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SYNOPSIS
  LECTURES  ON  OBSTETRICS,

                        AND THE

        FORMS OF  DISEASE PECULIAR  TO


WOMEN  AND  CHILDREN,
DELIVERED TO STUDENTS OF THE
PHYSIO-MEDICAL COLLEGE OF  OHIO,
           By ALVA  (IRTIS, A. M., M. D.,
                      * i«

Professor of the Institutes isn Practice of Medicine, Author of "A Synopsis of
     Lectures on Medical Science," of "Criticisms on all the Prominent
        Systems of Medicine in Vogue," and for Twenty-One Years
             Editor of " The Physio-Medical Recorder."
THIRTEENTH  THOUSAND.
   "Let Midwives know that they be nature's servants."—Willouohby.

   '■• A meddlesome Midwifery is bad."—Blundell.

   " The rash and preposterous use«f j!?s^»Afents has been the bane of thousands."—
Edinburgh Practice.      a+F&,  _  /  "O-

   " For one instance where^he retention of the platrenta has been attended with dan-
gerous consequences, its preRipitate-e'^tractiQrL.has been fatal to hundreds."—Ibid.






                  CIN'CItf'NATI:

           PRINTED  FOR THE  AUTHOR.

                        1862. 
 
ADVERTISEMENT TO  THE SECOND EDITION.
  So  highly was this work prized  on its first appear-
ance,  that the whole edition of 4,000 copies was sold in
less than twelve  months after it escaped from the press.
Many who were so fortunate as to possess a few of the
last copies for retail, sold them  for  five dollars each.
The demand still increasing, I have carefully corrected
its most important errors, and considerably enlarged it,
particularly by the addition of a copious index  and sev-
eral valuable plates.  As this edition  is  thus  rendered
much  more valuable than the former, and the number of
copies is no greater, those wrho want it will do well to
embrace the'first opportunity to obtain it.
      PREFACE  TO THE  THIRD  EDITION.
  The demand for the following work having increased
in proportion to  the acquaintance of the community
with its character, the second large edition has been ex-
hausted much sooner than the author expected;  and the
commendations of  its principles  and instructions,  and
the reports of success  in the practice in accordance with
them, have been as flattering  as his  highest  ambition
could desire.   Though explicit and decided in its princi-
ples, and  rigid in its requirements in practice, yet so
clear and conclusive are the facts and arguments  given
in evidence  of  their correctness, that the work. has 
IV
PREFACE.
 secured the approbation and patronage of all classes of
 persons, from the mothers  and nurses  of  the land, and
 the  Botanico-Medical Practitioners,  for  whom  it was
 especially designed, through  the  long catalogue of Re-
 formers of every description—the rooters, the Beachites,
 the  Eclectics, the  Homceopaths, even into the ranks of
 the regular faculty—hundreds of  whom have purchased
 it, and pronounced it, after trial of its plan,  the best
 practical work extant on this subject.  Many a regular
 doctor, after abusing the author as an ignorant empyric,
 has  been  persuaded,  by some friend, to commence read-
 ing  it, when  he soon  became so well pleased with it
 that he refused to return it.  Two such said that  they
 would sooner give fifty dollars  than return it  to the
 lender, if  they could not get another.  Others who  have
 become acquainted with the work,  have  purchased it
 and  given it, or requested its direction, to  their regular
 brethren, none of whom, so far as is  known, have  been
 offended at the present.
  But, while he has  learned with pleasure,  that physi-
 cians of every class have approved of it, and adopted it
 altogether, or in part, the author is still more happy to
 know that his little work has saved  many thousands of
 families from, not only " the rash  and preposterous use
 of instruments" which "has been the bane of thous-
 ands," but also from  all " obstetric violence," from any
 and  every source; from death, from danger, and from
even serious suffering; as well as the enormous  tax  in
doctors' fees, which the old course of practice, and the
"long spell of sickness," has heretofore imposed upon
 them. 
PREFACE.
V
  So  complete and  explicit  are  the instructions of this
volume,  that many  female nurses, after reading them,
have slipped out of the train of their medical advisers, and
taken the whole responsibility themselves.  One of these,
near this city, lately told  the author that, "within the
last thirty days, she had dressed  thirty-six children, and
that she had had less trouble  with them all, than she had
often  had with a single patient whom  she  had  nursed
according to the directions of the mineral faculty."
  Lastly—many  persons,  male  and  female, have ven-
tured,  on the  strength  of the  fundamental  principles
laid down in this work, to  enter on the general prac-
tice, and they have  been very successful.  These, howr-
ever, and others, are advised to  purchase, also, the au-
thor's  Lectures on Medical  Science, just  now com-
pleted, which will  give them the fundamental  princi-
ples of all medication, and directions sufficient for the
pi'actice in every special malady,
  Encouraged by the foregoing considerations, and feel-
ing a lively and lasting gratitude  to  the  community, for
the favors of the past, and a deep sense of the respon-
sibility of the undertaking to instruct when  the conse-
quences must be life or death, health or misery to thous-
ands, the author has carefully revised and corrected the
work, and  made  a few valuable additions among  the
recipes; and, lastly, impressed the whole  on a paper, and
dressed it in covering, more  becoming the high  charac-
ter which the volume has now acquired.
  To the candid, intelligent and benevolent  of every
class and station, trade and profession, who have pain
to prevent,  or  suffering to relieve, the author respect- 
Vi             PLAN OF  THE WORK.

fully dedicates this little volume of instruction;  for  the
labor of preparing which, if only a small portion of that
vast multitude of  his fellow creatures make the proper
use of it, he will feel himself amply rewarded-.
              PLAN OF THE WORK.
  I. Introduction.
  2. History of Midwifery.
  3. Dissertation—Showing  the reasons why  women
need assistance in parturition, the kind needed, and how
it is to be rendered.
  4. A complete system  of Midwifery on the true Bo-
tanic Principles, with illustrative plates.
  5. Testimonies from  the  regular  standard  authors,
proving the vast superiority of  the Botanic Theory and
Practice.
  6. Testimonies from the same, showing the errors  in
theory and dangers  in practice of the Regular System.
  7. Examples of the different  kinds of practice, show-
ing the safety and efficacy of  the  Botanic, the danger
and fatality of the Regular; and, of course, the  folly of
abandoning  the former  and resorting to the latter  in.
cases of supposed difficulty and hazard. 
A DEFINITION OF  ALL THE WORDS IN THIS  BOOK WHICH
    ARE NOT  CONTAINED IN  A  COMMON DICTIONARY.
                 A.
^Esophagus, the windpipe.
Accoucheur, male obstetrician.
Absorbent, a, taking in, receiving; n, a
  tube that takes in.
Antiasthmatic, opposed to asthma.
Ascites, dropsy of the abdomen.
Anasarca, dropsy in the flesh generally.
Anodyne, producing quiet or sleep.
Anthelmintic, opposed to worms.
Asphyxia, want of pulse.

                 B.
Bronchije, the  tubes leading from  the
  windpipe into each sideof the lungs.

                 C
Crotchets, obstetric instruments.
Oantharides, Spanish flies for blisters.
Congestion,  compression of fluids  in
  parts of the body.
Calipre, an instrument to measure the
  dimensions of the pelvis.
Catheter, a tube to draw off the urine.
Chyme, the food as it leaves the stomach.
Coma, drowsiness, stupor.
Craniotomy, the science of piercing the
  scull  of  fetuses,  and letting but the
  brains, in cases where  nature has for-
  gotten to prepare the size  of the head
  to that of the passage  through  which
  it must be discharged.  See p. 210.
Coagulum, clotted blood,'or other thick-
  ened  fluids.

                  n.
Ditodknum, second stomach, small intes-
  tines.
Diarrikea, watery stools.
Diaphragm, dividing membranous mus-
  cles between the chest and the abdo-
  men.
Diuretics, medicines that  promote the
  discharge of  the urine.
 Diaphoretics, medicines that aid in pro-
  ducing insensible perspiration.
 Heobstruent, a, removing obstructions;
  71. a medicine that  removes obstruc-
  tions.
 Diagnostic, deciding the disease by symp-
  toms; n, a decision, &c.
 Deuquia,  fluids suddenly reduced from
  solids.

                  E.
 Emenaoogue,  a,  promoting  menstrua-
  tion; n, a promoter, &c.
 Esiesis,  vomiting.
Escharotic, caustic, a caustic.
 Embryotomy, the dissection of a fetus.
 E*anthematic,  producing   cutaneous
  eruptions.
Expectorant, promoting discharges from
  the lungs.
Emollient, soft, slimy, lubricating.
Enemata, injections.
Epileptic, suddenly falling.

                 F.
Forceps, instruments for  clasping  the
  head of the child and forcing delivery.
Fontanelles, the  spaces  in  the  fetus
  where the seams  of the scull unite, or
  cross each other, below the crown and
  on the top of the head.
Funis, naval cord.
Fomentations, warm and moist  appli-
  cations.
Fissure, notch, or long, narrow, exter-
  nal cavity.

                 G.
Ganglion, knot in the nerves.
Genital,  relating to organs peculiar to
  males or females.

                  I.
 Intropelvimeter, see calipre.
 Ingesta, food.

                  L.
 Lymphatics, vessels that commence with
  open tubes in all the fleshy parts of the
  body, resemble the veins in structure.
  gather up or absorb fluids, and carry
  them into the thoracic duct.1
 Larynx, upper part of the windpipe.

                  M.
 Mamm«, breasts,
 Micturition, frequent desire to urinate.
 Monograph, a treatise on a particular
   disease or genus of diseases.
 Morbific, tending to produce disease.
 Marasmus, wasting of the flesh, health
   and strength, without.an apparent spe
   cific cause.

                   N.
 Mosology, classification of disease.
 Nomenclators, those who give names to
   things.

                   O.
 OssinrATioN, turning to bone.
 Os uteri, Os tincce, defined, pp. 57, CO.
 Os externum, external orifice or opening.
| OSdematous. swelling  with water, so as
I   to leave a pit after pressure.

                   P.
 Placenta, the cake that  unites  the  i;m-
j   bilicus to the uterus.
I Pelvis, the bony rim  that supports the
   abdomen. 
Vlll            DEFINITION OF  WORDS,  ETC.
 Prophylactics, preventives of disease.
 Polypus, tumors projecting from internal
  cavities.
 Plethora, fullness of blood, &c..
 Prolapsus uteri, descent of the  cervix
  through the vagina to the perinaeum.
 Pylorus,  lower orifice of the stomach.
 Pruritus, itching about the genitals.
 Pathology, doctrine of disease.
 Paralytic, benumbing, destroying sen-
  sibility or muscular motion.
 Plexus, a bundle of nerves.
 Parenchymatous, pulpy, fleshy.
 Porraceots, greenish, resembling leeks.
 Purulent, pus like.
 Phthisis,  pulmonary consumption.
 Pathognomic, characteristic of diseases.
 Parietal, inclosing like  walls,  as the
  high side bones of the cranium.
 Puerperal, relating to child-birth.

                 K.
 Rima Glottidis, rim  of the opening of
  the wind-pipe.
 Rubefacients, irritants that being rubbed
  on it, will make the surface red.

                 S.
Strangury, griping  pain in the bladder
  and loins, with dribbling of the urine.
Sedative, quieting excitement.
Sagittal  suture, the seam between the
  parietal  bones of the head.
Skcundines, placenta  and  fcetal  mem-
  branes.
Sudorific, producing perspiration.
■Secernant, carrying off obstructions.
Sialagogue, discharging saliva.
Suppuration, changing from an inflam-
  mation to an ulcer or sore.
Schirrus, cancer, in its first stages.
Sphincter, an elastic band that, by con-
  traction, closes up a tube.
Scrofula,  a tumefaction  and  suppura-
  tion of the conglobate  glands in differ-
  erent  parts of the  body,  particularly
  the neck.
Syphilis, the veneral  disease.
Slouohino,  dropping away in pieces un-
  dissolved.
Syncope, fainting.
Sibilation, a hissing.
Sinapism, mustard plaster.
Tenesmus, a griping which prevents stool.
Trachea, the windpipe.
Therapeutic, curative, indicating cuie.
Tetter, ring-worm, &c.
Tourniquet, an instrument to compresa
  vessels, and stop the flow of blood.
Transfusion, the transfer of blood from
  a well person to  one that is bleeding,
  to supply the waste.
Venesection, blood-letting.
Vesiculation, blistering.
Vermifuge,  a  medicine  that  expel1)
  worms. 
INDEX.
Abuse of this book, 19.
Ability of females to endure preg-
  nancy, 29.
Abortion, to produce, 38,40.
    "     habitual, 40.
    "     explained, 99.
    "     regulars on, 363.
Abdomen, enlargement of, 90.
Accoucheur, deportment of, 102.
             the best, 388.
     "       chief business of, 48.
Advice, applications for, 17.
Adhesion of Labiae, 65.
After pains, 134.
Age, old, what, 35.
Air for  children, 299, 301,  305.
Alterative pills, 426.
Alarming symptoms, L42.
    "      "  versus forceps, 144.
    "      "  treatment of, 144.
Amputation  of  fcetal arm, 409.
Amenorrhcea, recipe for, 422.
Anasarca, how produced, 204.
Aphthae or soro mouth, 330.
Appetite, capricious,  92.
Apparatus for steaming, 161.
Areola, changes in, 91.
Arm, presentation of, 106.
Astringents,  196, 198.
Asthma, recipe for, 426.
Atmospheric pressure, 46.
Athletic exercises good, 48.
Authors, the  best, sustain my prin-
        ciples, 18.
   "    condemn rashness, 18.
   "    motives of, 23.
   "    instructions in diet, 168.
Author, responsibility of, 19.
Authority, deciding by,328,416'17.

Bad cases, 374.
Barker on physic, 27.
Barbaric practice, 380, 381.
Balsam  of honey, 421.
Bayonet, worse than, 382, 387, 388.
Bed, to  regulate, 104.
Belts, pernicious, 38, 39, 43.
Bitters,  good laxative, 417.
Bitters, 197, 277, 340.
Blindness, remedy for, 426.
Bleeding of ihe nose, to cure, 425,
Blackberry root in diarrhoea, 338.
Bladder described, 61.
   "    irritation of, 89.
        lacerated, 398.
Blisters, Hillary on, 27.
Blood, the life'of man, 27.
Blood-letting, evils of, 27.
      "      Lobstein on, 27.
      "      action  and  effects,
                47, 268.
             Eberle on, 353, 354.
      "      produces   convul-
                sions, 363.
      "      see  Convulsions.
             murder by, 400, 403,
                412.
Book, this, occasion for, 17.
    "      character of, 18,  23.
    "      object of, 22.
    "      abuse of, 22.
    "      use  of, 22.
Botanic troatment, how acts, 41,42.
Breasts, changes in, 91.
Breech  presentation,  106.
Bruises, how treated, 190.
Bronchitis, 348.
Busks, injurious, 38, 39, 43.
Burning of the  stomach, 160, 161.

Catamenia, Curtis on, 32.
     "     Dowees on, 32.
     "     design of, 33.
     "     commences, 71.
     "     quantity of, 7L, 72.
     "     continuance of,  71.
     "     frequency  of,  72.
     "     nature of, 43, 44.
     "     disease of it, 71.
     "     treatment of it, 72, 73.
Cantharides,  evil effects of,  (Hil-
  lary,) 27.
Cancers in the  uterus, 69.
Canker medicines, 151, 196.
Catheter, use of, 220.
Carcinoma uteri, 232, 233. 
X
INDEX.
Catamenial  fluid, how employed,
  when first secreted, how often,
  how long, how chocked,  why
  checked, when ceases, how dis-
  posed of, 34, 36.
Cayenne, a pure stimulant, 147-49.
Catheter, to use, 68.
Causes of disease of females* 29.
Calomel, how acts, 41, 42.
    "    how cures, 42.
    "    effects, 42.
Cessation of milk, 93.
Character of this work, 18.
Change, not improvement, 29.
Child, to receive 113.
   "   to sever from mother, 114.
   "   to clean, 114, 135.
   »   to wash, 112, 114.
   "   to dross, 114, 115, 135.
   "   to nurse, 138.
Children, disease of, 286.
         to clean, 287, 288.
         to clothe, 288, 305.
         to feed, 288, 291, 293.
         to stuff, 291.
     "   medicine for, 296.
     "    never cheat, 298.
         to handle, 298, 299.
     "   cribs and cradles, 300.
     "    creeping of, 301.
     "    city and country air, 303.
          clothing for, 288, 305-9.
     "    cleanliness of, 310, 312.
 Chafes, to  prevent, 288.
 Cholera, and Cartrighl on it, 194.
 Choice of  evils, 267.
 Chicken pox, 356.
 Cholera infantum, 345.
 Circumstances of education, 29.
 Clement, Julian, first male accou-
   cheur, 25.
 Clary on physic, 27.
 Clivers,  (Gallium,) 154.
 Classification of remedies, 195-97.
 Cleansing, 203.
 Clothing for children, 288, 305.
     "   objects of, 36.
     "   inequality of, 37, 38.
 Colic, 318, 332, 334.
 Cold, to cure, 41.
 Cold in the face, to  cure, 426.
 Cold bath, 163.
 Cold, taking when "unwell,'' 50.
 Compounds, fallacy of, 278.
 Compounds, how to make, 188.
Composition, 155.
Congestion, regular treatment in 47
Conception, 77.
Condition  of patient,  to know,
             96, 97.
     "     safe-ty of our  practice
             in, 97.
Conduct of accoucheur when call-
  ed, 102.
Constipation, 157, 174.
Contrasts, 273.
Convulsions, 359.
     "     from blood-letting, 363.
     "     puerperal, 399.
     "     notions  of,  and  prac-
             tices in, 399.
     "     horrible  treatment of,
             400, 408.
Conserve, 419.
Copper, 145.
Corsets, stays, busks, belts, 38, 39.
Costiveness  in pregnancy, 214.
            chocolate for, 215, 318,
              335.
      "      recipe  for, 423..
Cough  powders, 419.
Cough syrup, 419, 423.
Course  of medicines, 156.
     "    intermediate, 173.
Cramp  of stomach, 161.
Craniotomy, heart-sickening, 388,
   389.
Cynancho parotides, 350.
     "     torisillans, 350.
     "     trachealis, 351.

Dangers of regularism, 239.
Death in utero, 411.
Deception, 373.
Deformities, 302.
      "      how discovered, 75.
Dentition, 319,  321.
     "     diarrhoea in, 321.
Delicacy of the subject, 22.
 Do la Valiere, Madame, 25,
 Depletion, 266.
 Delirium, 47, 285.
 Death  of foetus, 243.
 Dejections,  174.
 Deplorable case, 229.
 D« cidua, how formed, 242.
 Descent into the  pelvis,  109.
 Dewees on catamenia, 32.
 Death  by old age, 35.
 Disease of females, 29, 32, 203. 
INDEX.
XI
Disease of peculiar organs, 65.
Disease of pregnancy, 93, 94.
Diseases of children, 289.
Difficult cases, rare, 70.
   "    examples of, 70, 71.
Discharge of waters,  109.
Diuretics, 154.
Diarrhoea, 295, 321, 337, 338.
Dislocations, 302.
Dining, better than quackery, 385.
Dr. Dewecs, influence of, 250.
Dropsy 38, 353, 355.
   "    ovarian, 69.
Duration of pregnancy,  85.
Dysuria, 424.
Dyspepsia, 38.

Ear presentations, 383.
Eberle on lobelia, 352.
   "    on blood-letting, 353.
Eclat of instruments, 372.
Elder salve, 422.
Emenagogues, abuso of, 43.
       "        use of, 45.
Embryotomy, horrible,  386.
Embrocation  for  paralysis   and
  sprains, 425.
Enlargement of abdomen, 90.
Enemas to the vagina, 241.
Epilepsy,  362.
Eruptions, 315.
Erysipelas, 327, 329, 340.
     "     Mrs. Purkinson's case,
             329.
Ergot, very mischievous, 28.
   "   produces prolapsus, 412.
Evils of unequal clothing, 38.
   "    corsets, stays, &c. 38,  39.
External organs, 62.
Extra-uterine conceptions, 80.
Extravasation cured,  190.
Examinations, 38;).
Exercise, value of, 48, 298, 304-5.
Eyes, sore, 343, 344.

False facts, 261.
Fallopian  tubes, 59, 62, 63.
Fallopian  tubes, 232.
Faco presentation, turning in, 383.
Fainting, 282, 283.
False pains, 83.
Feeding after  child-birth, 134.
Feet, to warm, 160, 204.
Foot presentation, 107.
Force condemned, 19, 388, 389.
Fever, puerperal, 255, 256, 375.
   "   causes of 255.
   "   emetics in, 257.
   "   not disease, 258.
   "   maltreatment in, 260.
   «   mistake, 263, 264.
   "   hectic, 282.
   "   what, 346.
   "   to cure, 347.
   "   remittent, 347.
   "   catarrhal, 348.
Fillet, or noose, 369.
Fissure, recto-vaginal, 279, 280.
Flooding after child-birth, 17, 121.
    "    to provent, 121, 123.
    "    lacerations, &.c. 380.
    "    cases of, 386.
    "    maltreated, 413.
    "    to arrest, 131, 133.
Fluor albus, 66, 67.
Foetus rises into pelvis, 61.
   "   how supported, 82.
   "   growth of, 84.
   "   to  receive, 111.
   "   sreond, 115.
   '•   signs of death of, 243.
   "   motions of, 90.
Food  for the  mother, 134.
  "  for the child,  288, 289, 291,
       293, 295.
  "  in the course,  165.
  "  after the course,  166.
  "  test of,  166, 168.
  "  the best rule,  170.
Fomentations, 145.
Forcing hand into uterus, 374, 380.
Forceps, 392, 395.
        don't like them, 388.
        locking of,  392, 395.
        evils of, 393.
   "    condemned bv Blundell,
                     388.
   "         "     Dcnman, 393.
   "         "   Osborne, 394.
   "    destruction by! 394.
   "    unsafe, 410.
   "    difficult to apply, 410.
   "    plans  for   improvement,
          410.
Force, dreadful cvilaof, 396-8,412.
Fruits, for children, 293.

Genteel, effects of being, 38-9, 43.
Ginger, 148.
Graham on mercury, 360. 
Xll
INDEX.
Good, on catamenia, 43, 44,
  "   his plan of cure, 45.
Growth, what? 36.
   "    checked, 49.

Handling, dangerous, 70, 133.
Hand, in utoro, 364, 367.
  "   officious,  368-9, 370-1, 374,
        377-9, 381-2, 386-9.
  "   " worse than bayonet," 382,
        387.
Haemorrhages, 211, 242, 244.
      "       how  to treat, 253.
      "       blood-letting  and
                 ico for, 244, 245.
      "       opium for, by De-
                 wees, 246, 252.
Haemorrhoids or piles, 216.
Haemorrhage of uterus, 248, 249,
               372,  397, 398.
      "       transfusion for, 397.
Headache, what? 46, 47.
Health,  what? 36.
Heartburn, 212.
Heart, palpitation of, 219.
Healing salve, 424.
Hebrew midwives, 25.
Hillary, on blistors, 25.
History of midwifery, 25.
Hoarseness,  423.
Hot skin, 164, 172.
Hysterics, 273-
Hydrocephalus, 253.
Hymen, to sever, 57.
   "    imperforate, 76.
Hydatids in  utero, 68, 233.

Ico in haemorrhage, 244, 245.
 "  explanation, 246, 247.
Ignorance of condition, 49.
    "     evils of and causes, 49.
          of faculty,221, 223, 226,
             232, 373.
Instruments, bane,  19, 27, 70, 106,
               386, 372.
       "     used for eclat, 372.
      "     a great evil, 388.
       "     may always be omit-
               ted, 388.
       "     neglect better than
               abuse, 388.
       "     bad company, 374.
       "     patience and  nature
               the  best, 375.
       "      bad use of, 368.
Inversion of uterus, 21.
Incurables, 47.
Inactivity ruinous, 48.
Instruction from mothers, 49.
Improvements, surgical, 28.
Interruption of menses, 87.
Irritability of  alvino canal, 96.
Injections, 157, 161, 175, 215.
Inversion of uterus, 224.
Inflammation  what, 240.
      "       of uterus, 353, 355.
      "       treatment of, 240.
Inflamed tumors, 272.
Injuries in parturition, 279, 282.
Immolation  of thousands, 411.

Labor pains, 82, 98.
  "   causes of, 99.
  "   signs of, 100.
  "      "     tested, 101.
  "   strangury in, 364.
Ladies, should bo instructed, 22.
   "   should be pitied, 386.
Lacing, effects of 39, 40.
Labiae pudendi, to separate, 65.
Lacerations  of uterus, 122, 380-5.
Lactation, or giving milk, 134.
    "     how long,  314.
Lesions, to heal, 155.
Leeches to uterus, 233.
Ligaments, 59.
Liquor amnii, 80.
Liniment, of lobelia,  190.
    "     anti-spasmodic,  190.
    "     stimulating, 189.
    "     astringent,  191.
    "     for rheumatism, 189.
Lobelia  inflata, 141, 144.
   "     linament of,  145.
   "     powers of, 143-4.
         Eberle on, 352.
Likings  and dislikings, 92.
Lizars, mistakes of, 226.
Lochia, 269.
Locking the forceps! 392, 395.
Lungs,  to inflate, 112.

Manoeuvres,  rude, 20, 21.
Man-midwife, first, 25, 26.
Maltreatment, effects, 31,41, 43.
Marriageable state, 75.
Materia modica, 195, 202.
Meconium, first alvine discharge,
   115, 156, 389.
Measles, 356. 
INDEX.
Xlll
Menstruation, how suppressed 42-3
      "      how performed, 43.
      "      what  becomes   of
                it, 43.
      "      fluid described,43—4
      14        "  object of 32.
      "      irregularity of, 44.
      "      retention of, 44.
      "      symptoms,   effects,
                cause, 44.
      "      to cure, 45.
      "      excessive, 208.
             difficult, 209.
      "      decline of, 209.
             bloody, 210.
Menses, suspension of, 87.
   "    cessation of, 87.
   "    during pregnancy, 87, 88.
   "    rationale of, 88.
   "    retention of, 206.
Mercury, by Dr. Reese, 27.
   "     learned opinions of 28.
   "     Graham on, 360.
         effects of, 360, 362.
Mercurial disease, 28.
Membranes, breaking of, 367, 3G8,
  379, 380.
Meddlesome midwifery bad, 379,
               386.
     "       unpardonable sin,382
Medicines and  instruments, 105.
    "     to procure, 183, 187.
    "     classification of,  194.
    "     rules for testing, 193.
    "     action of, 218.
          for children, 296.
Meddling or not, 251
Midwives, the Hebrew, 25.
Midw fery,  necessity for, 26.
     "     what, 31.
     "     why needed, 31.
     '*     how teach it, 31.
Miscarriage, how produced, 35.
Milk, cessation of, 93.
  "   checked, 289.
Milk leg, 270.
Mistake, 372, 378.
Motives of author, 22.
Mothers, false delicacy of, 49.
    "    neglect of  duty, 49.
    14    advice to, 50.
Motions of foetus, 90.
Mortification of placenta, 131.
Mumps, cynanche parotidaEfi, 350.
Murder by blood-letdng, 400, 408.
Myers, Mrs', case, 21.

Nature's tourniquet, 381.
Nature does the work, 19, 29.
   "   work of, spoiled, 19, 29.
   "   follow her, 383.
   "   history of, 32.
   "   trust her, 365-6, 368-9, 372,
         373-4, 379-80-81-83-84,
         385, 389.
Nature's servants, (midwives,) 19.
Natural ability of women, 29.
   "    parturition, 109.
Nausea, 89, 212.
Narcotics, modus operandi, 193.
Nerve ointment, 424.
Necessity for this work, 17,
Nipples, sore,  424.
"No  medicines in  this country,''
    "must call regulars,'' 192.
Nursing, 290.
Nurses, 291, 292.
Nursery, 307,  310.

Object of it, 22.
Obstetrics, historv of, 25.
Obsteric violence", 122, 380,  386-7.
Obstructions, to remove, 273.
Occasion of this work, 17.
CEdema of the feet, 89.
Officious meddling, 48, 133.
Ointment for nerves, 424.
Oil, 425.
Opiates for  infants,  391.
Opinions of the menstrual fluid, 32.
    "   of physic, 418.
Op'um, Eberle on, 333, 335.
   "    in haemorrhage, 352.
   "    and instruments,  411.
   "    and calomol, murder by 414
   "    opinions of, 28.
Ophthalmia—sore eyes, 343.
Organs, special, 32.
   "    description  of, 53.
   "    objects of, 35.
   "    primitive state of, 35.
   "     injuries  to,  35.
   14    disease of the, 65.
Ovaries, 59, 60, 63, 69.
         disease of, 225, 231,232.
   14     dropsy of the, 69.
   "     maltreatment of, 226.
Opodeldoc for sprains, 425.

Patience, wait with, 70, 71. 
XIV
INDEX.
 Parturition, laborious, 366, 367.
      "     injuries in, 279, 282.
 Panting for broath, 283.
 Palpitation, what, 47.
 Pain  in the side, 213.
 Palpitation of the heart, 219, 283.
 Perinaeum, to protect, 110.
 Perspiration, what, 36.
      41      invaluable, 375.
 Pelvis described, 53.
   11   form and measures, 54.
 Pelvimetre, &c, 55.
 Peculiar organs, 55, 60.
 Perssveranco, 286.
 Peritonitis, 355.
 Physic condemned, 27.
   "   for children improper, 136.
   "   diverse opinions of, 418.
   "   for infants, 390, 391.
   "   injurious, 335.
 Physicians, duties of, 218.
     44     qualifications of, 278.
Phlegmasia dolens, 270.
Phlebitis, 271.
Pity for tho victims, 368,
Pipe,  tracheal,  113,  114.
Piles, 122,216,318.
Plainness, propriety of, 22.
Placenta,  no  force, 19.
    "     described, 81.
    "     to heat Jie, 113.
          to deliver, 116, 120,  124.
    »     how to remove, 120, 123,
           125,126, 129,'130.
    "     nodangorinleaving,130.
    14    decomposition, 131.
    "    premature removal, 121.
    "    injudicious removal, 122,
           124.
    14    danger  of forcing, 120,
           123, 126, 251.
    "    rules for removal, 12j.
    "    in case of twins, 126.
    "    over neck of uterus, 250.
    "    adhesion of, 251.
    "    retention of, L17-19, 364,
           365, 375.
    14    precipitate   extraction,
           365,381, 390.
    "    uterus close on, 365, 367,
           375.
    14    force  in delivery, 372.
    "     extraction of 375, 380.
    "     proper removal, 381.
    "     use no force, 381.
 Plan of cure in paramenia, 45.
 Plethora, blooding in, 243.
 Plourisy, 350.
 Plugging tho vagina, 396.
 Poisons, 145, 147-8, 193, 205,  219,
           331, 284.
    "    aid disease, 46.
 Poisoning, 268.
 Position and presentation, 105.
 Polypus of the vaginn, 66.
 Poisonous ometics,  145.
 Poultices,  145, 177,  179,241.
 Prevention bettor than cure, 38-9.
 Practical value of this  work, 18.
 Practice, old and new, 20.
 Proportion of difficult cases, 20-1 .
 Propriety of teaching f-3 males, 22.
 Prospects of reform, 29.
 Practice of midwifery, 79.
 Prsgnancy, 79.
     "      commencement of, 86.
     "      doctoring in, 287.
     "      duration of, 85.
     "     signs of, 85.
     14     causes of, 86.
     "•     mistakes about, 86.
 Presentations, breech, 369,371,384,
               395.
              ear, 383.
      14      face, 383.
      14      transverse, arm, 384,
               408.
      "     shoulder, 385.
 Prolapsus, 66.
     41    from ergot, 412.
Principles, general,  139.
    "     or practice, 262, 263.
Preparatory dose, 156.
Providence, death laid to, 286.
Puerperal convulsions, 399.
          fever, 255, 376.
    "        "   to make, 269,41.3.
                 l3outofl9killed
                 by blood-letting
                 and poisons, 416.
Purgatives injurious, 332.
Putting to bod, 133.

Quickening, 92.
Quackery, 238, 240,  244, 248.
    44     in haemorrhage, 397.
Quinsy, 350.

Rashness, effects of,  48.
Rashness condemned, 19. 
INDEX.
XV
Ready medicine, 156.
Recto vaginal and recto cystic fis-
  sure, caused by instruments, 398,
Reckoning, 98.
Rectum, 61.
Reese  on mercury, 27.
Reform, prospects of, 29.
Regular testimony, 18-21, 363-417.
Regulating room, bed, &c. 104.
Regularism, 219.
     41     quackery of, 226-29.
Relaxants, 195, 197.
Relax, 318.
   14  • the parts, 141.
   44   enemas to, 145.
Relaxation, 173.
Remedies, simple, 181-183.
    44      crude, 183.
    14      compound, 183.
           pure, 185, 187.
    14      caution in purchasing,
             184, 185.
    14      classification of, 194.
    "      restorative, 154.
Reproduce, woman's ability to, 29.
Reply of  Dr. Thomson, 17.
Responsibility of the author, 19.
Restlessness, 213.
Restorative bitters, 277.
Restoratives, 154,'165, 166-172.
Retroversion of uterus, 67.
Retching, 89.
Rheumatism, 188.
      14      liniment for, 189.
Rigidity of soft parts, 395, 396.
Rupture of membranes, 110.

Sanction  of best authorities, 19.
Salivation, 212.
Salve, elder,422.
   "   healing, 424.
Scarlet fever, 356.
Secret nostrums 185, 193, 194.
Secale cornutum, 411.
Servants, injury to tho  served, 48.
Signs of pregnancy, 93.
   14   treatment of, 94.
Sinking, 283.
Skin  hot, 172.
   "  cold, 173.
   "  binding, 330.
Small pox, 356.
Snakeroot, 148.
Sore breast, 272, 424.
  "  nipples, 424.
Sources of information, 18.
Sores, 202.
Spice bitters, 163,277,422.
Sprains, opodeldoc for, 425
Sponging  the surface, 164, 172.
Starvation, effects of, 39.
Stays, bad effects of, 38, 39, 43.
Steam boxes, 163.
Steaming, 158.
    "     how long, 159.
    "     when  necessary, 164.
    44     apparatus, 161-2.   '
Stimulants,  195,  197.
Stimulate, means to, 146.
Stimulating treatment, 259, 60-2-3.
     "      explanation, 265.
     14      when necessary, 272.
     "      bitters, 421.
Stomach and bowels, 96.
Stomach,  to settle, 161.
Straining  in labor, 364.
Strangury, 424.
Styptic, 426.
Stricture of vagina, 65.
    14     adhesion, 66.
Surgeons, tho French, 26.
Suro-erv, improvements in, 28.
Surface described, 36.
Suicide, to commit, 39, 40.
Surgical operations, 226-228.
Surface, to warm,  172.
Support the woman, 70.
Summer complaint, 295.
Suppuration of breasts, 273.
Swellings, to produce, 204.
     "     to cure,205.
Swelled neck, 350.
   "    breasts, 424.
Syncope, 282.
Symptoms of labor, 107.

Tanzy a diuretic,  154.
Test for medicines, 193.
Testimony of regulars, 363.
Theories, false, 263.
Thomson, Dr. Samuel's book, 17.
Tooth powder, 421.
Tongue-tie, 314.
Tonic pills, 426.
Transfusion, 397.
Tracheal  tube, 113, 114.
Treatment during labor, 108.
Turning  hazardous, 409,  368, 370,
   371,373-4,383,387-8.
Tying the cord, 114. 
XVI
INDEX.
Tumors in utero, 69.
        inflamed, 178, 205.
Uterus, quackery in, 397.
   "   rupture of, 409.
Utero-gestation, 79, 82.
Uterine affections, 234.
   "    why incurable,  234-5.
   "    to cure, 236.
   "    irritability, 237.

Vaccination, 355.
Vagina, dryness of, 366.
Vapor-bath,  below waist, 241-
Vertigo, 283.
Vitality of the system, 46.
Violence, obstetric, 122.
Vomiting, 89, 212, 336-7, 346.

Warmth of  extremities, 204.
   "    and moisture,  145-6.
Waters, to discharge, 109.
   "    see  "Membranes."
Weaning, 312.
Whooping cough, 35S.
Whimsicality, 92.
Witch hazle, 153.
Willoughby's opinion, 19-
Worms, 239, 342.
Worm syrup, 421.

Xanthoxylum,  148, 152.

Zinc, 145,
Ulcers of the mouth, 331-2.
   "  calomel  in, 341.
   "  cayenne in, 331.
Umbilicus, 81.
    "     to disentangle, 111.
    "     to protect, 115.
    "     to divide, 368.
    "     prolapse of, 373.
" Unwell," taking cold when, 49.
     "     bad conduct when, 49.
     "     bad medicine when,49.
Urine, discharge of, 137.
  "   incontinence  of, produced
        by instruments, 398.
Uterus, 58, 62.
   "   invasion of, 21.
       haemorrhage of, 248-9,242,
         397.
   "   change in, 82.
   "   displacements of, 220.
   "   position of, 83.
   "   contractionsof, 118,120-1,
         381.
   "   after delivery, 121.
   "   lacerations and  inversions
         of, 122.
   "   poultices and enemas, 241.
   "   closes on placenta, 375.
   "   lacerations of, 385, 389. 
INTRODUCTION.
   Though Dr.  Samuel  Thomson  has  exhibited, in  his
 "New Guide to Health" his general plan on which all
 forms of disease are to be treated, and relief from suffer-
 ing is to  be obtained, yet the want of that experience
 which inspires confidence in any plan, and in one's own
 ability and skill to apply to the best advantage the reme-
 dial agents recommended, has induced multitudes of  the
 true  friends of the Thomsonian System to  abandon its
 application for the experience of mineral practitioners in
 cases in which, when properly applied, its vast superior-
 ity is most signally displayed.
   Others, fully aware of the disadvantages  and dangers
 of such a course, have been, for several years,  making
 inquiries of me  for  particular instructions, especially in
 that branch of the practice called Obstetrics, the letters
 and  oral  directions  in answer to  which, would  fill  an
 octavo volume.
  These inquiries being multiplied upon  me  in my new
 station as Editor of the Recorder, I took the first con-
 venient opportunity  to request Dr. Thomson himself to
 give the  fraternity  a general answer in the form of a
 complete treatise.
  He  replied that  "his supplement contained all  the
principles  involved  in the  queries, and  examples suffi-
ciently numerous and various  to  give a  correct idea of
 the proper mode of applying  them in  all  conceivable
             2 
18
INTRODUCTION.
cases; and that, if the friends of the system wanted any
thing more minute, they must prepare it themselves.'1
   Though I published  in the Recorder the substance of
this  answer, the "inquiries for  information" have since
accumulated upon me to such a degree that I have deter-
mined to  publish, as an answer to the  whole, my Lec-
tures, delivered last summer  to the students of the Bo-
tanico-Medical School at Columbus, embracing the most
important instructions on those subjects, which the wis-
dom and ingenuity of man, either in or out of the Thom-
sonian School, has yet devised.
   In preparing this work for the press, I have made  use
of all the  means of information within my reach, (and
they are not scanty,) selecting from others, as well  as
from  my own  observations,  only  those  descriptions
which are essential, and giving  only those directions  as
rules  of practice, which will abide  the test of experi-
ence.
   By discarding  all reasonings  upon unsettled theories,
and modes and means of practice of doubtful efficacy, I
trust it will be found that I have gathered  into this small
volume every thing known  on  the subject of which it
treats, that is worthy  to be made the ground of implicit
confidence intpractice.
   I have endeavored to render  this volume such that, if
a Thomsonian should, through inexperience,  fear, in a
difficult case, to apply his favorite  practice, a reference
to its  pages would show him  that the fundamental prin-
ciples, and most common and important modes of appli-
cation, are  advocated and  sustained by  many of  the
most  learned and judicious  authors  of  the old school ; 
INTRODUCTION.
19
while these same gentlemen have given to the depletive,
antiphlogistic, rash, and instrumental system, the  credit
of almost all  the mischiefs that have ever happened in
the chamber  of parturition.   Take the following for
example:
   " Midwifery is the  art  of assisting women in  child-
birth."— Webster.
   "The proceedings of nature, in ripening her fruits, in
bursting the husks of walnuts and almonds, and opening
the shells of  eggs without force, when ripe, should teach
midwives patience, and persuade them to let nature alone
to perform  her  own work, and  not to disquiet women
by their strugglings; for such  enforcements  rather hin-
der the birth than in any way promote it.   They often
ruin the mother, and usually the child.  Let midwives
know  that they are  nature's servants."—Willoughby,
Ed. Pr. vol. 5, p. 5.
   " Let every candid practitioner acknowledge that, for
one  instance  where the  retention  of the placenta has
been attended with dangerous consequences,  its precipi-
tate  extraction  has been  fatal to hundreds."—Ed. Pr.
vol. 5, p. 127.
   " The rash and preposterous  application  of instru-
ments  [where  the head is squeezed into  the pelvis in
such a manner as to induce  the belief that it  cannot be
extracted without them] has proved the  bane of thou-
sands."—Ibid. p. 140.
   " The work of nature is too often spoiled by  officiou*
hands."—Ibid. p. 142.
   When I reflected on the great  responsibility of giving
directions which, if wrong, might prove destructive to 
20
INTRODUCTION.
the lives of my fellow brings, my heart shrunk from the
undertaking.   But, recollecting to have  seen saved by
by this practice many lives which had been pronounced
hopeless by the advocates  of the other, I felt it an imper-
ative duty to  proceed, especially  as I knew  that many
true Thomsonians had  placed  more confidence in  the
experience of  the old  school practitioners than in their
own ability and skill to apply the practice laid down in
the New Guide, who,  could they  see the many dangers
mingled with  the few advantages of this course, which
even my limited knowledge and  experience  might pre-
sent to them,  would prefer a plan of saving thousands
of lives that are now regularly sent  from the child-bed
scene to the place from which  no traveler  returns;  and
much suffering to other  thousands who escape immediate
death for the lingering torment of constitutional injury,
produced, as Dr. Dewees says,  by "ill-judged and  rude
manoeuvres, under  the  specious  pretence  of relieving"
the sufferer.—Introd. Mid. p. 14.
   In Dr. Rees's Cyclopaedia, it is  stated that  " not more
than one case [of childbirth]  in five or six  hundred
requires the use of instruments;" and Dr. Dewees states,
page 20th, that he has taken his measures of the deform-
ities of the pelvis, [the  most common cause which  ren-
ders instruments  necessary,] from European surgeons,
on account of the fact that the most extensive practi-
tioners in America rarely  witness such cases.
   I must therefore conclude that the many cases I have
krrown the regular faculty to treat, as they would have
it. in a scientific manner, by which either the woman or
child, or both, suffered death, or little less, did not really 
INTRODUCTION.
21
indicate any necessity for the  " rude and ill-judged man-
oeuvres " of the  " ignorant pretenders " with which they
were tormented.
  I have just now heard of the death of one of my early
associates, who had  suffered five or six  years from the
wretched effects of such  "rude  manoeuvres," and  I
expect soon to hear of the termination of similar suffer-
ings, in the similar fate of four or five more.
  As  I have the most conclusive evidence  that some
eighteen or twenty others of my particular acquaintances
have been  either killed outright or rendered miserable
for life, by the " rude manoeuvres of ignorant pretenders,"
and as the  authorities just quoted assure me that there  is
no just cause to  fear fatal results in more  than one case
in five or six hundred in Europe, and few, if any at all,
in America, I conclude  that, if I can persuade the ladies
to trust  altogether to nature, and  to  remedies  that act
in harmony with her operations, to  the entire exclusion
of all  "ignorant pretenders"  and their "ill-judged man-
oeuvres," I shall  perform an  essential service  to those
who have  "sorrow" enough in "bringing forth  child-
ren," without the aid of " rude hands, forceps, crotchets,
levers" and the death-dealing ergot.
  In adducing evidence from  the regular  faculty, I have
endeavored to give  a fair statement of their best opin-
ions, as based  on their own practice.
  But  how much  more favorable  to our views those
opinions would  be,  were their supporters  acquainted
with the superiority  of our practice, let the enthusiasm
with which those who abandon  the old practice for the 
22
INTRODUCTION.
new, condemn the former and applaud the latter, furnish
a more just intimation.
  The subject of the following pages is  admitted to be
very delicate ; but the conclusion often drawn from this
fact, that minute instruction respecting it should not be
given in books written expressly for the purpose of sav-
ing the persons concerned the mortification of indelicate
exposure, is equally unreasonable in itself and destructive
to one of the principal objects for which these books are
written.
  If we use general  terms, and dark, indefinite allusions,
so that  our descriptions and  directions  are  not under-
stood, we confer no benefit upon the reader.   It is only
when the case is accurately defined, the diseased organ
carefully described, and  the  treatment  clearly pointed
out,  that the patient will  have confidence  in  her own
knowledge  and skill,  sufficient to keep the case  to her-
self and those immediately concerned.
  This book is intended to be  a  confidential  friend to
married ladies, on the management of those forms of
disease that come more especially under their notice and
treatment.   Shall it  then be silent on all those subjects
whose delicacy renders it  unpleasant for her to consult
the experienced practitioner of the other sex in regard
to them ?   Surely not.
  If, instead of keeping my book out of the  way of the
common gaze  of  the  uninterested  and curious, to he
consulted in  her moments of leisure and seclusion, for
the plans and the means of relief in emergency and dan-
ger, or for  seasonable prophylactics, she  place it on the 
INTRODUCTION.
23
centre table to wound the delicacy of the  mixed com-
pany  that assemble around that interesting and profita-
ble source of amusement, I shall be no more worthy of
censure than if she were to proclaim  before a promis-
cuous audience the same instructions received  from me
in the private consultation, or the  confidential letter.
   Be this as it may, it is professedly  the want of  this
minute and  accurate  knowledge  that  has  dictated the
numerous and pressing calls  upon me for information, to
which the present work is intended to give a general
answer.
  I have therefore carefully  described the several organs
concerned ;  the forms of disease to which  they are lia-
ble ;  the most judicious prophylactics, and  the best
means and modes of curative process.
   While my course in this, as in all my other  labors, is
sustained by the consciousness that I have endeavored to
do my duty, I shall be happy if it  meet the  approbation,
and more especially the  wants, of  the Botanico-Medical
Fraternity and Sisterhood, to whom it is most respect-
fully  dedicated.                               A. C. 
 
HISTORY OF OBSTETRICS.
THE ART OF AIDING WOMEN IN CHILDBIRTH IS CALLED
          MIDWIFERY OR  OBSTETRICS.
   The first midwife, of whom we have any account, aid-
 ed Rachel  in the birth of her second child.  We have,
 in the Hebrew Scriptures, no account of any other mid-
 wives than women.   None but women are mentioned
 under this appellation  by the Greek and Roman histo-
 rians.  From the fact  that their names, in many differ-
 ent languages, are all  feminine, it is certain that, until
 lately, all  civilized nations employed women  only  as
 midwives.
   The first services performed by men in  this art, were
 to deliver those women who, it was supposed, could not
 be delivered without the  aid of instruments. The first
 employment of a man-midwife in general, is said to  have
 been by Madame de la Valiere, in 1663—only one  hun-
 dred and seventy-eight years  ago.   That lady sent for
 Julian Clement, a surgeon of reputation, who was  con-
ducted with great secrecy into the room where she  was,
 her face covered with  a hood, and where, it is said, the
 king was concealed in  the curtains of the bed.  His suc-
cess with  her, then and on subsequent occasions, ren-
dered fashionable the  employment  of men, who have 
26
HISTORY
since  so generally  usurped,  by degrees, the just and
natural prerogative of the other sex, that it is now gen-
erally thought a piece of imprudence, almost  amounting
to rashness, to trust the  management of this matter  to
the original and proper hands.
  But it  is abundantly  evident, from  a comparison  of
the rapid increase of ancient nations, and the robust con-
stitutions  and  extraordinary longevity  of  the  people,
with the destruction of  scores of modern women and
infants, and  the miserable condition of multitudes that
escape immediate death, that  this change was  not  made
for the better.
  It is true that the luxury,  idleness and congregation
in cities, manufactories, &c. of  modern times, have pro-
duced more deformity of frame, constitutional taint, and
liability to disease, in the generations of the present age,
than  were found among those of former  ages,  when
hunting, fishing, agriculture, war, the tending of herds,
and the construction, by  the hand,  of articles now made
by  machinery, were the constant employment, not only
of a few, but of the general mass of mankind, and whose
diet was simple and coarse;  still it is generally conceded
that rash and daring efforts of art,  to improve even the
slightest of nature's deformities, have  resulted in  more
mischief than good.—See Ed. Pr. vol. 5, p. 127.
   In view of the evidences afforded by dissections, Dr.
Rush  exclaims, " What mischief have we not done  under
the influence of false theories ?"
   The historians of the  French campaign  assert, that,
when the battles were over, the work of death was but 
OP OBSTETRICS.
27
just  begun ;  that  more  perished  in  the  camp  by the
hands  of  surgeons, than  by the sword and cannon on
the field of battle.
  The Edinburgh Practice says, " The rash and  prepos-
terous use of instruments (in midwifery) has proved the
bane of thousands."—Ibid. vol. 5, p. 140.
  Dr. Terry says that bleeding relieves spasms  by des-
troying the power of life to  produce them.  Dr. Lob-
stein, an eminent surgeon and medical practitioner, says,
" So far from blood-letting being beneficial, it is  produc-
tive of the most serious and fatal  effects;  a cruel prac-
tice; a scourge to  humanity!   How  many thousands of
our citizens are sent [by it] to an untimely grave!  How
many families are deprived of their amiable children!
How many husbands of  their  lovely wives! How many
wives of their husbands!  Without blood there is  no
heat, no motion of the system.  In the blood is the life.
He who  takes blood from the patient, takes  away not
only an organ of life, but a part of life itself."
   Dr. Hillary says, "The stimulus of the  acrid salts of
cantharides renders  a fever  inflammatory, and  all  its
 symptoms  worse ;  that they hasten and increase the
putrefaction of the blood, produce stranguary,"  &c.
   Dr. Barker says he has seen much  injury done by the
 use of physic where an emetic ought to have been used;
 and  Dr.  Clary thinks he lost several cholera  patients
 by  it.
   Dr. Reese, of London, says, "I know not whether  to
 hail the discovery  of mercury as a blessing, or  regard it
 as a curse, since the diseases it entails are as numerous 
88
HISTORY
as those it cures."  But Drs. George, Hamilton, Hooper,
Falconer, Donaldson, Swan, Coxe, Cheyne, and hundreds
of others, accuse it of destroying countless multitudes of
our race.   Cheyne and Chapman accuse it of producing
jaundice.   Coxe says,  in many cases it produced  the
black vomit in the yellow fever.  Hooper says it attacks
the bones, and sometimes  causes violent purging, even
of blood;  that  many courses, in any form,  would  kill
the patient—because it  proves  hurtful to the stomach
and intestines.   The United States Dispensatory says,
it  sometimes produces  extensive  ulceration, gangrene
and even  hsemorrhage.  Dr. Hamilton says,  there  are
few poisons which possess more  dangerous powers.   Dr.
Rush  calls it the Goliath  of medicine.   Dr. Cox and
others say it produces an eruption called erythema mer-
curiale,  or an excessive flow of saliva  ; and Dr. Bigelow
says that  this mercurial  disease  is self-limited—that is,
that it cannot be arrested by medical practice.
  Dr. Eberle calls the various forms of opium " destruc-
tive palliatives," and Dr. Gallup thinks they should  be
entirely banished from medical practice.
  Prof.  Beck has proved  ergot to be a most destructive
article;  and Dr. Smith says, "It must be wholly and
forever  abandoned, or be freely used."  It deserves  the
former fate.
  Similar testimony might be adduced against  the  use
of other popular medicines, and, indeed, against every
poison, mineral, animal  and vegetable.   Hence it  appears
that the improvements, as  they  are  called,  of surgery,
venesection* vesiculation, physic  and poisoning,  are  but 
OF  OBSTETRICS.
29
sorry substitutes for the ignorance of former ages, when
physicians  knew only how to sweat, to nurse, and to
heal.
  Yet, reader, strange to tell,  these and  similar are the
means which men have introduced into the  " art of aid-
ing women in childbirth," on account  of which  they
claim superiority of  skill  over  the  proper sex, whose
highest ambition was  to watch the indications of nature,
to aid her timely and  promptly, but never to oppose her
prophylactic or curative  efforts.  Sad change!  where
almost constant  wretchedness takes place  of  rare  and
partial inconvenience.
  I lay it down as a rational position, on the strength of
historical testimony,  then, as well as sound logic,  that
women are naturally  as able as other animals  to repro-
duce  their species without extrinsic aid;  that the disa-
bilities with which we actually find them beset, are rare,
very  rare, malformations of the system, and, more  com-
monly, hereditary, cankerous  taint;  but that  those by
far the  most frequently observed, are the  fruits of bad
management in their raising,  as comprehended in  their
clothing, exercise, food, and medical treatment.
  It will perhaps be inferred  that, as the chief business
of the advocates of temperance  is to preserve the sober
from becoming drunkards, so the  most that can be expec-
ted of the Botanic Physician of the present day, is to
save the  rising generation from the evils  above  enumer-
ated,  which  are  the  principal causes  of all the fevers,
tumors,  cancers,  polypes, hydatids, dropsies, rotten
bones, &c.  whose deadly  hold  on the patient may be 
30          HISTORY OF OBSTETRICS.

compared to that of the bottle on the appetite of the
confirmed sot.
  It is, however, encouraging to know that these con-
stitutional and educational evils  are far more manage-
able, in the hands  of a skilful physician, than the most
hopeful cases of inebriation are in the  hands of the ad-
vocate of temperance. 
MIDWIFERY  OR  OBSTETRICS.
  Midwifery or Obstetrics, I have  said, is the art of
aiding women in childbirth.
  But why, it has been  asked, does woman need assist-
ance in the performance of that to which her very nature
is especially adapted ?  Were it  not  almost as rational
to say that she needs assistance to keep the beard  from
growing, or to make the pelvis grow larger in propor-
tion to  the rest of the body than it  is in man, or to
complete any other peculiarity of her frame, as that she
needs aid in giving birth to her offspring ?
  I answer, the fact is  admitted  on  all hands  that she
does need it; and I therefore proceed  directly to show
both why  she needs it and how it shall be  the  most
promptly, judiciously and effectually rendered.
  I apprehend that the necessity for this aid is, with
few exceptions, the  result  of a series of injurious treat-
ment, by which her natural ability to do the work with-
out aid, has been so much abridged ;  and that,  therefore,
the kind of aid she needs is the removal of those obsta-
cles that have unfitted her for her duty, and the restora-
tion of those powers of whose free and full exercise she
ought never to have been deprived.
  Perhaps the best method of teaching this, as well as
any other art or science, is, first, to  present a compre-
hensive, clear and connected view of the whole subject. 
32
REASONS FOR  IT.
Then the relative importance  of the various details will
be  more  clearly perceived, properly  appreciated,  and
easily treasured up in the memory.
  It is especially because the female frame includes  cer-
tain organs made for special purposes, that derangements
of these organs, or their operations, have been  called
" diseases peculiar to women."
  To enable us, therefore, to rectify those derangements,
we  shall do well, first, to learn something of the objects
for  which those organs were formed, and the nature and
end of their operations in a healthy state.
  As in the superfluity of seeds  or  eggs, produced by a
single plant or insect, fish or bird, &c. which, when  cir-
cumstances do not favor their  being used for reproduc-
tion, may be devoured  by animals or  returned to the
earth unproductive—so,  in  every department of  the
economy of the Great Author of all other contrivances
and agencies whose existences or modes of existence are
subjected to the influence of conditions or circumstances,
there is  a superabundant provision of means,  both to
accomplish the great end in  view, and  to prevent  the
excess of those means from doing any injury, if not to
turn it into other channels for good.  The organs allu-
ded to are termed Uterus and Mammae, and the secre-
tions Menses and Milk.
  After a formal array of the most plausible hypotheses
which have been invented to account for the existence,
nature,  uses and periodical returns of the menses,  Dr.
W.  P. Dewees, Professor of Midwifery in the Univer-
sity of Pennsylvania, concludes, (page 67,) "From  what
has  just been said, it appears that hitherto nothing satis- 
       MENSTRUATION--FEMALE ORGANS.     33

factory has been advanced upon this curious subject.  It
yet remains for some future Haller or Hunter  to  enrich
medical science with a rational explanation of  it."
  Perhaps  the principal reason  why this  explanation
should be  referred to a Haller or a Hunter,  in prefer-
ence  to Dr. Dewees, is, that Haller and Hunter rejected
the trammels of medical authority,  observed, considered
and reasoned for themselves, and dared to publish what
they discovered; though, as Hervey  says, "The  hatred
and envy of physicians should swell  against them  as a
legion of devils against virtue;  and the  whole society
should dart their malice at them  and torture  them  with
all  the  calumnies imaginable, without sticking at any
thing that should destroy them root and branch."
  Now,  though I do not pretend to' possess the splendid
talents or attainments of a Haller or a Hunter, yet I do
claim the same right <to the untrammeled use of the little
share I have ; and, as  all  I  conceive necessary  to the
task is a careful observation of what almost any one can
see, and  a sufficient control of language to express what
I think,  I shall make the  bold  attempt, and  leave the
decision  of its correctness to  others  who  can see  and
think as  well as I.  And I shall  be quite as  indifferent
to the consequent charges  of ignorance  and  quackery
against me, as formerly was Haller or Hunter.
  The principal object  in the  peculiar structure of the
female body, was its adaptation to the continuance of its
species.  The  production,  occasionally, of the embryo
of another  self, a sort of parasite that should be sustained
awhile by the strength  of her own system, required the
establishment, in woman, of peculiar organs, and also of
              3 
 34         USES, COM M E NCEMKNT AND

 periodical secretions, which, when not  applied  to the
 objects to which they are adapted, should be discharged
 in such a manner as  to  inflict no  injury on  the organs
 by which they are secreted.
   For ten or a dozen, and sometimes sixteen or eighteen
 years, these secretions find full employment in contribut-
 ing to the growth of the  body, whose maturity, on that
 account, is generally  accomplished  several  years earlier
 in females than in males.
   After this perfection of the organs, completed in our
 latitude at the age of twelve to sixteen years, there is a
 periodical  secretion  from the  uterus, occurring  most
 naturally and commonly,  (but often irregularly,) once  in
 about four weeks, until  it is  arrested,  either by disease,
 or, as has been hinted, by being turned to  the  nourish-
 ment of a parasite—an embryo of a future man ; or, till
 the powers of life, through  the worn-out  capacities  of
 the body, are so  much  reduced, and all  the  secretions
 are so much diminished in quantity, that  this (the  men-
 strual) is  easily  absorbed away and distributed among
 the others, when  its distinctive character and locality no
 longer appear.
   This usually happens somewhere between the fortieth
 and fiftieth year,  though it sometimes occurs  much  ear-
 lier, and  at others  is postponed much longer.  An in-
 stance is  mentioned  in a New Orleans paper where  it
 commenced at four years ; and one in Good's  Studies  of
Medicine, where it occurred for the first time at seventy!
  From  the natural  cessation of this  secretion, to the
end of life, all the  secretions diminish in quantity and
quality, till finally  they  are  insufficient to sustain the 
ENDING OF  THE MENSES.
35
organic action—that is, to furnish solvents for digestion,
lucubrating fluids, &c. the friction stops the whole  ma-
chine, and the name of this condition of things is, death
by old age.
  From this general view  of the subject, it is evident
that, as the peculiarities of the female frame Were formed
for the  express purpose of bringing forth children, our
efforts to aid her in the accomplishment of  this object,
must begin where nature begins to fit her for the office ;
or, in  other words, at the  very commencement of her
existence.
  In her primeval  condition,  before her body was  cor-
rupted  by any   constitutional taint—that is, source  of
disease communicated from the bodies  of her parents—
woman was born free from  any other  defect than what
might  be brought upon her by bad  treatment after she
entered  the world; but, as civilization and moral and
physical corruption advanced, her  body partook  of the
latter, till it is often necessary to remove the constitu-
tional  taint or canker from  her frame as soon as she  is
born.   The presence  of this  material  defect,  then,  so
disables her for  the full and  perfect performance of all
her physical  duties, as  to become the  first  reason why
woman  so often needs aid in the  chamber of parturi-
tion.
  But, supposing  her  birth  to  have  been  timely  and
natural, from healthy parents, there  is a direct tendency
towards that state of maturity  in  which the size  and
tension  of all the  absorptive, circulating  and secreting
vessels are so completely balanced as to admit, require,
produce and maintain  an equilibrium  of fluids through 
 36    DEALT II--S U R F A C E--V ERSPIRATION.

 the  whole system.  Immediately after birth,  then, the
 proper secretions are chiefly engaged in contributing to
 the growth and perfection of each organ or organization,
 till the whole system  arrives  at  maturity,  when the
 waste-gates are opened and the overflowings appear.
   In the body, enclosing the organs  of digestion, assim-
 ilation and absorption, (the fountains of circulation and
 vivification, and source of the organs  of secretion,) we
 might expect to find the greatest amount of action, and,
 in the extremities, the least, while the  child  remains
 apparently  quiet;  but  the  almost  incessant  motion
 which  it  gives to its  limbs, is sufficient, by  causing  a
 free circulation, to maintain the proper equilibrium till
 it is able to stand and  walk,  when  the partial  diminu-
 tion of this action is compensated  by gravitation or the
 natural downward tendency of the  blood, produced by
 its own weight.   These several causes combine  to con-
 tinue the vital action and consequent heat of the  extrem-
 ities  nearly or quite equal  to those of the body; and
 thus  all  the  operations of  life  are  carried on  without
 obstruction;  and the condition so maintained  is termed
 health.
   The  surface of  the  body is a network  composed  of
 the mouths  of an infinite  number  of  invisible tubes,
 whose office is to cast off the  excess of heat and moist-
 ure, which, from  any cause, may at any  time accumu-
 late in  the system.   This secretion  is  termed perspira-
 tion—sensible when the water  is seen in drops on the
skin, and insensible when heat only is perceptible.
   The object of clothing is, in cold weather, to  protect
 the surface  from  the  astringent action of the' atmos- 
           CLOTHING, INEQUALITY OF.         37

phere, which it does by retaining, for a while, the disen-
gaged heat  around the body;  and, in hot weather, by
reflecting or warding off the excessive heat of the solar
rays.  In the former case it prevents the cold air, and
in the latter the dry heat, from contracting the  network
or pores of the surface, and obstructing the free perspi-
ration or escape of excessive heat and  moisture.  It is
evident, then, that, if the clothing be equal all  over  the
body, the pores will be equally open, perspiration will
be equal every where, and health, so far  as  the  proper
action of the surface is concerned, will continue perfect.
Here is  the moment when we begin to aid or hinder the
female frame in its preparation for the reproduction of
its species.
   First, then, I will ask the mothers of our land, whe-
ther the manner  in which many of them clothe their
daughters, from this time  forward, is  consistent with
the dictates of reason or of common sense ?  Do they
not encumber their bodies with numerous bandages  and
oppressive  clothing, while  they  leave the  extremities
almost  destitute?   What must  be the  effect of  this
course of conduct, but to relax and expand  inordinately
the pores  of the body, and  to  contract those  of the
extremities, thus forcing through the former all the heat
and moisture that ought  to be secreted from the whole
surface, and giving to the atmosphere the power  to  im-
pede the circulation  of heat and  moisture  through the
extremities,  which  impediment  or  obstruction must
necessarily reduce  their  temperature ?  The arteries of
the  lower  extremities being  contracted  by  exposure,
those of the chest and head are proportionably distended 
3S        PROPER (LOTHIN G--C O R S ET S--

by  the  pressure of the blood  that is  thus forced into
them, and the sensation  produced by  this pressure is
called  "fullness of the head," or cerebral  congestion;
while the distended blood vessels necessarily press upon
the nerves  and disturb the  uniformity  of their  action,
producing sometimes  a confusion  of their operations,
which  is  termed delirium.   Here, also, we  have  the
origin  of many  cold  feet and hands,  flushed counte-
nances, &c.  Though it is true that some sprightly girls
overcome, by exercise, &c. the deadly  influence  of this
inequality of dress, yet it is equally true  that, in the
constitutions of many  others, is thus  laid the foundation
of disease that follows them  to their graves.—See Lec-
tures on Medical Science,  pp. 73 to 81.
  If asked how I would have the  extremities  to  be
dressed, I answer, let thick flannel drawers and woollen
stockings  in winter, and  cotton in  summer,  be worn
next the skin ;  let the body be clothed so loosely  that it
can easily move itself within  the garments, which should
be no warmer  than those on  the extremities.
  Another reason why women need aid in childbirth, is,
that young girls are allowed, and sometimes even requi-
red, by their mothers, to wear those modern instruments
of lingering torture, called  corsets, stays, busks, belts,
&c. &c.                                 ,
  Shall it be objected  that these things cannot be dis-
pensed with, if a person would look decent and becom-
ing, not to say genteel ?  I answer, after an abortion or
a miscarriage,  a dyspepsia or a dropsy, has racked the
poor frail  body for several years, in consequence  of this
folly,  they are willingly  dispensed with, and no com- 
STAY S--B U S K S--B E L T S.
39
plaint is made of the privation.   Were it not  better to
regard, in health, the dictates of nature, of reason  and
experience, and  save the  future suffering, the  wreck of
constitution,  health and life ?
  Lest I seem too severe  on  these fashionable correctors
of nature's bungling architecture, I  will give, at once,
some of the facts and arguments  that  sustain my posi-
tion.  In  performing  this service,  I  may  omit  many
things  that might  be said against it; but there is no
fear that I shall, in any respect, represent  the evil con-
sequences  of its use as more numerous  or destructive
than they really are.  Language cannot reach them.
  In the first place,  these misery-making machines, like
the iron prison for the Chinese foot, prevent the growth
of the body to its intended and ordinary size; and then
it  renders cartilaginous and callous  those parts  that
were designed  to be, and,  if they were  permitted to
grow in their own  way to the size of their  own plea-
sure, would be  muscular and elastic, calculated  to ad-
mit, without  pain  or  inconvenience, those  different
degrees of capacity  so  essential to the safe carriage,
nourishment  and delivery of a healthy offspring.
  As the  starving  system  of  treating dyspepsia  by
withdrawing the periodical  internal  pressure of a full
meal, suffers  the external pressure to act constantly on
the  coats  of the stomach, till  they become  so  perma-
nently  contracted  that  any  increase  of  the dietetic
potion produces pain; so the superficial compression of
corsets, by preventing frequent  distensions  and expand-
ing  motions, permanently contracts the  chest, the dia-
phragm and  the walls of  the  abdomen, to such a degree 
 40       ABORTIONS  AND MISCARRIAGES.

 that the inordinate expansion  necessary to the  growth
 of the foetus, produces  similar pains in the diaphragm,
 the parietes (walls or coats) of the abdomen, ifec.   The
 painfully distended parts  continually  strive,  by  their
 reaction, to  expel  the offending  cause;  and hence a
 fruitful  source of  abortions,  miscarriages and  seven
 months children, besides all the current suffering to  the
 mother, and the incurable evils that so frequently attend
 those who  survive  such dangerous  conditions, to  drag
 out a miserable remnant of life  scarcely  preferable to
 death itself.   Within  the range  of my recollection  are
 more than a score of females in this  last condition, who
 are to charge their present  sufferings, in a great  mea-
 sure,  to early lacing, and almost altogether to  the  com-
 bined influence of this cause and the several others  pre-
 viously and yet to be explained.
   Of the multitudes that have sunk under the miseries
 attending the premature expulsion of the foetus, the dark
 and silent regions of the grave alone contain the  record.
 I have  no doubt  that, if all  who have thus committed
 suicide could array themselves before us, the effect would
 be insupportable to  the most hardened feelings  of our
 nature.  This  is another reason why women  need  aid
 in childbirth.*

  * When physicians discover  an abortion, a miscarriage,  or a
premature birth, they conclude that this accident, as they call it,
is to be considered a sort of legitimate cause of a similar catas-
trophe in  future.  They seem  never to have dreamed that  the
first accident was the legitimate effect of a cause whose tendency
is  to produce  the same effect in every instance.  And hence,
instead of directing their practice against the true cause which
produced the first effect, they  wait for the evidences that it is 
MAL-PRACTIC E—C A L O M E L.
41
  Another reason why women need aid in childbirth, is,
their power to accomplish it without aid  has been early
and frequently abridged by injudicious medical treatment
on the slightest indisposition.
  By the carelessness of the nurse, or its  own incessant
motions,  the infant is  exposed and  takes cold.   The
bowels are a little disordered, or the  stomach is  clogged,
or a fever rises ; it matters not what, the least irregu-
larity  creates alarm.  A few draughts of warm, stimu-
lating  fluid, or at  most a full botanic course, in such
cases, would put all things right; but no  ! the doctor is
called, and forthwith doses of calomel (from one grain to
three, and by some practitioners, eight, ten and twelve)
are immediately prescribed. This deadly drug, (like every
other  poison,  they all  agree  in this point,)  " suddenly
and rapidly  extinguishes a great proportion of the vital-
ity of the system."—Bost. Med. and Surg. Journal, vol.
9, page 43.
   Many a time have I  seen the vital energies of a poor
little  infant, laboring  under  the deadly  influence  of a
dose of calomel (a single grain to a healthy child is suffi-
cient  to prostrate all its energies.—Bost.  Med. and Surg.

about  to  produce  another, when their  efforts themselves  are
worse than vain, because made too late and upon a wrong princi-
ple.   Being  ignorant of the  true cause, they are incapable of
 applying the  proper remedy.
   The botanic treatment warms and relaxes the extreme vessels,
 discharges the cold and the morbific matter, promotes a free  and
 general circulation of the blood, and a regular vibration or action
 of the nerves, gives tone or contractile power  to the  debilitated
 organs, promotes digestion—in short, it removes the causes of
 disease, and restores health to the patient. 
42
C A L O M E L--Q U A C K E R Y .
Journal, vol. 9,  page 85) given  to suppress that  very
fever which,  if aided by a little stimulating  tea and
warmth and moisture to the surface, or even  if left to
itself, would soon put to flight  the offending cause, and
restore  health and activity to the patient.
  But scientific wisdom  adds  more  and more calomel,
till so  much of the " vitality  of the  system "  is  " des-
troyed," that no danger is apprehended from " the fever."
Many a little sufferer, being kindly nourished and nursed,
now steals a march on  the  doctor.   Its fever rises  by
steps so gradual as not to be discovered, while it works
off the most of the calomel  in the same silent  manner ;
and it would  appear to be  as well as  ever, but for  its
evidently increased liability to  the future attacks of the
same and similar affections.  But alas! how many others
there are who sink, under the influence of this  deadly
weight, to rise no more !   I  have seen not  a few perish
for  no  other reason, as  I firmly believed,  than  simply
that  they had taken more poison to  cure  disease  than
the system could bear.   Their death  was  attributed to
teething, to  summer complaint, to measles, to  croup, in
short to any thing  but the true  cause ; and the wreck
of constitution in  others  that  escaped  death, was
accounted for in the same irrational manner.*
  These children grow up still  more and more  liable to

  * That I may not stand alone in this judgment, I appeal.to the
testimony, respecting the injurious  effects of mercury, as descri-
bed by eminent physicians, in the Thomsonian Recorder, vol. 4.
pages 37, 38,  39.  See, also, Dr. Robinson on medical poisons,
Dr. Swan's " Inquiry into the action  of Mercury," and Dr. Don-
aldson's Practice in India. 
    OBSTRUCTION S--A MENAGOGUE S--M E N S E S.  43

disease, and  frequently attacked by it, till the period
when, had they always been properly clothed, fed, exer-
cised and doctored, the menstrual discharges would have
taken place.  In the United States, and under favorable
circumstances,  this  ordinarily  happens  between  the
twelfth  and fifteenth  year.
  But the vitality of the patient has been so much redu-
ced by  the  inequality of clothing, the  want  of proper
exercise, by  tight lacing, or  by poisoning the system
instead  of curing disease, that the growth of the organs
is not yet  mature; the preparation of the secretion is
postponed  for  a  while, or distributed among  others
when actually  prepared.
  It is well  if now some learned quack  does not per-
suade the patient's mother to give emenagogues directly
to force its appearance.  As  time passes  on, however,
the secretion accumulates in the proper vessels, and the
system makes an effort to discharge it.
  " When  the  growth  of the animal frame,"  says  Dr.
Good, " is completed, or nearly so,  the quantity of blood
and sensorial power which have hitherto been employed
in providing for such growth, constitutes an excess,  and
must  produce plethora by  being  diffused generally, or
congestion by being accumulated locally.  It takes  the
latter course in order to perfect the organs of genera-
tion, which, during the principal growth  of  the  body,
generally  remain  dormant  and inert.   It first  shows
itself in the ovaria, from which it soon  proceeds  to  the
uterus, where it accumulates and excites that organ to a
new action, by which  it is  thrown off periodically, by
lunar intervals, in  the form of a  blood-like discharge ; 
44         MENSTRUAL FLUID,  WHAT?

though it has hardly any common  property with blood,
except its appearance—that of a liquid of a red color."
" It is not always colored  at  first,  which may account
for supposed foetations before menstruation."   Nor is it
always discharged at lunar intervals.   " Women men-
struate somewhere every day in the year and hour in
the day."—Dewees.  " It is not coagulable, but a  fluid
thrown off from the mass of blood,  by  an action  of the
uterus, similar  to  that  of secretion."—Ibid.  Hence,
coagula in the fluid is proof that the discharge is unna-
tural, laborious or profuse.
  Among the difficulties attending this discharge, physi-
cians enumerate the rentention  already hinted at, indi-
cated by a doughy swelling  of  the feet  and  ankles at
night, of the eyes and face  in the morning, spots  on the
hands and forehead, a peculiar sensation in the breasts,
and a general sense of oppression, languor and dyspep-
sia.  The mind is unhinged, the  appetite capricious, the
extremities cold, the forehead often  hot, the pulse quick
and low, breathing difficult,  sleep  disturbed,  face  pale,
urine colorless, and bowels  often confined.
  The faculty have supposed many  causes for this secre-
tion,  (see page  32,) without  pretending  to know any
thing very  certain about  it, and pointed out many
modes and means of cure, without venturing to say that
any  of  them  are specifics.  Still   they  have  hit upon
both without being aware of it.   Dr. Good says, vol. 5,
p. 46, " All the  symptoms  indicate that  retained men-
struation is a  disease of debility; there can be  little
doubt that debility  is its  primary cause—a  want of
energy in the  secernant vessels  of  the uterus  that pre- 
       OBSTRUCTIONS,  CAUSES  OF--CURE.     45

vents them from fulfilling their office till  the  increase of
inability,  from the  increase  of general  weakness, at
length produces a degree of stimulus [i. e. the  reaction
of the system, or  fever,] sufficient momentarily to sup-
ply the place of strength."
  I have, therefore, the testimony of the London School
that I have given  the true cause of the disease in  the
" destruction  of a great portion of the vitality of  the
system, by unequal clothing," tight lacing, want of pro-
per  exercise,  or injudicious medical treatment, particu-
larly the administration of poisons in former attacks of
disease.
   Dr. Good  says, vol. 5, p. 49, " to  cure suppressed at
first, obstructed after it has appeared, and laborious and
difficult menstruation, we  must increase the tone of  the
general system, excite the action of the  uterine vessels
where they  are morbidly torpid, or relax  them where
they are pained by  spasmodic  constriction.   Both  the
last, however, are subordinate  to  the  first; for,  if we
can once get the system into a good state of general
health, the balance of action  will soon be restored,  and
 the affected  organs will fall  into the common train of
 healthful order."   What  a testimony  in favor of  the
Botanic Theory and Practice !   We have only to reverse
 the order—that is, first,  relax  the strictures: second,
 excite the system to  throw out the cold and obstruc-
 tions ; and third, to tone the debilitated organs.   Our
 botanic course (see  Lecture ix) is  the very thing  the
 good  doctor  wanted; and my  own experience corres-
 ponds with that of thousands of practitioners, in  assur- 
46
POISON S--C O L D--F EVER.
ing the sufferer that this practice, faithfully and energet-
ically applied, will do the work to admiration.
  I have quoted from the Boston Medical  and Surgical
Journal, vol. 9, p. 43, because I approve of it, the  doc-
trine  that all poisons  agree in  the sudden and  rapid
extinction of a great proportion of  the  vitality of the
system ; for I apprehend that the vitality of the system
consists in its power to circulate  the  blood and heat in
ample measure, to its remotest parts.  As poisons, then,
diminish this power, they circumscribe, in the same pro-
portion, the blood and heat to the regions of the heart,
lungs, brain, &c. and invite the cold  to  take possession
of the extremities, to contract the  vessels  and produce
a permanent reduction of their calibre.  This  reduction
of capacity in the extreme vessels produces  a propor-
tionate  distension of the  same character of vessels in
those deep-seated regions  of the system—as the heart,
lungs and brain—where the action of the vital  power is
more immediate, and where the influence of atmospheric
pressure is not so easily brought  to bear.  This disten-
sion of the  vessels is  the dull, heavy, stupifying head-
ache, of which most children who are  doctored  much,
and all dyspeptic patients, so constantly complain.
  The pressure of the atmosphere  on  the body,  as a
reaction upon the reduction  of vitality,  whether caused
by taking cold, losing internal heat, or the exhibition of
poisonous drugs, limits the heart  and lungs to a smaller
space, which  makes them  act proportionately quicker,
(like  the  balance-wheel  of a watch, when its  free and
full rotation is retarded by the dirty  oil about  the pivot) 
         PALPITATIO N--B LOOD-LETTING.       47

and this more frequent action  is called  " excitement of
the pulse," "shortness of  breath," "inflammatory ac-
tion," &c.  When the heart labors very hard, its action
is felt on the  surface, and is called " palpitation."  The
distension of the vessels of the brain, as I said before, is
one source of what is called headache.   The pressure of
the distended vessels  on  some of the  nerves, and the
stiffening, by cold, into a  sort of phlegm,  of the lubri-
cating mucous, that surrounds others,  cause an equal
action of the nerves extending to the brain.  This pro-
duces  inequalities in  the  time in which  the  different
branches  of  the nervous  system transmit to the brain
the subjects of thought, and hence arises a general con-
fusion similar  to  that produced by  the unequal vibra-
tions of discordant strings on a musical instrument.
This condition of things is called delirium.
   To  remove  the  pressure,   (congestion,) the  doctors
bleed  and cup  the  patient.   This,  it is  true,  gives  a
momentary respite to the distended vessels of the heart,
lungs  and brain; but, by  destroying the vital  energies,
it also admits a still further reaction of the atmosphere
on the extreme vessels;  and thus renders a future repe-
tition of the  practice still more necessary than  the com-
mencement.   But, since it is evident that,  if they were
to draw out  all the  blood, the patient would die imme-
diately, they leave enough to  sustain the breath of life,
for the present;  and when,  after lingering in  misery
some  hours, days, weeks,  months  or years,  the patient
dies of dropsy  or dyspepsia, the death is attributed to  a
chronic, " an incurable disease."
   Not approving of it, I should not  meddle  with  the 
48     QUACKER Y--1 N A C T I V I T Y--S E R V A N T S .

practice of the faculty, were it not, as Dr. Bigelow says,
that " the principal business of the skilful physician is
often  to prevent  the officious meddling of officious
quacks."  Could the Botanic  Fraternity, or the public
in general, be  aware of the  mischiefs that are done by
the rash, ignorant and officious members of the  mineral
profession, no  caution from me would  be necessary to
induce them to trust  nature in every extremity, rather
than to surrender their bodies as living  subjects  of reck-
less and dangerous experiments,  founded on the  wild
vagaries of the visionary theorists of the schools.
  Another reason why women need aid in parturition,
is, the inefficiency of the system, produced  by a want
of proper exercise during  the period  of  childhood and
youth.  The  employing  of servants  and  assistants  to
dress  and undress children, to bring and carry for them
even  a school satchel—in  short, to do for them every
thing  that requires the least exertion, and the too preva-
lent disposition to prohibit  athletic  exercises  for amuse-
ment, as unsuitable for ladies, are calculated  to  prevent
the full development of the  system, and the  acquisition
of that organic power, which are the well-known effects
of constant muscular exertion.   To  have  always  at
hand  some one ready and  willing to wait upon her, is
one of the greatest evils  a young lady can suffer; while
the necessity of waiting on herself, and  of making a rea-
sonable bodily exertion, is a real blessing, that sweetens
the enjoyment of every other.
  The miserable victim of inactivity is as feeble in frame,
as pale in appearance, and as unfit for the intentions of
nature, as the vine from  a cellar in summer is to endure 
         CORRECTION--FALSE DELICACY.      49

the withering influence  of a meridian sun, and to perfect
its fruit amidst the frosts of autumn.
  Though, by suitable attention to  the above hints, dur-
ing the period of its growth, the  full energies  of the
female frame may be easily developed, yet reason unites
with  experience  in  declaring that, when neglected, till
the growth of the body is completed, this very desirable
object is not easily obtained; still  the beneficial effects
of moderate and judicious exertions, even on  those who
have  been  inactive in early life, are worthy of the most
prompt and persevering attention.
  The last reason I shall mention, why women need aid
in childbirth, is, many,  I  fear most mothers, from the
delicacy of the subject, " leave their daughters," as they
express it,  " to find out  by their own experience," what,
if timely  and correctly  taught them,  might  prevent
much future suffering, if not save many a life.  It is not
only cruelly embarrassing to a modest young lady, to be
totally  ignorant  of the nature, cause and proper treat-
ment of a disagreeable condition  of her system, till it
comes upon her suddenly; but it has subjected many to
the ruin of their health, and some to the loss  of life
itself.   Girls have been  known to go, at a critical period,
into water, to wash  their clothes, and then  to stand in
the open air to dry them, that they might not be detected
and laughed at by other members of the family.   Thus
they have taken cold and  laid the foundation  of disease
that followed them  to their graves.  Others have been
injured for life, by improper medicine or manual  treat-
ment, or in other ways, for want of a few hours instruc-
tion which every mother is  amply qualified to give.  The
           4 
50    EXPOSURE--MATERNAL  INSTRUCTION.

mother, however, refuses, from motives of delicacy ; but,
when the dear object  of her  solicitude is dangerously ill
through this neglect, delicacy is set aside, and the modest
girl is unscrupulously subjected to the impertinent queries
of some pert son of Esculapius, just out of his teens, as
well as his  nosology.  This is no  harm!  " It is fashion-
able and necessary for the Doctor to know every thing."
Often, when reproving young ladies for exposing them-
selves to cold,  at  the commencement or recurrence of
their  monthly courses,  have I been  told that they did
not know  they  were doing  wrong.  Within  this  mo-
ment's recollection are several interesting young ladies,
whose bodies were put into such  a state  by imprudence
at this juncture, that nothing short  of  their lives will
pay the forfeit.
  Mothers, teach your daughters, seasonably and affec-
tionately, all you know, that  may save them future mor-
tification,   trouble  or  sorrow.   Charge  them  when
" unwell"  to beware of taking  cold, and  to take  no
medicine that is calculated  to impede the circulation,
but to wear warm clothing, to use gentle exercise, nour-
ishing diet, and warm, stimulating medicines, (if any at
all,) till they are entirely well.
  While I  am on the  subject of maternal instructions, I
may as well add that  you ought  by all means to teach
them the nature, cause and  treatment  of the forms of
disease, and all  the inconveniences, they are to expect
in the married relation.   Do  not  wait till you are cer-
tain  they  are about  to  enter into that  state.  It were
better to  teach them earlier than desirable, than that
your premature and  unexpected  death  should deprive 
             MATERNAL  INSTRUCTION.          51

them of any instructions at  all.   Young married ladies
are often subjected to much mortification, and not rarely
to severe  suffering, which might  have been easily pre-
vented by the faithful and  affectionate instructions  of a
judicious and intelligent mother. 
 
DESCRIPTION  OF  ORGANS.
  As  the defects in, and injuries  to, the female  frame,
pointed out in the introductory lecture, have  rendered
necessary a special attention to  " the art of aiding wo-
men in childbirth," it is proper to commence the devel-
opments of this  art with a description of the various
organs mostly concerned in the  processes which lead to
that event.  (See plates.)

                Pelvis.  (See plate I.)
  The bony rim, surrounding the lower part of the body
and lying  beneath the  walls  of the abdomen, is called
the Pelvis.  It took  its name from  its supposed resem-
blance to  a basin;  but it  must be observed  that it is
open at the bottom as well as the top, and that the pos-
terior sides are much higher than the front.  In an adult
it consists  of only three principal bones, the back or pos-
terior part, called the sacrum, and the two haunch, side,
and share bones, the back and high  parts  of which are
called  ossa innominata, (nameless bones,) the  sides are
called  ossa ilia, (iliac bones,)  and their anterior or front
ends the ossa  pubes, (pubic  bones.)  To the  lower part
of  the sacrum are attached several little movable bones,
which,  from  their supposed resemblance to  a cuckoo's
beak, were called os coccyx or  coccygis; and  from the 
54
PELVIS.
upper and front part is a projection  called the promon-
tory of the sacrum.   The ossa pubes  are  joined before
by a strong, thin  cartilage, called  the  symphysis pubis,
or joining of the pubes.  Directly under this, the  pubic
bones diverge into what is called the arch  of  the pubis.
The space included between the upper projections of the
ossa innominata or haunch bones, is called the false pel-
vis, and that below  the  upper part of the iliac bones,
the  true pelvis.   The upper part  of the iliac  and  pubic
bones, the promontory of the sacrum, and the corres-
ponding portions of the nameless bones, constitute what
is called the brim of the  pelvis, and the lower portions
of the same bones surround what is called  the outlet of
the  pelvis.   The passage into the brim of the pelvis is
termed the superior  strait, and that through  the outlet
is termed the inferior strait; the space between these
straits is called  the cavity of  the pelvis.   If the shorter
diameter of the aperture, from the symphysis pubis to
the  sacrum, be from two and a half to four inches, and
the  other diameter be still longer, and the parts  each
side of this be equally proportioned and of similar shape,
the  pelvis is  said to be well  formed, and to present  no
serious obstacle to a  natural  and  easy  delivery.  All
other forms are said to  present obstacles  in proportion
to the degree of their departure from this regularity, and
are  called ill-formed pelves.
  Much has been said and written about the importance
of measuring the pelvis and the head of the child (to be
born,) and thus determining beforehand whether nature
has been so careful  to strike the  due balance between
the  dimensions of the thing  formed and  the place de- 
         PELVIS--FEMALE  STRUCTURES.       55

signed for its egress, as  to  render  the assistance  of art
unnecessary; and not a few plans and instruments have
been  devised  to aid this  research.  While  Contonly
recommends  his pelvimetre, Madame Boivin  her intro-
pelvimetre, and Baudelocque and Dewees the calipre, the
conclusions of all these authors, especially  of the latter
gentleman, is, " we have reason to fear that none [of the
plans] hitherto projected has attained this end.  We are
certain  that the deviations from nature,  in the most
careful measurement, are often more than  equal  to the
exigencies  of the case."  While,  again, it is admitted
that these  means cannot  be universally and accurately
applied  in  the very cases where they are most needed,
Velpeau declares that,  " with the finger, we may esti-
mate every species of deformity of the pelvis, of what-
ever nature, and wherever situated."
  But, suppose all this  to be accomplished, how shall we
know the size and shape of the object to be protruded 1
Children have  been safely delivered through a pelvis
whose antero-sacral diameter was  only  two inches and
a half;   a  diameter less than this  would subject the
woman  to almost as much danger  as would a surgical
operation !  Since we wrote the above,  we have known
a case  in  which a large  child passed  through  a still
smaller  aperture.

    Structures peculiar to  Females—External.
  The fleshy substance lying directly on the  symphysis
pubis, is called mons veneris.  Its lower or back por-
tion is divided into  two parts, called the labia pudendi,
rima magna, or  labia externa, which diminish in width 
56    STRUCTURES PECULIAR TO FEMALES.

and prominence  as  they descend towards  the  coccyx.
Their union is called the fourchette, or fork.  Between
the fourchette and the coccyx is another aperture, called
the anus.   Between  the anus and fourchette is a septum
or division, called the perineum.
  On separating  the labia pudendi, we observe a  long
cavity, called fossa magna, or navicularis.   In the upper
or front part of this  opening is a small  spongy body, in
some measure  resembling the male penis, but impervious,
composed of two corpora cavernosa, and terminating in
a glans, which is  covered with a membrane called the
prepuce.   On  the sides  of the fossa  are two  spongy
folds, called nymphse, apparently much contracted, but
having the power greatly to expand, and thus  enlarge
the passage to facilitate parturition.   Between these,
and about the  middle of  the  fossa magna, is the orifice
of the  vagina, called  os  externum,  closed in the virgin
state, by  folds and  wrinkles called  carunculae myrti-
formes.   Some suppose that the carunculae myrtiformes
are the remains  of the  obliterated hymen; but I have
seen both present and distinct, in one individual at the
same time.  After childbearing, these frequently disap-
pear, and the interior of the vagina is visible on opening
the  labia pudendi.  About one-third  of the  distance
from this to the clitoris is the meatus urinarius, or orifice
of the  urethra, (a tube from one to two inches  long,
much shorter  though somewhat larger than in men,)
with a small projection at  its lower edge, for the  right
direction  of the  urine.  In  infants  the orifice  of  the
vagina is often found partly closed by a thin membrane,
called the hymen, which  is open sometimes in the mid- 
THE VAGINA.
57
die, and sometimes at the upper edge, so as to appear
like a crescent.  Instances have been known in which it
entirely closed the  orifice  of  the vagina.  This should
be opened  immediately with a sharp pen-knife or scis-
sors, to prevent the indelicacy of a future  exposure, and
because it can then be easily borne.

           Internal Organs.   The Vagina.
               (See plates IV  and V, G.)
   The os externum leads into  a canal called vagina, of a
conical form, from three  to  six or eight inches  long,
about two  inches broad at the upper end or fundus, into
which is a small projection, called the cervix  uteri (or
point of  the uterus,) somewhat in the  manner  in which
the small pointed bottom of a wine bottle  is projected
into the vessel.—See plate V,  D.
   The vagina is composed of two coats;  the inner is
velvet-like, interspersed with many excretory ducts, and
contracted into plicae or small transverse folds, particu-
larly at the fore and back part.  These are lessened and
generally obliterated  by child-bearing.  The outer coat
is firm, somewhat contractile, and  surrounded  by cellu-
lar membrane which  connects  it  to  the  neighboring
parts.  A portion of the upper and  posterior part is cov-
ered by the peritoneum  or membrane which includes
the intestines.  The vagina is between the urethra  be-
fore and the  rectum behind, to both  which it is firmly
attached by strong cellular membrane. 
5^
THE UTER IS.
          Of the Uteri's.  (See plate V, R.)
  Above or beyond the vagina, in the cavity of the pel-
vis, between the urethra and the rectum, with its lower
point projecting into the vagina, in the manner in which
the finger might be pressed an inch or so into the bot-
tom of an India rubber or  a leather bottle, is  a spongy
receptacle, called the uterus, resembling in shape a com-
pressed pear.  The lower point is called the cervix ; the
upper or bottom, the fundus, and the intermediate parts,
the body.  The whole  is  about three inches long, two
broad at  the fundus, and  one at the cervix.   Its walls
are nearly half an inch thick at the fundus, and  rather
more  than half at the cervix.  Though its surface  is
greatly enlarged, it is  so distended with blood that  it
preserves  about the  same  thickness during  the  whole
period of  pregnancy.   But the size of the uterus,  in dif-
ferent women, is so various, even when not impregnated,
as to prevent any very great degree of accuracy in the
measurement.   The back  is thicker and expands more
during pregnancy than the front.   The entrance into its
cervix forms a little protuberance, called os tincae.  From
the manner of its insertion into  the vagina, the cervix of
the uterus may change its position  and direction at plea-
sure.  The inner coat of the vagina is reflected over the
os uteri, and continued into the lining membrane of the
uterus.  This membrane secretes a mucus which gener-
ally closes the os uteri very curiously and perfectly, im-
mediately after  impregnation, and  continues it so during
pregnancy.  Several exceptions are on  record.
  The substance of the uterus is very firm, composed of 
   LIGAMENT S--F ALLOPIAN TUBE S--O VARIES.  59

arteries, veins, lymphatics, nerves and muscular fibres,
curiously interwoven, and united by cellular membrane.

                     Ligaments.
   Two broad ligaments pass from the  right and left of
the fundus  uteri to the sides  of the pelvis, serving to
support the uterus, and to convey to it nerves and blood
vessels.  Two round ligaments rise from the sides of the
fundus uteri, pass along within the forepart of the broad
ligaments,  descend  through  the abdominal rings,  and
terminate in the substance of the mons veneris.  Though
these ligaments will  allow the  unimpregnated uterus to
move only about an  inch up and down, yet, during preg-
nancy, they permit it to rise  into the cavity of the abdo-
men.   But, after delivery, they contract with surprising
quickness to nearly their original state.

                  Fallopian Tubes.
   From each side  of the  inner surface  of the  uterus,
near the fundus, a tube  passes through the uterus,  and
extends along the broad ligaments  to  the  edge of  the
pelvis, where it reflects back and turns  over behind  the
ligaments, so that about an  inch of its extremity hangs
loose in the cavity  of the   pelvis.   The  extremities of
these tubes, having a jagged appearance, are called fim-
briae.  The whole tube  is  about as long as the uterus,
very small in the uterus  and increasing in diameter  to-
wards the fimbriae.

                      Ovaries.
   Near the  fimbriae of  each tube,  and about an inch 
60
OFFICES  OF THE OVARIES.
from the uterus, is suspended  in  the pelvis, and covered
by the folds of the broad ligaments, (productions of the
peritonaeum) a flat, oval body, about an inch long, called
the ovary, which generally means a little egg, but repre-
sents here rather a nest of eggs, or berry inclosing  sem-
inal elements.
   Each of the ovaries includes from four to twelve vesi-
cles attached by threads to  the inner  surface  of the
ovary, some deeper seated than others, filled with coag-
ulable lymph.

       Physiological offices of the Ovaries.
   As the life of the  female advances,  they become tur-
gid, and a kind of coagulum  is  formed in or near the
surface, until it increases to something  like a quarter of
an inch in diameter.   In coition  the fimbriae of the fal-
lopian tubes clasp the ovary and  press it to  such a de-
gree as to burst the  delicate  integument and disengage
the little egg, which passes  through the  tube into the
uterus, where  it is impregnated by the  male semen, and
nourished  by  a secretion from  the circulation  to  the
uterus, until it  is ripe  for parturition.   These  ovula  or
little eggs  may be seen  in the healthy ovaries  of every
young woman.  It is certain that they form the basis of
every foetus, as none can be  found where  they do not
exist, and  the scars in the ovary, or nest, of women that
have had children, correspond  always with the number
of conceptions.   At  least such  is  the most  plausible
theory. 
            bladder--rectum--uses.          61

                      Bladder.
  Attached to the inner extremity of the urethra, behind
and above the symphysis, is an elastic and muscular ves-
sel, of an egg shape,  and  capable,  when  distended, of
holding near  a pint of fluid.  This  vessel is  called the
bladder.

                       Rectum.
  Behind the bladder is the uterus, and between this and
the os sacrum is the large tube  or  intestine  called the
rectum, the outer extremity of which is called the anus.
Both  the anus and  the urethra are surrounded  by mus-
cular  and contractile  bands, called sphincters, which are
powerfully  contracted  except when  the  pleasure  or
necessity of the person  requires  their relaxation, when
they give way for a moment, but quickly recover  their
condition.

                        Uses.
  One prominent use of the pelvis is to support the ab-
dominal  walls and viscera;  another is  to receive  the
ends  of the lower  limbs, and furnish suitable locations
and firmness for the insertion of the  muscles destined to
move those limbs.  In females, the cavity of  the pelvis
seems also destined for  the protection  of the principal
organs of generation, as the vagina, the uterus, the fallo-
pian tubes, the ovaries, and also of the bladder and rec-
tum.   (In the fourth  month of  pregnancy, the uterus
quits  the cavity of the pelvis, and rises  into  the abdo-
men ; so does it also rise in cases of dropsy that distend 
62         USES  OF THE PELVIC ORGANS.

it beyond the pelvic cavity.)  Some, however, of what
are called organs of generation, as  the labia, tfec. are
without the cavity of the pelvis, even in females.   Ano-
ther and very prominent use of the pelvis, is to protect,
from all outward pressure and injury, the delicate embryo
of the future man, till it shall have acquired that organi-
zation, firmness and conservative power that seem most
necessary to protect it from injuries,  when encased only
within the more plastic walls  composed  of abdominal
muscles.
  The labia  pudendi, the  nymphae,  and  the muscular
folds  of the  os  externum  (carunculae myrtiformes,) all
serve  to close the passage  to the uterus and protect  it
from  cold.  Their spongy structure  and elastic  power
enable them to expand for the purpose of parturition, to
protect the child against injury  from the  pelvic  bones,
and afterwards  to contract to nearly their  original di-
mensions.
  About  the  nymphae, in the vagina, uterus,  &c. are
glands and follicles, which  secrete, some an  oily, others
a mucus  substance,  which serve  to  prevent injury by
friction and close contact of the parts.
  The vagina, by its firm  texture and its attachment to
surrounding  parts, aids the broad and the round liga-
ments in supporting the uterus  in  its place, and  prevent-
ing injury to the cervix from external pressure.
  The uterus is  designed for menstruation, and  for con-
ception, protection, nutrition and expulsion of the foetus.
The broad and  round ligaments, aided by the vagina,
sustain it in its proper place and position. 
          USES OF THE PELVIC ORGANS.        63

  The fallopian tubes are evidently designed to conduct
the ovum from its nest in the ovary to the cavity of the
uterus.
  The ovaries are designed  to furnish the female  ele-
ments of the  future  man, in regular succession  during
the prime of life  of each individual.  The ova are  sel-
dom less than eight or more than twenty-four—usually
ten to fourteen.
   By a careful inspection of the plates and references,
the  location  and form  of these organs  will be more
clearly perceived, and their uses better understood. 
 
DISEASES  OF  THE  ORGANS.
   In infants, the  labiae  pudendi,  the nymphae, &c.  are
 often  inflamed.  This condition  may be prevented  or
 cured by washing the parts  often with warm milk and
 water, and with a tea of hemlock, bayberry, raspberry,
 or other medicine, or applying sweet oil, or  cream, or
 fresh  butter  to  them.  Similar  appearances about  the
 ears, groins,  and elsewhere, may be treated in the same
 manner.  Sometimes, from want  of attention  to these
 matters, the  labiae pudendi grow  together.  When this
 is observed, they should  be separated immediately. The
 best method  of doing this, in my opinion, is to take hold
 of the labia and pull  them apart.   This method  is less
 likely than cutting to injure  the minute vessels of their
 surfaces, and is said to give but little pain.  Dr. Denman
 says it will scarcely make the child complain.   Keep the
 parts asunder till healed, by a little lint  saturated with
 sweet oil, cream or butter.  These are also excellent  to
 prevent or cure chafes, &c. any where.
   The vagina is liable to stricture, so as to render it too
short and small for the purpose for which it was design-
ed.  This may be  obviated by injections  of No. 1, slip-
pery elm  and other  emolient  substances, and  by dilata-
tion with sponges, tents, &c.  The course of medicine,
(see it hereafter described,) injections and restoratives,
faithfully used, will almost, if not quite, always save the
              5 
66
POLYPUS--FLUOR ALBUS.
necessity of mechanical distension sometimes advised by
physicians.  Cohesion  of the inner surfaces after ulcera-
tion, and the scars thus formed, may be treated as direct-
ed for adhesion of the labiae pudendi.

                      Polypus.
  Attached  to its inner  surface is sometimes  found a
species of fungus denominated polypus.   It is  of various
sizes, shapes and textures, and variously situated.  After
some time,  it  generally  becomes  smaller  towards the
point of adhesion, when,  with a  double  canula  and a
loop, it may be compressed around the neck so as to stop
the  circulation.  In  three to six days it  will drop off,
and  the place  where  it was attached may be dressed
with healing salve, put on the side of a large  piece of
lint, or  even let alone,  and it will soon be well.  A very
bad  case was lately cured by pure botanic courses alone.
Such tumors are also sometimes found in the uterus.

           The Fllor Albus, or Whites,
So called  from its appearance,  which,  though at  first
generally milky, is sometimes changed to green, yellow,
or  even brown,  shows itself in  an irregular discharge
from the uterus  and  vagina.  It is  often  attended by
severe pain in  the back and loins, weakness, loss of appe-
tite, dejection of spirits, paleness and  chilliness,  and
sometimes by difficult  respiration, palpitations, faintings,
and swelling of the lower extremities, which are, rarely,
followed  by  prolapsus  uteri, or  the  " falling of the
womb." 
   fluor albus,  cure of-retroversion.   67

                     Treatment.
  This disease  being caused by cold, canker and other
obstructions of  the secernants, the proper mode of cure
will  be  to give the  patient full courses, promptly  and
energetically, with generous diet, moderate exercise, and
the best articles of  No. 4.   Great  attention should be
paid to injections into the vagina,  composed of witch
hazel, blood root, (or other canker tea when this cannot
be  had,)  with   a  little  cayenne and nervine.   These
should always  be strained.   The parts should be con-
stantly  protected  by  warm clothing  from  the  action
of cold.   Let this practice be continued  till the gen-
eral  health is  restored,  and the peculiar  affection  will
vanish.

                    Retroversion.
   The uterus is liable to retroversion, by wrhich is meant
that the  fundus is  turned  backwards and  downwards
upon its cervix, between the vagina and rectum, and the
os uteri is turned  forwards  to  the pelvis, and upwards,
in proportion  to  the  descent  of the fundus, so that it
cannot be felt by the finger, at  least without great diffi-
culty.   The fundus uteri may be felt between the vagina
and  the rectum, pressing the former towards the pubis.
This generally  happens about the third month of preg-
nancy,  though  it sometimes occurs  after  delivery.   It
causes severe pain, costiveness and suppression of urine.
Sometimes the  bladder is so distended and projected into
the abdomen, as to produce the appearance  of advanced
pregnancy. 
68   retroversion, treatment--hydatids.

                     Treatment.
  By inserting a catheter, through  the  meatus urinarius
into the bladder, (an operation which the patient can
perform with more ease and less inconvenience  to  her-
self than the administration of an  injection,)  the water,
if necessary, may be drawn off.  Then, (the patient lying
on one side,) by inserting the fore finger of one hand into
that of the vagina, and that of the  other into the  rectum,
keeping them as near together as possible, and constant-
ly alternating gradually inward, the fundus uteri  will be
easily returned to its place, when the cervix will return
as a matter of course.  By filling the vagina, during the
day, with  a thick India rubber bottle, or other  soft elastic
substance,  lubricated  with slippery elm,  after giving a
course of medicines and  injections,  to strengthen the
parts, the  derangement will soon be corrected.  A band-
age or  truss of that character may be worn  externally
to  some advantage, but I  entirely disapprove  of all the
pessaries  in use.  I have seen much mischief produced
by the use of some, and no good from that of  any.

                      Hydatids.
  The uterus is also subject  to hydatids; that  is, little
bags containing a watery  fluid supposed to surround liv-
ing animalculae, and attached by a  small neck  to  the sur-
faces.   " If," says Hooper,  " the vires  naturae medica-
trices are  not sufficient to effect a cure, the patient most-
ly falls a sacrifice to their  ravages."   It is therefore evi-
dent that  the botanic treatment (if  it should not always,
as it certainly  will generally, effect a cure) is the  best
that can  be applied—for it  is calculated  to  aid the vis 
            TUMORS--CANCERS--OVARIA.         69

medicatrix naturae, or healing power of nature, in doing
what it is of itself unable to accomplish.

             Tumors, or Dropsical Bags,
  That obstruct the  passage of a child, should be pushed
above the pubis, if movable—if not, they should be punc-
tured with a sharp instrument, and they will discharge
their contents.

                       Cancers
  Are  also sometimes found  in the uterus.   They may
be treated according to our plan, so far as they can be
reached;  or they may be treated with caustic potash, as
hereafter described.  With ulcers we (botanies) have no
difficulty.  (See Cancers, in Lectures on Med. Science.)

                    The Ovaria
  Are  also liable to dropsical affections, to inflammation,
&c.  Physicians guess at the existence  of this form and
locality of disease, and attempt to cure  the  former by
tapping through  the vagina,  and the latter by the use of
those antiphlogistic means which are well calculated to
produce the former.   They are subject  also to hydatids
and  cancers.   The  dropsy usually happens  about the
cessation  of the menses; sometimes earlier.  It is caused
by cold or obstructions, which  either  contract  or close
up the pores in those parts, and prevent  the fluids from
escaping.   The application of warmth and moisture on
the botanic plan, (see Course of Medicine,) will relax the
pores and discharge  the offensive matter. 
70      DIFFICULT  cases,  remarks  on.

                      Remarks.
  Though the above forms of disease need not be feared
by those who adhere strictly, from the beginning, to the
treatment I recommend, yet I have thought proper to
mention them for the purpose of showing that, in the
event they should, these of all difficult cases are the very
ones in which officiousness should be avoided.  A friend
asks what we botanies shall do in difficult cases which
demand the assistance  of surgeons?  I  answer in the
language of the very best surgeons:
  " Such  causes of difficulty less frequently occur than
many authors have  imagined.  The rash and preposter-
ous application  of instruments  has in such cases  proved
the bane of thousands."—Ed.  Pr. vol. 5, p. 140.   " And
should difficulties occur, what can we do but support the
strength of the  woman and  wait with  patience."—Ibid.
141.  " The work of nature is  too often spoiled  by offi-
cious hands."—Ibid. 142.  " Instruments  should never
be employed but when alarming symptoms occur !  The
assertion  perhaps is not more bold than true,  that, in
general, the most disadvantageous  position in which the
head can offer,  is not  sufficient (no other cause  concur-
ring) to endanger the  life of  mother or  child, so much as
would be  done  by the movement of the gentlest  hands."
Ibid. 140.
  I  repeat  it,  then,  that difficult  cases  and alarming
symptoms rarely occur, and when they do, we have the
best authority to prove that the best treatment, as well
as the only safe one, is to afford  nature all  the  aid we
can, but never  to interrupt her operations.  I  have wit-
nessed several  instances in  which the patient and the 
THE CATAMENIA.               71
bystanders were much alarmed, but, by " supporting the
woman"  and " waiting with patience," they were soon
convinced of the truth  of our  motto, that midwives
ought to  " know that they are nature's  servants," not
her  masters.
  These evils  rarely happen  to women  that have  not
borne children, nor even  to those who have, that have
been treated according to the botanic  system. They are
almost  universally  the fruits  of "scientific  skill in the
chamber of parturition."   This  same remark is equally
applicable to other forms  of disease peculiar to women
after childbirth.

                   The  Catamenia,
   Already described, commences its  discharge  at  very
different periods  of life.   In tropical climates, and  per-
sons of warm passions, it presents  itself usually at  eight
to  twelve years; in  temperate, at thirteen to  sixteen
years;  in cold, at sixteen to twenty.   There are instan-
ces in which it has commenced much earlier, and  one is
on record where it presented  itself for the  first time at
seventy years.
   At whatever time it commences, it  usually continues
about twice as long as the person has  already lived.  If
at ten,  it departs at about thirty;  if  at fifteen, it  ceases
at about forty-five, &c.   The commencement  and the
cessation of this discharge, are called  the  most critical
periods  of  life to the female.   It  generally commences
very moderately, and the next day  increases.   It  con-
tinues from two days to ten—generally three or four  to 
 72  CATAMENIA, DISEASES OF--TREATMENT.

 six.   From some persons  the  quantity discharged is
 much greater than from others—estimated at four to
 eight ounces.  So long, however, as the discharge gives
 no pain nor weakness, nor other evidences of constitu-
 tional injury, and is not mingled with clotted  blood, the
 quantity is not to be regarded as injurious.
   This  discharge  usually  occurs  once  in about  four
 weeks, and is generally supposed to be under the influ-
 ence of the moon.  I  know a few  individuals who al-
 ways have it in the increase of the  moon.  But I know
 many in whom it pays no regard to the positions  of that
 planet.  Females are menstruating somewhere  every day
 in the year and every hour in the day.  Many have it
 once in three weeks, others once in five or six.  In very
 cold climates it comes on late in life,  and returns only in
 summer.  It is not to be expected (though it sometimes
 appears) either during pregnancy or nursing.

                   Diseases of it.
   Those who  discharge clotted blood  with it, or those
 who do not regularly discharge it once  in  four weeks,
 (unless when pregnant or nursing,) seldom bear children.
The discharges are sometimes checked by grief or disap-
 pointment, and produced by agreeable surprise.

                    Treatment.
   Whenever irregularity, painfulness, suppression, milky
or bloody  discharge, or any other unnatural effect, indi-
cates a want  of healthy action, the patient should take
fujl courses of medicine, aided by appropriate injections, 
           TREATMENT OF CATAMENIA.        73

and steam should be frequently applied to the lower ex-
tremities, till the cold phlegm and canker are disengaged,
and then she should tone up the system with the various
articles of bitters, so tempered or  combined as to keep
the bowels open, and with stimulants and clothing, as
to keep the whole body warm.  When the  general sys-
tem is renovated, the particular affections will cease. 
 
MARRIAGEABLE  STATE.
  It is pretty certain that women are incapable of bear-
ing children till the catamenia commences; and it is al-
most  equally certain that they ought not  to  be  put to
the trial so soon, by three or four years at least,  as this
occurs.
  The consent of the parents and of the moralist being
obtained,  young ladies  in the southern states are mar-
riageable between sixteen and twenty, and  in  the north-
ern, between eighteen and twenty-five.   But  if any
know themselves to  be so  defective or deformed, as  to
render child-bearing evidently  impossible or  dangerous
to their own lives, were it  possible, they  ought  by no
means to  marry.
  If asked how they are  to know this, I answer,  the
most  common  difficulties in parturition arise from  de-
formities of the pelvis by the disease called the  rickets.
Every one knows  whether she is afflicted with this dis-
ease.   Many material deformities of the pelvis may be
discovered by examination of the exterior surface; small
deviations may be  ascertained by the  patient  herself, or
a confidential female friend, by  examination  and com-
parison with my  description of a well-formed  pelvis.
Velpeau, a famous French obstetrician, says, that  all de-
formities of the pelvis may be ascertained  with a suffi-
cient  degree of accuracy  by the  touch of the  finger. 
76
MARRIAGEABLE  STATE.
Want of genital organs, or  monstrosity of those exist-
ing, rarely occurs.
  The want of a healthy and regular menstruation is not
a reason sufficient to deter a young lady from entering
into  the married state; for such  a connexion is often
found the best remedy for this disorder.   But, whether
married or not,  a  faithful and energetic botanic treat-
ment, added to the prophylactic  means heretofore des-
cribed, will seldom fail  to remove  this form of disease.
  I have already remarked  that, when the  hymen has
never given way, (an  exceedingly rare case,) the cata-
menial secretions may remain in the vagina and  uterus,
and produce  the appearance  of dropsy.  This is easily
detected by examination, and as easily  removed by sev-
ering the membrane with a pen knife or a pair of sharp
scissors.  It has been remarked that, though not  remov-
ed in infancy, the hymen is almost always perforated in
the centre, if not notched from  the upper or forward
edge to the centre.  Still it has been sometimes found so
strong and wide  as  to present an effectual  barrier to
sexual union.  Instances have been known in which an
ignorant husband has made  application for divorce, in-
stead of performing the easy and safe operation of divid-
ing the membrane.
  Some have supposed that  the remains of the  hymen
form the carunculae  myrtiformes, or folds  which close
the mouth of the vagina; but I have seen the carunculae
perfect, in a grown person, in whom the hymen was not
deeply cleft.  As  the hymen, in  many, is  not ruptured
till the first  sexual embrace, some have  thought it a
necessary proof of virginity;  but its  total  destruction 
MARRIAGEABLE STATE.
77
(if it ever existed) in infancy, is so common, that authors
who never saw it have  doubted its  existence.   Many
well know, however, that " such things there are."
  Most authors on midwifery seem to feel bound to give
a particular account  of  the nature of conception, and
the modus operandi of producing it; but I think that
they might safely leave these matters to instinct, when
common sense is wanting, especially  as  the more they
write the more  clearly they exhibit their ignorance  of
the whole subject.  My task shall be to teach those who
have by any means assumed this responsibility, to bear
it with a good grace while they can, and to get rid of it
in the  safest and the easiest way when they must. 
 
PRACTICE  OF  MIDWIFERY.
                Of Utero-Gestation.
  By impregnation, in all ordinary cases, one of the ova
is detached from its place in the ovary, and conducted,
in the  course of about twenty days, through the fallo-
pian or ovario-uterine tube, into the uterus.  It is sur-
rounded  by two membranes—the inner called  the am-
nion, and the outer called the chorion.   The  former
incloses a fluid  in which the embryo  floats.   At first
these membranes are separated a little by a glutinous
substance, but they afterwards come nearly or  quite  in
contact.  The amnion is thin, smooth and  transparent,
without  the  appearance of vessels.   The chorion  is
nearly similar, but  of a  rougher texture.
  From the moment of impregnation  commences form-
ing,  on the inside  of the  uterus, a membrane called,
from its  transient existence,  the decidua,  its situation
being displaced by the introduction  of the ovum and its
membranes into  the uterus.
  Soon after the ovum enters the uterus, its membranes
are united  with, and incorporated into, the decidua, in
such a manner  as  to be inseparable after the  second
month.  The decidua is also firmly attached to the wall
of the uterus, generally at  the fundus.   (See plates.)
When this  union is effected, the chorion  and  decidua
permit each other's vessels to interlock through their 
80          ANOMALOUS CONCEPTIONS.
whole extent, so as to establish between them a union,
similar  to  that  which exists  between the arteries and
air-cells of the lungs.   The  amnion  and chorion inclose
a fluid  called the waters, (liquor  amnii,) in which the
foetus floats from the commencement to  the  end of the
pregnancy.   It is sometimes  transparent like water, at
others yellow, brown, green, &c. and of various consist-
ences.  It differs much in quantity—from a gill or so to
two quarts or more.   It  gives uniform distension to the
uterus, protects  the foetus against external injury, keeps
the surfaces  of  the  amnion and the foetus  constantly
lubricated, and aids in expanding the passage  to  facili-
tate parturition.

              Anomalous Conceptions.
  Instances have occurred in which the foetus remained
attached to the ovary; others where it  stopped in the
cavity of the pelvis; others  where it lodged in the fallo-
pian tubes; and  yet others where it made its bed in the
walls  of the  uterus instead of  the  cavity—and in all
these  situations it has come to maturity and  been deliv-
ered,  sometimes  by  dying, and  then  rotting a  hole
through the walls of the  abdomen and being  discharged
by piece-meal, and others by  the knife  of the  surgeon.
Such  cases, however, rarely occur.
  I have known  one  that carried a foetus twenty-four
months, when, by a course of medicine,  it was discharg-
ed dead and partially wasted away.  I knew another to
be retained as long, and  the last time I  saw the patient
she was attending in her little shop,  in tolerable health.
How  she fared afterwards, I know not. 
            umbilicus and placenta.          81

              Umbilicus and  Placenta.
                    (See last plate.)
   Attached to the  navel  of the  foetus, and of various
lengths, about half a yard in  the  full  grown child, is a
small cord, composed of one vein and two arteries, and
surrounded  by  extensions of the chorion and amnion,
through which it passes to the decidua, where it expands
into a circular cake  of various sizes, thick in the middle
and rather thinner at the margin.  The outside is  attach-
ed to  the inner surface  of the  uterus, generally at the
fundus, by a thin membrane, so delicate that  the  least
bending will crack it and produce a haemorrhage.  The
foetal surface is coated all over by the chorion and am-
nion, through which may be seen the  arteries and veins
before mentioned, as composing the cord, divided and
subdivided, sometimes diverging towards the margins, as
rays from a point;  at others, crossing each other in  the
most fantastic forms, and finally diminishing into invisi-
bility.
   Through the cord uniting the placenta to the foetus,
called the umbilical cord, the vein and arteries sometimes
run parallel for several inches, then twine around each
other in various ways, presenting the  appearance of  an
irregularly twisted rope.   In this cord are observed one
vein to carry blood from the placenta to the foetus, and
two arteries to return it from the foetus to the placenta.
These are embedded in cellular  substance, containing a
ropy fluid, and covered  by the membranes  called  am-
nion and chorion, as before observed.  The capacity  of
the vein is rather greater than that of both the arteries.
  The  placenta renovates the blood of the foetus,  as the
             6 
 V.2   CHANGES  IN THE UTERU S--L A B O R PAINS.

 lungs do that of the child or adult.  For  this purpose
 the arteries and veins of the uterus so completely inter-
 communicate  with  those of the placenta  as to bring
 each and every one of 'either into  such a nearness to
 some of those of the  other, as  to  render  the contact
similar  to  that  of the air in the lungs of the mother
 with that  of  the blood.   Thus  the foetus  is supported
 and built up by a secretion from the blood of the mother,
 through the membranes that  separate the respective ves-
 sels ; not by the blood of the mother circulated through
 the foetus.

               Changes  in the Uteris.
  As soon as  an ovum is impregnated, a larger propor-
 tion of blood is directed to the uterus.  The little crook-
 ed vessels enlarge and straighten, till the largest  some-
 times become, at  the end  of pregnancy, a  half inch in
 diameter.  For  about seven months,  the  fundus  and
 body of the uterus are mostly distended; after that, the
 neck continues  the development, till, at the full  period,
 nothing of it can be discovered save the os uteri,  which
 is generally a little open.

                    Labor  Pains.
  The fibres composing  the  uterus relax as the size  of
 the foetus increases, till their elastic power  is exhausted,
 when  they commence a contractile reaction, the foetal
 resistance to which  is  the disagreeable sensation  called
 labor pain.  As the foetus still  enlarges, these become
 more frequent and  insufferable, till, by a succession  of
 mighty efforts, they discharge the offending cause. 
     false pains--POSITIONS  of uterus.    83

                    False Pains.
  The  only difference  between  the  premature,  or, as
they are often  called, false pains and the  true, is, that
the former take place at any period of pregnancy, when,
from any cause, the expansion  of  the uterus does not
correspond with the growth of the  child.  Thus  a sud-
den  cold  contracts  the uterus  and produces abortion.
(See treatment  of this form  of disease.)   True pains
may be inefficient,  on  account  of their not extending
over the whole surface  of the  uterus.   Partial and inef-
ficient  pains during parturition, are  sometimes  called
false pains, though  more  severe than those in which
every portion of the uterus acts, and  the effect  is pro-
duced.

              Positions of the Uterus.
   We have already remarked that, if the patient have  a
sound  constitution, and the catamenia be  generally
regular and healthy, pregnancy  may be  suspected when
the periodical secretion ceases.
   Abating variations consequent on the form and capa-
city of the pelvis, the  tonic or  atonic (active or  debili-
tated)  state, of the organs, &c.  the  position of the os
uteri, for  the first three months, will be  rather lower in
the vagina than usual;  from the fourth to  the fifth, the
fundus can be felt outside above the, pubis; at the sixth,
half way between this and the umbilicus; at the seventh,
about  the umbilicus; at the  eighth, half way from this
to the  pit of the  stomach, which is about as high as  it
rises.  Then it settles and enlarges. 
84
THE F03TUS.
               Growth of the Foetus.
   For about fifteen days no solid form is discoverable.
At six or seven weeks, it is about the size of a small bee.
At two months, it is about two inches  long  and weighs
about as many  ounces;  the parts are distinct and ossifi-
cation commences.  At four months,  it is  five or six
inches long, and its motions are usually felt by the mo-
ther.   The first of these motions are called " the quick-
ening." The length is  seven to nine  inches.  In the
sixth  month the  hair commences  growing,  the foetus
weighs from one to two  pounds, and its  length  is nine
to twelve * inches.   During the seventh  month, parts
pretty  freely developed.  Eighth month, nails  firmer,
hair more  colored, weight three to  five  pounds, length
fifteen inches or more.   Ninth month, bones  more com-
plete,  head large, firmer, cranial bones touch each other's
margins, fontanelles narrower, nails extend to the  ends
of the fingers, and the whole  system is developed.  Its
weight then varies (in Europe) usually from five to eight
pounds.   Dr. Dewees,  of  Philadelphia,  says  that he
weighed one of fifteen  pounds  and a  half;  and thinks
that, in this country, they are often as large, and that
their average weight is over seven pounds.
  Sometimes the  foetus  thrives  in  weakly women, and
becomes proportionably  very large.  Sometimes healthy
women bring forth very  small children, that  are never-
theless perfect;  and sometimes the children are retarded
in their growth by an imperfection in  the development
of the parts, and sometimes imperfections  or  malforma-
tions arise from maternal associations during gestation,
and sometimes  the whole force  of the  mother's disease 
               PREGNANC Y--S I G N S .              85

falls upon the child, and it is born  almost  in a  state of
putrescency.

              Duration of Pregnancy.
  It is generally believed that the natural, uninterrupted
period of pregnancy, in a healthy woman, is from thirty
nine  to forty weeks,  or about nine months.  This is
about the duration in most cases which occur under cir-
cumstances that leave no doubt as  to  the exact time.
(Dewees, pp.  139,134.) From  various causes, however,
some females carry the foetus seven months, some eight,
some ten, and even more.—(Dewees, pp. 128, 142.)   As
it is impossible, however, always to know when it com-
mences, and as its  duration is different in different  wo-
men, and in the same woman at different times, so there
is no certain rule  by which either the duration or the
termination can, at all  times, be determined.  The most
important matter is, always  to keep  the female in good
health, as the first and best means to  render distinct and
certain those  signs which have generally been relied on
as indicating  the existence  of utero-gestation;  to be al-
ways prepared for the circumstances attending its ap-
proach or termination,  from the time that the reasons to
suspect its existence are first developed, and to become
so well acquainted with the signs of  approaching partu-
rition as to guard against improper conduct, and to  ren-
der the subject all the attention which those  circum-
stances require.

             Signs of Utero-Gestation.
  The uterus  is supposed to be the most favorable to 
86        MISTAKES OF THE  REGULARS.

conception or impregnation, directly after the periodical
cessation of the menses.  Sometimes women know the
moment it takes place; sometimes they discover its ef-
fects in a few days or weeks; sometimes three  or  more
months elapse  before they  discover it, and sometimes
they are  in  doubt  even  till they  are  in actual labor.
The same woman, in some utero-gestations, is in doubt
of her condition through the whole period, and in others
aware, not only of its  existence, but of the time  of its
particular stages.
              Mistakes of Physicians.
  Many  instances  are  known  in which medical men
have treated pregnancy for dropsy, till  the  actual ap-
pearance of the full grown foetus  discovered their mis-
take.   One instance occurred a few years ago in Mary-
land.   A  correspondent informed me  that two M. D's.
treated the  patient a long  time,  and  gave  her up as
incurable.   The  father called a Thomsonian, who steam-
ed the  living  dropsy into the world!  One of my pupils
informed me  that a similar case  fell  under his  own ob-
servation  in  the state of Tennessee, and I  have lately
heard of several  others.   (See  the  quotations under the
head of "Regular Mistakes" or "Scientific Quackery."
See also " Curious Physiological Facts.")
  The principal reasons for the above irregularities, are,
the different constitutional  temperaments  of  different
females, and  the different degrees of health and spirits
in the same female at different times.   When  they are
in perfect health, and  their spirits  buoyant, the slightest
impulse on the delicate structure of their peculiar organs
is sensibly felt. 
THE MENSES.
s?
            Interruption of  the Menses.
  In women whose constitutions and general health are
good, the monthly evacuations almost always cease im-
mediately after  conception, and do not  re-appear till
some time after  parturition, and seldom while nursing;
therefore, if the  menses do not occur for several succes-
sive periods, it may be generally inferred  that the sub-
ject is pregnant.   But this cessation may take place in
consequence of taking cold, and then bad treatment may
prevent  its  recurrence, and a consequent dropsy may
similate pregnancy so closely as  to deceive even experi-
enced accouchers.
  About the time of the final cessation of  the menses,
say forty to fifty years, there  may be  such  an enlarge-
ment of the  abdomen, irritation of the breasts, &c. in
consequence  of  too early a suppression,  as to induce
both the patient and the physician to suspect pregnancy.
  The regulars,  who are afraid to give their Samsons in
cases of gestation, are in a bad box here;  they are obli-
ged to  wait  the teachings of time, and let the  patient
suffer, lest, by their " incompatibles,"  they do her an in-
jury  instead  of  giving her relief.  But Nature's physi-
cian gives her a full course of  medicine  without fear,
and thus at once  decides  the question,  and always in
favor of health and comfort, be the condition of the pa-
tient what it may. I speak from abundant and satisfac-
tory experience  in this matter.
  Women, however, sometimes  do menstruate during
the  first months of pregnancy, and, in rare cases, they
have done it to  the very last!  " I  have  myself known
women," says Dr. Blundell, page 115, "in whom, during 
8S
INTERRUPTED MENSES.
 the first three or four months, the catamenia have con-
 tinued to flow, though not in so large quantity nor so
 long, as if they were not pregnant; and, in  rare  cases,
 I am told, but I have not seen  any such case myselt,
 that the catamenia may continue to flow up  to  the  last
 month.   A medical  gentleman related to  me the case
 of a lady who had had several children, and, in  three or
 four of  her pregnancies, the catamenia continued till the
 last month: in return, in kind, and in every point except
 the continuance and quantity, the flow was of the cata-
 menial  character.  I need scarcely add  that  women,
 when pregnant, are liable to red appearances, which are
 not of the nature of the catamenia."
  The  cessation  of the menses  is,  therefore, as  I before
 remarked, a valuable, but  not a certain, indication of
 pregnancy; and yet  pregnancy may exist where the  dis-
 charge still continues, one instance of which has  fallen
 under my own observation.  Still  these cases are so
 rare,  that  Denman  and  Burns, both very  celebrated
 accouchers, declare, that "no female, continuing  to men-
 struate, can, at the same time, be pregnant,"  they  never
 having seen such a case.
  The discharge may be prevented by local obstructions
 without pregnancy, in a woman  whose health has been
generally good, or by chronic general inability to furnish
 this fluid, in addition to all  the  other  secretions, while,
in consequence of a  surplus of vitality in health, or of
excessive weakness of the uterine secernants in  chronic
sickness, this secretion may become excessive at  the  ex-
pense of others thus rendered deficient.  This is the only
rational  account  I have  ever seen of these seemingly 
     THE BLADDER--NAUSEA--SWELLINGS.    89

unaccountable occurrences, and I believe it true, because
it explains all difficulties on principles in perfect harmo-
ny with the established laws  of vitality, as well as with
my view of  the  cause  and design  of this  secretion.
(See pages 43, 44.)

             Irritation  of the Bladder.
  Increase in the size of the  uterus, while  it remains in
the cavity of the pelvis, is apt to create irritation about
the neck  of the bladder,  and sometimes  an ineffectual
desire to discharge the urine.  This is called micturition.
Other circumstances being favorable, it is considered a
sign of pregnancy.

          Nausea, Retching and Vomiting.
  These suddenly  occurring in women  perfectly  well
before, particularly on rising in the  morning, and sub-
siding more or less during the day, the patient spitting
or throwing up, however, little else than mucus, gastric
juice, or ill-digested chyme,  constitute  another concur-
ring sign of utero-gestation.

        Swelling of the Lower Extremities.
  The increase of the uterus in the pelvis may cause  it
to press upon the veins and absorbents  that ascend from
the lower limbs, and this check to  the return of the fluids
causes those limbs to swell.   The same  cause may check
the action of  the nerves,  and render the limbs liable to
become numb, or occasionally to " go to sleep," as it is
called;  and these things  may happen, too, in the  latter
months of  pregnancy, when the weight of the  foetus 
90     MOTIONOF FCETUS--THE ABDOMEN.

presses on the brim of the pelvis.  Connected with other
concurring circumstances,  these signs are of some value.

               Motion  of the Foetus.
  It is generally supposed  that the motions of the foetus
are a  clear and  certain proof of pregnancy;  but nothing
is more certain  than that, in multiplied instances, these
cannot be distinguished from spasmodic  contractions,
the movement of wind, &c. even in women that have
had many children, and that this doubt may continue to
the very commencement of delivery.   Dr. Blundell says,
" When the motions of the child " [rather of the abdom-
inal viscera;  if "of the child," they  must  be  certain,]
are somewhat obscure, but little reliance  can be placed
upon  them as a sign of pregnancy;  but where  the child
is very turbulent, the  motions  frequent and violent, the
sign becomes so strongly marked that, without looking
any further, you may infer that gestation is undoubtedly
begun."—Page  114.  But he elsewhere says, "the only
infallible sign is the actual  expulsion of the foetus !" and
gives  examples  of the deception of eminent accouchers.

          Enlargement  of the Abdomen.
  Though various causes, as corpulency, dropsy, wind,
internal tumors, &c. may produce an increase of size in
the abdomen, where pregnancy does not exist—yet it is
certain that  a foetus cannot come to maturity without
producing this  effect.  Therefore, when a sudden, grad-
ual and considerable enlargement of the  abdomen takes
place  without any other known cause than its connexion
with other signs of pregnancy, it may fairly be considered 
THE BREASTS--AREOLA.           91
one of the many indications, and as such have its value.
Some advantage may be derived from a  careful atten-
tion to the  particular kind of swelling.  Swelling from
water or air is diffused quite equally over the whole  ab-
domen, and is yielding and movable; that from air is
fluctuating, often entirely subsiding; that from fat,  dif-
fused over the whole system;  that from tumors, very
gradual in its  growth, unconnected with other signs,
and  located  in  different  places, while the swelling of
pregnancy commences  suddenly, about  the first of the
fourth month, just over the symphysis pubis, is constant,
unyielding, and continually increasing—and therefore,
all others concurring, is a valuable sign.

               State of the Breasts.
  In  first  pregnancies, the breasts  are  apt to indicate
the condition of the uterus,  by enlargement, irritation
and secretion;  but, as the first  of these  may be induced
by corpulency, and the second and third by the frequent
exercise of a desire that they should become so, together
with repeated  trials, by pressure, to ascertain whether
there be any secretion, their indications are by no means
certain.   These appearances, too, are so  common about
the final cessation of the menses, as often, in connection
with that, to deceive even  the  experienced obstetrician.

                       Areola.
   Some have placed much confidence in the enlargement,
 and the changes in color to a darker hue, of the areola,
 or dark  circle  that surrounds the nipple, as  a valuable
 indication, especially of a first pregnancy.  Others place 
 92     LIKES AND DISLIKES--QUICKENING.

 but  very little confidence in  these changes.  But it is
 manifest that none but the lady herself, her husband or
 intimate female friend, could be much benefited by this
 sign, were it ever so good.  The physician is not  requi-
 red to examine each patient sufficiently often  to  profit
 by those changes; nor are they very distinct or worthy
 of notice after the first pregnancy.  The change, when
 manifest, is from  a narrow to  a wide circle, and from a
 rosy tint to a coppery  red or  a mahogany brown.  Dr.
 Blundell thinks it, in some cases, a very decisive con-
 current sign.

               Likings and Dislikings.
   Most women, during pregnancy, are beset with cer-
 tain  preferences and aversions.  They will choose those
articles for food  which  might be supposed  the most
unsuitable, and which  yet seldom disagree with  them,
while they will all at once become irreconcileably  oppo-
sed to  others of the  most inoffensive and nourishing
kind.   Some  lose their flesh  and health,  others  their
equilibrity of temper, some fret and others  cry, or exhi-
bit some other hysterical symptoms; few, indeed, are, in
all respects, in disposition and  action, just what they are
at other times.

                    Quickening.
  In the latter part of  the third month  or beginning of
the fourth, the uterus quits the cavity of the pelvis and
ascends into the abdomen.  In many females the  influ-
ence of this change is  distinctly felt, in motions in  the
abdomen, sickness  of the  stomach,  agitation  of mind, 
       CESSATION of the  milk--DISEASES.    93

and tendency to fainting.  In  others, these  effects  are
not strongly marked.

       Cessation  or  diminution of the Milk.
  When, during nursing, a sudden diminution, or almost
total cessation,  of the milk  occurs, pregnancy may be
strongly suspected, especially if there has been a return
and then  a suppression of the menses.   The fact that
lactation  and menstrual secretion very  seldom, if ever,
proceed together,  and that neither of them scarcely ever
exists during pregnancy, is proof that both these secre-
tions are engaged in  contributing to the development of
the future man,  till he is entirely detached from the mo-
ther,  from whose secretions he  has  been so long sup-
ported, and  furnishes another strong  evidence of the
truth of the doctrine  taught pages 33 and 43.

                      Diseases,
   Such as nausea, diarrhoea, effusions of water, dyspep-
sia, heartburn,  depraved  taste,  costiveness, prolapsus
uteri,  gravel, jaundice,  difficult  breathing and cough,
convulsions, tooth-ache, salivation, inflammation of the
breasts,  dropsy of the ovum  and of  the extremities,
rigidity of the abdominal muscles, false pains, agitations
in  the abdomen, &c.  have been considered  signs of
pregnancy; but, as some one or  more of all these may
be  often  present  where there  is no  pregnancy, and as
pregnancy may exist without  any of them,  they are of
little value  as signs,  except when the concurrent testi-
mony  of those already  mentioned gives them value.
   Regulars profess to determine the matter by a manual 
94   diseases  of pregnancy--TREATMENT.

examination; but, as this mode is calculated to do often
more harm than good, and in the botanic practice is sel-
dom useful, I cannot  recommend its  adoption.   The
signs they derive from  it are, they say, " in some dubi-
ous cases, the only certain" signs; and yet, with all the
precautions against error they can take, they are obliged
still to confess that no one of these signs of pregnancy
alone is very certain, and, indeed, that they cannot de-
termine the case infallibly by the united evidences of all
the signs with which they are acquainted.  Dr. Blundell,
after enumerating all the signs  that have been found
worthy of notice, comes  to  this sage conclusion, that,
" if pregnancy be doubtful, we had better  wait till the
end of ten or twelve months, when, unless  the gestation
be  extra  uterine, or out  of  all rule,  parturition  must
sooner or later  occur!"   Thus  he ends the chapter on
signs nearly as he begin it, viz. "The most  certain mode
of knowing whether a woman be pregnant or not, is by
waiting till the term of nine months is completed, when,
unless  the pregnancy be extra uterine, or  unless there
occur  some of those extraordinary and rare prolonga-
tions which have sometimes  been made the subject  of
physiological or forensic litigation, if the uterus contain
an ovum, it will  be expelled!"

                    Treatment.
  Though I have here spoken of what  are called " dis-
eases of pregnancy," merely with respect to  their  char-
acters  as signs of its  existence, yet, as they  are  sup-
posed, by the regular  faculty, to require  a treatment,
when found in this connexion, different from what would 
   TREATMENT OF DISEASES OF  PREGNANCY.  95

be proper when  the patient  is not pregnant, it may be
proper to state that all forms of disease are to be treated
upon  the same  general  principles, and with the same
characters of remedies, when the patient is  pregnant,
that would be adapted to the case if she were not.
  A woman  of  good constitution and in perfect  health,
will scarcely learn that  she is pregnant  from the evi-
dences which the  "diseases of pregnancy" afford, while
she that is feeble and sickly will find it as  difficult to de-
termine  from what cause her continued  and vexatious
hysterical symptoms proceed.  As to nausea, it may be
produced by any thing that can irritate the stomach—as
bad food, cold phlegm, &c. as well  as by uterine sym-
pathy.   From whatever cause it proceeds, however, it
is to be cured by a course  or two of medicine, (or fifty
if  necessary,)  with  laxative  bitters,  <fec.   The cold
phlegm above mentioned may check the power of diges-
tion, and the uterine irritability may fatigue the stomach
before the whole of the  food is reduced  to chyme. In
either case the pylorus relaxes and  the undigested food
is suffered to pass into the duodenum, where it continues
its irritation, and  of course  the velocity  of its descent,
till it is violently expelled from  the system, in connec-
tion with the fluids which have been  invited into the
alvine canal and hastened along past the mouths of the
absorbents too fast to  be taken up.   The discharges thus
produced constitute what is termed diarrhoea.   As this
form of disease, too, has its  origin in the stomach, it  is
 evident, from reason as  well as from experience, that a
 thorough course of medicine is the best cure for it.
   Dr.  Blundell says,  page  121, "Among  the diseases 
96
ADVANTAGES  OF KNOWING
which are either referred to pregnancy, or which require
a modified treatment in consequence of their connexion
with it, not the least troublesome, is  the irritability of
the stomach  and bowels, producing, in  the earlier and
middle months, both vomitings and purgings—sometimes
together—generally alternating.  *  *   *   *  Where
there  is  much irritability,  the  patient  becomes  much
reduced by it, and she may die of exhaustion  by vomit-
ings and purgings, or by flooding, perhaps, during pre-
mature delivery.  It is not always in our power to  put
a stop to these vomitings and purgings, but we  may do
it in many instances."
  I have not  found it more difficult to  cure  these  forms
of disease, in  connexion  with pregnancy than in its  ab-
sence, because I have uniformly treated them  without
any reference to that state. I  would make the same
remarks in regard to all  other symptoms above enumer-
ated.  As I shall hereafter give  particular directions in
regard to the  manner in  which all the forms  of disease
peculiar to women are to be treated, I  forbear to add
more in this place.

Advantages of knowing the condition of the Patient.
  What, I may be asked, are the advantages to  be deri-
ved from certain knowledge of the real condition of  the
patient?  I answer, some wicked persons desire to know
the fruits of one sin, that, by the commission of another,
they may avoid exposure.   To  such  persons it would
not be right for us to communicate the knowledge if we
had it.  Regular physicians are anxious to know it, that
they may not prescribe,  for disease, a course of  practice 
        THE CONDITION OF THE PATIENT.      97

 that would injure any woman  in a  state of pregnancy.
 Let them quit their poisonous  and  destructive practice,
 and adopt one that will cure all forms of disease without
 injuring any person, under any circumstances, and  this
 knowledge will be less important to them.
   But of what use is this knowledge to the patient, or
 to nature's physician?   Answer:  It is very pleasant to
 be relieved  of doubt  in any  respect,  and  particularly
 when it is necessary to make any preparations for the
 final result.   But, on the  medical practice  of the true
 physician, whose duty it is, at all times, to remove every
 cause of disease, whatever be the  condition of the pa-
 tient, it can  have no very important bearing.  Having
 given numerous  and  full courses of medicine, in  every
 stage of utero-gestation, I am  happy to assure  all who
 may desire information on the  subject, that I have never
 had the least reason to believe that  any thing but good
 resulted from them.  So far from being afraid to take
 full courses of medicine during pregnancy, every lady in
 that situation ought  to take them  so  frequently  as to
 keep her system  free from  every cause of disease, and
 in the  exercise of all its proper functions, as the very
 best means of securing the full growth, hardy constitu-
 tion, and  safe delivery of her offspring.  By giving a
 full course of medicine  the day before delivery, I have
 so prepared the system for its duty as to render the  bu-
 siness of parturition short in  its duration, and compara-
 tively trifling in the aggregate of suffering.
  I have known  a regular M. D. to forbid a patient  the
use of medicine, and thus prolong her complicated suf-
ferings for many  months, under the fear that the medi-
           7 
98
R E C K O N I N G--LAB O R .
cine proper for one form of disease would be injurious
to a patient  laboring under the symptoms of another.
Often have I  entirely released, in a few hours, the mis-
erable victim whom this species of medical superstition
had doomed to a three, four, or five months suffering of
the most  disagreeable and  even  painful kind.   How
ought we  to prize a system  of practice which may be
safely, freely  and  effectually applied, for any and every
form of disease, without the least fear of injuring the
patient!

                     Reckoning.
  Supposing  the  commencement, or the quickening, to
be correctly established, the  reckoning of nine months,
or thirty-nine weeks  and one  day, from the  former, or
about five months from the latter, will  complete the
term of gestation, and indicate the time when  parturi-
tion may  be  expected.   This is somewhat important;
for ladies,  who are properly treated during that  period,
are often very suddenly surprised at the end of it, and
are, of course, liable,  without  attention to the reckon-
ing, to be caught away from  home, or at least unpre-
pared.

                       Labor.
   Many causes may  contribute to retard or cut short
the hour of labor; therefore we should always be ready
for the circumstances  attending its arrival, and so well
acquainted with its approach, as to guard against impro-
per conduct,  and to render the patient all the attention
which those circumstances may require. 
         causes of labor--abortions.       99

                  Causes of Labor.
  Medical  men have written  much on  the  supposed
causes of labor, but have never very well agreed on any
point respecting them.   I think that the uterus is a mus-
cular structure, and, as  such, is designed to relax, unless
some internal cause of reaction  opposes, to an  extent
just  sufficient to  enclose a full grown  foetus, and then,
like  every other muscle, to return to its original dimen-
sions.   During the period of this relaxation, the decidu-
ous membrane, now called the placenta, as also the foe-
tus,  arrives at maturity, and, like a ripe apple, is read}"
to quit its strong hold upon the parent.  The whole now-
become an offence, as would any other substance that
did not belong there.   The regular periodical contrac-
tions of the uterus (for, though a long period elapses be-
tween them, they are strictly periodical) now commence,
and  are increased in frequency and power, till they expel
the contents  of that  organ and reduce  its volume to its
original dimensions.  This doctrine clearly explains the
mystery of abortions and false pains—subjects that have
puzzled the medical world not a little, and caused them
to scribble many  a ponderous folio of nonsense and ab-
surdities on  these topics.

                    Abortions, &c.
  The truth  is, the placenta is  a hard  cake, possessing,
from the commencement of its growth, very little adap-
tation  to contraction;  whereas,  the  uterus is capable,
when powerfully irritated, of contracting, at  any time,
in a  very few hours, from  the size to  which it may be
naturally distended,  to nearly its  original dimensions. 
 100       PLACENTA--SIGNS OF LABOR.

 The attachments between the placenta and the walls of
 the uterus are  so delicate  that the contractions of the
 uterus, by the side of the  unyielding cake, readily sep-
 arate them.  The whole contents of the uterus now be-
 come foreign to that organ, and, as  such, are immedi-
 ately expelled.   This is the reason why a  severe cold or
 a  sudden shock, as  a fall, a fright, grief, &c. all which
 act spasmodically upon the whole nervous system, and
 especially  upon  the  uterus,  produces  abortion.  But,
 among the refined classes of society, no  one cause so
 often produces  abortion  as the  contracted  condition of
 the abdomen produced by corsets.   That  cavity being
 thus  rendered  almost incapable of  containing a  full
grown foetus, it is wonderful,  not  that tight lacers so
often suffer abortions, but  that  they ever  carry a child
 to maturity.   Let every sensible  mother  consider  this
matter in season to  prevent  the evil by forbidding its
cause. This  is also the reason why the botanic practice,
which consists in relaxing constricted organs, removing
 the causes of irritation, and thus quieting the nerves and
 restoring a regular expansion of the  uterus and action
 of the general system, is so effectual in preventing abor-
 tions and  miscarriages.  The  treatment  in such cases
 will be given in its proper place.

            Signs of approaching Labor.
   As the signs or symptoms  of pregnancy may be simi-
 lated by  those of various forms of disease, so the signs
 of  approaching labor may be  similated  by what  are
 termed false pains, proceeding from colds  or other local
 irritants.   It is  therefore well, whenever any symptoms 
SIGNS OF APPROACHING  LABOR.      101
present that  are  suspected  to be  those of approaching
labor, to commence, at once, that kind of  medical treat-
ment which is calculated to  remove every vestige of dis-
ease.   If the symptoms  prove to  be those  of disease,
they will be removed; if those of actual labor, they will
be increased in severity and frequency till no doubt will
remain as to  their cause.
  Giving  canker tea, especially raspberry and cayenne,
applying warmth to  the feet, jugs of boiling water, or
bricks  or rocks heated red and then cooled in water till
done hissing, and wrapped  in linen cloths, (the patient
being in bed  or in a chair by the fire,) and thus  produc-
ing perspiration, or giving her a good steaming, are the
proper means to decide the  point.
  Sometimes, if  the gestation be complete, the patient
can  perceive, for  two or three days before  parturition
commences, a gradual sinking of  the  abdomen, which is
produced  by  the  sinking of the foetus into the superior
strait of the  pelvis.  Micturition and tenesmus  are fre-
quently troublesome.  There is  also, generally, a  dis-
charge from  the vagina, of a mixture  of mucous and san-
guinary fluids, which indicates some progress in the dila-
tion of the os uteri.  " The mucus," says Dr. Blundell,
"is  from  the numerous and large follicles which lie in
the mouth and neck of the womb, and the blood consists
of a small drain from a few  capillary vessels passing from
the cervix uteri to the membranes, and laid open by the
detachment of these membranes and  disruption  of  these
vessels, when the lower frustrum of the ovum descends
a little, and the moujth  of the womb dilates.   Hence it
is, because the show of blood [as well as  mucus] is indi- 
 102   CONDUCT OF ATTENDING PHYSICIAN.

 cative of the dilation of the os uteri and  the  incipient
 descent of  the membranes, that this sanguineous appear-
 ance may be looked on as a token of commencing labor."

               Conduct  when called.
   If the patient  have used  the botanic  remedies, and
 should request your services, you should attend as soon
 as possible, or it may be  too late to be useful.  I was
 called, one  morning after sunrise, to a lady  in Columbus:
 I went immediately, (about a  quarter of a mile.)  She
 said she wished she knew whether her time had really
 come.   I told her to take some raspberry  and cayenne
 tea, and she would soon know. . She drank some twice
 or three times, and in seventy-five minutes  after I enter-
 ed the house, she was delivered and cleared.   It is not
 often, however, that the  work  is done so speedily  as
 this; still it is proper, as was manifest  in this  case, that
 the practitioner should be present as soon as  possible
 after he is  sent for.  The umbilicus may be round the
 child's neck, or cramped between the foetal  body and the
 maternal pelvic bones; or there may, in some cases  of
 injury, be a flooding, which will demand immediate at-
 tention.  The desire to  relieve even the  ordinary and
 indispensable pains of travail, as speedily as  possible,
 should always be sufficient to prevent your unnecessary
 delay.
  As soon as you arrive, let the husband, or some fami-
liar friend,  inform the lady, and then you should remain
in an ante-chamber  till she requests  your presence.   A
sudden surprise, especially if attended  with the fear  of
 severe treatment, will  greatly  retard the  process, and, 
      conduct  of attending physician.   103

in many cases, cause the foetus to retract.   When  you
enter the  room, let your mind  be calm and collected,
and your feelings kindly sympathize with  those of the
patient.  Assure her that, though rather a severe duty
is before her, yet she has no reason to be alarmed, for
her peculiar organs are adapted  to the purpose, and are
no more liable to be injured than any  other organs  in
the proper performance of their  functions.   Give an ear
of attention and countenance of  interest to all her exhi-
bitions  of  suffering, or  her  fears of it.   If others com-
plain of her, take her part  whenever truth  will justify
you in so doing.
  But it is neither politic nor honest to assure her that
you can enable her to accomplish the work speedily and
with but little pain; for, though this may sometimes  be
the  case, yet it is  not generally so, nor was it in the
days of primitive society, before either  " doctor, or pin-
cers, or calomel, or opium," was known.   Even  when
" the Hebrew women were lively," and accomplished the
task "before the midwives came," the most  severe suf-
fering that the human body could endure, was said  to
have its parallel, if not its superior, in  the " pains of a
woman in  travail," especially  if it be "with her first
child."   The declaration, therefore, on every occasion,
that the sufferings of the patient are to be short and tri-
fling, will  frequently prove false in the result, and the
practitioner and  his practice will suffer more from one
failure of the fulfilment of such  a declaration, than they
would from fifty refusals to predict the  time  and degree
or  amount of  suffering.  Whoever has observed  even
the brutes  in the act of parturition, well knows that they 
 104       REGULATING ROOM, BED, ETC.

 exhibit more suffering under these circumstances than
 under any others in which  they can  be placed.  I have
 seen them  severely wThipped without  seeming to care
 much about it; but, in  the  pains of labor, I have seen
 them shed tears freely, and heard them make the  most
 piteous moans.  Some of them, too, exhibit signs of suf-
 fering much severer  than what  are apparently endured
 by others.
   The proper assurances from the practitioner are, that
 the botanic practice is far  more  efficient, in itself, than
 any other, in mitigating  the sufferings of the  patient, in
 removing the obstacles to delivery, in securing its safety,
 in hastening its termination, and in protecting both mo-
 ther and child against death or  serious  injury.  This is
 all  true.   And  he  may with safety add, that he will do
 his best to apply this practice  in the most  judicious
 manner.

     Directions in regulating the Room, Bed, &c
  Justify and aid the lady in making almost any change
 in her position that she may desire, at least till the labor
 is far advanced.   Neither watch  symptoms with mani-
 fest fear and trembling, nor with apparent indifference
 to  them.   Endeavor  to  inspire  in the  bystanders the
 same degree of composure  that you exhibit.   This is
 best effected by calmly preparing every thing  that  may
in any event be  wanted.  These things may  seem tri-
 fling, but I assure you they are matters  of no  little im-
portance.   All is generally believed to be well when an
attentive  physician seems  unconcerned  about danger
and acquainted with his business.  Let them keep up a 
          ATTENTION TO PRESENTATION.       105

 good fire in the room if the weather be cold;  somewhere
 else if it be warm.  Let them also keep plenty of boil-
 ing  water; let them prepare a chair or a low bed, or
 protect the one she sleeps on, by putting several folded
 sheets between the feather-bed and  the  lower sheet.
 The best  thing yet devised for this  purpose  is an India
 rubber or gum elastic spread  as  large  as an  ordinary
 comfortable.  This  is a complete  protection.   Provide
 means to bolster her up or lay her down, on  her back or
 either side, and blankets to wrap up  her  feet and  legs
 whenever they would  otherwise be  exposed  to  cold.
 Keep constantly prepared, cayenne, canker and nervine
 tea,  with No. 1 steeped, or 3d preparation.   Have a pair
 of sharp  scissors and a small cotton  or linen  string in
 your right vest pocket, and avoid making any  examina-
 tion till the pains become severe and frequent, and  then
 examine as carefully as possible.

      Attention  to Position  or Presentation.
  When the pains become frequent and severe, examine
 the abdomen, and determine whether the head be direct-
 ly over the pelvis.  If it be, all will  be well,  (unless the
 pelvis be known to be greatly deformed.)  If the lower
 extremity of the foetus be evidently resting on  the front
 (pubic) or side (iliac) bones, lay the patient on  the back
 or the opposite side, raise the  pelvis a little, put  one
 hand where  the^  protuberence  is,  and press it against
 the edge of the bone and  the lower part  of the abdo-
men, and with the other hand raise her up  in a sitting
posture in the direction of  the first hand.  This  process
will at once give direction  to the  foetus in  the pelvis; 
106   BREACH PRESENTATION--INSTRUMENTS.

repeated two  or three  times, the  chest, in raising, will
accomplish the object, even though the foetus were to lie
directly across the pelvis.  When this is effected, it mat-
ters little whether the feet or the head descend first.  A
careful  comparison of the records  of " turning,"  with
those of unassisted nature, has convinced me  that at-
tempts to turn the forehead  back, where  the face pre-
sents, are more dangerous than useful.

                Breach Presentation.
  My friend, Dr. Tibbits, of Cincinnati,  was  called to
" a difficult case."   Breach presentation.   He endeavor-
ed to bring down  the  feet, but found it  impracticable
without giving pain, and even  the" risk of doing injury.
Not considering himself authorized to thwart  the  mani-
fest resolution of nature, he contented himself with help-
ing her in her own way.   He  gave  her lobelia and its
helpmates, and she  soon rid  herself  of a  heavy burden,
breach foremost, legs  and knees on the abdomen !   Thus
we  see that botanic physicians  find  little difficulty in
managing those difficult presentations that frighten others
so much.

                     Instruments.
  The only  instruments that it is advisable for him to
carry, are a catheter, a syringe, and  a  pair of sharp scis-
sors.  Even Dr. Blundell, of Guy's Hospital, London, says,
" The very fact that an  accoucher, on all occasions, puts
the lever into  his pocket when he goes to  attend a labor,
proves that  he is an officious, a meddlesome, and  there-
fore, to my mind, so far, a bad accoucher." 
           presentation--symptoms.        107

             Arm or Foot Presentation.
  Should an arm, or a foot without the other, present,
raise the pelvis of the patient higher than the shoulders,
throw the whole foetus back into the abdomen, then, af-
ter lubricating the hand with slippery elm, enter it  into
the vagina, and the fingers into the os uteri so far as to
prevent the hand from descending  before the head, or, if
the feet present, to bring down both together, the  heels
forward if possible.  Then restore the  patient to the
sedentary or  the  standing  posture, the  hand still  pre-
venting a  wrong presentation.  These last directions are
to be followed only when such a  case occurs, which  is
not once in a thousand instances.   I here remark, and I
wish it never to be forgotten, that no manual operations,
internal or external, are ever to be carried to such an
extent as to cause the patient to forget her other suffer-
ings  and attend to these.

              Symptoms  during Labor.
  Most frequently, and especially in first labors, there is,
says  Dr. Blundell, " a great  deal of cutting, sawing and
grinding felt while the mouth of the uterus is gradually
expanding and the ovum is  pushed down.  In ordinary
cases these pains, felt in the back, front and sides of the
abdomen, below and in the upper part of the thighs, at-
tack  the patient at pretty regular intervals of from twen-
ty to thirty  minutes; occasionally, however, we  meet
with women in whom the grinding  and cutting pains
are  permanent, the patient complaining, and writhing
perhaps, almost incessantly, for hours  together;"  and 
108        SYMPTOMS  DURING  LABOR.
Dr. Merriman observes that  " the irritable state of the
os uteri, during the first stage of labor, [that is, expan-
sion of the os uteri and the descent,] very often produ-
ces,  from  sympathy,  shiverings  and  vomitings;   and,
when the  cutting pains are very frequent and severe,
despondency and lowness of spirits generally prevail."
   But I would remark here, that the  number, duration
and  severity of  these  "cutting, sawing and  grinding
pains," depend very much on the kind  of treatment the
patient may receive.  If due care be taken to have the
system properly  and  sufficiently relaxed, as will be di-
rected in the Lecture  on " Ways and Means," the " cut-
ting, grinding and sawing" will  be reduced to compara-
tively a  small  matter, where, if the antiphlogistic and
sedative  treatment were pursued, it might be thought
necessary to " aid the  too feeble powers of nature by the
skilful use of instruments!"  I  need scarcely  say that
the relaxations should be produced by steamings, fomen-
tations,  lobelia liniments or  poultices, &c. with warm
applications to the parts, of  bricks, rocks, boiled wood
or bottles of boiling water, &c.  After these pains have
continued some minutes or  hours,  seemingly without
much effect, the woman  begins seriously  to  exercise
every muscle of her body, as if to force away the offend-
ing cause.  She  seems desirous  to  get  a fast  hold  of
something that is firm, as a bystander's hand, or a hand-
kerchief or cord, tied to the bed-post, and to fix her feet
or knees  against the same support, so  that she  can pull
smartly when the pains are severe.   In  these  matters
she should be indulged and  assisted. 
       natural parturition--descent.    109

               Natural Parturition.
  When the head of the foetus descends first  into the
pelvis, and the efforts of nature are  sufficient, (at most
with a little  assistance from medicine, and attention to
the position  and movements of the patient,) to  expel it
in a reasonable time, (some say twenty-four hours after
the discharge of the waters, and the commencement of
the labor  pains,) and with no  extraordinary degree of
pain and suffering, the parturition is  said to be natural.
In this case, the delivery is sometimes effected  immedi-
ately, as  in women who have borne many  children,
whose pelves are large, and in whom the  parts are  well
relaxed.   Instances have been known in which  the  first
severe pain entirely expelled the foetus.  Generally, how-
ever, the process is more gradual and protracted.

       Descent of the Head  into  the Pelvis.
   During these muscular exertions, the  head generally
descends into the pelvis.  It usually starts with the face
and crown towards the  iliac bones, and the ears forward
and backward, and,  after passing the upper strait, the
crown (very rarely the face) turns forward, which direc-
tion it  continues  till it  is ushered  into  the world.   As
the foetus descends into  the pelvis, the waters of the am-
nion push that membrane before the head, in the form of
a bag, which generally opens the os uteri, descends  into
the vagina and breaks of itself before  it passes through
the  os  externum, discharging generally  a thick, ropy,
sometimes thin fluid, called  the amnion waters.  When
the  pains are  severe, the membranes are tense; when
off, they are relaxed.  It is not best to rupture them till 
110   RUPTURE  OF MEMBRANES--PERINEUM.

they protrude entirely through the os externum.   The
discharge from different persons is from a  gill  to a  pint
or more.

            Rupture  of the Membranes.
  "It is not always a rupture of the  membranous  cyst
containing the child that takes place at this time, for we
may have a rupture of another receptacle—this [general]
membranous receptacle being composed of three thinner
tunics, one lining the  other, and  the water may  issue
from the bag formed between the decidua and the  cho-
rion;  that is, the  two outer linings.  A considerable dis-
charge may be produced  in  this  manner."   It were  of
little  importance  to  mention  the  fluid, but to prevent
alarm at its appearance.   It may be repeated in cases of
plurality of children.  After the rupture of the mem-
brane, the head generally descends pretty rapidly  into
the pelvis, till  the face  lodges  in  the  hollow of the sa-
crum, the crown under the arch of the pubis,  the sagit-
tal suture on the perinaeum, and the chin upon the chest.

                  The  Perinaeum.
  It frequently becomes now the duty of the practitioner
to guard the perinaeum from injury, which he may do by
placing his fore finger  upon it, with the inside of the
hand  next  the child's  head, and pressing gently down-
wards and backwards, during the  existence  of the pain,
with design to get it underneath the head.  In this  way
there  is little danger  of rupture or injury to the perinae-
um, especially if proper care has been taken to have the
parts  well  relaxed.  The position of the hand  that I 
UMBILICUS.
Ill
recommend, is much better than that in which the inside
rests on the perinaeum, for it places the accoucher in the
proper position to attend  to the child as soon  as  it is
presented.

                     Umbilicus.
  After the head is delivered,  there is  usually a pause
for a few minutes for another pain to expel  the body.
During this interval, endeavor to ascertain whether the
umbilical cord is wound round the neck; and, if so, dis-
engage it if you can; if not, endeavor to keep the  head
and navel of the  child as near as possible to the os ex-
ternum of  the mother  till it shall be  disengaged, when
you may turn the head towards the  mother and easily
extricate it.  Endeavor also to disengage the face of the
child  from the membranes,  and  to clear  the  mouth and
nose as soon as possible, lest it take the mucus, water or
blood into  the lungs in  the  act  of inspiration, and  thus
strangulation take place.  When the child  breathes and
cries strongly, and the pulsation in the umbilical arteries
ceases, tie a small string or large twine round the umbil-
icus, about a half inch from the place where it ceases to
be of the same color as the body of  the child—that is,
generally  about  an inch from  the body, and  another
an inch or  two from this, leaving  one end  of  this last
string  a foot or  two long.  Let both be tied twice or
three times round, and  drawn so  closely as to  prevent
the circulation, but not so as to  cut the umbilicus.
  Now cut, with a pair of sharp scissors, the  umbilicus,
between the places where it is  tied.   The  reason why I
tie the last knot, is, I have seen two cases in which every 
112          TO  RESTORE THE CHILD.

other part of the  placenta was detached from the uterus
before its edges were, and consequently it formed a sack
filled with blood, which stopped the further bleeding of
of those arteries in the proper way.   Had the end of
the umbilical arteries been open, there would undoubt-
edly  have been a haemorrhage through them till the pla-
centa was disengaged.

                     The Child.
  It  is my practice to have ready a pan or  small tub to
wash the child in.  I have also a tea-kettle  or other ves-
sel full of boiling water and a pail full  of  cold.  From
these two I put into  the  basin, pan or tub, a gallon or
two, so combining them as to make the whole neither
warm nor  cold to my own flesh  at  the  naked elbow7.
As soon as the face  appears, I endeavor to clear  it of
blood, water, &c.  which  might otherwise  be taken in
with the  first breath and produce  strangulation.  If the
child  is  completely discharged and has not breathed,  I
dash a little sprinkle  of cool water directly along the
spine; this  will contract  the  muscles that  connect the
ribs with the lateral processes of the spine, and of course
expand the chest, which is the first step in  the  mechan-
ical process of breathing.   Lightly  rubbing the spine
also will aid the muscles in expanding the ribs.   A simi-
lar sprinkling may then be dashed  upon the breast and
upper parts of the chest.   These must be done with wa-
ter that is  pretty cool.  If the sprinklings  do  not  suc-
ceed, immersion in the water prepared for  washing, but
made warmer, say (95 or 100 degrees) about as warm
as will be made comfortable to your naked elbow, will 
              TO RESTORE  THE CHILD.         113

 do much.  In aid of these  means, put a little  strong
 cayenne tea into  the mouth, or  into the stomach from
 your mouth through a silver tube.  In most cases these
 processes will be found sufficient.
   Various other means have been resorted to and recom-
 mended, to aid the process.  It will be remembered that
 Dr. Thomson recommends the  placing  of the placenta
 on embers, and stripping the umbilicus towards the body;
 but it is evident that this cannot be done when the pla-
 centa refuses to  come  away immediately.  And  if  it
 could, there is no  reason to believe that the smallest ben-
 efit can be  derived from this process.   In the  case men-
 tioned, the child would have  breathed without it.   I
 lately attended a case  where  the. child breathed and
 cried, ate and slept, more than twenty hours before the
 placenta wras removed.  Some stop up  the  nostrils and
 blow into the mouth, either with  their own  mouth  or
 with a bellows.   Dr. Blundell says the mouth is the best,
 but he recommends the  use  of  a silver tube, which  he
 enters through the larynx, and hence he calls it the tra-
 cheal pipe.   There is reason in the  use of this  instru-
' ment, for it will inflate the lungs;  whereas,blowing with
 the mouth or a  bellows is as likely to inflate  the stomach
 as  the lungs, and of course it does little good.   This in-
 strument has the  rare  recommendation that it is not
 likely to do much harm if no good.  It is certainly wor-
 thy of trial, where it is  found  impracticable to accom-
 plish the object  in the ways I have before recommended.
 Stimulants  to the nose,  as bayberry  or hartshorn, may
 also be used to advantage.
              8 
 114         TO  RESTORE THE CHILI).

   There is no harm in persevering in the use of means
 of  this sort, for  you can but  fail;  and instances have
 been known of success after more  than  an  hour's  appa-
 rently fruitless labor.—See Blundell, p. 184.
  The  tracheal pipe is made just  like a catheter of a
 large size, and India rubber would doubtless be prefera-
 ble to silver.  " I pass the fore-finger of the  left hand,"
 says the Doctor,  "down upon the root of the  tongue,
 and into the rima-glottidis, and then with the right hand
 slide the tube along the surface of the finger, till, reach-
 ing the rima, I insert it at the moment when the  finger
 is withdrawn from it, afterwards feeling  on the front of
 the neck whether the instrument is  lying in the  trachea
 or the  oesophagus.  [It should be the former, of course.]
 This done, you may take the child into your  hands and
 inflate  its lungs from your  own, emptying them by  a
 double pressure with your hands on the  thorax and  the
 abdomen, the  latter being  necessary to raise  the dia-
 phragm.  This should be continued, alternately inflating
 the lungs and expelling  the air, till twenty-five or thirty
 respirations are performed in a minute by the power of
 the child, when the instrument may be withdrawn."
  If the child cries  and  breathes strongly, it may be sev-
 ered from the mother by tying and cutting the umbilicus
 as already directed.   It should now be smeared over with
 melted lard, wrapped in flannel, and laid by for an  hour,
 then washed in the  water above mentioned; then  put a
wide strip of linen or cotton about the body loosely, but
 in such a manner as to keep the portion  of the umbilicus
of the child, with a little bunch of rags upon it, in its pro- 
           MECONIUM--SECOND  F03TUS.        115

per place.  It is always advisable to make a little hole in
some of the rags put on, to allow room for that portion
to rest in.  Now dress it loosely and warm, not cover-
ing the face, and lay it in the lap or in a crib.

                      Meconium.
   You will often be annoyed with  entreaties to give the
child some kind of  physic to carry  off the meconium or
first excrement; but you should reason against the con-
duct, affectionately but firmly, unless there is satisfactory
evidence that the  child is  actually sick, as choked with
phlegm,  or pained  with  wind, or something else, when
your treatment should be the same  in character that you
prescribe to a grown person, but milder in degree.
   It is reasonable to suppose that the  child is  much fa-
tigued by its severe compression during its passage  into
this new world; it is, therefore, very proper, and  per-
haps always advisable, after applying the lard, (which can
be done in a  few minutes) to wrap it up sufficiently
warm, and not attempt to  dress it till it has had an hour
or so for sleep  and repose;  and this hour, as in general
in its other sleeping hours, should be spent in  its cradle
or crib, or on an even bed—not in the uneven and un-
comfortable and constantly changing lap of the  nurse.
When it  wakes, it may be dressed carefully  as  before
mentioned.

                    Second Fcetus.
   Generally, each foetus  has its separate placenta;  and,
in such cases, where there are  twins, the placenta of the
first sometimes comes  away  before  the birth of  the 
 116        SECOND FCETUS--PLACENTA.

 second.  Sometimes two placentas are so connected that
 the one cannot come away without  the  other.  In this
 case, direct efforts to disengage the first placenta before
 the second  birth, would be improper.  Always satisfy
 yourselves, therefore,  that  there  is  not  another foetus,
before  you make any considerable efforts  to  disengage
the secundines, by  rubbing  the abdomen directly  over
the uterus with the hand,  not so hard as to  produce
pain.   If there be no other child, that organ will imme-
diately contract to about the size of a child's  head, and
be felt  as such just  above the  pubic  bones.  The abdo-
men being now very flaccid or loose, the hand will  be
able to grasp the globular lump; but, if there be another
child, the uterus will still be large, and the abdomen but
partially reduced in size,  or the muscles in tension.   By
 external examination, also, may be discovered,  through
 the os  uteri, the watery sac, formed  by the membranes
 of another child; and the bursting forth of  those waters
 insures the existence of another foetus.  The same means
 are to  be used for the discharge of this foetus  that were
 used for that of the former.   If there be no other child,
 the placenta or the lacerated  membranes alone will  be
felt internally.

                     Placenta.
   It now  becomes the duty  of the accoucher  to attend
 to  the  delivery of the  placenta  and the  membranes,
 which, with  the umbilicus,  are called the secundines.
 Give the patient a little tea of cayenne, raspberry and
 nervine, and wait for the efforts of the uterus to disen-
 gage the placenta.   If the pains do not occur in fifteen 
EXTRACTION OFT HE  PLACENTA.      117
or twenty minutes, rub gently, with the left hand, the
abdomen, directly over the uterus, not so hard as to give
pain, holding the right in readiness  to receive  the secun-
dines.  The gentle friction will cause the  uterus to con-
tract, or, in other words,  invite the recurrence of the
pains, which may be aided by giving more cayenne tea.
If now the pains be severe and ineffectual, it is  either
because the placenta  strongly adheres to the uterus, or
because  the os uteri, or the os externum,  is strongly
closed upon or against it.   If the patient is  able to be
placed over the vapor bath, this will be the  best means
of relaxing the parts, stimulating  the uterus to action,
and  disengaging the  offending matter.   If not,  give
warming medicines, and apply steaming bricks or cloths
wrung out of hot water to the  parts, and keep the feet
warm.   Perseverance in  this  course  will finally  effect
the  object.  (In case of  flooding,  which will  rarely if
ever occur under the above treatment, give strong  cay-
enne tea, and an injection of strong witch hazle and  a
little cayenne to the vagina.)  Never fear  to  wait for
the efforts of nature, aided only by innocent  means and
processes, to disengage the placenta.   Many instances
have occurred  in which it has remained not  only for
hours but for many days, even fifteen  or twenty, and
then come  away without either danger or inconvenience
 to the patient.
   Sometimes the placenta is detached from  the walls of
 the uterus, but still inclosed within it; sometimes a part
 of it descends into the vagina, and the  rest is  inclosed
 firmly in the neck  of the uterus,  which collapses  upon
 it; or it descends  entirely into the vagina,  and is pre- 
118       REMOVAL  OF THE PLACENTA.
vented from final disengagement by the rigidity of the
external  parts.  The regulars are very much frightened
at these things, and forthwith often  attempt to effect the
delivery by  manual  force.   Whoever will examine the
reports of cases treated in  this way, will be persuaded
that, where  one has been benefited,  hundreds have  been
ruined by officiousness.  So many instances have occur-
red in  the practice of the botanic brotherhood, in which
nature, a little assisted by  relaxant and stimulant treat-
ment, has done the work  with ease, after a  powerful
force had been long used in vain, that it would  be  inex-
cusable in us to despair  of a happy result of judicious
treatment, and unpardonable, in any case, to allow the
direct force  of man to be used in disengaging either the
placenta  or  the foetus.  Dr. Dewees has been extremely
nice in pointing out the various ways and times in which
the uterus contracts, in order to  expel  either  the foetus
or the placenta.  The  whole  matter, however mysteri-
ous he has made it, is resolved into this:  The  only rea-
son why  the uterus relaxes or contracts partially, is, be-
cause there  is not living action enough in the system to
produce it generally.  If, therefore,  in any  stage of the
iab<»r,  or after delivery, the parts are too  rigid, make a
more  liberal use of lobelia, nervine, and the vapor bath,
or warm and moist applications in  bed.  If there be, on
the other hand, no  effectual  effort, or if  the efforts be
few and  far between, cayenne is your agent.  Use these
remedies, with nervine, with discretion and steady per-
severance, and you  may burn all  that Dr. D. has said
about  unequal contractions of the  uterus, and the diffi-
culties they oppose to parturition. 
          REMOVAL OF THE PLACENTA.        119

   In  a case  I  lately attended, the placenta  refused to
come away immediately.  The child was  born about 4
o'clock A. M.  I satisfied myself,  by slight trials, that
efforts, sufficiently violent to bring away the placenta,
would give much pain and suffering.  It appeared very
large, and was  doubtless partly inclosed in the neck of
the womb; just what Dr. Dewees would consider a very
bad  position.   Although a part of the placenta was in
the  vagina, the origin  of the umbilicus  could not be
reached; and yet it appeared to  fill the whole  pelvic
cavity.  The lady was  fed  and suffered to go to sleep.
Examinations were made at three different times, to
ascertain whether any  progress had been made in the
delivery.  At 9 P. M. the external  parts were contract-
ed nearly  to their  usual dimensions, and so rigid and
sore that it was painful to  introduce a finger.  Warm
applications were made, and the patient suffered to sleep
again, as she  had done the most of the day.   About two
next  morning,  (twenty-two hours  after the birth of the
child,) the lady  rose, and, while sitting upon a vessel,
the placenta was discharged without pain.   The  parts
relaxed of their own accord, and then there was  ample
room.   On examination, I found the placenta studded
with hard pillars, and, on the  uterine surface, many lit-
tle bony scales, which preserved the remarkable size of
the viscus.
  Notwithstanding my advice to  keep her bed as long
as her  patience  would hold out, she was about her house
five days afterwards.  I am  persuaded that, had the pla-
centa been taken  by force, serious  injury might  have
been done. 
 120     CONTRACTIONS OF THE ITERUS.

   In general, the expulsion of the  placenta is accompa-
 nied with a discharge  of blqod, which has accumulated
 either in or behind it.   This is no cause of alarm, but it
 may be well to see that the bed is protected against it.
   Authors recommend a moderate but steady pull at the
 umbilicus, to aid in the delivery of the placenta.  Against
 this conduct I enter my protest.   The cord  is usually
 inserted  in the  middle of the back of the placenta, so
 that when that .portion is brought forward  it presents
 the greatest surface to the external orifice, and of course
 meets the greatest resistance  in its passage.   I always
 allow the umbilicus to lie loose, and even  to fall back if
 it will, while, with the  first and second  fingers  of my
 right hand, I get hold of the edge of the cake or of the
 membrane, and bring it forward.  Thus the placenta  is
 drawn edgewise  through the passage, and meets  little
 resistance.

            Contractions  of  the  Uterus.
  Writers  on obstetrics seem very anxious  about the
 contractions  of  the uterus, both before  and after the
 delivery of the placenta.  They wish  these contractions
 to take place partially before the delivery, because  they
 know that  they are the best safeguards against both hae-
 morrhage and inversion.  They do not wish them to be
 complete till afterwards, lest  the  placenta be confined
 and produce mortification !  Hence their  great anxiety,
and often very imprudent efforts, to bring  away the pla-
centa by force, if it should  not  come  away of  itself
within half an hour or an hour from the delivery of the
child.  While, therefore, they enter  the  hand into the 
          contractions  of the uterus.      121

 uterus for the purpose of disengaging the placenta, they
 use  various  means  to produce uterine contractions, as
 rubbing gently the abdomen, grasping  the uterus care-
 fully with the hand, putting the child to the breasts, ad-
 ministering brandy or some other cordial, &c.  If they
 fail  to produce the contractions, they sometimes turn
 the  uterus  inside  out,  by bringing the fundus  down
 through the mouth into the vagina, and thus  they ruin
 the patient;  or, if they separate the  placenta from the
 walls of the uterus, before that organ contracts, there
 commences, from the expanded mouths of the vessels, a
 haemorrhage, which is often rendered fatal by the inju-
 dicious use of ice and sugar of lead to suppress it!
   If the strength of the patient be supported,  the  uterus
 will  do all its work in proper  time and  order.  Its con-
 tractions will, at the same  time, break the connections
 between  it  and the placenta, close the mouths of the
 vessels thus broken, and so  thicken its walls as to ren-
 der inversion impossible.  This is all that is wanted, and
 nothing is better calculated  to effect it than the admin-
 istration  of cayenne and raspberry tea, and  the  slight
 friction of the abdomen with the hand,  or, at all events,
 the judicious use of the vapor bath.   Contractions thus
 effected will be uniform, general, powerful  and perma-
 nent.
  " There are four  different conditions," says Dr. Blun-
dell,  "in  which  the  womb  may  be  found immediately
after delivery: sometimes it is lax, and nearly as large
as the adult head;  sometimes  small and soft, not  bigger
 than the head of a full grown foetus; sometimes  small
and rounded, and as hard as a cartilage or the head of a 
122    P L A C E N T A--1 N J U D I C I O I S REMOVAL.

foetus; lastly, it may be very hard at  one moment, and
very soft at another."  We must determine  these con-
ditions  by  an external examination  of the abdomen.
The contracted, round and permanently hard condition
is what he likes.
  Now, as this condition is the perfectly natural  condi-
tion  of the  organ when not pregnant, we might well
suppose, what experience proves universally true, that
the best way to produce it  is  to promote a  general
healthy action through the system.  I have seen  a  case
of the protruding piles [prolapsus ani] completely redu-
ced by a single steaming, after it had long resisted al-
most every other means for its contraction.  This is a
means, then, which  I would recommend to be used with
much confidence, whenever the patient is tired  of wait-
ing to be " cleared."
  As  I have known much  mischief to  be  done by  the
"forcible delivery  of the placenta,"  as  well as  of the
child, I  must be  permitted to make, here,  a  few quota-
tions on this head.

        Injudicious  removal of  the Placenta.
  " When  the placenta  is  rudely torn away by  the .
accoucher, the v/orst consequences  may  be expected.
Floodings,  tremendous lacerations,  inversions  of  the
uterus—such are the effects of obstetric violence—fero-
cious  and  atrocious  obstetric  violence;  that  insatiate
and  gory Moloch,  before whose  shrine  so many thou-
sands  have been sacrificed,  to be  succeeded, in future
years, by still more numerous victims." 
       PLACENTA--INJUDICIOUS  REMOVAL.    123

  " Observing the awful consequences resulting from the
artificial  separation  of the placenta, Ruysch  first, and
afterwards Denman  and  Hunter, recommended that, in
all cases, the expulsion of the placenta, like  that  of the
foetus,  should be left to the natural powers; for, they
argued, ' the same natural powers which are adequate to
expel the child, are surely adequate to expel the placenta
also.' "—Blundell.
  "There is no doubt that if our women, unaided by
art, were left to their natural powers altogether, like the
females of the barbarous hordes, in a great majority of
cases the placenta  would come  away; but experience
is said to have shown that, in some  such cases, fatal
consequences  occur.   Many  cases  are said  to have
occurred in which floodings took  place.  [The cause of
the floodings  is not  the  presence of the placenta, but
the neglect of restorative  treatment  to  the patient.]
Some,  in which the placenta  was long retained, could
not  afterwards  be   abstracted;  and,  when remaining
unexpelled for two or three days, under the  procrastina-
ted use of means to extricate it, the greatest injury has
been inflicted.  [I have seen, myself, great injury  inflict-
ed by the use of these, means,  but I am very sure that,
provided the  strength of the  woman be  supported, a
placenta  may remain and rot in the  uterus, and be dis-
charged  in  the form of putrescence, without doing so
much injury to that organ as is often done, without the
least necessity, as Dr. Dewees says, " by  the rude and
ill-judged manoeuvres of  officious  hands."]  So that the
practice  [of waiting  for the efforts of nature] brought to
trial in Holland under the authority of Ruysch, and in 
124   INJUDICIOUS REMOVAL OF PLACENTA.

England by the advice of Drs. Hunter and Denman, has
now been laid aside, probably not without good reason."
  They laid aside the wrong part of the  practice, the
"waiting" instead  of  the leaving of the powers  unas-
sisted.  The true  reason is, that,  in  the  cases where
injury resulted, either  nothing was done to  strengthen
the woman in aid  of the  efforts of the uterus, stimu-
lants and food being forbidden;  or that means were used
that  were  calculated, directly or indirectly, to destroy
those efforts, as the exhibition  of opium  to quiet the
nerves, sugar of lead, and  sometimes even  the use  of
the lancet, to prevent flooding, &c.
  " It seems, therefore, to be pretty well agreed, among^
those that are competent to form an  opinion, that, though
we are not to be injudiciously and rudely tearing at the
placenta, it is necessary, nevertheless, that some  artifi-
cial  assistance should  be given; and  the  greatest and
nicest, perhaps the  most important of all  questions  in
the management of natural  labor, is the discrimination
of the moment at which  the assistance ought to be in-
terposed ?  Shall  we interfere immediately ?  Shall we
wait for an hour ? or even  still longer before we  bring
the placenta away ?"
  Truly, I say also, some artificial assistance  ought  to
be interposed, and that assistance should  be, first, a little
good stimulating tea, and then rest  until  the living ener-
gies  are refreshed: then a strong dose  of cayenne, and,
if necessary,  steam and lobelia  to help it; when the
work will be sure to be quickly done and well done.  As
to ^he questions, shall we interfere immediately, or after
an hour or more ?  that will depend altogether upon the 
           REMOVAL OF  THE PLACENTA.       125

condition  of the patient:  if she  is sinking and  needs
restoratives, give them at  once;  if not, let her rest till
the fatigue of her recent labors has subsided; then com-
mence your aid, not abuse, and it will be kindly received
and properly used.   Minutes and hours have nothing to
do in the matter.
  " By different practitioners different rules may be pre-
scribed; some recommend taking  the  rule from time—
say four hours after the birth of the child.  Others judge
by the pains, without regard to time.  Pains,  they  say,
accompany contractions,  which expel  the  placenta—
therefore they seat themselves at the bedside, refraining
for one or two hours  from manual interference if no
pains occur; but, as soon  as the pains occur,  following
the track of nature, our best instructress, they lay hold
of the umbilical cord and endeavor to bring the placenta
away.  Nor is this rule  to be despised."
  The only difference I make in this practice is, that,  if
the pains  are  long postponed, I give stimulants, &c. to
arouse them again, and advise little, if any, pulling at
the cord.   " Others are governed solely by the situation
of the placenta.  If they feel it in the upper part  of the
vagina, and especially if they feel  its union  with  the
umbilicus, they do not hesitate to remove it.   But if the
umbilicus  ascend high into the uterus, and no part  of the
placenta can be felt, they wait.  Of the three rules enu-
merated, I think, on the whole, the last  is to be prefer-
red.  In  ordinary  cases you cannot err in abstracting
the placenta when lying in a great  measure out  of the
uterus, while there  is always a risk in removing it when
it lies in the fundus of the uterus; and not only a risk, 
126       REMOVAL  OF THE PLACENTA.

but a difficulty.   There are yet others who determine
the propriety of interference by the feel and  condition
of the  uterus.  If it present a permanently  indurated
and  globose  mass, they consider that a thorough con-
traction has taken place, and that the placenta may be
safely removed.   Not  to dwell on  single indications, I
would recommend a practice forming itself under the in-
fluence of all these considerations—a  rule of composite
order.
  " Before you think of removing the placenta, it is your
duty to ascertain whether  another  child be lodging in
the uterus; for, as a general practice, it is  improper to
remove  the  secundines of  former children, until those
remaining in the uterus  have been expelled.   Rupture
of the funis, suffocation of  the  unborn foetus,  in conse-
quence of the  premature abstraction  of  the  placenta,
perhaps common to both, not to mention those floodings
which  we shall hereafter  contemplate, must in some
cases ensue, where this caution is unwisely neglected ;
and you ought, therefore, to investigate this point with
the nicest care, before you  attempt to remove the  pla-
centa.  Again:  by all means, unless  there be haemor-
rhage more than ordinary, wait for half an hour before
you operate, for, at the end of this  time, you  will gen-
erally find that the  womb has  reposed itself, that its
fibres are contracted,  and that  the  placenta may be
taken away.   Examine further, with  nicety, the condi-
tion of the uterus: if contracted, globose and indurated,
you may extract the secundines with more confidence;
but, no  flooding  forbidding, you  had  better  delay  the
delivery  even beyond the hour, when the  womb,  whe- 
           REMOVAL OF THE PLACENTA.       127

ther contracted or capacious, is found  to  be soft and
pulpy.
  "Lastly: if you  find the placenta lying so low that
you may lay hold of its body, the half hour being expi-
red, you may remove it with promptitude; but  perhaps
you had better delay the removal, even though the glass
be run out, provided the placenta be still lying beyond
the touch of the finger.
  "Here, then, are the four  cautionary  points which I
wish  you  to remember.  Before you abstract the pla-
centa, ascertain always that  there  is no other  child in
the uterus.  Satisfy yourself that  the womb  is  perma-
nently contracted.  Wait half an hour after the birth of
the foetus, no  particular  symptom  forbidding; and re-
member that it is  always desirable that you may feel
[with your finger] the  insertion of the funis or the body
of the placenta, before this viscus is taken away."
  The above, condensed from Dr.  Blundell, is,  I think,
on the whole, the most judicious advice  on the subject
of the indications for removing the placenta, that are to
be found among the writings of the regular faculty.  To
what does it all amount, but simply this: When the en-
ergies  of the uterus  have  so far  recovered from  the
fatigue  of their exertions to expel  the child, as to be-
come sensible to  the irritation  of the still offending pla-
centa, their first effort is to disengage it  from the walls
of the uterus, and their second, to expel  it.   When it is
discharged entirely into the vagina,  the uterus contracts
to a comfortable condition, and its pains cease.  Wait-
ing now for  a  pain to remove the  placenta, is useless.
Labor pains are not felt in the vagina.  If, therefore, the 
 128       REMOVAL  OF THE  PLACENTA.

 external orifice be  contracted,  and the part rigid, the
 placenta may remain here for a  long time, without the
 least effort of the system to disengage it; but,  if the
 patient stand upright, or sit in a convenient posture over
 the vapor bath, the  parts will be warmed and  relaxed,
 and the weight of the viscus  alone will  be sufficient for
 its expulsion.   Try it.
  Such have been the mischiefs  produced by inversions
 consequent on  forcible  delivery, while the  uterus  is re-
 laxed, its mouth open, and the placenta attached  to its
 fundus, that most women are afraid to stand  on  their
 feet  directly after child-birth, lest the uterus  "fall through
 the  vagina!"   They  may rest assured  that, where no
 mechanical  force has been used in the delivery of the
 child, and where the powers of the system are  properly
 sustained by suitable food and nature's restorative  medi-
 cines, this justly dreaded condition of things  can  never
 take  place.   Dr. Blundell very  correctly  argues   that,
 "when the  uterus is  properly contracted, inversion is
 perhaps impossible."  A proper treatment of the patient,
 to the exclusion of all improper treatment, secures, with
 certainty, the  proper contractions of the uterus, and
 thus renders it  perfectly safe for the patient to stand up,
 if she is able;  and few will be the  instances in which, if
 she is properly treated and has  no debilitating disease
 upon her, she will not be able.  I will now, again, give
 a few directions, w;hich may be  safely and successfully
followed in all  cases where there is not  known  to  be a
 deformity of the pelvis  so great as  to render parturition
impossible. 
     DIRECTIONS FOR REMOVING PLACENTA.   129

   After  the birth  of the  child, give  the lady a  little
strong tea of raspberry, witch hazle and nervine, strain-
ed, and cayenne added in quantity suited to her condi-
tion.   Give also a little nourishing food, if she  have not
eaten within six hours.
   Now  endeavor,  if it can be  done without force, to
remove the placenta.  Rub the abdomen over the uterus,
(not so hard as to give pain,) put the child to the breast,
and, if the parts  are rigid, and the placenta refuses to
come away without a force that gives pain, inject  lobe-
lia and  slippery elm into  the vagina.   If the  uterus  is
contracted into a small hard lump, lying just above the
pelvis, and the insertion of the umbilicus can be felt by
the finger, push that part back, hook the finger into the
edge  of the placenta,  or take hold of the edges of the
membranes, and bring it away.  If it refuses to come
by the use of these means, then  sit by her  side,  and
require all in the room to be perfectly still, the windows
being  darkened by  shutters, or. blankets, or some  such
articles.   Cover her warm, especially her feet and lower
limbs, put a steaming stone or  brick, or a  poultice of
slippery  elm, &c. which is  better, near the genitals, and
let her sleep if she will, and as long as she will, provided
her pulse be good.   If this sink too low, which will sel-
dom occur, wake her and give her  a little  cayenne.
When she wakes, if the placenta be in the uterus, there
will be pains resembling those of labor; if in the vagina,
there will be none  of  any importance.   In  either case,
let her rise and stand  or walk.   Or the  means may be
used, before she rises, to produce the contractions of the
             9 
130  DIRECTIONS  FOR REMOVING PLACENTA.

uterus, and of course the descent of the placenta at least
into the vagina.
  If the placenta be entirely discharged,  well;  if not,
apply the vapor bath, and your object will soon  be  ac-
complished.  If the  placenta be not disengaged from the
uterus, there will be so much pain  as  to prevent  sleep-
ing; and, of course,  she  had better rise as soon  as  she
feels sufficiently rested for that purpose, and  the  means
above directed  must be used.   1 object to pulling much
at the umbilicus, because, being inserted generally in the
middle of a thick cake, it directs the discharge in  such a
way as  to present the greatest possible resistance.   If,
instead  of  this, you  hook your fingers  into  the  mem-
branes, you will present the  edge of the placenta, and
thus really facilitate  the discharge.  In several instances,
being satisfied that the placenta was  entirely in the va-
gina, I pulled upon the cord till I felt  some of its fibres
give way.   I  desisted, and watched  the  operations of
nature.   She gradually turned the  insertion of the um-
bilicus towards one side and out of my reach, so as to
present one edge of the placenta, when the  whole was
immediately discharged without effort or pain.  A word
to the wise is  sufficient.
  As to  the  danger of leaving the placenta to be  dis-
charged by decomposition and piece-meal, it is all a bug-
bear.  While  it maintains its hold  on  the  uterus,  it
retains its vitality, and, of course, will no more mortify
that organ than  the vagina or the fallopian  tubes will.
As  soon as it, or any part of it,  loses its vitality, the
uterus  contracts beside  that  part and  casts it off.   It 
FLOODINGS.
131
now becomes a foreign body in the uterus, and, as such,
the neck and the os uteri  relax and  let it pass, as they
do  the menstrual fluid or  the grown  foetus.  All that  is
wanted is to maintain  a healthy  action throughout the
general system, and to aid it by steam, lobelia and other
relaxants, whenever it manifests a readiness to discharge
the offending matter.   For  proof of the truth of  these
doctrines, I need only refer  to the facts that many wo-
men  have carried children far, even  a  year, beyond the
time, and those children have mortified and come away,
some of them even through the walls  of the  abdomen,
without materially injuring, much  less mortifying, the
mother.
   They that fear inflammation and mortification will do
well to refuse all aid from steel, (except in cases of mal-
formed pelvis, which  will  hereafter be pointed  out,) and
even from "the rude and ill-judged manoeuvres"  of the
least "officious hands."

                      Floodings.
   I have given no directions for removing the placenta
immediately  and by force, in consequence of  floodings;
for, if the directions  I have given for the management
of delivery be  strictly followed,  floodings will  rarely, if
ever, take place; and, when they do, will be arrested in
a  very  different manner.  But  as our  friends will' often
be called  to arrest floodings that  have  been commenced
by the  bad management of others, I  will here state that
the plan to arrest them is, first, to give very  hot  medi-
cines; secondly, apply warmth  to  the extremities and
the surface generally, by  steam, if convenient,  if not,  by 
132
FLOODINGS.
bricks, &c; thirdly, if the child is delivered, give strong
injections of witch hazle tea, nervine and a little cay-
enne, to the vagina.  Should the foetus not  be discharged,
this plan would not be improper in  severe flooding.   If
the time  be come, it will produce  a separation of  the
placenta from  the womb, and of course parturition; if
not, it will close the mouths of the blood-vessels that
have been laid  open, and  stop  the haemorrhage, leaving
the fruit to ripen still longer before it falls.
  Remember, to restore equilibrium to the circulation—
that is, to relax and expand the constricted blood-ves-
sels,  and  close, with astringents,  the  open  mouths of
others, is to check ha;morrhage wherever it  takes place.
  I have said that the patient  might rise  and stand  or
walk, for the purpose of disengaging the placenta when
you  are sure that it  has descended into the  vagina.
Some may  be  frightened at  this  direction, but I can
assure them this is the way ladies  have generally done
it, in  such cases, under my management.   " When  the
uterus has been properly contracted," says Dr. Blundell,
" prolapsus is scarcely possible."  If, however, from pre-
vious disease, much fatigue at the  time,  a still  relaxed
state of the  uterus, or any other cause, she should  not
wrish to rise, she may be lifted into a chair, or raised up
in the bed, or  relieved by warm injections of slippery
elm and lobelia, where she lies,  care being taken, as  be-
fore mentioned, to protect the  bed.   Any  disposition to
flooding must be checked by taking hot  medicines and
steaming, by witch  hazle  injections  to  the  vagina, and
by slight  friction  over the region  of the  uterus, which
will cause it to contract and close the mouths of its ves- 
          FLOODINGS--PUTTING TO BED.       133

sels so as to prevent haemorrhage.  But I insist upon  it
that no artificial force be used, nor officious handling be
allowed, to  disengage the placenta, that will give pain
or distress to the patient.
  Dr. Blundell,  speaking, page 172, of the  appearance
of a placenta which had been taken away by force, says,
"Do not needlessly pass the hand into the uterus, the
vagina, or even  the genital fissure—is the voice of this
preparation; he that hath ears  to hear, let him hear it.
Ah! that violence of an ignorant  and savage hand!  Af-
ter examining these preparations, tell me, is it too much
to assert that, in obstetrics, a thrust of the hand is  more
dreadful than a thrust of the  bayonet?  Could  the field
of Waterloo exhibit injuries more dreadful than these?"
  Let it alone  till it comes away of itself.  A case  is
reported in the Edinburgh Practice, where one remained
fifteen days;  another in  the Boston Medical  and Surgi-
cal  Journal,  where  the  placenta  remained twenty-four
days.  They both came away without the least pain to
the patient.   I saw one remain six hours, another twen-
ty-one or twenty-two hours, and  then both came away
themselves;   but they generally  come away  in a half
hour or so.

                  Putting  to Bed.
  Soon after the placenta, &c. are discharged, she should
be put to bed, as it is called—that is, washed, where ne-
cessary, with warm  water,  by means  of a  sponge or
cloth; her wet clothes removed, and warm and dry ones
put on her;  a broad bandage may be put round her, and
she may be  put either into  another bed, or  a dry and 
134         LACTATION--AFTER PAINS.

comfortable part of the same.  She should also be  pro-
vided with a soft, spongy, linen or cotton cloth, of many
thicknesses, to absorb whatever may be discharged, and
this should be removed as often as necessary.   The  ex-
ternal parts should  be mollified  with sweet oil, and a
steaming brick or stone placed near  them to prevent
swelling, inflammation   and  soreness.   This  warmth
should be kept up for several hours, say six to eighteen,
or till the soreness is entirely gone.  The cloths will, of
course, be  continued  as long as  there is occasion for
them.
  She should now be fed again, and permitted to rest
and sleep as long as she appears comfortable.  The food
should be light and nourishing, and given in  reasonable
quantity.   A bowl of bread or mush and milk, of chicken
soup, &c. almost  any  thing she wants,  may make  her
meal.  If puerperal  fever  should  arise,  it comes as a
friend to tell you of a cause which you  must at once
remove by  a course of medicine.

                     Lactation.
  If the  application of the child produces  the secretion
of milk,  well;  if  not, a lobelia  and slippery elm,  or
bass-wood, linn, (tilia)  poultice, sprinkled  on  its surface
with camphor, will keep the breasts from hardening and
inflaming, and relax the orifices and let the milk escape.
It will be sure to prevent sore breasts—mark that!

                    After Pains.
  Keeping the patient warm, especially the feet and the
pelvic region, will  secure her against  after pains, puer- 
      CLEANING AND DRESSING THE CHILD.   135

peral fever, &c. in all ordinary cases.   When  these
means do  not  accomplish this  object, remember the
course of medicine.   Attend  to her  for six to ten days,
removing  at once  every difficulty, and  she will, in all
ordinary cases, be about her business.

                Cleaning the Child.
  On page 114  I have given  directions  concerning the
treatment of the child.  I here add  that you should be
careful to get  off the greasy and yet wax-like substance
that adheres to its  whole body.  Strong soap-suds will
do it; but Dr. Dewees says, that the process is rendered
easier by first  rubbing, for some time, hog's lard upon it,
then using the soap and water by means  of a piece  of
flannel or other cloth.   This should  be done in a warm
room by the fire. No  spirits of any kind should be used.
They evaporate quickly, and of course leave  the surface
cold.  But  for  their  stimulating  properties, instead  of
preventing a person from taking  a cold, as is generally
supposed, few things are so well calculated to make one
take cold.  Vinegar is  equally stimulating, without either
the poison or  the evaporating and cooling property  of
alcohol;  but neither is wanted in this  case, unless it  be
to revive the apparently sinking child, when vinegar and
cayenne  should be used, and a  little volatile  salts  or
camphor put to the nose.

                 Dressing the Child.
  In dressing  the child, Dr. Dewees  says, "Pass the re-
maining portion of the cord [left  on the child] through
a hole in the centre  of a piece  of  linen  rag, seven  or 
 136    DRESSING THE CHILD--MECONIUM.

 eio-ht inches in length, and about two and a  half broad,
 envelop it in a bandage about ten inches long," and wide
 enough to cover it all; "turn it up towards  the  breast,
 and over it the lower  end of the  first mentioned piece
 of  rao-, and secure the whole with the bandage."   Then
 dress as before mentioned, page 114.  Examine  often,
 and take care that the dead matter be removed as soon
 as it is disengaged.  If the child is well washed in  the
 groins, under  the arms, behind the ears, 6zc.  and a little
 sweet oil, or fresh butter melted and boiled till the water
 is all  out, be rubbed on those  places, it  will  prevent  all
 chafes and soreness.  Let it be repeated often, first wash-
 ing with soap-suds, then greasing.

                     Meconium.
  The first discharge from the bowels of infants is called
 meconium.  It is a too  general impression  that physic
 ought to be  immediately given  to effect  it;  and  not a
 few children  are much injured, and  many are actually
 destroyed, by treatment in accordance with this impres-
 sion.  If the  mother afford the infant milk within a few
 (say two or three) hqurs  after its birth,  that milk is best
 adapted to the accomplishment of the object.   But, whe-
 ther she does or does not, it is not necessary  nor  proper
 to give medicine to remove it, till  the child  gives some
 evidence of  suffering  for  the want  of such  motions.
 When the mother  does not  afford milk  immediately,
 other food is provided  for the chi'd, as  milk  sweetened
with molasses, the quantity of which should be increased
 till  it produces the desired effect.   A tea of white elder
blossoms, sweetened, is excellent for this purpose.   Some 
I'RIN E--F O O D .
137
use salt and  water, some  rhubarb, and some aloes.   I
object entirely to this practice.   If the discharges do not
take place after a reasonable  time, they may be  effected
by an injection of slippery  elm tea, or sweet oil, with  a
very little cayenne.   True, Dr.  Dewees says that " the
practice of purging off the meconium  should never be
neglected."   Yet, in the same paragraph, (596) he refers
to two cases, one observed by himself, in which  the me-
conium was freely passed  for many  days, though  there
was no passage from the mouth  to the stomach!   Won-
der how the meconium got away without physic!   The
Doctor, however, "protests against the  use of any acrid
purgative  for this purpose."  The worst that he recom-
mends  is a tea-spoonful of castor oil.   But he adds, (sec.
600,) " Oftentimes much mischief arises  from  over-purg-
ing newly-born infants," &c.—and here I am  happy to
agree with him.
                       Urine.
  It is  also necessary to attend to the discharge of urine.
If this  be suppressed,  or  too scanty, the  bladder will
swell, and the child will suffer.   A little strong tea of
clivers, sweetened with  molasses, and  keeping the  parts
warm,  prevent costiveness  and the suppression of urine.
If the urine be much accumulated before it is discovered,
a lobelia poultice and a steaming brick to  the genitals,
will relax  the strictures  and allow it  to pass; and keep-
ing the parts warm  and moist will prevent a recurrence.

                        Food.
  Doubtless the best food for the child, when the  mother
does not supply it, is milk, warm from the cow, when it 
138
FOOD FOR  THE CHILD.
can be had so, and a little warmed when not; and here,
again, as it is a little more astringent and not so sweet
as that from the human breast, it is proper to add a very
little molasses or brown sugar, to  prevent it from pro-
ducing costiveness.   Give a very small portion at a time,
three to five or six tea-spoonsful at first, and repeat it in
an hour or two, but not so  often or abundantly as to
make  it  "run  over."   Nurses are apt to feed  them  a
great deal too much, and to  give them bread, crackers,
or other articles besides the milk, which are very impro-
per.  But  the  child should  be put  to the breast often,
and, when the milk flows freely, no other food should be
given.   Let the child be put  into a cradle or crib, and if
it cries do not take it up and stuff it with food and shake
it about, but examine carefully whether some of its pins
or bandages are giving it pain, and  if not, and  you are
sure that it cannot be  hungry, (it  should never be  sur-
feited,) let it  be.   A  piece  of gauze should be spread
over the top of  the cradle or crib, not its face, to keep
the flies from annoying it. 
GENERAL  PRINCIPLES.
  I am here compelled to refer again to the  principles
(see Introduction) by which we are guided in  the man-
agement of women  and children, before I can  so well
point out the proper ways and means of applying those
principles to every given case.   We base all our  medi-
cal practice,
  First—On the self-evident proposition  that,  as the fe-
male frame is wisely adapted to the performance  of all
the duties which will  ever  be incumbent on  it in  the
course of nature, so,  in all our medications, &c. we are
to aid when present, and imitate when wanting, these
several  operations, and to depart from these  principles
only so often and  in such  cases as  we  find that, from
some  casual obstruction of the proper growth,  there
was a manifest  departure from the course of these gen-
eral laws in the original structure  of that frame; and
then our operations must be precisely those that are cal-
culated, as far as possible, to remedy the  defects  of such
a structure.   For example:  In all cases  of well-formed
pelves, we believe  that a female may be, and ought to
be, safely delivered of her  offspring, without  any other
aid than that of keeping  her system free from obstruc-
tions and strengthening her  for  the  performance of her
duty; that artificial  intermeddling here, farther  than to
change her position so as to give a  proper direction to
the foetus, is in all cases reprehensible;  but that, when 
140           GENERAL PRINCIPLES.
the pelvis is so dwarfish or distorted as  to present insu-
perable obstacles  to delivery, then embryotomy or  the
Caesarian operation may be justifiable.
  Second—That all vital action is friendly to health, and
not to be opposed;  but that any irregularities in this
action are indications of the  presence of obstructions or
causes of disease,  (in different  degrees,) which must  be
removed.
  Third—That all disease  is caused by obstructions of
some kind  to  the  full, free and universal operations of
the living principle, and is itself, in essence, the incapa-
city or inability of some organ  or  organs to  perform  its
or their  duty.
  Fourth—That these causes of disease must be remov-
ed by supplying  the living machine with those substances
or medicaments, and aiding it by  those processes, which
it is pleased to make use of in the accomplishment of its
object.
  Fifth—That the intention  of  the system,  in  every ef-
fort to remove  disease, is, to remove  the obstructions,
generally;  first, by relaxing itself,  and, secondly,  by
stimulating the vessels to an unusual  degree  of action,
and, thirdly,  by restoring  the  organs  to their original
tone, texture  and  equality  of  action,  or by renewing
their connexions where they have been separated.
  Sixth—The obstructions to vitality are substances  ar-
rested in the capillaries, filling them up; contractions of
those vessels by irritation; substances relaxing them by
opposing the action of the proper  nerves, and mechanical
or  chemical  lesions of the  organs, as  wounds, bruises,
ulcers, corrosions,  &c. 
           WAYS AND MEANS--LOBELIA.       141

               WAYS AND MEANS.
   In the first, second and third cases, which may be ex-
emplified  by the condition of the  skin in  fever, after
taking a sudden cold, or the state of the stomach when
cramped, or of the bowels in constipation, or when the
capillaries are filled through the whole system, as is often
the case in jaundice and  bilious  fever, the means of re-
moving them evidently are, first,

            Relax  the parts obstructed.
   It is well known that a comfortable degree of warmth
and moisture are the most natural, direct and convenient
means of relaxing all animal bodies.   Hence, when the
stomach,  bowels, skin,  or any other part  of  the
system, is unduly contracted, cramped or collapsed, the
application of mere warm water will afford some relief.
If that water be in a state of vapor,, it will do  still  bet-
ter: hence the vapor bath and steaming stones or bricks
are better than baths of warm water, &c.  If materials
that possess the power to relax the system, by merely
quieting the irritation of the organs, without in  the least
injuring their power to react, (such as lobelia, nervine,
boneset, &c. &c.) be added to the warmth and moisture,
the effect is still greater.

                      Lobelia.
   The true therapeutic action of lobelia, I think, is not
generally understood.  Most persons are under  the im-
pression that it is the  principal  agent  in producing the
action  which we call vomiting.   But this must certainly
be incorrect.  All practitioners, regular and irregular, 
142      LOBELIA--ALARMING SYMPTOMS.

who habitually use it, agree that its  effect  is anti-spas-
modic, as  it  instantly relieves  spasms, fits,  lock-jaw,
cramp, occ.  and relaxes contracted  sinews.  But it  is
also agreed that vomiting is produced by muscular con-
traction either of the chest, abdomen or stomach, or all
combined.   If this were the effect of the irritation pro-
duced by lobelia, that article would not be, as it certain-
ly is, a sovereign remedy for spasm.  But, one will  say,
"How7 do you know that lobelia does not, like cayenne,
produce alternate relaxation and contraction, perhaps by
different  properties contained in it, that act at different
points of time?"   I answer: I know  it by the fact  that
the more vitality in the system  the less the relaxation,
and  the  more speedy and  effectual  the vomiting after
taking lobelia;  and that,  on  the other hand, the  less
vitality in the system the greater is the relaxation  and
the feebler the reaction; and further, when there is little
vitality, as when the patient is  dying, there is no reac-
tion at all.

                Alarming Symptoms.              v
   In what are called " the alarming symptoms," there is
so little vitality that the relaxing power of lobelia com-
pletely overcomes the  reacting  powers, and the only
reason why death  does not take place, is, because lobelia
does not injure the organs, by destroying the  sensibility
or stopping  the circulation, but only overcomes,  in a
greater or less degree, during the period of its  own in-
fluence,  the  disposition to reaction.  The nearer the
reacting  power of the system is to  an equality with the
relaxing  power of the lobelia,  the  greater will be the 
ALARMING SYMPTOMS.
143
struggle and alarm.  As the effort of the system is now
to recover its tone, giving  cayenne and astringents will
aid it in producing the reaction that constitutes the vom-
iting, which, if free, always relieves the patient.   Giving
more lobelia throws the scale  the other way, and makes
him quiet a while longer.  Letting  him  entirely alone,
the lobelia, after  some time, loses its  power to  act, and
then  the reactive energy of the  system  meets  with no
resistance, and recovers the condition of  its organs  as a
matter of course.  When there  is no disease—that is,
debility  of the  organs—the  lobelia  has not power to
relax the system much, and hence there is  no room for
any remarkable degree of  reaction, and of course  there
is little or no vomiting.  " But," says one, "are you sure
that  lobelia possesses  no  other control over the living
body than simply to relax its  several organs?" I answer:
not quite sure;  but am perfectly  convinced that, if it
have fifty other influences, this one of  relaxation so far
predominates over them all, as to throw them  entirely
into the  shade.   "But is not  lobelia a sudorific?"   Yes;
but its  mode  of producing  this effect  is by  relaxing,
through nervous action,  the contracted mouths of the
emunctories  or  pores  of  the skin,  and  letting off the
portion  of the  blood  called  perspiration.   It  also pro-
motes the secretion of bile  and urine, by relaxing the
vessels whose unnatural constriction is the cause of the
retention of these fluids.
   The object in  giving here  these  facts, arguments and
illustrations of the modus operandi of  lobelia, which are
more extensively considered in my "Lectures on Materia
Medica," is to  establish the point that lobelia is to be con- 
 144   LOBELIA A  RELAXANT--TREATMENT.

 sidercd,  at  all times, and under ail circumstances, and
 wherever applied, not only a pure relaxant, but the most
powerful and innocent yet known.   I wish this point  to
 be well settled, for, if it be proved true, it at  once puts
 to  flight, from  obstetrics,  the  use  of instruments, and
 even manual  force,  in  every case  except, perhaps,  the
 very few patients whose pelves are known to be remark-
 ably deformed by rickets or some other unfortunate cir-
 cumstance.

                     Treatment.
  I must not leave this article without repeating the re-
mark that, though giving more lobelia, during the arlarm
produced by a course, will check the struggle of the sys-
 tem for a while, yet  it  rather prolongs  the  duration  of
 the  condition.  Sweet  milk or sweet oil will, by com-
bining with it, check the action of what is already taken,
and a dose of cayenne and strong  bayberry or  other
astringent, will aid the vital energies in producing the
reaction  or vomit, which puts a period to  the  whole
transaction.  I must also  remark,  that, when lobelia
cannot be had, other articles, that are known to act like
it, must be used in its stead.  Thoroughwort is an excel-
lent article, but it is not, like lobelia, a pure relaxant.
The therapeutic  principle of a true emetic  must  be,
speed in relaxation,  great volatility, and incapacity  to
injure the vitality of the organs on which it operates.
Such is that of lobelia.   It is like the power that pulls a
bow-string: it strains the bow quickly, and as suddenly
lets it go; thus allowing it to recover its condition with-
out injury to its elasticity.  Did it act slowly, the tone 
      LOBELIA  A RELAXANT--TREATMENT.    145

of the system would gradually give way to it, and suffer
the encroachment to proceed without an effort at reac-
tion.  Did it not  cease to act suddenly, the  reaction of
the system also would  be gradual,  and would produce
no vomit.  Did it continue its power over the organs a
great length of time, they, like the long bent bow, would
lose their elasticity altogether.  Such are poisonous re-
laxants.   They either break the bow at once, by over-
straining, or they relax it so gradually as to  excite little
or no resistance,  (as tyrants fasten their chains on  their
subjects,) or else  they retain  their possession till all the
reacting power is destroyed.
   The emetic effect of copper and zinc, is the resistance
the  system  makes to  their introduction into it, as its
greatest enemies to healthy  action.   They threaten
" suddenly and rapidly  to extinguish the vitality of the
system,"  in  exact proportion to the quantity given.—
See Bost. Med. Sr Surg. Jour., vol. 9, p. 43.
   The administration of lobelia, &c. in warm teas, either
internally or externally, (in the  last  case it may be com-
bined with  poultices, slippery elm, oil, &c.) is the  best
means yet known to relax constricted or obstructed vital
organs;  and the more directly we can apply  these means
to the parts affected, the  more  speedily and effectually
shall we  accomplish our object.  It will depend  upon
the circumstances of the case, how long we wish to  con-
tinue this relaxation.   The  means  must, of course, be
used as long  as  we wish the effect to  continue—as in
fever, moderate steam and bland drinks should be  con-
tinued till perspiration is free; so,  in  cases of parturi-
tion, a lobelia liniment  should be used, and fomentations
              10 
 146          STIMULANTS--CAYENNE.

 or other applications of warmth and moisture, should be
 kept about the parts to be relaxed, till the end is accom-
 plished.   In cases of local inflammation, tumors, ulcers,
 &c. these relaxant properties  should  be  combined  in
 poultices, which should be continued till the end is  ac-
 complished.  By the  administration  of articles  which
 soothe the action  of the nerves, the constricted vessels
 are enlarged, and the fluids combine with and attenuate
 and dissolve the morbific materials that obstruct the pas-
 sages ; and now, the next step is to

   Stimulate these vessels to a  healthy action.
  For this purpose  the acrid principle  of cayenne, in
 combination with a suitable  portion of heat, is the best
 means yet known.  Any other stimulant that is perma-
 nent and innocuous—that is, that will excite the organs
 to action without exhausting their power too suddenly,
 or depriving those organs of the power to  react as well
 as before—may be combined with the cayenne, or used
 instead of it when it cannot  be had.   The specific action
 of cayenne is evidently in perfect harmony with the op-
 erations of the living power—that  is, when the  action
 is too low, cayenne will raise it; when congested, it will
 extend its influence through the nerves of the  circula-
 tion,  till  that action  is equalized.   Therefore, whether
 cayenne find  the system, or any organ  of it, too much
 relaxed or contracted,  its  power to excite the living
 principle,  and, of course, organic action,  is  adapted  to
 bring the  living organ from  either extreme to a healthy
state.  The stimulus of cayenne, then, in a morbid con-
dition of the body, or any part  of it, aided by the  me- 
STIMULANTS--CAYENNE.          147
chanical structure of valves, is calculated to push all the
circulating materials forward through   their destined
course.  If applied to a relaxed stomach that is full of
fluids, it produces  vomiting;  if to  the  bowels, in the
same condition, dejections;  if to the skin, when the sys-
tem  is full  of fluids,  perspiration; and, lastly,  (which
comes  more  particularly under our  present  considera-
tion,) if given to the stomach, (between which and the
uterus there is an  intimate  nervous connexion,) at the
time when that organ is disposed, but  unable, through
weakness, to expel  its burden, and also, if rubbed lightly
on the abdomen, it will wonderfully  aid in  facilitating
parturition.  There is, on  this very account, no one
article in  the  materia medica, so  universally applicable
in all cases of disease, as  cayenne.  I can conceive of
but two states of the living body in which its internal
use is injudicious; one  is,  when  the  skin alone  is ob-
structed, and a consequent fever pervades the whole  in-
ternal man, (rather a rare case, and, when it occurs, to
be cured by  a plenty of bland fluids and steam;) and
the other is, when the patient is, in all respects, in per-
fect  health, when its use would make him wear out his
system too fast.  Cayenne  is not directly injurious, like
brandy and other poisonous stimulants,  because, first, it
does not suddenly raise  the action to an excessive de-
gree, and  then let it as suddenly sink  under consequent
exhaustion.   It continues the irritation for a great length
of time, which so  recruits  the debilitated organs  as to
enable them to retain their power and  sensibility after
the cause which arouses them to action is  discharged
from  the  system.   Second—It never destroys,  as  do 
148
STIMULANT S--C A Yfi N N E .
opium, nitre, digitalis, mercury, &c. the  power, capabil-
ity or fitness of the organs for vital action, but rather
renders them more susceptible to that action.   It is uni-
formly, universally true, that  the more opium, nitre, or
mercury you give a patient, the  less vitality  there will
be in his physical organs, till paralysis, apoplexy, or ana-
sarca, &c. close the scene; and it  is equally true, that
the longer you  give a patient  cayenne, the better  effect
it has upon him, and the less he needs, till he gets entire-
ly well and needs it no longer.
  If cayenne be introduced rapidly into the  system, it
will produce momentary pain, by exciting the stomach
before  other parts  relax;  but, if gradually introduced,
and the outlets of the system  be  kept free, little incon-
venience can be produced by giving it even in very large
quantities.   But for its extremely pungent, and, to some,
(especially infants,) very disagreeable taste, and also the
impossibility of always getting enough of it in its purity,
we might safely rest satisfied with it in  all cases where
a natural stimulant is required.  Various other  articles,
however, as ginger, xanthoxylum,  snake-root, &c. may
be used as substitutes when pure cayenne cannot be had,
or when its  taste is peculiarly disagreeable.
   Cayenne, then, should enter into the composition  of
all those articles which are intended to excite  the sys-
tem, or any organ of it,  to  a natural  action.   "Why
then," says  an  objector, "if cayenne always  stimulates
the system in the same way, do you prescribe it both to
prevent  abortion  and to  promote  parturition?"   I an-
swer again, cayenne always stimulates  the living organs
to  act in harmony with the  living intention.  Now, it 
C A Y E N N E--L O B E L I A .
149
happens that abortion is threatened by accidental con-
tractions of the uterus, (by cold, fright, &c. or by a par-
tial disengagement of the placenta, occasioned by exces-
sive labor, walking, fatigue, &c.) during  a period when
the natural disposition of that organ is to expand to  ac-
commodate the growing foetus; whereas, in parturition,
that expansion having been carried to the utmost extent
of the natural law, the disposition  of the organ now is
to  contract and  expel the full  grown foetus.  If, then,
cayenne aids the  intentions of nature, it must, of neces-
sity, both prevent abortion, by removing the cold or ob-
structing fluids,  and allaying  the irritation  caused by
fright, &c.  and  promote  parturition  by enabling  the
uterus to  detach itself  from the  placenta,  and  expel
from its  cavity that which, like ripe fruit, has no longer
any need of nourishment  from  the parent stock.  Can
we place too high a value on a  medicine which almost
supersedes the necessity of the administrator's knowing
much more of the condition of the patient than simply
that she is sick?
   Some  suppose  that lobelia is the most important arti-
cle in the  materia  medica.  In this  opinion I  cannot
agree; for,  though I  admit that there  are  some cases
that cannot be cured with cayenne without lobelia, yet
I am sure there are more that cannot be cured with lo-
belia without cayenne, or something that will serve as a
substitute.
   Indeed it may  be  said, that, while  cayenne is proper
in every form of disease, (except the one just named,) it
may as  truly be  said  that lobelia  is  proper in only one
form of disease, and that is where  relaxation is necessa- 
150
CAYENNE AND LOBELIA.
 ry.  (See remarks  on Lobelia, supra.)  We would not
 give lobelia to contract a muscle after we had relaxed it
 to set a bone; to restore  the tension of the viscera after
 we had reduced a hernia or a prolapse;  nor would we
 give it to a patient to restore the strength after a course
 of medicine had removed  the  cause of his  weakness.
 But cayenne is not only invaluable in all these cases—it
 is even so in aiding  lobelia in  all its own appropriate
 spheres, as in removing a fit and reducing a lockjaw, &c.

            " For all its various virtues to relate,
            Would tire e'en Fabius, with eternal prate."

  "How, then," says the objector, "does lobelia always
 harmonize with  the living intention, if its sole  power  is
 exerted in relaxation?  Surely we  do not always  wish
 to be relaxed!"   I answer: Lobelia is a medicine.  We
 do not recommend  it as  a  food.  As a medicine it  al-
 ways acts according to a  certain intention, viz.  to relax.
 When a patient is  sick, there is always some morbific
 material (as canker)  or contracting influence (want of
 heat) in the system, which it is the intention of the liv-
 ing power, the vital energy, (vis vitae,) to remove.  But
 this morbific matter, or the  cold fluids, cannot  be remo-
 ved till the vessels in which they are lodged be relaxed.
 Therefore lobelia acts in harmony with the intentions of
 the living power, aiding her in the  first step to  remove
disease.  Were  lobelia able to entirely  overcome the
living power as opium does, or to destroy the  capacity
of the  organs for action,  by continuing  a deadly grasp
upon them as mercury does, it would be a poison, like
them; but it  only relaxes  the organs—that is, takes  off 
                CANKER MEDICINES.            151

their tension till they rest awhile—to recommence their
operations,  in  a short time,  with  redoubled  energies.
Glorious medicine!   It acts in perfect harmony with the
living intentions.   But he must be a sad blunderer in
therapeutics, who  gives it for  any purpose except to
relax  the vital organ or organs to which he applies it.

                 Canker Medicines.
   In addition to cayenne, we have several  articles  that
are calculated " to scour the stomach and bowels, and to
remove the thrush" or canker from  the system.  From
what I have said of the relaxing power of lobelia,  the
stimulating principle of cayenne, and what I shall  pre-
sently say of the tonic power  of bitters, &c. the reader
will perceive that all the intentions  of the living princi-
ple, in the restoration  of health, are fulfilled by the arti-
cles above  named,  and, perhaps, be at a loss  to know
what peculiar office I shall assign  to the articles that are
said to  be  "good  for canker."   In elucidation of this
subject,  I remark,
   It is well known  that the effect of introducing canker
medicines into the  system, is " to stimulate the glands,
to cause the saliva to  flow freely," to detach the  thrush
from  the mouth, and to  promote  secretions  wherever
their influence extends.   Now, it  is  very  certain that
neither saliva  nor  any other secretion  can flow freely
till the vessels from which it is secreted are first relaxed
to permit the discharge, and then stimulated to reaction
to aid the valves in pushing along the fluids  to the places
of their destination.  It is  this alternate relaxation  and
reaction, aided by the fluids thus put in motion, that dis- 
152
CANKER MEDICINES.
engage  the  canker or thrush from  the parts on which,
or the  pores  in which, while inactive, it settles, and  to
which it adheres.   It is, therefore, demonstrated that the
canker medicines possess a compound character,  com-
bining  the relaxing properties of lobelia with the irritant
properties of cayenne.   The  astringency  of some,  as
witch hazle, sumach and raspberry, and the bitterness  of
others, as hoarhound, wormwood, tansy, camomile, bit-
tersweet, &c. prove that they might, also, with much
propriety, be placed among the class  of tonics or resto-
ratives.   It is important to remember these facts, as they
show why it is that the  canker medicines generally are
so efficient in removing disease and  restoring a healthy
condition of the organs, without the aid of either lobelia
or cayenne.   They carry on gradual]},at the  same time,
all the  operations of a full course of medicine.   These
facts also prove, what all experience confirms, that cay-
enne itself is the simplest and most  efficient of all the
canker medicines.  It has been supposed that roughness
is essential to a canker medicine, but this cannot be cor-
rect, as some of the  roughest articles, when  chewed,
"leave the mouth dry and parched."
  It may be asked, then, " If cayenne is the purest and
most efficient canker medicine  known, why not depend
on  it altogether  and seek no other?"   I answer: the
chief value of canker medicines depends on the  acrid
properties they possess, which are  calculated to excite
the living action.   These  properties  are various, stimu-
lating the organs in different ways;  the  effects of some
being very disagreeable, as those of cayenne, xanthoxy-
lum, gum myrrh,  <kc; those of others very agreeable, as 
                CANKER MEDICINES.            153

the juice of a delicious apple, of an orange, and of vari-
ous other fruits.  Other pungent articles may produce
all  other  imaginable  sensations, between  the  most  de-
lightful  and the most disagreeable.  It is  our duty, as
well as  our pleasure  and our  interest, to select, out of
this vast multitude of irritants, those which will produce
the best effects with the least unpleasantness in  the  ad-
ministration.  These  will be different for different per-
sons, and in  different states  of the same body.  Of
course,  if a patient has a peculiar dislike  to the  taste or
mode of operation, resulting from the administration of
one kind of canker or  stimulating medicine, we should
try another, which may be  less objectionable and equal-
ly «useful.
  On this principle we administer, to infants  and weak
patients, ginger  instead of cayenne; raspberry or witch
hazle, or tea of  dried apples, instead of bayberry: pop-
lar  bark tea, sweetened with molasses, instead  of com-
mon bitters.
  Many substances, very agreeable to the taste, as dried
apple tea, molasses and vinegar, &c. will cause  the saliva
to flow as freely as cayenne.   These should,  therefore,
be  chosen instead of that  article, when the  object is
merely  to keep the  mouth moist and  to slake thirst.
The fact that an article  produces a most powerful and
disagreeable sensation, is not proof that  it is  the most
effectual in the  cure  of disease.   Witch  hazle tea pro-
duces a pleasant effect on the organs to which it is  ap-
plied, yet  no  article  excels it in closing the  relaxed
mouths  of vessels.  So sage,  pennyroyal,  catnep and
balm, all pleasant  to the taste,  are as good sudorifics, in 
154         RESTORATIVE MEDICINES.

ordinary cases, as cayenne;  and clivers is as good a diu-
retic as tansy.  Moreover, judicious combinations of the
most pleasant with the more acrid articles, will so mod-
ify the latter as to render the whole unobjectionable to
the taste, while the combinations themselves will  be far
more efficient in the removal of disease in general than
even the most efficient simples when used alone.
  Another important property of  the  canker  medicines
is the astringent and  antiseptic  influence of  the tannin
they contain.  This  principle  coagulates the  phlegm,
renders it thick and ropy, and thus greatly facilitates its
entire removal; while, by its stimulating power, it keeps
up such an action in the  system as to remove all mor-
bific agents from  the body before  they produce inflam-
mation and gangrene.

                    Restoratives.
  It now remains to consider the last class of remedies,
which  I here call restoratives.   Many of them  are  bit-
ter, but they are not all necessarily so.  It is  important
in the  restorative process, not only to  furnish  the  bitter
principle, but to keep up the reaction in cases of relaxa-
tion, as after diarrhoea—and the relaxation in cases of
too much tension, as after costiveness.  Hence we need
some restoratives to furnish the  bitter principle, as bal-
mony; others to contract relaxed  organs, as  the astrin-
gent articles, raspberry, witch hazle, birch, cherry, oak,
&c; and yet others to relax constricted organs, as but-
ter-nut, bitter-root, and the like: and we often want the
combination of them all with the stimulant property of
cayenne.   This demand for general remedies, in almost 
RESTORATIVE treatment.       155
 all cases  of sickness, has stamped such a  permanent
 value on  the "composition  powder," which combines
 almost all the properties wanted in the healing process.
   I may close this article as I did the last, with the re-
 mark that restoratives the most disagreeable to the taste
 and in their effects, are not necessarily the most efficient
 in the cure, and that a judicious combination of the sev-
 eral articles demanded by the  given  case, will be both
 more pleasant and more  salutary, than the most irritat-
 ing simple, unmodified by the more mild.  I account for
 the fact that they are more salutary, by  supposing that
 their  different properties may stimulate different organs,
 or the same organ in  different ways, and that they may
 also  supply some of  the  materials whose deficiency  in
 quantity or in aptitude for vitality may be the  secondary
 or proximate cause  of the disease.
   The fourth condition of the body, organic lesion, comes
 rather under the head of restorative treatment than the
 removal of disease, inasmuch as  the business of the prac-
 titioner is  rather to  aid  the living power, and  protect
 and supply the organs  with  whatever  materials  they
 want for  the performance of their own duty, than  to
 remove by art any obstacle to their operations. If, how-
 ever,  the lesion be a fresh cut, we can often so unite the
 parts  as to give efficiency to the tendency of the organs
 separated to re-unite, and the  permanent restoration  of
 the connexions is almost immediate.  In cases  of bruises,
 ulcers, &c. we must  aid  the vis vitae, by keeping the
whole system clear  of obstructions, protecting the parts
from atmospheric action  or other injury,  and sustaining
 the action of the organs  at the healthy standard. 
156
COURSE OF  MEDICINE.
  Having exhibited the intentions of nature in  her at-
tempts to remove disease, and described the character of
several articles wrhich are calculated most effectually  to
aid her in the accomplishment of those intentions, I  now
proceed  to show how  these  agencies  of  art  may be
brought to bear the most speedily and effectually in the
removal  of the most various, complicated, powerful or
inveterate causes of disease.   In  other words, I  shall
give what I conceive to be a good example of the mode
and means of administering what is commonly called

              A Course of Medicine.
  As soon as you determine on giving a course of med-
icine, in  a cold, languid,  debilitated  and chronic  case,
give a tenth of a tea-spoonful of cayenne in a little milk,
honey or molasses,  to  commence raising the action  of
the system.  I always carry in my pocket a vial of cay-
enne and molasses, or some kind of hot syrup.   It  is an
excellent article  for  this purpose, and to cure  pains  in
the viscera, relaxes and slight colds, and to  convert the
enemies of the practice.
  Put into the fire a dozen half bricks, or as many rocks
about their size.   Into a two quart pitcher put an ounce
or a very large  table-spoonful (heaped as high as you
can) of canker powders, or of composition, a tea-spoon-
ful of nerve powder and an ounce of brown sugar.  Mix
them well with a spoon, pour on a quart or three  pints
of boiling water, and stir it up  till the powder is  well
wet.  After it  settles  a little, pour out a tea-cup half
full, dilute it a little with cold water, and, if composition,
give it: if canker tea, add cayenne enough to make it as 
course of  medicine.
157
hot as  composition would  be, and then give  it.   Pour
out another cup full, and set it upon the table or win-
dow to cool.  Pour out half a cup, and put into it cold
water  till it will  not  burn your  mouth; add  five tea-
spoonsful  of lobelia  (powdered  herb,) or three of the
seed, and let it stand where  it will  keep warm.   Pour
off another tea-cupful of the tea, put in a tea-spoonful of
cayenne, another of lobelia seed, and another of nervine,
and let it  stand by the fire to keep warm.  Give  the
second cup of tea about  five to ten minutes from  the
first, and get your steam apparatus in readiness.  Pour
out another cup, put  into it a quarter of a  tea-spoonful
of  cayenne, and  give  it  about  ten  minutes  after  the
second cup.  Prepare also a quart  or  more of penny-
royal,  sage, catnep or peppermint, or some other plea-
sant tea  to  drink during steaming, and also during  the
operation of the emetic, when the canker tea is particu-
larly disagreeable.  By this time the steam  should  be
ready.
   If the bowels be either constipated or much relaxed,
obstructed or cold, or there be pressure  to  the head or
lungs, an injection of  the canker tea, with cayenne, slip-
pery elm and a little lobelia, should be administered be-
fore getting over the steam.   This plan is always  good,
as it tends greatly to  equalize the heat of the body, and
prevent the unpleasant sensation  of fulness in  the head
and chest, often experienced during steaming.   It  is also
an excellent plan  to wash the feet  in water, scrape  off
 the dead skin, throw away the dirty water, and  fill up
 the vessel with clean, as hot as it can be borne, to keep
 the feet in  while  steaming. 
 158    course of .medicine--steaming.

                      Steaming.
   Put two strips of  board,  about two inches  wide,
 across the top of the largest wash tub  about the house,
 in such a manner that you can set an open, flag, or split-
 bottom chair upon  them, with the back  feet  directly
 over the edge of the tub.  Put into the tub a common
 wash-basin, or other small vessel, and then place the pa-
 tient upon the chair, covered only with a blanket, pinned
 round  the chair and  tub so as  to exclude all the air, ex-
 cept from the face.   As soon as she  is seated, open  the
 blanket a little at the bottom, and pour into the basin,
 from a tea-kettle, (which must always  be ready,) about
 two or three quarts  of boiling water.  Now give  her a
 little more hot tea, and take, with  the tongs, a  brick  or
 rock from the fire, put it partly into  the water, but still
 hold it fast (resting the tongs on the  edge of the tub) till
 it is so much cooled, by gradual depression into the wa-
 ter, that it  will  not make too much steam, when you
 may let  it entirely  down into the basin, and  leave it
 there till it ceases  to  make steam  enough, when you
 should take  it out of the  basin and leave it in  the tub,
 on the side where the patient feels the  coldest.   Give a
 little tea of some sort, with cayenne  if necessary, every
 time you change a brick.  Take another brick  and  use
 it as you did the first.  If sickness at the stomach occur,
 the patient's face being red, her muscles strong and body
restless, give a little tea with cayenne, dash  a little wa-
 ter suddenly in the face and on the breast, and she will
 soon vomit and be relieved.   If faintness, weakness and
 paleness  occur, lower the steam by removing the stone
and opening the blanket about the neck, and dash  the 
        COURSE OF MEDICINE--STEAMING.     159

face, and if necessary the breast, with cold water;  and,
if this is not sufficient,  take hold of the back of the chair
and  pull it back, (seating yourself in another,) till the
head is at least as low as the pelvis, and retain  her in
that position, giving warm teas, and occasionally sprink-
ling  the face suddenly with cold water, till she recovers
her  strength, when  she  should  be raised up again and
the steam applied till she gets warm.   I have sometimes
held a  patient  in  my lap and arms in  this way two
hours, letting pass under the  blanket, from a pipe, just
steam  enough  to keep  the air warm about  him.  He
would be as cold as clay the whole time, and unable,
through weakness  and chilliness, to lift  a hand to his
head, or, many times,  even to speak, till  the cold fluids
were all  expelled  and the heat  pervaded  the  system,
when  the strength  would return, and he would sit up
and receive a fine steaming, during which he would be
very amusing in conversation.
   1  never measure  my steaming by minutes and hours.
The object  of  steaming is, in cases  of cold and conse-
quent fever, to open the pores and let out the cold and
dense fluids.  In patients filled with  cankery fluids, it is
to carry out the virus that may be afloat in the  system
at the time, and to  excite the  skin to action by the stim-
ulus of heat.   The first will  be accomplished when the
patient sweats freely all over, and her flesh is hot, par-
ticularly on the knees and the tops of the feet just back
of the toes.  The second should be continued as long as,
by giving freely of the pleasant  tea before mentioned,
with occasionally a little cayenne, she can comfortably
endure it.   During the latter part  of the  steaming, let 
160     COURSE OF  MEDICINE--STEAMING.

an attendant  wash  clean, with soap-suds and  a cloth,
every part of  the body, to get away all the dead skin,
the dirt that is  loosened, and the morbific matter that
wras  disengaged, that it  may  not be  absorbed  again.
This is very  important.   After the washing, close the
blanket, put in a hot  rock, give a little  hot tea  to raise
the action pretty high, and then dash with  cool water,
rub dry and put on the under-clothes, and  help,  if neces-
sary, the patient into bed, and put a  steaming stone or
jug of  boiling water  to the feet.  Give another cup of
tea, and soon  after a cup of the  emetic first prepared.
After ten  minutes, at most, whether the patient pukes or
not, give more tea, and, soon afterward, as much  more
of the  emetic as you can pour off clear from the powder.
Now follow up  with  teas every five minutes or  so, (put-
ting into the pitchers more boiling water when  necessa-
ry,) till she has puked at least once freely.   Fill up the
cup  of lobelia with  tea  again, and, after it has stood
awhile, strain  and press it.  Continue the teas, using the
tea of lobelia if necessary, till  the  stomach is  settled,
making them as  stimulating as the case requires, and
adding a little pearlash, sal aeratus or carbonate of soda,
(the  size of a large pea of the first is the best,) whenever
there is acidity on the stomach, and rubbing the surface
dry often if the perspiration is continued and profuse.
   It must not be forgotten to keep something warm at
the feet;  a gallon jar or other bottle  of boiling water is
an excellent article, much better than  steaming stones,
except in cases  of burning fever.  It is more equal, will
last ten times as long, as  is every where convenient.   If
the patient is very sick, full of tea, and cannot  vomit, 
       PORTABLE STEAMING APPARATUS.     161
                  «
give her a  table-spoonful  of the liquid out of the cup
containing lobelia, cayenne and nervine, and this will do
the work.   If her stomach is  cramped, give a cup  of
weak lobelia tea.  If it burns, give some sweet milk  or
milk porridge.  Continue the process, especially the can-
ker tea and  cayenne, till the stomach appears  free from
morbific matter and settled—in  all weak, chronic  cases
using porridge freely after the first thorough vomiting.
  It will often seem as though  the stomach were  sick,
when, in fact, the disagreeable feeling is caused by mere
emptiness, and will be removed  by a tea-cupful of por-
ridge.  If the stomach refuses to settle, give an  injec-
tion, and the patient will either  get better or puke.  If
she sickens  and  does  not  puke, give tea and  cayenne,
and rub the gastric region.  If one course does not ap-
pear to give essential relief, give another after an  hour
or two.  Keep up the action and advantage  gained, by
stimulants and tonics; and, while the  patient improves
fast, courses are not necessary;  but if she sinks, repeat
the courses.  Wherever it can be had, a steam-pipe and
stop-cock connected with a boiler, is much better  than
rocks and bricks, as it is far easier to use or to regulate.

          Convenient Steaming Apparatus.
   A convenient apparatus for steaming may consist of
eight or  ten pieces of tin or copper pipe, from a half to
three quarters of an  inch in diameter, so constructed
that the  small end of any one piece will just fit into the
large end  of any other.  Two  of the  pieces should  be
knees extending about  an inch each side  of  the joint,
two inches  long in the whole, and  making an angle of
              11 
162     PORTABLE STEAMING  APPARATUS.

one hundred and thirty-five degrees, or a right angle and
a half.  Take a common brass stop-cock, drive out  the
stopper and saw it with a key-hole saw from one side of
the hole down to  the lower end;  saw oft' the other side
at the top of  the hole, smooth the remainder  and put it
back again, but do not fasten  it.   Let the coppersmith
or tinner  solder a tube, an inch  or an inch and a half
long, to the small circular projection directly below  the
stopper, the lower end of  the tube being  rather smaller
than the upper.  Let now a thick copper plate be  made
in circular form, large enough to cover the top of a large
tea-kettle; bore a hole through the centre one-fourth of
an inch in diameter, and make a screw three inches long
with a high flat head and a flat smooth shoulder to cover
the hole.  Make a flat iron bar, half or three-quarters of
an inch wide, one-fourth  of an inch  thick, and just as
long as  the diameter of the copper plate, and cut a hole
in the centre  to fit the screw.   Now make  a hole in  the
copper  plate, an inch from the central one, to fit  the
tube that  is soldered on  the under side of the stop-cock;
put the screw through the plate, and just insert it into
the bar below; then put the bar  into a tea-kettle,  lift it
till it touches both sides, and turn the screw till it brings
down the copper plate  close  to  the top of  the  kettle.-
To make a good fit, the plate should be bound round the
edge with a strip of cloth an inch and a half wide, with
fine  twines so run along its edges as to tie above and
below the plate, and draw them like the lining of a hat;
or it may be made of two circular pieces sewed at  the
circumference and the centre cut  out.  Put the tube of
the stop-cock through the hole  of the plate, and fit  the 
STEAMING APPARATUS.
163
first piece of pipe on it.   This plate has another hole at
right angles with the centre and the last mentioned, for
the purpose of inserting a small funnel and pouring in
more hot water when necessary.  This is  stopped  (ex-
cept when  filling  the kettle)  with a cork or piece of
wood.   The joints enable the practitioner to direct the
steam into the tub, to the floor, or into the bed.  This
cap will fit on  any tea-kettle, and  constitute a complete
steaming apparatus.  By turning the stopper you may
regulate the steam at pleasure.
   The tub protects the  carpets or  floors from being wet
by the perspiration and the water that may be dashed
on the patient, and elevates her to  a proper height above
the steam, and prevents the  cold  air from coming up
under the  blanket; but, if it  cannot  be had, the chair
must be put upon  the floor, and the process conducted
as I have already directed.
   A narrow and low cot-frame, covered with very open
cloth, should be provided in houses where there is a very
weak patient that will need many  steamings.
   I have  steam-boxes  that  come  up  to the waist, con-
taining an open seat within, and requiring a blanket only
round the neck, shoulders and chest.  They hold  water
at the bottom, near which, at one  end, is a hole to ad-
mit the steam-pipe.  1  like these  boxes,  because they
admit of the utmost convenience in handling the patient,
and keeping the  lower extremities warm.  They also
allow the tying of a towel or handkerchief around the
waist, so as to confine the steam below it—a practice of
great  importance in removing obstructions in the pelvic
region. 
164       STEAMING, WHEN NECESSARY.

  It may be well  to  remark here, that steam, confined
below the waist in this manner, may often be applied so
long and so efficiently as to remove  obstructions from
those parts, when, if it were permitted to come up  to
the chest and neck, it would so fatigue and exhaust  the
patient that you would be obliged  to remove  her before
her feet were scarcely warm.

            When  Steaming is necessary.
  High heat is a tonic.   When the skin is cold, lax and
clammy, it  has lost its  tone  or  tension.  Steam will
stimulate it  to its natural action, and enable it  to hold
the heat of  the body in  quantity sufficient to keep  the
whole warm.  If the skin be very hot and  parched, its
tension  is too great.  Sponging with lukewarm water
and giving bland fluids, in this case, till the perspiration
is free, is better than steaming, as  there is so  much heat
directly under the skin that none is needed outside of it.
After giving emetics and  injections, which let down  the
inward action and take off the tension of the  skin, the
steam may be applied  to advantage,  and it  will aid in
removing the morbific matter  from the  capillaries,  the
deep-seated glands, &c.  If  the skin be dirty or scurfy,
though  it be neither  parched nor clammy, steaming is
necessary to cleanse it.   If it be clean, of natural color
and temperature, and so active  that a cup or  two of
weak cayenne  tea will excite a perspiration,  but  not  be
succeeded by chills, and  the  extremities be not cold  nor
inactive, steaming is not necessary. 
FOOD.
165
                Food in  the Course.
  Weak patients, and those that have  not lately eaten,
should have milk porridge, or chicken broth, or beef tea,
or rice water, or toast water, or some such nutriment,
after  the first free vomiting.  After the course is com-
pleted, a little pleasant bitter—as  peach syrup, or some
similar compound—should be given, and then the patient
may have some dry toast, a cup  of milk  and water, or
chocolate,  some broiled or fried  bacon,  or  mush  and
milk, or indeed any thing  she craves;  and at this time
she will seldom, though sometimes, be inclined to eat too
much.  The demands of the appetite at this time, though
often very  singular, are, in my opinion, our best guides
as to what is proper for food.
  Some  spice bitters,  or  cayenne  and golden  seal, or
chewing some ginger, or a tea-spoonful of the  cayenne
and molasses mixture, taken soon after, will prevent the
food from hurting her.  When the patient craves some-
thing solid and salt or acrid, give her a piece of broiled
fish,  bacon, or dried and broiled  beef, with vinegar  and
cayenne, which I have never known to  hurt any  one
that  craved it.  Though, for a well person, and  in gen-
eral, I prefer vegetable food to flesh, yet, when  the  sto-
mach is very weak, it wants something that will digest
quickly, lest it should sour and fill the bowels as well as
the stomach with carbonic acid gas, producing  distress-
ing colic in the bowels and pain at the pit of the stomach.
But she frequently desires to go to sleep, and she should
be allowed to do so, and eat when she wakes.   If she has
perspired freely, rub  dry,  or steam again and then rub
dry,  and have her dressed  with dry clothes. 
166
FOOD.
              Food after  the Course.
  Before I leave this subject, I may as well give what I
consider the best directions respecting diet  for all per-
sons at all times, old or young, male  or female, sick  or
well.   The fundamental propositions are—
  1. The  feebler the digestive organs, the more urgent
the necessity for selecting that food which requires  the
least  exertion  of  those organs to derive from  it  the
greatest proportion  of nourishment—that is, the  more
nourishing and the more easily digestible  should be  the
food in proportion to the quantity that  is taken.  This
will not be doubted by any one who reflects upon  it.
  2. The  only means by which a patient  can certainly
know what articles of food are, to  him,  the  most  easily
digestible, and wall afford him the most nourishment, is
actual experience — not the experience  of others  on
others, nor his own on others, but of himself on himself.
  Lest this proposition be so controverted as to injure
the force of the  conclusions  I shall draw from it, I  think
proper, at once, to establish it beyond a doubt.

                 Food  in  Cholera.
  When the news arrived in America, several years ago,
that His Sovereign  Majesty, the  Cholera, proposed to
make us a visit, and to  abstract from amongst us all who
were  in any way predisposed to give  him a welcome
reception,  the whole medical  faculty,  throughout  the
length and breadth of the land, made up,  in their  sepa-
rate conclaves, their opinions  relative to  what was  the
most and what the least digestible and nutricious  of all
the articles of food ever devoured or thought of for con- 
food in  cholera.
167
sumption, by that omniverous and ever-changing animal
called man.  Between these extremes, they arranged,
with the  nicest care and gradation, according to  the
wisdom of "four thousand years of experience," all the
several articles known in the catalogue of eatables, from
the delicate frog-soup of the French or Italian Madame,
through the train-oil of Greenland, the codfish of Maine,
to the bacon and  greens  of Virginia.   The vegetable
world, too, was no less strictly examined, and its various
elements nicely approved or condemned; and forthwith
clouds  of sage manifestoes were sent forth among  us,
teaching us  what  we should eat  and  what  we  must
sternly  refuse—but lo! when  all these  directions were
assembled in mass, such was the praise bestowed by one
set of medical philosophers on  an  article, and such  the
condemnation of the same by another, that it was found
utterly impossible, for the  ordinary sagacity of man, to
discover whether any given article  could be eaten with
safety or not.  To  this collection of records of medical
discrimination, the  universe contained  but one like—I
mean a library of all the nosologies, from the monographs
in the  Delphian temple to the  volumes of Good and  the
pamphlet of Hosack!
   With  this mighty accumulation of  wisdom  before
them,  the people   began  to select, as best they could,
the  prophylactics   of the  cholera; but, lamentable  to
tell, experience soon taught them the  lesson that  they
who supposed  that they had done the most to ward off
the  stroke, had in reality done the  most  to invite an
attack. 
168    f o o d--1 nstruction s--d eductions.

              Instructions of Authors.
  In  the course  of my  reading, I  observed great dis-
crepancies  in the  recommendations of eminent  medical
authors in relation to different articles of diet.  Obser-
vation of the  instructions  of  practitioners, also, proved
that  they had  learned no rules on the subject that could
be depended on;  for they  not only differed from each
other, but each individual was constantly changing his
prescriptions in this  respect.   I  have known a doctor
advise, in the  course  of a  few weeks, many changes  of
diet,  to  the same  patient, when there was  no apparent
change  in the  symptoms of the disease; the only found-
ation for his changes being simply that the former arti-
cle did not suit the  condition  of the  patient, which the
doctor himself had  learned only by  trial.   I observed,
too, that almost any change in diet for a sick  person,
especially if it was  what the appetite craved, generally
proved  beneficial for a while, and  then  the  article not
only lost its power, but even became disagreeable.

                     Deductions.
  Reflecting on the  above facts, as well  as upon the
results of  my  own  practice, and  comparing  them with
the omniverous habits of man, I concluded that  the rea-
sons  why a person craves a particular article of food, is
the same as that why he sometimes craves food at all,
and at other times prefers drink, viz. that the system  is,
at that  time, in actual need of at least some of the ingre-
dients  contained  in that article, and  that,  but  for the
presence of other ingredients also contained in it, which
may  not be suited  to the  condition of the  patient, the 
FOOD--DEDUCTIONS.            169
gratification,  in  reasonable quantity, of this craving of
nature,  would never prove injurious.   This discovery
also explained the reason why an article of food or med-
icine soon lost its  power  to produce a generally benefi-
cial effect.  It does, indeed, continue to  produce its spe-
cific  effect, whether  good or  bad.  But,  while we are
directing our attention to  one  specific effect, and  giving
a simple article of food or medicine to produce it, we
are neglecting the use  of the means to produce  other
effects equally important, for want of which the general
system  soon  begins  to languish, even under influences
which at first seemed to promise all  that was  desirable.
Indeed,  it seemed to me  perfectly reasonable  that the
body, which is  composed  of different simple and com-
pound substances that are in a constant course of  wast-
ing and renewal, could not be sustained for any length
of time by the  use of any one  simple  article, however
good in itself, or however much needed  at the  time it  is
first applied; and  that  the most effectual way to keep
up these changes in due proportion is to eat  a  moderate
quantity of several different  articles  of food that are
known to be  good for the  sustenance of the body; and
so, also, the most effectual means to remove disease and
restore  health  is  to  use  together, where proper, and,
where not, in rapid succession, all  the means within my
reach that are calculated to  effect  the object I have in
view.  These principles, constantly demonstrated by my
experience to be true, led  me, in practice, to adopt the
two general rules I have so often urged  in the Recorder,
to wit: 
170       FOOD--RULES--EXPLANATION.

  First—Whether sick or well, never deny yourselves
variety in food, but reject  only  that which your  own
experience tells you is not good;  and, in all ca-es, con-
fine yourselves to what is  generally considered a small
quantity.   Don't eat too mi en, sick or well.
  In explanation of this  rule, and to  guard it against
abuse,  I must remark  that we  must not mistake a good
effect that is temporarily disagreeable for one that is  in
its nature bad;  for the best articles  of food, as milk,
sweet butter, and many vegetables, will often so excite
the living organs  to an  effort  to  throw out the canker,
phlegm, morbid secretions, <$cc. from the system, as  to
make us feel very disagreeable, and induce us to suppose
that these articles of food "hurt us," when,  in fact,  they
are acting, not only as food to nourish us,  but  as salu-
tary medicines to rid  us  of disease.   When, therefore,
any article of food, that is generally good, for us, actually
makes  us sick, we may conclude with certainty that we
were sick before  we  eat it, and  kindly warned, by the
disturbance  it  produces, of  the propriety, if not the ne-
cessity, of taking at  once a full  course of  medicine, to
remove the real  occasion for that disturbance.   It is
proper here to remark, that, when a great  number and
variety of articles are eaten at once, there is more  dan-
ger of eating  too much than when the whole meal is
made from  a  single article; because, in the first case,
after some of  the  craving:, as for meat, bread, &c. are
so satisfied that no more would be eaten  if confined  to
them,  there may yet  remain some cravings  or tastes
which  will  carry  down, without  disgust, an additional 
           FOOD--RULES--EXPLANATION.      171

quantity of pies, puddings, sweetmeats, &c.   This is the
reason why high living is supposed to produce gout, &c.
not that spices and sweets are, in themselves, in reason-
able quantities, more injurious than meat or bread, &c.;
for experience proves that the aromatic spices, as cay-
enne, cinnamon, ginger, nutmegs, &c. which were for-
merly supposed to have produced the gout, are, in reali-
ty, the best possible means for curing it.  Hence, when
I find a patient that will not confine himself to a reason-
able quantity of compound food at a meal, I recommend
to him to make each meal from  a single dish, and change
every meal, if he pleases.
   Second—When you wish to  remove  obstructions  or
restore  health, use, together, a good number  of the best
articles  and processes  that  are  calculated  to effect the
object you have directly in view; and follow them, im-
mediately, with a similar combination of means and pro-
cesses that are adapted to the fulfilment of the next in-
tention—being careful  always  that the various means
used shall produce effects in due proportion with  each
other.
   For example, cayenne in pills is calculated to excite
the system, general heat, remove obstructions, pain,&c;
but all these operations are greatly aided by  putting the
article in hot water and the patient into  the steam-bath.
So lobelia  alone will  relax the nerves and  muscles  in
such a manner that the reaction of the whole  will,  in
general, produce a vomit;  but these processes are much
facilitated by the addition of boneset, pennyroyal, steam
and cayenne.   So the  i itter herb is a very good tonic;
but, in  cases  of great debility, the  addition  of some 
172    MEANS OF  RELAXING THE  SURFACE.

astringent will help the cause,  and,  if the  bowels are
constipated, something laxative,  as well  as bitter and
astringent, is indispensably necessary.  Sprinkling cay-
enne into the stockings, or rubbing the lower extremities
with the strong vinegar extract, will still further aid the
p?-ocess of cure.  These hints will  be sufficient.

   Other Means of Warming  and  Relaxing  the
                      Surface.
  Inasmuch as the modes and means  of steaming I have
recommended, are not convenient in all  places, nor  at
all times to the same person, I here mention others
which can be used as substitutes.
  When the skin is moist and cold, and the  patient can-
not be conveniently steamed  and rubbed dry, the best
applications in bed are gallon  jugs  of  boiling water
wrapped in  a thick  cloth and put  at the feet and sides.
Common flat-irons will  answer a good purpose  in this
case.   But,  where the skin is dry and contracted, whe-
ther cold or hot, (it will generally be the latter,) wrap
the bottles or  irons in wet  cloths, if good porous rocks
or bricks cannot be had.  Or wrap in cloths a dozen  or
so of large boiled potatoes, or ears of corn,  or pieces  of
very porous green wood,  as ash, &c. just out of the
boiling  water, and  apply them, renewing as they cool.
I saw boiled potatoes, and peppermint, catnep  or sage
tea, cure many a "bad cold" and "obstinate rheumat-
ism," before I ever  heard of the New Guide.
  When the skin is very hot and dry, and the heating
applications are oppressive, sponge it with water, nei-
ther so  warm nor so cold as to be  disagreeable, till it 
              INTERMEDIATE COURSE.          173

becomes cool and  comfortable, giving diluted sudorific
(but not heating) drinks—as sage, pennyroyal,  catnep,
balm, &c.—till perspiration is free, and the  pulse begins
to diminish in frequency and increase  in volume, when
you may give cayenne according to the necessity of the
case.
  When the  skin  is cold,  lax and inactive, use freely
some  good stimulating  liniment,  all over  the  system,
and in the bottom of the stockings, to keep up, the action
of the skin and prevent  the feet from becoming cold.

                Intermediate Course.
   It is now  all-important  to maintain the action and
advantage gained.
   The first step in  this process is to give, regularly, just
cayenne enough to maintain constantly a standard action
in the system.  If more  than is necessary of  this article
be  given, it will produce fever, high  excitement and un-
easiness, or else profuse  perspiration, especially at night.
So long as the quantity regularly given produces neither
of these effects, it  is not too great.   If fever and irrita-
bility, or profuse perspiration occur, lessen  the quantity
of cayenne.
   The next  step is to furnish the system with bitter ar-
ticles, which  experience proves are calculated to increase
and correct the biliary secretion and promote digestion,
and of course restore the natural action  of the  various
organs.  A compound  of poplar,  balmony and golden
seal, equal parts, may be styled a neutral bitter, it  being
neither laxative nor astringent.   This and  composition
given alternately, morning and evening, and cayenne on 
174
INTERMEDIATE  course.
the food at dinner, are suitable restoratives for a patient
whose bowels are neither too loose nor too  constipated.
  If the bowels are too constipated, give the same arti-
cles, adding  enough  of butternut, bitter-root, or some
other mild and innocent relaxant, to produce from  one
motion of the bowels to three in twenty-four hours.
  If the voluntary  dejections be  bilious—that is,  light
yellow, acrid or cutting, or very offensive—five or six a
day will be of service, provided cayenne be given freely
and the patient steamed daily to keep up the  action of
the general system and the tendency to the  surface, and
a stimulating injection  or two a  day be added.   After
several days, these free passages of acrid bile, &c. will
either cease of themselves or  begin to weaken the pa-
tient.  If the  latter effect take  place, use many warm
and astringent injections, and  give a thorough course of
medicines, steaming after the emetic, and confining the
steam below the waist, as already directed, till the lower
parts  be as warm as they  can  bear, then  letting  the
steam  all over the  system till the whole body is very
warm before you dash with cool water.  Indeed, this is
the best mode of steaming patients in every case;  for,
while  the lower parts are  generally the coldest,  and
need  the  most heat,  the tendency of that  agent is to
rise as high as it can; of course, when the blanket is
loose  round the body, it surrounds  the head, neck  and
shoulders, and expands  and stimulates the vessels there
more  than those of the lower extremities, which perhaps
are the only parts that much  needed  its influence.   In
proof of these assertions, every  attentive  practitioner
has observed that, in  steaming in the ordinary way, the 
USE OF THE  COURSES.
175
head, neck and breast often become uncomfortably warm,
while the knees and feet still remain cold; and, if he try
my plan of confining the steam below the waist in sim-
ilar cases, he will find that the upper parts will be suffi-
ciently heated, through sympathy with the lower, even
though the steam should  not be permitted to surround
them.

                Use  of  the  Courses.
   It should be remembered that the courses are intended
to break down the morbid tension of the system, and to
disengage,  at once, those accumulated morbific materials
which the unaided efforts  of the vital power are unable
speedily to remove.   Therefore, if  the attack has been
acute, and the course has  been sufficient  to remove the
cause, the restoration will be speedy; but if the case be
chronic,  and the  organs  much debilitated  or injured,
some time will  be required to restore the tone of the
organs, even after the morbific materials are removed.
If, in this  case, the appetite and digestion be good, and
the  patient feel that  she  is relieved from this burthen,
and gradually improve under a  good tonic  treatment,
the courses need not be repeated until she begins to sink,
or ceases to improve, and even  then, perhaps, a more
energetic use of the tonics and stimulants will supersede
the necessity of a course.  It  is a fact, well  established
by the history of the botanic practice, that  those who
work rapidly till they remove  the obstructions, and then
keep up a thorough tonic  treatment, are more successful
with less courses than those who give a course once a
week, and depend upon  that  chiefly for  the cure.  In- 
176
USE OF THE COURSES.
deed, what is the use of removing half of the  obstruc-
tions and leaving the organs too feeble to prevent the
re-accumulation?  I  have entirely cured, in a very short
time, many very obstinate cases, by giving a full course
of medicine every six hours for twelve or twenty-four
hours; and I recommend this plan in all obstinate cases.
Why should  we fear such  rapid treatment?  I give a
course of medicine, and feed the patient, and let her rest
an hour.  Finding her  better, but  not well, I reason
thus:  If one  course  has  made her better, by removing
part of the morbific  matter, another course will make
her still better, by removing more of it.  I give it, and
the reasoning is demonstrated.  I go on till the morbific
matter is removed, and then find my tonic course to tell
fast in the restoration of the organs  to  a  healthy state.
To know when I have  given courses enough, I  com-
mence the tonic treatment directly after  each course,
and, when I find this treatment able to sustain the action
and advantage gained,  know, of course,  that I  have
removed the primary cause  of the disease.   After this,
I give  them only when  I find that  the progress of the
cure is retarded by a fresh cold, or by the  patient's ne-
glect to keep up the  action, or by new accumulations  of
obstructions through inability  of the organs  to prevent
them.
   Let it be remembered, however, that multitudes, by
errors  or excess in diet, directly  after a course, prevent
that speedy reaction of  the  system which would other-
wise take place, and thus render necessary many an ad-
ditional course which prudence  in eating  and exercise
would have enabled  them to  avoid.   The  stomach has 
POULTICES.
177
had  a severe  task  during a course, and  should  not be
heavily loaded with food directly afterwards.

                      Poultices.
  In cases where there is much soreness, inflammation
or ulceration, and the ordinary courses are not sufficient
to remove the morbific  matter with  ease,  poultices
should be applied to the parts affected.  The  intentions
to be  answered by poultices are two—relaxation  and
stimulation.   The  ingredients  necessary to fulfil them
are three—warmth, lubrication and irritation.  It is fur-
ther necessary that means be used to keep these agen-
cies  constantly  at work.   The warmth desired may be
secured either by  applying some non-conducting sub-
stance to prevent the  escape of the natural heat of the
body, or by rubbing on some irritating  article, as  cay-
enne, &c. and the lubrication or moisture  suited to the
case is found in a tea of slippery elm, or any other mu-
cilaginous article.
  It is also necessary, in cases  of ulcers,  that the poul-
tice  be a porous body, in  order to absorb and remove
from the system the morbific matter which it is calcula-
ted to aid the efforts of the vital power in  throwing to
the surface.  As I have said in regard to food and med-
icines, the most effectual  means  of  securing  all these
ends, is a judicious combination,  in one  application, of
all the agents  that  are calculated  to  secure any one of
them.   A tea  of slippery elm, lime tree, or other similar
article, will furnish the  lubricating  fluid; lobelia  and
other  anti-spasmodics will aid these in  relaxing  the
pores; cayenne, ginger and the like, will stimulate the
              12 
178
POULTICES.
nervous tissue, so as to put the vascular system in  mo-
tion, a body of cracker, wheat flour, and other bulky and
somewhat porous article, will absorb the morbific virus,
and preserve around the  part the heat  of the body gen-
erated by its own action.  The  thick slimy tea of slip-
pery elm that remains in the poultice, dries on the outer
surface  in such a manner as to form a sort of skin or
crust, which prevents a very  speedy evaporation of
moisture from the remainder;  that part of it which may
be taken up  by  the absorbents, so  lubricates the inner
surfaces as to enable them to force  along, without pain,
the morbific materials contained in them—and  here we
have an explanation of the mystery that the same poul-
tice should sometimes "scatter" a threatening ulcer,and
at others " draw it to a head."
  Inflammatory Tumors  are  ordinarily  produced  by
the increased action of the capillaries in their efforts to
move forward certain morbific materials, which, either
from their own crude or  non-assimilated state, or from a
collapse of the capillaries upon them, are  obstructed in
their progress.   Of course these materials will  accumu-
late, till, in some way or other, the  obstructions to their
passage are removed.  The influences of a poultice con-
taining  the ingredients above enumerated, explained and
illustrated, will relax the pores both where the morbific
materials are lodged and  between them and the surface,
dissolve and thin them, and render smooth their passage,
and  stimulate the  absorbents   and  secernants  to move
them along, some  to  the excretory ducts within the
body, and others to the surface, from which they will be
removed by absorption into the poultice.   If the quan- 
POULTICES.
179
tity of morbific material deposited be not too great or
too corrosive to be discharged  by all these means, with-
out injury to the vessels containing it, it does not accu-
mulate in any place, and therefore it is said that it has
been scattered;  but, if  the quantity be too  corrosive to
remain  in, or pass  through, the vessels without injuring
them, the tendency of the vital action to force it to the
surface, and the  aid given by the poultice in relaxing the
external secernants more  than the internal, combine to
produce what is called  suppuration or ulcer; and, with
few  exceptions,  the  more corrosive  or  poisonous the
morbific material, the more speedy will be  the  progress
to the surface, and  the less extensive the  swelling.
  From the above explanations and facts, it is evidently
unphilosophical  to talk  about one poultice as a " draw-
ing poultice," and another  as a "scattering poultice,"
because  all kinds of poultices, that are  worthy of the
name,  act  upon the  same principles.  A poultice  that
would  contract  the surface and stop its action, would
have the same effect  on the  vessels deeper seated, and,
of course, produce  an  ulcer  like  the  other, only under
more aggravated and painful circumstances.  It is  also
evident that it  matters little  what  are the particular
materials of which you  make the poultice, provided they
are known to contain the principles of relaxation, lubri-
cation  and stimulation, and will protect the part  from
atmospheric  influence  and  absorb  the  virus that the
action  of the system has forced  into contact  with it.
These  considerations are very important, as  they do
awav all the necessity of searching after specific articles
for a poultice; prevent  the culpable neglect  to apply one 
*
 ISO                poultices.

 when needed, for the want of those  articles, and enable
 the practitioner to select, from nature's  botanic  garden,
 with  speed  and judgment, such articles as he wants,
 whenever he cannot readily obtain those with which he
 is familiar.  Thus, for example, when I could not obtain
 lobelia to relax, I would take any other  article (not poi-
 son) that I  knew  to be  neaseous  or sickening to the
 taste.  For  slippery elm  I would use  basswood bark,
 (tilia,) or the herb saponaria, or  any other vegetable of
 the caryophyllous tribe, or any other plant that has very
 succulent or slimy leaves  or roots,  as  lilies, &c.   For
cayenne or ginger, I would take snakeroot, prickly ash,
 or any other article (not poison) that would produce a
 permanent stimulating and heating effect, when  rubbed
in my hands, &c.  These directions are  not given to in-
duce persons to be continually experimenting with new
articles, but  to  enable them to accomplish the humane
 and benevolent object  of  healing the sick, at all times
 and under all circumstances, even though they may not
 have at hand the best means of doing it.   When a part
 becomes debilitated, and there is danger that  morbific
 accumulations may be  directed  and  deposited there, as
 in  the incipient formation of wens, polypuses, and the
 like, an astringent is applied to advantage.  By collaps-
 ing the capillaries, it checks the determination to the
 part, when the venous  radicles remove what is there—
 and this ha3 been termed scattering the  swelling. 
REMEDIES.
                  Simple Remedies.
  From what I have said on the subject of vital action,
on the simplicity of its intentions, (notwithstanding the
great variety of its modes or symptoms which the fruit-
ful  and erring fancy of man  has transformed into so
many evidences of a great number and variety of invad-
ing and active enemies to  life  and health,) and on the
three classes of remedies that  are calculated  the most
effectually to remove all obstructions, it is evident  that
the best means of  knowing and applying our  remedies,
are, to keep these classes, as far as it  can well  be done,
in their most simple state.  For example, if we  keep
lobelia in  the seed, and  cayenne, bayberry  and bitter-
root by themselves,  either crude or  powdered by  our
own hand or under  our own inspection, we are better
able, in the  first  place, to judge of their genuineness,
purity, quality and power, and the character and degree
of their effects on  the system, than if they are combined
with other articles; and,  in the  second, to unite them in
a moment in such  a manner as  to  suit the condition of
each and every patient.  It is, therefore, evidently  bet-
ter  to keep all our remedies  in  a  separate state, except
where their  specific action can be rendered more speedy
and powerful by combination with something else.   For
articles in their simplest form, classed according to their 
182
R E M E D I E S--S I M P L E .
powers and  intentions, as anti-spasmodics,  stimulants,
laxatives, astringents,  bitters, demulcents, diaphoretics,
&c. to which arrangement I shall hereafter aid you, will
always provide you with the best means of bringing all
the powers of your science and your art to  bear in the
most effectual manner  upon any given case.  Thus, to
unite all  the simply relaxant, or  simply stimulant, or
simply  astringent, or  simply  diaphoretic,  modes and
means in the same process, is to produce a much greater
specific effect than to use any of these  means  and pro-
cesses in connection with others.
  But I have already proved that  most vegetables con-
tain various  active properties, and, of course, that the
effects they produce on the system are  not the specific
effects of any one property, but the predominant effect
of some over others,  or the resulting effect of the com-
bination.  In this sense, many single vegetable prepara-
tions—as an astringent bitter,like birch; a bitter cathar-
tic, as bitter-root; or  an astringent stimulant,  as bay-
berry—are actually compound medicines.  If we could
separate one  of these principles from the other, the med-
ical effect of each would be  different from that of the
combinations, and more powerful in its own way.  To
do this, as far as we can, is certainly desirable.   I would
therefore recommend the procuring of essential oils by
distillation;  of extracts by boiling down the  decoctions,
compressing the juices, &c. by preserving them in spir-
its or oils.
  There are,  however, many  articles  that  cannot be
made to act speedily  and powerfully  in their  simple
state, and these we are obliged to  combine with others 
             REMEDIES--COMPOUNDS.          183

that are calculated to prepare  their properties for ab-
sorption into the system.   For  example, gum myrrh is
not  suited to the immediate wants  of the system till
either  digested  or  dissolved in alcohol.  The relaxing
property of lobelia seed  is  more available, in sudden
emergencies, in  the concentrated tincture  of the third
preparation, than in the form of powder, and, of course,
when  combined  on scientific principles, the more  con-
densed and better suited to assimilation, the more speed-
ily will its benefits be felt.

                     Compounds.
   I consider the compounds made by Dr.  Thomson as
among the most judicious  that  can be made.  They are
so, because they were framed by experience, and are cal-
culated, of course, to be generally useful.  Their useful-
ness can be increased by variations to  suit particular
cases,  and by the condensation of their  powers, so far
as  that can be  effected without  altering their nature;
but it  is equally true that  any  condensations  are objec-
tionable,  which, on account of the  trouble or expense
of effecting them, open the door for designing, avaricious
and unprincipled men, to  injure, destroy  and corrupt or
adulterate them, and thus, by monopolizing the sale at a
high price of what cost them little or  nothing, to  make
themselves  rich at the expense  of the credulity, the
health, and ultimately the life  of the  people.   I would
therefore recommend  to  all  practitioners and to every
family,
   First—To collect or purchase,  in  their crude state, all
the valuable remedies within their reach, and to prepare, 
184          REMEDIES--COMPOUNDS.

of each, at least as much as they may probably want for
their own use, in the most condensed and efficient form
that their knowledge will  suggest and  their means will
enable them to effect.  Some will be able to do much
more  of this work than  others;  but I  solemnly warn
every man that the moment  he commences to trust  to
the knowledge, skill,  means and faithfulness of another
to do what  he cannot effect himself, that moment he
takes the first step which  may end in risking his  life  in
the hands of an unprincipled villain.  The wisdom and
benevolence  manifested by Dr. Thomson,  in exhibiting
the ingredients and proportions of his  compounds, and
in recommending,  teaching and permitting every man
to prepare them for himself, cannot be  too  highly com-
mended.   Though  no man who  understands  the  real
value  of  the  blessing  thus  conferred, will think it over-
balanced by  paying the paltry sum of twenty dollars for
the little  "Guide to Health," or  will,  for  any trifling
reasons, abandon it for other means of doubtful charac-
ter and value, still, on the other  hand, no one who is
able to give greater  efficiency to  Dr. T's  means, or  to
aid them by others of similar  character, or of superior
efficacy, if such be found,  will hesitate to do it, for fear
that he should be branded with degrading epithets for
attempting " improvements on perfection!"  If any man
is able to make real improvements even on what is by
many counted " perfection," I say  let him  do it.   All 1
want is, to be  sure that it  is an improvement.  But im-
provements that are  available only to a few choice spir-
its, even  though good in  themselves,  can scarcely  be
considered, on the whole, desirable.  They compel  the 
          COMPOUNDS--ILLUSTRATION.       185

few that devise them often  to use inferior articles, to
satisfy the increasing demand, if not to endeavor, for the
sake of fame and filthy lucre, to destroy the confidence
of the many in the value  of  that which is  not only as
good, but within the reach of all.
  I would not be understood to say, that, in no case are
we to trust to  the honesty and fidelity of others for
what  we cannot prepare for  ourselves.  We are under
the indispensable  necessity of doing it in  many cases.
The principle I advocate is, that we should do it as  little
as possible,  and least of all in preparing food and medi-
cine,  in which our health  and life are concerned.   The
reason is this: In proportion as the manufacture is  con-
fined  to a few, in just that proportion will  the demand
on the few  increase.   As the  demand  is increasing, so
will increase the difficulty of obtaining genuine and effi-
cacious simples for the  manufacture.  Indifferent  arti-
cles will be considered better than  none.   The security
which compounds afford against detection of fraud,  even
when the ingredients and proportions are  professedly
made  known, the greater profit made on the mass  com-
posed of cheap ingredients, and the lasting influence of a
fame  acquired, perhaps at first justly,  by  the manufac-
ture and sale of a good article—all combine to  deterio-
rate  a compound food or medicine, whether secret or
not, and consequently to  jeopardize the health  and life
of him who uses it.

                    To Illustrate.
   I go to the  fields and gather the seeds  of lobelia; I
raise  my peppers  in  my  garden; gather my myrtle or 
186       COMPOUNDS--ILLUSTRATION.

bayberry from  the sea shore;  my balmony from  the
water courses, and my bitter-root  from the uplands or
sandy intervales.   I now know what I have, and can
estimate  their power and  depend on  their effect.  If  I
buy these articles  from my neighbor, I am not sure that
he may not  have  gathered, through mistake, if not de-
sign, some of the  seeds of campanula, or of the poison
cardinal flower, for lobelia inflata.  The cayenne brought
by the merchant may be much adulterated by the intro-
duction of other fruits of similar  shape and  color, espe-
cially if ground.   My bayberry may be the bark of the
branch instead of the root, if not even much alloyed
with that of some other bush.  My balmony and bitter-
root may suffer as much, if it be in no  other way than
by being gathered in the wrong season.  Indeed, what
attentive practitioner has not observed that  the most of
the simple articles of the Botanic Materia Medica have
actually diminished in power as the demand for them
has increased?  Take another step into the liabilities to
deterioration and abuse, and who has  not observed  that
it is now far more difficult  to  get good  composition,
spice bitters, &c. than it was five years ago?  Is it not,
then, evident that the more complicated and difficult to
be made, the compound, whether for want of the whole
ingredients  in  their  purest state, or of the ability or
honesty  of the maker to be faithful, the less likely is the
 medicine to be genuine and good? And do we not actu-
 ally find it so?   Is it not sometimes the case that a skil-
 ful practitioner fails by the use  of medicines  which he
 purchased, and  of which,  for that reason, he  did not
 know the genuineness and  the  power; when, had he 
COMPOUNDS.
187
gathered and prepared the articles with  his own hands,
he might have succeeded?
  If such things happen where the whole matter is open
to inspection, and that, too, without charging any pur-
chaser, manufacturer, vender or practitioner with  delib-
erate design to do wrong, what are we  to expect from
rushing, with our eyes wilfully blindfolded, into the arms
of those who manufacture  nostrums in  such  a manner
as to elude the detection of fraud, without the possibility
of any other motive  than the mere monopoly to  them-
selves of all the money that can be made by it ?  every
motive of philanthropy urging them, if they have really
made any valuable discovery, to make a fair disclosure
to the world!
  I would  then  conclude this article by  repeating the
recommendation to every one to gather all the simples
that he can, and make  as many as he  can  of all the
compounds that he wants.  When he must purchase of
others, let it be in as crude a  state as will answer his
purpose, and always  use first in practice  those simples
or compounds with the nature and powers  of which he
is the best  acquainted.  A  strict  adherence to  this ad-
vice will soon enable him to arrive at almost entire in-
dependence of others, and freedom  from hazard, in the
supply of his own medical wants and those of his house-
hold, and  confer on  him and his the greatest  blessing
limited to  earth—a sound body, through  which the im-
mortal spirit can have free and perfect  exercise, in the
accomplishment of all her vast, philosophic and  benevo-
lent aims. 
188     remedies--rheumatism cured.

        Instructions  for making  Compounds.
  In accordance with the  principles just  laid down, I
proceed to give some specimens of  my practice, for the
consideration and profit of all who prefer knowing what
they do and why they do  it, to becoming the mercenary
tools of others, who, by withholding these important
matters, literally say  that  men are  not worthy to be
trusted with the knowledge of the means of preserving
life and health.
  For the eighteen months  previous to 1814,1 had been
affected with a pain at night in my  arm.   Being inform-
ed by an old gentleman, too familiar with the complaint,
that it was rheumatism, and proceeded from cold, I de-
termined to  burn it out.   I obtained a number of red
pepper pods, put them into a pint of vinegar, and boiled
them till there  was but a  small quantity of the fluid,
with which I bathed my arm for half an hour, heating it
in by holding a hot shovel near it.  I then took  out the
dregs, put them on a  large piece of flannel, bound them
round my arm and went to bed; but, such was the  in-
tolerable irritation, that I felt no disposition to sleep till
about daylight, when I drowsed a little.  So  much of
the article was absorbed that it produced a burning heat
and  redness, which spread over my whole side, neck,
face and head, and did not  entirely cease its action  for
more than a week; but I  felt not another vestige of the
disease for three years, when  it returned again in the
same place.   I repeated the  experiment, with the same
success.  I felt no more  of the disease  till, in 1832, I
commenced  the Thomsonian practice, when the frequent
and sudden  changes, from a hot room and a free perspi- 
REMEDIES--LINIMENT.           189
ration to a driving on horseback through a keen  north-
wester, or  a  cold, damp and dreary north-easter, gave
me colds and produced rheumatic pains, not only  in the
arm but in other parts of my body.  I now bathed with
Dr. Thomson's Rheumatic Liniment, and took  No.  6
according to  his directions, but it did not touch the dis-
ease.  I doubled the portion of cayenne, but still failed.
I again resorted to my old plan of bathing with vinegar
as strong of cayenne as I  could  make it, and was soon
cured, and still remain so.

                Stimulating Liniment.
   Cayenne has ever  since  been  my  stimulater;  its
strength being obtained either by boiling it in vinegar
or in neatsfoot or goose oil or fresh butter, and pressing
it out hard.   The oils enable it to retain its power longer,
and they aid, by lubrication, the action of the capillaries.
This liniment may be concealed by aromatics, injured by
gums, and  counterbalanced by poisons; but it will not
be much improved by them.   I object to gum myrrh in
a mere stimulating  liniment,  to be used where there  is
only inaction and no danger of putrifaction, for it tends
to close up the pores.   There are, indeed, other  stimu-
lating articles that would  aid the  cayenne, if combined
with it;  but, as they are  not indispensable  nor  always
convenient, I omit to mention  them.  Spirits are too
cooling for any case but a hot skin, and it is much bet-
ter to dispense with  them, even  in  this, than to keep
them in the house.  The soft animal oils are preferred,
because they  do not prevent the perspiration; and vola-
tile oils evaporate and cool the surface too quick,  except 
190
R E M E D I E S--L INIMENT.
in cases of fever.  The vegetable oils, as oil of sassafras,
juniper, origanum, ecc. are good; but, as  they must be
bought from the merchant, who, in his  turn,  obtained
them  of the distiller or presser, how can we be sure that
they are good?  Some may think there is little danger
of their being impure, but I can  assure them  that  it is
no easy matter to obtain them in their purity—and the
more  valuable they are, the more likely they are to be
adulterated.
  A lady fell upon a chair and bruised her  eye very
much. It turned quite black.   After suffering  it  to ex-
tend for several  days, she applied for relief.  I bathed it
frequently with No.  6, which relieved it some.   I  then
put a tea-spoonful  of cayenne into  a  half ounce phial
full, and directed her to put it on often enough to keep
the part constantly smarting.   In twenty-four hours it
was  entirely natural.  From  these, and a multitude of
similar facts, I can  assure you that cayenne, although
when strong it  is very unpleasant  to  bear, will, in no
form  in which you can apply it, produce a blister or
mortification; but that, on the contrary, it is not excell-
ed by any known article in its power  to prevent  both.
This should be used in all  bruises and places where the
blood settles and turns purple, and  put into  old sores,
especially if they contain proud flesh.

              Anti-spasmodic Liniment.
  If it could be obtained in sufficient quantities, the oil
of lobelia would probably be the  best article for this
purpose: but that is not yet certain; for, as other parts
of the plant than the  oil  are certainly  relaxant,  their 
R E M E D I E S--LI N I 31 E N T .
191
properties may be advantageously employed in the com-
position of the liniment.   1st.  Bruise the  young plant,
add  as much  vinegar, press  out the juice with it,  and
cork it up.  2d. Take  the bruised seeds of lobelia  and
powdered nervine, and make a  saturated tincture in  vin-
egar.  This is an excellent article to open the skin in
cases of swelling, fever or inflammation.   3d. Put the
powdered seeds of lobelia into  twice as  much neatsfoot
or goose  oil,  sweet oil or fresh better, and keep them
warm, but not scalding hot, for five or six  hours,  then
press with a very heavy weight, through a strong cloth,
and  preserve it for use.  To cure sores on the surface,
or counteract the effects of corrosive poisons, the above
cayenne and  lobelia preparations, or others  of similar
character, should be united.

                   Tonic Liniment.
   It is very evident that, for the  contraction of relaxed
parts, some kind of astringent  is necessary; but, as  it is
also certain that vital action is indispensable to the res-
toration of a healthy condition of the debilitated  organ,
astringents alone will not answer all the indications for
the  use of this species  of liniment.   We must  therefore
not  only  prepare some of the  most astringent articles,
either in liquids or oils, but we  must add to them the
stimulant properties of cayenne, or  some of its various
equivalents.  A strong decoction of witch hazle, red oak
bark, common galls, birch bark,  or  any similar article,
with cayenne, will effect this object.  Every  body in the
country is acquainted with some powerfully astringent,
 vet  innocent  article, to which he may resort for  such a 
192
REMEDIES--LINIMENT.
purpose.  If he can add  to it others  that are valuable,
let him  do so; but let him not hesitate to use one good
article because he has  not  at  hand all the others that
may be  recommended to accompany it.  It is painful to
receive, almost  daily, from  Thomsonians  in different
parts of the country, from  Maine  to Texas, and from
Florida  to Wisconsin, the lamentation that the people
must call in an M. D. because  they cannot get all the
articles  necessary to make  the several compounds, so
much praised  by some  of the  fraternity, nor even the
few very simple, but very useful ones  recommended  by
Dr. Thomson,  when I am fully convinced that, were one
who thoroughly understands  the  principles I have here
presented, and the science of botany,  caught in  any of
those four quarters, or any  spot  of ground within the
compass of a line that should surround them all, and de-
prived of every accredited article in the Botanic Materia
Medica, he would soon  muster, from  the fields  of that
region, remedies sufficient to cure nine-tenths of all the
forms of disease  to which the  inhabitants  of the  place
are liable.  I therefore impress again on your minds the
importance of becoming well acquainted with the true
principles of medical science, with the science of bota-
ny, and the art of applying  the remedies effectually in
the prevention and cure of disease.
  Unless this is done, avaricious and  unprincipled men
will  impose on the public, by preparing worthless com-
pounds  and  vending them at enormous prices; practi-
tioners will fail in their attempts to cure with these pre-
parations; confidence in the  whole system will  be lost
or greatly shaken; the regulars will cry " I told you so," 
REMEDIES--BLEEDING, ETC.        193
and the whole world will again fall into the cruel tender
mercies of calomel, opium and the lancet.
  But, I may be asked if the obviously good effect of a
medicine is not an all-sufficient reason for us to believe
it good in itself, whether we  know its  constituent  prin-
ciples  or  not?  I answer—no, by no means.   This is
the rock on which  all learned quacks have split;  the
very foundation-stone of the boasted four thousand years
experience.
   The  doctors say, "bleeding removes spasms"—it is
true.   They continue, " calomel opens the bowels"—true
again.  " Opium eases restlessness  and pain"—even so.
" Sugar of lead stops bleeding and diarrhoea"—still cor-
rect.   " Ice cools a fever"—can't dispute it.
   But I am not  quite ready for the conclusion, that,
therefore bleeding should be  prescribed for spasms, calo-
mel for costiveness, sugar of  lead for cholera and dysen-
tery,  ice  for  fever, and opium for delirium and pain.
Surely not.   Of what use,  then, to  the practitioner is
the criterion so boastfully set forth by a certain celebra-
ted nostrum maker, that " no remedies, purporting to be
his, are genuine, unless they immediately relieve pain"?
We know that pain may be  removed  in two ways—by
removing the cause of it, and by destroying the power
of the nervous system to be sensible of it.  Opium  and
strammonium, and  many other articles, will surely re-
lieve  pain;  but is it a matter of no importance in which
of these ways they do  it?  Suppose the  action  of the
living principle should recover,  in  some, yes, in many
cases,  the  healthy  tone  of  the  organs, in spite  of the
bleeding, calomel, opium, lead,  ice,  strammonium,  &c. 
194        REMEDIES--CLASSIFICATION.

is  it riomt  to attribute  to  all articles  called medicines,
the good results  that may have  been  produced by the
sanative  efforts of nature in opposition to the specific
tendency of those articles?  It is well known, too, that
a majority  of good articles in a compound will often en-
tirely overrule the evils which  the  minority of bad  are
calculated to produce.  This was  the case in the cholera
medicine of the celebrated Dr. S. Cartwright, of Natchez,
Mississippi, who was rewarded with the honor of a ser-
vice  of plate for mixing so much  cayenne with his calo-
mel that  the medicine  cured a great many patients in
spite of both the disease and the poison! Who does not
see that the only way in which we  can rightly estimate
the value  of any  compound, is  to become thoroughly
acquainted with each  and every ingredient in  its  sepa-
rate  state?
   Lastly:  when a practitioner is ignorant of the true
therapeutic principles, and uses secret nostrums, or even
compounds, professedly  made after a well known recipe,
if he should fail  in  a given case,  how shall he  know
whether  the failure is to be attributed to the science, the
skill, the general remedy or some ingredient in it, or to
the only proper and legitimate cause,  the total loss of
vitality in  the essential organs ?  And,  if he knows  not
where the  fault lies, how, I ask, can he  apply the proper
remedy ?

             Classification  of Remedies.
   It is not the  object of this little  book  to exhibit the
entire  materia  medica,  nor to teach the whole theory
and practice of medicine.  It is  presumed that all who 
          REMEDIES--CLASSIFICATION.         195

purchase it will possess some other work in which these
subjects are more minutely set forth.  I shall merely in-
sert the catalogue of articles prepared by my friend Dr.
A. C. Logan, and published in  the second volume of the
Thomsonian Recorder, page 351, with the addition  of
their several predominant powers or properties, so  far
as I am able to determine them.
   Those that  relax  the nervous and muscular fibre, I
shall call anti-spasmodic and relaxant;  those  that con-
tain tannin and contract it, I shall call astringent;  those
that contain acrid principles, which so irritate the nerves
as to produce  both relaxation  and contraction, I shall
call stimulant;  those that furnish the bitter principle, I
shall call bitter;  those that have a very slimy or mucous
parenchyma, I shall term emollient; those that strengthen
the system, or  restore the powers of the organs, I shall
call  tonic; and I shall, in general, endeavor to arrange
these in the order  of their predominating properties.
The difficulty of  this last task may subject  me  to  some
errors, but I am happy to  say  that these errors are  of
little importance.
  I would remark, in general,
  First—That, as all relaxants  open the pores of the
system, they must necessarily  be measurably secernant
and deobstruent—that is, they must indirectly promote
salivation,  gastric and biliary discharges,  the internal
secretions and  perspiration.  On this principle we find
that lobelia increases the  saliva, the  perspiration, and
sometimes even the urinary and alvine discharges.
  Second—That all stimulants, because they recover the
action of the system, must  necessarily  be more or less 
196       R E M E D I E S--C LASSIFICATION.

deobstruent and  tonic, or restorative; these effects, with
proper nourishment, being all that is necessary to bring
the system to a healthy state.  Hence we find cayenne
to be so valuable in  the removal of canker, and  in the
restorative treatment.
  Third—That the only reason why canker medicines
are so useful  in the  removal  of obstructions, is, because
they contain such varied combinations of irritating  pro-
perties as to  promote both relaxation and contraction,
or action and reaction, which are  but other terms for
stimulation.   The acrid effect of bayberry on the glands
of the mouth is a striking illustration of this position.
  Fourth—That it is improper to use pure astringents
while there is much canker in the system to be removed.
The fact  that the regulars  could never cure the dyspepsia
with bitters, nor  the  diarrhoea,  dysentery nor cholera
with opium, may serve to illustrate this remark.
   Fifth—That  it is equally  improper to use  antispas-
modics  and relaxants, when  it is our sole object to  tone
up the system; and,
   Sixth—That,  when  we  are in perfect health, stimu-
lants are not wanted, and of course are improper. 
MATERIA  MEDICA.
CLASSIFICATION  OF REMEDIES.
           FIRST DIVISION.—SIMPLES.

               Class  I.—Relaxants.
  This class includes those that merely reduce the ten-
sion of the organs.
  The purest and most powerful  known to  us, that is
also perfectly harmless, is Lobelia Inflata.
  It may be aided by all the articles that move the bow-
els, promote the perspiration or any other secretion, and
make  the person feel weak and free from excitement.

               Class II.—Stimulants.
  This class includes those that stimulate the system to
a uniform action and reaction, and leave it in neither a
relaxed nor contracted state.
  The purest is Cayenne, to which we may add Ginger,
red and black Pepper, &c.

                 Class III.—Bitters.
  That  which  comes  the nearest to a  simple  or pure
bitter is Balmony.  Golden Seal, Aspen  bark, Barberry,
and Peach and Cherry barks, leaves and kernels, are ap-
proximations towards it. 
198
MATERIA  MEDICA.
     SECOND DIVISION.—NATURAL COMPOUNDS.

                Class IV.—Astringents.
   Tannin is the principle  of vegetable  astringency, but
 it is not found pure in any one article.  It predominates
 in Witch  Hazle, Sumach,  Marsh Rosemary, the leaves
 of Birch,  Alder and forest Poplar, Hemlock bark, and
 any other article which, when  chewed, will dry up  the
 saliva, and permanently contract the muscular fibre of
 the tongue, cheeks, &c.

                       Class V.
   Articles containing many properties, the principal of
 which are mentioned in connection with each.
   The following are prominently  anti-spasmodic, partak-
 ing also of the other properties named.
   Lobelia  Inflata.  Universal  relaxant, anti-asthmatic,
 sialagogue, and general  secernant, through relaxation.
 Its effects are followed by reaction  of the stomach and
 chest, or emesis.
   Verbena Hastata, Verbena Urticifolia.  Blue and white
 Vervain.  Nearly similar, but stimulant.   Not used.
   Cypripedium Pubescens,  vel P arvifiorum,  vel Luteum
 ct Humile, vel Acaule.  Umbil or Valerian.  Nervine and
 bitter stimulant.
  Panax  Quinquefolia.  Ginseng.  Nervine, stimulant
 and secernant.
  Nymphcea Odorata. Pond Lily.   Anti-asthmatic, stim-
 ulant and secernant.
  Arum Tryphillum.  Wake  Robin.   Stimulant and
secernant. 
MATERIA MEDICA.
199
  Gallium Verum et Aparine.  Clivers.  Stimulant  and
secernant.

  The following are variously and prominently stimu-
lant :—
  Capsicum Annuum.  Cayenne.  A pure stimulant; of
course secernant, deobstruent and tonic.
  Zingiber Ammomum.  Ginger.  Stimulant, secernant,
deobstruent and tonic.
  Piper Nigrum.  Black Pepper.  Like, but inferior to,
Ginger.
  Oleum  Terebinthince.   Spirits  of  Turpentine.   Bal-
samic, vermifuge and tonic.
  Myrica Cerifera.  Bayberry.  Astringent.
  Erigeron Purpureum.  Squaw Weed.   Deobstruent
and tonic.   We have never been satisfied that this  arti-
cle is really the Squaw Weed of Dr. Thomson.
   Laurus Camphora.  Camphor.  Astringent.
   Mentha Piperita.  Peppermint.   Secernant and de-
obstruent.
   Mentha  Viridis.   Spearmint.  Anti-spasmodic and
nervine.
   Saturday Hortensis, vel Satureja Hortensis.   Summer
Savory.  Secernant and tonic.
   Hedeoma Pulegeoides.  Pennyroyal.   Secernant and
 tonic.
   Matricaria   Vulgaris, vel Chrysanthemum  Partheni-
 cum.  Featherfew.  Secernant and tonic.
   Geum Virginianum.  Evan Root.  Deobstruent and
 tonic.  The Geranium Maculatum is also sometimes call-
 ed Evan Root. 
200
MATERIA  MEDICA.
   Abies, vel Pinus  Balsamea.  Balsam  Fir.  Balsamic
and tonic.   Healing.
   Sinapis  Alba,  et  Nigra.   Mustard.   Secernant and
tonic.
   Aristolochia  Serpentaria.   Snake Root.   Secernant
and tonic.
   Solidago Odora.  Golden Rod.   Balsamic and tonic.
   Cochlearia Armoracia.   Horse  Radish.   Secernant
and tonic.
   Pyrola Umbellata.  Pipsissaway, (green.)  Secernant
and tonic.
   Pyrola Maculata.   Pipsissaway,  (white.)  Secernant
and tonic.
   Cnicus Officinalis.   Bitter Thistle.   Bitter, secernant
and tonic.
   Rumex Crispus.  Yellow Dock.   Acrid and cathartic.
   Carduus Bcnedictus, vel  Centaurea Benedicta.  Bless-
ed Thistle.   Bitter, secernant and tonic.
   Xanthoxylum Fraxineum.   Prickly Ash.   Secernant
and tonic.
   Pyrola Rotundifolia.  Wild Lettuce.   Secernant and
tonic.
   Helonias Dioica.   Colic Root.  Secernant and tonic.
   Lycopus  Vulgaris,  vel Europeus.  Archangel, (light
green.)   Secernant and tonic.
   Myrica Gale.  Meadow  Fern.   Balsamic and tonic.
   Trifolium Pratense.  Red Clover.  Mild escharotic.

   The following are  prominently bitter:—
   Anthemis Nobilis.   Chamomile.   Secernant, stimulant
and tonic. 
MATERIA  MEDICA.
201
   Chelone Glabra.  Balmony.  Secernant and tonic.
   Anthemis Cotula.  May Weed.  Secernant, stimulant
and tonic.
   Marrubium Vulgare.    Hoarhound.   Anti-spasmodic
and tonic.
   Inula Helenium.  Elecampane.   Demulcent and tonic.
   Berberis Vulgaris.  Barberry.   Stimulant,  deobstru-
ent and astringent.
   Amygdalus Persica.   Pe*ach.  Stimulant, deobstruent
and tonic.
   Apocynum Androstemifolium.  Bitter Root.   Laxative,
stimulant and tonic.
   Hydrastis  Canadensis.  Laxative and tonic.
   Frasera Verticillata.  Mild cathartic and emetic.
   Prunus Virginiana.   Cherry.   Stimulant,  astringent
and tonic.
   Amyris Kataf,  vel Myrrha.  Stimulant, anti-septic
and tonic.
   Artemesia  Absynthium.    Worm-wood.   Stimulant,
deobstruent and tonic.
   Tanacetum Vulgare.   Tansy.   Stimulant, secernant,
emenagogue and tonic.
   Betula Lenta.   Black Birch.  Astringent and stimu-
lant.
   Celastrus Scandens.   Bittersweet.   Stimulant, secer-
nant and tonic.
   Eupatorium Perfoliatum.   Boneset.  Relaxant, stim-
ulant, emetic and tonic.
   Juglans Cinerea.  Butternut.  Stimulant and cathartic.
   Aletris Farinosa.  Unicorn.  Acrid, stimulant, secer-
nant and tonic. 
202
MATERIA  MEDICA.
  Coptis Trifolia.  Gold Thread.   Stimulant, secernant
and tonic.
  Lycopus Virginicus.— Var. Ruber.  Archangel, (dark.)
Bitter, stimulant and tonic.
  Popuhts Trepida, vel  Tremuloides.  Poplar, (yellow.)
Stimulant and secernant.
  Ptelea Trifolia.  Stimulant, deobstruent and tonic.
  Jeffersonia Diphylla et Lobata.   Stimulant, deobstru-
ent and tonic.
  The following are prominently astringent:—
  Hamamelis Virginica.   Witch Hazle.  Stimulant, and
(when green) demulcent and tonic.
  Rubus Strigosus.   Red Raspberry (wild.)  Stimulant,
and (when green) demulcent and tonic.
  Statice Caroliniana.   Marsh Rosemary.  Stimulant
and tonic.
  Rhus Glabrum.  Sumach.  Stimulant, secernant, tonic.
  Abies, vel Pinus Canadensis.   Hemlock.  Stimulant,
secernant and tonic.
  The following are prominently emollient:—
   Ubnus Fulva, or Slippery  Elm,  Basswood, Comfrey,
Saponaria, Adder Tongue, Field Sorrel, Hollyhock, Mal-
lows, &c.  All  excellent in poultices.
  Though, by reference to  the  principles, page  139 and
onward, and a practice accordant with  them,  all the
forms of disease peculiar to women and childen, if taken
in time, may be removed—yet I shall now present the
common forms  to which  they are liable, making further
remarks on some  that have  been  mentioned,  and pre-
scribe what I deem  a judicious and  effectual mode of
treatment in all. 
DISEASES  PECULIAR TO FEMALES.
   Adhesion  of  the Labia Pudendi.  Inflammation of
 the external parts.  See page 55 and onward.
   Constant cleanliness of these parts, merely washing
 them in warm water two or three times a day, and then
 greasing them with sweet oil or butter melted before it
 has been salted,  will preserve them from irritation  and
 inflammation, and, of course, adhesion.  A general puri-
 fication of the system,  by the canker teas, cayenne  and
 frequent steamings, or washings with warm water,  will
 prevent the supply of  the canker which produces sores
 in these as well as in all other parts.  The inflamma-
 tions, suppurations, swellings,  tumors, warts, polypes,
 &c. found in these parts and in  the vagina, are made up
 of the cankery humors and morbid secretions that lurk
 here for want of attention to the free action  of the sys-
 tem, and to cleanliness  of the parts.

                       Sores.
  If cleansing and greasing, and  a free use of canker teas
and the courses, should not be sufficient to cure any
sores that may break out about  the external parts, or to
reduce any swelling, poultices  of slippery elm, ginger,
cracker  and lobelia, (adding a little myrrh if necessary,)
should be applied till the disease is removed.   The form
of disease called  pruritus, which so often  troubles, with 
204
SORE S--S WELLINGS.
apprehensions, the mineral faculty, and baffles their skill,
will  readily yield to this course of treatment.  When
disease is in the vagina, it  must be  met by injections
suited to its character.
  Except the above, and others before mentioned, the
forms of disease with which females  are attacked, pre-
sent little that is peculiar to them  till  about the age of
puberty, especially if care be taken, according to our di-
rections, to keep them equally comfortable all over as to
their clothing.  If this latter  point  be neglected, then
the female may expect, as a certain consequence, sooner
or later,  an  ample reward  for  her folly, in  a postponed
and  suppressed,  or a painful and irregular menstruation.
  During the period from infancy to puberty, care should
be taken to keep the lower  extremities warm,  by wear-
ing thick cotton drawers in warm weather,  and flannel
and thick shoes and stockings in cold;  and, if girls should
be so unfortunate as to take a little cold, instead of giv-
ing them calomel, that (I had almost said) greatest ene-
my to the female frame that ever bore the name of med-
icine, let them take hot ginger, cayenne, composition or
other stimulating and sudorific  teas,  keeping the  feet
warm till a free perspiration throws  it off, or, if neces-
sary, let them take a full course of medicine.

                      Swellings.
  Swellings of all kinds, wherever they occur, arise from
obstructions of some sort to the action of the  organ or
organs  affected.   Thus the dropsy in  the flesh is occa-
sioned by a  collapse in the skin, that prevents the serum
of the blood from escaping in  the form of perspiration. 
SWELLINGS
!--C U R E .
205
Inflamed tumors may arise from  this collapse, but more
commonly from the lodgment of morbific materials in
the parts.  They may also succeed organic lesion.  I
say, these things and others may be the cause of various
forms of disease; but, let it ever be  remembered, that
the true cause of action in the system, (except mortifica-
tion—chemical action,) is the presence of the vital power;
and that the action of the organs will always be proper
or improper, in proportion to the capacity or condition
of those organs to be acted upon.
   All poisons, in any quantity, diminish, and, in larger
quantities, destroy  entirely, the capacity of  the organs
to be acted upon.   This is proved by the fact  that, the
more they are taken, even in small quantities, the less
striking is the apparent result—that is, the less able  is
the living power to bring the  organs to operate  upon
them.   This is the reason why it is so much  more diffi-
cult  to  restore a patient to sound health after he has
been  treated a long time with calomel, opium, &c. even
though he should not appear very sick, than to cure one
that has just been attacked, though ever so violently, by
disease in almost any form.
   To cure swellings, then, of every description, relax
the parts, generally if the swelling be general, and local-
ly if it be  local, and then stimulate the organs to a
healthy  action  to  remove the  morbific  matter.  (See
" Ways and Means," page 141 and onward.)  The swell-
ing of the lower limbs  in females, is sometimes caused
by the weak and relaxed state of the veins and absorb-
ents, which, instead of forcing the fluids up into the
body, enlarge and  allow too great a quantity to remain 
206       MENSTRUATION, AS  A DISEASE.

in them at a time.  The frequent  and faithful applica-
tion of the stimulating and astringent liniments,  (pages
189, 190,) after the system has been thoroughly cleansed
by courses, will correct these evils.  Sometimes, partic-
ularly during pregnancy, the lower limbs swell, because
the foetus presses on the veins and  lymphatics  in  the
pelvis.  This may be removed any time by lying down
a while, with the  pelvis  and lower limbs higher than  the
shoulders.  Ladies thus affected should not allow them-
selves to  be  constantly walking.   Let  them frequently
assume, for a short time, the position above mentioned.

        Menstruation, as a form of Disease.
  I have already  remarked that  the  early or  tardy  ap-
pearance, the small quantity, or the profuse discharge of
the menses, is no  proof of disease, without some other
concurrent symptom, as general  debility, congestion in
the head, palpitation of  the heart, cold feet and  hands,
clots of blood in the  discharge,  too frequent occurrence,
&c. &c.   It is obvious,  therefore, that a mere  retention
of this fluid beyond the usual time, is not to be consid-
ered disease, much less to be treated on any other than
general  principles, and  with those  universal  remedies
that are calculated to promote the general health and
remove all the causes of disease without regard to name.
  When the retention is connected with serious derange-
ments of vital action, as evinced by cold extremities,
flushed countenance, palpitation of the heart,  &c. great
pains should  be taken  to heat thoroughly the cold  ex-
tremities, by  confining  the blanket round  the  waist in
steaming,  wearing flannel drawers, &c. and  by using 
         MENSTRUATION,  as a disease.      207

stimulating liniment.   (See  page 189.)  Direct efforts
should also be  used  to relax the parts constricted,  by
warm fomentations,  injections  of lobelia, &c.  If the
uterus swells  so as to  indicate  an accumulation of the
secretion in its  cavity, and the general treatment does
not succeed in  a reasonable  time, introduce a  catheter
and discharge it.  If a  membrane cover the  os  uteri, (a
very rare occurrence,) it must  be pierced by a sharp-
pointed instrument.
  Regular physicians  recommend and practice, in the
above cases,  bleeding,  purging, low diet, &c. and warn
their  students  and patients  against taking stimulating
remedies and generous food; but, after  all, nothing is
more common in medical practice than for patients, who
have  exhausted all their skill  to no good  purpose, to  go
to the Thomsonians and be steamed, puked, stimulated
with cayenne, and fed  with nourishing diet, and thus, in
a few weeks, or months at most, to recover sound health.
Dr. Dewees  finds the  patient  "laboring under severe
headache, pulse full and a little  quickened, tongue slight-
ly furred, appetite impaired,  and bowels costive;" sup-
pression caused by "standing  on a damp brick-paved
cellar in a hot  day, at the warm employment of pre-
serving."  Her  mother "put her feet in warm water,
and gave pennyroyal tea, which removed  the chills, but
did not  restore  the discharge."   For three months she
took " remedies," (doctors' emenagogues, I suppose,) and
then called him, who found her as  above stated.  Had
he been a friend of vapor,  cayenne and lobelia,  three
hours would,  in all probability, have been sufficient to
relax the parts and restore the discharge:  but he "direct- 
208        EXCESSIVE MENSTRUATION.
ed her to lose twelve ounces of blood, to be freely purged
by senna, and to confine herself to rennet-whey, barley
water, or thin tapioca, for nourishment."   The next day
he repeated the order for purging; directed a continu-
ance  of the  diet, and added  the aloetic pill  at night.
After several days her menses appeared.
  The doctor supposes that his treatment was the cause
of the cure in this case, though he must have seen hun-
dreds in which it would have failed.   Indeed he admits,
just before, that  the same treatment might, in another
case,  have not only been unavailing, but injurious.   Be-
cause his guess-work  here did not hinder nature  from
performing her  work, he  concludes  that  he must  have
guessed right.  But what is the reason that similar guess-
work did not cure, or did actually cause, the suppres-
sions  in  the  dozens which we,  and the hundreds which
our friends have been obliged, after the doctors had ex-
hausted  all their skill, to  cure  with steam, lobelia  and
good  food?

              Excessive Menstruation.
  This  is the reverse of retention.   Instead  of being
closed so as to prevent the discharge, the uterine  vessels
are too  much relaxed, and, in case of  bloody discharges,
some  of them are even ruptured.  This  easy egress in-
vites the fluids to this organ at the expense of the healthy
performance of some other function.  The vessels  from
which the fluids are abstracted and diverted are, of course,
collapsed, and hence  there is a continued pressure to the
uterus.   Though the principle of cure, viz. to relax the
constricted vessels and restore an equilibrium to the cir- 
            decline  of the menses.         209

culation and proper tone to each organ, is the same as
in retention; yet  the locality of the operation will be
reversed.  Astringents must be directed  to the vagina,
and the general system must be  warmed and  expanded
so as to direct the  fluids from the uterus and restore the
full action of the other  secretions, particularly the per-
spiration.   This will regulate every  thing as nature
requires.  The doctors  use all possible efforts to  make
the people tremble at the thought of using hot  medicines
in this  case and  in  floodings;  but, never mind  their
learned folly;  experience, the best  of all  teachers, uni-
formly proves that this is  the true way to do  the work.

   Difficult or painful Menstruation is to be treated,
in all  respects,  as  I  have  directed for retention of the
menses.—(See page 206.)

              Decline  of the  Menses.
   Were the general health always attended to, the final
cessation of the menses  would be so gradual as seldom
even to disturb the animal economy; but, by a sudden
cold, or bad medical treatment  of  cold or some  other
form of disease, this secretion is often suppressed before
it should be, and then the system suffers.   Being entire-
ly ignorant  of the whole  philosophy of  this discharge,
(Dewees, page 67,) the regulars have adopted  a mode of
treatment calculated to  increase  rather than correct the
difficulty; and this  has induced females  to suppose it
among  the  most dangerous  forms  of disease.  By the
practice I have recommended for the retention of the
discharge, I have not only soon relieved  patients in or-
             14 
210      M E N S T R U A T I O N--H M M O R R II A G E S .

dinary cases, but eventually restored some to health, who
had been tormented several years  by the lancet, calomel,
opium, assafoetida, musk, belladonna, colchicum, &o. &c.
which so generally prove curses instead of blessings  to
the female system!  One patient had been thus afflicted
for several years, when the doctor told her he had " tried
every thing he could think of" for her case, till he knew
of nothing  that would benefit her  in one respect that
would not injure her in another!   We  might  well sup-
pose that, when a learned doctor had given  all the poi-
sons he could think of, she must have been in a deplora-
ble state;  and truly she was little better  than a raving
maniac.   But unwearied diligence in the use of the bo-
tanic remedies eventually  restored her to comfortable
health.

               Bloody Menstruation.
  This arises from the same cause as haemorrhage from
any  of the  capillaries,  viz.  collapse or obstruction  of
other vessels, and pressure towards these;  and must be
treated as we treat excessive or  too frequent menstrua-
tion,  only more  vigorously—collapsing by astringents
the expanded or ruptured capillaries, relaxing constricted
parts, and equalizing the circulation.

                   HEMORRHAGES.
  These, wherever found, arise  either from a relaxed
state of the capillaries or a lesion of the larger vessels,
from which the blood flows.  The relaxation  is  caused
by actual debility of the  parts; but  the  lesion is  either
from direct violence or from  the  pressure of  the fluids 
HEMORRHAGES.
211
forced from other collapsed parts to the region whence
the haemorrhage proceeds.
  The regulars bleed to take off the  pressure, and use
sugar of lead and other mineral, and occasionally vege-
table, astringents, and often  aid them with  ice  or cold
water to the parts.   I have known them put, at  once, a
half bushel of ice round a female pelvis, to stop a severe
haemorrhage!   It is no wonder  that death so often fol-
lows.  It is certainly better,  much  better, to do nothing
at all for the patient than to treat  her with  this savage
cruelty.   Very few, if any, would continue  to bleed till
they died, if left entirely to themselves: and suppose
they did—is it not  better to die of disease than to perish
at the point of the lancet?   But,
   Once let the equilibrium be restored, by warming  the
patient with hot teas and steam, and the blood, no longer
forced by collapse  of the vessels in one part to  congest
in those of another, will remain in the system in hydro-
static balance (as water in a sponge) without any dispo-
sition to discharge  itself.   Now, by astringents, collapse
the  parts effected, and keep the system in this condition
for a time, till the  injured vessels regain their integrity,
or the weakened their tone, and you have effected your
object.  Cayenne, tonics and food will do the rest. This
plan is  to be  pursued in  all cases of flooding, without
regard  to circumstances.  If it  take place  in or before
the  commencement of child-birth,  no fears  need be ap-
prehended of the consequences  of  this treatment.  Give
cayenne  and bayberry, or witch hazle, and the uterus
will contract as it  should—expelling the foetus, disengag- 
 212         nausea, vomiting, etc.

 ing the placenta, closing the vessels, and stopping the
 discharge.   Do it, and fear not.
   Among the best astringents within the compass of my
 experience are a strong tea of witch hazle leaves or bark,
 red oak bark, running blackberry, grape vine root, &c.
 Alum water is sure to stop the haemorrhage—and I  have
 never known it to do any injury.  Blood-root is  said,
 by our friends, to be excellent.  I have  never tried  it.

          Nausea, Vomiting, Salivation, &c.
   On these subjects  I  have treated  in general terms,
 page 89.  I add only  here, that  thorough courses, being
 careful to keep up the determination to  the  surface  dur-
 ing the  intervals, until the stomach is evidently cleansed,
 have, in the botanic practice, proved not only all-suffi-
 cient to subdue these disagreeable symptoms, and secure
 a comfortable degree  of health, but also to enable the
 female to nourish, and afterwards safely to  bring forth,
 an offspring free from canker and hereditary taint.
  Heartburn is caused by the fermentation  and souring
 of the food, and the corruption of the gastric juice before
 digestion can take place.   Dr. Dewees  says, " It is  gen-
 erally very distressing and very difficult to subdue." He
 has tried so many " remedies " for it, with so little effect,
 that he  " thinks it better, in bad  cases, to abandon the
 attempt to neutralize the acid."—(Females, page 212.)
 How scientific!  Can't cure, nor even palliate, the heart-
burn, which proceeds from a foul  or inactive stomach!
  Salivation, in this  case, is caused  by the nervous
sympathy of the stomach and the  salivary  glands with
the irritated and expanding  uterus.  I  have observed 
       PAIN IN THE SIDE--RESTLESSNESS.    213

that, where  the  stomach  had  been  kept thoroughly
cleansed, the salivary discharge, though a little increased
in quantity, was not very troublesome  nor disagreeable.
The  length of its duration will depend  much on the
treatment it receives.  If the  regulars  treat it, we may
expect it to  be "self-limited"  and "run its  course,"
which is  sometimes  the whole period of pregnancy.  I
once broke it up in a week, in a  lady who had generally
suffered from  it during a large  portion of  her utero-
gestation.

      Pain in the  Right Side during Pregnancy.
  Dr. Dewees informs us that, " after, seldom before, the
fifth  month, the woman is  sometimes attacked with a
deep-seated, rather obscure pain  in the right side," espe-
cially troublesome  at night.   He says, that, having treat-
ed it with " blood-letting, leeching, cupping and blister-
ing, without," as far as  he has  observed, the slightest
advantage, he  " has now ceased  to  prescribe  for it!"
This pain is doubtless caused, as  he says, by the pressure
of the ascending and expanding uterus on the liver; and
we can assure him that a fine steaming and a little lobe-
lia now and then, will so relax the walls of the  abdomen
as to  give room for  the uterus  to enlarge and  ascend
without  encroaching on the liver and  producing pain.
Will he dare to try it?

               Restlessness at Night.
  It is really amusing to notice the various " regular
opinions  of the cause of this affection during pregnancy.
Some attribute it  to fulness of blood, others to a defi- 
214       RESTLESS NES S--C OSTIVENESS.

ciency; and each treats it according to his notion of its
cause.   All  of them  consent  to bleeding,  purging,  low
diet, &c.  and object to all heating stimulants.  Some
prescribe  opium  in  large doses,  others in  very small
ones, and in a peculiar form.
  This  restlessness,  watchfulness, and generally febrile
state of the system,  no doubt, arises from  the  new  irri-
tability of the nervous system, and the pressure on  cer-
tain  nerves and vessels, by the expansion of the uterus
and its dependents;  but, instead of bleeding, &c. to cure
it, the  true plan is to relax the  general  system so  that
its capacity may increase  in proportion to  the augment-
ed quantity of the material secreted  for, and embodied
in, the constantly enlarging foetus.   This may  at  any
time be  effected  by  a judicious course  of medicine,  if
nothing else ail the patient.

                     CoSTIVENESS.
  This  arises, during the early periods of  pregnancy,
from the pressure of the enlarging uterus on the rectum
in the pelvis; and also from the circumstance that the
irritable state of the stomach prevents much eating, and
throws up some of the little that is eaten.   These com-
bined causes render it so long before the foeces collect in
the rectum in quantity sufficient to force a passage,  that
they become so hardened  and dry as to be  still longer
impeded in their progress.  The rectum is  less  irritated,
chiefly because a  smaller portion of irritating matter  is
permitted to descend into it.  Let a lady, not pregnant,
in ever so good health, eat as small  a quantity of food,
for days or weeks, as many a female does when  laboring 
COSTIVENESS.
215
under this irritation of the stomach, and she will gener-
ally become costive.
  To cure this costiveness—first, relieve it, for the pre-
sent, by  emollient and stimulant injections; secondly,
cleanse the stomach and restore the appetite, so that a
reasonable quantity of food can be eaten and digested:
thirdly, eat such food as will keep the bowels open, (ex-
perience  and observation will  tell you what,) and take
cayenne  enough  to aid the  operation when necessary.
A constant  use  of unbolted wheat  bread,  with proper
exercise, seems to be  sufficient, in  almost  all cases, to
prevent costiveness.   Always relieve the bowels  by in-
jections whenever they have been motionless for more
than twenty-four hours.  An excellent substitute for in-
jections, where  it may be  inconvenient  to administer
them, is  a small piece of castile soap, first rolled in a lit-
tle powder of cayenne, and introduced into  the rectum.
It will soon produce a passage.
  In a very obstinate case of costiveness that came un-
der  my  observation, the  lady took a fancy to  eating
chocolate in the cake.  She  ate it freely.   It corrected
the acidity of the stomach, nourished the system abun-
dantly, and  kept the  bowels free, after  all the other
means tried  had but partially accomplished these desir-
ed ends.
  Costiveness also occurs in the latter months,  from the
pressure of the more grown foetus on the  rectum where
it passes the brim of the  pelvis.  Let is be relieved as
often as it occurs, and be careful  that no other cause
unite with this to produce it. 
216
HEMORRHOIDS.
               Hemorrhoids or Piles.
  Costiveness is the principal cause  of this very painful
complaint.  Of course, strict attention to  the foregoing
directions will generally prevent  it, as  well as  be very
serviceable in curing it whenever it occurs.
  It presents itself first in the descent of the inner coat
of the intestine.  If immediately poulticed with slippery
elm, &c. it will soon return, and seldom descend again
until forced down by hardened foeces.   If this is neglect-
ed,  and the organ remains protruded, it soon swells, in-
flames, becomes very sore, and turns purple.   Some of
the regulars now recommend making a longitudinal  slit
in it; others, tying a string round it and letting it mor-
tify and fall off; others, leeching  or  puncturing it, &c.:
but I have cured very bad cases, by perseverance, with
the poultice, and  keeping the bowels  free.   This is  cer-
tainly the best plan.  Emollient  injections—as  slippery
elm—should  be used immediately before  every passage
in this case, and, after  the passage, a strong decoction of
some astringent—as witch hazle, red oak bark, galls, or
any other  innocent, powerful and permanent vegetable
astringent—to contract the organ to its proper dimen-
sions.  Steaming and  full courses of  medicine, I have
found the best means of reducing it.   A little soft grease
—as  neats-foot or  sweet oil—frequently  applied, is an
excellent preventive of piles.
  As causes of piles,  Dr. Dewees enumerates costive-
ness, pressure of  the uterus on the pelvic vessels, seden-
tary habits, soft cushions for seats, and long standing on
the feet.—(Diseases of  Women, page 223.)  I think these
are all probable causes.  Many hypotheses are  then  ad- 
HEMORRHOIDS.
217
duced from different authors, and strictures are made
upon them, after which comes the  treatment, viz. emol-
lient poultices, purging, puncturing, leeching, hot  and
cold applications, (even ice,) opiates, injections of sugar
of lead, and  finally  " the knife."   If,  however,  the in-
flammation should be subdued, and the organ reduced
by the bread  and milk poultice, castor oil injections, light
food and mild physic, then the doctor thinks " the vege-
table astringents" will do much  to effect  a cure.   Of
these, nut-galls, the  dust  of puff-balls and opium are
considered among the best.  It is not a little strange,
that, while the piles are considered the effect of costive-
ness, and costiveness the effect of diminished vitality, the
cure should be expected from the use of opium and sugar
of lead, some of those deadly " poisons which all agree
in suddenly and rapidly extinguishing a great propor-
tion of the vitality of the system!"  But nothing is too
absurd to be  believed or recommended by a regular doc-
tor.  No  caution is deemed necessary by Dr. D. in the
use of these; but stimulating vegetable astringents must
be  administered  with a  discriminating judgment,  lest
they should  restore the vitality of that sluggish organ,
the rectum,  which  would prevent costiveness, and of
course piles,  that proceed from it!  When  will  doctors
learn, that, to keep the system  clear  of canker, the di-
gestive powers in order, and to  take a reasonable quan-
tity of good food and moderate  exercise, are the sure
means  of preventing disease or curing it?
  Dr. Cullen  learned, of " an empyrical practitioner," the
great value  of balsam  copaiva.   Dr. Good  did not be-
lieve in it, for he had  " tried it, and  varied the dose." 
218       PILES--SCIENTIFIC PRACTICE.

" When the tubercles are not very sore," he says, " they
will often yield to a layer of gypsum, or, what is  better,
fuller's earth rubbed into a soft paste."  But these  things,
he intimates, will not answer in a bad case.
  Now, what can be the  reason why  the learned doc-
tors differ so much in their opinions respecting the value
of different remedies in this  or any other form  of dis-
ease?   It  is simply because the different conditions  of
the body  render it in  some cases more, in others less,
susceptible to  the action of all remedies;  and, of course,
a remedy will be effectual in the cases  of some patients,
or in some attacks of disease on  the same patient, and
not in others.   The doctors, who  see  the good effects,
praise the remedy;  those who see  the failures, condemn
it; while the true nature and effect of that remedy must
forever remain the same in all cases.  If a medicine ever
has a tendency to  remove disease,  it  always has that
tendency, and is proper  to be  administered whenever
the state of the system demands its peculiar action.   If
it is ever adapted to destroy life or injure the system, it
always  has that fitness;  and, when its  evil tendencies
(as  is sometimes the case) are overruled for good, the
credit is due, not to the poison  nor the skill of the ad-
ministrator, but to  the  power of the system to  defend
itself against all encroachments upon its  sanative opera-
tions.
  The business  of  the  physician,  then,  is to learn the
true nature and effects of all the remedies he uses;  to
study the  condition and  demands  of the  system, and
then to apply the  best remedy for that condition, in
quantity and frequency adequate to the demand.  With 
PALPITATION  OF THE HEART.
219
these rules for his guide, he will never reduce, directly,
by blood-letting, the arterial action, in order to aid the
vital power in removing obstructions; nor will he ad-
minister, to restore the action of a sluggish organ, any
of those scientific remedies of the doctors, which, how-
ever different their action in other respects, " all  agree
in suddenly and rapidly extinguishing a great proportion
of the vitality of the  system."—Boston Med. and Surg.
Jour. vol. 9, p. 43.
   The people of  the United States have much reason to
be grateful for the improvements which the fame of the
botanic practice has effected, even in the regular prac-
tice, where its humble self can find no admission.  The
doctors are now  often most sadly hampered, as they ask
for a  bowl  and a towel or a piece of paper, by the
solemn charge, "Doctor,  you must not bleed me.   Doc-
tor, don't give me your calomel; I won't take mercury
nor opium."  Unless, now, he can persuade the patient
that cupping or leeching is not bleeding,, that blue pills
are not mercury, and morphine is  not  opium, as he
sometimes does, he is reduced to the extremity of saying,
" If you know better  than I do what should be done, you
 must take care of yourself."

              Palpitation of  the Heart.
   Whatever much disturbs  the  nervous action,  or  ob-
 structs  the free and universal circulation of the fluids,
 will produce that labored motion of the  heart called pal-
 pitation.  I have before  shown  that the  more free  the
 system  from canker, and the more relaxed, warm, active
 and supple the parietes or walls of the chest and the ab- 
^20     DISPLACEMENT OF THE UTERUS.

domen, and the  nervous vessels of the pelvis, the less
disturbance can  take place in the action of the vascular
and nervous systems.   Of course reason unites with ex-
perience in dictating the propriety of full courses of med-
icine, with special attention to those parts of the system,
as the pelvis and lower limbs, that seem most obstructed.
Equalize the action of the system,  and you stop palpita-
tion.  The extremities  must  be heated, stimulated, kept
clean and  clothed  warm,  and  the chest  clothed more
lightly and loosely.

            Displacement of the Uterus.
   Of retroversion I have spoken on page 67. The uterus
is  sometimes inverted—that is, the fundus  descends  into
the vagina  through the os tincoe.   To cure  it,  give  a
course of medicines, with thorough application of strong
lobelia and slippery elm tea (nothing else)  to the vagina,
keep the patient in bed, with the pelvis high, and it will
soon return.  Now use injections of strong witch hazle,
or nut-galls, raspberry, blackberry briar or sumach, or
any innocent strong astringent, and tone up the general
system.
   Sometimes the uterus sinks too low in the vagina and
even through the external orifice, without turning inside
out.   Give injections  of bayberry or  other canker teas
and  cayenne, and  follow them with  the  astringents as
above.  This course will contract the upper parts of the
vagina and the round and  broad ligaments, the weak,
relaxed state of which  is the principal cause of the affec-
tion.   Whether the fundus of the uterus falls forward or
backward  or  sideways, the  plan  of  restoring it is the 
        displacement of the  uterus.      221

same, viz. raise the pelvis and administer an injection of
lobelia and slippery elm  to  the vagina.  If the bladder
is  distended by urine, it should  first be emptied by a
catheter.  The rectum should be emptied by an injec-
tion before, if it can, if not, after the reduction.
   I am aware that, if regulars read  my book, they will
condemn me  as " ignorant," because I have not carefully
distinguished between inversion of the uterus and poly-
pus, and given the precise treatment.  My first  reason
is, if ladies reject their destructive  practice, and apply
the true,  life-preserving,  anti-poison system, they will
never be troubled with either.  My second is, that, with
all the researches the regulars have made, they have ar-
rived only at the sage conclusion, that," though inverted
uterus and polypus may readily be confounded, and  the
mistake  either way may give  rise to very  different
results, yet the diagnostics of the inverted uterus, and a
polypus of this organ, as laid down by writers, are both
vague and discrepant.   This has created no small em-
barrassment  and uncertainty  to the surgeon who is
about to undertake the removal of the tumor occupying
the vagina, since he cannot satisfy  himself of the real
nature  of the  disease he has  to contend with.  Mr.
Newnham appears to have felt all this uncertainty in its
fullest force  when he was  about to apply the ligature
upon the uterus.  To aid his judgment in  this interest-
ing and perplexing case, he laboriously consulted almost
all the authorities extant; and,  after carefully  collating
their opinions, he reduces them to the following summa-
ry."—(Dewees on Females, page 251.) 
222     DISPLACEMENT  OF THE UTERUS.

  "It is generally remarked, that inversio uteri may be
distinguished from polypus  of that organ by the os uteri
not encircling the former tumor in cases of complete  in-
version, and by  the  impossibility of passing  the  finger
around the neck  of  the tumor,  between it and the os
uteri, where the inversion has been only partial; by the
form of the tumor, the polypus being broad at its base,
and attached  by a narrow peduncle, while the inverted
uterus is broader above than below; by the insensibility
of the tumor in the one case, and by its extreme  sensi-
bility in the other; by the comparative fixity of the one
tumor, and the extensive sphere of motion of  the other;
by the rough  and fungous surface of inversion, contrast-
ed with the smooth and polished surface of polypus; and
by the previous history of the  patient's disease."   "But
it is clear that these diagnostics are liable to a great de-
gree of uncertainty," as he proves by most ample quo-
tations.
  Dr. Dewees says,  " We are a little  surprised at this
distinction; for certain it is, we have  never witnessed
an instance  'of the inverted  uterus' being 'broader
above than  below;1  nor can  we imagine how it can
exist.  We are every way sure that the same relative
proportions exist  between the  fundus and the body, and
that of the neck, in both the natural  and inverted con-
dition of this organ; consequently, the mark  mentioned
by Mr. N. cannot  be present, but by some unusual  ar-
rangement;  and,  of  course, must not  be considered a
diagnostic."
  "Mr. Newnham has collected, as we have  remarked,
with great industry,  nearly all that has been  said  upon 
         DISPLACEMENT OF THE UTERUS.      223

the diagnostics of these  two complaints; and, from all
that can be learned from these various sources, a con-
clusion  must be drawn  that there are none which are
absolutely  certain.   Mr. N. says,  'On  reviewing the
foregoing testimonies, we shall  be induced to conclude
that it  is  always difficult,  and sometimes impossible,
with our present knowledge, to distinguish partial and
chronic inversion of the  uterus from  polypus:  since, in
both diseases, the os uteri will  be found encircling the
summit of  the tumor, and, in either case, the finger may
be readily passed around it.   And if, in order to remove
this  uncertainty, the whole  hand be introduced into the
vagina, so as to allow the fingers to pass by the side of
the tumor,  to the extremity  of the space remaining be-
tween it and the os uteri; and if we find that the finger
soon arrives at this point, it will be impossible to ascer-
tain whether  it rests against a portion of the uterus,
which has  been inverted in the  usual way, or  by the
long-continued dragging  of polypus  upon its  fundus.
And if, under these embarrassing circumstances,  we call
to our assistance our ideas concerning the form of poly-
pus, its  enlarged base and  narrow peduncle, we  must
also recollect the abundant  evidence  to prove  that the
neck  of such a tumor is often  as  large, and sometimes
larger, than it3 inferior extremity; and we shall still be
left in inexplicable difficulty.'"
   Now, suppose we botanies admit that we are  not suf-
ficiently learned or skilful to discover the  difference be-
tween polypus uteri and invercio uteri, how far should
we be, in this respect, behind our "scientific" brethren,
even according to their own showing?  But the fact is, 
224
FACTS AND CASES.
we have vastly the advantage of them; for, by follow-
ing the plan I have recommended, all cases of real in-
vercio  will be  easily and speedily reduced;  while the
polypes will either be absorbed away or increase in size
till there is no doubt of their real character, when they
will often ripen and  drop off, or may be safely removed
either by suppuration produced by the vegetable caustic,
or by ligature, as described page 68.

                  Facts and Cases.
   After trying various means to cure a case of inversio
uteri, Dr. Dewees  and his " consultation" resolved  to
apply the ligature,  " but the patient died before the ope-
ration could be performed!"   One  case only ever  came
under my knowledge;  that was  made  by a "learned"
doctor in pulling away the placenta.  It was treated by
the same and others, " in consultation," for four years or
more, and finally the patient died under the influence oi
this  learned quackery, in  the full  persuasion  that " the
will of the Lord " alone was accomplished!
   On the other hand, I do not know  of  any instance
(and many  have been reported  to me, besides several
that have come under my own treatment,) where de-
rangement and excrescences of the uterus have not been
entirely cured  by  our  treatment.   One of the cases I
treated had been  under the  management  of  the  most
eminent regulars for more than six years, and had be-
come truly deplorable.   The nervous system was nearly
ruined.   But how can the M. D.'s be  expected to cure
by their quackery, what they have first made  by quack-
ery?  Where upon the earth were such forms of disease 
          DISEASE OF THE UTERUS, ETC.       225

ever serious, till the patient had been treated a while for
these or some other affections, by the sons of iEscula-
pius?  Again I say, let the ladies abandon all medical
poisons and " obstetric violence—ferocious and atrocious
obstetric violence," and adopt the  cayenne, vapor and
lobelia system, and they may dismiss their fears of poly-
pus and prolapsus uteri.  These, with the lancet, calo-
mel, opium, and other  poisons, as remedies  for disease,
are destined soon to  be numbered among " the  things
that were."

      Disease of the Uterus and its appendages.
  Of these Dr. Dewees says, (Females, page 254,) " The
whole of the internal organs of generation are liable to
disease, the most of which may be considered incurable.
To  describe minutely the whole that are known, would,
of itself, require a volume;  and,  if this were  done, we
might be disposed, in many instances, to  inquire, cui
bono? [whom would it  profit?] as regards the success of
medical treatment."
  This  testimony is fully sustained by Dr. Mackintosh,
page 667:
  " Ovarian Disease.—In the exercise of our profession,
nothing is more disagreeable, and even humiliating, than
to be obliged to witness, from day to day, for a period
of months and years, the sufferings  of patients  under a
disease  like this, without being able to do more than
palliate symptoms by  means  of narcotics.  Sometimes
we  have the additional mortification to find that tempo-
rary tranquility is produced at the expense of increased
after-suffering;"  so that there really is  something to
             15 
226
OVARIAN  DISEASE.
tempt an  individual with  an enterprising spirit, to the
performance even  of  the horrible operation  of opening
the abdomen from  the ensiform cartilage to the pubis, in
the hope of being  able  to effect a radical cure!   This
operation has now been performed several times by Mr.
Lizars of Edinburgh, and I have no doubt, from his an-
atomical knowledge and experience in operating, it was
done, in all the cases, with  the  greatest dexterity, and
that no  means were neglected which  could  insure suc-
cess.  But  mark the results:
  "The first woman died in forty-eight hours, and no-
thing was discovered but flatus in the  intestines."  The
second wras laid open;  the  uterus and ovaria were sound
and healthy, but it was discovered that the woman was
very fat.  She escaped with her life at that time, although
stated often to be  severely  tortured  with  pain.  The
third had also ascites; a large tumor was taken from the
left side, but one on the opposite side was left untouch-
ed, from the  extent  of the adhesions  to surrounding
parts.  She survived the operation, but died  three years
after.  The fourth case, Mr.  Lizars took away a tumor,
and separated  adhesions between it and the viscera; but
she died from  mortification.   The fifth case, the tumor
was so completely attached  to the surrounding viscera,
with so many large blood-vessels in the way, he wTas
forced to abandon it  and  stitch up.   She survived the
operation.  The sixth case, a tumor was  cut away pro-
jecting from the fundus of the uterus, which was thought
to be an ovarium; she died  in a few days from inflam-
mation.  The  ovaria were found quite snug  and  sound
in their proper situation. 
         REASONS AGAINST OPERATIONS.      227

   The following are the reasons why I consider this op-
eration unadvisable:
   First—It is difficult to tell whether there is a  tumor
or  not in  the abdomen.  See  two cases out of  six in
which no disease was found to  account for the tumefac-
tion of the abdomen.
   Second—If there is a tumor, it is impossible to  deter-
mine if it is  in  the uterus, ovaria, or some other part.
Another  case, examined, per vaginam, by many M. D.'s,
was pronounced, by all, ovarian disease.   She died six
months  after, and was  dissected.   The ovaries  were
found quite healthy, but the liver was  enormously en-
larged, which was the cause of the  tumefaction  of the
abdomen.  Another case was most  unhesitatingly pro-
nounced  to arise from ovarian disease.   She died  some
time  after, and, on opening the body, the uterus and
ovaries were perfectly sound, but extensive disease ex-
isted in the stomach, colon, liver and kidneys.
   Third—It is impossible to tell if the diseased ovarium
is attached to surrounding parts, which is always  an in-
surmountable objection; for, should  there be  extensive
adhesions, which require to be separated during the ope-
ration, such separation, whether effected  by the knife or
by  the fingers, must seal the fate of ninety-nine out of a
hundred.  Even in a dead body, half an  hour has been
taken in  separating an ovarian tumor from its adhesions,
which was not  effected without wounding many large
blood-vessels.
  Fourth—It ought to be considered whether the dan-
gers arising from  the  operation are not greater  than
from allowing the disease to remain undisturbed.   First, 
 228      IGNORANCE OF THE  REGULARS.

 we have to consider the chance of the patient dying im-
 mediately from the shock, or from haemorrhage, or after-
 wards from inflammation, after she had undergone the
 horrid torture occasioned by an incision from  the  ster-
 num  to  the pubis, independently of that produced by
 exposing and handling the viscera and cutting away the
 tumor, not to speak of the  difficulty of restraining the
 protrusion of the intestines, both during the performance
 of, and after, the operation.   To give my opinion in the
 shortest  manner possible, I simply state that I  regard a
 recovery, after such an operation, as almost miraculous,
 and to be considered more in the  light of an escape than
 a recovery to be expected."
  The instruction, then, derived from  the above extracts
 from the most celebrated pathologists of the age, of the
 schools of Philadelphia and Edinburgh, amounts to sim-
 ply this: that the regular faculty know not the  causes
 nor the seats of  the most common forms of disease; that
 they have no certain remedies for their cure; that  they
 often  perform the most dangerous  surgical  operations,
 which destroy many lives,  on the strength of a  mere
guess that these  operations are needed to save life;  and,
 last but not least, that it is much safer to trust to  nature
 in all cases of disease, than  to employ the most  distin-
 guished among them, unless he has  abandoned  the rules
 and instructions of authors  and professors, and limited
 his practice to simple and innocent  means.
  With all due respect for the benevolence of physicians
 as a class of men, and admission of the  usefulness  of
 many of this latter class, so  fully are we  convinced of
 the  pernicious tendency of " the science of medicine," as 
SAFETY OF  THE BOTANIC PRACTICE.   229
they understand it, we solemnly declare that no morbid
condition of our body could induce us to prefer the prac-
tice of "the regular physician" to the unaided efforts of
nature.  Let us die at once by the violence of disease,
rather than be poisoned to  death, or  ruined for life, by
the desperate remedies of the popular medical and  sur-
gical practice.
   Do  our  female friends suppose that we are about to
leave them in this dilemma—this "glorious uncertainty,
or rather  inglorious  certainty?"  No!  we can assure
them that  the botanic practice is so  sure and safe, in all
" diseases of the generative organs,"  that, under its judi-
cious  and  persevering application, according to  our di-
rections, the chances for death, from  any of them, are so
few and far between as to cease to be legitimate objects
of dread.  The most conclusive proofs of the  truth  of
this declaration may be found  in almost every number
of the Botanico-Medical Recorder,  issued for  the last
thirteen years.
   While I lived in Richmond, Va., a  lady in the country
wrote me  a letter,  in which she described her case.  Ac-
cording to  the opinions  of her numerous  physicians,
 several  of whom were  among the  very heads  of  " the
 profession,"  she had been at different times  afflicted
 with almost every form of disease to which the peculiar
 structure  of the female frame is liable.   I  put away the
 letter, with intent to use it in  this  place, so safely that
 I cannot now lay my hands  upon it.  So  thrilling was
 the description of  her "miserable" and truly deplorable
 condition, that I could  scarcely read  it, even a second
 or third time, without shedding tears of sympathy  for a 
230
A LADY'S  DIPLOMA.
 suffering fellow being.  Truly, thought I, (confident that
 her afflictions were chiefly the results of  the fashionable
 poisoning and depletive practice,)

          " Man's inhumanity to man,
          Makes countless thousands mourn."

   The last  affection  she  mentioned, if memory serves
 me, was ovarian disease.  It being impracticable for her
 to come to my infirmary for some weeks, she  entreated
 me to prescribe something that would relieve her imme-
 diate sufferings, from which death would have been, as
 Dr. Good  says, "a friendly stroke" to relieve her.
   Her letter indicating that she was a very intelligent
 and judicious lady, I wrote her a long answer, prescrib-
 ing the proper course, and advising her to commence it
 at once, and have  it applied  by some member of her
 family, and by herself,  so far  as she was able.  Some
 months  afterwards  I  saw a gentleman from  the same
 neighborhood, who said that she had followed the pre-
 scription  to the letter,  and was at that  time  perfectly
 well;  that she had preserved my letter, and was in the
 habit of showing it to her intimate friends as her " med-
 ical diploma," which she valued  beyond all price.  The
 directions  given were substantially  the  same that are
 given in various  parts  of  this work.   Much stress was
 laid on the very frequent  use of canker  enemas to the
 vagina, and keeping the pelvic  region and all below it
warm.
   I have attended, in  person, many other ladies whose
female organs had been  so much deranged by " learned
quackery" that "the most gifted sons" of this hypothet- 
MORE CONFESSIONS.
231
ical science could  not determine what particular organ
was affected, such were the number, variety and contra-
riety of the symptoms in the  case.   Yet I never  lost
one of them when I  was  the  sole physician.  The pro-
per indications  of cure  have  been developed  in  the
"General Principles," and the  modes of operation  will
be found in the chapter on " Ways and Means."
  To the  account  of the above reported cure  by my
prescription, I might add multitudes from the Recorder;
but, suppose a patient had no confidence in our remedies
or our judgment  of.the real  nature of these cases, and
should go to the regulars for advice: some might say that
we revolutionists  were " ignorant quacks, more likely to
kill than to cure—that they have all the science, and can
cure if the disease be curable."   But what do the wisest
of them say on this subject to their brethren  and pupils/
Let Dr. Dewees answer this question.
  Of  the  ovaries, he says, (see Females,  page  256,)
" They seem to be so far  removed from the general sym-
pathies of  the system, so insulated  in position, so inde-
pendent in function, that the  common  agents  for the
removal or control of disease seem to waste  themselves
in unavailing  attempts to influence  their actions  or to
modify their  affections.   Who flatters himself that  he
has  removed  a dropsy, resolved a scirrhus, or interrupt-
ed  suppuration of these bodies ?  We believe, if he  be
candid, none will declare he  has."  [We know, whether
they confess it or not, that the regular practice has made
many such affections.]   " Little more, then, is ascertain-
ed  than that these parts  are very liable to disease [about
as much so as the patient is  to fall into the regular prac- 
232      CONFESSIONS  OF THE REGULARS.

tice,] and but very little susceptible of cure," [while she
despises and rejects the botanic]  He mentions five dif-
ferent affections, as discovered by dissection, and adds.
"unfortunately, they have  much  more  frequently fur-
nished subjects for the anatomist's knife, than  triumphs
to their skill."
  Of the fallopian or  utero-ovarian tubes, he says, page
257, " We have every thing yet to learn  as regards the
diagnostics of the  diseased  tubes; for, to this  moment,
we are altogether unacquainted with  the portions of the
body with which they sympathise."
  How, we ask, can ladies expect to gain important in-
formation from persons  who confess that  they  " have
every thing yet to learn?"   We assure  them  that we
steamers have  learned  at  least one  thing  about these
affections—that is, how to cure them.   But  one  will  ask
how I know that we have cured them ? it may  be we do
not understand pathology sufficiently  well  to detect the
peculiar characters  of internal  diseases.   I answer:  the
regulars have declared that many patients had these dis-
eases, and  were consequently incurable.   We neither
affirmed nor denied the testimony, but cured the patients.
Now, it follows of course, either the  doctors cannot de-
tect  these  diseases, or they are the  witnesses  that the
botanies can cure them.   They may  choose either horn
of the dilemma.
  Of the particular diseases of the uterus, says Dr. De-
wees, as  carcinoma, cauliflower excrescence, corroding
ulcer, &c. " a short account will be sufficient, as we are,
unfortunately,  acquainted  with little  more than their
ravages."—Pages 258-9. 
        REGULAR  TREATMENT--HYDATIDS.    233

   Carcinoma uteri  is a tumor on, or thickening of, the
cervix  uteri,  which  is  disposed  to ulcerate.  Several
have been cured by the steamers.  "It seems doubtful,"
says the  doctor, " to those best acquainted with  this
disease, whether a  cure or mere  suspension  of  this  dis-
ease has  ever  been effected;" but he thinks the best
treatment is " local bleeding, severe diet, and  absolute
rest.   Leeching, immediately, from the  uterus, is incom-
parably better than more remote  leeching; and, not-
withstanding the great aversion of our American ladies
to this mode of depletion, we are happy to say that we
have, in a number  of instances, been able to overcome
this aversion!"  So it seems that, " in  a  number  of in-
stances, our American ladies" have allowed a learned
doctor  to cram the  vagina full  of leeches, that they
might  get hold of the cervix  uteri.  For  conscience
sake,  let  us hear  no  more about  the  vulgarity of the
Thomsonian practice.   Proper diet, constant cleanliness
and frequent rest, I can cordially approve.   I am, how-
ever,  fully persuaded  that the  anti-phlogistic  plan  of
treatment, recommended by Dr. Dewees,  in these cases,
is better calculated  to render existing cases fatal, and to
produce others, than to prevent or cure any.

                      Hydatids.
  After having proved that their  origin and  nature  are
involved in total obscurity, Dr.  D. says,  " No  remedy
has hitherto been discovered for the relief of hydatids,"
but fortunately it is a form of disease rarely to be found.
Madame Boivin uses stimulating  injections;  Dr. Clarke
uses cold  applications  and astringents; Dr. Dewees his 
234   UTERINE AFFECTIONS--TREATMENT.

hand, and the poison  and destructive ergot or spurred
rye!   So they go.  They agree only in one thing: they
all cause the  patient much pain and suffering, while the
benefits they confer are  few and far between.  While
Dr. D. advises the insertion of the hand into the uterus,
he says, " violence must  never be employed  in this or
any other instance, in  passing the hand into the  uterus !"
Wonder what the doctor means by the term " violence!"
Can  it be  any thing  short of breaking  the   patient's
neck ?

         Treatment  of  Uterine Affections.
  Let it be remembered that the affections of the uterus
and  its dependents, to  which  I  have just alluded, are
very rarely found, seldom more than two  or  three  in-
stances of each, and often not one, in the whole practice
of the most experienced accouchers ; that they  are gen-
erally the most common in the fashionable and idle cir-
cles of life; and, lastly, that they are  the most dreadful
and fatal under the treatment of the regular faculty.
  Among the botanic  fraternity, (except those who may
have retained them as memorials  of  their former allegi-
ance to the lancet, bleeding, poison and starvation,) they
are seldom found.   Where they are permitted  to arise
through neglect to attend to the general and particular
internal and external  cleansing of the system, they may
be soon cured by  a judicious  medical treatment.  But,
if this be true, I may  be asked why are  they professedly
incurable in the hands of  the regulars ?  I answer: sim-
ply because the course they pursue is calculated to make
disease, not to cure it.  Let me prove this.   To prevent 
            ERRORS OF THE REGULARS.        235

ulceration, their plan is to destroy the " local  inflamma-
tion which," they say, " is essential  to the disease; to
diminish the circulation  of the blood, and to abate  arte-
rial action."  Here they start upon a fatal blunder, in
taking an effect of the disturbed  vital action, for the
cause which produced the disturbance.   I need not say
that all conclusions drawn from false premises, are  erro-
neous.  Let me present the facts, as they are often  more
conclusive than argument, however sound.  Dr. Dewees
says, (Females, page 263,) "These ends will be found
best answered by blood-letting, general and  local; by
purging,  by abstemious diet,  by cleanliness,  by  rest."
True, these means, especially the  first three, are effectual
to  accomplish "these ends."   But are  these  truly the
ends  to  be accomplished? This is  the question.   All
admit that the vital  action  is  the  only  conservative
power  of the  organized body against  putrefaction;
therefore,  I argue, the  greater  the  diminution of this
vital power,  the more danger of its total extinction by
the encroachments of mortification.  Example: Bind a
ligature round any organ and stop the circulation  in it,
and it  immediately mortifies or dies:  yet Dr. Dewees
advises us to diminish the circulation  in an organ " to
prevent ulceration " or mortification!   The bleeding and
purging check vital action, and prevent it from pervad-
ing the affected organ; of course it checks the warfare
for the time, between the conservative power  of life and
the chemical power of decomposition.  If, then, decom-
position does not soon  take place,  in every instance, it
must be because the conservative power is not, as in the 
236        ERRORS OF THE REGULARS.
case of the  ligature, entirely destroyed, but is continu-
ally rallying its forces and trying to repel the encroach-
ments of chemical decomposition, or, in other words, of
mortification.
  To either prevent or cure these affections, it is  evi-
dent, from reason as well as the facts, that the regular
plan renders them  " incurable," while the botanic prac-
tice either  prevents  or cures  them;  that " the  ends"
above are the true causes of death instead of life to  the
part, and  therefore are not the true ends to be accom-
plished.
  What, then, are  the true ends to  be accomplished ?
Evidently to  relax  the  strictures and remove the  ob-
structions which  disturb or  repel vital action.  This will
equalize the circulation of the blood, when  it will be
found that there  will be no necessity for  " diminishing
its  quantity."  The "arterial  action"  is   always suffi-
ciently "abated" when  the circulation of  the blood is
free and universal, and  the absorbents, secernants  and
excernants  are in good order.  Therefore  we botanies
reverse all the doctor's prescriptions.   Instead of with-
drawing vital action from  the part which we fear will
"ulcerate,"  we stimulate it  directly to the  performance
of its duty; instead of  "diminishing the  quantity" of
the vital fluid, we promote its equal and universal diffu-
sion; instead  of  removing  the organ to get rid  of the
obstructions that hinder the due performance of its func-
tions, we remove  the  obstructions to save the organ.
For the plan and process proper in the case, see " Ways
and Means," page 141. 
THE UTERUS.
237
            Irritability of the  Uterus.
  Dr. Dewees classes this property among diseases.  I
should be glad to be told the use of a uterus that is not
" irritable."   It  surely could never  perform  any of its
proper functions.  But Dr. Gooch calls it " a painful and
tender state of the uterus "■—something  rather more  in-
telligible.   Dr. D. says, "The general symptoms are, an
increased frequency and a preternatural  firmness of the
pulse;" that it  "is  always  more  frequent and  corded
than usual."  But Dr. G. says, "The pulse is soft and
not much quicker than natural"—a direct contradiction;
but that is  a small affair among doctors.   Dr. D. adds,
" headache, pale and white tongue, dry skin, irritable
stomach, scanty and high-colored, or pale and abundant,
urine."
  Now, we ask, if the above symptoms  are peculiar to
the uterus, why  are they as common to  males as  to fe-
males ?  If  not peculiar, of what use are  they but to per-
plex the practitioner and lead  to an erroneous course of
practice ?   The doctor then gives the local symptomatic
descriptions, after which he quotes those of Drs. Gooch
and Addison, and says, " to be  convinced that these gen-
tlemen have added many symptoms that do not belong
to  this affection, it will  only  be necessary to compare
their descriptions" with his !  Very modest, indeed!  He
goes on  through  twelve octavo pages, reporting  the
opinions  of various authors, coming, as usual, at  last to
no conclusion for himself,  though fully establishing, in
the mind of every reflecting reader, the declaration of
his  worthy colleague, Dr. Chapman, (Therapeutics, vol.
1, page 23,) "To harmonize the contrarieties of medical 
238      IRRITABILITY OF  THE UTERUS.
doctrines is, indeed, a task as impracticable as to arrange
the fleeting vapors around us, or  to  reconcile the  fixed
and repulsive antipathies of nature."
  Having fully established the certainty of " the highest
degree of uncertainty" in the knowledge of "the facul-
ty" in regard to the nature and symptoms of this form
of disease, Dr. Dewees commences an exposition of the
regular treatment—" the remote and  predisposing causes
are involved in great obscurity"—and then  (notwith-
standing the regular hue and cry against the steam fra-
ternity for treating all forms of disease on  the same plan
and with the same general remedies,) we have the  same
old tune of "bleeding,  purging, blistering and rubefa-
cients, narcotics, injections of nitrate of  silver, opium,
sugar of lead, &c. starving and rest."  But mark, it  is
by no means certain  that this course of treatment will
do any other good than  make a long doctor's bill; for
he says, page 326, " From  the length of  time required
to overcome the disease, and the privations  to which
the woman must submit who  looks forward  to its  cure,
patience becomes exhausted, and confidence in the effi-
cacy of remedies is too quickly destroyed;  for relief  is
not only almost always tardy, but is too often uncertain;
# ■ *   *   *  forj however judiciously remedies may be
advised, or however faithfully they may be applied, they
are far from being speedy and uniform in their effects.
This is the declaration of the  several authorities before
us, and but too  certainly confirmed  by  our own  expe-
rience; months, nay  years, are sometimes  required  to
accomplish a cure; and, if it be effected even after a
very long trial of means, the  woman may felicitate her- 
      EXPERIENCE OF A REGULAR DOCTOR.   239

self that she has been able to procure health even at so
great a price."
  The doctor gives us three cases which he treated: the
first "was so far relieved as to enjoy a very comfortable
state of health;" the second " was  entirely restored in
seven  months;"  the third was  relieved in about five
months"—she, however, did  not  "persevere three or
four months longer," under the " reasonable expectation
that it [the  plan] would have  proved still  more  benefi-
cial."   But, " notwithstanding the success that attended
the  cases just related, [only  one cured,  and that after
having suffered seven  months,] as  well  as many more
that we  could  mention, it is  but  fair to  acknowledge
that  there  have been  others in  which no such  benefit
was received, though remedies, generally speaking, were
faithfully used,  and every  reasonable  precaution  taken
to insure success."—Page 336.
   I  have copied thus extensively from Dr. Dewees, for
three reasons: first—because he says, page 327, he has
" detailed all that experience has hitherto suggested for
its  relief;"  second—because, being " Professor  of Mid-
wifery in the University of Pennsylvania," he is a stand-
ard authority in the United States; and  third—because,
by so doing, I fully redeem my pledge given in  the first
number, to  prove that  if, in the use of the botanic prac-
tice, there should be, in any case, the fear of a failure of
success, a resort to the regular would almost certainly
insure wreck and misery to the constitution, and loss of
health and  happiness, if not even life itself, to the patient.
   But, must I leave this subject  of irritable uterus as I
find it in the hands of Dr.  Dewees ?  I hope not.  I in- 
240     IRRITABLE UTERUS--TREATMENT.

quire, then, what is irritable uterus?  Answer:  such  a
complication of local  or general  affections, that ' the
faculty,'  as  we have seen, can  neither tell  what it  is,
what is its cause, nor how it should be treated.   What
are  its symptoms?  Answer:  "inflammation,"   to be
sure, and  "great tenderness  in the  first  stages," with
" danger of suppuration," &c.  Now, what is the cause
of inflammation?  Answer: it  is  the  accumulation  of
vital  action.  But vital action  cannot be accumulated
where there are no  obstructions to the free operations
of vitality;  therefore, obstructions are the  cause  of this
disease as well as every other.
  What, then, is the proper treatment? I answer: relax
the parts constricted; remove obstructions from the ves-
sels that are clogged, and restore a healthy action to the
organs.
  But how shall we know, any better  than the M. D.'s,
amidst the multitude of conflicting symptoms, what par-
ticular organs are diseased?  Answer: Here it  is that
we have the advantage of them.  We commence with
general remedies, means that are calculated to remove
obstructions wherever found,  and which cannot, like
their specifics, do mischief where we do not intend they
shall  operate.   A  repetition  or  continuance of this
course, by removing,  one  after another, the different
causes of the various  symptoms, soon reduces them  to
so few in number,  and confines them to such narrow
limits, as to  leave no doubt what is the organ  primarily
diseased, what is the nature of its affection, or the pro-
per local treatment.  As fast as we thus  determine  the
seat and character of the affection, just so fast  we apply 
        IRRITABLE  UTERUS--TREATMENT.     241

the proper modes and means  of removing the obstruc-
tions to a healthy  action  of  the  organ,  and thus our
patient is  soon restored, in all cases where the  vitality
of the  organ  is not extinct.  For the proper mode  of
doing this, see "Ways and Means," page 141.
   I add only in this  place, that  the  practitioner is  to
remember, in  all cases of disease within  the  pelvis, that
the vapor-bath, confined below the waist, and injections
of the required character to the part  affected, are pow-
erful  means  of removing  obstructions  and promoting
healthy action; that nothing is  equal to a  poultice of
lobelia and slippery elm for relaxing ' inflamed surfaces,'
and removing the cause  of their  ' tenderness;' and that
few things are easier in practice than  to fill  the vagina,
and of course surround the  cervix uteri, with  such a
poultice.  It cannot do the least harm, may be confined
at pleasure with a cloth, and  easily washed  out  with a
syringe as often as it  is proper to renew it, which should
always  be as  often,  at most, as every  twelve hours.
After all the " inflammation and tenderness " are  remov-
ed, the injections  should   contain  the  astringency  of
witch  hazle,  and the stimulus of cayenne or  ginger,
enough to be  felt.
   The above is a course which, in its  essential features,
I have actually pursued with  complete success,  without
being compelled to acknowledge, with the  learned Dr.
Dewees,  the  intervention  of a   multitude  of  failures.
Similar advice, also, sent in private letters to individu-
als, has been  attended with similar results.   In fine, I
remark that  a judicious and faithful  practice will not
require "  some months " to exhibit evidences of its util
              16 
242      HEMORRHAGE OF THE UTERUS.

ity, or to afford  "reasonable expectation" of final  suc-
cess.

           Hemorrhage of the Uterus.
  I have already given a sufficient account of the causes
and nature of this form  of disease, with  directions  for
its treatment, wrhich, if followed fearlessly and faithfully,
will be found amply sufficient for its management.   But
the evil consequences of the great terror which it gen-
erally carries to  the heart of the patient and her friends,
have  induced  me  to  add, here, a few remarks which
prove that nearly all  the causes of alarm are to be found
in the bad management of the regulars, from which, if
she abstain, she shall do well.
  Of  the connection  of the ovum with the fetus, Dr.
Dewees says, " Soon  after the ovum is deposited in  the
uterus, its external covering, or chorion, shoots out in-
numerable vascular fibres, and, on the  internal face  of
the womb, is produced a soft, spongy, vascular substance,
called  decidua;  these, when  connected,  serve  as  the
bond  of union between the ovum and the uterus.   These
minute vessels interlock with each other, after a certain
period,  so firmly that they cannot  be well  separated
without  rupture.  Therefore,  should a portion of  the
ovum  be detached, in the earlier months, the quantity
of blood that will issue will  be commensurate with  the
surface, especially if  it be from the  fundus, and propor-
tioned to the advancement of  pregnancy."—(Condensed
from pages 336-7.  Dr. D. must pardon this liberty  here
and elsewhere.   I have not patience to copy his unmean-
ing verbiage, nor any disposition for mere book making.) 
         HEMORRHAGE OF  THE UTERUS.      243

  It is agreed by all, that the separation of some part of
this connection is the principal, if not the sole, cause of
haemorrhage during pregnancy.  Whatever can produce
this separation,  as  mechanical violence, unequal circu-
lation, and  disease  in any form, should  be carefully
avoided.
  Doctors enumerate plethora among the causes of the
separation, and hence they direct bleeding as the reme-
dy.  But their error lies in mistaking inequality of cir-
culation  and local congestion for excess of fluids.   On
this mistake they build the practice of drawing entirely
out of the body that blood which they ought rather to
invite  to places where it is deficient, as the true mode
of relieving  the system from danger.   Dr. Dewees thinks
that abortion is generally produced directly by the  con-
tractions of the uterus, whatever be  the remote causes
of those  contractions.  I think so too.   Dr. Burns thinks
it impossible to prevent them  after  they commence, and
of no use to try.   Dr. D. doubts this position, and thinks
he  ought to try in every case, though he should succeed
in only one in twenty!   In only one case does he " never
interfere"—that  is, "where  the breasts have  become
tumid, and  then  pretty  suddenly subside"—" the  only
symptoms  that mark  the  death of the ovum,  with a
certainty that has  stood the test of experience  ever
since the days of Hippocrates."   The  doctor says he
" must confess that he has known the ovum to be expell-
ed  where this sign of death was wanting," yet he be-
lieves  the  expulsion was  owing to "the indomitable
nature of the  contractions of the  uterus."  He thinks
also that the contractions may be prevented after  they 
244      HEMORRHAGE OF THE UTERUS.

commence;  for he brings cases of  the expulsion of one
foetus prematurely, while the other of the same gestation
remained to maturity:  therefore  he concludes that the
contractions may be prevented  and the  haemorrhage
stopped, though it be but in  one case in twenty.  The
ways and means by which he attempts to prevent these
contractions will sufficiently explain the reason why he
is so unsuccessful.
  Among the first  steps in  his curative process, is the
use of " ice-water," &c.  " No  stimulating  substance of
any kind should be permitted."  All changing of clothes,
"putting the  bed to rights, or altering  her position,
should  be strictly forbidden."  This  done, if plethora
present, "blood should be  taken  from the  arm, in  a
quantity proportionate  to the arterial system; remem-
bering that we do little or no good by the operation if
we do not decidedly  diminish the force of its  action."—
Page  347.   Take  an example of the  manner  in which
the doctor treats these cases.
  "In 1796, Mrs. B. was much exhausted  with uterine
haemorrhage, in the  fourth month of gestation.  Early
on the 16th  of January,  the usual means were employed,
and, for the time, the discharge was arrested.  At 5 P.
M.  it returned, and  was soon flowing very rapidly.
There being a high arterial action, she was instantly
bled  from the arm until there was a reduction of the
force  and frequency of the pulse:  the abdomen wras cov-
ered with ice  and snow.  There was an abatement in
the discharge, followed  by slight alternate  pains in the
back, shooting towards  the pubis.   Forty-five drops of
laudanum wrere now given, and  strict  injunctions left 
         HEMORRHAGE OF THE UTERUS.      245

that the patient should be kept as quiet as possible.  On
the morning of the 19th the patient was free from fever,
and almost  free from discharge.  About 5  P. M. the
whole scene, as described before, was renewed; she was
again  bled;  ice was  applied, and  laudanum repeated.
On the 18th at 8 A. M. she had a return of fever, with
haemorrhage;  she was again bled, &c.   In  this manner
did matters  proceed for several days, when  it was ob-
served  that the arterial exacerbations observed no regu-
lar periods, but that the  floodings were  uniformly con-
tinued  during  the excitement.  To interrupt  this recur-
rence, I placed a young gentleman at  the patient's bed-
side, with orders to bleed her the moment he perceived
an  increase  of pulse; this  was  done, and  from  each
bleeding decided  advantage was discovered.  The loss
of five or six ounces of blood was sure to stop the uter-
ine discharge in a few minutes, and sometimes even to
prevent its appearance.  Proceeding in this manner, till
the 23d, entirely relieved the patient from this  distress-
ing complaint.  She was bled seventeen times, and lost,
by computation, one hundred and ten  ounces  of blood in
the course of seven days."—Page 348.
  Had I not known some cases that were treated in the
same  manner, I could scarcely  believe  that any  man
could be so cruel; and did I not know  the strong  ten-
dency of the living  power to maintain  the possession of
its citadel, I could not readily believe  the doctor's  addi-
tional  remark, that  the  patient "gradually gathered
strength, and was safely delivered at  the proper time."
Having known so many to be delivered, by this kind of
treatment, of their own lives,  instead of living children, 
246      HEMORRHAGE  OF THE  UTERUS.

I must regard this, as Dr. Mackintosh  says, as rather a
miraculous escape from a  destructive  medical practice,
than a cure of haemorrhage.
  But the doctor is not yet done with the course; hear
him through:
  "The acetate of lead should now be given, [that is,
after  the  reduction  of the pulse  by bleeding,] in doses
and  frequency proportionate to the extent of the dis-
charge.  From two  to three grains, qualified with opium,
must  be given every half hour, or less  frequently, as cir-
cumstances may direct; per  anum, in  case the stomach
be irritable.   Twenty or thirty grains may be dissolved
in a gill of water; to  this  must be  added a  drachm of
laudanum, and this be repeated, pro ne rata, [in case of
emergency,] &c.   If pain attend, opium should be given
until  a decided impression  be  made  upon  the  uterine
contractions, or till it appears to  be totally unavailing.
Should the discharge  be profuse, a large bladder, two-
thirds filled with ice and water, should be applied to the
pubes, and a tampon  [sponge] should  be   introduced
without delay."—Page 348.
   But, fair reader, severe  as this practice appears, we
are told, " the discharge from the uterus, when very pro-
fuse,  will  not  always yield to these remedies."  What a
story!  Has  the doctor so  little sense  as to suppose that
blood can still flow from the uterus  after it has been all
drawn out of the body through the veins ?
   This is  "scientific  practice" with  a vengeance!   A
person takes  cold—the vitality  of certain organs  is di-
minished—the circulation is  deranged—congestion takes
place—a fever rises—delicate and distended  vessels are 
         HEMORRHAGE  OF THE  UTERUS.     24?

ruptured, and haemorrhage occurs.   To cure it, the cold
is increased, and of course the congestion; the vitality
of the organs is still further diminished by the poisons,
sugar  of lead and opium; the blood, already flowing
with  dangerous rapidity, is made to flow still faster, by
opening other vessels, till there is not enough  in the sys-
tem to flow at  all!  If, now, one patient in twenty sur-
vive this murderous practice, it is considered sufficient
to sanction it on  nineteen others whom it kills.—See Fe-
males, page 350.
   Suppose the  haemorrhage were left undisturbed, could
it continue after all  the fluid was exhausted?   But, says
the regular  practice,  " taking it from another quarter
diverts it from the uterus,  and the application of cold to
that organ contracts the ruptured vessels, and then they
have  time  to heal."   If this  be  the case only once in
twenty,  under  that practice, it can be easily proved that
death by flooding, where this practice is  not used, does
not occur  in one case  in twenty!   The chance is, there-
fore,  four hundred to one in favor of having  no  interfe-
rence at all, rather than the regular practice.
   Let me  not be understood to attribute  to Dr. Dewees
any bad motive for  prescribing such a course. I  believe
 that  he is  a  humane man, as ready, perhaps, as  myself
 to relieve  the sufferings of the distressed. My warfare
 is against  the errors of his head, not his heart.   Still it
 is, to me,  passing strange  that the regular faculty, with
 all their advantages  of numbers, wealth, respectability,
 science, &c. have learned, in four thousand  years, only
 how to murder people instead of curing them. 
 248      HEMORRHAGE OF  THE UTERUS.

   Will the reader now believe that I have taken such a
 case as Dr. D. describes, given a strong dose of cayenne,
 &c. put her directly over the vapor while flooding, con-
 tinued the stimulants, raised  the heat of the  bath to a
 hundred and twenty degrees, (by which I stopped the
 haemorrhage in fifteen minutes,) washed off, rubbed dry,
 given  an  emetic, witch hazle injections, with cayenne,
 and followed with restoratives, and the next day repeat-
 ed  the course, and  thus cured a patient in whose case
 the most of Dr. D.'s prescriptions had been followed for
 several weeks before, with no other effect than to aggra-
 vate the  fever  and the haemorrhage?  Never, since I
 commenced practice, have I failed completely to subdue
 a uterine haemorrhage in less  than one  hour, whatever
 were the cause of the discharge or the condition of the
 patient.  Those who wish occular demonstration of the
 sovereign  power of this plan, have only faithfully to try
 it in similar cases.  True, the regulars cry, "not a par-
 ticle of stimulus should  be used," but what should this
 weigh  against our own positive experience?
  But, does the propriety of our practice rest  solely on
 the mere fact that some have been so  treated and escap-
 ed death?  By  no means.  This  fact is the principal, if
 not the only evidence on which rests  the practice I have
just condemned in Dr. D.   The regular course is justly
 condemned, because all the means used are calculated to
 destroy the life of the most healthy.  In the first place,
 the patient is bled profusely to prevent  her from bleed-
ing to death; then she is treated with snow and ice to
cure her cold;  now it is expected that opium and  sugar 
         HEMORRHAGE  OF THE  UTERUS.     249

of lead, which all admit are calculated to " suddenly and
rapidly extinguish a great  proportion of the vitality of
the system," will give to the minute vessels  lacerated,
the vital power  to  contract  their walls and  join their
edges!  Can more direct paradoxes be found in language,
or more consummate folly  be pronounced philosophy ?
  But, what is the  philosophy of our plan?
  Answer: The patient caught  cold, which caused col-
lapse of the extreme and  external vessels,  and conges-
tion in the larger and deeper seated.  The uterus, parti-
cipating in the general spasm, contracts, and thus separ-
ates itself, in part at  least, from the  placenta, if  one
exist;  or, if none exist, the minute vessels are ruptured
by  the pressure.  Our practice reverses  all  these  unna-
tural conditions.  We warm and  relax the surface  and
let  out the cold fluids;  the extreme and the  superficial
vessels being thus expanded,  their enlarged  capacity in-
vites back the blood  from the places of congestion, on
the principle of hydrostatic  balance.  Then  the stimu-
lants and astringents increase, instead of " diminish," the
vitality of the injured  parts, and enable them to con-
tract and soon  to  knit again; and  this is done without
the smallest injury  to the uterus or the ovum.
  The generality of mankind seem not to be aware that
the blood, in all parts of the  body, has immediate access
by  pores to some internal or external surface;  that the
healthy tone or contraction of  these pores is  more than
equal to the pressure of the blood in its efforts to escape
through them and to  seek  its gravitating level; that all
haemorrhages by rupture must, of course, arise from ex-
cessive contractions  in  some parts and  congestions in 
250      HEMORRHAGE OF THE UTERUS.
others, and must therefore be cured by restoring  the
equilibrium.  Let the public meditate a short time on
these manifest truths, and they will not much longer suffer
a fever to be discharged, or a haemorrhage suppressed,
by  reducing the quantity of the blood, and  destroying
the vitality of the organs, instead of equalizing the cir-
culation and aiding  the curative  process.
  I must be excused for a seeming wantonness in oppo-
sing the practice of Dr. Dewees, against  whose charac-
ter, as a well-meaning  philanthropist, I bring not  the
slightest accusation.  It is because, as I have said, being
Professor of Midwifery in the University of Pennsylva-
nia, his  work is at  the head of authorities  for all  the
regular physicians in the United States.  " If, therefore,
the light he gives be darkness, how great  is  that dark-
ness?" and how important that it should be dispersed by
the light of true medical science.
  It is  proper, however, to admit that  there may  be,
(though it very rarely happens,) a case of flooding which
is not so  easily subdued.   It is  that  in which the pla-
centa is  attached directly over  the  neck of the  uterus.
In this case it would seem  that  haemorrhage must take
place during the latter  months of pregnancy, when  the
neck of the uterus commences its expansions; but this
conclusion is not inevitable, for the placenta may expand
in its centre to accommodate itself to the emergency, or
the rupture may be of  such a nature as not  to  expose
many large vessels.  But  suppose the worst, the man-
agement I have directed will, in  all probability, save the
mother, even though the foetus be prematurely expelled.
   Nothing can be more diverse than the opinions of dif- 
         HEMORRHAGE OF THE UTERUS.      251

ferent Professors of Midwifery, on the propriety of med-
dling  or not meddling  mechanically in flooding  cases.
Some advise  measures for the immediate  expulsion of
the ovum, and yet dread the haemorrhage that will  pro-
bably ensue from the relaxed state of  the vessels  of the
uterus;  while others object to the  abortion on account
of the difficulty of removing the young  and adhesive
placenta.
  I remark, first, that, if we treat the  patient aright—
that is,  according to nature, with  means and processes
in harmony  with her operations—either  the placenta
will be disengaged by uterine contractions, and  it and
the foetus will come away together, or else it will strong-
ly adhere to  the uterus; in which case, as the tone  of
the uterus is restored,  the  haemorrhage  must  cease.
" Hands off," then, in  all those cases where  the foetus
may not be arrested in full growth, (by wrong position,)
ought to be the  inviolable motto.  If authority were  of
any use to us who have absolved ourselves from all alle-
giance to what is generally called authority, Dr. Dewees
and many of his brethren would fully sustain us  here.
" That the most mischievous consequences have followed
the practice of those who forced the hand into the uterus
and immediately effected delivery, we have the authori-
ty of Pasta,  who deprecates the practice  as both  cruel
and dangerous;  of Kok, who says he has seen it  follow-
ed by inflammation  of  the womb; of Leroux, who de-
clares it to be dangerous to both the mother and child;
of  Baudelocque, who insists that nothing can justify the
accoucher who  persists to deliver while the neck  of the
uterus retains its natural thickness and firmness; and I 
252      HEMORRHAGE OF  THE UTERUS.

may add my own experience, as I once witnessed  death
as the consequence of  this proceeding."—Dewees on
Females, pages 356-7.
  After this testimony  against violence, Dr. D. recom-
mends plugging the vagina closely with sponge, which
could do no harm, but  would be unnecessary in our
treatment;  and, lastly, delivers by force,  {arts non ri,
says Blundell,) though with little  expectation of saving
the patient's life.   To this last I say no; let the patient
die, if need be, but not by my violence.   Let me not
do, to save  life, what is  of itself sufficient, generally, to
destroy it.
  Some suppose opium to be good to stop  haemorrhage.
Dr. D. says  he  " has not  recommended it, simply because
it has never merited the  smallest  commendation in his
hands, nor does he believe that it  deserves  the  encomi-
ums which  have been  so lavishly  bestowed upon  it by
others."  So agree Denman and Barlow.   He also  con-
demns the  cold, (except  merely enough to  abate local
inflammation and act as a uterine  astringent,) and says,
" it has acquired so much popularity among  the vulgar
[who but the  doctors gave it that popularity?]  as  to
render it unsafe for the practitioner who has  omitted it
in his treatment of this complaint.  [Do they still retain
their  popularity?]  The  injecting of  cold  water,  cold
alum water, the solution of acetate  of lead, the intro-
duction of ice  into the vagina, and even into the uterus,
have  been  practised;  and,  it  is said,  with advantage.
The merits  of such applications must rest on the author-
ity of those who recommend  them.  I have no experi-
ence in either of them."—Page 350. 
         INFLAMMATION of the UTERUS.     253

  I have devoted a large space to the subject of hae-
morrhage or flooding, because no affection of the female
system excites so much alarm, and  because  it is gener-
ally aggravated, if not  most frequently induced, by what
is called " scientific practice."
  I finish the whole with this  direction:  Equalize  the
circulation, use astringent but not cold injections to  the
vagina, remove morbific matter from  the stomach, &c.
keep the action of the system up, and the extremities
warm.  For the plan of doing it, see " Ways and Means,"
page 141.

            Inflammation of the  Uterus.
  This is another of the forms of disease which, produ-
ced, as it generally is, by violent  artificial means,  to
hasten or facilitate delivery, and aggravated as it  is by
mal-treatment, often becomes  a terror,  if not destruc-
tion, to the sufferer, and a disgrace to the  practitioner
and his science.  In reality, however, it is  an  affection
little to be dreaded when  the proper means of preven-
tion and cure are seasonably and faithfully applied.
  First—When no "instruments nor rude hands"  are
used in delivery, inflammation of the parts  will seldom
occur.  Second—Where  care  has been taken to keep
the pelvic region warm and  relaxed, by clothes, fomen-
tations, the direct application, and the taking of lobelia,
&c. it will occur still less frequently; and third—Wher-
ever it occurs, and from whatever cause, a thorough
course or  two, added  to the above local  applications,
will  soon  remove it.   Constantly warm, moist, and
slightly stimulating applications, are sure to reduce in- 
254     INFLAMMATION OF THE UTERUS.

flammation and remove soreness, wherever seated.  The
divisions of the symptoms, by  authors,  rest  upon no
foundation  that requires any variation in our plan or
remedies, nor in fact do they much affect the " regular
treatment," which is uniformly "bleeding, purging, blis-
ters, opium," &c. with now and then  an incidental pre-
scription of fomentations,  sudorifics,  and the  like.  In
proof of the  above I need only state that, among  the
causes, Dr. Dewees mentions  four  grand divisions, the
principal of which are, 2d.  "Violences committed in the
use of instruments of any kind; injuries sustained in the
act of turning, or ill-directed manoeuvres executed on
the neck of the uterus, in  attempting its dilatation, or
too frequent  handling." 3d. "Lesions of the internal
face of this organ, from a sudden, rude, and unnecessary
interference  in the separation of the placenta," &c.—
Females, page 260.  Hence, if ladies  are anxious for an
attack of this formidable affection, which  carries multi-
tudes of them  to  the  grave, they have only  to call a
regular doctor, who, to show his superior  skill, will first
bleed them—this will  so  reduce their power to deliver
themselves,  that  "the  action of the  forceps"  will be
"indicated"—then, according to the  above  statement,
the "injuries  sustained" will secure inflammation of the
uterus.  Now for " the hair  of the dog that bit them,"
viz. "bleeding," to cure this affection, of  which it was,
itself, the remote cause!
  As to the other causes, " the rigidity of the soft parts,
caused by colds, the violent  action of the uterus," &c.
we know that these may be easily obviated by  fomenta-
tions, vapor, lobelia and cayenne.  The more  local and 
PUERPERAL FEVER.
255
definite the symptoms, of course  the  more attention
must  be paid to local warmth,  moisture, fomentations
and injections.   The  locality of the pains and soreness,
will  distinguish inflammation  from the  general  fever,
commonly called puerperal, and indicate all the necessa-
ry difference in the treatment.  This affection, like most
others, if  allowed  to progress,  will soon, involve  the
whole constitution in the suffering, and give rise to a
great  number  and variety of symptoms, which it  is
unnecesary to detail;  first, because they are not, in  any
two cases, in all respects exactly  similar; and, secondly,
because a judicious general  treatment is the only cure
for them.

                  Puerperal  Fever.
   " This species of fever," says the Edinburgh Practice,
"is usually the most fatal of all  the disorders to which
the sex is liable.  But, notwithstanding its prevalence in
all ages, its real nature  has  remained,  to  the  present
time, a subject of dispute and uncertainty.  Some  wri-
ters have considered  it as proceeding entirely from in-
flammation of  the uterus; others from  an obstruction to
the secretion of milk, and still more from a suppression
of the lochia.   Perhaps it is  not  the  necessary conse-
quence of any of the causes above mentioned."—p.  542.
   " It generally occurs within forty-eight hours  after de-
livery, though  it may occur many days later."—Ibid.
   A  minute description is unnecessary here, for we bo-
tanies consider it (as we  do  all other fevers) an  indica-
 tion  of the presence of  obstructions,  which  must  be
 removed.   The only reason why I need give particular 
256            puerperal fever.

directions about it is, that ladies are so generally deterred
from a  proper  course  of  tieatment by  the fear of the
awful consequences, popularly supposed  to be necessary
to any considerable disturbance of bodily repose, so soon
after parturition.   Nothing, however, is  so good for it as
a thorough course of medicine, (see  page 156,)  giving a
good  vapor bath before and after the  emetic, and an
enema  or  more before the  first bath.  Keep up the
action of the system and the warmth of the extremities,
(see page 173,) and repeat the course if necessary.  This
fever frequently indicates not only an  obstructed perspi-
ration, but the  presence of much morbific matter, both
in the stomach and the bowels, and is attended with an
irritability which  is calculated,  unless it be  speedily
arrested, to carry off the dejections so  fast as  to over-
come the tendency to the surface and draw the  deter-
mining powers inward, as in cholera morbus.   Hence it
is important to give the course promptly, to keep up the
action  of  the  system  steadily with  cayenne, and to
soothe the stomach and bowels with  mucilaginous sub-
stances as  soon as the cold, tough phlegm and the bilious
or putrescent matter are discharged.
   Among the immediate causes enumerated by authors,
" are  the stoppage of perspiration, neglect to procure
stools after delivery,  and too hasty separation of the pla-
centa."—Edinb. Practice, p. 545.   As the  cure is often
"gradually effected  by spontaneous  vomiting, or by a
long-continued discharge, by stool, of  that porraceous
matter, the existence of which in the stomach is usually
evinced at the first attack of  the disease, the most unfa-
vorable prognostic arises  from such a  weakness  of the 
PUERPERAL fever.
257
patient as renders her unable to support so  tedious an
evacuation as that by which the disease is overcome."—
Page 544.
  Hence it is evident that an emetic in the onset will
clear the stomach and check the formation or supply  of
"porraceous matter," while the cayenne will maintain
the  determination to the surface,  and prevent all the
danger of sinking; and the regular action of the bowels,
procured  by injections,  will prevent the accumulation
there.  So much  for the cure of this puerperal fever,
caused by obstructed perspiration, " the action of the
forceps, or injudicious handling, either in removing the
child or the placenta;" or by " porraceous matter " accu-
mulated in the stomach and bowels.  In no case of labor
that I have attended, has this fever presented  any alarm-
ing symptoms, nor have I ever heard of a death from  it
under  the  administration of the true botanic practice.
I lately relieved a case in  three hours, (a lady who  had
been treated with the  lancet  and  opium till her death
was expected every hour,) and in a few days  cured  her.
She  was relieved of all  disease in twelve hours.   The
balance of the time was required to restore the loss pro-
duced by the lancet and morphine.
  After an elaborate essay on Puerperal Fever, its causes,
&c. Dr. Dewees remarks, page 387, "From all this  it
would  appear that the subject is still  open for  inquiry;
and we would earnestly  recommend it  to  those whose
practice will furnish  them with opportunities to inquire
into the fact, and  endeavor to discover the cause why a
tedious and protracted labor should be any way instru-
mental in  diminishing the liability to puerperal fever:
             17 
25S   FEVER  IS DISEASE—FALSE PRINCIPLE.

for we may well ask how it is  that long  suffering, and,
very certainly, lesion  of some  kind, and to various ex-
tents, should diminish the predisposition to this  disease,
or abate the force of exciting causes !"
  We answer the doctor, that even our  little observa-
tion on fevers in general, (we have seen only slight symp-
toms of this in particular,) affords us an  answer to his
queries, as clear as the noon-day, and as easily and cer-
tainly demonstrable as  any conclusion drawn from the
principles of other physical sciences.  Will he give it a
candid consideration ?   All the reason why medical men
have not ascertained the reason of this medical fact long
ago, is, they have made all their  observations, and con-
ducted  all their arguments, under the guidance of the
false  principle that  fever  is  disease!  Let  them just
abandon this error, and all their difficulties will at once
vanish.  Let  them receive the  truth that fever is  an
extra effort of the system to remove all obstructions to
ordinary and proper action, and it will follow of course
that the more vigor in the system the more likely it will
be  to show irritation  from obstructions; and that the
lower the power of  the system is reduced, by  " a tedi-
ous and  protracted  labor," the  less able it  will be  to
 make any sudden and powerful  effort against obstruc-
 tions-  The system, under  these circumstances, must
 rise by slow and almost imperceptible degrees, and such
 also must be the removal of the obstructions, if they are
 ever removed at all!   More:  The reason why bleeding
 ever reduces this or any other fever, is not because it
 diminishes, in the smallest degree, either the disease or
 the cause of  the disease—but  because it acts like a tedi- 
     FEVER IS DISEASE--FALSE PRINCIPLE.  259

ous labor, in  checking, if not destroying, the power  of
the system to  war against disease.  On  the truth  of
these propositions, we are willing to stake  our medical
reputation.  Disprove them by  demonstration, and we
will never wrrite another line against the regular theories
of fever, or  the modes of treating it:  nor  will we, for
any consideration, give a grain of cayenne  to  any sick
patient who is so  fortunate as to be too low to " have  a
fever."
   But, dear sir, we have so much faith in your benevo-
lence, that, could you visit with us a patient  suffering
under the influence of the form of disease which, from
your experience in treating it, you have so  much reason
to dread, and see us remove all the alarming symptoms
in an hour or two, without doing the slightest injury to
the patient, we are confident that you would be the first
man to commit to the flames all your  recommendations
of the lancet and of leeches  in the case.   Yes, sooner
would you cut off your right hand than allow your book
to continue a standing authority for shedding  rivers of
the vital fluid from  the frail, fair, and will-be happy
daughters of our country, when physicians shall  have
learned to relieve their  special sufferings.   I am aware
that you have quoted Dr. Armstrong to prove that " the
stimulant treatment is  at  once the most delusive and
dangerous that can be  adopted,"  and have stated that
Dr. Denman, though once an advocate of " the  stimulat-
ing treatment," finally " renounced  it with much  mag-
nanimity, and  a  candor which all must admire, though
few may imitate it."—p. 425.   And I  am as ready as
you to admit (p.  426) that " it is a great error to sup- 
260        STIMULATING TREATMENT.

pose that, when a case will not bear depletion with pro-
fit, it then absolutely requires the opposite treatment."
Though I believe  that  no disease  is ever  removed  or
organ cured without stimuli, either  natural  or artificial,
yet I am far from supposing that the system always
needs the latter.  It was this supposition, and a corres-
pondent  practice,  that  discouraged Dr. Denman, and
made him abandon the whole  plan; whereas, if he had
been  satisfied with  the natural  action  of the system
when sufficiently strong, and directed his attention, with
proper means, to  the aid  of that action  in disengaging
the morbific  materials which disturbed or displaced  it,
he would have had  the pleasure of seeing his patients
recover rapidly and almost universally.   The failures  of
the stimulating treatment were not then, nor are  they
now, attributable  to error in principle, but to injudicious
means and modes; while  the " escapes" from  the de-
pleting system are to be ascribed, not to any virtues  of
that system, (for its  whole tendency  is to the destruc-
tion of life,)  but  to  the power  of  life—the  vis vitae—
often to overcome the attacks of both disease and  a
destructive treatment: for no man will dispute that de-
pletion, carried out,  will universally destroy life;  while
all  sound medical men agree that nature  alone cures,
either by her own  power (stimulus,) or sometimes by
the aid of artificial irritants.  The question, then, is, not
whether the stimulating treatment is  the  correct one—
that is immovably settled—but by  what  means, and  in
what way, and to what extent, it shall be applied.  And
the answer to this question is simply, viz. When the liv-
ing action is  altogether too low,raise  it;  when disturbed 
             STIMULATING PRACTICE.          261

or displaced, remove the cause  of  derangement;  and
when confined, remove the obstructions to its diffusion:
and do all these by means and modes  that  experience
has proved will do  them, without injury to any of the
organs.   Such are the means and modes prescribed by
the botanic system, and success will almost universally
be the reward of their timely and judicious application.
  But you cite cases to  condemn  the stimulating prac-
tice  and  commend the depleting.   These cases  are
among the " false facts," of which Dr. Cullen said there
were  more than of false theories, in medicine.   Let us
examine  them.
  In order that you may understand my explanations of
the cases, I must entreat you to adopt,  as  a key, while
you  read them, the sound principle  that  excessive or
disturbed action, or fever, is  vital, not  morbific action,
and always friendly to life and health,  inasmuch as its
object is to remove obstructions  to healthy action.  I
know that this will be difficult for you, and perhaps you
will tell me that Cullen  and others believed it long ago,
but their practice did not prove it true.  I answer: their
practice did not prove it false;  for, while  they  believed
that the vis medicatrix  ought  to  be  aided in removing
disease, they  attempted  to render the aid by means  and
processes directly hostile to its action—they still  gave
poisons and depleted.  Had  they  known  the character
and use of the botanic remedies of the present  day, Dr.
Dewees would not have been an  advocate  of depletion.
While, then, they  were more correct  in  theory, they
were  less consistent  in  practice  accordant  with  their
theory; hence, physicians of the present  day  suppose 
262
STIMULATION.
that the science  of medicine, as  they teach it, has  im-
proved  since the days  of Cullen; whereas, in fact, the
most important truth which was  then believed, is now
abandoned,  while a deadly practice  is retained.  Con-
sider, then, fever  as a friend, and the whole of the  fol-
lowing explanations will be clear as  the  sun, and con-
clusive as mathematical demonstration.

                    Stimulation.
  You  say  of the  first case, that the stimulus of  the
tenth day " reduced the pulse " from  120, and made  her
better.  Now, you well know that no stimulus reduces
the pulse, unless  it promotes some  confined  secretion.
In this case, though you do not say what, it was proba-
bly perspiration;  for the previous involuntary discharge
of urine is proof of suppressed perspiration, and the pre-
sent correction of this discharge is proof that  the fluids
found their way through the surface, as you mention no
diarrhoea.   Or else, as we suspect, the poison destroyed
the energies of the system, and thus  checked  the pulse
and the urine without any secretion.   On  the  eleventh
day, although the pulse was still  106, the physicians
gave more stimuli, which  raised the pulse to  120, in-
creased the " heat," and so overcame  the living energies
by excessive action, that " the patient became gradually
weaker, her pulse was accelerated more and more, and
her urine was again discharged involuntarily.  She lived
two days  in great anxiety and restlessness, and died"
the fifth day of their practice.   This death you  attribute
to the stimulating practice, although you admit (p. 426,) 
STIMULATION.
263
that the first stimulus given was " exactly suited  to the
system!" and  " happily achieved an improvement."
  This case being one of " derangement" and "  excite-
ment " of some organs, proves that some other  organs
were  deficient in  the performance of their duty, and
that the latter needed suitable stimuli to enable them  to
perform that duty, so that the former need not perform
excessive duties;  for we know that a free, universal and
equal performance of all the functions, constitutes  a state
of health.   In this case the skin was closed and inactive;
perhaps other secretions were obstructed, and hence that
of the urine, sustaining all the pressure of vitality, was
uncontrollable.  The skin,  therefore, demanded moisture
to relax it; the stimulus of heat it  already  possessed.
A cool, pleasant bath would have given vent to the accu-
mulating heat, and a free use of warm drinks, as soon as
they were  demanded, would have washed out the mor-
bific obstructions that checked the perspiration; the flu-
ids, being diverted to the surface, would no longer rush
to the bladder: and now a  cleansing of the stomach
with  an emetic,  and of the bowels  by injections, and
the administration of a few laxative  bitters, and  a little
stimulus to excite the wearied organs, would have com-
pleted the  cure.  But no;  the stimulators did not under-
stand  their business.  They failed  to give  the succour
needed.
   True, they  relieved, by injection, the bowels of mor-
bific matter, which was right, as is proved by the fact
that the system, thus relieved, directed a still stronger
power to the contracted surface.  This they erroneous-
ly  considered  making her worse,  notwithstanding the 
264
STIMULATION.
increased effort of the system to relax the surface, raised
the pulse to 132,  and forced again an involuntary dis-
charge of  urine!  Frightened  at these effects—so con-
trary to their  notions  of " better"—the practitioners,
instead of relaxing the surface  and aiding the  pulse  to
reduce itself, administered  a  deadly poison (sulphuric
ether,) which, you all agree, " suddenly and rapidly di-
minishes a  great portion of the vitality of the  system,"
(Bost. Med. and Surg. Jour., vol. ix, p. 43, and Hooper
on poisons,) without removing a particle of the obstruc-
tions  which excited that vitality.  This reduced  the
pulse to 106, (I repeat, not  by  relieving  it, but by des-
troying its  power  to act,) and this  condition of  the
patient you all pronounce " better," though, in fact, it
was worse;  for, while  the obstacles  to be overcome
remained  the same, the power  to surmount them was
diminished.   Still it was not too late to save the patient,
had they  relieved  the  surface.  But  they  raised  the
action of  the system, already, as you agree with me,
high enough, and kept  it up,  not  only  till the organs
became fatigued with excessive action, but till  the mor-
bific materials  in the system, which  ought at first to
have been removed,  had accumulated a chemical power
superior to the over-fatigued and consequently debilita-
ted vitality, and commenced the process  of decomposi-
tion, which of course soon terminated in death.
   Now, doctor,  I assure you I have  treated (on  the
stimulating plan) many  such  cases, and should  think
myself  much to be censured if (my prescriptions  being
strictly followed) I should lose one  in a hundred of
them.   As  you will, doubtless, agree  with me that no 
DEPLETION.
265
plan ought to  be condemned for its mal-administration,
so you will agree (indeed you have virtually agreed) with
me that the stimulating plan in this  case was "doing
well," "achieving happily," so long as it was judiciously
administered.
   The reasons why the patient died, are, the stimulating
was done  internally instead of externally, and, at first,
with  a deadly poison, (see Toxicology, Art. Nitre,)  in-
stead  of an innocent sudorific;  and the stomach  and
bowels were left full of morbific matter, instead of being
cleansed by lobelia, cayenne, &c.
   Let us examine the second  case, where  you suppose
that the depleting system was  triumphantly sustained.

                     Depletion.
   " On the tenth day, the patient appeared very low, and
her pulse was  frequent and feeble.  Her tongue was dry
and brown, and her teeth were encrusted with sordes.
Her head was  yet affected with pain, but she made but
little complaint of her body.   It was, however, enlarged,
and, though not very tender,  was sensible to  pressure.
The symptoms of active inflammation having given place
to those of a typhoid character, the purgatives had been
omitted, and the evacuations had consequently decreased.
" I recommended,"  says Mr. Hey, " such  a repetition of
the purgative as  might procure an evacuation about once
in four hours,  and a  continuation of  the  saline mixture
in a state of effervescence.  The strength of the patient
was supported by  a  light but nutritious  diet, such as
broths, jellies, chocolate and milk.  This plan was regu- 
2,66                 depletion.

larly pursued for four days, when the patient was con-
valescent."
  You seem to  triumph in  the success  of the case, as
though it had been treated on your depletive plan;  but,
in fact, it was treated on the  stimulating plan, less inju-
diciously than the other, but not half so judiciously as it
might and ought to have been.  The bowels were  full
of morbific  matter, which was removed by  dejections
every four hours; (in the other case they were left  un-
disturbed,) being careful  to  support the system by  the
stimulus  of nutritious diet, such as broths, jellies, choco-
late and milk, which are well calculated to promote also
a tendency to the surface.  The " saline mixture," being
about as  stimulating as it was cooling, was of little  im-
portance any way, except to furnish fluid for the  use of
the system.  This case had three important advantages
over the other, which are, first, no deadly poison (nitre)
was given  in the commencement; second, the morbific
matter was removed from the alvine canal;  third,  the
system was supported by food instead of barks and wine.
To  these we may  probably add a fourth, perspiration
was doubtless produced by the draughts, broths, &c. as
nothing is said about the "pulse being 132," or the "heat
increasing,"  or  the  "urine  discharged  involuntarily."
That, had she been more judiciously treated,  she might
have been cured sooner, I believe; or that, had she been
treated as the other was, she might have died also, I am
disposed  to admit;  but how it can  be  shown that  she
was treated on the depleting  plan, and that her recovery
justifies you and Dr. Clarke  in abandoning  stimulants 
DEPLETION.
267
and operating freely with the lancet and direct antiphlo-
gistics, I cannot comprehend.  The fact that many es-
cape the dangers of extensive and deep-seated injuries,
or of violent  attacks of disease, by the  mere recupera-
tive efforts of nature, is proof enough of her power  to
resist injuries; but no reason why still  greater injuries
should be heaped with design to remove the former, on
those who have been so unfortunate as to  suffer some
by accident.
  But, you will ask, shall I not try a plan that has saved
more than this stimulating one, even though I know  it
to be sometimes injurious?   I answer no—positively no.
This principle  of  doing positive evil  in the hope that
good  may come, has been the greatest hindrance that
medical  science ever had  to  encounter.  What then
shall  I do,.say you?   I answer again, reject both prac-
tices, and, in  the  guidance of principles known to  be
correct, experiment with means and in modes known to
be innocent,'till you hit a better plan.   You well know
that, to bleed as you direct, till no more blood will run,
even when invited by  warm water, and to physic till
the bowels, overcome by the chemical  agency of pois-
onous drugs, cease their action, and to destroy the sen-
sibility of the  nerves  to pain,  with opium, as  others
recommend, will greatly endanger, if not certainly de-
stroy, the life of a well person, whatever it may do with
the sick.  Away, then, with that practice in any form of
disease, which loses every ninth patient, as did that you
detail presently; or, if it loses every fiftieth, search dili-
gently for, and promptly reject the deleterious article or
process that causes the failure. 
268
DEPLETION.
  On pages 430 and 432, you give comparisons of cases
treated, some with and some without depletion, in which
you show that the larger proportion of recoveries was
of the former.  Hence, you  draw  the  conclusion  that
judicious depletion is always  a proper course of treat-
ment for the disease; whereas it only proves that it was,
on  the  whole, less destructive in those cases than the
other.
  The truth is, that bleeding, being in  its nature calcu-
lated  to destroy life, can never be the proper means of
restoring health, however much more destructive some
other course may be.   The deaths of the patients treated
without depletion,  may have  been, and doubtless were
effected by giving poisons as stimulants, a plan more
certainly destructive than the rash and daring use of the
lancet can  be.   In some cases, failure might also follow
an injudicious use of the proper stimulants.  Does  the
fact that what you call depletion, which signifies a pretty
severe evacuation of blood from the veins, and  an ex-
cessive discharge of excretory matter from the  bowels,
was less destructive than  the stimulation with poisons
in the cases quoted, prove that the depletive  plan is, in
itself, either right, or preferable to the stimulating  plan
with proper means, properly applied?
  Had the  stimulating  plan been used with proper means
and in  a proper time  and manner, it  would probably
have  saved all  those  patients.  At  least, the botanic
practice of the present day,  whenever judiciously ad-
ministered, fully sustains us in this belief.  It is  always
wise to avoid that which is calculated, in itself,  to des-
troy life, (as bleeding  and poisoning,)  and, if we must 
DEPLETION--:
LOCHIA.
269
make experiments, to make  them with means and  in
ways that can do no harm if no good.
  In the cases you report of those that had been deple-
ted,  out of eleven, three died;  of  thirty-three, three
died; of forty-three, five died; and  of  fifty, five died.
Here are 137 cases of puerperal fever, treated with de-
pletion, of which sixteen died, one out of every eight
and  a half!  And this is  called skillful treatment, and
justifiable in every case where the symptoms are urgent!
  Suppose the  Botanic Doctors of  the United States
should  lose every ninth patient that happened to have a
fever after child birth, what a hue and cry  should we
hear about" quackery " and " murder by steam and lobe-
lia!" and with what a good grace would it originate, as
it always does, directly or indirectly, with regular phy-
sicians !  When a certain botanic accoucheur  had atten-
ded the 200th case, he had not lost the  first  mother or
child.   Dr. S. Thomson lately stated that he never lost
either,  in his practice of more than forty years!

                       Lochia.
   After the delivery of the secundines, the  extremities
of the  uterine vessels being open, there will be a dis-
charge from them which will continue during  the slough-
ing  of pieces of the placenta, or the membranes that
may be left behind, and until the uterus  is entirely clear,
and the lacerated capillaries are healed.   This discharge
is called the  lochia.   If it flows constantly, and con-
 tinues  to change from a bloody to a light color, and  to
 diminish in quantity, keep up the action of the  system, 
270
L O C II I A--M ILK LEG.
see pages 173-4, cleanse the parts  at least once a day
with injections of canker  tea, and afterwards slippery
elm, and all will be well.  If it become bloody and pro-
fuse, treat  it as directed for haemorrhage, page 110.  If
it  be suppressed,  and  pain an'd  inflammation follow,
treat it as directed, pages 206-7, for suppressed  men-
struation.

           Milk Leg, {Phlegmasia Dolens.)
   " Its pathology," says Dr. Dewees, " is still unsettled."
"We have five different  hypotheses,  [respecting  the
cause,]  of either of which  it would be difficult to  make
choice."   He " believes neither to be the true proximate
cause."    The symptoms are  heat, pain and swelling,
commencing in  the  hip, groin or  back,  and  proceeding
down only one leg  at  a time.  Swelling elastic,  white
and  exquisitely sensible;  total inability to  move  the
limb, and great suffering when moved.   After some time
the sensibility diminishes, and the swelling becomes oede-
matous, [watery, leaving a  pit after pressure,] and then
the same symptoms and effects are felt in the other leg
and side of the pelvis.   The milk usually diminishes and
sometimes disappears."
   I consider that  the causes of this affection are,  either
a  cold taken, or the cooling and sedative treatment of
the fashionable practice.  It has never supervened in  a
single case that I have attended.  To  prevent, or cure
it, steam the lower extremities as directed, (" Ways and
Means," page 141,) give a full course, and  repeat it  if
necessary; maintain the power gained,  and it will soon 
MILK  LEG--PHLEBITIS.           271
" run its course."  When the limb is already swelled and
tender, a poultice of lobelia, slippery elm  and cracker,
will aid in the cure.

                      Phlebitis.
   This is an inflammation of the coats of the  veins or a
filling up of  their cavities, so as to obstruct  the  return
of the blood to  the heart.  Instead of being loose and
general in  the whole structure, the cold humors or cank-
ery materials are here lodged in definite localities.  The
 veins first become tender  and corded or  hard, and then
 the flesh swells  because  the blood  is arrested in  its  re-
 turn.  This  form of disease, being more difficult to cure
 than the other, will require a more rigorous and  perse-
 vering treatment, but of the same character.  The mor-
 bific matter  must be loosened from the veins by relaxants
 and stimulants.   The surface should be frequently rub-
 bed with  equal  parts of  the  antispasmodic  and  stimu-
 lating liniments.  I need not  remark that the  regular
 practice in this, as in every other inflammatory affection,
 is depletion; "blood letting, leeching, cupping, purging,
 blisters, opium," &c.  Nothing is so good, intimates Dr.
 Dewees, as  to promote a perspiration of  the whole limb
 by " steaming it with hot bricks, cooled by plunging them
 in vinegar, folded with cloths and put at  the side of  the
 leg and the foot," the limb being covered with the bed
 clothes raised from it by a rick of half hoops  fastened at
 right angles to longitudinal strips.  But,  unfortunately,
 this cannot be  effected till, by bleeding, leeching, purg-
 ing, &c. the arterial action [of the veins!] is "reduced
 to the sweating point!"   Fortunately this affection is of 
272
SORE  BREASTS.
rare occurrence in the regular practice, and seldom if
ever found in the true botanic.

                   Sore Breasts.
  Under the head of poultices and inflammatory tumors,
pages 177-8-9,180,1 have given an account of the prin-
ciples on which this disease should be treated,  and the
means of reducing the tumor.   On a review, I  perceive
that I omitted to state that, when there are heat and sore-
ness already in the tumor, the  stimulating  article is not
wanted in the  poultice.   Stimulation is  necessary only
when the  flesh is cold and clammy, as in oedema, anasar-
ca,  and the like.   A simple lobelia  and slippery elm or
basswood (tilia or lime bark)  poultice,  is  all  that  is
wanted for sore breasts or any other tumor that  is hot
and painful.  If the heat and pain are very great, the
poultices  should  be kept cool  and moist,  by  frequent
applications of cold water, till  the temperature  of the
tumor be reduced to nearly or quite the healthy  stand-
ard; when the organs will be relaxed,  and then the
morbific humors will be either excreted by perspiration
or  absorbed away, and the milk will  be softened and
thinned and discharged.  The practitioner on fever and
inflammation, should always bear  it in  mind  that too
much action in a part may dry and contract the skin,
and cause the accumulation of  too much heat  (the ex-
treme of which is  a burn) as well as that too little  action
in a part  may leave it  to become cold, inactive and ob-
structed;  and that his  duty is to  equalize the action.
" Hold there," says the  regular, " you are coming over
to our  side!   We teach that  the action and the heat 
           SORE BREASTS--HYSTERICS.        273

must be  equalized!"  So you do;  and, were  you to
practice what you teach, all would be well.  We never
left those " sides " in which you teach truth.   It is only
your errors that we abandon.  We all  teach that the
tone of the organs must be regulated, and their action
and  the  heat equalized: but  you do  it by  destroying
their power to act at all, and we, by  removing the cause
of the disturbance.  You "kill  the  fever" by bleeding
and  poisoning; we remove the obstructions that disturb
vitality, by relaxing  the  strictures, with  means that in-
flict  no organic injury.
   I have never had a case of suppuration of the breasts;
I have always prevented it  by removing the cause  in
season.  Should one occur in my practice, I should treat
it  exactly as I  do  every  other  inflamed tumor, with
moist, cool and relaxing  poultices, courses  if necessary;
and, lastly, if much  swelled,  painful and evidently full
of matter, I should lance it and  discharge the pus, and
poultice again.  Ladies who will keep out cold and can-
ker  from their systems,  and  nurse their children, or, if
they lose them, draw  the  breasts often, need have no
apprehensions of  this painful  affection.

                      Hysterics.
   When, in the  course of  "medical  maneuvering,"
most commonly—very rarely of neglect  to  attend to
herself in cases of slight  cold, &c. (or by the indulgence
of a fretful or crooked  disposition,  of which I  do not
mean to say that  one  of them ever is actually guilty;
but only to hint what would  happen if they should be,)
a lady's whole nervous system becomes so deranged that
             IS 
•274
HYSTERICS.
the doctor cannot determine what plan  of treatment to
pursue, where to begin it, or what remedies to use; it is
fashionable  to style the  whole hysterics, and  place it
among the opprobria medicorum (reproaches of the facul-
ty,) diseases, the cause of which they do not  know, and
for which they have no remedy;  and to hold forth as a
reason for refusing  to  treat it, not their ignorance and
inability, but the declaration  that it is a  disease of the
imagination, not  of the  body.  The true definition of
the name is,  disease in, or inseparably connected with,
the uterus; and,  of course, wholly confined  to  females.
But, even the  sapient nomenclators sometimes forget  its
origin, and  apply it to  similiar  symptoms in  our sex,
which circumstance, while it  is not a little ridiculous in
them, is  a positive  proof  to others,  that they are igno-
rant of its nature.
   Of all the diseases, both of males and females, that I
have ever treated, this general derangement  of the sys-
tem, indicated by irregular, fitful and anomalous, nervous
action, has been  the most common.  As either this or
death is  generally the  end of the "bold and energetic"
regular treatment of all acute forms of disease, so it is
the form with which our botanic brotherhood,  through-
out the country,  are most frequently called to  grapple;
I shall, therefore, be pardoned for devoting a number of
 pages to the consideration of it.
   The first  difficulty you  meet in the treatment of this
universal-chronic, is the popular doubt thrown over your
ability to cure it, by your manifest inability to give it an
appropriate and  specific name.   To obviate  this,  you
should make  extensive and minute  inquiries respecting 
hysterics.                275
the symptoms, and then name it, as you find  it in fact,
a complication of affections, a universal derangement of
the system.   This will not only be admitted, but felt to
be true;  and will inspire confidence in your prescription
of  a  general and thorough treatment,  as the proper
means of checking the sympathetic affections, and ena-
bling you to discover and eradicate  the original causes.
   Another difficulty is the discouragement, arising from
the slow progress of cure, even after the remote  causes
are removed; the recovery  being protracted by the ina-
bility of the organs to regain their tone  and activity.
Because the  patient is not in constant agony from acute
pain, she thinks  she  is not very sick; and, because she
does  not rapidly recover,  she doubts the propriety  of
 the practice, and begins to lose confidence.   To prevent
 this difficulty, assure her, before you commence, of what
 I am supposing to be true, that, though she is not in any
 apparent danger of immediate  death,  yet she must, in
 reality, be very sick, or the means already used by oth-
 ers or  herself, would  have cured her; that  she is sink-
 in<r,  and will  continue to  sink, unless more  energetic
 means  be used to  save her.  If she doubts  this, while
 you know it to be a fact, you had better do nothing for
 her till she is convinced of  it; otherwise you may labor
 in vain as to the cure, and be afterwards abused for your
 lenience.   If,  however, she sees her  condition clearly,
 and, after some weeks  or  months  of resolute practice,
 finds even that she only is  no worse, she will  still  be
 encouraged, as she  might have  been  dead without it.
 If, now, a given general  treatment prevents her from
 crowing worse on  the whole, it will be found, by strict 
276
HYSTERICS.
examination, that she  is, in  sundry important respects,
materially better; that, in other respects, chronic symp-
toms are exchanged for acute, which, though not more
agreeable to bear, are certain  indications of return  to
the healthy state from which she  has  so far departed;
and, of course, that  a prompt increase in the  energy and
frequency of the prescriptions, will soon  turn  the  scale
in favor of the  patient.  This looks reasonable enough
to induce a trial; and, fortunately for  the practitioner
and the patient, the practice corroborates the reasoning.
In time, patient and energetic perseverance are rewarded
with success.  Such, at least, has been  my  experience.
In several  instances, two or three years have accom-
plished what one year's faithful effort hardly seemed  to
begin.   To a vigorous and unremitted general treatment,
I kept constantly adding direct  applications to local de-
rangements, till  the  vitality, or circulation and action of
the whole system, was  equalized, and the organs enabled
to maintain, by  their natural operations, what they had
been enabled to regain only by  the aid of our art.
   In the treatment  of this affection, or this compound
of almost all affections, care must be taken to obviate
every local difficulty as fast it arises—as,  to remove
costiveness, a slight cold  or a sick  stomach, &c.—and so
to vary the articles of general and  constant prescriptions
as to prevent the patient from  getting tired  of any one
thing.   The reason  of  this, I have not room here to ex-
plain;  I only state the fact  that, when  a good medicine
answers  well the design for which it was given, but does
not accomplish  all  that  is wanted, we should  endeavor
to supply the deficiency with  another; but we should 
HYSTERICS.
277
not abandon entirely the use of the former, lest we lose
what we had gained.  All the remedies should  be ren-
dered as agreeable  as  possible to the taste.   The com-
pound called restorative bitters, which I shall presently
mention, is  agreeable, and a  person  will cheerfully eat
enough of it to keep up the action of the system.
   In this chronic affection, as in almost all others, the
action of the  system is partial, and  the  progress  of
remedial influence is slow;  therefore  it is  important to
apply the means at as  many points as possible.   While
general cleansers and  restoratives are regularly  given,
the surface should be  stimulated to action by an occa-
sional vapor-bath, followed  by a free  use of the stimula-
ting liniment,  p. 189;  and a small but  pretty  active
enema  should  be  administered occasionally  when  the
bowels are empty, to rouse them from their torpidity.  If
it irritates them more  than  is intended, give  another of
slippery elm.   The feet should be kept constantly stimu-
lated till  they cease  to be  cold and  clammy.   If the
urine is vitiated, give  the diuretics—as clivers, &c. free-
ly ; if these do not soon correct the difficulty, inject with
a small' syringe, through a catheter, a little of the tea of
these, and  of bayberry and cayenne, into the bladder.
Make up a compound  of equal parts  of as many of the
different approved bitters as you can get; add of slippery
elm, bayberry,  nervine and cayenne, the same quantity
as of each of the others; half as much cinnamon and
cloves, if you have them, and sugar enough to make the
whole agreeable to the  taste.  Mix well in dry, fine
powder, and take  a tea-spoonful  three to six times  a
day, dry, if the bowels  are too loose; in cold  or  hot 
27S
HYSTERICS.
water, if too costive.   Watch the effects.  If the whole
compound is too astringent, mix in more bitter  root, or
butternut extract; if too laxative, put in  a strong astrin-
gent, as woods poplar, &c. till you temper it to  suit the
case.   No man is fit to be  a general practitioner, who
is not well enough acquainted  with the several condi-
tions of the body in sickness, the principles that should
govern his practice, and the qualities and powers of his
remedies, to enable him to  proportion and apply  them
so as to suit the  case before him.  To  depend always
on compounds made to our hand, and  on giving  them
according to a written prescription, is to fail  in  many a
case where  the exercise  of our own judgment might
have given us the victory.
  It is  freely admitted that many of  these  hysterical
cases are very difficult to cure.   The  organs have been
so long and  so much debilitated  by the  presence of ob-
structions, either naturally or artificially introduced, that
the prospect of restoring their energies is gloomy in-
deed, and would be totally  abandoned, but for the cer-
tainty that death is the only alternative to perseverance.
I have, therefore, in many instances,  persevered in the
expectation   of only  keeping  the  patient  comfortable
while  she lived;  and, in  not a  few,  have  seen success
awarded to  perseverance, rather than to any change to
an  apparently more  energetic  or judicious  course of
practice.  Hence it is, that  I have so often  advised per-
sons not to let any unfavorable circumstances discourage
them.   If the case does not improve under  a judicious
and energetic  practice, it  is  certainly  hopeless under
none.  And diligence and faithfulness may be crowned 
     INJURIES SUFFERED BY PARTURITION.  279

with success.  Be sure, then, when you have a bad case,
that you are doing that which is  best  calculated to aid
nature in the  recovery, and  persevere, till death arrest
your efforts, or health reward your toils.

         Injuries suffered  by Parturition.
   I have stated that,  when the patient is  properly
treated, both  during pregnancy and at  the  close of it,
material injury is seldom inflicted  on any of the  organs
concerned in any part  of the process.  But it is  not
every  one  who  is thus treated.  For want of proper
attention in relaxing  the system, the  parts concerned
are sometimes lacerated in  parturition, communications
have been made between the vagina and the rectum, or
the bladder, the uterus has been torn by the fingers, the
perineum has been sometimes entirely divided, and sad
work has been made by the  forceps on  the pelvic mus-
cles and ligaments.
   When these are not so injured as to cut off their con-
nexions, and  destroy  Nature's means of applying the
healing  process,  constant, moist  and soothing applica-
tions to the  parts, and  a general sustaining treatment
of the whole  system, will, in time, effect recovery.  In
lacerations  of the recto-vaginal partition, if we see them
while  fresh,  we must fasten in  contact the  adjoining
edges, either by stitches with lead wire or white  silk, or,
what is better, if they can be made to stay, by strips of
adhesive plaster, at short distances from each other, on
the vaginal side.  If  their  lacerated  edges  are  healed,
we must flay them afresh and then join them.  The sys-
tem must be prepared for this operation, by thoroughly 
280 INJURIES SUFFERED BY PARTURITION.

emptying the stomach  with emetics, and  the bowels
with injections, and  then  continued  in a quiet and un-
oppressed, irritless state, by giving the patient only food
enough to sustain  her, and  that in a liquid  state, until
the adhesions  are  complete and  firm.   This plan has
been adopted  and has succeeded.—See cases by Dr. J.
P. Mettauer, in the Bost. Med. and Surg. Journal.
  My advice was lately asked in a case where  the ac-
coucher, in an attempt at  embryotomy, or cutting away
the foetus by piecemeal, made the small mistakes of cut-
ting out a piece of the neck of the bladder on one side,
and of opening a passage  to the rectum on  the other!
The latter difficulty comes under the above  treatment;
but, for the former, a remedy is scarcely possible; the
preventive of such disasters is to keep off men who " aid
delivery" with knives and forceps.   Even in this  case,
however, I should endeavor to pass a catheter through
the external part of  the urethra, across the  separation,
and through the remaining part into the  bladder.  If,
now, the cut ends of the urethra could be reached through
the vagina, scraped till they were raw, brought together
and confined till they should firmly adhere, well; if not,
possibly a silver tube might be constantly worn there  to
some  advantage.  But  the urine  would be  constantly
flowing, unless the  healing could be effected and the
tube removed.
  The  debility of the organs, even  where  there is no
lesion, produced by the use  of fingers, forceps, crotchets
and blunt hooks, is often  the cause  of diarrhoea, incon-
tinence of the urine, prolapsus uteri, &c;  to  correct
which, the parts should be kept well cleansed, and prop- 
     injuries suffered  by parturition. 281

erly lubricated and toned.  By compression of the nerves,
or actual  lesion of  them,  these  means  often  produce
spasmodic or paralytic affections, which are more  easily
prevented than cured.  In cases where the supports of
the uterus have been so weakened as to permit its vertex
to descend to the perineum, I have been able, by a long
and thorough course of restorative practice on  the gen-
eral system, and of cleansing and astringent applications
to the vagina, to effect a cure.  But the regular practice
has sometimes  taken away parts of the vagina, and, at
others, ruptured its body, or  turned  it wrong  side out-
wards, and then cut it off.  I know of no  cure for those
forms of disease!  We must learn to prevent them.
   Sometimes, from  the  swelling  that  follows  injury to
the pelvic organs, the urethra  is closed, and the urine
accumulates.  Efforts are frequently made  to  draw  it
off through a catheter, but the insertion  of the instru-
ment, in  this condition of the organ, is  painful.  The
same means should be used as for a dysuria, or  retention
of the urine, at other times;  viz.  emollient and relaxing-
injections to the vagina, poultices of powdered and sifted
slippery  elm, made  in strong lobelia  tea, inserted into
the  vagina,  sustained by  a  cloth and   bandage,  and
washed out clean every twelve hours, with warm water,
injected from the common syringe.  Keep up the  action
of the system, and place a half gallon  bottle or jug full
of boiling water, wrapped in a large towel, with its side
in contact with  the external  parts  during the  night.
This practice will soon relax  the pores and remove the
swelling, or a stricture from any cause, and will let the
water escape. 
282  INJURIES suffered by  parturition.

  On the other hand, the sphincter of the  urethra  may
become relaxed, and the urine will flow involuntarily.
In this case, use astringent injections, as  witch hazle,
oak bark, &c. after having first cleansed with bayberry
and a little cayenne.
  If hectic fevers  occur, it is  proof either that the ac-
tion  of the  system is low and unsteady, or that there
are obstructions  which  should  be removed.   Equalize
the action and retain it, and remove the obstructions, if
any.  If the fever be intermittent, alternated with chill,
and succeeded by perspiration, the  surface is too open;
it must be  kept  closed  by frequently rubbing  dry, and
the stength must be supported.  Syncope or fainting, or
a frequent sense of sinking, is  proof of either much in-
ternal obstruction, or much debility of the deep-seated
organs, or  a very lax surface.  The  indications  are  to
cleanse the  general  system,  and  close the surface  by
friction.
  If the lacerated parts show a strong tendency to pu-
trescence, or if the system exhibit much eruption, it is
proof of the presence of corroding canker, which must
be removed by our ordinary method, remembering  that,
after a general cleansing of the system, a  constant and
steady aid must be afforded to  maintain the action as
nearly at the healthy standard as we can.  The morbific
matter that is distributed  throughout the  system,  must
be removed by the  regular course of absorption, and
secernance  or excretion; and   this process requiring
some time, the organs should not  be so over-exercised
as to become fatigued before the  labor is accomplished. 
          palpitation, sinking, etc.      283

Palpitation, sinking, panting for breath, vertigo, &c.
  These are a series of symptoms that, generally if not
universally, have their causes in the mal-practice  of de-
pletion.  By  abstracting an undue portion of the fluids
of the  system, the  hydrostatic pressure is every where
diminished;  the power of the cool atmosphere, in some
cases,  and the obstructed condition  of the  organs in
others, force  the fluids to those parts that are less influ-
enced by these causes: hence, there is a  passage  of the
blood to the large veins and heart, and an opposition to
its repropulsion through  the arteries;  consequently it
accumulates  in the heart* lungs, &c. producing conges-
tion and causing the heart to labor fruitlessly " in back
water."  The symptoms thus produced are called palpi-
tation.  It takes place at the commencement, during
the progress, or at the termination  of exercise, because
it is then that this  inequality  of distribution  of the fluid
is most powerfully resisted.   The power of the  system
to overcome  it will be exerted to fatigue, and sometimes
to absolute prostration, which will be  indicated  by the
sinking of strength, panting for breath, &c.
  The vertigo, or  swimming of the  head,  arises from
the same  cause, pressure  of the fluids, but upon differ-
ent organs, viz. the nervous system, instead of the vas-
cular.  Some of the nerves are  harder pressed, and, of
course, more impeded in their action than others.  This
makes a difference in the time in which the different ex-
ternal  objects, and  parts of objects are impressed upon
in the mind ;  hence these objects themselves appear to be
in motion, now towards, and now from us.  We imagine
ourselves falling towards those that appear to approach, 
284       PALPITATION,  SINKING, ETC.

and we make  efforts  to balance ourselves accordingly.
These efforts, together with our real weakness, make us
really stagger, and sometimes throw us entirely down.
  Poisons  of  every  description, tend  to destroy the
vitality of every organ on which they are permitted to
produce their natural  effects.  This needs no proof.  It
is universally conceded that it is only when  the system
is able to throw off both them and the cause of the dis-
ease for which they are given, that their administration
is justifiable; and  that, when they remain long in the
system, they do it a real injury.  See the  disease  called
"mercurial," in any of the popular works on the prac-
tice  of medicine.   In proportion, then, as mercury, or
any  other  poison, fastens  upon any ganglion, plexus,
ramification or fibre  of the nervous system, it checks
the vitality of that part; what is  the necessary conse-
quence  but confusion in  the combined  action of  the
whole? Thus calomel is  frequently the  cause of  this
derangement, yet how  often do we see, instead  of an
attempt  to remove  the  calomel,  another poison, as
opium, &c. administered, to check the action  of the re-
mainder, and thus equalize the nervous excitement?
  Such treatment reminds me  of the conduct  of some
wricked boys, who found the head, fore-legs, and body of
a toad, making powerful and uncommon efforts, because
its hind-feet were deep in  the throat  of  a serpent  that
was  about to swallow the whole.  To quiet this unusual
action, they very scientifically cut off the head  of the
toad, instead of  that  of the serpent.  I  need  not  say
that their skill was crowned with a success quite equal
to that of the administration of poisons to cure deli- 
          PALPITATION, SINKING, ETC.       285

rium  and congestion!   It sometimes happens, indeed,
that the blow at  the  head, however destructive its  na-
ture, or mistaken its intentions, does not entirely answer
the aim;  and, after a few more struggles, the  poor ani-
mal escapes  the two-fold danger, with only a scar on
the head, and the loss  of the use  of only  his lower
limbs. But who will contend that  the blow itself, or
the intention  in giving  it, is  the  means  of saving  the
poor reptile's life?
  I would not be understood  to say that  nothing  but
poisons in the system can be  the  occasion  of delirium.
Any substance that can produce unequal pressure upon
the different  nerves of sensatibn and motion, will pro-
duce the  same irregular action  for a  time;  but there is
this difference, that the irregularity produced by the  lat-
ter, as it suspends or impedes  only the action, not  the
capacity  to act,  is easily removed;  while  that produced
by the former is  less  or more  permanent, according to
the partial or total destruction  of organic capacity.  Of
course, the delirium that proceeds  from mere obstruc-
tions  to nervous  action, will be cured  by simply remo-
ving  those  obstructions.  That which  proceeds  from
partial or total destruction of nervous capacity, will be
but partially cured,  if cured  at all.   I know this will
sound harsh  to many "believers  in  calomel, opium,
nitric acid, digitalis, cicuta," &c.  &c; but I feel it  my
duty,  as  their friend, to warn them that these deadly
poisons are what  first  make  nine out of ten of  the
chronic diseases in  our  country, and  then render them
"incurable;" to say  nothing of the  "countless  hosts"
that are  sent  to the grave  from infancy,  childhood, 
2SG       PALPITATION,  SINKING, ETC.

youth  and manhood, by the same  destructive  instru-
ments, administered so rapidly, or under  such circum-
stances  as  to  destroy  the whole, instead of a part, of
the vitality of the system,  and thus produce a more
speedy death.   But even  this is  certainly preferable to
a lingering existence, unprofitable to  the world, and  a
burthen to one's self,  from which, as Dr. Mason Good
says,  "Death, with a friendly  stroke, finally  puts  a
period to one's sufferings."   And then, what renders
this course the more reprehensible, is, the  blame is  laid
to the  will of that kind Providence who, instead of
ever telling us to  use  poisons to cure disease, actually
told us that poisons are  themselves the  consequence of
wickedness; that we are to eat only what is "good for
food," and cure our diseases only with  healing balms;
and more than all this, who has scattered  these  healing
balms, in rich  profusion, wherever man is  found with  a
malady  to be  cured.
  The description of the causes and pathology of these
affections, will suggest the plan  of cure.  The particu-
lars are given in the Lectures  on " Ways  and  Means,"
p. 141.   The steaming should be confined longer to the
lower than the upper extremities, the obstructions re-
moved,  and the circulation equalized, not by destroying
the little  action  that  remains, but  by  stimulating the
sluggish  organs to come  to the performance  of  their
duty.  All the difficulty in these cases, is, like  the pre-
servation of civil liberties; they require (almost) " eternal
vigilance" in the practice.   Long perseverance is  often
rewarded with success,  after  the most vigorous treat-
ment, for a time, seemed to do no other good than mere-
ly to postpone the dissolution. 
DISEASE  OF  CHILDREN.
  I have already shown, p. 33, that many forms of dis-
ease of children, such  as  scrofula, erysipelas,  consump-
tion, syphilis, &c. may have  their origin in  the parent.
It is therefore  evident  that the  first medical treatment
of children should be exercised  on their parents, whose'
blood and flesh should be kept constantly free from all
impurities.   It  is a mistaken  notion that "it is  danger-
ous to doctor women during pregnancy."   If " the sci-
ence of medicine teaches the art of preventing and curing
disease," where can be the harm of exercising it in any
case?  If experience has proved that what is commonly
practised as  this art, actually makes  disease instead  of
preventing it, then it may be,  and ought to be,  aban-
doned, not  only when persons  are very liable to be
seriously injured by it, but when they are the least sus-
ceptible of  injury.  But, does  this prove that means,
calculated to effect the end in a  proper way, should not,
at all  times, be  used?  Surely  not.   Let the  parents,
then, be kept in good health, and  their offspring will be
blessed with a  sound constitution, as surely as a  flour-
ishing, healthy plant will  produce a perfect seed.
   I have already spoken extensively  and  carefully on
the treatment of the new-born infant, pp. 112, 135, and
elsewhere.  To wash  off the  sticky  matter from the
foetus, Dr. Eberle says that the yolk of an egg is  better 
288
DISEASE OF  CHILDREN.
than the soap and lard of Dr. Dewees; that the water
should be at least luke-warm, in all cases, and warmer
where the infant is feeble.  Dr. Gunn  says  this meally
covering is designed by nature to protect the child from
the too violent action of the atmosphere, and should by
no means be removed by us.  In a few  days it will come
off itself, and leave the skin soft, natural, and free of all
disease.  Care should be taken not to  fatigue the  child
too much.  Infants  should be washed at least once a
day, over every part of the body, and always rubbed
dry with a soft cloth: then a little sweet oil, or oil made
by melting unsalted butter, rubbed into the groins, arm-
pits, and wherever else chafes are likely  to  occur, will
prevent them.   The lower part of the body should be
washed clean twice a day, and at other times as circum-
stances require.  Dr. Eberle  thinks that the  bandage
should be worn "four  or  five months," and longer  if
" the parts about the navel appear to be weak and read-
ily to yield to the pressure of the viscera."  These parts
should be examined often, and kept dry and clean.  It
cannot be  too strongly  urged on those who have the
care of infants, to "keep the feet warm, the head cool,"
the clothing loose,  and the  body free  and  easy; to
change the clothes to suit the variations of the weather,
and  not  to  let  them sleep in  cotton  or flannel worn
during the day.
  Disease  is  often  produced  in infants, by unsuitable
food, or by a too frequent, or a  too  liberal  use  of  that
which is  good.   The new-born infant is not in sp great
a hurry to " eat, or take physic," as most persons  im-
agine.  It may,  if vigorous, pass five or six  hours  after 
               DISEASE  OF CHILDREN.           289

 birth, without either food or injury; and, when food is
 given, if the mother does not supply it, new milk, sweet-
 ened with  a little molasses, is  doubtless the best.   No
 remarks would be added  here to what  have been made
 heretofore,  but  to correct  an  error which Dr. Eberle
 seems to have committed in supposing that, because the
 mother frequently supplies  no  milk for some  time, we
 are to conclude that the child  does not  need nourish-
 ment till she does supply it.  But I would not do  him
 injustice.   He "does not mean to  inculcate  that nour-
 ishment is always to be withheld until  the milk is secre-
 ted; but that, "with healthy infants,  several hours, at
 least, should  be suffered  to pass after the birth, before
 any alimentary substances are introduced into the  sto-
 mach;*' and then he "would most strenuously insist on
 the importance of giving but  small portions  at  a time,
 and at such intervals as will obviate  all  risk  of over-
 loading the stomach.  A  few tea-spoonsful of some very
 bland and weak fluid could not be detrimental, though
 given immedately after birth; but  the  usual practice of
 filling  the  stomach  to overflowing, and keeping it in
 this state of fullness and  distention, is  most ruinous to
 the health and comfort of the child."   I perfectly agree
 with the doctor,  in all but the supposition  that " the
 supply" will generally be furnished as soon as the want
 is felt.  This ability of nature to do her original duty,
 in spite of the impediments thrown in her way by the
refinements  of the age—as luxury,  idlenes■-, corsets,  silk
stockings, bleeding and physicking out  the  plethora,  and
checking, with poisons, the tendency  of the  system to
produce it in the idle and luxurious—has been examined
              19 
290     DISEASE OF  C II I L D R E N--N U R S 1 N G .

in the first lecture, where it is rendered at  least ques-
tionable.  As  but a small quantity of food, however, is
requisite to support the system, and as the  digestive ap-
paratus is unaccustomed  to its  intended exercise, much
caution is necessary as to the nature, quantity, and fre-
quency of the food that seems requisite, before the child
is  furnished by the mother.  When  it  is  necessary to
feed  the infant, Dr. Eberle  says, " two parts  of fresh
cow's  milk  and one of warm water is  the best."  And
this,  he thinks, should be " the  only  food for the infant
during the first three or  four months,"  when it  cannot
be supplied by the mother or a wet nurse.

                      Nursing.
   When, from any cause,  the  child cannot  be entirely
supported from the breast  of the  mother or the nurse,
small quantities at a time of the milk, or milk and water,
should be given it.  It should  be  drawn from  a vial, or
little bottle, through an  artificial  nipple; or, when  this
cannot be had, a  piece of clean linen rag an inch wide,
and  long enough, when rolled up closely, to fill the mouth
of the vial, may be used.   This will prevent  the child
from eating too fast, and give  the stomach time to be-
come  satisfied before  it has received  too  much.  The
cloth must  be  unwound and washed in scalding water
once or  twice a day.
   After six months, even when  the  mother nurses the
child, it  may be well to commence giving  milk, in small
quantities, two, three,  or four times  a day, to  gradually
accustom the  child to derive its food from  other sources
than the breast.  Light bread may be, by degrees, finely 
KURSIK G--N IESES.
291
crumbled and mingled with the milk; and thus the light-
est food may succeed, from time  to  time, till the child
will not only  become  accustomed and able to  subsist
without the mother, but be very willing to do it.  There
are many things that  may be given to  it in infancy with
impunity, provided they be not given in too great quan-
tity.  Barley water, rice water, milk  porridge, fine corn
mush and milk, &c.   But milk is the best, and this should
be given, by the judgment of the parent, not to stop the
cries of the child.  The common practice of nursing or
feeding a child to stop it  from crying, or to put it to
sleep, is  not only very injurious to the infant, but  un-
wise in the person who does it: as the cry is not  unfre-
quently  an indication  of pain  produced by previous
over-feeding; and,  of course,  more stuffing only makes
the matter worse.  When a  child cries, that is  known
to have eaten  enough for the abundant support of na-
ture, it would  be much better to endeavor  to  ascertain
whether the cause may not be the irritation  of a pin in
the clothes, or some uncomfortable position,  tight band-
age, or the like.

                       Nurses.
   Though it  is generally supposed that it is  about as
well to obtain  a wet  nurse for the child, as for the lady
to nurse it herself, yet I am inclined  to think that, in
general, the disadvantages of "bringing a  child up  by
the bottle," (I don't mean  the rum bottle,) are far  less
than those of entrusting it to  nurses.   In the first place,
their milk  is not so suitable, especially if they have  not
just then begun to afford it.   The first milk, says  Dr. 
292
NURSES.
 Dewees, is the most appropriate "natural physic to the
 child."   Secondly—they may have  some disease in the
 blood, as syphilis, tetter, itch, occ. which they may com-
 municate to the child.   Thirdly—they draw its attention
 and attachment from  the  mother.  Fourthly—they do
 not so  well  attend to  the child as the mother  would,
 either as it regards its food, clothing, comfort,  or clean-
 line ;s.  They are  impatient of the necessity of  incessant
 watchfulness, feed it too much at one time and too  little
 at another, leave  it too long  in the  same position, and
 handle it too roughly when they condescend to move it
 at all.   They not unfrequently, too, give it some vicious
 anodyne to keep it quiet and  make it sleep.
   But, bad as these evils are, they can scarcely be con-
 sidered  the  worst.  Nurse* communicate  to the child
 the influence of all their evil  tempers and examples, and
 teach them false and vicious notions of right and wrong;
for it  must not be forgotten that infants begin to observe,
and to  receive deep and lasting impressions from  the
 moment they open their eyes.   If there were no other
 objection to employing  a nurse, than simply the disad-
vantage to the mind and manners, I should strenuously
 oppose  it in all cases, except those in which the nurse
were  a  better woman than the  mother!—cases that do
 sometimes  occur.  In other  cases, even where a nurse
is  employed,  it will be profitable that the mother  should
 take charge of the child at all times, except when at the
breat.  A nurse  of vicious  passions  even vitiates  her
milk,  as well as her  example, and renders it not  only
totally unsuitable to the infant,  but  positively injurious.
'Mich, therefore, should always  be  avoided.   In  some 
NURSES.
293
cases, however, of very weakly or premature  children,
all efforts to raise them by feeding, prove fruitless.  Then
the best nurse that can  be had should be obtained, and
dismissed as soon as she  can be spared.
  After the teeth begin  to  appear, it is proper enough
to commence giving the  child  a little mutton, or chicken
soup, and  small portions of boiled beef or  mutton,. or
chicken may be chewed; but greasy food—as pork, and
what is hard to digest, as veal—should be avoided.  A
few articles that are plain  and nourishing, are the best
food for children.   They may eat four or five  times  a
day, if they  do not  eat too  much.   Milk  and water,
when young, and water alone  afterwards, should be their
only drink.  The  pulp  of ripe  peaches and apples, is
good for food; but the infant should never be permitted
to eat the seeds, the core, or the skins  of  these or any
other fruits.  Currants, cherries, whortleberries, grapes,
raisins, &c. are particularly objectionable on  that ac-
count.  Tough,  smooth  skins should  never be  eaten.
Being  indigestible, they  irritate  the stomach and bow-
els, and create serious derangements.   The little seeds of
raspberries and strawberries are indigestible—of course
they will irritate the  internal canal, and become sources
of disease—but the juice expressed from them, or other
similar fruits, is good.  In short, nothing should be given
to infants,  or young children,  that is known  to  be diffi-
cult to digest; for, whatever is  not well  digested,  is
pretty sure to produce diarrhoea.   Nothing,  however, is
better for this affection, than the raspberry or blackberry
juice, or a tea made of the roots or leaves, sweetened
with loaf sugar and  a little milk  in  it.  This  last may 
294
N U R S E S .
also be given by injection.  The principal  reasons w hy
any of the ordinary fruits are injurious, is, either they
are given unripe, or in a hard, solid state; or the skins,
cores or  seeds, that cannot be  digested  at all, are not
removed.  Clear these from the rest, reduce the remain-
der to a  pulp or jelly-like substance, free from  shreds or
fibrine, as well  as hard  coriaceous or bony substances,
and the remainder of any fruits that are good to eat  by
any persons, under any circumstances, may be eaten by
infants with impunity.  It  is the want  of  proper mas-
tification that  renders many  vegetables—as  potatoes,
turnips, parsnips, carrots, peas,  beans, &c.—often inju-
rious.  I   have  repeatedly been told  by  a  sick person,
that he or she had an almost insatiable desire for certain
vegetable food—as potatoes or turnips—but that they
were  sure to produce diarrhoea—that is,  " to come away
as they  were  eaten."   In hard lumps? said  I.   "Yes.
mingled with watery fluid."   It appeared to me that the
fault  was altogether  in their not  being masticated so
that the gastric juice  could  act upon  them.   Passing in
ragged, angular forms  through the intestines,  they pro-
duced an irritation which  forced  them  along rapidly;
and the fluids, which generally pass so slowly as to give
time  for  absorption, were carried along with  them.  I
directed  these very articles to be thoroughly boiled, then
bruised till all the lumps disappeared and forced through
a fine seive, to  get out all but the parenchymatous sub-
stance.   Of this  I permitted the  patient to eat  freely,
and I never knew an instance of injury from it.   Child-
ren may  eat the expressed juice, or the fibreless pulp, of
any fruits that are good for the parent.   There is, there- 
NURSES.
295
fore, no painful necessity of denying them any fruits or
vegetables which  they see  their  parents  eat.   Peas,
beans, snaps, cherries, and all such  things, are innocent,
delightful, and nourishing,  when  thus treated.  Pears
are supposed to  be more indigestible than apples; and
all dried fruits than flesh.  The  only reason is, they con-
tain more hard or  stringy  substance, in proportion  to
the parenchyma, than others do.  Bruise and strain the
pears, or  dried fruits, and they  are  quite as good as the
fresh apples;  far  better, unless they, too, are thus pre-
pared.  You may cure, in  children, with the expressed
and clear  juice of raspberries and blackberries, the very
diarrhoea  which was produced  by the irritation  of the
seeds of the same fruits, when  eaten whole.   Hence, it
is not only necessary that  children, and  the  sick adult,
should  have good  food, but that  this food should be
properly  prepared.  I give  a sick person a little of any
thing he craves;  but I take care that it is properly pre-
pared for  his reception.  I  have seen  a patient eat with
impunity  the  expressed juice  of  a  raw turnip, when
there was neither appetite  to  eat,  nor ability to digest
the fibrous pulp of a boiled one.
   Even particles of matter that is  not very fibrous—as
boiled potatoes, artichokes, &c.—may be so  firmly united
by cohesion, that  they will not all,  except  when well
masticated, be submitted to the process of digestion;  of
course  they become irritants to the alvine canal.  The
reason why a roasted potato is  more  wholesome than a
boiled one, is simply  that  the  dry  heat disengages the
water from them, separates  their particles, and gives free
admission to the gastric juice among them.   Hence they 
296
NURSE S--M E D I C I X E .
are reduced to solution, and rendered subservient to the
nourishment of the system, while their power to irritate
mechanically, is destroyed.  I have never known good
Irish potatoes  do harm, when they were ripe and well
roasted, and skinned and thoroughly bruised before  they
were  eaten: and I have  frequent))' prescribed them in
this way for very weak stomachs.

              Medicine for  Children.
  In the commencement  of this work, I mentioned some
of the evil  effects  on  children, of improper  medicine,
and wrong modes of practice.  As they have, generally,
a more healthy constitution than  grown persons, it will
require a far smaller portion of medicines to cure them,
or of  poison to kill them.  The organs being more read-
ily roused into action, a  larger portion  of the medicine
is used at the same time, and, of course, the effects are
more  alarming.  In giving medicine, therefore, to child-
ren, great care should be taken that nothing poisonous,
or in  any respect  hurtful, should be  used, and that no
excessive  quantity should be given, even of that which
is innocent and good.  None but the attentive practi-
tioner can determine just how much should  be given in
any particular case, the  action of the pulse,  and the
state  of the stomach,  bowels, extremities and surface,
when well  understood, will give a clue to the proper
quantity of medicine, and the time and mode of admin-
istration.  The true way  is  to begin  with  a little, and
increase  or vary  the  dose, as the circumstances  and
effects require.  In  general,  I have found ginger suffi-
cient!} stimulating  for infants, and they are  much less 
MEDICINE  FOR CHILDREN.         297
displeased with this  than  cayenne.  Raspberry leaves,
too, are excellent  for them, and  bayberry, if good,  is
often  sufficiently stimulating without cayenne.  It may
be remembered that, while there is a high  fever  and a
burning surface, there is more need of external  relax-
ants than of internal  stimulants, till the pulse begins to
sink, when stimulating fluids may  be given  more freely.
There are cases, however, which will require the energy
of a half tea-spoonful of cayenne at a time, and even
several times repeated.   If necessary to sustain the sys-
tem, let it be given, and  as long as required.
   As it is very difficult to make children take medicine
of a  suitable  kind, and in sufficient quantity, particular
attention should be paid  to giving it by the bowels, and
applying it to the surface, whenever there is a prospect
of its acting with  equal  comfort  and benefit that way.
Nauseous medicine should never  be given  to  open the
bowels.  It is much better, as well as quicker done, by
an injection,  only  slightly stimulating, and repeated, if
necessary.   The necessary articles  may also  be much
disguised by putting milk, sugar, and some pleasant aro-
matic in the tea.  Milk may procrastinate the time, and
moderate the  violence of their effects,  but  will not ma-
terially diminish their value.  But I insist that children
should never be cheated  as  to the sensible qualities or
the intended effects of what is given them.   They should
be told candidly the danger of their condition, the taste
of the medicines, and the  effects which it is intended
they shall produce.   Then they should  be  persuaded to
take them, if  they can be; forced to take them if they 
298
EXERCISE.
must.  To cheat them is  the way to make them  trou-
blesome.

                      Exercise.
  However feeble the first motions  of the infant,  noth-
ing  should  be permitted to impede them.   Its  dress
should  be free, and  no  heavier than  is necessary  to
keep it warm.  When asleep, it may of course be cov-
ered with more clothes than might be convenient  when
in active exercise; but, when inclined to be restless, it
should be laid upon a mattress,  or hard wide pillow, and
suffered to use its feet and hands as  freely and as  long
as it pleases.  In cool weather its arms  and legs should
be covered with  cotton, and, in cold, with  flannel, and
thick woollsn socks.  It should also  be  carried about in
the  arms, but not required, for  two  or three months, to
support itself upright,  without assistance  to keep its
back and  head strait.  Its position  should 'be  changed
frequently, as from  one arm to  the  other, that  it may
neither grow crooked, nor become  tired.   Its spine is
too  weak  to support its body erect, for the first three or
four months, nor is its  neck  strong  enough  to hold the
head up long at  a time even then, without fatigue and
pain.   Therefore,  when  carried in  the arms, all  parts
should be supported as much  as possible.  Those that
handle the little  infant, should remember that it is  not
accustomed  to rough  treatment, to being so suddenly
raised and depressed several times its length, as almost
to deprive it of  breath; and, especially,  they should re-
member that its  arms are  not so strong as to justify the 
EXERCISE.
299
frequent lifting of its whole weight by them.   All  sud-
den jolting or  jarring  of infants, as  dandling  them
severely on the knee, and letting the heel strike the floor,
or striking them with the hand on the back, or  rocking
them  violently in a  cradle; in short, all  operations by
which the whole or  parts of their bodies are suddenly
and severely  shaken, are injurious, and  should be dis-
countenanced.
   The custom of giving infants air and  exercise in little
wagons, is good.  But  1 have thought that the air so
near  the ground may not be so refreshing,  as it is well
known, at some times and in some countries, to be very
injurious  to health,  when that which is inhaled at the
height of  a  man is  good.   Perhaps the best mode of
carrying an infant about, is to  place it on a pillow in an
oblong basket, hung upon the arm, or string it by a belt
under one arm  and over the opposite  shoulder.  The
basket may be pushed forward under the  nearest breast.
The holding by the arm to  the neck of the nurse, as  it
is commonly carried, is calculated to deform  the  shoul-
der, especially unless it be frequently changed from  one
arm to the other. Whatever  be  the mode of  artificial
exercise for  infants, it  should  be  frequent,  moderate in
character, and short in  duration, and under  such circum-
stances that all its limbs may be free for whatever mo-
tion  they may be inclined to make.  All uncomfortable
motions should  be carefully avoided.  It is often the case
that an infant is sadly shaken about, jolted or rocked, to
prevent it from crying, when  the fatigue and suffering
it has already endured, in consequence of former shaking,
may  be the cause of its crying. 
300
EXERCISE.
  "Creep before you walk," says the proverb.   Cribs
are preferable to cradles, if they are not made  too high
and too liable to turn over.   The upright posts are fine
things for the infant to try the strength of its hands and
arms upon.   It  will  often seize them, (they should  he
small, round and plain) and pull just as  much  or  as lit-
tle  as  it should, and let  go when it is  tired.  In this
way, the  development of  the muscular  power of  the
hands and arms will commence   much  sooner, and  be
more gradual and more effectual,  than when confined in
a smooth-sided cradle which it cannot  seize  with  its
fingers.   It  should never be  taken up, nor even sup-
ported when up, by one hand or arm, nor should it ever
be lifted by its arms at all till it  has been  observed  to
raise itself upon  its feet by their use, and even then it
should   not  be  held long by them.   To  develop the
strength of  its feet and legs, the foot of the crib should
be a solid hoard,  and the bed should be made so near
it  that  the  feet may push against it when the legs are
straight.  The head  can  be filled up with  pillows.  It
will be soon observed that the child takes great pleasure,
at a very  early period, in pulling at the pillars  and kick-
ing the  foot-board of the cradle, and much time will  be
spent in this way, which would be passed in crying in
an ordinary cradle with the bed made close to  the head.
When  the child  becomes so strong as to hold its head
firm and  erect, and to balance its  body in the  cradle,
without holding to the pillars or rails, it may be  placed
upon the carpet, and watched, relieved and stayed often,
till it has  learned to sit firmly, when various play-things
should  be put into  its lap.   It will  presently begin to 
EXERCISE.
301
lose them, and reach and move itself after them, and, in
a few  days, will creep  all over the floor.  The articles
may then be put into a  little chair, to induce it to climb
after them, and it should be watched and prevented from
falling  in its first attempts, till it has acquired so  much
pleasure and skill in the exploit, as to encourage its fre-
quency and secure  its safety.   Let the  articles now  be
placed upon a common  chair, and it will raise itself upon
its feet, where it should not, at first, be  permitted to  re-
main long at a time.  By degrees it will learn to  let
itself down again,  when  it becomes tired, and now it
may be permitted to rise, stand, or sit  at  pleasure.   It
will nowT commence walking round the  chair, and, when
it is  strong enough to steady itself by one hand, it will
attempt to ya^s  from one  chair to another that may  be
within  its  reach.   It may then be held by both  hands
and  induced  to  step after a  person; and, after this is
done with  ease, twro  persons  may teach it to walk by
itself from one to the other, near together at first, after-
wards  at greater distances.  These  exercises must not
be continued long at a  time, but may be frequent.  But
I repeat it, that children should not be pulled and whirled
about by their arms, nor tossed high and suddenly into
the air; nor should their bodies be subjected to  any ex-
ercise  much  more violent  than themselves are capable
of making.  They are  often materially injured  in their
form and future growth by these means.   When they
have learned  to  walk, they should be permitted to do it
as much  as  they choose,  out of doors, whenever the
ground is dry.   For  this  purpose every nursery should
have a small piece of grass near it, which should be free 
302
EXERCISE.
from stones, sticks, &c. and not permitted to grow high,
and  here it should be permitted to rise, walk, and fall,
too, as much as it pleases.
  I have said that children ought  never to be pulled
about by their  arm  or  arms.  Dislocations,  sprains,
and deformities are the frequent results of such conduct.
I have seen nurses, in leading a child by one arm, pull
so hard as to cause it to fall forward, not being able to
set its feet  firmly on the ground, and then, of course, its
whole weight would be suspended upon one arm.   Not
unfrequently, too, does the nurse lift it in  this way over
a drain, a log, or up or down a step.  Those who handle
children in this way do not seem to reflect that it would
not  be very comfortable for themselves  to be pulled
about by the arm with a power and velocity adequate
to the taskj  Yet, what reason have they  to believe that
children can bear it better than adults?  They may rely
upon it,  that the  cause of much of the fretfulness and
crying  of children, and  of  many a deformed shoulder,
may be  found in  this violent dealing with  infants, per-
haps for the purpose of preventing their crying.   Not
only are "infants  thus treated  by a careless, unfeeling
nurse, when unobserved by the parents, but I have often
seen it in the mother  herself.   She  cannot be supposed
to "forget  her child," but it were much better that  she
should at times neglect  it, than to  treat it so rashly as
she frequently does.
  "After children have acquired the  entire  use of their
legs," says  Dr. Eberle, very justly, " walking is decidedly
the best exercise that they can take.   When the weather
is fine,  they  should be taken  out  daily, and freely in- 
EXERCISE.
303
dulged in running  and walking out, under  the superin-
tendence of a careful nurse.  These little excursions, if
prudently conducted, have a highly salutary influence
on the infantile system.  Children that are raised in the
country, are, in general, much more robust, healthy and
active than those that are brought up in cities: and this
difference is mainly to be ascribed to the greater freedom
which the former  usually  enjoy, of walking, running,
and  tumbling about  the grass-plats;  enjoyments often,
in a great measure, denied  to the latter.   In  taking this
kind of exercise, children should not be  accustomed to
rely too much on the assistance of others.  If  the ground
is soft, or covered with grass, and free from stones, tim-
ber, &c. they should be permitted to have  their way.
A few falls will do them no  injury; but, on the contrary,
make  them  less timid, and  teach them better than any
other instruction how to avoid a similar accident in fu-
ture.  Children that are never suffered to surmount, by
their own efforts, the little difficulties which  may occur
in their  sports, and are continually warned against tri-
fling accidents, seldom fail to become unduly timid, help-
less and irresolute in their  actions.   Parents  ought  not
to intimidate their children by  inspiring  them with a
constant dread of falling and hurting themselves.   The
custom of exaggerating the dangers  incident  to  their
usual  sports, and of plying them  continually with ad-
monitory injunctions against accidents, when they  are
engaged in their amusements, is calculated to favor  the
very accidents which they  are meant  to  obviate, by the
timidity which  these  perpetual  lessons of caution and 
304
EXERCISE.
 fear almost inevitably inspire.  When the ground is soft,
 it is much better to let the child take the chance of two
 or three falls, and give a full scope for the exercise  of
 its limbs, by running and gamboling about till it is satis-
 fied.   Nothing  can be more invigorating to the whole
 organization than this kind of unrestrained exercise,  in
 suitable situations, and under the superintendence of a
 prudent nurse.  When they happen to fall or hurt them-
 selves, they should not be soothed by expressions of pity
 and  sorrow, which tend very effectually to  render  them
 effeminate and timid.  Children thus commisserated, sel-
 dom fail  to acknowledge the tender sympathy in strain-
 ing their little lungs to the utmost by crying, on the re-
 ception of ever}' slight  injury.
   After they have passed through the primary period of
 dentition, they should be encouraged  in the pursuit of
 active amusement out of doors, as an essential and reg-
 ular  part of physical discipline.  Nothing  contributes
 more  effectually to enfeeble the  body, and to lay the
 foundation  of permanent constitutional  infirmity,  than
 confinement within doors, and want of active  exercise,
 at this tender period of life.  The development of the
 moral  and physical energies of children, can in  no way
 be more  effectually promoted, than by permitting them
 to engage freely in the usual sports of childhood, in the
fresh  and open air.  The practice of obliging them to
 remain within doors,  and to con  over their lessons be-
tween  school hours, is by  no  means  commendable.
These  intervals  should be  devoted to innocent amuse-
ment and bodily exercise." 
               clothing, air, etc.            305

            Clothing, Air, Exercise, &c
  In  the  preliminary lecture, I spoke especially of the
evils  that follow a want of proper clothing, pure air,
and abundant exercise.   I  must insist here, that child-
ren that are constantly deprived of either of the above
named comforts, are seldom healthy, and never have a
good constitution.   Nothing is more important, whether
we desire the development  of the physical power or the
mental energies, than that the system be  protected  from
the excessive action of the atmosphere, the  sun, or the
shower, by suitable clothing, comfortably adapted to the
figure and motions of the body, and then permitted to
enjoy the pure air, from which it may derive oxygen for
the perfecting of the blood, and be subjected to steady
and varied exercise during the whole period of its growth.
Children that have been bred in the house in idleness, or
in factories where the air was  impure, or in the depths
of that poverty which  deprived them of comfortable
apparel, are seldom able to bear, with impunity, the  la-
bors and privations of those reverses of fortune to which
all are  exceedingly liable,  while  those that have  been
accustomed to labor on a farm, (on the whole the best
exercise in the world) more or less every day, during the
whole period of their growth, are  seldom  afterwards
broken down by any severity of either bodily or mental
exercise.  The clothing  should not only be warm  or
cool, according to the season, but it should be properly
distributed and comfortably attached.   The feet,  legs
and arms should be clothed as warm as the body.   No
bandage should be drawn so tight round any part of the
system as to leave a mark after removal.  The shoes
             20 
306
CLOTHING,  AIR, ETC.
should be always loose and comfortable;  in infants very
soft, and the feet should  always be kept as dry as pos-
sible.  All  children should wear drawers  under  their
clothes, adapted to their necessities; cotton  in summer,
and flannel in winter.   Thus apparaled, and comfortably
fed, there need he little fear of their taking  cold, on ex-
posure to any ordinary atmosphere, while they should
be frequently employed in the greatest convenient variety
of useful exercises, in which it  may  be supposed that
they will ever be necessarily or profitably  employed.
When the weather is  damp and chilly, they should have
an opportunity to play in  a large room.  They  may be
permitted to walk or run through passages and draughts
of air, but never to lie, sit, or stand long  in them.  They
should not be tied a long  time  in  a little armed chair,
but allowed to run about and tumble over the floor, any
thing against which they might injure themselves being
removed.  For several years, girls should have  the lib-
erty to play out of doors with the boys.   Nor do I see
any good reason why they should  not, till  they  are ten
or a dozen years old.   But if any think that they should
be separated before this time, I earnestly insist that the
girls be not deprived of exercise  by themselves in the
open air.  The keeping of them in the house, or always
covered with a  long, close bonnet  when out, may give
them a whiter  and more delicate skin, but  it  deprives
them of that robust and hardy constitution, which is  of
far  greater value.   Neither girls  nor  boys, however,
should be permitted to stand, sit or lie, long at  a time,
on the damp ground.  There  is little danger of taking
cold while exercising;  but, when the exercise  is over, 
     CLOTHING, AIR, ETC .--T HE NURSERY.   307

care must be taken that they do not cool too suddenly.
They should be required to walk about till the perspira-
tion has ceased, and  by no means permitted to drink
more  than a swallow of water at  a time.  If they are
very warm, a cup of  warm water and milk is far better.
Washing the hands and face in cool water, directly after
severe exercise in hot weather, is not only a sure rem-
edy against taking cold, but will allay the thirst,  in a
very great measure.  The  clothing  that  may have been
throwm oft* before  exercise, should always  be immedi-
ately put  on afterwards, that the  heat  which  is  then
escaping  too fast, may be retained  round the body till
the pores close gradually, and exclude the chilly air.

                   The  Nursery.
   Where children are kept in the  room  with  the other
members of the  house, as is  most commonly the case,
especially in this  country, the  rooms are so often opened
as to keep  the air pure and wholesome, unless, indeed,
the house is so small as  to require many to huddle in
one room, and sometimes even to cook there.  But  most
families, who have the  conveniences appropriate to the
children and their attendants, have a certain room  they
call a  nursery.   Into  this they are  frequently pretty
well  crowded, together with their dirty clothing, and
 every thing that pertains to them.  This  room is fre-
quently made nearly air tight, lest they take cold; others
are suffered to crowd into it and corrupt the atmosphere
 by absorbing the oxygen, and what is  worse than all,
 the childrens' clothes are changed, and,  if only wet, are
suffered to dry in the room; if dirty, as well  as  wet, 
308               the nursery.
 they are frequently suffered to remain in the room till
 they have rendered the air totally unfit for respiration.
 Instead of all this, the room should never be thronged
 with those who do not belong in it, (the larger children
 being  compelled  to take their  exercise in more  open
 places, and to " play with the baby," when brought to
 them, or, to be but few at a time in the nursery,) should
 be so constructed as to be easily and freely ventilated at
 any time; should often be deserted while a current of
 air is permitted to pass through it, by door and window,
 for half an hour or so; should be very frequently washed,
 always  kept  free from any and every  thing  offensive,
 even a wet  diaper, and constantly ventilated by lower-
 ing the  upper window-sash a  little, if no  more.  How-
 ever unwholesome may be the air without, that within
 will soon be more so, unless  it be often changed.   The
 room should never be entirely close, either at night, or
in the coldest weather  in winter.  It is well to keep a
 thermometer in the room, and never to raise the heat
 above 65 to  70 degrees.  But there should, if possible,
 be two  rooms for this  purpose.  It were much better
 that a nursery be  divided into two apartments,  even
 though  they should be small.  Then the children may
sleep in one and play in the other, and be changed from
 one to the other while washing, sweeping, or ventilating.
Still, it is desirable that, both  should  be  large, airy, and
well lighted and ventilated.  An upper room is prefera-
ble.  It may be warmed either by a fire place or a stove,
 provided the latter be not heated too hot, and a basin
of water be  kept upon  it, so that the evaporation  shall
 prevent  the  air  in the room from  becoming too dry. 
THE NURSERY.
309
 Let the stoves be proportioned in size to the rooms, and
 there will  not  be much danger that there will be  too
 much heat.  But this heat is, in my opinion, far prefera-
 ble to that of a fire in  the chimney, as it is much  more
 equal all over the room.   A high fender should surround
 the stove or fire place, so  that the children cannot get at
 it to burn  themselves  on  it.  The room in which they
 spend the day, should have little furniture in it, except a
 good, thick, woollen carpet  to prevent the children from
 injuring themselves by falls.  Now  fill it with useful
 play-things—such as balls,  and various geometrical  fig-
 ures made  of cork and painted—and with any thing else
 that is  calculated  both  to amuse and instruct them.
 Their little eyes may as well become accustomed to see-
 ing, at once, something that is useful as  something  that
 is worthless.  If attended by an intelligent person, they
 may learn, even  in  infancy, the nature, operations and
 names of  all the geometrical figures, and a thousand
 elements of useful science, merely as  matters of amuse-
 ment.   But,  of all the requisites in the  nursery, none is
 so  really important as that which  is  frequently least
 thought of, viz. a person to direct the amusements and
 attend to the wants  of children, who  is well acquainted
 with human nature, and qualified by experience and self-
 government  to  mould the infant mind in the way it
 should be formed.   I have not a doubt  that a large ma-
jority of infants  commence,  before  they  are  eighteen
 months old, that course of subjection either of the judg-
 ment to the passions, or the passions to the  judgment,
 which  is rarely  changed in  character during the whole
 course  of after life.   And yet, how often do we see them 
310       THE NURSERY--CLEANLINESS.

taught, during  this period of their pupilage, to indulge
the most revengeful spirit, allowed to " whip," or com-
mand  the  nurse  to whip, those persons or things that
are supposed to have annoyed them;  to get almost any
thing or license they want, provided they will cry long,
loud and pitifully enough to weary the patience  of  the
attendant;  and to  get  rid  of  the performance of any
duty by merely making  a  firm  and persevering  resist-
ance.  What can be expected of the child that has com-
menced its mental discipline in this manner?  Yet such
it will be, unless the nurse be both able and disposed  to
teach it better.

                    Cleanliness.
  Nothing is  more important in  the  preservation  of
health, and the prevention  of disease, than cleanliness.
By this remark, I do not wish  to be understood  that a
child should be prevented from going where it would  be
likely to  get dirty.  It will become  as dirty from  the
drying of its perspiration on  the  surface,  as from any
other cause or exposure.   The surface should be cleansed
often, and that, too, not merely by wiping with a damp
cloth.  Children  should  be taken into a  warm room,
every night before going to bed, the doors of the room
being closed to prevent currents of cold air from striking
ihem,  and  should be stripped and thoroughly washed
in a  tub of warm water, and with a little soap; then
rubbed dry, dressed in clean night clothes, and  put to
bed, at least till they are weaned;  and it should be con-
tinued often, by the nurse, till they can do it themselves,
when they should be required to do it till they do it wil- 
CLEANLINESS.
311
lingly, for the pleasure and comfort  it affords.  Some
are afraid that this will give their children a cold, but I
am sure sickness has occurred ten times, for the want of
this frequent ablution,  where it ever did in consequence.
Children that are permitted to get ever so dirty during
the day, and are thoroughly washed every night, do not,
in reality, get half so dirty as  those  that are supposed
to be kept  so constantly clean as  to need no general
washing at all.   The custom of wiping instead of wash-
ing, and  thus leaving the  acrid fluids, or  the  still  more
solid and offensive materials, about the groins and hips
of children, is the  principal  cause  of chafes and  erup-
tions  in those parts.
   A dirty, waxed up, or contracted skin,  too, is sure to
check the perspiration and produce derangement of the
stomach  and bowels.  It predisposes to internal  and
eruptive forms of disease, by checking the vital opposi-
tion to them, and makes them much more dangerous by
retaining them longer in the system  than  the morbific
matter  that induces them.  The water in which the child
is washed should be as warm as is comfortable; and, after
three or four months,  the washing be finished by a dash
of water a little  cooler, in the manner of our cold dash
after steaming, proportioning the heat so as only to make
the child startle  a little at  the change of temperature.
It  should then  be  wiped dry immediately and dressed
warm, and, if it  be thought at  any  time that there  is
any danger of taking  cold, it should have a little  warm
tea, and be induced to commence some active exercise,
to raise  a perspiration before the skin becomes cold and
contracted.  Warm  baths and  cold  dashes  should be 
 312         C L E A N L I N E S S--W E A N I N G .

 given to children frequently, till—even  their  second
 childhood  is  ended!   Physicians recommend washing
 with cool water after the child becomes older; this may
 be well, but the warm bath with the cold dash is doubt-
 less  far preferable at any time.  If the cool bath is used,
 it should not be while the body is perspiring, unless done
 very quickly.   They think the warm bath the  most de-
 sirable to benefit the constitution, and the cold, the best
 calculated  to  secure  against  taking cold.   Our  plan
 unites both  these  advantages.  I  have no objection to
 a sudden plunge into cold water,  when the tendency to
 the surface is strong; but I  am persuaded that it is inju-
 rious to  let the body remain long in  a bath much cooler
 than its own temperature.   To wash the body in warm
 or tepid  water, and leave the  skin relaxed, would  tend
 to debilitate it;  but the sudden cold  dash, or a  thorough
 rubbing, restores the tone, retains the heat, and greatly
 strenghtens  the system.

                      Weaning.
   "The obvious correspondence," says  Dr. Eberle,
 "which exists between the successive appearance of the
 teeth, and the  development  of  the digestive powers,
 affords us a safe guide  in relation to  this subject."  The
 artificial nourishment may be commenced with the ap-
 pearance of the first teeth, and  gradually increased in
 quantity and  quality,  till the  incisor teeth have made
their appearance, (seldom  sooner than the  eighth,  or
 later than  the twelfth  month,) when, the child  being
 pretty healthy, it  may be  taken  from the breast  alto-
 gether;   and  its  digestive  organs will  have  acquired 
WEANING.
313
 sufficient activity and power to enable them to digest
 what the system demands, viz. a more substantial nour-
 ishment than that of the breast.  But the change should
 be very  gradual, first  to  a very simple  fluid,  then to
 more dense,  and then to solids.   " When the period of
 weaning  is approaching, small  portions of milk, thick-
 ened with bread, rice or flour of rice, chicken, mutton
 or beef tea, &c. should be allowed the child two or three
 times a  day, whilst,  at the same time, the intervals of
 sucking  should  be more  and more prolonged."  The
 same kind of food should be continued some  time after
 the child  is taken from the breast.  The  first  meat that
 is generally allowed  is  chicken, mutton  or beef.  I re-
 mark that these ought to be boiled, and the  fluid only
 given, for some time.  When  meat is boiled till  it falls
 off the  bones, the nutritious parts are chiefly  in  the
 fluids, very little is left in the fibrine, which is now in-
 digestible, and ought  not to be eaten.  Care  should be
 taken not to  give too much at a time.
   In case of  the death  of  the  mother, or  her inability
 to furnish milk,  the child must, of course, be  either en-
 trusted to a nurse or  fed from the phial; but  the mate-
 rials must be such as have  been  already recommended.
 Sometimes, however, the  mother gives abundance of
 milk, but  its  quality  is vitiated  by disease—as scrofula
 and other morbific humors.  It is apt to be  bad when
 menstruation occurs, as it sometimes does during lacta-
 tion.  So it happens  too,  occasionally, when little but
debility appears to affect the mother.  In all these cases,
 the health of the child will generally be seriously affec-
 ted.  It must be withdrawn from her breast  and nour- 
314
W E A N I N G--T ONGUE-TIE.
ished from some other source.  When its constant drains
from her breast, seem greatly to exhaust the mother, it
must  be withheld from her for her own sake.   Many
females, especially young and delicate, are able to supply
only a  part  of the nutriment that is  wanted.  They
should be permitted to supply what  they can  comforta-
bly, and the  deficiency should  be  made up by feeding:
but the period of  lactation should seldom be prolonged
beyond twelve months, on  any account.   When child-
ren show very great unwillingness to  quit  the  breasts,
they may be  induced  to  do it by putting  some bitter
substance  on  the  nipple—as  butternut  extract, gum
myrrh, &c.

                     Tongue-tie.
   Sometimes there is a thin, wide  membrane  extending
under the tongue of infants  almost to  the  tip, so as  to
hold the tongue from projecting beyond the 'tops of the
under  teeth.   This membrane should be carefully cut
with a pair  of blunt pointed scissors.  Examine care-
fully and not cut  so far as to take what ought to be left,
in which  there are aiteries and veins, to  sever which
might produce dangerous  haemorrhage, besides the mis-
chiefs  that would be done to the motions of the tongue,
by cutting off the  FjCj"3 muscle that attaches it to the
arch of the lower jaw bone.
   Thus far, I have  treated on the prevention of disease
in children, which I consider a matter of the first im-
portance.  Unless these hints be regarded, it will be very
difficult  either to cure sick children, or to  keep them
well after they are cured.   But, if they  are carefully 
            TONGUE-TIE—ERUPTIONS.         315

obeyed, I am persuaded that there will be but very little
sickness to cure.  I have treated, also, in  the preceding
pages, of several forms  of disease peculiar to children.
I shall  now  mention the symptoms  and treatment of
most others of any importance, and give directions which
will answer for all, of however minor consequence.

                     Eruptions.
  Eruptions of various names sometimes  come out upon
children, and sadly frighten doctors,  if not old women.
They are called, jaundice,  erysipelas, measles, scarlet
fever, chicken pox, and other " exanthematic affections,"
&c.   These are said to be more or less " acute," accord-
ing to the degree of fever that attends them.   Our plan
is to treat  them all upon the same principle, and with
different degrees of energy, according to  the urgency of
the case.  The best plan is to give an  emetic, and empty
the bowels at once, in our  peculiar way, accompanying
both administrations with just  stimulus enough to keep
up a moderate tendency to the  surface.  If the internal
canal is very foul, we repeat this, until it  is pretty clear;
then continue the determination gently  to the surface,
which must  be kept  clean  by occasional steamings, or
washing in warm water, when steaming cannot be prac-
tised, and the patient will soon  be well.  The only error
I have seen committed by our friends, in  their treatment
of these forms of disease, is  such an effort to  drive the
obstructions  out  so  soon, that, in some  cases, the skin
was opened  too  freely, and the patient rendered too
liable to take cold; and, in others, the fever was raised
unnecessarily high, before  the surface was opened at 
316
ERUPTIONS.
all.  One or two gentle emetics in the beginning, and a
few  injections, followed, not  preceded,  by a judicious
steaming, will, in all ordinary cases, break  the power oi
these forms of disease:  and then a steady course of stim-
ulation, just energetic enough to keep up a healthy ac-
tion, is the best course.  In measles, expectorants should
be given  to loosen  the phlegm;  and, if there be much
irritation, emollients—as slippery elm, or flaxseed tea—
should be drunk.   In this, and in scarlet fever, generally,
some mild sudorific—as sage, boneset, pennyroyal, cat-
nep,  peppermint,  &c.—is sufficiently stimulating.   In
the putrid sore throat, a gargle made  of  tincture of cay-
enne and gum myrrh, not so  strong as Dr. Thompson's
No. 6, should be  frequently used.  The bowels should
be kept  free by enemas, and the extremities warm.   I
have  had  patients of  all these forms  of  disease, and
treated  them  as above, without  the  loss of one.   The
symptoms  do not decide so that  a regular  physician
would be sure which it is, till a  botanic, following  the
above plan, would have any of them half cured.   The
eruptions are  all preceded by more or  less fever, some
by chills, &c. but these  do not determine which  it is to
be, soon  enough  to be of use to the practitioner who
knowTs how to cure them all in the best way.  "He sees
nature struggling  against [obstructions, the cause  of]
disease," which are threatening to produce disease, and
'• he raises  his club and strikes,"  but  not " at  random."
He has a club as sure as a Kentucky rifle, that is terrible
and dangerous only to the  enemy of health and life.   He
takes a certain  aim, and disease alone  is   slain.   The
scarlet fever, and  the measles, require three or four to 
             ERUPTIONS--THE URINE.         317

six or eight days to get entirely out  of the system;  the
jaundice,  erysipelas, and small pox, some  longer:  but
none of these forms of disease are much to be dreaded,
if properly treated.  The botanies  do not  lose one in
fifty of them.
   Regular physicians  often make a great  noise about
our  commencing practice on  every  one of these forms
of disease, before we are certain which  it will  prove to
be;  but nothing is more certain than that we can break
the power of any one  of them before  they can decide
the same, to us, little important question.  Our practice
for one, is not, like theirs, injurious  to any other.   But,
as for those who teach that "scarlet fever is best  sub-
dued by the most powerful bleedings in  the  onset,"  and
that some of the others " are of a  typhoid  character,"
in which "even moderate depletion would be death,"
we  admit that they are  right in waiting till they are
sure that bleeding will not be death, even  though the
disease should become, by such delay, far more difficult
to cure.

                      The Urine.
   Cold or  obstructions may contract the  urethra, and
check, or entirely stop, the discharge of the urine.   Af-
ter these  causes have been in  operation for some time,
the sphincter urethrae  may relax and allow the  urine to
pass involuntarily.   In all these cases the parts must be
relaxed a little, and stimulated  to such  a degree as to
disengage and eject the obstructions.  This is best  done
by applying warmth and (if necessary)  moisture to the
parts, and then giving freely diuretics—as  clivers, bay- 
318         THE U R I N E--T HE BOWELS.

berry, ginger, sumach,  cayenne,  asparagus, or  water
mellon seed tea,  or the aromatics—as the mints,  &c.—
and, in  a short time, these  difficulties will all vanish.
To prevent them, children should be induced to discharge
the urine late at night, and early in the morning, and to
sleep on the side.   These forms of disease are  supposed
to be very difficult  to cure, but  I think that it depends
altogether on  their treatment.  I have had but little
difficulty with them.

   The  Bowels—Costiveness, Relax,  Piles, Colic, fyc.
   No physic should ever be  given merely to open the
bowels.  Injections  are not only the most  speedy and
effectual remedies in the case,  but  they are the  most
easily administered.  They will generally open the pas-
sage, and,  if they are  made  of cayenne  and bayberry,
lobelia  and slippery elm, they will correct  the morbid
state of  those viscera so as to prevent disease.   When
the bowels are too lax and the stools  watery, containing
undigested food, the stomach  is in  fault,  and the  child
should have an emetic, and then injections.   The state
of the skin should be examined, cleansed, and kept open.
If the stools are slimy  or bloody, and seldom  contain
natural  foecal matter, the bowels are  in fault, and must
be cleansed with  injections  of canker teas, and then a
small injection  of  slippery  elm.   If they are painful,
slippery elm will  relieve them; if they descend  in the
form of piles, use astringent injections after  the cleans-
ing ones, and then  the slippery elm.   If  they are sore,
grease them with sweet oil, goose grease, or fresh  butter.
Injections with a little  cayenne are  the  best means of 
THE BOWELS--DENTITION.         319
relieving wind in the bowels, or colic, with which child-
ren are  very apt  to  be afflicted, when  the  abdomen
sometimes swells quite large and is very elastic.

                     Dentition.
  The teeth, as  they appear in infancy, are four incis-
ors, or  cutting  teeth, two  bicuspid, or eye teeth,  and
four grinders, or double teeth, in each jaw—in  all twen-
ty.  The two  front teeth  generally  appear about the
fifth or sixth month; sometimes the second or  eighth!
Some  children  have been  born with  their front teeth
protruded, others have  lived nearly two  years without
them!  Three  or four weeks afterwards, those  above
them.   Then follow, generally, the  other incisors, the
first eye teeth, and,  lastly, the  second  grinders—the
lower  of each pair preceding the upper.
   The chief symptoms are  the widening and flattening,
 reddening and swelling of the top of the  gums, the dis-
 position to bite  the finger,  a  fretful  temper, starting  in
 sleep, salivation, sometimes  fever  and  diarrhoea, &c.
 Dr. Eberle thinks that this  disease, " although  a  process
 of physical  development, and, therefore, strictly in ac-
 cordance with the regular process of nature," gives  the
 body "an increased susceptibility to the injurious influ-
 ence of irritating  causes, and hence all diseases, what-
 ever be their cause or origin,' are apt to assume a  more
 violent character during dentition than at  other periods.
 From this circumstance, as well as from the direct ten-
 dency  of dentition  to  originate  violent  affections, the
 period during which this process  is going on is justly
 regarded as one of the most  perilous  stages of life.  It 
320
DENTITION.
has  been computed  that one-tenth, at  least,  of all the
deaths that occur during childhood, may be fairly ascribed
to dentition, and it does not appear to me that the esti-
mate is exaggerated."
   Now it seems rather strange  to  me  that " a  process
strictly in accordance with  the arrangement of nature,"
should naturally kill  one-tenth  of all nature's children.
There must be some other reason for their death!   Let
us see what it is.   1st.  This disease has been so  formid-
able in the fashionable  circles, in the mouths of doctors,
in college  text books, and "Domestic Medicines," that
a doctor is generally sent for to cure it.  He begins by
saying that  the  "febrile symptoms," the slight irritation
in the system and derangement in the circulation, caused
by the pressure  and pain in  the part of the gum pressing
on the top of the  tooth, this  sensitiveness of nature to
expel from the system  any thing and every thing  that
opposes her  uniform  and universal action, is " the dis-
ease" that is to be cured!   So, to the work he  goes,
(certainly very consistently with this theory,) " to dimin-
ish the irritability [the vital action] by bleeding, purging,
poisoning," &c. and he  follows up this practice as far as
he dares, without the danger of immediate destruction
to the patient.   Nay, he frequently gives, within a  short
space, what he knows to  be enough poison to kill  two
or three well children, when given at once.  True, the
child often  dies, but  it is so far more  scientific  to at-
tribute the death to  "a process strictly in  accordance
with a development of physical nature," than to poisons,
the legitimate enemies  of vitality, that the  doctor, in-
stead of being called by his right name, a man-slayer, 
DENTITION.
321
gets praise for his science and  skill!  I accuse no man
of evil intention in this matter, but  I do  accuse, of  the
most consummate  stupidity, every man that gives a
poison to cure "a process of nature."
  But I am asked, Why the diarrhoea just at that time?
I answer, the diarrhoea takes place, because  the system,
being  irritated  generally   by the  tenderness  of  the
gums, is  more sensible  to  the presence  of trifling  ob-
structions, which, when less active, it would  disregard.
Why are other diseases so much worse?  They are  not.
Greater  excitement in the  system is  proof of  greater
sensibility to the  irritation  of obstructions, but by no
means the greater  danger  of the  case.    Is  a  smart
fever, from violent cold, more dangerous, or difficult to
cure, than the comsumption, the dyspepsia, or the  hys-
terics ?  Regulars " guess" so; but we know better.   But,
say they, the diarrhoea relieves the febrile symptons, and
checks the violence of arterial action, by  diminishing the
quantity  of the blood, and thus proves that depletion is
good.  No, I answer.   The diarrhoea  removes the mor-
bific matter that was  deposited in the vascular  system,
for  want  of that action, which the febrile stimulus  of
dentition  excites, and  hence the real  cause  of disease,
 not the imaginary one, is removed, while the symptoms
 of dentition only remain.
   " When the gums become inflamed, swollen and pain-
ful, the  secretion of saliva scanty, with torpor of the
bowels,  the whole organization generally sympathizes
strongly  with  the local affection, the nervous  system,
especially,  is liable to  great  and dangerous  irritation.
Indeed,  when, from  the influence of previous morbific
              21 
322
DENTITION.
causes, the system has  become  feeble and unnaturally
irritable, the most alarming consequences sometimes  re-
sult from  the irritation  of the advancing teeth, before
any signs of irritation and inflammation are discoverable
in the gums."
   These "consequences" of dental irritation are "alarm-
ing" only to those who have adopted the principle, that
lever and irritation are disease, and that depletion and
poison are  the proper cures.  The numerous deaths, un-
der this  faith and practice, are  indeed  alarming, but I
am not disposed to ascribe them  to " a physical develop-
ment strictly in  accordance with  the designs of nature."
It seems to me  a very blundering design that contem-
plates and  renders  unavoidable the  destruction of one-
tenth of all the ends  it was  made  to  subserve.   It is
surely not  the work of Him who is wise in counsel and
infinite in power.
   But, it is said, that one cause of these  alarms is, that
the fretfulness of the child induces the nurse to feed the
stomach too frequently, and with indigestible  materials,
which derange the  functions of that organ and  induce
dyspepsia.   Very true, but then the fault is in the nurse,
not in dentition.   Still, Dr. Eberle insists that " the risk
of [even these]  consequences from  dentition  is always
very  considerable."  Surely  no  one  will  dispute the
soundness  of such scientific logic!  It is added, that
stimulants  increase the  danger of  this  disease,  by  in-
creasing the irritation.   I answer, no: they increase the
danger of the patient by inciting the doctor to an effort
to destroy  the vitality  of the  organs, instead  of remov-
ing the causes  which disturb their action.   But  " the 
DENTITION.
323
practice of covering the head with caps, and keeping the
child confined in impure  air, make the consequences of
teething more alarming."'   They have no consequences
of their own it seems!   If these things are attended with
bad consequences, (and they certainly  are,) condemn
them as severely as you please; but lay not all their sins
to dentition; for, as this  cannot be prevented, there  is
no hope of cure.
  " The morbid sympathetic  effects of difficult dentition
are very various."   Why? Because all the effects, what-
ever their  origin, that happen about that time, are as-
cribed  to this as a cause.   But it is here  that excessive
local irritation  is calculated to check  the action of some
of the important functions, and render  excessive that of
others, as  that of anxiety,  grief, &c. checks digestion
and excretion,and increases cerebral  action; and, there-
fore, disagreeable consequences ensue, for which some-
thing ought  to be done.   And what is  it?  Answer I.
Clear out all morbific matter from the system, and leave
nothing to  obstruct the  action  exerted  by the dental
irritation;  then give none but suitable food in  reason-
able quantity.  For the manner of doing it, see " Course
of Medicine,"  p. 156,  and onward.   This  being done,
and the patient being secured  against  the danger of
taking poisons  or  losing  blood, the system will be left
solely  to the effects  of " a process of nature designed
for  the development  of the system," which  cannot well
produce death, without going out of its appointed course.
If the  child be permitted to have, among its  playthings,
something of proper shape, a piece of smooth wood, or
polished and rounded bone, fastened to a ring or cross 
324
DENTITION.
piece, like the handle of a gimblet, or an ivory ring, to
prevent it from getting too far  into the mouth, and to
bite it as soon and as often as it pleases, the teeth will
be cut through  in due season, without much " disturb-
ance  to the general system."  The child  will show, a
disposition to relieve itself by biting the nipple or the
finger, when  it should  be taught to bite  the wood or
ivory, which it will  soon much  prefer.  The teeth will
thus make way for themselves as fast as they grow, and
little disturbance will be produced in the circulation.  If,
however, the gum should swell and be painful, and yield
very unwillingly to the pressure  of the tooth, it should
be lanced directly on the top, which may be known both
by the feeling, and a little white mark, produced by the
compression of the capillaries, over the end of the tooth.
The incision must be made entirely to  the tooth, and as
long as the tooth is wide.  When convulsions attend den-
tition, they should be treated as  those are  that proceed
from any other cause.  A course of medicine is the re-
lief, and a regular restorative treatment the  cure.  At-
tend strictly to the  above  instructions, and few will be
the victims of the tithing disease called dentition.
  Dr. Eberle says,  " Nothing tends more  strongly to
favor the  occurrence of convulsions during dentition,
than gastric or intestinal  irritation from the use of im-
proper articles of nourishment, or from overloading the
stomach.  I am inclined  to think that the majority of
instances of convulsions usually ascribed to the sole irri-
tation of dentition, are, in fact, excited by the improper
or immoderate  use  of  alimentary ingesta.   When the
diarrhoea, which frequently accompanies   dentition,  is 
DENTITION.
325
suddenly arrested by astringents, opiates, &c. the liabil-
ity to convulsions is always much increased; more espe-
cially in robust and  plethoric infants.  The same thing
occurs when, from cold or any other cause, the salivary
secretion  is  suddenly checked  or suspended,  and the
bowels  remain costive."
   "Various eruptions on the skin are among the most
common  morbid  consequences of difficult dentition."
This is  because the "general irritation" moves  forward
more rapidly to the surface, the various morbid humors
and morbific substances  that are lodged in the system
then, than at other times.  "Fever is perhaps the most
common sympathetic affection  of difficult dentition.   It
seldom, however, assumes  a vehement character, unless
there are other sources of febrile irritation present.   It
is  generally slow, irregular, changeable, intermitting  or
remitting, presenting  the usual phenomena of chronic,
irritable fever from slight local  affections.  This  shows
that, in fact, dentition  alone  is not capable of creating
any great disturbance in the system.  "The majority of
instances of fever that occur during dentition, are exci-
ted, or, at least, greatly  promoted  by other  causes."
Then, pray, why lay them all to the charge of dentition ?
   Dr. E.'s plan of prevention is, air, exercise, cool head,
warm feet, free bowels, &c.  Very good—"avoiding all
stimulants!"  For the cure—strong  purges do "much
harm."  "When habitual costiveness," says the doctor,
"is attended  by a  deficient secretion of bile, from one
to two grains of calomel should be given every third  or
fourth  evening,  and a moderate  dose  of castor oil  or
magnesia on  the following morning;" but, "great care 
326
DENTITION.
should be taken that it be not carried  to  the  extent of
inflaming the gums and  producing a general mercurial
action on the system.  [Yes, he  adds]—I  have wit-
nessed several highly distressing instances of extensive
ulceration and sloughing  of the gums and cheeks, in con-
sequence of employing calomel," &c.   I  suppose that
the doctor intends that  we shall " take care" to stand
and watch the operation, and forbid it from  producing
such an effect!   "Sloughing of the gums and cheeks,"
however, can be borne with from calomel, more patiently
than a few moments smarting from cayenne!   The doc-
tor prescribed the calomel with ipecac and chalk, in  one
case in which "nothing  of a  dangerous character  oc-
curred, except a diarrhoea, which, in a short  time, be-
came  extremely violent and prostrating."  Thus " mod-
erating the complaint to  a sufficient extent, he advised
a decoction of the  root of geranium maculatum, in milk.
The bowel complaint was soon entirely arrested.   In
about ten hours  after the complaint was thus stopped,
a violent paroxysm of convulsions  occurred which  ter-
minated  in a torpid  or  comatose condition;  and, al-
though an active purgative and repeated enemata were
administered, a second fit of convulsions terminated the
life of the little sufferer."  Drying up sores  produces
similar effects.
  This child doubtless died because, not only the effort
of the diarrhoea to throw off  irritating substances was
arrested, but poison (calomel) was given to destroy vital-
ity, by this scientific doctor!  A  very  little calomel,
given  when the  system was exhausted by over excite-
ment,  was sufficient, it  seems, to  destroy  life.  The 
            DENTITIO N--E RYSIPELAS.         327

spasms, or convulsions, were nothing more nor less than
fruitless efforts of the system to recover its wonted  ac-
tion.   The doctor recommends blisters  behind the ears,
in some cases, to prevent inflammation in the brain.
But, to prevent sanguineous congestion, and convulsive
action in the brain, OCT3" the simultaneous application of
a cloth, dipped in cold water, to the  head, and  a warm
bath  to the  feet and  legs, is, in general, more  prompt
and certain in giving relief, than any other remedy we
possess."
  Here, then, is the declaration of a Professor, supported
by cases of his own reporting,  that, while his poisoning,
purging, and constrictions, produce  death, the  botanic
remedies, the cool bath to the head, and the warm bath
to the lower regions, badly as they apply them,  equalize
the circulation, and are the most prompt  and certain
remedies they possess.   Alas for the four thousand years'
experience, and  the war against steam and  lobelia!
Choose your practice, friends!  Good and evil,  life  and
death, are set before you.

                     Erysipelas.
  This form of disease is common to  infants and adults.
It is supposed, by physicians, to have  some peculiar con-
nexion with, or affinity for, the first  four or five weeks
of infancy.  It is characterized by the presence  of small
blisters on  the surface, occupying different places at dif-
ferent times, and  sometimes separating and producing
mortification; in short,  it is  an itinerant,  whose visits
are rather unwelcome  in any place.  From  all  that has
been written on the subject, no decided points  can be 
32S
ERYSIPELAS.
learned respecting its origin, nature, or cure.   It is ex-
tremely doubtful  to  physicians whether the fever that
attends it,  is really " active" or  " typhoid;" and,  of
course, whether they should deplete or stimulate.   They
decide this point  according to the general strength of
the patient.
  Dr. Eberle—to whose work on children I refer for the
truth of what I  have just said,  on the disease, or may
yet say on the regular treatment—thinks that four leech-
es may draw blood enough from  an infant in any  case-
He thinks  it generally  of  a  typhoid  character, not ad-
mitting active depletion.  The remedies mentioned by
him are calomel,  castor oil, ipecac, bicarbonate of soda,
James' powders, quinine, hyoscyamus, chalk, laudanum,
ammonia, spirits of turpentine, &c.  The "calomel," he
says, "can seldom be omitted with propriety," in  "the
early stage," '* though it is apt, at this tender age, to give
rise to dangerous irritation of the stomach and intestinal
canal," p. 156.  In the typhoid stage, quinine  and am-
monia are his best remedies.  Of the value and  use of
external applications, " the weight of good  testimony is
decidedly in favor," though writers " of respectability"
say " they are generally unnecessary if not prejudicial."
However, as the  poisons and leeching before mentioned,
frequently  fail,  (no! they do their work  very surely,)
the affected surface must  be treated with " blisters, [to
cure blisters! like bleeding to cure  haemorrhage! ]  lead-
water, mercurial  ointment,  corrosive submlimate,  and
nitrate of silver  [the last  two must be put on with  a
brush, feather or  pencil, lest it eat off the fingers that
apply it!]  must  be  successively tried."   Last, but not 
ERYSIPELAS.
329
least" scientific," " the practice of making free incisions,
through the  inflamed  skin, and subjacent cellular and
adipose [fleshy] structures, has recently been extolled as
a means of arresting  the  progress of phlegmonous [in-
flamed] erysipelas!"  This answers " when the case is a
proper one for the practice! and the state of the patient
admits of its being  fairly tried!"  Some  recommend
" one long incision through the whole inflamed  part;"
others, " several short ones, an inch or an inch and a
half long," &c.  When, by  these means,  they make
large sores and bring on mortification, then, "a poultice
of charcoal, oak bark and yeast, forms a valuable  appli-
cation," though  there is little hope of cure in these cases!
Is not all  this very learned?  I assure the reader it is the
only legitimate  child  of  the  celebrated parent of four
thousand  years!
   I  have  never treated this form  of disease in infants;
but, as the  doctor  says it  is the  same in adults, I will
close this subject  by giving a case.  Mrs. Purkinson, of
Richmond, Va. had been afflicted with  this disease, every
summer,  for three years.   It was  more aggravated  and
continued longer at each successive season, than at  the
preceding, the attack of  1833, continuing under "regu-
lar" treatment  nearly all summer.   In  the spring of
 1834 she  applied to me.  Her face was so swollen that
she  could scarcely see, and blisters  an. inch long, more
or less, were raised all over  it.   I  directed  an  emetic
and a.sweat, relief to the bowels, and  a poultice of bay-
berry, slippery elm, &c. to the face.  The next day  she
 was about, and, in less than a week, entirely well.   No
 traces of the disease had been seen when  I left Rich- 
330       SKIN BINDING--SORE  MOUTH.

niond,  the latter part of the  next summer.  I advise,
then, first, a  course  of medicine; secondly—poultices
of bayberry, lobelia,  slippery elm and cracker to  the
sores, and repeat till they all disappear; then the " inter-
mediate course;" and I advise it with full confidence of
success.

                   Skin Binding.
  A form of disease in which the skin commences dry-
ing and hardening about the pubes and the thighs, and
spreading on the body, till it finally so confines  the  ac-
tion as  to stop respiration.  It  is very uncommon,  sel-
dom occurring in this country.  I notice it only because
Dr. Eberle says it is nearly allied to erysipelas, and that
" the aqueous vapor-bath is  decidedly the  most valuable
remedy that has hitherto been  recommended  for  the
cure of this affection."

          Aphthe, Thrush or Sore Mouth.
  This is  a very common as well as a very  troublesome
affection of infants, and not unfrequently of their moth-
ers too.   Sometimes  it appears, at first, in small white
spots on  the  tongue  or  inside  of the mouth—as  the
cheeks, fauces, &c.—the spots increasing in  number and
size, &c.  ripening, detaching  and  falling off;  at  other
times turning brown,  becoming harder and more exten-
sively diffused down the throat.   It is the canker of  Dr.
Thomson, the  effects of obstructed perspiration and  ef-
fectually  treated with  bayberry, gold-thread, slippery
elm, the vapor-bath, &c.   The cure is very easily effected
by the botanic practice.   Emollients—as slippery elm— 
APIITHE, THRUSH  OR SORE  MOUTH.   331
should be freely used, both to soften  the  crusts and to
protect from irritation the tender skin after the thrush or
old coat has been removed.   This  should not be rubbed
off, rudely, before a new coat is formed under it.  Light
and easily digested food should be given, if  the child  is
not supported by the breast.
  Sometimes  the mouth is  troubled with  ulcers of a
more malignant character and a darker hue; but they
are to be treated as directed  above—remove the canker,
keep  the  surface  free,  and  soothe  the  irritation—you
know how.   Notwithstanding  that  physicians  are  so
much afraid of inflammation, and  so  constantly pro-
claiming that  our poison (cayenne, &c.) will produce it;
yet, while  they prescribe cayenne gargles in putrid sore
throat, they recommend, in  the above cases,  the giving
of  " Dover's powders" (opium, &c.) and  washes of " su-
gar of lead, nitrate of silver, sulphate of copper," &c.
In  one case  Dr. Eberle " ordered five grains  of ipecac,
and  two grains of calomel.  Active vomiting  was in-
duced, and three  or four alvine  discharges followed;"
but, he adds,  " In using calomel, great care ought to  be
taken lest it affect the gums—an occurrence which could
hardly fail to impart a dangerous  character to the ulcer-
ation."  Dr. Good, of London, and Dr. Abercrombie, of
Ediburgh, say, of  calomel and other poisons, that it de-
pends on the  operation of causes in the  system entirely
beyond the reach of our observation, whether these  ar-
 ticles act at all, act  in  accordance with our wishes, or
in  opposition to them, " with dangerous violence."  Still,
 Dr. Eberle does not think the disease itself very " dan-
 gerous," except in hospitals, and very crowded places, 
332    APHTHE, OR SORE M0IIT H--C O L I C .

where many are afflicted with it.   A writer in the Bost.
Med. and Surg. Journal, lately inquired whether some
one  had not found out  a  more  excellent  way to cure
this  " chronic thrash," as it is  vulgarly called, than is
generally known to the profession.  Another answered,
as is usually done in such cases, that  he had  succeeded
in saving sundry cases, (that is, he did not kill them,)
by varying the quantity and proportion of the old doses,
and by some other similar " modern improvements !"   In
conclusion of the article, I remark, I have known a great
many children, and mothers too, die of something called
chronic thrush, or aphthae, under the  regular  treatment,
and I have seen a number of  cases cured in three to six
days, by the botanic practice, that had been continually
growing worse under the regular, for as many months.

                        Colic.
  Pain in  the  stomach  or bowels, occasioned  by gas
accumulating in and  distending them.   The immediate
cause is imperfect digestion.   A  more  remote cause is
improper food, or  too  much  of what is good, or both.
Some  of it  remains so long undigested in  the stomach,
that it  ferments and generates gas which accumulates
and produces the effects just mentioned.  If so, regulate
the  stomach and  bowels,  and  correct  the quality and
diminish the quantity of food.   If it proceed from a bad
state of  the nurse's system, take the child from her and
feed it with cow's milk.  If from injury  done to the
alvine canal, by the use  of purgatives or opiates, aban-
don  them.   Says Dr. Eberle, "Active purging is  often
decidedly injurious.  The habitual use of opiates in in- 
c o l i c—o p i u m .                333
fantine  colic, almost  always leads to very unfavorable,
and often to very distressing and dangerous consequences.
The dose  must  be  progressively increased; and thus a
habit is soon formed which renders its discontinuance a
source of  inexpressible inquietude, whilst its continuance
in increasing doses, never fails to operate perniciously
on the whole organization.  Under the habitual use of
these treacherous palliatives, constipation soon ensues;
the appetite  and digestive powers fail; the  body ema-
ciates, and the skin becomes  sallow, dingy and shriveled;
the countenance acquires an expression of languor and
suffering;  and a general state  of apathy,  inactivity and
feebleness  ensues, which ultimately leads to convulsions,
dropsy in  the head, glandular indurations, incurable jaun-
dice, or fatal exhaustion of the vital energies.  The pain
may, indeed, be lulled by  the anodyne, but the infant is
evidently under the influence of highly disagreeable sen-
sations, as is manifested by the sudden startings, unnat-
ural, whining cry, and the exceedingly irregular respira-
tion, now  very  hurried  for  a  moment, then  slow and
moaning, with occasional  intermissions of so protracted
a duration  that 'one  would  think  the breathing had
ceased  altogether.'   All the usual soothing mixtures—
such as Godfrey's cordial, Dalby*s carminative—so much
employed  for allaying colic pains and griping of infants,
contain more or less opium, and innumerable infants have
been irretrievably injured by  the  habitual use of these
popular nostrums."
   I  believe  this because  I  have  actually seen it;  but
what a commentary is it  on the  invaluable remedy, 
334
C O L I C--O PIl'M.
opium !—a " treacherous palliative," that produces " fatal
exhaustion of the whole vital energies, irretrievably in-
jurious to innumerable infants!"  What a curse to our
country is opium !  The person that gives it in any form,
to an innocent and defenceless infant, after  such  testi-
mony  from  such high authority,  ought  to be totally
rejected  as a physician.  Yet the very good doctor him-
self recommends its use by  physicians, in almost  every
form of disease!  Surely, " much learning has made him
mad!" for he continues this  wickedness after the " igno-
rant," (such  as  ourselves, and "old  women") have dis-
carded it forever.
   It must not be forgotten that the  "active" ingredient
in Dover's powders, laudanum, paregoric, morphine, and
all the " anodyne drops," aye, and the " styrax  pills " of
Drs. Wood & Bache, too—U. S. Dispensatory, p. 934—
is this very "accursed thing," called  opium.
   To cure this colic, then, when  trifling,  a little ginger
tea, or cayenne, or No. 6, will relieve the stomach from
pain, or  even pressure on that organ, and a mildly stim-
ulating injection will relieve it from the bowels.  Taking
the child up  by the body, holding the pelvis for a very
short time higher than the chest, and pressing the viscera
in different places alternately, will  remove it  from the
bowels.   The head must not be held down till  the face
turns dark with venous blood, nor need it be held much
lower than the pelvis at any time.  If  it return, give a
full course of medicine, and  be more careful about the
quantity and quality of the food  taken.   I have always
found  ginger and raspberry, or, at  most, a little bay- 
C O LI C--C OSTIVENESS.
335
berry,  amply sufficient  for courses to infants; though
cases  may occur where  cayenne and  composition  may
be necessary.
  Give  no  poisonous physic, feed with good food  in
reasonble quantity, and colic will rarely happen.  When
it does happen, remove it  by  the above simple means:
if it returns, and  is troublesome, give courses of medi-
cine and strengthen the  system.

            Constipation or Costiveness.
  Torpor of the bowels is common among infants, and,
though  it may sometimes continue to  seven or eight
days without materially  injuring the general system, yet
I would recommend that in no  case it be permitted to
continue beyond the second day.   The cause is said, by
physicians, to be sometimes constitutional habit,  at oth-
ers the improper  character of the food,  or  accidental
" circumstances."  Dr. Eberle says," the giving of  opiates
to make them sleep, that they may not require much at-
tention during the night, is a frequent source of obsti-
nate and injurious costiveness."  Dr. Dewees says, that
" nurses are now so familiar with this drug, [who taught
them ? ] that they as regularly carry it about with them
as their scissors or thimble, and consider it much more
indispensable to their comfort, than either of those em-
blems of industry.  If the child does not go to sleep, or
if it is even feared that it will not,  at the exact moment
when it will suit the arrangements  of  the nurse,  or if it
cry, from any cause, so as to give any additional trouble,
laudanum  is given so  as  to  make 'assurance  doubly
sure.'"  This  "very frequent cause of  costiveness," I 
336         COSTIVENES S--V OMITING.

suppose, will  trouble none of the friends  of botanico-
medical reform, except  the  par excellence " scientific"
ones of the Beach and Worthington School, who use it
very  freely.  The  treatment, according to Drs. D. and
E., consists chiefly in cathartic, or opening  medicines,
castor oil, senna, magnesia, calomel, &c; but, say they,
"In moderate cases of constipation, relief may frequently
be obtained by the daily  introduction of a soap  supposi-
tary, or of laxative enemata," instead of aperients; " for
a long continued and frequent employment of even  the
mildest laxatives, is apt to injure the digestive functions,
and give rise to some degree of intestinal  irritation."—
Eberle, p. 204.
   As, therefore, in the worst cases, the opiates generally
begin the " habit," and the physic to cure  it produces a
still worse condition, we will just reject these two, and
use the proper enemata,  diet and exercise, and the dis-
ease will  not  be troublesome.  The  enemata should be
made  of lobelia, bayberry, slippery elm, nervine*and a
little cayenne, from a wine-glass full to  half a pint, and
repeated  till  the  effect is produced.   For diarrhoea*,
witch hazle or raspberry, and cayenne should be used.

                      Vomiting.
   This is  a vital operation  and salutary in its tendency,
but, like all other disturbed actions, is an indication  that
something is  wrong. When  the infant  is otherwise
healthy and cheerful, the vomiting indicates only  that
the stomach is overloaded, and the cure will consist  in
preventing it from taking so much.  It should  be stopped
from sucking or eating as soon  as it  manifests  the least 
V O M I T I N G--:
DIARRH03A.
337
 indifference in these matters.  Vomiting is  a habit that
 ought not to be acquired, though no medicine should be
 <riven to stop it.  When it arises from irritation of the
 stomach, the suppression of morbid  discharges,  the  in-
 troduction  of  proper food, &c. clear it by a  lobelia
 emetic, and the warm bath, and regulate the diet both
 as to quantity  and  quality.   No sedative should ever be
 given to stop the vomiting—as laudanum and paregoric
 —as recommended by Dr. Eberle.

                       DlARRHOJA.
    The  diarrhoea, watery or mucous and frequent stools
  of children, generally  proceeds  from eating too much,
  or from eating things indigestible, or from  taking cold.
  In the first case,  check the appetite—that  is, limit  the
  quantity;  in the second, change the diet.  In both these
  cases,  cleanse  the stomach and  bowels and restore the
  tojie.   When  it proceeds from  cold, open the pores by
  the vapor-bath, or perspiration in some form.
     Diarrhoea is also a frequent result  of giving poisonous
4 physic to  cure costiveness.  To cure it when it arises
  f/om this cause, cayenne must be used pretty freely after
  the courses.
     Diarrhoea is very often a result of a sudden check to
  perspiration, and  may be almost as certainly corrected
  as  that  secretion is  restored.   Physicians enumerate
  many  species  of  diarrhoea, proceeding from numerous
  causes, as indicated  by a  great variety of symptoms,
  and requiring  different  treatment; and they ridicule  us
  for treating them  all  upon  the same general plan, and
                22 
338
DIARRHffiA.
with only some twenty or thirty different remedial arti-
cles or processes.   But what, we ask, is the  use  of all
their  hair-splitting  about the causes of the affection,
when, at  last, they actually use less  remedies than we,
and in a  manner  less varied?   Calomel, magnesia, rhu-
barb,  castor oil, ipecac, nitre, opium, blackberry, gera-
nium, tartar, antimony, hyoscyamus,  charcoal, canthar-
ides, and a few others; but calomel and opium are the
great  articles more used and relied on than all the rest.
  After prescribing, with great nicety, the quantity of
the above poisons, especially opium and calomel, which
seem  to be  the "sheet  anchors" of  prophylactics,  and
the great levers of the curative process, in measures,
proportions, grains, fourths or eighths of grains, accord-
ing to the color,  consistency, character, quantity  and
frequency of the stools,  (for the medical indications of
which physicians who can seldom see them, depend upon
the testimony of patients or attendants, no  doubt  often
quite  as ignorant  of  these scientific  distinctions, as the
most  ignorant steam doctors in the land!) and especially
cautioning his pupils against giving these poisons " inju-
diciously," or in too large  quantities, Dr. Eberle  says,
that  the  root  of  geranium maculatum, boiled  in  milk,
and a strong decoction of blackberry root, have been the
most efficient remedies in his hands, in the cure of some
 forms of this disease, and that they  possess  the import-
ant recommendation, that they may be used  freely with-
out danger.  Of running blackberry briar root, I can say,
from my own  knowledge, that its  aid in  the cure of
diarrhoea is invaluable; not merely because  it is astrin- 
D I A R H II OE A--W O R M S .
339
<rent,  but because it  removes  canker from the whole
canal.   Of geranium, I  know that it is astringent, and
not poison, and scarcely less valuable.
   In addition to full courses for diarrhoea, dysentery and
other looseness of the bowels, I have found that a syrup
made of  a strong decoction of equal parts of golden
seal and nervine, is excellent.  After boiling the  ingre-
dients half an hour, strain, press, add a fourth as much
No. 6, and the same measure of loaf  sugar, boil it to a
syrup, and use a tea-spoonful at a time for a child, or a
table-spoonful for a grown person.

                       Worms.
   One of the most troublesome complaints to children
is worms.  " Concerning their origin," says Dr. Eberle,
"much has  been conjectured, but  little  asceitained.*'
There are five different species. The long thread-worm,
an inch and a half to two inches; the small thread-worm,
white,  from two to  five inches long; the long round,
from two to twelve inches;  the long tape-worm, some-
times thirty to forty feet long, and nearly an inch wide,
white, flat and jointed; and  the gourd-seed tape-worm,
which generally comes away in pieces, sometimes single,
sometimes many feet of them together.
   But,  says the doctor, " observation has revealed  to us
many circumstances  that favor their  production and
increase.   The principal of these are, a general debility
of the system, and a feeble or deranged condition of the
alimentary canal. Whatever, therefore, disposes to these
states, constitutes a remote cause of worms." 
340
WORMS.
   Now, as the doctor had previously informed us, that
frequent doses of opium, and of calomel, oil, or any kind
of physic, were calculated to produce just these effects
on  the  internal  canal;  therefore, I conclude,  from his
facts  and  argument, that calomel,  opium, and  other
poisons, (for they all check  vitality) are " among the
principal causes of worms!" and  that the most of the
cases  of worms found in practice, might have been pre-
vented, by refusing all poisons as medicines!   However,
I must not stop  here.  These  worms are  often  found
where no poisonous medicine or food has  been know-
ingly  taken.   The question is,  then,  rather, how shall
they be removed?   Dr. Eberle says, by the exhibition of
calomel and other physic, the principal "remote causes"
of their origin or existence!  This may be good science
with regulars; I have not  sense enough to  perceive its
consistency or propriety.  My plan is to clear out all
the morbific  matter, by lobelia, cayenne, canker  medi-
cines, steam, &c. and then give strong laxative bitters,
with cayenne, which generally drive them from the sys-
tem.  Not having killed any one by this process, I have
made no  post mortem  inspection to discover whether
the internal canal was " burned up" by it; but  if it was,
I suppose, according to Dr. Eberle's argument, it  might
as well have  created inflammation and cured it, as calo-
mel and other poisons can be both the " remote cause "
and  the " proximate" cure of worms!  The  bitters  I
have used,  were  boneset, hoarhound, motherwort, balm-
ony, poplar, golden seal, bitter  root,  butternut, pride of
China, gum myrrh, &c; placing great dependence upon 
WORMS.
341
hot enemata.  The compound just mentioned for dysen-
tery, is first rate for worms.  I  once cured a case with
two tea-cupsful of composition, after a regular had ad-
ministered  calomel," wormseed oil, spirits of turpentine,
&c. in vain, till he said "she could not bear any more
medicine;" and I believed  him, for she could not bear
upright even her own head!
  The sort of worms called ascarides, very small  and
short, are found low in  the rectum.  To remove these,
make a poultice  of the  bitterest herbs you  can get—as
balmony, tansey,  motherwort,  bitter root, &c. cracker,
cayenne  and No. 6, or rather the dregs of No. 6.  Use,
three to six or eight times a day, three  or four injections
of the decoction of the herbs, and, immediately after
their  operation,  apply the poultice  to the  outside  and
bind  it close.  At the same  time, give the  same bitter
tea, or the docoction above named, to  produce a slight
action on  the bowels, or, at all  events, to meet the
worms, should they attempt to rise in  the  canal out of
the reach of the lower applications.  Give a full course,
if necessary.  Follow this plan immediately and faith-
fully, and you will not need to follow it long.  If this
course fails, you  may consult the scientific Dr. Eberle,
Professor of the Theory and Practice  of Medicine, late
in the Ohio Medical  College, now  in Transylvania Uni-
versity, Kentucky, who says,
  " The complete  removal of these worms (ascarides) is
a work of great difficulty.  The ordinary vermifuges are
of little avail in  their destruction; acting more particu-
larly upon  the upper portions of the intestinal tube, they
lose their  virtue before  they arrive at the location  of 
342
W O R M S .
these animals.  Even  the  most  active cathartics are
insufficient to expel them.  Aloes, however, from the
peculiar influence it exerts on  the lower  portion  of the
bowels, frequently causes their expulsion  in large quan-
tities, especially if assisted by the  action  of proper
enemata.
  " My usual mode  of proceeding for the removal of
these troublesome worms, is to prescribe three or four
aloetical purgatives every second day, with  two or three
enemata  composed with a mixture of lime water  and
milk in equal proportions, daily.   Injections of a solu-
tion of aloes, or of infusions of any of the above named
vegetable  anthelmintics, will generally succeed in bring-
ing  away great  numbers.  In a few instances  I have
procured  their expulsion, in large quantities, by injec-
tions composed of a tea-spoonful of spirits of turpentine
mixed  with a gill of  milk.   Injections  of any  of the
common  oils will oftentimes soothe the  extreme irrita-
tion, and  destroy the worms. According to Rozin, a
drachm of refined sugar, dissolved in warm milk, has
been injected with great success.  [Both  of these had
just been prohibited in the diet, on account of their ten-
dency to  produce worms; hence, their great success in
destroying those animals!—in  perfect  keeping with the
use of poisons to cure the sick and  to  kill  the  well! ]
Another  remedy highly spoken of is  a bougie  smeared
over with mercurial ointment, and introduced  into the
rectum.   Dr.  Vanvert  asserts that  flour  of  sulphur,
taken in the  morning on  an  empty stomach, is one of
the  most  efficacious remedies for the distribution  and
expulsion  of ascarides.  In obstinate cases,  the  fumes of 
WORM S--O P H T II A L 311 A .
343
tobacco, or an infusion of the male fern, has been recom-
mended by Dr. Bremser.  The same author  states that
injections of cold water, with a small portion of vinegar,
is the best remedy we possess."  [All common remedies,
recommended directly after stating  that they are of little
avail.]
  Is not the above vastly scientific? or will  my readers
agree with me that  it is  a tissue  of quackeries, for the
recommendation of  which, to the trial of young  physi-
cians, Dr. E. ought to be expelled from the  Ohio Medical
College, if he had not been called to Transylvania?
   Do our friends  in "the great Western Valley" really
know that such is the beauty, such the certainty  of the
medical  practice to be spread over  this whole wide west-
ern world,  from that great source of medical science to
which the  doctor has lately been with much applause
translated ?  Humiliating fact!

              Ophthalmia or  Sore Eyes.
   Infants  are very  liable to have  sore eyes.  At first,
the eye-lids are glued together  in  the  morning, slightly
swelled  and red.  As the redness and the  swelling pro-
gress, the light  is  painful, and "a thick, purulent  matter
 begins  to issue from the eyes."   It sometimes extends
 to  the ball, destroys the coats, discharges the humors,
 and ruins the eye.  Dr. Eberle thinks the  exciting cause
 to  be " some acrid or morbific secretion in the vagina of
 the mother, applied to the infant's eyes" in parturition;
 as  "its occurrence is almost universally confined  to  the
 two  first  weeks  after  birth, and,  in  a vast majority of
 cases, comes on as early as the fourth day."  If  this be 
344
SORE EYE S--T R E A T MEN T .
the cause, our botanic friends, who keep the mothers free
of "morbid secretions" during pregnancy, need not fear
it.  But it is sometimes ascribed to applying the  light
to  the  new-born  infant.   On this  subject, Dr.  Eberle
remarks:  "It maybe observed  that the good and all-
wise  Author of  Nature  has  endowed  every  creature
with a capacity to accommodate itself to the inevitable
changes and transitions, which  it is designed to under-
go, in  the regular process of  its development;  and it
seems  inconsistent with  the perfect adaptation of the
appointment  of Providence, that the new-born infant
should be liable to serious inconvenience or injury from
this cause; though it  cannot be doubted that unneces-
sary exposure of the infant's eyes to a bright and heated
light  [as  a  fire or a  candle] may do much mischief."
What a pity  that  the  doctor could  not  reason  as  well
on every subject.
   Treatment.—Cleanse  the eyes thoroughly at birth, and
keep them so.  Wash  them often with milk  and water
and canker  tea;  and, if the disease is obstinate, apply
the ginger, cracker and elm poultice, adding bayberry
to it.   Give  also the teas to cleanse the  system.  " The
occasional administration of a gentle emetic in the early
stage of the complaint, sometimes proves decidedly ben-
eficial," says Dr. Eberle.  So say I;  therefore, keep  the
stomach and bowels clean, and  the  skin  open, the eyes
clean and  oiled, and there will be no difficulty.
  The  fact  is,  the cause  of sore eyes,  sore ears,  sore
neck, sore hands, &c. in infants, is  morbific matter  in
the system.   True, this morbific matter is of different
characters—as  the  scrofulous, the ophthalmic, the  ery- 
        SORE EYES--CHOLERA INFANTUM.    345

sipelatous, &c.—but the  plan  of removing it is  in  all
cases the same, viz.  give it vent by warm, moist and
slightly stimulating applications, absorb into poultices the
virus discharged, and take proper measures to cleanse
the canker from the  alvine canal, and to force to the
surface that  which may  be  already in the circulation.
Nothing is more  important  than to remove from the
body every drop  of poison virus as fast as  it  is dis-
charged;  lest, by  its  corrosive power, it increase the
size  of the orifices whence it issues, or produce new
lesions and sores, where none before existed.
   A case of  sore ears, last summer,  that  had  continued
a long time under mercurial treatment, was soon cured
by the application of absorbing poultices  and the  drink-
ing of a little canker tea.   When, however, these slight
applications  prove insufficient, the  thorough  treatment
recommended before, will not  fail to  do  the  work,
wherever there is  a constitution to build upon.

                  Cholera Infantum.
   Sudden  and violent vomiting  and purging, generally
commencing  nearly together, but rapidly  exhausting the
strength and extinguishing vitality.  "At first, the dis-
charges  from the bowels usually consist of  a turbid,
frothy fluid,  mixed with small portions of green  bile, or
of a nearly  colorless  water,  and contain small  flocculi
of mucus.  After the disease is fully  developed, the evac-
uations very rarely exhibit any traces of  bilious matter;
that secretion being evidently entirely suspended.  In
some instances death occurs in a single day.   This form
of disease undoubtedly proceeds  from some very irrita- 
346       CHOLERA INFANTUM--FEVERS.

ting cause in the alvine canal.   It is of little use to know
exactly what, but it is very important to know that its
effect is to contract  the  folds and  pores in which it  is
lodged, so as to keep  up a  constant  irritation without
producing its ejection,  as in cholera.
   The  error  in the  treatment, to which our botanic-
friends are most liable, is the supposition that the vom-
iting and purging should be stopped by any other means
than by giving lobelia and injections, and the vapor-bath.
Give  lobelia in warm canker teas: this will relax the
contracted  folds and  pores, from  which the  irritating
virus  will  be  released and  soon be  thrown out by  a
vomit.  Do  the  same with  the  bowels, and they  will
cease their action, then steam, and  the stomach will be-
come quiet, and may  be fed with porridge, &c.   Now
promote perspiration  and  give  cayenne, with lobelia
seed, bitter  root and nervine, equal parts in pills, to act
upon  the liver.  This,  and good nursing, will soon effect
a  cure  from the first  stages.  This course,  seasonably,
judiciously and faithfully tried, is sure.  Even Dr. Eberle
says, no means will  do any good that do  not tend " to
correct the  morbid condition of the liver and skin."   But
I beg leave to be excused from  using his calomel  and
blisters for these  purposes.

                       Fevers.
   These, wc know, whatever be their varieties, are the
results of efforts of the system to  remove morbific ob-
structions;  not disease itself, but mere  symptoms of
disease.  They are all  known by inordinate heat, quick-
ness of the  pulse, restlessness, and, generally, thirst and 
          FEVERS--REMITTENT FEVER.       347

pain.   The plan of cure is, to remove all obstructions to
every secretion, carefully  observing  what part of the
system, whether the  head, the stomach, the lungs, the
bowels, the  skin, &c. is most  obstructed, and directing
the proper means immediately to these, at the same time
that we use them to protect the general  system and aid
it in removing all offensive matter.
  Dr. Gregory says that, though fever is not present in
every case of disease, it is so, generally, that " the phy-
sician ought to be always prepared to expect it."  If this
fever is found to attend teething, I  have already shown
how to treat it.

                  Remittent Fever.
  If it is of the remittent kind—that is, constant but vari-
able—care must be taken  not  only to clear out the mor-
bific causes, but to keep up the action of the system to
the healthy  standard, during the intervals.   In this form
of fever, there is generally a  hot, dry  skin, and much
uneasiness, loss of appetite, costiveness, &c.   If the ac-
tion of the  pulse  is  too  quick, and the body hot from
head to foot, much cayenne, at first, would be improper.
Let the stomach and bowels  be cleansed with emetics
and injections, and  the skin  be  relaxed by moistening
with warm  water, and this state be kept up till  the cir-
culation is free and general, and the appetite is restored.
The head should be kept  cool  and  the  feet warm.  As
long as the fever is kept up without the aid of artificial
stimulus, so long you may be sure that there yet remain
obstructions somewhere.   When the stomach and bow-
els  appear to be clear, and the skin to be easily opened, 
34N    CATARRHAL F E V E R--B R O N C II I T 1 S .

and yet the dejections are of a light color and the fever-
ishness  continues, there is  probably  no  action  of the
liver.   Make pills of equal  parts of lobelia seed, bitter
root, cayenne, nervine, and slippery elm moistened, roll-
ing them, if necessary,  in  butternut  extract, and give
enough  of  them to  cause  two or three  dejections in
twenty-four hours.   Keep up the  strength with  bitters
and cayenne, and light, nourishing food.

                 Catarrhal Fever.
  This is  the form of fever that seems to proceed  from
cold in the head, though, in  reality, it as often proceeds
from cold, wet feet, and is attended with much running
of a watery fluid from the nose and eyes, with  hoarse-
ness,  stopping of the nose  and difficulty  of breathing.
It requires more stimulation than the preceding,  as will
be clear to any attentive observer who  sees  a  case of
each.   Steaming, or warm fomentations, or warm  flan-
nels, about the neck and head, and breathing in the vapor
of vinegar, will  be  particularly serviceable, and  expec-
torants should be used to clear out the phlegm, Ate.  Be
careful also to keep the feet warm, the  surface clean and
active, and the alvine canal free.  The restorative treat-
ment  as above.

                     Bronchitis.
  This is  an inflammation of the mucous  tissue  of the
bronchial  tubes, and an accumulation of phlegm, in these
and the air cells of the lungs.   The cough, difficulty of
breathing, &c. make  it sufficiently evident that the lungs
are obstructed. 
bronchitis.
349
  In addition to an emetic, or even before, if it can be
done speedily,  the  vapor of vinegar  should be freely
inhaled, and the neck and chest should be enveloped in
the same, or some warm and moist application  should
be made to them to relax the strictures and  loosen  the
phlegm.   A small quantity of cayenne in the vinegar
from which the vapor is  inhaled, will  enable the lungs
to remove the phlegm  and cankery coat, and cough it
up.  Steam often and promote the action of  the surface
with  friction,  and stimulating  liniments  if  necessary.
Continue this  course with the emetics, keeping the whole
system warm.   In  this way the judicious botanic will
cure all the cases to which  he is called in  due season.
The regulars give us little hope in this  case.   "The pro-
gress of the disease," says Eberle, " is generally  rapid.
In  some instances, it terminates fatally as early as  the
third day; more frequently, however,  its  course  is pro-
tracted  to the sixth  day. Great drowsiness  or coma
almost invariably precedes the fatal termination."  Child-
ren, p. 328.   It must be recollected that this  rapid pro-
 gress and fatal termination  are what take place under
 the " blood-letting," " leeching," " blistering," " calomel,"
"antimonial," "opiate"  and "hyoscyamus" treatment,
 recommended by Dr. Eberle—see pp. 330 and 331. The
 course of  practice which I have  recommended, being
 entirely  different, must necessarily  produce different
 effects.   And, as  the final  effect of the  doctor's treat-
 ment, according  to his statement, is generally  death,
 so  it will be found  that the  general  result  of ours will
 be health. 
350        P L E U R I s Y—m u m p s—Q U I N S Y .

                      Pleurisy.
  The symptoms of this form of disease are  much like
those  of the preceding, with the  addition of pain and
soreness in the side,  breathing rather in  the abdomen
than the chest, the mucus in the lungs not quite so much,
but sometimes tinged with blood.   In this case, the same
course of bleeding and poisoning is recommended by the
regular faculty.  I have  treated it with emetics, sudo-
rifics, injections, and warm applications to the side, and
cured it in two or three days, in cases where it was said,
by persons professedly very wise in these matters, that
the patient must die.

  Mumps, Swelled Neck, &c. {Cynanche Parotidcea.)
   A course or  two, and warm applications to the neck,
on the first appearance of the symptoms of this  form of
disease, will disarm it of its terrors, and reduce it to " a
small affair."   If any swelling occur, let it be fomented
with steam  from vinegar, and covered with  relaxant
poultices.  Keep the  patient comfortably warm, (though
not  excluded from fresh air,) and the secernants  and ex-
cernants free from obstructions.  Let the treatment be
 moderate, but steady, and adapted to the current symp-
toms.

           Quinsy, {Cynanche  Tonsillaris.)
   An inflammation of the  tonsils and fauces, attended
 with a stinging, cutting pain, first, only on swallowing,
 afterwards more constant.  The  tonsils swell, and, un-
 less preventives be used in time, ulcerate and suppurate. 
QUINS Y--C ROUP.
351
  The treatment of this form of disease, should be  like
that of mumps, adding gargles of diluted No. 6.  If the
system be well cleansed at once by courses, the morbific
matter will be  removed  and the ulceration  prevented.
Expectorants should be used from the beginning.  These
may consist of  skunk cabbage, hoarhound, cayenne, and
a little lobelia, made into a syrup.

            Croup, {Cynanche  Trachecdis.)
   This may be defined, "an inflammation of the glottis,
larynx, and upper part of the trachea, attended with a
hoarse and ringing cough, sonorous respiration, and a
sense of impending  suffocation."—Eberle.   This is one
of  the forms of disease which Dr. Bigelow says is " self-
limited;" that is, that "it is not known to be shortened
in duration or materially mitigated in violence, by any
[regular] medical treatment."  Its principal predisposing
cause, is sudden cold on the lungs, on  the suspension  of
violent exercise, or on a very relaxed state  of the sys-
 tem from some other cause.   It  is  sometimes attended
 with inflammation, and the supposed consequent forma-
 tion, in  the  bronchioe, of a false membrane.  But, as I
 have known a  severe attack only one hour after the pa-
 tient appeared perfectly well; and  this attack, amount-
 ing almost to suffocation, broken  in  less than  another
 hour, and entirely cured in five  or six more, by steam,
 lobelia, &c. I cannot think that much inflammation ex-
 isted in  such cases.   Be that as it may, steam and lobelia
 are seldom known to fail to cure, when promptly and
 faithfully  applied.   The  steam  of  vinegar and  water
 should be applied to the neck and received into the lungs. 
352                   croup.
When the paroxysm is  relieved, and  the breathing be-
comes easy, give a full course of medicines, and strength-
en the system.  Dr. Eberle says," In the whole catalogue
of inflammatory affections, there is no disease  in which
bleeding,  when  promptly and efficiently practised,  is
more likely to  prove  beneficial."  Now, it  will.hardly
be disputed, that steam and lobelia are far more success-
ful than the regular practice, in the treatment of croup;
therefore, blood-letting is, in  no case, either necessary
or proper in  the treatment of any form of disease; as
other more innocent  means  are proved to be grealy
superior.  Dr. Eberle says, (on children, p. 359,) DC/3 "I
have, in some  cases, administered the lobelia inflata, with
a view to its emetic operation, with the happiest effect.
From its well  known powerful influence  on the respira-
tory  functions  in  asthma, independent  of its  emetic
effects, there is reason  for presuming that, in relation  to
the present disease, it may possess peculiar virtues; and
my limited experience  with it, inclines me to this opin-
ion."
  What  a wonder the doctor did not  kill  his  patient
with this  \fj='" among the most deadly poisons in the
materia medica?"   However, we must recollect  that
the article was used in connexion with so many others
that were  calculated to neutralize its effects that it could
not be held responsible,  even if  mischief had followed.
We  cannot, after this, be surprised  to  hear the same
gentleman say, p. 367, "  among the  remedies that  may
be usefully employed for the  reduction  of tracheal, in-
flammation, the warm  bath  deserves  to  be  particularly
mentioned!" 
CROUP--DROPSY OF THE BRAIN.      353
  Similar affections, that is, inflammations, or spasmodic
affections of the larynx, should be treated as above.
  Dr. Eberle says, p. 367, "Although  blood-letting does
not often procure any prominent benefit in this affec-
tion, it is unquestionably decidedly indicated, and ought
always to be promptly and efficiently practised."  Ls not
this  "scientific?"  It is  unquestionably indicated, al-
though " it does not often procure any prominent ben-
efit!"

       Dropsy of the  Brain, {Hydrocephalus.)
   Symptoms, irritable temper, irregular bowels, variable
appetite, irritated and  quick pulse, wakefulness, frown-
ing expression of the countenance, followed by pain  in
the bowels, nausea and vomiting, feverishness, distressed
expression  of the countenance, sudden waking from
sleep, transient and severe pains in the  abdomen, alter-
nating with  similar pain  in  the head, dislike  for light,
noise, &c. then  becoming drowsy, numb on  one side,
vision deranged, eye-lids paralyzed, and, finally, comatose
or sleepy, and convulsive.
   To regular physicians, this is a most frightful form of
disease.   I once took with me a converted regular to
see a case.   After examination, he feared it could not be
 cured.   I asked him to treat  it exactly as I would pre-
 scribe,  and  I  would "take  the responsibility."  As  a
 child had lately died of the  same form  of disease, the
 parents  of this were very anxious.   The head was hot
 and dirty, and covered with a cap, and  the child exhib-
 ited the symt.oms of the last stage.   I took off the cap,
 called for cold vinegar  and a comb, wetted the head and
              23 
354
DROPSY OF THE BRAIN.
combed it till I had gotten off all the scurf that had been
left " to prevent the child  from taking cold."  Before I
had half cleaned and cooled the head, the child fell asleep,
and the before constant motions of the head and  hands
ceased.   The bowels were swelled, hot and sore.   I di-
rected an injection to them, and moistened cloths  to the
abdomen, to keep  the  feet warm, and  to  cool the head
with the vinegar whenever hot, till it should be comfort-
able.  The effects of these two processes were prompt
and great relief.   A tea of ginger and raspberry  leaves
was  then given, and perspiration induced; and, by the
use of these and similar articles, in  three days the child
was entirely well.  I forget whether I directed an emetic
of lobelia  or not; but I certainly should  have done so,
had not  these measures  proved  amply sufficient.  My
advice is, keep the feet warm, the head cool, the stomach
and bowels clear of morbific matter, and  the  skin open.
Do it and succeed.
  Dr. Eberle says, " The instances  of recovery are, in-
deed, exceedingly few.  In the course  of  twenty  years'
practice, I have  known but  two  fully developed  cases,
which terminated in health, and it has fallen to my lot
to have  seen and prescribed for a very considerable num-
ber of patients ill with this appalling disease."
   Notwithstanding this  bad success, the doctor  still
prescribes  the same course  of bleeding  and poisoning
which has so often stuck a dagger to the very heart of
his professional ambition.   He says, "The temporal ar-
tery, or a vein in  the  arm, should  be opened, and the
blood allowed to flow, until a very obvious  impression
is made on the system," &c.  Then " leeches " and " pur- 
      PERITONITIS  AND DROPSY--COW POX.  355

gatives are among our most useful means;" then, " mer-
cury is undoubtedly a remedy of valuable  powers in the
treatment."  " Dover's powders have found advocates,"
and " James' powders have been spoken very favorably
of," and " tartar emetic has been used with great advan-
tage."  For what purpose, I ask, in mercy to the heca-
tombs of victims yearly  sacrificed  to  this practice, for
what have  all these  remedies  been  so  useful?  Dr. E.
says,  virtually, to kill all  the  patients, but two, that  he
has treated in twenty years!   The man that, after such
a succession of results, would not abandon a  practice
under which they occurred, even though he should know
no other, ought to be considered no better than a thought-
less murderer!

              Peritonitis and Dropsy.
  Inflamed peritoneum and consequent effusion of serum
into the cavity of  the abdomen.  Known by swelling,
and rattling of water in the abdomen.
   Treatment.—Cleanse the  general  system, and then
give the warming medicines with but little if any fluid,
as in pills, the bread of life, &c.  If this fail  to reduce
the swelling, tap the patient, and draw off the water;
then treat as before.

             Vaccination, or  Cow  Pox.
  This is  supposed to be the  origin of the variola  or
small pox, continued through  the bodies  of beasts, and
of persons  not much  predisposed, till it has assumed a
mild form.   This is quite probable, and accounts for the
action of the one preventing the occurrence of the other. 
356        COW POX—SMALL POX, etc.

To inoculate, take  the virus from  the  sore and put it
into  a puncture in  the arm.  To preserve  the matter,
draw a needle full of silk slowly through  the full pustule,
or press a little lint upon the matter, and inoculate with
bits of these, or preserve the scab, and  pulverize it  for
use.   It begins to  inflame and fester the  second day,
grows larger and sorer, but seldom produces any consid-
erable derangement of the system till the  eighth or ninth.
Keep the determination to  the  surface,  and the  system
clear of morbific matter, and no evil will arise.   Child-
ren ought to be vaccinated whenever there  is danger of
their taking the small pox, which  disease it will  render
milder, if  it does not entirely prevent it.   Care should
be taken that the virus be obtained from a  healthy per-
son.
   Since writing the above, I have known so many cases
of mischief from other forms of disease  inoculated with
the small  pox, that  I am doubtful  whether the danger is
not as great as the  benefit.

Small Pox, {Variola)—Chicken Pox, (Varicella)—Mea-
     sles, {Rubeola)—Scarlet Fever,  {Scarletina.)
   Each of these forms of disease is produced  by a spe-
cific virus which tends to  the surface, from which it
leaves the system.  Their appearance  on the surface is
preceded  by fever  and evident internal derangement.
   If there is evidence of much morbific matter within,
I commence  the treatment with emetics and injections.
These first cleanse  the alvine canal, and then  throw the
remaining virus to  the surface, to which a slight tenden-
cy should  now be constantly kept by  mildly stimulant 
SMALL POX--MEASLES, ETC.        357
sudorifics.  The vapor-bath  is  good, till  the  eruption
comes out, but better  omitted while  it remains on  the
surface.  Expectorants should be used to clear the bron-
chial  tubes, fauces  and glands, and gargles of cayenne
tea, or dilute No. 6, when these are sore.  There is  no
necessity or propriety  in  raising  the  action of the sys-
tem very high, at any  time, but to  keep it  steady, is  the
most  important point  in  the treatment of these  affec-
tions.  If the action be  made at  one time too great,
there will follow a fatigue and dangerous depression.   If
perspiration be made too  profuse, it will be followed  by
too much  absorption.  Therefore, cleanse well the  in-
ternal canal before  the breaking out, and then keep up a
moderate but steady tendency to the surface till all traces
of the virus have  departed.   In  scarlet fever, cayenne,
gum  myrrh, and  kercuma, should be freely  used as a
gargle for the throat.
   Before the virus appears on the surface,  the symptoms
of these different forms of disease—that  is, the effects
produced by the difterent species of morbific matter that
thus obstruct the vital action—have  so little peculiarity
about them, that the most experienced practitioners gen-
erally find it very difficult,  and often impossible, from
these  alone,  to decide which  is present.   But, as  the
means to develop any  one, are equally applicable  to  the
exhibition of all the rest, the early decision is not very
important.  When the eruptions appear, those  of small
pox are coarse, and sometimes cover nearly the whole
surface of certain parts, particularly the face; but, more
commonly, they are isolated, there being sometimes  not
more  than  half a  dozen pustules  on the whole body. 
358  SMALL POX, ETC.--WHOOPING  COUGH.

The chicken pox is much like the small pox in character,
but more mild in effect.  The measles extend more gen-
erally still over the surface, but rise only a little  above
it, while the exanthema of scarlet fever does little more
than inflame and scale off the skin.  Under the regular
practice, the small  pox  and chicken pox often much dis-
figure the  countenance; but, under a judicious botanic
treatment, this  seldom  happens.  I have treated  many
cases of all these affections, except small pox; and, though
one died of phthisis and measles, and another of maras-
mus, dropsy and scarlet fever, combined, I have yet to
lose the first patient of any one of these affections  alone.
Of more than thirty cases of measles, I have  lost  none,
nor found  any difficulty in restoring them  shortly, on
the above plan.

                  Whooping  Cough.
  This is another of what Dr. Bigelow calls "self-limited
diseases."   This cough is convulsive and suffocating, and
accompanied by a shrill, reiterated whoop.  If the treat-
ment proper for its premonitory symptoms, which arc
quite  similar to those  of catarrhal fever, be promptly
and efficiently applied,  this form of disease will be ren-
dered quite mild, and its duration much shortened, if it
should not be altogether prevented.  Let it  be remem-
bered, as a well known fact, that some persons are much
more liable to  contagious affections than  others, and
much more  affected by them  when  attacked,  (because
their  systems  are already diseased;)  and it  follows, of
course,  that, if you keep the system clear  of  morbific
matter, it will be much  more able to ward off an attack, 
       WHOOPING COUGH--CONVULSIONS.     359

or to sustain its  actual  pressure.   I  knew not  a  single
instance of an attack of the  cholera, in Richmond, Va.
in 1832, on a patient that had lately been taking courses
of medicine.
  The proper  process for croup will, of course, be  tho-
rough relaxation and cleansing by steam, &c. then the
proper  tonics.  Some  anti-spasmodic and  expectorant
preparation should be administered whenever the lungs
seem stuffed, till the  affection entirely ceases.  Keep the
chest and neck comfortably warm.

                    Convulsions.
   Dr. Eberle says that convulsions are among  the most
fruitful causes of deaths among infants; and this arises
from the great susceptibility of their nervous systems  to
irritation.  So far, I agree with him, and hence draw  an
argument for keeping the infantile system free  from  all
those deadly drugs with which, if we were to follow his
advice, we should be stuffing them, on every appearance
of a little ailment.   I have not a  doubt that calomel, ad-
ministered according to his directions, is the  cause  of
more infantile convulsions  than all other irritating agents
combined.   To  this, add his other drugs, and  you will
have  at least three quarters of all the causes of convul-
sions   to which infants are liable.   Now, our botanic
friends do  not need  to be told how to avoid these causes
of disease.  But they  may be told, (and would that I
could make them and others feel  it, from the crown of
the head to the sole  of the foot,) that, when  once  the
calomel gets in, it is a hard matter to prevent its specific
effects, or  ever  to eradicate  it  from the system.  Even 
360
CONVULSIONS.
 Dr. Eberle says, p. 156, though "calomel can seldom be
 omitted with  propriety in infantile erysipelas," yet " it
 is necessary to proceed with caution in its use;" for,
 " when given freely, at  this tender age, it is apt to give
 rise to dangerous irritation of the stomach and intestinal
 canal."  On page  185,  he says, " In  using  calomel in
 this  affection,  [ulceration of  the mouth,]  great  care
 ought  to be taken lest it affect  the gums—an  occurrence
 which  could hardly fail  to impart a dangerous character
 to the ulcerations."  But what sort of "care" can be
 taken  in  the  case? Dr. Graham,  of Edinburgh, says,
 p. 137, "An improper or excessive use  of  the  generality
 of medicines, is recovered from without  difficulty;  but
 it is not so when the same error is fallen into in regard
 to the  mercurial oxides.  They affect the  human consti-
 tution  in a peculiar manner, taking, so to  speak, an iron
grasp of all its systems,  and penetrating even to  the
bones,  by which they not only change the healthy action
of its vessels, and  general structure, but greatly impair
and destroy its energies;  so  that their abuse is rarely
overcome.   When  the  tone  of the stomach, intestines,
or nervous system  generally has  been once  injured  by
this mineral, according  to my experience, (and I have
paid considerable attention to this subject,) it  could  sel-
dom  afterwards be restored.  I have seen many persons
to whom it  had been largely given  for the removal of
different  complaints,  who, before they took it,  knew
what indigestion and nervous depression meant, only by
the description of others;  but  they  have since  become
experimentally acquainted with  both;  for  they  now
constantly complain of  weakness and  irritability of the 
CONVULSIONS.
361
digestive organs, of frequent lowness of spirits  and im-
paired strength; of all which, it appears to me they will
ever be  sensible.  Instances of this description  abound.
Many of the victims of this  practice are aware of this
origin of their permanent indisposition, and many more,
who are at present unconscious of it, might here find,
upon investigation, a sufficient cause for  their sleepless
nights and miserable days.   We have often every benev-
olent feeling called into painful exercise, upon  viewing
patients already exhausted by protracted illness, groan-
ing under the accumulated miseries of an active course
of  mercury, and  by this  forever  deprived  of  perfect
restoration.  A barbarous  practice,  the  inconsistency,
folly and injury of which no words can  sufficiently de-
scribe."—p. 138.
   Now all  this might pass with me for mere  opinion,
were it not that I have long seen and daily see the same
thing with my own eyes.  I lately saw a  patient die un-
der a most dreadful mercurial salivation and  ulceration,
who had not taken a grain for five years; and there now
sits by  me a gentleman whose gums are so sore  that he
cannot  eat solid food, and has been under a free saliva-
tion for several days, though he has taken  no  mercury
for nine years.  The mercury was given, in both  these
cases, with great " professional skill."   So much of Dr.
E.'s " care" was taken that no great mischief  was im-
mediately perceptible.  But, in one case, there  followed
a life of five years  suffering far worse than death, and,
finally, death  itself.   In the  other, a limb  is  forever
ruined, and  misery entailed  upon the system  which, I
believe with Dr. Graham, he will scarcely ever  recover. 
362         CONVULSIONS--EPILEPSY.

Oh the  curse  of mercury as a medicine!  The sword,
the pestilence, the famine, yes, and even the dram bot-
tle, all fail in the comparison with it, in the destruction
of the health and life  of civilized society!  Beware of
it, fellow-citizens, as the deadly bohon upas of the desert!
It biteth like a serpent and stingeth like an adder.
  But these convulsions must be treated on our plan of
relaxing the system and removing  the obstructions; lo-
belia, cayenne, the vapor-bath, canker teas, &c. are the
articles, and they must be faithfully applied till the sys-
tem is cleansed, and  then  the tonics  must be  used to
keep what is gained.

    Epilepsy, or Falling, sudden Exhaustion, &c.
   These arise from internal obstructions, when the  sur-
face is much relaxed.  The heat and  moisture escape
from  the surface  faster than the  supply is  furnished
within.  The balance  of  power is lost.  To correct
them for the moment, lay the patient on the back, with
the  head lower than  the body, dash  cold water on the
face and breast, and give hot medicine within.   As soon
as the balance is restored, give a regular course, or more
if necessary.—See Lectures on Med. Science. 
TESTIMONIES
OF THE REGULAR FACULTY  AGAINST  THEIR OWN THEORY

               AND IN FAVOR OF OURS.
                 Natural Labors.
  After the bold and free use of the  lancet, cool regi-
men, spare diet, opium,  cantharides, and  profuse evacu-
ations  from the bowels, "if convulsions succeed, they
are generally mortal.  The vis vitae, in such circumstan-
ces, must be supported  by replenishing the vessels with
the utmost speed; this is to be done by pouring  in nour-
ishing  fluids as  fast as  possible by the mouth  and  by
clyster; warm applications should also be  made to the
stomach and feet."—Edinburgh Practice,  vol. 5, p. 105.
  " Abortion is not  easily prevented, as it is  often pre-
ceded by no apparent symptom, till the  rupture of the
membranes and evacution of the waters announce the
approaching expulsion of the foetus.  Either  to remove
threatening symptoms, or to prevent  miscarriage when
there is reason to apprehend it, often baffles our utmost
skill; because it generally happens that there is a cessa-
tion  of growth  in  the  ovum;  or, in  other words, the
extinction  of life  in the  foetus,  for  some  time pre-
vious to an appearance  of abortion;  but, for the  most
part  very little  can be done in  the way  of medicine.
Manual assistance is seldom or never  necessary during 
364
NATURAL LABORS.
the first five months of pregnancy: the  exclusion of the
foetus and placenta should very generally be trusted to
nature.   The medical treatment of abortion must there-
fore be considered with a view only to the prophylactic
cure.  The preventive means, to which  I wrould wish to
solicit the attention of practitioners in  midwifery, con-
sists in strengthening the habit previous to a subsequent
pregnancy."—pp. 114 and 115.

                Of Natural Labor.
  "All efforts to press or strain,  except what nature ex-
cites, are improper, hurtful, and  should be  avoided; the
membranes, if possible, ought not to be ruptured till they
almost protrude at the  os  externum."—p. 124.
  " The separation of the placenta is also  the work of
nature, and seldom requires more force to bring it along
than if it lay entirely loose in the cavity of the uterus.
Thus, in  pulling, no greater  force should  be  employed
than is just sufficient to put the funis on  a stretch ;  for,
if it is  already separated, no violence  is  necessary to
extract  it; and, if the  adhesion is very firm, all violent
efforts are improper, and  often  followed with the most
dangerous consequences."—p. 125.
  "Though bad  consequences  sometimes  follow from
the retention of the placenta, yet it is much to be ques-
tioned, if these are  not less to be dreaded than the dan-
gerous floodings, convulsions, deliquia,  inflammation of
the uterus, fever, &c. that may be induced  from the too
prevalent practice of passing the hand to make the ex-
traction.  Where the adhesion is so firm as to require
force, or where its place of attachment is out of the 
NATURAL LABORS.
365
reach of the finger, by which, for the most part, the
edge may be brought down, is it not by far the safest,
and  the  most rational practice, universally to trust  to
nature?  Should the mouth  or  body of the uterus be-
come constricted  before  the  separation is effected, no
matter; little is  to be dreaded: it will afterwards kindly
dilate, and the separation and expulsion will spontane-
ously be accomplished with as much safety as in other
animals, where no force is ever used.   Let every candid
practitioner acknowledge, that,  for one instance where
the  retention of the placenta has been attended with
dangerous consequences,  its  precipitate  extraction has
proved fatal to hundreds."—pp.  126 and 127.
   [I have  read  of  one case  in which  the  placenta was
retained  fifteen days;  of another where  it  remained
twenty-four days; and  I had one myself, last winter,
where it was retained twenty-two hours.   In all these
cases, the  patients suffered no injury from this cause.
In the last, she was about the house the fifth day.]
   " In natural labors, almost our whole business consists
in encouraging the patient, and preventing  the fourchette
or frenum labiorum from being  torn, when the head  is
protruded through the os externum.  For, although it is
commonly said, that such a woman was laid [delivered]
by such a person, the delivery is generally performed by
the labor pains; and, if we wait with patience, Nature,
of herself, will do  the work.  We ought not, therefore,
to fatigue the patient by  putting her too  soon  in labor,
according to the common phrase; but  to attend care-
fully to  the operation of  the pains; and, in most cases, 
366      LABORIOUS PARTURITION, ETC.

we shall have nothing else to do but receive the child."
—p. 129.

              Laborious Parturition.
   " When a woman is nervous, low spirited, or weakly,
from whatever  cause, in general her strength must be
supported; the pains at last will  become strong  and
forcing, and the delivery, even where the patient is very
weakly, will often have a safe and happy termination.
In these tedious labors, if the strength of the woman be
properly supported, every thing almost is to be expected
from nature."—p. 135.
   "From mismanagement in time of labor, often arises
great debility; so that the patient's strength is exhausted,
the pains at length  entirely  cease, and the head of the
child remains locked up in the pelvis, merely from want
of force or pain to push it forward.  It  is of the great-
est consequence,  and the advice cannot be  too much
inculcated, to avoid exhausting the woman's strength
too much at first."—p. 137.
   Alas! and must her  strength  be exhausted  after she
has gone safely through?  This is making her sick for
fear she will get well too soon.   How long will the  fair
sex consent to be made sick  for fear they will enjoy too
much health?

    "Dryness and  Constriction of the Vagina."
   " Here, all  stretching and  scooping is  to be avoided.
The  natural  moisture  is to be supplied by lubricating
with pomatum or butter, or by throwing up  injections 
DRYNESS, ETC. OF THE  VAGINA.      367
of warm oil; the parts are likewise to be relaxed by the
application of warm stupes, or by warm steam directed
to them.  Thickness and  rigidity of the os tincoe, is to
be relaxed in the same way."—pp. 138 and '39.
  "If no  obstacle appears,  but the presenting  of  the
fontanella, the labor will, by proper management, gen-
erally end well;  and much injury may be done  by the
intrusion of officious hands."
  " Face cases are the most difficult and laborious of all
kinds of births;  and our success in this will chiefly de-
pend upon a  prudent management, by carefully support-
ing the strength of the woman."—p. 140.
  " The os uteri, rarely, if ever, is capable of contract-
ing upon the neck of the child, and thus preventing the
advance of the shoulders; and, should  this be the case,
what can we do but wait with patience?"—p. 141.
   " Besides these," [cases cited] says Dr. Smellie, " I have
assisted in a great number of cases where the membranes
have opened the os externum, and  the  head  has been
delivered before  they  broke.  Indeed, in all natural la-
bors, I wait for this  operation, which renders  the pass-
age  of the child much  more easy."—p. 131.
   " We should always be exceedingly cautious of having
recourse to the common expedient of breaking the mem-
branes, which ought never to be done, till we be certain
the difficulty depends upon  this cause;  and, even then,
the head of the  child should be well advanced, and  the
membranes protruded almost as far as the os externum."
   " Many inconveniences arise from a premature evac-
uation of the waters ;  for thus the parts become dry and
rigid, a constriction  of the os  uteri for a time  ensues, 
368     DRYNESS, ETC.  OF THE VAGINA.

the pains often either remit, or become less strong and
forcing, though not less painful and fatiguing;  the dila-
tation goes on so slow, and the labor becomes so severe,
that the woman's strength and spirits, by the  unprofita-
ble labor, are quite overcome and exhausted: so that the
head remains  confined in the  passage, merely for want
of force or  pain  to push it forward.  The woman, in
the beginning  of labor, should therefore be treated with
the utmost  delicacy and gentleness.  The work of na-
ture is too often spoiled by officious hands.  She should
be seldom touched while  the membranes are whole, lest
they should be ruptured; and, even when touching is
necessary, this should only be done when the pains begin
to remit, and  the  tense  membranes begin to  relax."—
pp. 141 and '42.
  " When the funis  umbilicus is  too long, it forms cir-
cumvolutions  round the  child's  neck,  but it is  time
enough, in  general, after the child  is  born, to slip  the
noose over the shoulders  or head; there is seldom occa-
sion to divide  the chord after birth; a  practice  that may
be attended  with trouble  and hazard."—p. 142.
  " To push up the  head, and turn the  child, with a view
to preserve its  life, as many  authors recommend, is  a
practice by no means  advisable; we  should seldom, in
this position, be enabled to save the child; and turning,
under  such circumstances,  can  never be done  but  at
the immediate hazard of losing the  mother."—p. 143.
This relates to  the prolapsus of the funis before the
head.
  " In many women I have known the membranes break
several days, weeks, and  even months  before labor; and, 
          SAFETY OF NATURAL LABORS.      369

provided they were not much weakened, they have been
delivered with ease."—p. 148.
  An ineffectual attempt to pull away the child, with
a noose over  the head—which was safely delivered  by
the natural pains—with  the  head galled and inflamed,
is recorded, p. 184.
  A safe delivery, by trusting to  nature, after  the lady
had  been delivered  of four dead  children—by  force.—
Case 4, p. 191.
  "The unfavorable position of the head is,  of itself, a
cause insufficient to justify the use of destructive instru-
ments."—p. 205.
  " In whatever manner the breech presents, the deliv-
ery should be submitted to nature, till  the  child be ad-
vanced as  far as  the  thorax, when the feet  are to  be
brought down and laid  hold of, the child, if necessary,
pushed up, the mechanical turns effected, and the deliv-
ery otherwise conducted as in a footing case.  There  is
much less hazard in general, agreeably to an  old obser-
tion of Mauriceau, in  allowing  the  child  to  advance
double, than in precipitating  the  extraction by pushing
up to bring down the  feet, before the  parts  have been
sufficiently dilated;  a  practice difficult and  troublesome
to the  operator;  painful and sometimes dangerous  to
the  mother, and by which the child is exposed to the
risk  of strangulation,  from  the  retention of the head
after the  delivery of the body.   If the child be small,
though doubled, it will easily pass in  that  direction; if
large, though  the labor be  painful, the natural throes are
less  violent, and  less dangerous  than   the preposterous
help of the accoucher."—p. 2S3.
              24 
370      DANGER OF  TURNING IN UTERO.

  A great effort  was  made  to  deliver a child with  a
breech presentation, but, not succeeding, the patient was
nourished,  and soon delivered with  great ease  by the
natural pains.—Case 17, p. 303.
  Rash and preposterous management by an  accoucher
who had acquired much celebrity.—9 p. 339.
  Heart-moving  and disgusting  scenes recorded upon
pp. 360, '61, '62, '63 and '64.
  By their fruits  ye shall know them.  Fruits in abun-
dance recorded on pp. 364,  '65, f66, '67, '68 and '69.
  From  p. 372 to 379 inclusive, important lessons  are
to be learned.
  From p. 384 to 389  and '90, are illustrated  the inju-
rious effects of too great haste.
  The doctor pulled at the lower jaw and body until he
felt them give  way—then said he could not save its life,
(as he had broken its neck.)   The woman did well until
—she died!—pp. 394 and '95.

         TlIE  DANGER  OF TURNING IN  UTERO.
  "Long-continued efforts have  sometimes  succeeded
in turning the child; but too frequently the  event  has
been fatal; sometimes the uterus  has  been ruptured in
the operation, and sometimes where this misfortune has
not  been  known  to have happened, the uterus has suf-
fered so much that fever and  death have  been the con-
sequence.  The more experience I have had, the  more I
have been desirous of  rather  bringing away the child in
any way I could, than running the risk  of  these very
difficult turnings."—Dr. Sims of London, p. 405.
  "  It may not be amiss to remark here, that, whenever 
         DANGER OF TURNING  IN UTERO.     371

there are strong labor pains present, turning ought not
to be attempted; and that, not only on account of the
increased difficulty  and danger  of the operation, but
because, whenever there are strong forcing pains present,
a  favorable issue may, under  all circumstances, be ex-
pected ; for, as if Nature  felt  her own inability to ac-
complish  the  delivery in  cross presentations, there are
rarely  any pains; and  where these exist, to a  certain
degree, I have always found that, from the small size  of
the  child,  or, which amounts to  the  same, the large
dimensions of the pelvis, the child was about to be ex-
pelled  double, or that the  head or  breech were coming
down  with the arm, though not within the reach of the
finger.  Often, when there are no pains whilst the pa-
tient is left to herself, the  uterus is immediately thrown
into strong action by the irritation which  the  attempt
to introduce the hand  must  occasion, and  this circum-
stance always  adds  to  the difficulty and danger of the
operation."—p. 406. See, also, Dr. Clark's letter to Dr.'
Sims,  p. 407.
   "The number of foetuses eventually destroyed, with
the  intent of preserving the life of the  patient, are inci-
dents  of the utmost importance to the community, and
claim  a proportionate share of consideration from every
accoucher concerned in these unfortunate  occasions."'—
p. 434.
   "The implicit act of  turning  and delivering by the
feet, is a practice, even in the most promising situations,
always attended with danger to the foetus."—ib.
   " I think no  one  excusable who  attempts premature
delivery,"  in cases of habitual miscarriage at  a certain 
372       DELIVERY OF THE PLACENTA.

period of gestation, beyond which the foetus is supposed
to die, " as instances are not wanting where, after a num-
ber of periodical immature births, the woman has at
length gone her full period of nine months, and become
mater familas."—p. 435.
  " The uterus is an organ in  no  respect governed  by
the will, and the efforts of that viscus are  most regular
when left uninterrupted."—p. 435.
  " Should haemorrhage take place in  the early part of
labor," Boudelocque says, and I fully concur with him,
" whatever  abundance of blood  the woman may lose,
nothing could  justify the conduct of the  accoucher who
would persist in endeavoring  to deliver without delay;
for it would only be creating  new difficulties, instead of
relieving the existing one.'"—Dewees' Midwifery, p. 236.
   " I believe that the frequent mention of difficult, dan-
gerous, and rare  operations,  lead, oftentimes, to  the
unnecessary use of instruments, not always so  much
from  the  necessity  of the case, as the  eclat which  at-
tends them, however unsuccessful."—Dewees' System of
Midwifery, p.  307.

          The delivery  of the Placenta.
   " It would be in vain  to  attempt the  delivery of  the
placenta by any exertion made  upon  the  cord, though
this is almost  always  resorted to; and, as  the whole of
the uterus will sink lower in the pelvis by the effort, the
inexperienced practitioner imagines that the placenta is
descending—he continues his traction under this illusion,
and, thinking  a little more force will overcome  the diffi-
culty, he multiplies  it; the cord is ruptured, and his diffi- 
DELIVERY OF  THE PLACENTA.      373
culties are increased; he now becomes alarmed, and the
panic spreads to the patient and her friends; every thing
is thrown into confusion; a consultation is demanded;
and a rival practitioner robs him of the little reputation
he may have acquired, and  thus interrupts his progress
in business.   Or, fearing the consequences  a  discovery
of this accident  might produce, he disingenuously con-
ceals it;  and attempts, without method, the delivery of
the imprisoned placenta, to  the immediate torture, and
subsequent injury of the patient—not knowing exactly
what causes  the  delay, or the nature of the  difficulties
which oppose him, after excrutiating  his patient, by un-
availing  efforts, he, in  a paroxysm of mental anguish,
abandons her, and declares  the case  must be  left to na-
ture."—Dewees'  Sys. Mid. pp. 446 and '47.
   Behold how these regulators love their patients! how
kind they are to  them, and  careful  not to  do  them  any
injury!  How kind to one another, and how  willing to
assist each other!  How scientific and learned, to bring
their patients  into so deplorable  a  condition, by their
folly and rashness!  Who can but  love  such  physicians
and such a science?
   " Turning must always be looked upon as of doubtful
safety to the child; its adoption must therefore be con-
stantly regarded  as a choice of evils.   In the case  of
prolapsus funis, it should be resorted  to with great cau-
tion, especially as there is no question that children are
frequently born alive after the cord had been prolapsed,
and when the progress and termination  of the labor was
confined to the natural powers.  While, on the contrary,
the fact  is  equally well  established, that they have per- 
374       DELIVERY OF THE  PLACENTA.

ished during the extraction;  and  I believe we may safely
say, with Boudelocque,' and  all this, in cases where they
might have been born alive,  notwithstanding the exit of
the cord, had the delivery been left to nature.''   It is not
sufficient, because  the  pains  are feeble  and  long in
returning, to make us conclude that  the powers of na-
ture are incompetent to the  end,  and make  us  resort to
the doubtful expedient  of turning."—Dewees, pp. 526
and 527.
  "Even  under favorable circumstances, turning  is, to
the child, a hazardous operation; under perverse ones, it
is but too often fatal to it; and it must ever  be looked
upon as a doubtful alternative, rather than as a probably
safe resource."—Dewees, p.  551.
  " Nothing can  justify a violent entry into  the cavity
of the uterus."—Dewees, p. 544.
  " The laborious and difficult labors are  by no means
so frequent as those who are  inexperienced are apt to
imagine."—Blundell's Obstetricy, p.  141.
  " I  strenuously dissuade  you from making familiar
companions of  your instruments; because  they are not
wanted.   Noscitur a sociis—(he  is  known by his  com-
panions.)   The very fact that  an accoucher, on all occa-
sions, puts the lever into his pocket when  he goes to
attend a labor, proves that he is an  officious, a meddle-
some, and, therefore, in my  mind, so far, a bad accouch-
eur.   Some men seem  to  have  a sort  of  instinctive
impulse to  put the lever or  forceps  into the  vagina.
' Lead yourselves not into temptation;' if you put your
instruments into  your pocket, they are very apt to  slip
out of your pocket into the  uterus.  Patience and good 
          DELIVERY OF THE  PLACENTA.       375

nature are two useful obstetric instruments, which may
be fearlessly carried to every labor."—Blundell, p. 143.
  " When it was the custom to bring away the placenta
immediately after the birth  of the child, three  reasons
were assigned for the practice; first—that it was a dead
substance, without any power like that which was sup-
posed to be inherent in the child; secondly—that it was
an  extraneous  mass,  which  became  pernicious every
moment it remained; and, thirdly—that,  if not imme-
diately extracted, it would be almost impossible to bring
it away, the os uteri closing in such  a manner as abso-
lutely to prevent the  introduction of the hand  for  the
purpose of extracting it.  These opinions are  proved to
be  groundless, for the  placenta, we know, may remain
many hours, or several days, (fifteen  or twenty)  without
doing any mischief to  the uterus; and the opinion of
the os uteri closing so  soon after the birth of the child,
is without foundation, as that seldom or never  happens."
—Edinburg Practice, p. 445.
  A case is recorded upon p. 494, of a complete inver-
sion of the uterus, without the labia, caused by  the pla-
centa having been too forcibly extracted.
  Another, p. 495, " where Dr. Smellie was called to  a
woman, who died before his arrival.   He found  the uterus
inverted, pulled quite without the external parts, and the
placenta adhering firmly to the fundus.  This misfortune
was occasioned by the midwife pulling at the placenta
with too great force."   One such in Cincinnati.
  " No excretion is of more consequence to the patient's
recovery, after delivery, than a free perspiration; which
is so  absolutely necessary, that, unless  she has  a mois- 
376
PUERPERAL FEVER.
 ture continually on the surface  of her body for some
 days after the birth, she seldom recovers  to  advantage:
 her health, therefore, in a great measure, depends upon
 her enjoying undisturbed repose, and a constant breath-
 ing sweat, which prevents a fever by can-} ing off the
 tension,  and assists the equal discharge  of the lochia
 when  these  are obstructed, and when a fever  ensues
 with pain and restlessness, nothing relieves  the patient
 so effectually as rest and moderate sweating."—p. 522.

          Puerperal or Child-bed  Fever.
   " Notwithstanding the prevalence of this disease in all
 ages, its  real nature has remained,  to  the present time,
 a subject of much dispute and uncertainty."  The cure
 is  gradually effected, either  by a spontaneous vomiting,
 or a long-continued discharge by  stool  of porraceous
 matter, the existence of which in the stomach is usually
 evinced at the first  attack of the disease.  The five prin-
 cipal causes of this  disease are, " the endeavors to  dilate
 the os internum, a  stoppage  of perspiration, too hasty
 separation of the placenta, and  binding the abdomen too
 tight, and the neglect of procuring stools after delivery."
 Within these few years, this fever has  been treated  by
 several writers, most of whom have differed from each
 other,  and it has likewise  been the  fate of puerperal
fever, that no disease has more  divided the sentiments of
physicians in regard to  the method  of  cure.   The  appa-
rent indications and contra-indications of bleeding and
other  remedies,  arising  from a complication of inflam-
matory and putrid symptoms; the equivocal appearance
of  the  vomiting and purging,  and  the different causes 
OFFICIOUS TREATMENT.         377
whence symptoms  similar to each other may arise in
pregnant women; all these circumstances concur  to in-
volve the subject in great  obscurity and indecision.—
pp. 542, '44 and '55.
   On the effects of  the treatment of officious regulars.
   " By frequent and incautious touching, the glands fur-
nishing the fluid to lubricate the vagina and os uteri, are
over stimulated, nay, sometimes become inflamed.  In
this case, the  secretion ceases, and  the parts become
tender and swollen, especially the  mouth of the uterus,
should it not be fully dilated; the pains are less frequent
and less protrusive; the woman is restless, and enjoys
no calm in the intervals  of the  pains; fever is excited;
head-ache,  thirst,  and a hot skin follow;  in  a word, a
new condition of the system arises, and almost suspends
the business of labor.  This state of things can only be
altered by rest and free blood-letting.   To the latter, we
must have  immediate recourse, if we  wish to subdue
the unnecessarily provoked inflammation; and to restore
the uterus to the re-enjoyment of its suspended powers,
in many cases like those just mentioned, I have seen this
remedy act with the  certainty and  promptitude of a
charm."—Dewees' Sys. Mid. p.  174.
   It seems, then,  that Dr. D. in "many cases," by  his
"incautious"  and  improper "touching," produces the
most alarming symptoms, and suspends  the business  of
labor, but (oh, what a beautiful science!) these dreadful
effects can be removed like "a  charm" by "free  blood-
letting."  How long would the intelligent ladies of Phil-
adelphia employ such  an  accoucheur, provided they
knew that,  by his " frequent and  incautious  touching," 
378
A SMALL MISTAKE.
he produced such distressing effects, which he  removes
like a "charm," by bleeding them almost to death?
  " In the management of labors, much judgment and
caution are required,  that  a simple  and natural case
may not be converted into a laborious and dangerous one.
And, unfortunately for the interest of humanity, it  re-
quires more knowledge not to be officious, than falls to
the  share  of many  of those who pretend to  practice
midwifery.  It is a vulgar prejudice, that great and con-
stant benefit can be derived from the agency of an  ac-
coucheur, especially during the active state of pain; and
this feeling is but too often encouraged by the ignorant
and designing, to the injury of  the  patient, and to the
disgrace of the profession."—ib. p. 1S5.

                 A  small  Mistake.
  "A gentleman once calling at my house told me, not
without some earnestness, that he had under his care a
case of labor about which  he was very anxious.  ' The
mouth of  the womb,' said he, ' is beginning to open, and
I can feel the child, but the patient is somewhat weak,
and labor makes but little progress.'   On my enquiring
how  long  delivery  had been protracted—a few hours
was  the reply, and  he added  that  there was  no very
pressing symptom.   A meddlesome midwifery is bad, I
rejoined; therefore, it is better to wait, and not unwisely
and  rashly disturb  the  best accoucheur—Nature, the
mother of us all.   A  day or two  passed away,  after
which he called on me again, observing that his patient,
still  undelivered, was getting weaker and weaker, and
that he wished me to give her a visit.  On entering the 
DANGER OF MEDDLING.          379
apartment, I saw the woman lying in state, with nurses,
accoucheur, and all the formalities attending a delivery;
one small point only was wanting to complete the labor,
which was, that she should be pregnant; for, although
the practititioner, one of the omnipotent class, had dis-
tinguished the child's head  in  the uterus, there  was, in
reality, no foetus  there.   A few hours  after  the  patient
died,  and, on examining the  abdomen, we  found  the
peritoneum full  of water,  but the womb, clearly unim-
pregnated, was no bigger than a pear."—Blundell's Obst.
p. 153.
   " To burst the membranes with the  finger, instead of
waiting'for their spontaneous rupture, is faulty."—p. 154.
   " In labors  generally,  it is of very  little  importance
whether the practitioner knows or not what is the pre-
sentation ; because, in general, it is a natural one, and,
notwithstanding  his  ignorance,  the child  will safely
enough  come away."—p. 155.
   "In ordinary labors, it matters little whether you are
acquainted or not with the situation of the cranium."—
p. 156.
   "A meddlesome  midwifery is always  condemnable."
" When  the head is in the world, do not lay hold of the
neck  and  endeavor to  draw down the shoulders; for
here,  as ever, a meddlesome midwifery is bad.  The nat-
ural efforts, if fairly tried, will, in ordinary labor, expel
this part of the  child;  and  it is  found that, when  the
efforts are left, in this manner, to expel the shoulders as
well as  the head, the womb contracts afterwards more
kindly and effectually, and  the placenta  becomes  more
safely detached.  When  the child's head is  come into 
3-80
OBSTETRIC VIOLENCE.
the world, therefore, remember that  a prudent  practi-
tioner ought not to interfere;  but must still suffer  the
uterus  to  act  in  its own  way, when, by the natural
efforts, the shoulders will be expelled."—p. 15S.
   "Rarely is it requisite to examine whether delivery
be or not begun.   With the rupture of the membranes,
the less you interfere, the better."—p. 161.
   "Where the placenta is rudely and  injudiciously torn
away by the hand of the accoucheur, the  worst conse-
quences may be expected to ensue.  Floodings, tremen-
dous lacerations, inversions  of the uterus—t;uch are  the
effects of obstetric violence—ferocious and  atrocious ob-
stetric violence; that insatiate and gory Moloch, before
whose bloody shrine so many thousands have been sac-
rificed, to be  succeeded, in  future years, by still more
numerous victims.   Observing these awful  consequences
resulting from the  artificial  separation  of the placenta,
Ruysch first, and afterwards Denman and Hunter, recom-
mended that, in all cases, after the birth of  the child, the
expulsion  of  the placenta, like that of the  foetus, should
be committed  to the natural  powers; for, they added,
' the same natural powers which  are  adequate  to expel
the child, are surely adequate to expel the placenta also!'
And there is  no doubt  that, if our women, ferino more,
unaided by art, were committed  to the natural powers
altogether, like the females  of barbarous hordes, in  the
great majority of cases the placenta would  come away."
—p. 167.
   " I hope that no one will needlessly thrust his hand
into the uterus, yet I have my misgivings.  I hope, after
all I have said, of the tearing and lacerating and slough- 
OBSTETRIC VIOLENCE.
381
ing of these  parts, you will never needlessly have  re-
course to this barbaric practice.  Some of my obstetric
friends, and whose talents I  esteem, fall into  this error;
they  grate my  ears, by  boasting how frequently they
have  carried the hand into  the  uterus, and with what
facility the placenta has been removed: that  this opera-
tion may be easily effected, I have no doubt;  but depend
upon  it, if  you do carry your hand into the uterus on
every occasion,  to get away the  placenta, some women
will die at  last, and die the victims  of  your mismanage-
ment; at this moment, perhaps, some amiable  but ill-
fated  creature, blooms, the light and life of her admiring
circle, who must hereafter fall an  untimely  sacrifice to
some cruel and ruthless arm."—pp. 171 and '72.
   "I have  the preparation  of a  uterus in my museum,
in  the uncontracted state;  and, looking  on the inner
surface to which the placenta cohered, vou find  there is
a number  of large unclosed vascular  orifices, yawning,
as it  were, destruction on the patient.   Now this prepa-
ration shows the condition  in which  the vessels are, if
you  tear away  the placenta before  the womb is  con-
tracted, exhibiting the formidable openings at which the
effusions of blood occur.  But here is another prepara-
tion which is contracted; if you look  at  the blood  ves-
sels,  you will find them all closed by the abbreviation of
the surrounding fibre,  as by so many ligatures, and  this
is the best  prevention against hsemorrhage; it is Nature's
tourniquet, her  system of  living  ligatures.  You  see,
then, that  it is  not without  good reason that  I am so
anxious, before  you  abstract the  placenta, that  you
should secure the contraction of the womb. 
382
OBSTETRIC violence.
  " Do not needlessly thrust the hand into the uterus, is
the voice that issues from this preparation:—he that has
ears to hear, let him hear it.
  " Do not  needlessly thrust the hand  into the vagina,
is the voice  that issues from  this preparation:—he that
has ears to hear, let him  hear it.
  " Do not needlessly pass the hand into the  genital fis-
sure, is the voice that issues from this  preparation:—he
that hath ears to hear, let him hear it.   Ah! that vio-
lence of an ignorant and  savage hand!   After examining
these preparations, tell me, is it too much to assert that,
in obstetrics, a thrust of  the hand is more dreadful than
the thrust of a bayonet?  Could the field of Waterloo
exhibit injuries more dreadful than these?"—p. 172.
  "When the face is lying  forward  on  the  symphisis
throughout  the labor, many difficulties  are occasioned;
what is it, then, that the accoucheur can  do in order to
diminish, surmount, or  remove them?   What is there
that he can  with prudence do, and without committing
the unpardonable  sin of midwifery; the sin, I  mean, of
those obstetric reprobates, the meddlesome and the prag-
matic?  That turning the child is  universally unjustifia-
ble when the case is indisputable, the dexterity great,
and the circumstances are conducive, I will not venture.
And, when  the  softer  parts relax,  and the  pelvis is
capacious,  and our dexterity, from long practice, such
that we can introduce the hand into the cavity of the
uterus, and lay hold of the child's legs, and bring it away
with facility,  by the  operation  of turning;  I  will  not
say  that, under such circumstances, we  may not,  72010
and then, be justified in making the attempt.  Decidedly, 
OBSTETRIC VIOLENCE.
383
however,  and  in  the  strongest language  I  can use,  I
would reprobate this turning as a general practice even
in these cases."—pp. 179 and '80.
  "As a general rule  of practice in  face cases, with the
whole weight of authority I may possess with you,  I
condemn it.   Do it ninety-nine times, successfully, and I
condemn it still, because you are meddling; because you
are cramming your hand  into the  uterus without any
sufficient cause; because you are,  as it were, doing your
best to tear the vagina;  because ninety-nine operations,
undeservedly successful, may lead  to the hundreth, and
the  destruction of your patient.   It is the same with
respect to rectification."—p. 182.
   " In presentations of the face, the stoical rule will ap-
ply;  a rule which might be whispered into the ear at all
times, when you  are  at the bed  side, naturam sequere
(follow nature,) delivery is  a natural process; give, there-
fore, a fair trial to the natui'al efforts.   When, then, you
find a face case, frequently, nay generally, you have lit-
tle to do;  you need not send  for another practitioner;
you need not allow your minds to  get  into  a state  of
perturbation, as if you had some mighty feat to achieve.
You have only to sit quietly at the  bed side, to  support
the confidence of the woman, to  let the  uterus  act,  to
protect the  perinaeum, to  open your hands, as it were,
to receive the child which Nature deposits in  them.'"-183.
   " Ear presentations also  occur, but they are so rare,
or so easily  conducted on  the principles laid  down, that
I consider it  unnecessary  to enlarge on them."—Blun-
ders Obst. p. 183. 
384       TRANSVERSE PRESENTATION.

  " Under breech presentations, if you give a  fair trial
to the natural efforts, in most instances the foetus of itself
descends the outlet, the accoucheur happily having little
to do, except to sit at the bed side, and to abstain from
injury or mischief."—p. 190.
  "The  first stage  of labor, in  breech  presentations, is
frequently very slow; for, though the nates and thighs
do not take  up so much room as the head, yet either
they do not  readily adapt themselves to the shape of the
pelvis, or the action  of  the uterus is slower or less reg-
ular,  in  consequence of the awkward position of  the
foetus.   No  means, however, can with propriety be em-
ployed to hasten  the progress of the labor, and by de-
grees the dilatation of the parts is effected, and the  nates
are forced lower and lower into  the pelvis, till at length
ihey protrude through the os externum."—Merriman's
Synopsis, 4th ed. p. 73.

         Cases of Transverse Presentation.
  " I was called, some few months ago, to a case in  the
neighborhood of the  London Hospital, of a presentation
of the arm,  attended by a gentleman of some  obstetric
tact  and talent.  In  two minutes  after I entered  the
room, with scarcely a complaint on the part of the wo-
man, the arm  presenting, the  child was brought away.
As my predecessor  had  been laboring without success
to deliver, this speedy abstraction of the child occasioned
no small mortification of surprise; and, when  we were
apart, my friend asked me how it was possible I  could
deliver her so  easily  and speedily, after he had labored 
          TRANSVERSE PRESENTATION.      385

so much and  to  so  little purpose?  To say the truth,
said I, I did not deliver her at all; for, on reaching the
bed side, I found the spontaneous evolution was nearly
completed, and I  had only to hold forth  my hands  till
the child dropped into them.  To another case I was
called, where  two  practitioners  had tried to turn the
child and failed, and where I tried myself, and failed too.
Finding  that perseverance would burst the uterus, let us
wait, I said, to see what the  natural efforts will accom-
plish; if they do not  effect  the  delivery, further mea-
sures may be  used;  but do not let us distrust our great
and kind mother too soon.  In the course of an hour
the  child came away, under a spontaneous  evolution,
effected  by the natural powers, and the woman did very
well; and we all found that we did more  service by sit-
ting down at the dinner  table than by working at  the
bed side."
   In the face of such testimonies, what value can we
 place on the boasted superior skill of the  mineralites in
 obstetrics ?
   " However clumsy, and however rough, and however
 dangerous the practice,  yet, I am compelled to admit,
 that" sometimes " in  shoulder presentations, the prac-
 titioner must take off his coat, remove the sleeve of the
 shirt, lubricate the  arm,  and particularly the hand, and
 then, arte, non vi, with the fear of lacerating the womb
 before your eyes, relentingly, tremblingly, I  had almost
 said, if indeed  a surgeon may  tremble,  you  carry the
 hand into the uterus, and draw down the feet of the
 child, alwaijs with the risk of tearing the genitals, when
              25 
3S6           DANGER OF  MEDDLING.
you  operate in a manner the most skilful and  dexter-
ous."— Blundell's Obs. p. 193.
  " For once, even in floodings, a meddlesome midwife-
ry is bad."—p. 207.
  " I acknowledge, whatever opinion  might be  formed
by those about me, for myself, however, I  had rather
feel within that the patient perished under the operations
of nature, than  that my meddlesome hand was, unhap-
pily, auxiliary to her destruction."—p. 218.
  "For the  sake of humanity, allow me again to remind
you that, from whatever cause the flooding arises, wheth-
er in the earlier or latter months, before or after the
birfh of the  child,  before or  after  the  birth  of  the  pla-
centa, so long as the woman is lying in  the state ap-
proaching to asphyxia,  the disturbance of your  hand is
death!  Ah, how I commiserate those unsuspecting, but
ill-fated victims, who are designed to perish by your for-
getfulness of this  caution?   At  this  moment  live the
women who must sink  under this mal-practice."—p. 227.
  " Should you carry your hand into  the cavity of the
uterus,  now, over and over again, not,  however, too
often, I have told  you  that  such  practice is to be con-
demned; and if,  in defiance of warnings, anyone of you
still addict himself to  these  mal-practices, let him take
the consequences;  on his head be her blood!  My hands
are free, whatever befall the patient."—p. 235.
  "The blood chills and curdles at the thought of tear-
ing out the intestines of a living foetus.   By the people
of England—the censors and monitors of nations—wild
beasts are caged, but worse  than these—the accoucheur, 
DANGER OF MEDDLING.          3S7
meddlesome and violent, yet responsible to none—has
been unwisely let loose upon society, with all his instru-
ments about him."—p. 236.
  "The  tremendous  and heart-sickening operation  of
opening the cranium in the uterus, can never be  neces-
sary, till foetal life is extinct.  ' Thou shalt  do  no mur-
der.'  These words cannot too often tingle  in obstetric
ears."—p. 238.
  " Dreadful lacerations may result from rash attempts
to introduce the hand."—p. 246.
  "A thrust  of the hand is contusion,  laceration, de-
struction, death.
  " The grand  error  to which you  are  obnoxious, the
error against which you  have been cautioned so often,
on other occasions, is, the use of too much  force—arte,
nan vi;  ferocious, atrocious violence, is to  be exploded
from midwifery.  Contusions, inflammations, lacerations,
fractures, decapitations—these are the tremendous  con-
sequences  resulting  from  the  error—consequences  at
once fatal to the mother  and  child.   Laceration  of the
womb, laceration of  the vagina, extensive laceration  of
the perinaeum; one or other of  these certainly will oc-
cur if you operate  rudely, and now and then, perhaps,
when turning is performed with the  nicest care.   Those
make a mock turning who have never seen  its dangers;
it is, at best, a fearful operation."—pp. 250 and "51.
  "Beware of  impatience and violence.   Beware  of
lacerations.  Have  mercy  upon the patient:  again, I
say, have mercy upon her.  Remember that a thrust  of
the hand is as fatal  as a thrust of the bayonet.  Wounds
more  dreadful  are  not  inflicted in  the  field of battle. 
388
DANGER  OF MEDDLING.
 When the hand is carried into the os uteri, to perform
 the operation  of turning, you may find  it necessary to
 repress a little the presenting part; to push  the  foetus
 back hastily and extensively, is fatal; and you must not
 think of it;  you will tear the vagina, lacerate the  uterus
 —do both perhaps—how easily too—but, can  you after-
 wards repair them?"—p. 254.
   " In all cases, the use of instruments contrived for the
 extraction of the foetus, is  to be looked  upon as a great
 evil."—p. 295.
   " In the general, as I have observed on  preceding oc-
 casions, the best accoucheurs are  those who interfere the
 least with the finger or hand.
   "I now repeat what I observed once before:  in  ob-
 stetrics,  a thrust of the hand into the uterus may prove
 as  fatal,  and will, generally, produce a  more  extensive
 wound than the thrust of the bayonet."—p. 285.
   " I do  not like to see  an elegant pair of forceps.  Let
 the instrument look like what it is, a formidable  weap-
 on."—p.  312.
   " Force kills the child, force  bruises the softer parts,
 force occasions mortification, force bursts open the neck
of  the bladder, force  crushes the  nerves; beware of
 force."—p.  317.
   " The  cases in which patients may suffer, because in-
 struments have  not been  employed when they have
really been  required, are by no means frequent in their
occurrence, and, therefore, it is  impossible for men, in
general  practice,  to err frequently  by abstaining alto-
gether from the use of instruments in all cases."—p. 327.
  " If you must err, then, take my advice, and err  rather 
DANGER OF MEDDLING.
389
by the neglect or rejection of instruments, that their too
frequent use, for the cases in which you may use instru-
ments, without need, are as numerous as the cases that
may fall under your care, with the exception of the few,
very few, in which these weapons are really required."—
p. 327.
  " Of ail obstetric operations,  there is none, perhaps,
more easily performed, than that of perforation, or cra-
niotomy;  and many a life, I  fear, has  fallen a sacrifice
to this facility of execution.  Of all  the operations  of
our  art, however, there is none more dreadful, not  to
say more  awful; never  suffer your minds, on any  ac-
count, to be divested of that salutary horror, with which
I conceive it ought at all times to be contemplated."—
pp. 330 and '31.
  " Cases  have happened in which the cranium has been
opened, and a part of its contents  have been removed,
the child coming into the world  alive, to look, as it were,
into the face of the operator, and reproach him for  his
cruel ignorance or negligence.   The very image of these
horrors is enough to make the blood curdle."—p. 334.
  " I knew an instance in which the fillet had been used,
and actually scalped the child; and another, in which
the child's under jaw had been cut to  the bone  by  the
force of pulling."—Edinburgh Prac. p. 223.
  "I was  employed  in a case where, by using  great
force, in  order to  save  both mother and  child, the os
uteri was  torn; the woman  died soon after, from  the
loss of blood, as  I  then imagined, proceeding  from  the
torn vessels of the uterus."—ib. p. 316.
  " In the  number of those diseases which the skill of 
390
DANGER OF MEDDLING.
the physicican, or the hand of the surgeon is not able to
cure, maybe counted those dropsies peculiar to females,
which originate in the appendages of the uterus.   These
dropsies are not unfrequent."—ib.  p. 50S.
  " Puerperal fever is not unfrequently produced by too
hasty  separation  of the placenta;  the  consequence is
generally a copious discharge of blood."—ib. p. 546.
  "Let us  beware  how we interrupt  the operation of
nature by rude and  uncalled-for handling."—Dewees'
Prac. Mid. p. 174.
  " Much mischief is  occasioned  by  the  method  too
generally  adopted immediately after birth.  A  child is
scarcely dressed,  when a  tea-spoonful  of castor  oil is
wantonly forced down  the throat;  or  a great  deal of
sugar and water, is given, for the  unnecessary  purpose
of purging away the dark  matter which collects in  the
large intestines during the last two months of its uterine
life.   We ought to be in no hurry in producing  the  ex-
pulsion of this,  matter, as if it were  a poison, the reten^
tion of which  would  carry death  to  the  vitals.   We
frequently see fatal bowel  complaints  produced by  this
cause, and it is no uncommon  thing  to discover that
drastic purgatives have been  employed.   Not long1 ago
I was called to see a  child, under a fortnight old, who
was taking half a grain of calomel and two of scammo-
ny twice a day, although it had  from fifteen to twenty
stools during the course of twenty-four  hours, notwith-
standing the exhibition of occasional doses of chalk mix-
ture.   In such  cases, the drastic purgatives are given in
the first instance  to'clear out the bowels,'and  after-
wards persevered in to 'improve the evacuations.' 
USE OF PURGATIVES.
391
  "Another cause of the bowel complaints of children,
proceeds from the absurdities constantly committed with
respect to their food.   Soon after the castor oil has been
exhibited, food is given, consisting of thick gruel, which
the  stomach is totally incapable of digesting; flatulency
is the  consequence; they  cry; Dalby's  Carminative is
resorted to for relief, which  produces  ease for  a time,
but  by  inducing constipation, which  renders   another
dose of castor oil necessary; this, in its turn, frequently
gripes.  This is  attributed  to wind in the  stomach and
bowels; and again, thick, indigestible  food is given, to
drive out the wind, which, in its turn, again  requires
Dalby's Carminative.   In this manner, the functions of
the stomach  and bowels are too often impeded,  and not
only impeded for a time, but the  children  are rendered
ever afterwards  liable to complaints in the  stomach and
bowels.
  "Daily do I see the advantage of pursuing an opposite
plan with new-born children.  I allow no laxative to be
given, unless an infant suffers from distension of the ab-
domen, which is to be ascertained  by examination."—
Mackintosh's Pathology, p. 219.
  "There is, oftentimes,  much  mischief  arising  from
over-purging newly born infants;  they not only require
very mild remedies, but proper doses of such remedies."
—Dewees' Sys. Mid. p. 216.
  " My friend, Dr. Parrish, and  myself, were called to
attend  a  child  ten  days  old.  It was  a  healthy  baby
when born, and  had had several sparing  stools, of a very
dark green  color; two tea-spoonsful of castor  oil  were
given in the morning.   Two more tea-spoonsful of cas- 
392
USE OF INSTRUMENTS.
 tor oil were given in the evening.   The child, however,
 gradually declined from our  first visit, and died on  the
 third day after."—p. 217.
   "Forceps  oftentimes become  very injurious to  the
 patient, by including, while locking, either  a  portion of
 the soft parts, or some of the capilli of the pudendum;
 thus creating a great deal of  pain.
   " It is, however, insisted that this objection can always
 be removed,  by  carefully  passing the finger  round  the
 lock; but this is a  mistake; for it is in the act of locking
 that this inclusion takes place.  Now, it is certain  that
 the  locking of the  instrument requires the use of both
 hands; consequently, we cannot pass a finger round  the
 locking  portion,  so as to extricate the soft parts, or
 capilli, if  included, or prevent them from insinuating
 themselves between the joint; as the hands, and of course
 the  fingers, are otherwise employed at this moment.   It
 is true, we may search for the included part or parts,
 before we commence extracting; but, to relieve  the  soft
 parts, would require  the separation of the blades to a
 certain extent, and this without any security that it will
 not happen again, when the  handles are again pressed
 together; and the capilli can  only be relieved, with  cer-
 tainty, by breaking them, which would be painful, or by
 cutting them, which is not altogether decent."—p. 278.
   " The proper application of the forceps, in each situa-
 tion of the head, has  ever  been considered an achieve-
 ment of difficulty.  It will be necessary, to the success
of the operation, that the  practitioner understand  the
construction and  mode of action of his instruments, and
 have, by practice, acquired  some facility in placing them. 
USE OF INSTRUMENTS.
393
It has been  considered  by Dr. Denman, as uncertain,
whether the art of  midwifery has been benefited  or
injured by the introduction of instruments into its prac-
tice.  That much mischief  has been  done by the ill-
judged, and worse conducted, application of the forceps,
I have had reason to know.   But it would be unfair to
charge all the mischief which  has followed the use of
forceps, to the ignorance of those who employ them; or
to the action of the  instrument itself—much  is justly
attributable  to  the views which  many celebrated men
have  taken of their necessity or utility, as well as the
rules  they  have laid down for their application.  A se-
vere probation awaits an upright and conscientious man,
upon his  introduction into  the practice  of midwifery;
for, if he be such, it will be  a long time  before he will
dare to flatter himself that he  can do what is best for
his patient."—pp. 282 and '83.
   [Some  of  the advantages  of using the  forceps,  are
illustrated  in the case recorded  by Dr. Dewees, p. 283.]
   " Dr. Denman, more perhaps than any other man, is
chargeable with  perpetuating errors in  the use of for-
ceps, because he is considered the highest British author-
ity upon the subject.  In his attempt at precision, he
has created confusion; and, in his  desire to generalize,
he has made  so many exceptions that his Aphorisms are
no longer rules."  [Really, what has  Dr. Denman writ-
ten that is  so very displeasing to the Professor  in Phila-
delphia?    Just  hear  the charge.]  "His  aversion  to
instruments, made him restrict their power to such nar-
row  limits, as to render  them  scarcely subservient to
the art; and  he reduced the cases proper for their appli- 
394
USE OF INSTRUMENTS.
cation to so few, and so peculiar, that they are scarcely
to be met with."—pp. 2S4 and '85.
   Here is the rub.  This learned Professor would  soon
be out  of business, if  the ladies  in the  United States
knew that the cases that call for the use  of instruments
are "so few,  and so  peculiar,  as scarcely to be  met
with."  American obstetricians are determined to make
the people believe that  it is necessary for them to exam-
ine and finger over every case, for fear that it should be
difficult, when not one in a thousand ever needs  their
assistance.   Dr. Denman, as well as  every other  high-
minded and benevolent  man,  has come very near the
truth;  but, alas, his opinions must be  opposed and con-
demned, lest they should become known to the discern-
ing people of this Republic, and our famous accoucheurs
should be compelled to seek a living in some other way.
But again, says Dewees,  p. 288, " Dr. Osborn carries his
reluctance to the use of forceps still  further than Dr.
Denman, but he has not done equal  mischief, because
his authority was not equal."  Refusing to do mischief
is  to do it, eh!
   "I was once called upon to determine whether  any
thing could be done for a newly born child, which had
been most unskilfully" [but scientifically, and by a reg-
ular M. D.] " delivered by the forceps.   The frontal bone
was severely indented  by the  edge  of the forceps; and
one eye entirely destroyed, by the extremity of the blade
being fixed upon it;  yet it was  born  alive.   The case
was, of course, a hopeless one;  and the child fortunately
died in a few hours after its birth.  I was once shown a
blade of the forceps, which had been  excessively bent, 
USE OF INSTRUMENTS.
395
by an endeavor to make it lock!  In  this case, the for-
ceps were exhibited  in  triumph"  [by whom?   Oh, a
scientific M. D.] " as a proof of the great difficulty the
operator had to encounter, in effecting the delivery; and,
as an additional  evidence of this, he declared that no
strength was sufficient to  deliver the head, as both  his
(and he was a powerful man) and that of another  prac-
titioner  [equally  ignorant,] were  unavailingly exerted,
alternately and collectively.  He at last  delivered her
with the  crotchet, after having experienced very great
difficulty in withdrawing the bent blade of the forceps.
I have seen the whole length, or nearly the whole length,
of the frontal bone cut  through  by one of the  sharp
edges of the forceps, by an  effort to  compress it; and,
in another instance, I have seen the parietal bone in  the
same wretched plight, from  the same wretched cause.''
—Dewees, pp. 293 and '94.
   " I was once called to a poor woman who  had had a
considerable  portion of  the internal face of the right
labium removed, by its having been included in the joint
of the short forceps."—Dewees, p. 299.
   " I am aware that many respectable practitioners are
in the  habit of introducing the  hand and bringing down
the feet, in all cases of breech  presentation; but  I  am
abundantly convinced that, as a general rule, it  saves
the mother nothing, and  that it is  highly dangerous to
the child."—p. 320.
   " In difficult labors, arising from a rigidity of  the  os
uteri, there is an unnatural resistance to  be overcome;
and to  effect  this, unfortunately, mechanical and other
equally improper means  are resorted to, which, so far 
396
UNNATURAL DELIVERY.
from fulfilling the intention in view, oftentimes increases
the very evil, and converts an otherwise safe labor (were
it properly managed) into  one  of great danger, or at
least into one of great tediousness."—pp. 354 and '55.
  "When  the  os uteri  remains unyielding for a long
time, it is an evidence that the natural processes, which
so beautifully, kindly and safely  effect the change, have,
from some cause or other, been interrupted.  And, though
mechanical force may be  made to usurp the organic func-
tion, it nevertheless will always be at the expense of the
health, or even the integrity, (be this more or less,) of
that portion of the uterus to which force is applied."—
p. 356.
  " I have lately been informed from very good authority,
(namely, a man to whom one of these  cases occurred,)
of the three unhappy instances  of error in forcing  de-
livery too soon, which happened some years ago to three
surgeons of established reputation, who, from  the  suc-
cess they had met with  in  delivering several who were
reduced to the  last extremity, were encouraged  to  at-
tempt it where but very little blood had been  lost,  (by
flooding) in hopes that their patients'  constitutions would
suffer less  injury, and  their recovery be more speedy,
which, till the experiment was made, was a very reason-
able  supposition—the  women  died, and they seemed
convinced that  their deaths were owing to the violence
of being delivered too soon, and not to the loss of blood,
or any other cause.
  "There appears to be  excited, at the  present time, a
passion for novelty in the treatment of uterine haemor-
rhage ; but no remedy or  means that has  hitherto reached 
HEMORRHAGE  OF THE UTERUS.      397
our knowledge, appears to have any decided efficacy in
themselves in arresting this discharge.  Both therapue-
tical and mechanical agents are anxiously sought after i
and each inventor of a new mode of fulfilling an old and
never-to-be-deserted principle, vaunts  his supposed  im-
provement with a confidence  that  almost bids defiance
to scepticism, until trial is made of its boasted powers;
it is then found to have no superiority over the remedial
agents already known, and heretofore relied upon.   In
all  these attempts it appears to be forgotten that the
only indication in a threatening haemorrhage, after the
delivery of the  child,  is,  to procure the  tonic  contrac-
tion of the uterus; yet, some of the means had recourse
to, are but illy calculated for this end.  Of this kind, are
•transfusions,' the 'filling of the  uterus with  rags,' the
' compression of the aorta," injecting the  umbilical vein,'
&c. &c.  And the therapeutical means, such as the intro-
 duction of vinegar, or the acid of lemons, have no other
 power, perhaps, upon the flaccid uterus, than as a kind
 of vehicle to the mechanical  agents, if we may so  ex-
 press it; and a variety of these  can  unquestionably be
 employed with at least  equal success without their as-
 sistance.
   "Messrs. Gorat, Evart, &c.  propose  the immediate
 application of the citric  acid  to the  internal surface of
 the uterus, with a view to arrest haemorrhage  after de-
 livery.   They  describe  this  method in  the following
 terms:  they strip a lemon of its skin, and then express
 the  juice on the sides of the cavity.   They allow the
 decorticated lemon to remain, until  the irritation pro-
 duced by the juice, and the foreign  body, excites the 
398      HEMORRHAGE OF THE UTERUS.

uterus to contraction, which, constringing the tissue of
that organ, stops the haemorrhage, and the lemon is ex-
pelled with the coagulum formed about it.
  " This is one of the late  improvements in  the treat-
ment of this formidable complaint, and  to  which we
have just alluded."—Dewees, pp. 410 and '11.
  "A woman aged thirty-two was taken in  labor with
her  first child, on the twelfth of February, 1825.  The
pains soon ceased, and, on the fifteenth, M. Bedel, phy-
sician  at  Schirmack,  was consulted,  who speedily de-
livered  her, with  the  forceps,  of a dead child.  The
haemorrhage was so considerable,  that he determined to
deliver the placenta immediately;  but the uterus  did not
contract,  and  the  bleeding  continued,  together  with
tremblings, syncope, cold sweats, &c.   Irritation on the
internal surface of  the uterus, cold water to the abdo-
men, injections into the uterus of cold water and vine-
gar,  were  unavailing.
  "Plugging the vagina, and also  the uterus,  were now
resorted to, as the only remaining means of safety.  The
uterus was filled with rags, for fear the patient could not
sustain  the  loss of blood necessary to fill the  cavity;
while  a methodic compression was at the  same time
made upon the abdomen.  This  is  another  instance of
attempting to  arrest an alarming  uterine haemorrhage
in a  new way."—pp. 412 and '13.
  [An instance is  recorded on pp. 436, '37 and '38, Edin-
burgh Practice, where the bladder was  opened and a hole
made into the rectum, by the force employed  to  hasten
delivery.  The woman lived forty years with a constant
dribbling of the urine, and in a most deplorable situation. 
            PUERPERAL CONVULSIONS.         399

The writer remarks " that the wonderful power of the
constitution to support life under the pressure of such a
train  of accumulated injuries, seems truly astonishing;
and that accidents of this nature, are  by no means un-
common.   [We saw a case in Virginia, have heard of
several in Ohio, one, in which  the urethra was  cut off
and  separated, so that  the urine passed  through. the
vagina!]  And what may not be expected from  an un-
skilful use of instruments?"
  I ask, how happened it that this " scientific accoucher"
was  unskilful?  If he could not  use them skilfully, who
can?  None!   None!!   None!!!

             Of Puerperal Convulsions.
  "This truly frightful  disease may attack a woman,
perhaps at any period of utero-gestation; but more fre-
quently after the sixth month.   The causes  assigned for
convulsions have been  various;  some have supposed
they arise from some peculiar  irritation of the  uterine
fibre  during pregnancy; others considered them  truly
epileptic;  while others regard them as  nervous or hys-
terical.
  " This difference in  views, necessarily leads to  a dif-
ference  in  treatment—the  first,  makes safety consist
alone in immediate delivery;  the second,  forbids this
practice; whilst the third relies  upon the use of opium.
  " To be  successful in  the  management of this  com-
plaint, it  is necessary that attention  be  paid  to the
species  of  the  disease with which the woman may be
attacked."—Dewees, pp. 452 and '53. 
400        PUERPERAL  CONVULSIONS.

   Here follow cases quoted at length from this  learned
Professor, which show the  practice as taught in the Col-
lege at Philadelphia:
   " Mrs.----, aged seventeen, pregnant with her  first
child,  complained on the  20th  of July, 1824, of slight
pains  resembling labor; and also, a generally diffused
pain, but severest in the limbs;  so  much so, in  these
parts,  as  to render her almost incapable of removing
them; some fever,  though slight.  Dr.  Shaw,  under
whose care she was, ordered her to be bled and purged.
29th, 3 o'clock, P. M. she was attacked with labor pains;
at first, they were slight;  but  had  much  increased by
the time the doctor was called.  Upon examination, the
os uteri was found a little  opened; at 8 A. M. she was
attacked with strong convulsions, which wTere repeated
about every twenty minutes.  She was bled about twenty
ounces; convulsions continued to recur.   At 10 o'clock
the same morning, the os uteri was pretty well dilated;
and, from a belief that  convulsions were at least main-
tained by  uterine distention and irritation, Dr. Shaw
ruptured the membranes, with a  hope of tranquilizing
them.
   At this time I was called in.  I found the  patient to-
tally insensible  to any sensibility  after the second fit;
breathing with much difficulty, and snoring pretty loud.
The pulse was full, frequent and hard, and the skin  hot.
Upon examining  per vaginam, the head of the child was
found at the lower strait, presenting with the posterior
fontanelle behind the left  foramen  ovale, and  entirely
within the  uterus—up  to this time, about thirty-five 
PUERPERAL CONVULSIONS.
401
ounces of blood were drawn.  She was attacked with a
fit soon  after examination.  There was something re-
markable in the character of the convulsions; her eyes
were  but little agitated;  the pupils  much  contracted;
her face was but little suffused;  there was less  frothing
at the mouth, and less sibilation  than is usual.
   " I  applied  the  forceps, and  delivered her in a  few
minutes without the slightest  difficulty.  She  remained
after  this for two hours without  a fit; at the expiration
of this time, they recurred about every half hour, until
9  o'clock,  P.  M. when they  ceased, but without  any
amendment in- the condition of the patient; she appeared
completely apoplectic.   She continued much in  this sit-
uation until 6 o'clock in the evening of the 31st, at which
time she died.  Leave could not be  obtained to inspect
the body.  She did not complain of  headache until the
29th, and this but a short time before she became con-
vulsed.   She lost, altogether, [only] eighty-two ounces
of blood; was freely purged, and once cupped."—De-
wees' Sys. Mid. pp. 457 and '58.
   Case I.—Mrs.----,  a delicate, small  woman, twenty-
three years of age, pregnant with her first child,  was
attacked on the 16th of November,  1809, at 8  o'clock,
A. M. with epileptic convulsions.  I saw her in an hour
after  the attack; previously to  my seeing her, she had
had three  fits, and a fourth was just coming on as I en-
tered the door.  Three or  four days • previously to the
attack,  she complained of a violent jaw  or toothache,
which was looked upon as rheumatic, and no attention
was paid to it.  On the 15th, that is, the day before her
illness,  she was seized  with an extremely  acute head-
              26 
402         PUERPERAL CONVULSIONS.

ache; and, during the night,and just before the onset of
the fits, she was violently sick at the stomach, and vom-
ited  a large quantity of  thick glairy mucus;  immedi-
ately after this,  she said she could not see, and was, in
a  few minutes  more,  seized with convulsions.    She
labored under these violent and terriffic symptoms in an
extreme degree.  I instantly bled her from a large ori-
fice in the  arm, thirty-five ounces; this, as I have just
said, was  at 9 o'clock,  A. M.  11  oclock, had  two fits
during my  absence,  and  was now in  the  third—bled
twelve ounces.  Ordered a  strong  infusion of senna as
an enema—os tincoe a little opened, but rigid.   1 o'clock,
P. M.; had two  fits since  last visit; injection operated;
pulse still active; face flushed; very restless and uneasy,
arising, I believe, from the pains in the uterus; os tincoe
rather more dilated;   to  be bled by cups  ten ounces.  4
o'clock, P. M.; one fit;  cups drew well;  senna operated
again two or three  times;  very comatose; ordered cold
applications  to  the head  by means of a  large  bladder,
partly with water and some  ice; blisters to  the  legs.  7
o'clock, P. M.; no fit since last visit; pulse very active;
very restless, constantly trying to get  out of bed; os
tincoe not much more dilated; took ten ounces of blood;
senna continued to   operate.  10 o'clock, P. M.; no fit
since last visit;  pulse still too active; took  ten ounces
more of blood; cold applications.  [Only seventy-seven
ounces of blood taken from a very ' delicate, small  wo-
man' in thirteen hours!]
   "  17th.—Mr.  Purnell, now Dr. Purnell,  one of my
pupils, staid all night with the patient.  He said she had
one  fit, after which he took ten ounces of blood; senna 
            PUERPERAL  CONVULSIONS.        403

continued to operate.  At  10 o'clock, A. M. I saw her;
stupor much less; recognized her friends, and asked some
questions;  she did not look  so well, a slight squinting
was observable.  7 o'clock, P. M. better; pulse  less ac-
tive; but had three stools since  the morning visit.
   "18th.—Mr.  De  la Motha,  now Dr. De la Motha,
another of my pupils, staid with the patient last  night.
She passed a good night, was tranquil  and  rational; no
return  of fits during the night;  two stools.   Saw her at
10 o'clock, A. M.; skin dry and hot; face a little  swelled,
but perfectly collected.  8 o'clock, P. M.; face  more
swollen, and a little  flushed; much  headache, pulse very
active; great thirst; took  ten  ounces of blood;  much
relieved by it; pulse softened, and diminished in  frequen-
cy; cold applications continued.
   " 19th.—Passed a good night, free from fever and pain;
no return of convulsions;  bowels rather tardy;  ordered
senna tea.   Continued much  in this condition until the
28th, twelve days from  the first  attack; this  morning
was seized with brisk labor pains, and was soon  deliv-
ered of a dead child.  From the degree of putridity, it
is  presumable that the child died early in, or before the
attack.  There  is by no means any certain proof that
the child died before this."—Dewees, pp. 457 and  '58.*
   [Only ninety-seven ounces  of blood taken in  three
days!  Really, what did kill the child?]
   Case II.—" Mrs.----,  aged  twenty-six  years,  preg-
nant with  her first child—a  large,  plethoric, robust
woman, was, on the 9th  of September, 1811,  about  5
o'clock, A. M. taken with labor  pains,  and sent  for  her
midwife;  before the midwife arrived, she was  seized 
404        PUERPERAL  CONVULSIONS.

with  terrible convulsions, and I was immediately sent
for.   The fits were frequently repeated, and were, from
their  extreme violence, very threatening; her face was
immoderately  swelled;  her eyes fairly protruded  from
their  sockets;  her  tongue terribly  wounded, &c.   I
instantly bled her from the  jugular vein more than forty-
eight  ounces; examined her and found labor approach-
ing; ordered a brisk injection; saw her two hours after;
had  had several severe fits; pulse  extremely  active;
labor  advancing;  bled  her  twenty ounces;  injection
repeated; a stream of cold water was poured  on her
head during the interval of the fits.   11 o'clock, A. M.;
fits not  so severe, but pretty frequent; pulse  still very
active;  took [only]  sixty-four  ounces of blood more;
apparently much relieved;  lay  more  quiet.  1 o'clock,
P. M.; had had two or three fits; very restless; mourned
every few minutes; desirous of getting from  the  bed;
bled her twelve ounces; examined, and found  the  head
low in  the pelvis, and  delivered with  the  forceps; she
had two or three fits after delivery, and remained insen-
sible  to  every  thing for forty-eight hours.  She  now
began to show some signs of returning sensibility; was
bled twice in the interval—[How much,  doctor? sixty-
four ounces each time?]—cold was applied  to  the head,
and legs blistered; she was purged freely with senna
tea.   After  this  she gradually recovered her  senses.
She was left completely blind for two weeks; she then
began to see imperfectly, but was six weeks before she
could distinctly discern objects.  It may not be amiss to
observe, the child was still  living!"—pp. 459 and '60.
  [Does any one wonder that the doctor was  surprised 
PUERPERAL  CONVULSIONS.         405
to find the child living?  If nature can endure this, what
can  she not withstand?   Fits are efforts of nature  to
recover from prostration; is it  any wonder  she should
make them as long as she is able, and cease them wiien
all her strength is exhausted by bleeding?  No; but it is
a wonder that she could so often recover after the exer-
cise  of this barbarous practice!]
  Case III.—" Mrs.----was seized at 1 o'clock, P.  M.
November 10th, while at  the ironing table, with vertigo.
She  fell, and was immediately attacked with convulsions.
I was living near, and was instantly sent for.  I found
her laboring under the general symptoms of this disease.
I bled her from both arms  at once, to the  amount of
about sixty-four ounces.    She appeared, for a time, much
relieved;  that is, the  convulsions were abated.  An  in-
jection was ordered, which operated well; about an hour
after the bleeding, her pulse rose very much; her breath-
ing was more labored and stertorous, and some convul-
sive  twitchings  over the body.   Fearing a repetition of
the convulsions, I again tied up the arms, and took about
twenty-five ounces more  of blood; this seemed to mod-
erate the  symptoms!
  " 4 o'clock, P. M. the convulsions were renewed with
considerable  violence; twenty  ounces more of blood
were taken; cold water was poured upon the head;  she
was  more tranquil, but not less comatose.   6 o'clock, P.
M.;  had had several fits, but [for want of power] not so
violent as at first; pulse still  too active; took  eighteen
or twenty ounces of blood.   As the pulse was consider-
ably reduced, applied a pair  of blisters to the legs,  and
sinapisms  to the feet.  [Really, after taking  one hundred 
406         PUERPERAL  CONVULSIONS.

and thirty ounces of blood in the space of five hours, I
should think it would do to begin to warm the feet with
a mustard  poultice.]  At 10 o'clock  she was sick and
made an effort to vomit.  At 6  o'clock next morning I
was  suddenly called, as her breathing  was becoming
more laborious and  loud, and face more  flushed, with
some convulsive agitations; pulse rather  too  active;
took ten ounces of blood and applied a large blister plas-
ter between the shoulders.  She gradually recovered her
recollection, but remained until some  time after the de-
livery (one  month after) with imperfect vision, especially
with one eye.   She was, for many years  after this, sub-
ject  to  violent headaches, which must be removed  by
bleeding."   [The cruel practice that first  caused them.]
—ib. pp. 461 and '62.
  Case  IV.—"Mrs.----, October 1st, 1803, had  been
in labor several hours; she had every  appearance of be-
ing happily delivered, when, during  a strong pain, she
instantly cried out ' my head!' and immediately fell into
convulsions.  She was under the care of  another^ physi-
cian, to  whose aid I was  instantly called  by  his own
desire;  the convulsions were strong and often repeated;
she was largely bled;  on examination,  the child was
found to be  far advanced, and was speedily delivered by
the aid of forceps; the convulsions, however, continued
in spite  of every exertion to relieve them, and she died
in  about three or four  hours  after  the  attack."—ib.
p.  462.
  [I am astonished, Dr.  D. that a man so accustomed  to
use the  lancet, with  an assistant equally skilled, should
let a woman  die  because he could  not  let blood fast 
           PUERPERAL CONVULSIONS.        407

enough to save her life, when he had three or four hours
to do it in.  Why did you not  open both jugular veins,
and " tie  up both arms" and open their veins;  and, if
that was not enough, you should have opened the carotids
and brachial  and femoral arteries, and then, it appears
to me, you might have let blood enough to save her life,
as you  assert that blood-letting is " the cure for convul-
sions."   If your theory is true, and  your statement is
correct, it follows that this woman died because  you
were too  indolent to let  blood fast enough to save her
life.  You should have cut her  head off, if you could
not have let blood fast enough  without, rather than  had
her die in your  hands, because you were afraid  to act
according to your principles in blood-letting.]
   Another Case.—"I was called on the  16th of April,
1810, to Mrs.----, said to be  in strong convulsions.  I
was from  home when the messenger  came, but went as
soon as it was in  my power.   When I  went into the
sick  chamber  I  found Dr.----  with the patient.   He
told  me ' Mrs.----had been attacked about two hours
before with convulsions, and was in the ninth month of
pregnancy; that, previously to  the  attacks of the  fits,
she had complained of violent pain in the forehead, which
she told her husband she could  cover with her  finger.'
She was now  lying senseless and without motion on the
bed; she  breathed very heavily, and snored loudly; the
pulse frequent and small, and the extremities cold.  I
enquired what had been done, and was informed by Dr.
----, he had given her, twice, sixty drops of laudanum
at a  time; and that, since the last dose, she had  had no
fit, and was, in his opinion, very much better, requiring 
40S        PRESENTATION OF THE ARM.

nothing but sleep to restore her.  I told him very plain-
ly, that I thought he  had mistaken the patient's case,
and  had, in my opinion, sealed her fate  by the use of
laudanum.   He  appeared  alarmed, but not altogether
convinced.  We did every thing that we thought might
be useful, but all exertion was unavailing, and  the  pa-
tient died in about  three hours."—ib. pp. 463 and '64.
  [All the convulsions, in all the foregoing cases, might
have been relieved by a few doses of the third  prepara-
tion of lobelia, and  the patients soon cured.]
  "Examinations of women who  have died during la-
bor, or soon after delivery, are not  so  frequent as their
importance  seems to  demand."  One of the principal
reasons why they are not more frequent is to be attribu-
ted " to the disingenuous conduct of the attending physi-
cian himself,  who may not wish the  cause of death to
be ascertained, lest it should do injury to  his character,
either from his not having known or suspected  the  true
one, or by exposing some lesion for which he  fears  he
would be held accountable."—pp. 465 and '66.
  "It is almost universally believed that an undue force
applied to the cord, for the delivery of the placenta, is
the principal cause of the untoward, and too fatal acci-
dent,  the inversion of the uterus."—p. 469.

             Presentation of the Arm.
  " There is no presentation that gives rise to so much
bad practice as the  presentation of the arm; for its me-
chanism is generally but very illy understood.  The arm
itself, is almost constantly supposed  to offer great diffi-
culties, by its  presence in  the vagina; hence it  has been 
        PRESENTATION OF THE  ARM, ETC.     409

scarified, twisted off, or amputated, to the disgrace  of
the profession.   It is true that, in most instances, these
severe operations  have been performed after the  sup-
posed death of the child; but, in many other cases, we
fear that the life of the child  has  not been  taken into
consideration.  In arm presentations, the amputation,
or other operations upon it, should always be' forbidden ;
especially as the signs  of death are, in many instances,
equivocal, as  the  evidences of  life  are obscure.  Dr.
Chapman relates an instance, where an accoucheur am-
putated the  arm on the presumption that the  child was
dead;  it was, however, alive, and  lived  to  manhood.
And, more recently, a  surgeon was sued for amputating
the protruding arms of a child, which he supposed had
been long dead, but proved to be alive.
  " It is, therefore, best not to meddle with the descend-
ed arm; for, if turning be attempted, it offers no diffi-
culty to the  passage of the hand."—pp. 508 and '9.
  "As  regards turning, it must not  be disguised,  that  it
is  an operation of hazard to the child, even  under the
most favorable circumstances of the uterus or position  of
the child; and, of  course, the risk will be in  proportion
to the departure from the best conditions."—p. 515.
  " During labor, the uterus every now and then is rup-
tured; and, perhaps, even oftener  than  at present we
dare assert.   Sometimes this accident is concealed, from
ignorance, and, at other  times, from design;   hence,
many cases  must occur of which the public remains un-
informed.  Concealment often arises from a previously
adopted theory upon the subject, and the supposed risk
of professional reputation."—p. 535. 
410
USE OF FORCEPS.
  " It must, however,  not be concealed, that these in-
struments (forceps) are not safe, under the circumstances
we are now considering, (a deformity of the pelvis,) but
in the hands of a few; and are only rendered so to them,
by their superior professional attainments, and  the  long
habit of using them.  To the inexperienced practitioner,
they  should  be entirely forbidden;  not only because
they may destroy the child, but also because the mother
may be severely or irreparably injured by  their use."—
p. 552.
   [It seems, then,  that  those do  not know how  to use
the forceps "scientifically" who  have not been  in the
habit of  killing  people with  them, by way of acquiring
skill " in  their  use!"   Who are  the  victims of this
quackery ?  The poor deluded patients who have resorted
to the hospitals and the alms houses, and others who are
the first subjects of every upstart doctor's obstetric skill.]
   "The most  difficult  operation  on the living subject,
is the scientific application  of  the forceps, when the
head  of the child  has  descended  so  low as to occupy
the vagina.
   " How much greater eclat  do most of the operations
of surgery obtain,  than a delivery by forceps !  Yet we
do not fear, nor do we hazard a contradiction when we
say, there is no operation in  all  surgery, that is not  of
more easy attainment than the rational and just appli-
cation of the forceps.  We feel  that it • is  proper  that
some delicate effort should be made to elevate the  char-
acter of the well instructed accoucheur, and to have a
just value set upon the most difficult operation in the
range of  medical science."—p. 555. 
          FORCEPS--SEC ALE CORN UTUM.      41]

  [It is doubtless best to  have a law passed that only
one  in  a hundred gentlemen of the  faculty shall ever
use this scientific instrument; that he  be called to every
case in which nature is a little  tardy, and receive from
ten to five hundred dollars, " according to the ability of
the patient," for bruising the head, lacerating the labiae,
or tearing out the capilli, &c. &c!   Dr. D. should be
made President  of this  company of "celebrated  ac-
coucheurs."]
  " The  too implicit reliance upon certain  of the signs
which are said to characterize the death of the child in
utero,  has been the cause  of  the immolation  of thou
sands."—p.  614.
  "We may with much truth declare, that  the inertia
of the uterus is very apt to follow the use of such stim-
ulants as opium, oil of cinnamon, volatile alkali, &c. or
the mechanical  stimulus  of  the  forceps, vectis, or  the
hand.  Thus we witness haemorrhage sometimes follow
the use  of  either of the  remedies just named, though
they may have been successfully exerted, as  regards  the
mere delivery."—pp. 615 and '16.

                 Secale  Cornutum.
  " More children, I am satisfied  from what  I have seen
and heard, have  already perished  by the injudicious  use
of ergot, during  the few years which have followed its
introduction into the practice of this country, than have
been sacrificed by the unwarrantable use of the crotchet
for a century past."—p. 621.
  "We have known the 'ergot' given where the pains
were natural and powerful, to render  them  more effec- 
412
IMPROPER TREATMENT.
tual, when the uterus became exhausted by being  thus
unduly urged; and the only resource ultimately has been
in the forceps."—p. 625.
   "The  too  free  use of the 'ergot' in a certain physi-
cian's practice  in this  city, has  occasioned very many
cases of prolapsus uteri."—Dewrees, p. 626.
   " Contusion, laceration, sloughing, decapitation, dislo-
cation, fractures—these are the dreadful evils to which
brute force may give rise."—Blundell, p. 185.
   "Elizabeth Clark, aged thirty, was delivered (scientifi-
cally) and soon after complained  of sickness, and had  a
slight vomiting;  but by means  of an  anodyne, these
symptoms  abated, when she was immediately  affected
with universal coldness  over the whole body, which also
abated by the  application  of warm irons  to  the  feet.
Next morning, at 2 o'clock, she complained of consider-
able pain, for which she was  bled, and an  injection ad-
ministered, but -without effect,  for  her  pain increased;
pulse became frequent;  she was hot, and complained of
drought.  At 7 P. M. same day, the injection was re-
peated, but with no better success; eight  ounces more
of blood were  taken from  the arm; a third injection
given, which  also failed  to  evacuate the foeces, and the
pulse rose to  one hundred and twenty-eight.  Her pulse
being fuller at noon, she was bled again.   At  3 P. M.
her pulse rose to one hundred and forty.  She was much
oppressed, and complained  of faintishness,  but the  pain
still- increasing,  twelve ounces  of blood  were taken
away.   At 8 P. M. her pulse was small  and  feeble, she
looked ghastly, and soon expired."—Ed. Prac. pp. 452,
"53 and '54. 
IMPROPER TREATMENT.         413
  Thus, in the space of eighteen hours, this delicate lady
was bled largely four times, had five injections adminis-
tered, took medicine constantly at "short intervals," and
was in constant suffering, until death closed the dreadful
scene.   She had a long and tedious labor, and was great-
ly fatigued, and this is  merely the  closing scene.   Now
what was the  cause of her  death?  Her  long, tedious
labor, or the treatment  after  parturition?  What  lady,
setting aside the weakened and exhausted condition  of
the individual in  the above case, could bear  four  large
bleedings, and  five scientific injections, besides  quanti-
ties of poisonous drugs, in the short space  of 18 hours?
   " I was called," says Dr. Smellie, " to a woman who
was above  eight months  gone with  her  fourth  child,
when  she  was taken with a violent flooding, which al-
most filled her chamber pot.  When I came, the flooding
was stayed, she was easier and not much weakened.   I
told her friends of the  danger to which she was exposed,
if the flooding  returned, and exhorted them, in that case,
to send for me immediately.   In the mean time I ordered
ten ounces of blood to be taken from the arm!"  The
flooding returned,  (of course,) the doctor was  called,
when, he says, "I could scarcely distinguish the pulse;
 her extremities were cold; a cold sweat spread all over
 her face and breasts, and she  could scarcely speak.  I
 immediately ordered a cordial, and gave her  some warm
 red wine.   Her blood  vessels were  much emptied.   I or-
 dered ligatures above  the  knees and elbows, and warm
 cloths and bricks to her feet.   All these steps were  ta-
 ken in order to recover  her  strength  and spirits; but, 
414
IMPROPER TREATMENT.
before  my directions could be put in practice, she  ex-
pired."—ib. pp. 463 and '64.
  " Treatment of Elizabeth Thompson, aged thirty-two,
after she had endured much suffering, and been delivered
' secundum artem.'  After she was delivered, on Monday
night about 10 o'clock, an opiate was administered, after
which her pulse beat 100 strokes in a minute.   On Tues-
day three grains of calomel, and one of purified opium
were given; pulse 108.  Wednesday  at 7 A.  M. pulse
120; five grains  of calomel were ordered.   At 4 P. M.
pulse 144; half an  ounce of castor oil was  given, and
an injection given in which were two drachms of tobac-
co.   At 9 P. M. same evening, her pulse was 140; five
grains  of calomel and one of purified opium were  or-
dered, and a blister applied to the abdomen.
  " Thursday,  7 P. M. pulse  150.  Till  then  the anti-
phlogistic regimen had been pursued; now  a stimulating
one was adopted.  A  suppository of soap  was  ordered.
At 2 P. M. her pulse was 160; ten grains  of hartshorn
and ten grains of musk were ordered, and were to be
repeated in four hours; soon after which her pulse was
exceedingly weak and feeble, and she soon  died.
  " Post mortem examination revealed gangrene in  the
cervix  uteri, and  the  physician  gravely concluded that
was the cause of her death!"—ib. pp. 468  and  '72.
  I  think any young lady would have  the  gangrene
somewhere, if she should  submit to  such treatment  for
three or four days!  The above course is recommended
as scientific by the first accoucheurs in the  wrorld, and as
a rule to direct the student in medicine. 
           SCIENTIFIC SPECIMEN, ETC.        415

A  Scientific Specimen  of  the way to  make  Puer-
                   peral Fever.
  "All women, during, and  immediately  after delivery,
lose  more or less  blood, from  the quantity  of  half a
pound to that  of a pound, or even two; but, should it
exceed this, the patient is in great danger of her life."—
ib. p. 528.
  "A lady  aged twenty-eight, and  of a delicate habit of
body, was delivered on the 7th of July.   The birth was
not attended with any dangerous or uncommon circum-
stance.  She was easy after delivery and rested well at
night.  The next (8th) day she complained of headache,
which was not  relieved.   9th, headache worse, with
acute pain  in her right side; and, in the afternoon, there
was great internal heat  across the  breast and stomach,
with coldness of the extremities.   Her pulse was exceed-
ingly quick, headache violent, tongue white and dry, &c.
Half an ounce of blood was taken away, and antimo-
nial powders  given,  and ordered to  be repeated.  A
clyster wras administered, and bladders of warm water
put  to her  sides and the soles of  her  feet.   There was
no abatement of the pain  that night."  [No wonder,
doctor, after you had taken from this lady, of " delicate
habit of body," half a pound of blood, and poisoned the
remainder  with antimony.   But let us see what must be
done next.]  "10th, pulse full, hard and frequent;  skin
dry, and respiration difficult and painful.  Half a pound
of blood was  again drawn, antimonial powders repeated
every four or  five hours, and a blister [of poisonous can-
 tharides] applied.   She  was ordered to drink plentifully
 of common emulsion with nitre!"  [Well, doctor, how 
 416       scientific specimen,  etc.

 did  she  rest after  this kind treatment?]   "She had no
 sleep that night."
   11th.  [Is  she not  easy and well this morning, doc-
 tor?]  "Pain  in the head, and difficulty  of breathing
 still increased."  [What next?]  " Nearly another  half
 pound of blood was taken.   At this time she  began to
 be  troubled  with  cough,  was  much oppressed with
 phlegm, and expectorated with great difficulty.  Saline
 draughts, emulsion  of  nitre, clysters, &c. repeated.  At
 night all the feverish symptoms returned with violence.
 She was again bled as before."  [A pretty day's work
 for a " delicate lady," I think.]
  "12th.  A  little  better in the  morning; but  in  the
 afternoon the  pain returned, with difficulty of breathing,
 for which she  was again bled."—pp. 569 and '70.
  Now,  doctor, you have,  yourself, taken  more than
 two pounds of blood  from a "delicate lady," after all
 she had lost in parturition, which you say is always from
 a half to two  pounds, at the utmost,  and that, should
 more than  this quantity be lost, the " patient is  in  the
 utmost danger of her life."   How shall I  reconcile such
 statements with the treatment?  If  I believe vour first
 statement, I must believe that all this suffering, pain  and
 distress was caused  by your abominable treatment.
  " In the Westminister new Lying-in Hospital, between
 the 30th of November and  15th of  May, 63 women
were delivered, 19 of whom had the child-bed fever, of
which number 13 died."—p. 577.
  The reader may wonder why I give so much testimo-
ny from the professors in Edinburgh, London and Phila-
delphia.  I answer,  because these colleges are the three 
               laxative bitters.           417

points  from which  radiate the principles and practices
of medicine that  govern  the  conduct of practitioners,
wherever the English language is the vehicle of thought.
If such be the practice of these great professors, what
must be that of their satellites?   Have I not redeemed
my pledge; viz.  to give such a specimen  of medical
iniquity in  obstetricy, as  to  deter from  a regular pro-
cess, every sensible lady in the land?   Still the stock of
materials is scarcely broached!
   Many of the above extracts are condensations of more
prolix  accounts, by the omission of unimportant matter,
to bring them within  our space; but no injustice has
been done to the  authors, as may be seen  by reference
to the  original works.
            LAXATIVE  BITTERS.

   Cayenne, Nervine,  Bayberry, Poplar, Golden Seal,
Balmony, Bitter Root,  Boneset,  Slippery Elm, equal
quantities,  all  in powders,  mix  well.  A tea-spoonful
every night is calculated to keep the bowels free.  When
not sufficient to  produce  this effect, increase  the Bitter
Root, Boneset and Golden Seal.   If very costive, or the
liver torpid, add powdered lobelia seed.  It may be ta-
ken in a little  cold water or molasses, or may be pre-
pared in hot water, and suffered to cool and then drunk.
Or half as much powdered  sugar may  be added, and
then it can be  eaten dry, which is an excellent way.  If
a little Bitter Root be added to the common  Spice Bit-
ters, the mixture will answer well for this purpose.  But
             27 
418
LAXATIVE bitters.
the best article to keep the bowels  open is  unbolted
wheat bread.
  Physic.—There  seems to be much diverisity of opin-
ion among our botanic friends about  the  propriety of
using physic in any case.  As is usual with enthusiasts,
the champions on each side lean as far from those on the
other as their rope will let them.  Some say that physic
is poison and death; others say that catharsis is  one of
nature's most common modes of removing disease.  For
myself, I believe that the truth is just about midway be-
tween them.   Spontaneous purging  is quite as common,
and, therefore, quite as natural, as  spontaneous  vomit-
ing.  I never give  cathartics merely to open the bowels.
I always prefer enemata.   Nor do  I give them to clear
the stomach—I much  prefer emetics.  But  I  now and
then find a case in  which, after  the  stomach and lower
bowels  are well cleared, there seems to be a want of
action in the middle region, expecially in the liver.  The
above compound takes hold of this  inactive  part.  The
bitter root, boneset and lobelia  relax the  parts;  and the
cayenne and the bayberry stimulate them to action, and
keep up the determination to the surface, and  most of
the articles  furnish the bitter principle  to correct the
bile.  Cayenne itself  produces,  in most cases, all the ac-
tion that is  necessary on the bowels.  Though  I have
seen much good done by butternut  physic, yet, in  gen-
eral, I prefer emetics  and enemata.   I  have given very
few compounds in this book, because I wish the reader
to study the principles so well that  he  can make up at
any time, something to suit  the case, whether he has all
the articles  or not. 
RECIPES.
  Conserve, or Woman's Friend.—To a pound of fresh
blossoms of holly-hock, well bruised in a  mortar, add
four pounds  of  powdered  white  sugar,  pound  them
together till  well mixed;  then add of  poplar  bark,
bayberry, golden seal, nervine, cloves  and cinnamon,
each 2 oz.; cayenne, 1 oz.; and bitter root, \ oz.; oil of
pennyroyal a table-spoonful, mix and knead in a mortar
till  it becomes thick like dough.  If too  soft and moist,
add more poplar and golden  seal; if too dry, more holly-
hock flowers, which  should always be  carefully cleared
of worms or bugs, calyxes or dead  petals.  Roll it  out
thin, and cut it into cakes  to dry.
  This  is a valuable stimulant and tonic, to  be  used
whenever these  effects are  wanted.  As  the  taste is
agreeable, patients will be quite willing to take  it.   Slip-
pery elm mucilage will answer when holly-hock cannot
be obtained.
  Cough Powders.—Hoarhound, golden seal, unicorn,
skunk cabbage, boneset, bayberry, nervine, 4 parts each ;
cayenne, cloves and cinnamon, 1 part each; lobelia seed
? part;  loaf sugar 12  parts, all in powder.  Mix  to a
thick dough with mucilage  of slippery  elm, holly-hock
blossoms or comfrey root.
  Cough Syrup.—See- cough powders—The best  thing 
420
RECIPES.
for a cough is, first, a course of medicine, and then close
attention to the action of the surface.  This directs the
determination from the lungs, and leaves them to recov-
er, but  for present  relief,  the  cough  powders  may be
made into a syrup.
   Composition.—2 parts bayberry, 1 part ginger, 1 part
golden  seal,  l-16th  part each  of  cayenne  and cloves.
Shake together in a corked bottle till well mixed.   Dose,
a tea-spoonful, sweetened to the taste.
   Other canker medicines may be used where bayberry
cannot be had.  The red leaved sumach bark and leaves
are excellent.
   Spice Bitters.—Poplar bark, golden  seal, balmony and
boneset, equal parts, cloves \  part, all in powders, mix
and sweeten  to  the  taste.   Dose, a tea-spoonful, to be
taken in cold water.
   Cholera or Dysentery Syrup.—Equal parts of pop-
lar, bayberry, golden seal and hemlock, boiled, strained
and pressed,  then boiled down very strong and added to
the same measure of powdered loaf sugar.
   Another.—Grape root bark, (common sloe,)  root of
geranium maculatum, (crow foot,) root of running black
berry briar, equal  parts, decoct, strain, and sweeten as
above.  After an  emetic or  two,  and the vapor-bath,
these preparations are a sovereign cure for cholera, dys-
entery, flux,  summer .complaint, &c.  and  children like
them.   Blackberry, raspberry and grape jelly (not  the
seeds,)  are excellent food, as well as medicines, in these
cases.
   Eye  Water.—A weak decoction of willow bark, (yel- 
RECIPES.                  421
low ozier,) or white maple bark, after  the inflammation
has been removed by a poultice of slippery elm, cracker
and a little lobelia, or a course of medicine.
   Tooth Powder.—Fine bayberry  and golden  seal,
equal parts, or fine powder of sumach leaves or bark, or
of yellow poplar.
   Stimulant Bitter.—The bark of the  root  of Ptelea
trifolia, or prairie grub.  Also, prickly ash bark.
   Worm Syrup.—Take the  most  intense of our  bit-
 ters, as bitter root, butternut, boneset, poplar, balmony,
 meadow fern, &c. and make  a decoction, strain, press,
 and boil down  pretty strong.  Add as much loaf sugar.
 After cleansing the  system  with courses,  take  on an
 empty stomach, and drink  freely  of slippery elm tea.
 Many things are recommended for worms,  but  no spe-
 cific is yet found.   A strong tea of  peach  bark, leaves
 or flowers, is good, and we have used a tea of the leaves
 of the pride of China with success.   We have also  cut
 them to pieces by giving a powder of burnt corn cob m
 molasses.   Wormseed  oil or spirits  of turpentine, in
 tea-spoonful doses, often cures.   But we generally give
 courses and use the above syrup, and we have failed in
 but one case, and  that was  a consumptive, given  over
 by three M. D's. before we saw it.  A medicine that
 will kill all worms and not  injure  the patient, we  fear
 is not known, though  our  course  of  removing them
 alive, by emetics, injections, and  the above syrup, is
 pretty sure.
    Balsam of  Honey.—Simmer one part of Canada bal-
 sam, balsam of fir, with three parts of  good honey.
 Dose, a tea-spoonful on  an  empty stomach, for healing 
422
RECIPES.
 internal sores.   Also for application to external swellings
 or wounds.   Mucilage of  slippery elm alone is good for
 internal sores and inflammation.
   I have avoided here  the use of alcohol  in  all cases,
 believing that it is unnecessary, as well as injurious.   A
 pound of gum myrrh, bruised with an ounce of bayber-
 ry or poplar bark, and an  ounce of cayenne, mixed, are
 as good to take on the stomach as No. 6, and in no way
 objectionable.
   Elder Salve.—Make a strong decoction of the green
 bark of the  sweet or white pithed elder, add six parts  of
 mutton tallow and beeswax, and one of balsam  of fir,
 simmer till done sparkling and  box up for use.   If too
 hard add a little more tallow  and  balsam, if too soft add
 more wax and a little rosin.   This is an excellent heal-
 ing salve.
  See stimulating and antispasmodic liniment.
  Spiced Bitters.—4 parts each poplar and golden seal,
 6 parts bayberry, 2 parts each prickly ash and cloves,
 3 parts each unicorn and nerve powder, 1 part cayenne,
 16 parts loaf sugar, all finely  pulverized and well mixed,
 make good spiced bitters.
  x\menorrhcea.—Give a course of medicine and equal-
 ize  the circulation  and the  nervous  action,  dress  the
 lower extremities warm, and drink a strong tea of spear-
 ment, rattle  weed, (macrotrys racemosa,) or of maiden-
 hair, (adiantum pedatum,)  or  of motherwort, (Leonurus
 cardiaca,) with ginger or polygonum  punctatum.  The
 bath should  be frequently  repeated, and the spiced  bit-
 ters, or the conserve, should be taken three or four times
a day.  Nothing should be used  to promote  the men- 
RECIPES.
423
strual secretion that  does not favor the  general health.
If a specific could be found for this defect, it would  not
always be good to prescribe  it, as  it might sometimes
produce abortion.
  Costiveness.—First—Eat unbolted wheat bread,  ripe
or stewed fruits, and now and then a little molasses, and
bathe once a week.
  Second—Always attend to the requirements of nature
when they are made on you, and invite them  by walk-
ing,  champooning and brushing  down the abdomen,
when they are not made; and  live an active life.
   Third—Use enemas of weak composition, and a little
lobelia, capsicum and slippery elm.
   Fourth—Take, when needed, a  pill of poplar, golden
seal, bitter root and  balmony, rolled in boneset or  but-
ternut extract, or moistened slippery elm or gum arabic.
   Fifth—When none of the above means succeed, drink
cold  boneset tea, or take a tea-spoonful  of  leptandra
 virginica in  a cup of hot water  sweetened; and aid it
 with an enema  of  weak composition,  lobelia and  slip-
 pery elm.
   Sixth—Fon Infants.—A strong tea of dwarf (white
 pithed) elder berries or bark, sweetened with molasses.
 It will prove emetic when  the stomach is foul, and after-
 wards it will loosen the bowels.
   Cough or Hoarseness.—Scrape a hole in the top of a
 turnip, fill it with a dessert spoonful of honey, and bake
 it in a plate in the oven or stove.  Dose, a dessert spoon-
 ful  every half hour after  a  bath, till relief is  obtained.
 At  the  same time wear round the neck a flannel band-
 age dipped in a strong vinegar decoction of capsicum. 
424                  RECIPES.
  Swelled or Sore  Breasts.—Bruise  elder leaves, Or
wilt them in hot water, and bind them on.
  Or, stew wormwood and hops in vinegar, and thick-
en  with  wheat  bran, or  corn  meal and slippery elm,
and apply.
   Or, make a poultice  of pond  lilly,  iris versicolor,
marsh  mallows,  purslane, any  or  all, and lobelia and
slippery elm, and apply it.
  Or, use bread and milk and lobelia.
  Or, mix powdered camphor with hog's lard, and apply
it on leather.
  Or, make one of yeast and unbolted wheat flour, and
sprinkle on camphor.
  Dysuria or Strangury.—Drink a strong tea of poplar
bark, clivers, water mellon seed, pumpkin seed, queen of
the meadow, potentilla, (five finger,) peppermint, spear-
mint, asparagus root, cedar bark, elder  bark, &c.  See
diuretics  in Lee. Med. Science.
  Sore Nipples.—Wash them  with raspberry tea and
apply the healing salve on a piece of leather.
  Healing Salve.—To a  strong  decoction  of dwarf
elder bark, add half as much mutton suet and fresh un-
salted butter or sweet oil, and for  each  pint  thus  pre-
pared add a piece of rosin and  of beeswax as  large as
a small hen's egg, and a desert spoonful  of Canada bal-
sam.  Simmer  all together till perfectly incorporated.
Let it cool and  put  it into  tin  boxes.   If too  stiff, add
more butter or  oil;  if too soft,  add more  beeswax and
rosin. •' Apply on a piece of leather.
  Nerve Ointment.—To a vinegar tincture of lobelia,
cyprypedium, add as  much goose or neat's foot oil, and 
RECIPES.
425
simmer away till  done sparkling.  Or rub with  oil of
hemlock, of origanum or monarda.
   Liniment for Contracted Muscles.—Oil  of monar-
da, (horsemint,) 2 oz., sassafras  3, wormwood H,  tur-
pentine 3, neat's  foot  3,  gum camphor 3.  Mix  and
apply.

          DR. A. C. LOGAN'S  RECIPES.
   Opodeldoc  for Sprains, &c.—White Spanish soap,
shaved  in very thin flakes  10 oz.; gum camphor 2 oz.;
oil origanum, oil amber, oil rosemary, each  4  drs.: oil
turpentine 1 oz; oil monarda, oil  sassafras, each 4 drs.;
oil wormwood, aqua ammonia, each 2 drs.; alcohol 2 qts.
Mix, put in a  sand heat, shaking it frequently; or set it
in the sun from five to eight days in the summer.
   Stimulating Oil and Embrocation for  Paralysis,
Rheumatism, &c.   (The oil must  be  used first, then the
embrocation.)
   Oil.—Oil British 24 oz.;  oil  amber 4 oz.;  oil  spike 6
oz.; oil olive 4 oz.;  tincture capsicum 2 oz.   These arti-
cles to be  diluted one-half with neatsfoot  oil when used.
   Embrocation.—Oil hemlock. 2?  oz.; oils winter-green
and cinnamon, each li oz.;  oil lemon 1 oz.; oil origanum
2 oz.  Mix.  These articles to be  diluted one-half with
whiskey when used.
   Embrocation for Sprains and  Lumbago, Rheuma-
tism, &c.—Pulv. sal. ammoniac 1 oz.; spirits hartshorn
4 drs.; spirits  lavender, (or better) oil spike 4 drs.; oil
turpentine i pt.  Mix.
  Bleeding at  the Nose.—Pulv.  bloodroot 14  ozs.;
witch hazle 2? drs.; geranium  maculatum  1  dr.; cloves 
426
RECIPES .
•A dr.  Mix.  Snuff a small pinch, or blow into the ru^e
slightly with a quill.  [T~P Blood root alone, will do ; so
will witch  hazle.
  Tonic  and Alterative  Pills.—Pulv. green lobelia  I
tea-spoonful; pulv. nerve powder 2 tea-spoonsful;  pulv.
capsicum i tea-spoonful; pulv. gum myrrh J tea-spoon-
ful.  Add No. 6, and make into  pills with gum arabic.
  Tonic  Pills.—Capsicum and rhubarb, each \ dr.; gin-
ger and extract gentian, each 2 drs.  Mix and make into
150 pills.
  Styptic.—4th proof brandy 2 ozs.; castile soap 2 drs.;
potash (not pearlash) 1 dr.  Dissolve the soap in  the
brandy warm, then  add  the  potash and  shake  it well;
when used for a wound or a bleeding gum, warm it, and
dip lint into it and apply it to the wound.
    For Blindness from  Gutta Serenna.—Take best
capsicum 1 gr.; infuse in a wine glass of distilled water,
let  it stand 24 hours, and  then filter it;  and lay the  pa-
tient on  the back and wash the eyes several times  a day
until cured.  Isolate the  patient, charge her, and  then
draw electricity from the eyes.
  Asthma.—Give  composition, nervine,  cayenne and
astringents, in bed, with hot bricks to the body and feet;
when in a free perspiration give a  tea-spoonful of the
tincture  of lobelia every 10 or 15 minutes until emesis,
or  relieved.
  For a settled  Cold in  the Face.—Wormwood and
hops, stewed in vinegar, and  a little thickened with bran
and slippery elm.
  Styptic.—Blood root or geranium maculatum, for ex-
ternal bleedings. 
EXPLANATION  OF  PLATES.
PLATE I.
A WELL FORMED PELVIS.
   Front view, as  in  the skeleton.  A A, (upper)  os*a
innominata.   A  A,  (lower)  iliac  bones.   B,  ischiatic
bones.  C D, os sacrum.  E, os coccyx.  F, lower ver-
tebra.   K, promonitory of sacrum,  a a,  iliac fossae, or
false pelvis.  H, symphysis pubis, or joining of the pubic
bones over  the arch.  I b,  P P, b I,  brim  of the  true
pelvis.   V,  head  of  the  femor.   m, acetabulum,  u,
ischiatic holes.   12 3 4, holes through which the nerves
pass into the pelvis. 
428         EXPLANATION OF PLATES.

                     PLATE II.
PERPENDICULAR VIEW OF THE UPPER STRAIT.
  A B, short or sacro-pubic diameter.  D C,  long or
iliac  diameter,  a a, iliac  fossae,  b c,  lower vertebra.
d, upper  part  of os sacrum,  c, prom, sacrum,   e e, sa-
cro-iliac  symphysis,  f f, parts over the acetabula.  g,
symphysis pubis. 
EXPLANATION  OF PLATES.        429

         PLATE III.
AN ILL-FORMED PELVIS.
  a, ossa  innominata.   c, ossa ischia.   d, last  vertebra,
pressing  obliquely  into  the  sacrum,  f, os ilia   h h,
foramina ovalia.  Here the diameter B B, is nearly the
right length; A A,  too narrow; C C, quite  too narrow,
and D D, rather too wide.  Such pelves are sometimes
formed by the rickets, but that disease is not common in
this country. 
430         EXPLANATION OF PLATES.

                     PLATE IV.
A POSTERIOR SECTION OF THE PELVIS CONTAINING THE
                INTERNAL ORGANS.
  A, the last vertebra.  B, ossa innominata.   C, acctab-
ula.  D, lower edges of the ossa ilia.  E, fleshy parts
covering the coccyx.  G, vagina, cut and stretched open.
I!, part of the bladder.   I, the neck  of the uterus.   K,
the fundus.   L, fallopian tubes.  M,  ovaries.   N, broad
ligaments.   O, upper parts of the rectum.   The fallopian
tubes and  the  ovaries  are  elevated  from their natural
position  besidu the body of  the uterus, that they may be
seen. 
EXPLANATION OF PLATES.        431

         PLATE  V.
FRONT VIEW OF THE POSTERIOR SECTION OF THE UTERUS AT THE
              FIRST MONTH OF PREGNANCY.
  A B, front view of the posterior section of the uterus
at the first month of pregnancy.   A, fundus;  B, neck;
C, cervix.  II K, G F, same view as plate 4th, with the
uterus, K K, as it appears  at the second or third month
of pregnancy.   H II, parts of the bladder.  G, vagina,
with  the  cervix uteri depending  in  it.   The foetus  is
floating in the waters with the placenta attached  to the
fundus uteri between K  and K. 
432
EXPLANATION  OF PLATES

         PLATE VI.
      THE GRAVID UTERUS.
               A
  A,  the  gravid  uterus  in  the  eighth  or ninth month,
stretched  by  the waters, the  foetal head in the false
pelvis, pressing down.  H, the os uteri, the neck  being
obliterated.   G, the vagina.   K,  the  placenta.  L,  the
membranes. 
EXPLANATION OF PLATES.         433

         PLATE  VII.
A LATE RAL VIEW OF THE LUMBAR REGIONS, PELVIS, AND FOETUS.
              WHEN LABOR HAS COMMENCED.
  C E F, different  forms of the uterus  before  the  dis-
charge of the waters.   D, same after discharge.  H, os
uteri  opening  before  the sac of waters.   I, the vagina.
K, the left nympha.  L, the left labia pudendi.  M, part
of the  bladder.  N, anus.  O P, left hip and thigh.   E,
the uturus, as  in a pendulous abdomen.   F, the uterus,
in this  case,  presses  on the  diaphragm  and produces
vomiting, dispnoea,  &c.
             28 
434
EXPLANATION OF PLATES

         PLATE VIII.

     LABOR FAR ADVANCED.
  This is  the  most convenient and  common  position.
A, the uterus, after the discharge of the waters.   B C,
lateral view of lower  veterbruc and the ischium.   I, os
pubis.   H, os externum. 
EXPLANATION  OF  PLATES.          435
                       PLATE IX.

A FRONT VIEW OF THE POSTERIOR HALF OF THE PELVIS, (AS IX
 PLATER IV,  V, VI,) WITH  TWINS,  THEIR UMBILICAL CORDS,  PI A
 OEM AS, &.<■.. AT THE BEGINNING OF LABOR.
  II, os  uteri  just opening by the  presence of the wa-
ters.   G, vagina. 
436         EXPLANATION OF PLATES.

                      PLATE  X.
A FACE PRESENTATION.
  A, lateral section of the vertebrae.   G, uterus.  B, os
coccyx.  E, perinaeum.   C, os pubis.   F, right labium
pudendi.  The chin presents at the os  externum.  More
tedious, but a natural and not dangerous presentation. 
E X P L A N A T 1 ON O F 1' L A T E S .
437
                      PLATE XI.

A BREECH PRESENTATION WITH  THE BACK  IN FRONT AND THE
      UMBILICUS WOUND ROUND THE NECK AND BODY.
 
438          EXPLANATION  OF PLATES.
                PLATE  XII.
BREECH PRESENTATION WITH THE FACE  FORWARD.
                    PLATE XIII.
THE HEAD PRESSING THROUGH  A  DISTORTED PELVIS. CAUSING
     THE PARIETAL HONES TO OVERLAP EACH  OTHER.
 
.,    © O  «S
     ^ S-g                                 FIGURE  I-
                           POSTERIOR VIEW OF THE VIRGIN UTERUS AND ITS APPENDAGES.
£    * §^ ..      a a, the body; b, os  tincoe; c, longitudinal fibres: o o, utero-sacral ligaments;
"    ^S.-o-S   dd, wings of the uterus  or ovarian ligaments; e e, ovaries;'//, trunks of the
     £ J  g'o   fallopian  tubes;  5- #, enlargement of do.;  h h, fimbria;  of do.; i i, broad  liga-
    ^ >fa^   ments, or  duplicatures  of the peritonaeum; j j, cords of the ovaries; k, internal
     0 § "5 I   face °f tne aniel'i°r portion  of the vagina.
<
 
FIGURE II.
                             ANTERIOR VIEW OF THE UTERUS, &C.
  a, anterior longitudinal fibres; b, anterior lip of the os tincoe, longer than  the posterior,
and obscuring it; e e, origin of the  round or sub-pubic ligaments; o o, round  ligaments;  d
d, fallopian tubes; e e, fimbria?; //, the ovaries seen through the tissue of the broad  liga-
ments ;  g g, broad ligaments,  or folds of the peritonaeum.
D.0B 
EXPLANATION  OF PLATES.         441

        FIGURE III.

    PROFILE OF THE UTERUS.
  a, posterior surface, more extended and• rbumied than
the opposite; b, os tincoe;  c, ve.uco-uteruu-  fold  of the
peritonaeum; d, recto-vaginal fold of the same. 
442         EXPLANATION  OF PLATES.

                     FIGURE IV.

VI KW OF THE INTERNAL  SURFACE  OF THE UTERUS, DURING THE
 MENSTRUAL DISCHARGE, OPENED INTO ANTERIOR AND POSTERIOR
 HALVES.
  a, the body, containing median lines and drops of red
fluid; b, the internal orifice of the neck; c, external do.
The whole organ is here gathered into  folds, which are
gradually  obliterated during pregnancy or dropsy. 
EXPLANATION OF  PLATES.         443
     FIGURES V, VI, VII,  VIII, IX.
OS TlNCffi IN ITS NORMAL OR HEALTHY CONDITION.
 FIGURE V.
INFANT STATE.
       FIGURE VII.
AFTER THE LOSS OF VIRGINITY.
  FIGURE VI.
STATE OF PUBERTY.
  FIGURE VIII.
DURING MENSTRUATION.
        FIGURE IX.
OF A LADY WHO HAS HAD A CHILD.
 
Ill        EXPLANATION OF PLATES.

                    FIGURE X.
THE UTERUS SOON AFTER CONCEPTION.
  a a,  the  body; b, the internal, and  c,  the  external
orifice.  This  is the uterus of a lady who died  in  the
early part of pregnancy.  The internal walls appear of
a deep red, and soft tissue; they are marked with dee.])
longitudinal lines or furrows, which run down  into  the
neck.   The neck  is of a violet white, its  cavity almost
as large as  that of the body, with many folds, some sim-
ple, others  compound,  running  in various  directions,
among which are found numerous mucus follicles.  There
are often also  globose concretions containing sometimes
transparent fluid, at others calcareous matter, and they
have been found so abundant as to fill  up the whole cav-
ity.  But  in the healthy state, and the commencement
of pregnancy, these folds  are  filled with a thick, glairy
humor, which completely fills  the cavity, and serves to
close it, to  the end of the term; when it flows  in abun-
dance, and lubricates and prepares the neck and vagina
to dilate during parturition. 
EXPLANATION  OF PLATES.        445
                   FIGURE  XI.

FIBROUS FOLDS OF THE UTERUS AT THE COMPLETION OF THB
            UTRO-GESTATION.  FRONT VIEW.
   a a, median  line,  the fibres from which,  instead  of
being parallel, as in the first plate, are now widely divar-
icate ;  b b, the fibres,  forming, by their union, the round
ligaments.  The contraction of these fibres, which are
inserted to  the  pubic  bones, is the principal  means  of
expelling  the child;  c c, fallopian tubes; d d, ovaries:
e e, the neck of the uterus, containing  the head  of the
foetus;  /,  corpus  lutem, or cicatrice whence  the  ovum
issued; g, uterine veins; h,  section of the vagina; i,
external orifice dilated so as  to show a portion  of the
membranes. 
446         EXPLANATION OF PLATES.

                    FIGURE XII.

   ANTI-VERSION OF THE UTERUS IN THE EARLY PERIODS OF
                      PREGNANCY.
Ikv
  a, right  section of the  pelvis: b,  the  sacrum; c, the
bladder;  d, the urethra; e e, the rectum; f, view of  the
tube and ligament on the left side of  the ovary; g, body
of the uterus; h, lateral  portion  not covered  by  th^
peritonaeum; i, os tincoe;  k, vagina.
22 
         EXPLANATION OF  PLATES.         447

                 FIGURE XIII.

RETROVERSION OF THE UTERUS IN THE EARLY PERlOD.S OF
                   PREGNANCY.
  a, right pubis; b, os  tincoe; c,  urethra:  d, vagina: e,
body of the uterus; /, the bladder distended  to  the ut-
most;  g,  the rectum;  h, promontory  of  the sacrum;
i, view of the fallopian tube, and  of the ligament of the
left ovary. 
    Refekencks.- 1. Placenta.  -2.3.  Foetal Membranes. Chorion, and Amnion.   4.  Fcetal Side of Placenta-   5. Umbilical
Vein.  <\. Foetal Distributions*.  7. Hepatic Branches.   8. Abdominal.   9.  Gastric.  10. Vena Cava.  11. Azygos Vein.
12.  Clavicle.   13. Heart.  14. Right Ventricle.  15.16.  Pulmonary Veins.  17,18. Pnlmonary Arteries.  19. Left Auricle.
20.  Left  Ventricle.  21. Arch of  the Aorta.   2*2.  Aorta.   '23. Epigastric Artery.   24. Umbilical Arteries.   25.  Liver
26  Gall Bladder.  27. Urinary Bladder.  a8.Kidii.-v-   2'J. Stomach. 
 

 
I 7  48 ,
T~^   X 
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