the patient, in order to its reduction, must be laid upon h\4 hack, and made fast by bandages, or held by assistants, while hy others an extension is made by means of slings, fixed about i.he bottom of the thigh a little above the knee. While the extension is made, the operator must push the head of the bone outward until it gets into t'.ie socket. If the dislocation /e outward, the patient must he laid on his face, and during 'he cvtension flic head of the hone must he pushed inward. f'-^-"' 466 INJURIES OF THE HEAD, AND Dislocations of tho knees, ancles, an 1 toes, are reduced much in the same m inner as tliose of. the upper extremities, viz. by making an extensiosadn opposite direction-!, while the operator replaces the hones. ■ In many cases, however, the extension alone is sufficient, and the bone wili slip into its place merely by pulling the limb with siifiicient force. It is not hereby meant that force alone is sufficient for thp reduction of dislocations. Skill and dexterity will often sicceed better than force: aud one man who possesses them has been a»!e .u perform what the united force of many was found inadequate to accomplish. EtfTSTE.SSS OP THE HEAD, AND FRACTURES OF THE LIMBS. If, in consequence of a bed fall or blow, a considerable in- jury appears to have been received, the sufferer being unable, in consequence of the loss of his senses, to point out the in- jured part, some consideration is necessary before any at- tempts arc made, even to raise him from the ground. He- oause, should a fracture of one of the hones have happened, and not suspected by his assistants, their exertions to raise him, and to place him on his feet, might force the ems of the fractured hone through the soft past, and convert a simple fn. coagulate, which will form a kind of scab, and every effort should he made to unite the Wound by the first intention, thereby converting the accident to t e state of asimph fracture. Almost all fractur-s are attended with contusion and conse- quently swelling; th' abating of winch is the first step that should be tak< n towards the cure, and is to he effected by bleedi-g, if the patient is of a pleth-ric hab.t, by mild purges, a cooling regimen, and by the ex'obiti >n of the anon of the lancet, and communicated from the p»rt to the extre.nity of Hie member. The treatment of this complaint consists in fie early use of cloths, wrung out of lead water, applied to the part, and adopt'ng. in every respect, the antiphlogistic plan, as blood-letting, cooling cathartics, and a low diet, to obviate inflammation. This treatment not succeeding, laudanum must be given ia large doses, which, also failing, a free division of the .M-rvj or tendon, which was pricked with the lancet, is the only remedy left. The last accident required to he noticed, is the wounding ef an artery, which is known immediately after the operation, by strong compression of the vein, above and below the ori- fice, by the tremulous motion in which the blood flows, and by not being able to st >p the discharge as usual. The cure of this affection may be attemp'ed in the early stage by com- pressing, an I obs-rving t'»e ant;phlogistic regimen. On their fading, the tumor must be extirpated, and then the ends of the vessel s--cured by means of a ligature, until a reunion of the part* is affected, when the circulation is made to pursue a different channel. 473 ISSUES. Thesb are a kind of artificial ulcers, formed in different parts of the body, tor the purpose of procuring a discharge of purulent iiiatu-r, wh ch is frequently of advantage in vari- ous disorders. Practitioners were formerly of opinion that issues served as drains, to carry off noxious humors from the blood; aud, therefore, they placed them as near the affected part as possible. But as it is known that they prove useful, partly by the quantity of matter which they produce, and partly by sympathy, they are generally placed win re they will occasion the least incouvi nience. The most proper parts for ti cm are, the napr of the neck; the middle, outer, and fore-parts of tlie shouhler; the hollow ahove the inm r side of the knee; or either side of the backbone; or between two of the ribs; or wherever there is a sufficiency of cellular sub- stance for the protection of the parts beneath. They ought never to be placed over the belly of a muscle; nor over a ten- dim or thinly cove, ed bone; nor near any large blood-vessel. The. issues commonly used, are the blister issue, the pea- issue, and the seton or cord. When a blister-issue is to be used, after the blister is re- moved, a discharge of matter may be kept up by dressing the part daily, with an ointment mixed with a little of the pow- der of canthaiides, or Spanish flies. If the discharge be too little, more of tl e powder may be used; if too great, or if the part be much inflamed, the issue-ointment may be laid aside, and the part dressed with basilicon, or with common cerate, till the discharge be diminished, and the inflammation abated. It is sometimes most proper to use the issue-ointment, and a mild one alternately. A pea-issue is formed either hy making an incision with a lancet, or hy caustic, large enough to admit one or more peas; though, sonaetiwus. instead ef peas, kidney-beans, gentian- 47^ ic>i;es. root, or orange-p-al, are used. When the opening is made by an incision, the skin should he pinched up and cut through, of a size sufficient to receive the substance to be put into it. But when it is to be done by caustic, the common caustic, or lapis inferualis of the shops, answers best. It ought to be re- duced to a paste with a little water or soft soap, to prevent it from spreading; and an adhesive plaster, witli a umall hole cut in the centre of it, should be previously placed, and tbe caustic paste spread upon the hole. Over the hole, an adhe- sive plaster should be placed, to prevent any caustic from es- caping. In ten or twelve hours the whole may be removed, and in three or four days tbe eschar will separate, when the opening may he filled with peas, or any of the other substan- ces above mentioned. The seton is used when a large quantity of matter is want- ed, and especially from deep seated parts. It is frequently used in the back of the neck, for diseases of the head or eyes, or between two of the ribs, in affections of the breast. When the cord, which ought to be made of threads of cot- ton or silk, is to be introduced, the parts at whicli it is to en- ter and pass out, should be previously marked with ink, and a small pari of the cord being besmeared with some mild ointment, and passed through the eye of the setnn-ncedlc, the part is to be supported by an assistant, and the needle passed fairly through, leaving a few inches of the cord hang- ing out. The ne.-dle is then to be removed, and the part dressed. By this method, matter is produced in quantity proportioned to the degree of irritation applied; and this can be increased or diminished; by covering the cord daily, be- fore it is drawn, with an irritating or mild ointment. 477 MALIGNANT FEVER. *In the year 1825, while the Epidemic Malignant Fever, sometimes denominated the Cold Plague, was raging in the Western and Southern country, and when physicians were unsuccessful in its treatment, and divided about its nature and origin, the author received the following letterf from sundry respectable gentlemen, citizens of Louisiana, asking informa- tion from him, as to the management of a disease, which had 'This article, the author wished to place under the head of Fevers: but as it could nut be conveniently prepared till the former portion of the volume was in type, and as the author has not aimed at a strict nosological arrangement, he thought it as well to introduce it at the find ot diseases generally. FEUCIAKi PaHTSH, LoTTISTAlTi, J-Dr. James Ewell, September 24th, 1823. Dear Sir:—We have perused your Medical Companion, with pleas- urable and profitable attention, and though professedly ignorant of the science of Medicine, wedeem that work a valuable addition to the libra- ries, and eminently deserving the grateful acknowledgements of your fellow citizens, in consequenee ot" its peculiar excellence and utility. That portion of it dedicated to Materia Medica, the Dispensatory, and a table of Medicine, entitles the author to the gratitude and respect of many families. From observation, we have found that those physi- cians are the most successful in their practice who have followed the directions which you have offered to the public. Entertaining an exalted opinion of your professional talents, we have concurred in addressing this epistle to you, in the confident ex- pectation, that your popular benevolence will prompt you to favour us with your valued advice on a disease, generally acknowledged mortif- •rous in this section of the union, which of all others has most severe- ly suffered from annual epidemic distempers, mostly of a febrile de- scription. The Cold Plague is the ordinary denomination of the formidable malady to which we allude, and for which, no adequate remedy has, as vet, been discovered. « To afford you some idea of its prevalence and malignity, we state the fact, that, in the space often days, our neigbour, Mr. Waddle, lost six of his household who were attacked by this disease; that he him- self is now its victim, and is hurrying to the threshold of eternity, while his sister is, at the same time, confined to her bed, with all the symptoms of the same complaint; and this, sir, is but one instance of many thousands of the fatality of that disease, which annually deso- lates Louisiana and the bordering stat«* of Mississippi. 4-78 MALICiNANT FKVKK proved so fatal in their neighborhood. The author, having u<* personal knowledge of the disorder, being far r< moved from the scene of its devastation, and having no sources for information, on which he could r< ly, was constrained to decline giving the advice requested. He lias since met with the elaborate and satisia'-tory Essivs on the subject* written by Samuel A. Cartwright, M. D. of \a co z. vIin-.h- sippi, and published in tbe Medical Recorder, V >». IX. year 1826. From those K.ssavs he has made copious extracts* which he presents to his very polite rorresp' ndents of Felici- ana, and to the publ c, in general, as the best treatise on the cause, symptoms, and cure of malig■■ nt fevers, that has ever been published, and indeed the best which could be gathered from the whole stock of information on the subject, now pos- sessed by the profession. The thanks of the Medical I'rofes- That distance precludes you from personal contemplation of the symptoms of theCoid Plague, isseriojsly lamented by u.-., as it subjects vou to disadvantage in prescribing, and us to less certain benefit from your medical knowledge. We will, however, attempt to describe it. One of the undersigned was seized with the Cold Plague, about the conclusion of August, 1821. Symptoms. Pain in the stomach extremely violent; a vibrating coldness; a fever, duruii; which :ci.uis, that the patient was in a high fever, the latter felt a death like coldness, in all parts of hi* body, except the region >f the hem! :Ie whs continually tn rstv; and, for three days and nights, complained of extreme pain in the stomach. We earnestly request you. Sir, to give your opinion relative to the best method of treating this enemy of Louisiana. Address to Mr. William George Dixon, St. Francisville, Feliciana Parish, Louisiana. (Signed.) \\gus Umphraville, "j A.W. Draughan, Uenj. O Williams, ! Esa's Francis Brian, itOBKRT DYER, r " ' Ln Kentz, David Pipes, Sen. J Joseph Drawdt, Jesse Knightly, Merchant. H H. Harrkll, N M. K. Keid, (J. S. Surveyor. Joseph Vick, Wm. G. Dixon, Wm. Campbell, John Rowley, Stephen Shelton, ft. ^H* NCE, MlCAJAH CoURTNKI. RoBT Nevland, * I'lunti-ro. M. DlKSWf, K A MALIGNANT PEVER. 479 sion, and of the public, are due to Dr. Cartwright for his seal and industry in invesfigating this subject, and f >r the ability With which he has communicated the results of his labors. Symptoms. The disease was marked by three distinct stages, each of which had ils p; culiar symptoms. As it might, in its first and second stages, have been mistaken for some other malady, I will only describe the last stage, which pre- sented features altogether peculiar, and could he confounded with no other disease whatever, in the last stage, there was apparent!) no lever, and little or no pain. The patient ofteii regained his stiength so far as to be able, in tl e most of cases, to walk about his room. His eves were of a yellowish red, sparkling appearance, and lent to a countenance, otherwise of apathy, a strange expression ofwildness and horror. Black dissolved blood oozed from the mouth, the gums, and the nose; coffee ground vomit, or a dark brown flaky matter, with but little effort, was thrown from the stomach; anxiety, restlessness, and great flatulency of the stomach, portended and accompanied its discharge, spasms seized the muscles; the breathing became heavy, slow, and irregular-^attended often hy a hoarse, deep, sullen sound. The speech became incoherent; yet, when the patient was spoken to, he appeared to be able to collect himself so far as to answer questions ra- tionally, and although sensible of his situation, seemed resign- ed to his fate. These were the symptoms that characterized the third or last stage of the disease. Although all of them did not invariably occur in every patient, yet a sufficient number were generally present to point out the character of the disease to the medical attendant the moment he entered the sick room. The first stage consisted in ^broken or irregular re-action; and the second, or milder stage, in a general excitement dif- fused throughout the system. The duration of the first stage was generally from one to twenty-four hours; and that of the second stage, from one to forty-eight hours. The first stage • ould readily be distinguished from the second period, by the -180 MALlfl\A.Vr fEVEf partial evolution of heat in the one, and the uniformly hot sur- face of the other. The patient was found covered up with bed-clothes in the first stage, but in the second and third, he greatly preferred lying entirely naked. In a great many cases, the worst cases too, the state of the system which constitutes the second stage, never occurred: but tbe disease passed immediately from the first to the last stage, without going through the second stage of re-acii >n.— These were called the cold cases of yellow fever, or yellow fever without re action. The approach of the first stage of the disease was announced by an intoxicated appearance, and a remarkable exhileration or depression of spirits, and was soon ushered in by a cotem- poraneous sensation of heat and cold. The patient, although complaining of great internal heat, was often found under one or more blankets, whicli he would not permit to be removed. His skin, which to him, felt excessively hot, was often actual- ly cold to the touch. Yawning, stretching, soreness of the flesh, achings of the bones, and at length, flatulency of the stomach, with great weight and oppression about the prce- cord a, took place, followed by pain in the head, stomach, aud back. The pain, in this stage, was never so severe as in that of general re-action. Indeed, it was sometimes entirely absent. It was remarked by a very intelligent and accurate observer of the disease, Dr. Gustiue, that the most fatal cases were those whicli were attended with the least pain. A want of thirst also attended tbe disease in its first stage. The tongue was then seldom much furred; its edges were of- ten red; sometimes, it presented no unusual appearance in the most malignant cases. The patient, in this and the second stage, was as anxious abeut living, as he was indifferent and careless of life in the last stage. Treatment. Experience has long since proved that the same remedies produce very different effects in different dis- eases, and in different stages of the same disease. Stimulants, MALIGNANT fever. 481 emetics, cathartics, tec. arc only relative terms; for, in many conditions of the system, stimulants impart no strength, tartar emetic will not puke, nor will calomel purge or salivate. I shall Grst point out the state of the system in which they were used, the effect they produced, and the manner in whicli they influenced the disease. In all important cases, I was in the habit of noting the state of the system when a remedy was given, and on my next visit, noting also the changes produced in the disease. When a remedy, in any particular state of the system, was found to he pernicious or useless, it was not concluded to be pernicious or useless in all states of the sys- tem, but only under those particular circumstances in which it had been proved to be so. When the disease terminated fatally, I looked back on the situation of the patient when the remedies had been used, their effects on the disease, and im- mediately proceeded to make post mortem examinations, and to note down every morbid appearance. Having the charge of Natchez hospital, from the 6th of September, until the epi- demic terminated in November, I had an excellent field for observation. Patients of every description were admitted, and in every stage of the disease. Some who had been un- der the treatment of other physicians, and others wdio had taken no medicine. This hospital, with my private practice in the city, in which I resided during the epidemic, and the experience of the disease in my own person, in the present, and also in a former epidemic, are the sources from which the following observations have been drawn. I have seen pa- tients recover from yellow fever under very different, and apparently, opposite modes of treatment. The narrow views which are too often formed of the action of medicines, and of the laws which regulate the system, aided by the dogmas of the schools, have, until within a few years ps st, shackled the science of medicine, and hindered its progress. B'acts are yet tow often overlooked or disregarded, when they do not sup- port some slender-built theory, or favorite hypothesis. In the first stage of yellow fever, or in that which consists of an ataxic or crippled re-action, when the blood is unequal- •182 MALIGNANT FEVE*. Iy determined, the heat unequally diffused, seniatiow impair- ed, and secretion suspended, I found no other remedy, or combination of remedies, which produced such decided ef- fects, as tartar emetic, in full doses. It, however, seemed sometimes inadequate to make a sufficient impression on the torpid system. When given in this stage of the disease, its effects were not so soon apparent, as in the healthv state of the system, or in less violent diseases. Verv often, it would be an hour or more, after a full dose had been taken, In t >rc the system appeared to feel it. At length, that peculiar sen- sation of heat aud cold, at the same time, would somewhat yield to a sensation of heat only; the temperature ol the skin would become more uniform, and as the excitement was brought out. great distress would ensue, and the system ap- peared to aro«.se Iroin its torpor, and to regain, in some mea- sure, its organic sensibility. Some one or more of the great organs i»f secretion now took on a secretory action. The nausea, the retching and anxiety, soon gave way to full vo- miting, first of phlegm, and then of bile. This, to a specta- tor, was an alarming period in tbe disease, and most distres- sing to the patient. The powers of life would sometimes ap- pear as if they were about to give way under it, but happily it was only in appearance. Tlie vomiting at length subsided, and the patient enjoyed a little respite from bis sufferings. and bathed in a perspiration, he would fall into a slumber of short duration, for these were only the first effects which tartar emetic produced on the system. Soon re-action took place, and the disease passed into the second stage; but the re action was general, and lost its ataxic or broken character; it was accompanied with a hot skin, violent pain, and a full, strong, tense pulse. The patient would now complain of excessive misery. I delighted to see the disease come out thus openly, and show itself by fever and pain; for, although the patient might fancy h mself worse, yet he was far removed from the danger which attended on the ataxic fever from which his sys- tem had just emerged, and only required a bold use of the lan- cet, and other remedies hereafter to be mentioned, to restore MALIGNANT FEVER. 483 him to health. But it was not always that tartar emetic, when given iu the first stage, would produce vomiting. In those caves iu the first stage, in which the skin was cold, and even when the re-action was ataxic and scarcely perceptible, the organs as if palsied, secretion entirely suspended or strangely vitiated, the stomach irritable, aud little or no pain complained of, tartar emetic, in full doses, might be given without produ- cing vomiting. Strange as it may appear, tartar emetic, in such cases, was a most powerful stimulus; it brought out the excitement, heated the skin, raised the pulse, allayed the ir- ritability of the stomach, restored sensibility to the organs, and finally awakened one or more of them, the kidneys, skin, &.c. to active secretion. To have this effect, it should be given in doses of from three to ten grains every one, two, or three hours, dissolved in a small quantity of water, or what is bet- ter, as I have since learned, in similar states of the system, in pills. When secretion lias been brought about by the reme- dy used in this way, and the excitement developed, it should not, at once, hut gradually, be discontinued, by giving smaller portions at longer intervals. Should a vomiting cn«me before the skin has its heat and sensibility somewhat restored, bile will rarely be evacuat. d; in this event, another dose of the medi- cine should be immediately given, and repeated whenever great nausea ensues. I have rarely seen this practice fail, in such states of the system, to check the vomiting and heat the skin, when mustard and blisters had failed. It will be re- membered, that those which are denominated cold cases, are the most hopeless. 1 have used the hot bath, frictions, sinap- isms, blisters, besides various internal stimulants to bring on re-action; but the combined influence of all these remedies has never had the same beneficial effect as tartar emetic alone.— But in some cases of this kind, particularly in hard drinkers, it fails to produce secretion, and to develope excitement. It may he imagined hy men in their closets, that these are cases of congestion only, which congestion could readily be remov- ed by small and repeated bleedings combined with internal 481 MALIGNANT 1TEVLK and external stimulants. If the malignant nature of these cases depend entirely on congestion, it is a very different con- gestion from that which takes place in many other diseases. In the latter, I have often succeeded in removing the conges- tion, by blood-letting, combined with internal and external stimulants; but in the cold cases of yellow fever, never. In such cases, if blood be taken away, even should the patient not immediately sink nnder it, so far from re-action being produced, the blood-vessels lose more and more of their con- tractile power; stimulants impart no strength; the warm bath and rubefacients produce no more effect on the skin than if applied to so much leather; the organs become more para- lyzed; the sympathies more deranged; and the whole system soon appears as if it were divided into different parts, one not depending on another, and each having the principle of life diminished in it. Instead, then, of using' blood-letting in such cases, to remove congestion, I used tartar emetic to pro- duce secretion, and to develope the excitement. Although tartar emetic was sometimes inadequate to produce these de- sirable effects in the cold cases, it scarcely ever failed to he eminently serviceable in the first stage of cases of a less ma- lignant nature. The earlier it was given in the first stage of the disease, the bitter. When given freely, so as to produce secretion in the liver, kidneys, and skin, a general and equa- ble re-action soon succeeded. It shortened the duration of the first stage, or that of ataxic re-action, and thereby con- verted a highly malignant into a mild case of yellow fever.— For, in the mild cases, when left to nature, the first stage con- tinues but a short time, and the disease soon passes into the second, or that of general re-action. These are the cases whicli bear bleeding and purging so well, and in which emet- ics are of no service, (unless given h 'fore the general re-action has taken place.) The good effects of emetics appear to de- pend on tlieir ultimately producing a general and equable ex- citement throughout the system. In the more malignant forms of yellow fever, the stage of ataxic re-action, when left to na- MALIGNANT FEVER. 485 i.re, continues a longer time; and should the second stage, or stage of general excitement ever occur, its duration is so limited, tbat a sufficient time is not given to subdue the dis- ease, before it passes into the third and last stage. Tartar emetic, then, given in the first stage, shortens its duration, and places the system in a similar state to what we find it in the milder forms of the disease. And in proportion as the ataxic stage is shortened, so is the stage of general excite- ment prolonged, and the chances of the patient's recovery greatly increased. On looking over my notes, I perceived, that when it had been given in the first stage, such patients not only bore bleeding better, and could be purged more easily, than those to whom it had not been given; hut whether they lived or died, the symptoms of the second stage, or that of re-action, continued longer than when tartar emetic had been omitted.— For in those cases in which it had not been given, should the stage of re-action ever occur, it continued but a short time, frequently not more than an hour, then external re-action, like the blaze of recently ignited coals, would subside, not from the fire having been extinguished, hut from the heat which supported it having become greater. My notes likewise showed me, that tartar emetic, however well adapted to some states of the system, was not so to every one in yellow fever. For when it had been given in the stage of general re-action, its effects were extremely equivocal, and, in some cases, in- jurious; and in the third stage, it appeared to accelerate the fatal black vomiting. I thus found that I had pushed a favorite remedy too far, by using it iu properly; and, at the same time, learned the particular states of the system to which it w as pe- culiarly adapted, viz: during the first stage of the disease, antecedently to the devel/ipemcnt of a general re-action. Tar- tar emetic used in this stage, restored sensibility to the tor- pid organs, produced secretion, and destroyed the ataxic character of the disease, hy establishing a general and equable excitement; or. in other words, converted an Irregular and 4^ MALIGNANT FEVER. intractable condition of the s) stem, into an open, plain, anil manageable case of f ver. When 1 first tr< ated yellow fever, in its first stage, by tartar emetic, anil witnessed the violent re-action that shortly succeeded its use, and heard the agon z- ing shrieks of my patients, from the pain that attended the in- creased sensibility and universal excitement t at succeeded it, for a moment, I thought I hail done wrong, am! would have ceased to use it, had I not found that this was the only state of the system in whicli the laihrtt could fearlessly and success- fully b>' used. Even when the lancet was not used, the gi ne- ral re-action indu; 1 ALIGNANT Fl.'.KR. Uf the Bath. The (old hath, it used in tlr.i *t ite o^ the system, which I have railed ataxic i'-action, was evi- dently injurious. 1 cannot bettor describe us effects, than hy the following case. Mis. Kin , m tue first Mi.ige. used abiu- tions of cold water and vinegar. The efforts uiaile by Hie system, towards general re-action, hi came immediately sub- dued; and to use her own language, "the cold water drove tbe fever in upon her heart and stomach." Great coldness and shivering, with internal heat and oppression, succeeded its us-, lie-action never took place, ami tue disease passed at once into the last stage; and when I was called to see her, fatal symptoms had appeared. Had an emetic, instead ot tbe Cold ablutions, been tried, it is prob.ble, \'v.v iv action would have b en genera.; would have b >rne blom'-Htiug, and have been attended with a different result. The only condition of the system, in which cold ablutions or air .sums were advanta- geous, was wneti tbe surface was unif-rndy and preternaiu- raily hot. In this epidemic I never foetid any difficulty in reducing the re action by t.'ie 1 ncet and other remedies, con- sequently, I seldom ever found it necessary to call m the aid of cold" affusions. In the.yellow fever under review, when re-action was re- duced, or on the wane, if secretion did not take place, Ihe fepul bath, apparently hy removing the remains of morbid heat, and by restoring the natural sensibility ol the skin, en- abled that important organ to take on a proper secretory action. But cold water, by carrying off too much heat, re- duced the temperature of the skin below that degree which if compatible with natural sensibility; and, consequently, with healthy secretions. Pleased with the effect of the tepid bath, after tlie use of the lancet in the re-acting stage of the disease, I resorted to the same remedy in the ataxic stage. The tem- perature of the bath was 1)6 dcg. The patient, as so in as immersed, complained of being disagreeably cold; he was taken out in a shivering fit. an 1 was shortly afterwards im- mersed in a bath so hot, as to he extremely painful to my own liands, yet he did not in the least complain of it. His skin soon MALIGNANT FEV'tK , became generally warm, and an emetic, which he had_ previa ously taken, began now to operate. He was removed from the bath, and in a lew hours a fever so violent ensued, tlu.t copious blood-letting was employed to subdue it. The hot bath, whenever it could he procured, was employed in con- junction with emetics, in the cold cases of yeHow fever, in order to bring about a general re action. If emetics were not used in conjunction with the b ith, the skin, it is true, would be he;,ted. but its heat, like that of any inanimate sub- stance, would soon subside on being removed into a,colder medium. Dr. Cartwkigut furtlu r states, that he personally wit- nessed the yellow fever of 1825, in Natchez, •* L nder the Hill;" in Washington, a village six miles from the river Mississippi; at Haughton's, a tavern in the country; and* lastly, in Natchez, " On the Hill;" and he proceeds to give the following additional facts relative to the causes, nature, and treatment, of the disease, which its occurrence and pre*- valence in the abovementioned places afforded him an oppon- tunit;. of observing. Natchez Landing, (or Tnder the Hill, as it is called,) consists of a few rows of buildings, situated immediately on tbe brink of the Mississippi river, at the foot of a bluff about two hundred f et high, which forms the site of the principal part of the city, called, Natchez " On the Hill." Although during high water, the buildings under the hill are immediately on the brink of the river, yet when the river falls, as it always does in su'iner, a surface of ground several rods in width, becomes uncovered between tlie build- ings and the river. The surface thus exposed hy the falling of tbe r ver, consists of mud recently deposit'd, and of the debris of various vegetable and animal substances, which, dur- ing the season of trade, had been thrown out by thejlat boats that landed at this place. On the margin of this uncovered surfai e, there is a warehouse, which, in the months of July and August, 1825, contained a large quantity of spoiled porter MALIGNANT PEVELi. uii'l smr pork. The, owner of the warehouse was constantly engaged iu re-packing the po k; the brine from whnh, was I i i.nted to run through tie floor, into a kind of cellar, which bed no outlet to ii. Some of the port- r barrels burst, and ti • spoih (j porter also, ran through tin- floor info the cellar, w th Ihe br im from the sour pork. Some few hundred yards above the warehouse, t i re was a boat containing a quantity of rolf n corn, which had been sunk in the water, but became exposed iu the summer, by the IV.'liug of the river; and below toe war« house, but not so far from it, there were two or three bo .s s tnat conta ned stagnant water, others, putrid sour krout, fish, oystcis. \.<. in their cellars. Leaving Natchez for the present, I proceed to Washington, to ^ive a brief sketch of its topography, and an aexount of tho egidemic yellow fever, which prevailed there in the autumn of ibis. Washington, a small village, containing about four hun- dred inbab.tants, is situated six miles east of Natchez, and not less than the same distance from the nearest point o' the Mississ ppi river. The town occupies a high and healthy situation, remote from any swampy ground, or from any water course whatever, except a small stream of running water, a branch of the St, Catharine's, about a quarter of a mile northeast of it. The citizens of Natchez, prior to 1825, always found Washington to be a place to wliMi they could retreat with safety, 'roui the ravages of the malignant fever. The inhabitants of that town had hitherto opened their doors to the sick and the dying, and received no harm, as not a case of yellow fever ever occurred among those who had not breathed the, Natchez atmosphere. A grocer, who had been living * Under the Hill,' removed his grocery store to Washington in the latter part of the sum- mer. He rented an old wooden house on the north side of main street, which, with the lot attached to it, is situated in the hollow space of ground described above. The earth had been thrown up around the palings of the lot, except at one place, to eerve as a drain in rainy weather. Tbis drain was MALIGNANT 1 iIVLL. Choked up with weeds and trash when I examined it, during the progress of the epHemic about to be described, and sei ved but imperfertlv, the purpose for which it was intended. The grocer, who removed his store to the house on this lot, remo- ved also a quantity of bacon and mackerel, a great part of which had begun to putrefy at the time of its removal, or pu- trefied soon afterwards. These provisions the grocer was in the habit of selling to negroes* Mr. Alfred Radcliff informed me,that a few days before the yellow fever originated in Wash- ington, he called on the grocee. in order to purchase some bacon, for a friend in the country, hut on examining it care fully, the whole quantity whicli the grocer had on hand, was found to be in a putressent state, and none of it fit to purchase. About two thousand pounds of bacon, he stated, was fihul wi ,h large worms, and was in a putrid condition. The llev. Mr. Burruss informed me, that in addition to tbe putridity within the house, the grocer was in the habit of re- ceiving from the fishermen on the Mississippi river, supplies of fresh cat-fish, (a fish in this river weighing from ten to one- hundred pounds,) Ihe heads and entrails of which, besides what rotted on his hands, were thrown into the hack yard of the lot above described. All I personally know with respect to the real situation of the grocery, is w hat every person knows, who either lived near, or came in its vicinity, that the stench from it was extremely disagreeable. The principal stores and boarding-housns in town, were situated a short distance from the grocery, both ahove and below it. Both of the town mar- kets were within twenty-five steps of it. Should it then be a matter of wonder, if a few persons living in the suburbs of Washington, in the most healthy situations, should have been attacked with yellow fever, a little after the time it broke out around the grocery, when it is recollected that tliose who visit- ed the stores, the taverns, and the markets, were exposed te the same atmosphere with those residing in the vicinity of the grocery. The yellow fever of Washington, like that of Natchez, in 18-23, had three stages. Ihe first stage was generally pre- MALIGNANT KEVL.i. ceded by, and attended w.th, catarrhal symptom^. It was known by the p.iticnt's sensations being no true evidence ol the actual colduess or heat of his surface; by the heat of the sur- face being unequally diffused, the head and breast hot, the ex* tremities often cold; by the patient preferring to he wrapped up in blankets, although at the time. Ins skin may have been pungently hot to the touch, by the chilly feel ing being greatly increased, if the patient merely reached out h;s arm to have his pulse felt, or if any of the bed clothes were removed, although he might have complained of these making him disagreeably hot, by a copious perspiration occasionally taking place, and drying up without relieving the disagreeable chilly feeling, abating the pungent heat of the skin, iqualizing its evolution, or establishing the lost rel.ition between the patient's fe. ling of heat, and the real heat ofhis body. So different were the sensibilities, both organic and animal, in this fever, from a held thy condition of the system, that I have known patients to complain of their extremities being cold as ice, when they were actually burning hot. I was forcibly impressed Witk this fact, on seeing patients hear to their extremities, particu- larly their feet, applications sufficiently hot to corrode or blis- ter the skin, and produce great pain, were not the organic and animal sensibility ofthe part very different from health. I recollect of having affronted one person, from having him put in a tub of water, disagreeab'y hot to my hands, not he^ cause he found it too hot, but too cold. Tbe second stage was known by the patient losing all his chi! y feelings; by his throwing off the bed clothes, calling for c id drinks, being tortured with the severest pain in his head and hark, tossing himself from side to side in his bed, or going from one bed to another, by his uniformly hot surf re, hy a diminution in the secretory process, to wit: a paucity of bile and urine, great dryness and heat of the skin, and mucus membranes, and lastly, by an increased energy of the whole a>terial system. The third stage was pointed out, by the heat of the surface having diminished, but not the patient's sensation of heat ha- lA& proportionally diminished, by a slow irregular respiration, MALIGNANT FEVK^. or even when the number of respirations, differed but little from the healthy state; by the yellow skin, accession of Strength, the black vomit, and hemorrhages from the mouth and nose. The first stage, in some cases, quickly passed into the se- cond, in others, it continued twenty-four, or even forty-eight hours, before the re-acting stage ensued. This stage, in some never occurred, the disease passing at once from the first to the last stage, while in others badly managed, it lost many of its characteristic features, viz: there would be great hi at, thirst, and pain, yet a quick irritable pulse, which would not bear lie lancet; a comatose sta>e of the brain, similiar to ty- phus fever, accompanied with extreme irritability of the stomach, and a strong disposition in the bowels to take on a watery purging. Such cases were very fatal. The disease, not only in Washington, but in Natchez, the present season, differed from that of the latter place in 1823, in its very great liability, in many cases, to be attended with copious and vitia- ted secretions, not only in its first, but in all its stages. Treatmlnt. As in 1823, during the first stage, or that of ataxic re-action, tartar emetic was found to he the most nse- , mI remedy, I generally gave from «ix to t n grains at a dose, and repeated it in small r doses, until it either produced bilious einesis, removed the chilly feeling, developed an excitement throughout the system, produced secretion in the skin or kid- neys, subdued th.- ataxic fever, or palsied the deranged or- ganic actions. Vitiated secretions seemed to depend on the hitter, as, in many cases, the first doses of tartar Emetic put a utop to the vomiting of a vitiated fluid, which had taken place hrfm-e its exbibiti »n. Tartar emetic, however, used in small and repeated doses, often rendered the stomach more irritable, md even when used in effectual doses, it often did harm, tin- es* properly managed. When the chilly sensation was very guar, th*' warm or hot bath, if n-ed a "ittle h< lore, or at the time, the emetic was gtven, ••nahleil it to produce bilious se- cretion, in j-L more readily, and with much less distress to the patients, than when the emetic had been trusted to alone. MALIGNANT FEVBIt. Case. Mr. K. of Natchez, was violently attacked. He told me to give him any thing hut tartar emetic, for it alw ays cramped him, produced great coldness, and he had, every time fce had taken it, come near losing his life. His life appeared to me to depend on a bold use of the remedy he so much dread- ed, as I had no hope of subduing so violent an attack, unlesn some great change could be produced iu bis system by the remedy in question. As his kidneys were torpid, I gave him freely of gin sling, had him put into a hot hath, to remove the chilly sens ition he complained of, and gave him, while in the bath, ten grains of tartar emetic in half a pint of strong seneka tea. He puked bile copiously and easily; and so far from requir- ing harts-horn, laudanum, &c. to remove the coldness and cramp, as formerly, he soon lost near two pounds of blood, to subdue the consequent arterial re-action. He soon recovered. From Dr. Mcl'heeters, I learned the efficacy of black mustard in ■vinegar, both as an emetic itself, and as a 'powerful coadjutor of tartar emetic, in cases wherein the latter alone, from tor- por of the stomach or some otlier cause, failed to awaken the energies of the system. Warm brandy toddy, in some cases, prevented the tartar emetic from producing vitiated secretions, and at the same time enabled it to produce those of a proper kind, «*r at least enable it to prepare tbe system for their profocjipn. As cold feet and hands had a great effect in op- posing the beneficial action of tartar emetic, warm pediluvia sinapisms, frictions, tec. were found to be necessary to placa the system in a proper condition for its reception. It was always necessary to subdue hy the lancet, general arterial re- action or fever, whenever it came on, as it sometimes did, be- fore bilious vomiting had been produced. If it were a broken re-action or fever, however, tartar emefic was its best febrifuge.* Great determination of blood to the head, in the ataxic stage, with a pulse at the wrist, which will not indicate blood-letting, wbi'e at the same time there is a very strong pulsation of the carotid arteries, so far from being a state of the sysfem that contra-indicates tartar emetic, is the very s*nte of the system in which I have witnessed more beneficial effects from the h - # iJALIftNANT PKVER. Medy in question, than any other whatever. I am net th* onlv one who can bear testimony of the beneficial effects of tartar emetic in such stales of the system. Dr. MciMieetcrs has kept a record of a great number of cases of this kind, wherein emetics were found tube no less usel'ui, than the bark in intermittent fevers. 1; the pulse, at the wrist, and other circumstances, do not forbid blood-letting, this of course should be premised, previously to the exhibition of the emetic, hut when tbis is not the case, the blood-letting should be deferred until after the remedy has produced a change on the deranged organic sensibility of the system, broke up the irregular de terminations of blood, and brought out a general re-action of the arterial system. s The worst consequences sometimes occur from a timid use of tartar emetic, from giving it in too small doses, repeated at too long intervals, or from discontinuing its use on the first appearance of any unpleasant symptom, at a time when it may he most needed. Case. Col. Marschalk, a very large, corpulent man, was attacked with the yellow fever of Washington, I gave him an emetic iu the ataxic stage of his fever. In a few hours after- wards. I was called in great haste to see him. He was panting for brca'h, as if in a fit of asthma. No bilious vomiting bad yet been produced. Great heat, pain, and inward distress, were complained of, I bled him about a pint, as his pulse would bear no more, and gave him three grains of tartar emetic every half hour in spirits seth. nitr. The second or third d'ise brought on effectual vomiting, attended with no dis- tr ss, the skin became moist, the difficulty of breathing, inter- nal heat, pain and distiess, were removed, and the patient re- covered without further difficulty. But it behoves me to state, that the worst effects are some- times produced by tartar emetic rashly persisted in, without regard to the condition of the patient, in order to bring about some particular effect on the system, as, for instai.ce, bilious vomiting. But who has not witnessed the worst effects imni *athartics, or from mercury, rashly persisted in, without re- 6SB « MALIGNANT FEVER. gard to the condition of the patient, in order to bring about some particular effect on the system, as for instance, dark bi- lious stools, or a discharge of saliva? By an emetic properly managed, if given early in the dis- ease, not only the fever of Washington, but that of Natchez, was often cut short at once, and the patient recovered without farther tiouble, while the mildest attacks, if left tw nature, ul- timately seldom failed to prove fatal. If the disease did not yield at once to emetics, general arterial re-action ensued in the most of cases, requiring the lancet for its reduction, to- gether with purgative medicines, which brought on bilious evacuations, that soon relieved the patient. Sometimes, how- ever, when em tcs had not been used at a period of tbe dis- ease, suflii iently early, or if used, had not been properly ma- nag d, or if properly managed, owing to some peculiarity of the case, had not produced their general beneficial effects on the sys- tem, but niostgencrally,wheii emetics bad been < utirely omitted, itwas difficult to | roduce, by purgatives, the properk.nd of eva- cuations from the bowels—I mean evacuations of adark bilious matter of tolerable consistency. In such cases, it w as very diffi- cult to main purga'ive medicines on the stomach, owing to its irrir ;ouity, and, if retained, even calomel would often produce watery evacuations. In such cases, to continue the use of this or any otlier purgative remedy, without first altering that con. ditinn of the system on which the watery evacuations depend- ed, was to continue to use them to the destruction of the pa- tient. In as much as he became speedily exhausted under such evacuations, I made it a rule to check them by an enema, of a tea spoonful of laudanum in a little starch gruel, or by g'ving opium or >ts tincture. The next object was to alter that morbid conditi n of the system on which the watery or yitiated secretions depended. Tartar emetic, either with or without the addition of a little opium, in two or three grain doses, every one. two, or three In urs, calomel with two or three grains of opium, or with ten or twenty grains of camphor, rejieated according to circumstances, and assisted by the warm bath, blistering, tec. were often found useful in preparing '•1 MALIGNANT FEVEK. Uie system to be properly acted on by purgatives. A remedy, however, which appeared lo suit some cases the best, was the sulphate of quinine, or, wliere the stomach would bear it, the Peruvian bark with cream of tartar and cloves, either ol which was given without regard to fever, if such fever would not admit of blood-letting. Even when the fever, (I mean heat of akin, tec.) was increased under this practice, the various or- gans of tiie system, became more disposed to take on a proper secretory action, than before such fever had been excited. I am confident that I used the sulphate of quinine in too small doses in our late epidemic. Dr. Perrine assured me, that in the bilious fever iu the country, ten or fifteen miles from Nat- chez—to prevent a watery purging, which so often took place in that disease, he resorted, after having premised sufficient blood-letting, to the use of the sulphate of quinine in eight grain doses, every two hoars through the day, notwithstanding the presence of fever, and at night gave aloe*, s^ammony, and calomel in {tills, still continuing the sulphate. He assured me that under this free use of the sulphate, the fever would abate and the cathartic would produce thick, copious evacuations of a dark color, which would soon relieve the patient; whereas, to use the purgatives without the sulphate of quinine, if they •perated at all, they only produced watery stools, which soon robbed the patient of his strengtii, and aggravated his disease. Dr. McPheeters and myself have both used, with a similar intention, the sulphate of quinine, after the plan of that excel- lent physician, Dr. Perrine, and we have found it even to sur- pass our expectations. The purgatives which could be the most relied on, in the epidemic of 1825, to produce bilious se- lections, were calomel, aloes, and scammony combined, the purified spirits of turpentine, and the croton oil. When there was much pain in the bowels, accompanied with tenes- mus, the charcoal was of great service. The best plan of giving medicines in cases of great irritability of the stomach, which neither sulphuric aether, opium, effervescing mixtures, ice. will allay, has heretofore been with me a desideratum in practice. The fate of a patient frequently depend* on minutiae j * » AlALlflNANT FKVKIL too often unattended to in practice. It is an easy mptfrU prescribe aloes, scammony. jalap. \c. in or.'.r to | urg. a patient, who is constantly sirk at lis st.marh. But tbe ubjc-cfr of the prescription is often entirely defeated, in conseqin m« of the patient refusing to take these remedies, or if In takef them, by the impossibility of his being able to ictain them on his stomach. The best plan I ever tried, «•!' giv ing ihes.. and similar nansious medicines, so as to obviate iiu> mconu hi< n< e of their disagreeable taste, and to prevent them from being vomited, is to have the various purgative articles made into a Soft mass with syrup. Any given quantity of this mass, is to be inclosed in a very thin warnr, made of 11 >ur, and softened by being soaked a few minutes in water or indk. The enclos. d mass is then put info a spoon with a little water in it, out of which the patient is to swallow it. "" Alter this manner, a pa- tient can take, atone rfoqg, a massMn'Jicient to make a dozen pills, and he can not* without the strongest efforts, throw it up from his stomach; he tr.vrs nothing but the Hour waf« r, and the nausea ofhis stomach is not in< reused, as it would be from his swallowing a quantity of bitter pills. In this way, a large quantity of Peruvian bark may be given at a dose, without the patient's tasting it. One table spoonful of flour, made in- to a buttervr'tth water, is sufficient to make sixty wafers. The plan of making them is, to have two smoothing irons heated, one of whicli is to be 'placed w ith its face upwards, on which a few drops of the baiter is to be pouted, and the other iron is then to be pressed upon it. The little cake or wafer, thus made, is, as 1 before observed, to be soaked in water, before using it, in order to make it sufficiently pliant to enclose the medicine. I venture to assert, tbat whoever tries this plan of giving nauseous dru, differed but little from that of Washington. But • Under the llil.,' it resembled more closely in its symptoms and progress that of 1823. Nearly all the physicians who got much practice, adopted the emetic plan of treating the disease of the present year, and these seldom lost more than one in ten of tlieir patients; while, under the old plan, ol trusting to a few grains of calomel, frequently repeated, with inunction of mercurial ointment in order to bring on saliva- tion, the disease was about as fatal as formerly. Dr. Hunt, who came to Natchez, very much prejudiced, by education, against emetics in yellow fever, but who is too liberal to ad- vocate the errors of theory, unsupported by facts, threw aside his prejudices, and not only prescribed emejics with great success to his patients, but when attacked with yellow fever himself, commenced the cure by an active emetic, so did Dr. Walker. Neither of these gentlemen ever had cause to repent of this-first, yet all-important, step in the treatment of their disease. MALIGNANT FEVER. Prevention. As respects the best method of preventing the disease, while usual health exists; and the best method of preventing the disease, when tliose who are exposed to its causes become indisposed, Dr. Cartwright makes the following observations. Those persons in health, who, in order to avoid an attack of tbis epidemic, had recourse to medicines and ardent spirits to which they were unaccustomed, were among the first to be attacked. Fumigations and the smelling of volatile substances, were also found to be of no service. Those persons who escaped, regulated tlieir diet and drinks, not by any fixed rule or standard, but by their former habits; and if they deviated from those habits, they approximated to simpli- city and abstemiousness, not carried to the extent of debility; for if the stomach were not sufficiently excited hy food and drinks, the same effect was produced as if it had been too highly stimulated, viz. a derangement of action between it and the organs with which it is associated. Those who had been temperate and abstemious, continued to be so. Two persons who had, for several years, kept up a strong excite- ment by ardent spirits, continued it during the prevalence of the epidemic, and entirely escaped. But all who had not previously been habitual drunkards tbat imitated their exam- ple, became sick and died. Ardent spirits kept up the equi- lebrium of action in the systems of the former, but destroyed that (quilebrium in the latter. Finally, those who escaped were such as preserved this equilebrium, by accommodating their diet, drinks, sleep, and exercise, to the existing state of the system, and to their former habits, avoiding all exist- ing causes, as heat, cold, fatigue, tec. As to those who are indisposed, it was found that the best means of warding off the attack, or rendering it milder, was to ascertain in what way the threat is made, and to apply the remedies accordingly. Persons of plethoric habit, whenever they felt a fulness and uneasiness about the head, or a dispo- sition to fever, were relieved by bleeding, and escaped. Others whose indisposition proceeded from a torpid state of the bow- w IIALMNANT FKVER. els, to which they were subject, escaped hy the occasional n*« of aperients. To ll.ose who complained of a bitti r or mawkish taste in the mouth, sickness at the stomach, achings in th» bones, soreness of the flesh and sleeplessness, emetics were prescribed with success. A g< ntlcman who complained of pain in his back, witli restlessness and anxiety, and whose urine bad, for several days, been small in quantity, was ena- bled, by a free use of diluent drinks and diuretics, entirely to avoid the attack of the epidemic. From these facts it is plain, that though the poisonous atmosphere of yellow fever may long be breathed with im- punity, while a due balance of action among the various organs is preserved, yet not so when it* is broken; that I ving in such an atmospbore tends to break that ba'ance; the small- est distuHiance of which is announced by symptoms which often point directly to the organ in whicli the disturbance has commenced, and which, in many cases, may, by timely and appropriate measures, be restored to its heathy functions. 493 ADMONITORY HINTS TO LADIES. Light were my task if every gentleweast Owned the just laws ot" native truth imprest; For not by hopes of vain applause misled, In reason's injured cause alone 1 plead. ,ri'is you to judge; nor I that judgement fear If truth be sacred, and if"virtue dear. Roscofc. If we consider but for a moment the wonderful power which superior beauty in woman exerts over the human breast; how instantly, on the approach of its possessor, the hearts of the young are thrown into the most delightful pal- pitations, and the looks of the aged brightened with admira- tion and pleasure; we can no longer wonder that it should be so highly prized by the^ sex. But it is to be lamented, that the most preposterous means should be employed to gain a property so desirable, and that real beauty should be so often abused. Thus, some girls fancy that beauty can only exist in forms slender and delicate. At the very thought of being corpulent, they are alarmed, and to obviate grossness, as they call it, they drink such quantities of vinegar, that not only destroys the tone of the stomach, but introduces a withered ghastly paleness. For the same purpose they continue the absurd practice o'' wearing jackets, or corsets, so oppressive, as by compressing the ribs, to prevent the expansion of the lungs. 6J. 4114 ADMON IVORY HINTS TO LADIL?. Another imprudence, and still more detrimental, is that of* appearing at assemblies, in winter, in light die s, exposed to the baneful effects of cold, with the'aggravating addition of extraordinary warmth, hy the fatigue of dancing; hence con- sumptions, and a train of maladies, tod long to he here parti- cularly described, are produced. Motives of delicacy, as well as regard for health, have been repeatedly urged in vain to enforce the necessity of relin- quishing these destructive habits; tbe arguments of the mor- alist and of the physician, having alike failed to convey con- viction, and hundreds, who would now have shone forth among the loveliest of their sex, have been dressed in shrouds, because, " iu an evil hour," they laid aside those articles of tlieir apparel which health, as well as decency, forbade them to relinquish. There are others who, reading of the fair skinned belles of Europe, foolishly conclude that the rose and the lilly arc the only colours of beauty. Catching at this female passion for fair and unfrcckled faces, the quacks have prepared a number of nostrums, called cosmetics or beautificrs, which, they vauntingly profess, arc to heal the chaps on the lips; to remove pimples and freckles; and to give the countenance such a fair, smooth, and charm- ing appearance, as to reder it impossible for any one to con- template it without being enamoured. But unfortunately. these boasted cosmetics, instead of heightening the polish and charm of beauty, too often contribute to tarnish and destroy it* The truth is, beauty is not the creature of a quaCk, but the gift of nature; and to bring it to perfection, nothing more is necessary than exercise, cleanliness, temperance and checr- " l'o such of my readers as »re partial to the use of cosmetics, an infusion of hofse-radish in milk, is recommended as one ot the best and safest Another innocent preparation for clearing the ^kin of pimples, and ecent eruptions, is the expressed juice of house-leak, mixed with an equal quantity of sweet milk or cream. When these fail, blistering the face all over the eruptions will often succeed in re- moving them. ADMONITORY HINTS TO LADIES. 4Q5 tulness. These are the handmaids of health; and heal h, to persons of'certain symmetries and expression, is beauty. ______________________The rural wilds Invite; the mountains call you, and the vales, The woods, the streams, and each ambrosial breeze That fans the ever undulating sky; A kindly sky ! whose fostering power regales Man, beast, and all Che vegetable reign. Armstrong. How much, then, is it to he deplored, that so many of our young females should think so meanly of exercise, which, alone, brings the female frame to perfection—paints it in tbe loveliest colours—and by giving richness to the blood, and vigor to the nerves, disposes to habitual cheerfulness, and alike qualifies the mind fur thought, and the heart for hve. On the contrary, how different is the female who leads an inactive and sedentary 1'fe, too generally looked on as proofs of a fine modern lady. w hit b seldom fail to relax the systcu — retard the cinulath i—viliatc the blond, s.nd obstruct tie se* cretions. Hence, that chalky paleness of the face—'Imt faint- ncss of the eyes—indigestion—f:afulence—weak licrvfi-—low spirits—irregularities of nature and constant complainings. The grand discharge, th' effusion of the skin Slowly impaiicd, the languid maladies C'ucp ci:, and through the sinking functions steal. Armstrong. Yes, many a girl fcy constant muffling and bousing herself; hy dreading tbat the sun should ever kiss her cheeks, or the wind ruffle her tuckers; by much indulgence in bed, and other impruilencies, renders herself so exceedingly pale, delicate, and puny, that her appearance is better fitted to damp love than to excite it. «< The vigor sinks, the habit melts away; The cheerful, pure, and animated bloom Dies from the face, with squalid atrophy Devoured." * 4% MANAGEMENT OF FEMALE COMPLAINTS. MENSTRUATION. One of the principal constitutional characteristics of tlie female, is menstruation, or the monthly evacuations peculiar to the sex. This important operation generally takes place about the age of twelve or thirteen, but varies through the world, either in degree or frequency, both from constitution and climate. Women in the higher ranks^ of life, and those of a delicate nervous constitution, are subject to sickness, headixh, and pains in the back and loins, during the periodical evacuation. Those of the lower rank, inured to exercise and labor, and strangers to those refinements which debilitate the system, and interrupt the functions essential to the preservation of healthy are seldom observed to suffer at these times, unless from ge- neral indisposition, or a diseased state of the womb. After the discharge has become established, it recurs peri- odically while in health; and its recurrence is so regular that it can he calculated with great exactness. The usual perind of its visitations is from twenty-seven to thirty days. As to the time of its continuance, this is various in different women: but it seldom continues longer than six days, or less than three, and does not cease suddenly, hut in a gradual manner. Its approach is generally preceded hy certan f clings of oppression or devi^ion from the ordinary state of health which warn the individual of what is to happen. There is, in particular, a sensation of fulness about the lower f Ascertaining its existence. The operation by whicli it is completelv^rcmedied, is not more painful n^r formidable than blood-letting. Fortunately, in most cases, the evacuation takes place in ' due time, and the constitution sustains no material or perma- nent injury. It is, however, in every instance, proper to pay particular attention tp the^systcm during the continuance of the evacuation. j The stomach and bowels are, at this period, very easily disordered, and therefore every thing which is heavy or indi- gestible, ought to be avoided. Some arc hurt hy eating fruit or vegetables; others by taking fermented liquor. In tbis res- pect experience must enable each individual to judge for her- self. Exposure to cold, particularly getting the feet wet, is 9 FEMALE COMPLAINTS. 499 fruitful, as it tends suddenly to obstruct the discharge. The same effect is likewise produced hy violent passions of the mind, which are also at (h:stinie, peculiarly apt to excite spasmodic affections, or hysterical fits. ft. is, in gcflcrul, a very proper rule, not to administer any very active medieim s, at this time, unless some violent symptom absolutely requires, the'm. Opiates, for instance, are, in many cases, necessary to allay spasmodic affections, or abate pain; and they are in such circrmstances uniformly safe. They give speedy relief to hysterical feeling or suffocation, or r should costiveness prevail, give a dose of castor oil in conjunetion with the ano- dyne. ' * ft()2 MANAGEMENT OF ' For the cure of fhis distressing complaint. Dr. Fothergill recom means a pill of opium, of one grai: . to be t.ikim the mo- lt -u. " r ment tie 'pain Pannes on, and to be repeated rvuy hour until it be suppressed; to keep the patient iu bed; and t > let her di- lute freely with herb tiv.s, until the discharge he fully estab- lished, after wldch (he pafdjseldom return-; and when the period has passed cl.alibeatc hitters until within a few davs of the next period. Dr. Denman proposed snail dosis of calo- mel every nigh: at bed time, for several weeks together, and twice in the course of the day, a dose of the volatile tincture of the Peruvian bark. Dr. Oewees, of Philadelphia, recommends the volatile tincture of gum guaiacum, to be continued for a considerable length of turns ami says it acts aloost as a spe- cific* And Dr. liobertson, of Edinburg, is as sanguine in praise of the tincture of rautharidcs given in pretty large do- ses, thrice a day, until it excites some degree of pain in void- ing the urine. Prevention. In order to prevent this painful state, 'in those who are subject to it, the warm bath should be used, three or four nights preceding the menstrual period, and on going to lid, two tea-sp lonfuls of the diaphoretics drops,, or ten grains of DoverVjmwder should be given in some warm tea. The bowels are to be kept uniformly regular; and ex- posure to cold, especially near tbe time of the appearance of the discharge, is to be carefully avoided. The coastitution is to he improved, and strengthened by such means,as its particular condition requires, and in gene- ral, by the use of tonic medicines, and the shower bath, pro- vided these do not disagree with the patient. OBSTRUCTED MENSES. Many woman have the menstrual evacuation postponed for a week or two, beyond the usual time, or miss one or two pe- riods without any very evident cause, and without inconve- PKMALE COMPLAINTS. 50; Vr». nience. But when it is suddenly suppressed very traddcsome symptoms occur; aud when it is retained for any considerable length of time, it is usually attended by bad health. Symptoms. vVhen suddenly checked, it is usually attend- ed with considerable pain in the back, bowels, or stomach, and sometimes in the chest. In persons of a full habit the face is generally flushed, the pulse hard and frequent, flying pains in the chest, permips spitting of blood, cough, palpitation, diffi- culty of breathing, and a complication of nervous affect ion. Persons of a delicate frame and a melancholic temperament, and especially those who have suTered from some debilita- ting cause, have different symptoms, constituting what has yjjeen called chlorosis, or Green sickness, a disease alwayVcon- nected with, and depending on, some derangement of the sen- sual organs. In chlorosis, every symptom of feebleness prevails, a pale skin, and even a greenish complexion, succeeds to the rosy hue of health; the skin under the eyes puffy and of a leaden colour; the whole body lax, (edematous and doughy; the judgment, memory, and natural cheerfulness impaired; the pulse is ge- nerally slow and feeble, but easily excited; and it is then ac- companied with shortness of breath, a palpitation of tbe heart, and an almost unconquerable disinclination to motion; the ap- petite is destroyed, and the stomach so de-rang' d, that the food, insteadof being digested, undergoes the fermentation peculiar to its nature. Hence the patient finds gratification in chalk, lime, pieces of old wall, and other improper substances; and the bowels are commonly costive. It not unfrequently happens that the blood which should have passed off by the uterus, being determined more copi- ously and forcibly to other parts, gives rise to hemorrhages; hence it is frequently poured from the nose, stomach, lungs, and otlier parts, in such cases. Causes. A constriction of the extremities of the vessels of the womb arising from accidental circumstances, such as ex- 504 MANAGEMENT Ol posure t-jcold. anxiety of the mind, fear, excessive evacua- • tions. inactivity of the body, poor blood, the frequent use of aru's, ami other sedatives, tec. In some constitutions, parti- cularly in those wliere pain attends the (list hUrge, very slight occurrences suddenly interrupt the flow, and prevent its usual return, nuchas p iss-ous of the mind, fright, fatigue, irregula- rities of diet, ;»utting on damp clothes, «Vc. This fact shews the necess.ly for certain c.unions and attention during the dis- charge. Obstruction, too, is sometimes the effect of disease of the general habit Treatment. When the evacuation has been suddenly checked, it is proper to have immediate recourse to the warm bathyor s tting up to the hips in warm water, or fomentations to tbe lower part of the abdomen, and bathing the feet vBBk warm water. It is also advisable to put tbe patient to bed and give a tea-spoonful of the diaphoretic drops, or five or six grains of Dover's powders, in a cup of warm herb tea, such as sage, hysop, penny-royal, every two hours until a gentle perspiration is produced. Should there be fever, or pain in the head, or discharge of blood from other organs, bleed, give the cathart.c mixture, or an infusion of salts, senna and man- na, and afterwards endeavour to determine to the surface by the exhibition of diaphoretic medicines. In every case where there are febrile symptoms, and amendment cannot take place until the at tip! logistic plan, such as bleeding, nitrous medi- cines, cooling cathartics, and a low diet, with rest, are adopt- ed. After the febrile symptoms are removed, strengthening mediones, if necessary, may be employed, and in no instance suffer the bowels to remain in a constipated state. It is necessary to observe, iu endeavouring to restore the monthly evacuation, we shall more likely succeed; if the usual remedies for removing the constriction whicli affects the ex- tremities of the vessels in the womb are directed at the time of its expected return, or when some natural efforts for tbat pur- pose are observable, which may be known by a sense of ful- ness in the organs of generation, a weight in the back and FEMALE COMPLAINTS. 505 loins, and slight spasmodic pains in the uterus. At this pe- riod, bladders two thirds filled with warm water, applied to tlie lower part of the abdomen, or sitting over a vessel filled with hot water, will have a most happy effect. And to in- crease the relaxing powers of these topical applications, we may. at the same time, give an opiate, particularly in the form of clyster, when there is pain. Sometimes an emetic administered about the time when the evacuation should appear, and the patient during the opera- tion to sit in a warm bath has been of infinite service.* In some instances an obstruction may\continue in young and healthy woman, for many months without any inconvenience. This is chiefly the case in those who are very corpulent, or who have been in the pernicious practice of employing^ inegar and strong purges to reduce their size. By the regular use of exercise, rising early in the morning, avoiding supper, keep- ing the bowels correct, and living upon the whole rather ab- stemiously, the health will be preserved, and in course of time, the desired alteration will take place. J Obstruction of the menses may also occur in young women with florid complexions, but, at the same time, of very deli- cate constitutions, and subject to a slight cough, with pain m the breast, and a predisposition to consumption. Such cases require the utmost caution; and in them, small bleedings, an antiphlogistic diet, mild laxatives, a temperate climate, warm dress, and moderate exercise, are essential; and when it can be procured, a sea-voyage, or change of air, will probably prove the most useful remedy. In the chlorotic species of obstruction, the treatment is much the same, as advised under the bead of menstruation, for the management of those who ate long having this evacua- tion. It will he found, almost in every instance, the complaint is occasioned by general debility, consequently, the cure must he regulated on the plan of increasing the tone of the system and exciting the action of the uterine vessels in particular. This is to be effected by a nourishing diet, moderate use of ^r 504. MANAGEMENT OF wine, change of airs gentle exercise, particularly riding on horsebackJWith strengthening medicines, as bark and elixir vitriol, tJk% ruit or tincture of steel, or the tonic powders or pills in their usual doses." together with the occasional use of calomel or the stimulating purgative pills. [See Dispensatory] to keep the bowels in a regular state. The nitric arid, di- luted.in doses of a wine glassful three or four times a-day, will be found a valuable medicine to improve^ t!>e habit of body. And if tlie obstruction be att» nded with cough, it should be given in the form of the nitric lac-ammonic. [See Dispen: at or ij.] Previous to the use of tent'- medicines, it is advisable to give an eue-kr. and nfter.v »n's a dose of calomel end rhubail*. or the ap^ruot and diaphon li' pills, for «n • purpose of < housing the stomach an.I fr°cieg it from ar.«:u. s and h ari'Vf; '"ds. Costiveness being a constant attemlaof on *• ii«t ifr*a»«e. it is of the greatest importance, that purgatives be repeated, until all the ^ordes which have been collecting, n ost ,o<>b. blv for a considerable length of time, shall be removed. \I(t this, and not before, the happiest effects may be exjitcted from the use of tonic medicines. Besides the above remedies, many 'rtthrrs may be employed with the same view, as an infusion of camomile, wild cherry, OT dogwood hark, tansy, penny-royal, hysop, rue, tec. A t|Me-spoonful of mustard seed, morning and jfvening, or a tea-cupful of a weak infusion of horse-raddish on some occa- sions have produced very good effects. Two ounces of the rust of steel, or filings of iron, steeped in a bottle of wine or cider for a week, and gftcn in doses of a small wine-glassful morning, noon, and night, has also been found beneficial. With the view of exciting into action the uterine vessels, the surface of the body should be kept warm by means of a flannel shift and drawer*, by frequent friction of the lower part of the abdomen and limbs with a flesh brush or flannel, aud by the exercise of walking, dancin% and jumping. By flffiS?^ FEMALB COMPLAINTS. 507 marriage, or a change in the mode of life, the disorder has freipiently been removed, alter having resisted all the ordinary remedies. *^ In those instances, when the evaluation has become sup- pressed in consequence of previous bad health, it is evident that no attempt to restore it can ejther b - effectual or useful till the cause he removed. Some have obstruction caused hy very slight weakness, or very earlv in chronic diseases, others continue regular, till even the last stage of consumption. From the great variety of causes of sexual obstruction, it is certaiu that many medicines, which possess very opposite powers, may, in different cases, produce the same effects. For the same reason, a remedy which, in one case, may prove mild, inoffensive, and successful, will, in another apparently similar, occasion a most violent disorder. No remedy applicable to every case can possibly be discovered, therefore, medicines, with a view to restore the periodical evacuation, ought to be employed with the greatest caution. IMMODERATE FLOW OF THE MENSES. This alarming complaint may occur under two different states of the constitution. In the one, the woman is of a full habit, and often of a ruddy countenance.* In the other, she is pale, delicate, and easily fatigued. Symptoms. In plethoric habits it is often preceded by headach, giddiness, or difficult breathing, and is afterwards attended with pain in the back and loins, universal heat, and a frequent, strong, and hard pulse. But, when it arises from general debility, or iu consequence of a laxity of the organ, paleness of the face, chilliness, lassitude of the whole body, op- pressed breathing on the slightest effort, pains in the back on remaining any length of time in an erect posture, and coldness of the extremities, together with a long train of nervous com- plaints. 508 MANAGEMENT Of Causes. A variety of causes may produce this trouble- some disease. Some of these are general, such as a state of greatrtoeakness, or of too much blood; others arc local, such as debility of the uterus occasioned by tedious labor or fre- quent miscarriages. It may also be produced by accidental circumstances determining the blood more copiously and for- cibly into the uterine vessels, as violent exercise in dancing, much straining at stool from great costiveness, contusion on the belly, excess in venery, or strong passions of the mind. particularly at the menstrual period. Treatment. In the management of this disease wo have two objects: first, to moderate the discharge and procure pre- sent security; and, second, to prevent a return. The first thing to be done when the hemorrhage is sudden or profuse, is instmtly to remove the clothing which may oc- casion the least interruption to the free circulation of the blood, and to put the patient to bed, lightly covered with clothes. So long as the discharge continues, it is of importance to keep her in a recumbent posture, as cool as possible, and perfectly at rest, both in body aud mind. Cloths, (lipped in cold vine- gar and water, and renewed as often as they become warm. These cold ajiplications have a powerful effect in restraining uterine hemorrhage^ and ought never to he omitted where the d.schargcof blood is profuse. If the patient be of a full habit, attended with severe pain in the head or back, and febrile symptoms, it will be proper to bleed, and to give the antimonial, or febrifuge powders or mix- ture. [See Dispensatory.] The state of the belly must also be attended to. It can he kept gently open by tbe cathartic mixture, sulphur, or any mild laxative medicine. Stimulating purgatives, or clysters, under such circumstances, arc improper, from their tendency to increase the discharge., When no symptom indicating an increased action in the ves- sels of the womb are present, astringent medicines shoubl he • FI.■..ifALB COMPLAINTS. 50(J employed. And, in cases where the discharges have not con- tinued long, and the strength not much impaired, it is often suffi- cient to arrest the disease by giving fifteen or twenty drops of elixir vitriol, or six or ightgrams of alum dissolved in aglass cold water every hour; or, what is preferable, alum whey, sweetened to the taste, in doses of a small cupful, as often as the stomach will receive it. But, if the discharge be obstinate, we should have recourse to pills of sugar of lead and opium, [See Dispensatory.] In no instance which has come under my knowledge, where the hemorrhage was in consequence of a laxity of the uterine vessels, have these pills failed iu producing the desired effect. In those cases where the hemorrhage is profuse, or of |;/ng continuance, and resists the means already pointed ovCttwill be proper to inject into the uterus from a gill to a.'ialf pint of a .strong decoction of oak bark, in whicli one or two drachms of alum has been dissolved, or as much of the saturated solu- tion of alum in water, in order to oonstringe and strengthen the vessels of the womb. This may be repeated twiceor thrice a-day, according to circumstances. When symptoms of an increased action in the vessels of the womb are observable, the tincture of foxglove, in doses of twenty drops every four hours, constitute the best remedy. When there is reason to suppose the hemorrhage proceeds from a scirrhous or ulcerated state of the womb, all that can he done is to afford temporary relief by giving opium in largedoses. Indeed opiates may be given with advantage in every case where there is considerable pain or anxiety, and the patient - much exhausted. Under these circumstances, from one to two tea-spoonfuls of laudanum, or from two to four grains of opium, according to the urgency of the case, wdl be useful not only in giving a check to the discharge, but also in preserving the strength, and abating nervous irritation. In most cases it is preferable to give opium in the form of injections to allay the spasmodic pains of the womb, and, when administered in this w*y, clysters of thin starch or gruel, in each ef which 510 MANAGEMENT OE two tea spoonfuls of laudanum is added, should he given eveiy two imu'S until relief is obtained. [St e abortion and flooding.] Regimen. The diet, at the time of excessive discharge, must be light and cool. The drink must always be cold, as ice wuIt, leiuonV.ie, or tamarind boverage. Port wine in such ca.es is tio tVequeutiy r sorted to, which uniformly does harm by increasing tue circulation. Prevention. To prevent a recurrence of the attack in those who are subject to it, the patient must necessarily avoid the causes by which it hasjieen produced. When it is evident that the discharge is inconsequence of a full ^tbjt, it will he proper to reduce the system, hy living spar- ingly, /keeping the. bowels rather in a laxative state, and by rising earlvv an.! taking through the day regular but frequent exercise; and, after the plethora is removed, by strengthening vessels which have been over distended, by the use of the cold bath. In a greater number of cases, however, we meet with a deli- cate constitution and spire habit, with pale countenance; this state requires the use of sea bathing or the shower bath, and the vessels of tbe womb are particularly strengthened by pour- ing cold water daily on the back and loins. It will be advisable to use a generous nutritive diet, with wine, and to have recourse to some of the tonic medicines, as advised under the head of obstructed menses, to strengthen the system generally. At the same time the bowels must be attended to, and invigorating exercise taken daily; whilst, on the other hand, fatigue, and especially exposure to relaxing heat, must carefully be avoided. SEXUAL WEAKNESS. This complaint, commonly called fluor albus, or whites, to which women are peculiarly subject, must form an important ob- ject of attention, since it is always attended with disagreeable FEMALE COMPLAINTS* 511 symptoms, and, when aggravated, soon spoils the beauty of a fine face, weakens the digestive powers, produces a general bad habit, and occasions sterility. Symptoms. An irregular discharge from the passage lead* ing to the womb, of a fluid, which, in different women, varies much in colour, being of a white, green, yellow, or brown hue. In the beginning it is, however, most Usually white and pellu- cid, and, in progress of the complaint, acquires the variou- dis- solorations and different degrees of acrimony, whence proceed a slight smarting in making water. Besides the discharge, the patient is frequently afflicted with severe and constant pains in the hack and loins, indigestion, paleness of the face, chilliness, and langour. In process of time, every symptom becomes highly aggravated, the feet and ancles swell, palpita- tions, and a difficulty of respiration are experienced, the men- strual discharge is rendered irregular, the urine is turbid, the mind is dejected, and either consumption or dropsy sepervenes and terminates a miserable existence. In some languid habits, the floor alhus returns periodically, instead of the proper mcnsti'ual evacuation, until the patient's constitution is dulyinvigorated. Causes. It may be produced by any cause which either weakens or irritates the womb and its appendages. It may arise from general debility of the constitution, but it is espe- cially caused by circumstances impairing the power of the womb itself, as, for instance, a severe labor, a miscarriage, or profuse menstruation. In some instances it appears to depend on a full and irrita- ble habit of body, and, in other cases, of local irritation, such as disorders of the womb, or of the urinary organs, or a Col- lection in tbe gut of the small thready worms called ascarides. Upon the high authority of Dr. Hamilton, this disease is most frequently first brought on by some imprudence in re- spect to diet and clothing, or exposure to cold or fatigue, or neglect of the bowcl&about the time when menstruation begipsw t :'12 NANAoT. ■II'.NI O* rf iieatment. In the treatment of this complaint regard nvi^t he had to the apparent cause, and to the state of the pa- tient. The discharge is too often considered by tie six as the effects of general weakness in their habit, and, therefore, are led to the indiscriminate use of heating medicines, as port wine, balsam capivi. . The bowels must be kept in a regular state by conjoining a few grains of rhubarb with some of the tonic medicines, or by takin"- occasionally, at bed time, one of tbe aloetic, or aperient or diaphoretic pills, or in the morning a tea-spoonful of Ep- som salts dissolved in a tumbler of water. If there be a fulness of the stomach after eating, the tincture of rhubarb in small doses will excite digestion. In obstinate cases, it is often expedient to produce a change in the system, by giving a grain or two of calomel, or one of the mercurial pills at bed tune uutil the gums become slightly effected, and then the cure may he completed by strengthening medicines, together with the shower bath. Besides tonics, stimulating medicines, such as commonly determine to the urinary passages, have very frequently been employed with great benefit. Of these, rosin in doses of ten grains in the yolk of an egg, or spoonful of molasses, or bal- sam capiva in doses of a tea-spoonful, or tincture of catharides in doses of twenty or thirty drops in some mucilaginous drink, and taken three or four ^imes a-day, will he found mcst salu- tary. These means strike at the cause oftle complaint, hut if it do uot remove the effect very scon, v,c are not to trust to them alone. For once a morbid secretion being excited, it is very apt to continue, although the exciting cause cease to operate. On this account we ought, without delay, to have recourse to astringent injections, such as a strong decoction of red oak hark, wit', the addition of a little alum or a solution of alum in wa'er. Half an ounce of the former to be dissolved in a bot- tle of water which should be thrown into the vagina by means of a female syringe, two or three tines a-day. The celebra- ted Dr. Burns, says, after many trials, he satisfied himself, Ihat although assistance may he derived from internal medi- tiucs and the cold hath, yet the chief dependence is to be placed on astringent applications to the seat of the discharge; and these, where there is no fulness of the general system; nor any affection of the womb itself, are perfectly safe, and seldom fail in producing a cure. 514 MANAGEMENT OV It will be prudent when tbis disease occurs as an early symptom of pregnancy not to check the discharge suddenly, lest miscarriage be the consequence; but it may be moderated by injections of water, with the addition of a little vinegar, or an infusion of green tea. Neither should the discharge be suddenly suppressed when it has been of long standing, and acquired a considerable degree of acrimony, with an offen- sive smell. For if it he unseasonably checked, the belly swells, and a train of the most disagreeable symptoms occur. In such cases, soap suds, or an infusion of camomile flowers or bops, should be frequently thrown up the vaginaj and so soon as the blood is freed of its impurities, by suitable medi- cines, and recovered, in some measure, its soft and balmy quality of which it hath been deprived, the astringent injec- tions may be employed with perfect safety. The application of a blister to the sacrum, has, in some obstinate cases, been attendee with advantage. When the floor albus proceeds from worms, purgatives and bitter clysters are the proper remedies. Pain in the back and loins is often mitigated by the appli- cation of a large adhesive or strengthening plaster, and by avoiding a standing posture of long continuance, much walk- ing, dancing, or any other violent exertion. Women should can fully avoid all the remote causes of the disease; they should pay diligent attention to cleanliness, by washing the parts frequently with cold water; and when there are excoriations, milk and water, or lead water, may be em- ployed as a wash. Regimen. The diet should be light, cordial, and nourish- ing, consising of isinglass dissolved in milk by boiling it, jellies, custards, rice, milk, soft boiled eggs, gelatinous broths, and light meats, together with a prudent use of genuine wine, particularly claret or port. Women, afflicted with this discasp, should hy no means in- dulge in the use of tea and other warm slops of a relaxing nature: but should lie on a matress in preference to a feather !• FEMALE COMPLAINTS. 515 bed; and they should rise early, and take such daily exercise as their strengtii will admit, particularly on horseback. When there is much langour with chilliness, friction with the flesh brush, and wearing flannel next the skin must not be omitted. PREGNANCY. The great varieties of the female constitution occasion preg- nancy to be, to some of the sex, of no trouble or distress, through the whole period of child-bearing; but it is to others often a continual disease, being, perhaps, from the very first week to the last of their pregnancy, more or less disturbed in their frame from the peculiar irritability of tlieir habits. Some feel, very soon after conception, such an alteration in the state of the stomach, or in their sensations in general, as apprises them of their situation. The woman is troubled with heart-burn, acidity, want of appetite, or disgust, at her usual food, and sometimes has a craving for things she formerly did not desire. She is usually sick in the morning, and gem rally vomits after she gets up, though some have no sickness till the afternoon. Sudden qualms and feeling of faintness, with or without an inclination to reach, occur at different times iu the day. The bowels also generally become bound. Some, instead of being sick, or in addition to the fits of sickness, arc troubled with a constant desire to spit, with tooth ach, water-brash, cough, nettle-rash, or other affections. But the time to which these extend, varies, as well as the period at which they take place. In the young and healty constitution, one of the most early sympto;; s of the incipient stage of pregnancy, is an uneasiness in the breasts, somewhat differing from what she may have oeen accustomed to on the eve of menstruation, and soon at- tended with some sensible addition to the natural fulness and weight, as well as with a particular change in the appearance ef the areola, or dark circle round each nipple. The nipples * 316 MANAGEMENT OF also soon becoire more prominent, the bulboui or gladular eminences around them eularg , aud a m ky fluid will sta.n the linen, which hal not been observed before. These occurrences may justly rxcit? in the mind, the first apprehension of pregnam y, after which, the interrupted course of the menstruation g nerally establishes the certainty of the situation. Obstruct.on, however, it must be recoil- (led, may take place from other causes; hence, though we conclude, tbat she who is regular is not pregnant, wo cannot infer, to a cer- tainty, that she who is obstructed is conceived. A woman in good health may accidently be obstructed for one or two pe- riods, but in this case the other signs of conceptions are usually absent, and at all events, prudence will dictate the necessity of patience till the fourth month. In had health the courses are often stopped, but in such circumstances the appearances of pregnany are absent, whilst the symptoms of the accompany- ing disease point out the nature of the case. There is a situa- tion m whicli there may, for a time, he some ambiguity, and that is where the woman has actually conceived, but tbe em- bryo has almost immediately perished, yet has not come away, but, together with some blood in the vvoinb, is converted into a pretty firm, but shapeless mass, called a mole or false con- ception. About the end of the fourth month, or a little sooner or later, in difiicult cases the motion of the child is perceived, and this is the most satisfactory of all the signs; hut those who are anxious to think themselves pregnant, when they really are not, are apt to mistake wind, passing along the bowels, for the motion of the child. The motion is at first gentle, it is felt pretty low, and re- sembles a gentle fluttering. The sensation is peculiar, and not unfrequently is, at first, accompanied with sickness, faint- ishness, or hysterical affections. It may he felt by night or day, and may either he repeated pretty regularly, or may not be again observed for two or three days. It is called Quickening, net because the ehild at this time begins to live- EEMALE COMPLAINTS. 517 for it is alive from the first, hut because it can now move, or its motion is not till this time perceptible. Nature would seem, by these early notices, to put the mother immediately upon her guard, that she might not dis- turb the tender embryo, by avoiding the occasions of either sudden alarm, fatigue, fever, or whatever might derange the equitable state of her health, and by attending to those means for its preservation, which are best suited to her particular constitution. At the end of five months, the infant's size is nearly dour ble what it was at the completion of four months, and the size is again nearly doubled by the commencement of the eighth month. At the full time, or nine calender months after con- ception, the ordinary size of the child is twnty inches in length, and seven pounds avoirdupois weight. But there are deviations from this standard,- S» me do not exceed sixieen or seventeen inches in length, and five pounds in weight; while others weigh nearly fourteen pounds, and measure ahove twrtity-four inches. This difference in sizi and weight renders it extremely diflh tilt, and it may he said impossible, to determine, in many cases, whether the infant have attained to its maturity or not. The ordinary marks of hair on the head, nails on the fingers and toes, usually depended upon by those unaccustomed to consider this subject, are quite fal- % lacious; and although there be certainly marks by which it can be unequivocally determined when the infant has not ex- ceeded the sixth month and a half, it would be an imposition on the credulity of mankind to allege, after the seventh month, tlie exact age of the infant could be ascertained by its general appearance, or its size and weight. To protect the child, while in the womb, from the numer- ous accidents to which it might be exposed from the exertions or imprudencies of the mother, a most simple and effectual apparatus is provided. Not only is it enclosed in a bag, and surrounded by a quantity of water, but also is it nourished by means of a substance similar to a sponge, by which the blood of the mother does not run directly into its system.. 67 518 MANAGEMENT OK The infant lies generally with its head down-most, that m towards the mouth of the womb, and with its limbs so bent and folded together, as to occupy wonderfully little room, like the chick in the egg just before it breaks the shell. W Leu there are twins in the womb, each infant is included in a se- parate bag, and attached to its own aftir-binh. The head of the one infant lies towards the breach of the otlier. By means of the apparatus thus imperfectly desi i died, it may be understood that the infant, while in ihe vvonii, i> ad- mirably definded from external injuries, but it ma.. ••» be very obvious how it is nourished, and by what coni ivance its increase of bulk is accomplished. 'There is ev» iy reason to believe, that the aft r-birth serves the purpose; and c< <-.d- ingly, the quantity of blood suit to it always keep pa > with the size of the child. Thus, in the early weeks, the vessels which run from the womb to the after-birth are not laiger than the hairs of the head; while, in tlie latter months, many of them are as large as an ordinary writing quill, and the number of vessels always corresponds with the extent of its surface; for at every period of pregnancy, it is found, that a separation of the slightest portion of the after-birth is pro- ductive of the bursting of numerous blood vessels. That the derangement of the general system during preg- nancy is produced by the new actions which take place, for the purpose of supplying the infant with the principles of life., is rendeijL'd probable, by the fact, that the breeding symptoms cease from the moment the infant dies, and by the additn na! fact, that they most commonly are less aud less severe the more children a woman has. Accordingly, the ordinany com- plaints during pregnancy seem to be the immediate effects either of a disturbed action of the stomach and bowels, or of the formation of too much blood. The most important circumstances to be attended to in the incipient months of pregnawy, is the costive habit of the how- els. Its prevention will subdue, if not wholly keep off, some of the troublesome complaints of the stomach, and will often f i FEMALE COMPLAINTS. 51Q guard, most securely against some of the exciting causes of early abortion. Blood-letting, cautii i?y used, either to reduce a too ple- thoric state of the geftg^H habit, or to alleviate some morbid affection, is a salutary agent; but it is in general more frequent- ly had recourse to in pregnancy, than it should be, upon very erroneous principles. Because a pregnant woman, though by one of the established laws of nature, is now obstructed, they conceive it proper to draw blood, that the constitution may be freed of an imaginary redundancy, not recollecting tTie process of pregnancy is going on, to employ the interrupted menstrual fluid, to the novv essential purpose of affording growth and support to the increasing womb itself, as well as to i's contents. All the temporary benefits to be derived from bloo'l letting may be most safely and permanpntly attained by a dup attention to the di